Countertransference issues in the assessment and treatment of trauma recovery with victims of violent crime

This article examines countertransference in the assessment and treatment of recovery from traumatic incidents of adulthood, with specific focus on victims of violent crime. It reviews Freud's impediment theory, with particular attention to implications concerning empathic strain and vicarious traumatization. It introduces Wilson and Lindy's Type I Countertransference (avoidance), Type II Countertransference (overidentification), and their respective manifestations. It then proposes a Type III Countertransference (communicative) that applies a more totalistic perspective that utilizes concepts of splitting, projection, projective identification, and intersubjectivity. It differentiates between countertransference orientations to trauma that are content-based or processed-based as well as those that may be figure or ground. Finally, it presents some common countertransference reactions and roles that become enacted and therefore have treatment implications, examines the interaction between therapeutic and real relationships as contributors to those scenarios, and presents case examples.