Celebrating the Wounded Healer Psychotherapist

Pain, Post-Traumatic Growth and Self-Disclosure

Sharon Klayman Farber, Sharon Farber

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781138926738
• eBook ISBN: 9781317405016
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Why would someone decide to become a psychotherapist? It is well-known within the field that psychoanalysts and psychotherapists are often drawn to their future professions as a result of early traumatic experiences and being helped by their own psychoanalytic treatment. While dedicating their lives to relieving emotional suffering without being judgmental, they fear compromising their reputations if they publicly acknowledge such suffering in themselves. This phenomenon is nearly universal among those in the helping professions, yet there are few books dedicated to the issue.

In this innovative book, Farber and a distinguished range of contributors examine how the role of the 'wounded healer' was instrumental in the formulation of psychoanalysis, and how using their own woundedness can help clinicians work more effectively with their patients, and advance theory in a more informed manner.

Celebrating the Wounded Healer Psychotherapist will be of interest to psychoanalysts and psychoanalytic psychotherapists, graduate students in clinical disciplines including psychology, social work, ministry/chaplaincy and nursing, as well as the general public.

Part I

The wounded and wounding healer

Introduction

Nothing to hide, plenty to celebrate

Sharon K. Farber

Some people who have been hurt by experiences in their life have learned something valuable, and in turn want to help others as they have been helped, often through their own psychotherapy. They become wounded healer psychotherapists. This is indeed something to celebrate.

Some wounded healers, however, hurt those they are meant to help and bring shame to this profession. All psychotherapists, even the most outstanding ones, can damage a patent severely when circumstances in their own lives and in the treatment of a particular patient are such that the damaging acts seem at that moment to be the solution to a major problem in the treatment. This can happen to any psychotherapist.

This became painfully clear to me when I discovered that an analyst whom I had greatly admired, respected, and with whom I had done collaborative work, lost his professional license after having a sexual relationship with a patient. He had formerly been president of his area’s psychoanalytic society, clinical professor of medicine, a training and supervising analyst. He was also author of many journal articles and several books. He and I reviewed each other’s writing. I looked up to him and in some ways he was a mentor to me. This news left me feeling confused, disillusioned, angry, and betrayed. Who was this man anyway? What was wrong with me for trusting him? But after some time, I came to feel as sad for him as for the patient whose trust he had betrayed. The practice of psychoanalysis, as you will read, is indeed a perilous calling (Sussman 1995).

The wound in the psychotherapist

Long before I began thinking of the concept of the wounded healer, I was well aware that colleagues whom I had gotten to know fairly well had been deeply hurt in their lives. Then when I did my doctoral dissertation (Farber 2015), I discovered that a number of therapists hurt and wounded themselves quite literally.

When I decided on the topic of my doctoral dissertation study, I had also begun specialized training in the treatment of patients with eating disorders. When I discovered that there was a very strong comorbidity between eating disorders and self-mutilation, I become intrigued. Further exploration revealed that there was virtually nothing in the literature to explain it and so I did a study exploring the factors I suspected might be involved (Farber 1995, 1997, 2000). The severity of the self-harm behavior these subjects presented was staggering, potentially life-threatening, and I was shocked when a surprising number of subjects identified themselves as professional social workers, psychologists and psychiatric aides. I certainly knew that many therapists had considerable problems but I never would have imagined that they suffered such life-threatening psychopathology.

More recently, a candidate in a psychoanalytic training program consulted with me about her self-mutilating behavior getting worse. Apparently, those who interviewed her for the training program knew nothing about this or that she had been diagnosed with dissociative identity disorder and had been treated several times in an inpatient unit for trauma-related disorders. She cut herself the evening before seeing me. To assess the severity, I asked to see it. I was shocked to see on her midriff a jagged network of bright red bloody cuts, very different from the “delicate self-cutting” (Pao 1969) seen in those who cut themselves less severely. I was appalled that someone so much in danger of killing herself had been admitted to a psychoanalytic training program undetected. I wondered how many others there were like her, wounded healers who wounded themselves severely. When I collected chapters for this book, Annita Perez Sawyer described how she cut and burned herself, banged her head against the wall, and swallowed broken glass in her memoir Smoking Cigarettes, Eating Glass (Perez Sawyer 2015). She submitted a chapter, and so did Gretchen Heyer who came close to death from anorexia nervosa. Both are included.

Who becomes a psychotherapist and why

We ask patients to disclose painful personal experiences so that they can begin to recover. At a time when people are more candidly coming out about their own struggles in life, we in the mental health field have been conspicuously silent for fear of being stigmatized. Therapists are often expected to be immune to the kind of problems that they help clients through (Adams 2014) and often try to project that persona. In linking therapists’ personal histories to their choice of career, Adams challenges psychotherapists to take a step back and consider their own well-being as a vital first step to promoting change in their patients.

Recovering from these painful experiences is an ongoing process. Even though our own psychotherapy or psychoanalysis helped us heal, disclosing this experience continues the healing process. There is a myth, which contains some truth, that psychotherapists are emotionally disturbed people, which is what attracts them to do the work they do. Thomas Maeder (1989), son of two psychiatrists, interviewed many psychotherapists, children of therapists, and former patients, and found that many therapists’ children spoke of their parents’ horrendous early life and difficulties in coping with their families, something they believed was the critical factor in their parents’ choice of profession. Maeder concluded there is something amiss with those who proclaim that they want to help others. They may be attracted to the position of authority, the dependence of others, the image of benevolence, the promise of being idolized, and, last but not least, the hope of vicariously healing themselves.

Other research reveals a connection between choosing psychotherapy as a profession and one’s own woundedness. When Gertrud Mander examined candidates who wanted to train as psychotherapists or counselors, a main theme was that they felt “summoned by an internal voice, a call from the super-ego which forms the basis of any vocation” (Mander 2004, p. 161). When Marilyn Barnett (2007) interviewed experienced psychoanalytic and psychodynamic therapists about their personal and professional histories, two major themes were early object loss and narcissistic needs.

The psychoanalytic mystique

All modern methods of psychotherapy started with psychoanalysis and so psychotherapy continues to be associated with Freud and psychoanalysis, a process depicted in New Yorker cartoons showing the patient lying on a couch. The patient may be a man, woman, cat, dog or rooster lying on the couch, literally at the feet of a man, often bearded, who sits behind the patient. This is the wise, omniscient analyst, silent, and impassive, as Freud was thought to be.

In fact, Freud was not a silent analyst until late in life when many oral surgeries for cancer of the jaw made talking painful for him (Gay 1988). Previously, he had been a rather talkative analyst. The truth is that Freud asked patients to lie on the couch simply because it made him anxious to be looked at all day. (Many things made him anxious, which you will read about later.) For the patient to go more deeply into himself, he should not be distracted by the analyst’s facial expression or objects in the room, and so, ever since Freud, psychoanalysts have continued to use the couch, which has become an icon, along with the notion that the patient lies on the couch four to five times a week. In fact, purchasing the couch has become something of a rite of passage for a psychoanalyst (Gordon 1992). A photograph of the late Martin Bergmann, one of my favorite teachers, shows him sitting on his psychoanalytic couch, covered with colorful Oriental rugs much like Freud’s, which can be seen at the Freud Museum in London.

Psychoanalysis has evolved considerably since Freud’s day. It is rare for the patient to have sessions four or five times a week; one or twice a week is usual; if U.S.-managed care insurance has its way, it will be less than once a week. It is also rare for the patient to lie on a couch as most treatment is done sitting up, face to face. The couch in my office is simply a piece of furniture. Some patients sit on it, others use the chair directly across from mine. When a patient is distracted by my face or office, he can lie down or look away.¹ One patient simply sits up and closes her eyes when she needs to.

Psychotherapists do not use any mysterious means to help those who are suffering from emotional distress. As Adam Phillips simply put it: “a psychoanalyst is anyone who uses what were originally Freud’s concepts of transference, the unconscious, and the dream-work in paid conversations with people about how they want to live” (Phillips 1994, p. xiv). When psychoanalysis works the way it should, there is nothing esoteric about it; it is a form of conversation that helps some people feel better. It differs from ordinary conversation in being a kind of reciprocal free association, with the patient saying what comes to his mind without censoring it while the analyst listens with free-floating attention and then may share his thoughts with the patient, facilitating the emergence, understanding, and interpretation of what the patient is saying (Isakower 1992). This is really an altered state of consciousness for both patient and therapist.

Interest in the personal lives of psychotherapists

Ever since the mid-1980s, there has been a growing interest in the personal lives of psychotherapists, as shown by the publications of Jeffrey Kottler (2010), Carl Goldberg (1991), James Guy (1987), Michael Sussman (1992, 1995), Lee Kassan (1996), Steven Kuchuck (2013), and Marie Adams (2014). Despite the bashing psychoanalysis has taken in the media, The New York Times recently began publishing postings about psychoanalysis which have generally been quite favorable (opinionator.blogs.nytimes.com).

Because Carl Jung was one of the first to articulate the concept of the wounded healer, most publications on the wounded healer are from a Jungian perspective (Hockley & Gardner 2010; Merchant 2011; Sedgwick 1994). This book is a pioneering contribution by a non-Jungian psychotherapist, combining theory and clinical practice with personal contributions written by wounded healers.

Psychotherapy is a two-way process in which both people are changed. The intimate connections formed in long-term psychotherapeutic relationships can result in changes in the therapist that last a lifetime:

We find ourselves talking in sessions, preaching lessons to our clients, and then realize, suddenly, that we are really talking to ourselves. We end up taking the advice that we offer to others when we tell them such things as the importance of living more in the present moment or spending more quality time with loved ones.

(Kottler & Carlson 2005, p. 4)

One therapist, Laura Brown, said “Anyone who meets us, changes us. Every encounter we have, transforms us. How could we be therapists and not be transformed personally in all kinds of ways?” (Kottler & Carlson 2005, p. 214). She said that one patient opened a sense of the divine in her that was healing. In Martin Buber’s (1970) concept of the I–Thou relationship, in which the sacred is potentially present in any relationship, our relationship lives in the space between us—not between me or you or even in the dialogue between us—it lives in the space we live together and that is a sacred space. Irvin Yalom describes the patient and therapist as “fellow travelers, both on a journey of discovery together” (Yalom 2002, p. 8).

Although there are many theoretical schools of psychotherapy, I write from a psychoanalytic orientation. Despite my training having been in the one-person psychology of classical psychoanalysis and ego psychology, I knew that the two-person or relational psychology was the most important factor in successful therapy. I knew the therapist should not “be opaque to his patients and, like a mirror, should show them nothing but what is shown to him” (Freud 1912, p. 118). It is the patient–therapist attachment relationship that is transformative for the patient (Wallin 2007).

The rationale for all this secrecy about the analyst derives from traditional thinking that much of the psychoanalyst’s healing power comes from observing and analyzing the transference, those interpersonal attitudes and expectations learned early in life that the patient unconsciously transfers to the therapist. The transference may be positive, as in assuming the therapist will be interested and caring, or negative, as in assuming the therapist will be uncaring, competitive, or shaming, and is quite revealing about how the patient sees others. When the analyst interprets the transference, thus making these unconscious assumptions conscious, it frees the patient to relate to himself and others more realistically. This is the origin of Freud’s tabula rasa or blank screen concept, meaning the less the patient knows about the therapist leaves the room there is for the patient to form a transference.

My own experience over the years has told me, however, that transference forms with or without the therapist’s intentional self-disclosure. Many believe that the judicious use of self-disclosure, when done to meet the needs of the patient, adds a most human and needed dimension in therapy and can enhance the attachment bond.

Common sense tells us it is impossible for the therapist to be a blank screen. Our demeanor, gender, appearance, accent, race, ethnicity, location, and decoration of the office all provide patients with personal information that allows them to infer the therapist’s socioeconomic status, his formality or lack of it, his warmth, frustration, tolerance and many other qualities. Simply by our look of recognition or lack of it, we show whether we are familiar with the movie, restaurant, book, music or slang the patient brings to the dialogue. And of course, when he wants to know more about his therapist, there is always the Internet and Googling.

In my training the notion that the analysts’ own transferences and countertransferences might be used to impact the treatment positively was never considered. Today, relational theory believes all feelings, thoughts and actions of both patient and analyst are embedded in an intersubjective field. For example, in projective identification, when the patient, unable to contain an unacceptable affect or thought, projects it into the therapist (Klein 1964), it is described by Bromberg (1998) as a process of communication by which the patient could dissociate and project his own unacceptable emotions into the analyst, who could then know experientially what the patient was feeling. The analyst might disclose what was felt to the patient, which might help the patient disclose more.

Relational self-disclosure

The headline on the front page of The New York Times was “A Down-to-Earth Defense Lawyer with Felonies on His Resume.”

A well-worn felon with more than a decade spent in places like Sing Sing and Rikers Island stood before the judge. But as Allan P. Haber appealed for mercy, he did so not for himself, but for a client. Mr. Haber, 75, is one of the more unlikely criminal defense lawyers in New York. For the last three decades, first as a public defender and then in private practice, Mr. Haber has long represented the kind of hardened criminals who might seem beyond redemption. As ethical lawyers must, he has always kept his clients’ secrets. But throughout his career, Mr. Haber has also kept tight guard of a secret of his own. Mr. Haber was once a drug dealer, selling heroin in Midtown Manhattan, carrying a gun, running a stash house and earning thousands of dollars a day selling bundles of heroin . . . through a network of distributors. He had 10 convictions in his 20s an...

Table of contents

• Cover Page
• Celebrating the Wounded Healer Psychotherapist
• Praise
• Title
• Copyright
• Dedication
• Contents
• Preface
• Acknowledgements
• Contributors
• Part I: The Wounded and Wounding Healer
• Part II the Wounded Healers Speak
• Epilogue
• Index