Doing and being: How psychotherapists balance the impact of trauma: A grounded theory study
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The psychological trauma from a traumatic event is known to be ‘contagious’ for a witness. Psychotherapists who work with traumatised clients can potentially experience terror, anger and despair; causing secondary traumatic stress that can lead to compassion fatigue and burnout. So, how do psychotherapists, who often carry their own trauma histories, bear such fear and pain when being with and listening empathically to traumatised clients without feeling overwhelmed or losing a sense of hope? The purpose of this grounded theory study was to identify the main concerns of psychotherapists when working with traumatised clients and to describe and generate a conceptual model that explains the processes therapists use to continually manage these concerns. Over a period of ten months, eleven psychotherapists with a minimum of five years work experience were recruited from the New Zealand Association of Psychotherapists (NZAP). Constant comparative analysis of eleven interviews generated through open-ended questions was carried out. A total of twenty-one drawings obtained at different stages of the participant interviews, were used to fully capture the inner world of the traumatic impact. The emerging theory, whose development is grounded in the data, shows that psychotherapists grow through three main psychosocial developmental stages of balancing the impact of trauma: DOING to protect from pain and fear, BALANCING doing with being, and BEING with trust, pain and joy. The participants, however, were likely to involuntarily recycle the three stages when experiencing personal traumatic stress or organisational stressors, in addition to holding clients’ trauma. The intention of this research was to raise awareness of work-related traumatic stress, and to provide an educational conceptual model to assist psychotherapists’ understanding of how to positively manage secondary traumatic stress and its impact on the physical, emotional and spiritual, before it manifests in burnout, disillusionment or illness.