The Empathic Response of Relational Therapists Treating Trauma: A Dialectical Experience

Relational therapy is a contemporary psychoanalytic therapy, influenced by a paradigm shift that puts therapeutic relationships in the middle of the therapy and emphasizes intersubjectivity. This new relational paradigm also shapes the dynamics of trauma treatment while working with dissociation, enactment, and self-states. This therapeutic stance and techniques require high levels of empathy and intense use of the self from therapists. The main argument is that relational therapy holds high levels of empathic response. The empathic response was found to be a major factor in the secondary traumatic stress mechanism for developing compassion fatigue in the compassion fatigue resilience model. Therefore, relational therapists are a unique and important population that may hold the answers to questions about the in-depth mechanism of compassion fatigue. This study investigated 12 relational therapists treating mostly complex trauma and suggests that their empathy is a double-edged sword and a dialectical process that at the same time encompasses the cost of caring but also resilience and growth. The results offer a dialectical approach to trauma treatment and suggest that compassion fatigue is inevitable. But, at the same time, it is also a part of the therapeutic process and even the resilience and growth process. Indeed, the empathic response can include connectedness and separateness at the same time. The practical outcomes discussed here are the importance of self-care, the use of supervision, setting external and internal boundaries, and the implementation of trauma-informed care.