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The wounded healer is an archetype that suggests that a healer's own wounds can carry curative power for clients. This article reviews past research regarding the construct of the wounded healer. The unique benefits that a psychotherapist's personal struggles might have on work with clients are explored, as well as the potential vulnerability of some wounded healers with respect to stability of recovery, difficulty managing countertransference, compassion fatigue, and/or professional impairment. The review also explores psychologists' perceptions of and responses to wounded healers and examines factors relating to social stigma and self-stigma that may influence wounded healers' comfort in disclosing their wounds. We propose that the relative absence of dialogue in the field regarding wounded healers encourages secrecy and shame among the wounded, thereby preventing access to support and guidance and discouraging timely intervention when needed. We explore the complexities of navigating disclosure of wounds, given the atmosphere of silence and stigma. We suggest that the mental health field move toward an approach of greater openness and support regarding the wounded healer, and provide recommendations for cultivating the safety necessary to promote resilience and posttraumatic growth. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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The Dilemma of the Wounded Healer
Noga Zerubavel and Margaret O’Dougherty Wright
Miami University
The wounded healer is an archetype that suggests that a healer’s own wounds can carry curative power
for clients. This article reviews past research regarding the construct of the wounded healer. The unique
benefits that a psychotherapist’s personal struggles might have on work with clients are explored, as well
as the potential vulnerability of some wounded healers with respect to stability of recovery, difficulty
managing countertransference, compassion fatigue, and/or professional impairment. The review also
explores psychologists’ perceptions of and responses to wounded healers and examines factors relating
to social stigma and self-stigma that may influence wounded healers’ comfort in disclosing their wounds.
We propose that the relative absence of dialogue in the field regarding wounded healers encourages
secrecy and shame among the wounded, thereby preventing access to support and guidance and
discouraging timely intervention when needed. We explore the complexities of navigating disclosure of
wounds, given the atmosphere of silence and stigma. We suggest that the mental health field move
toward an approach of greater openness and support regarding the wounded healer, and provide
recommendations for cultivating the safety necessary to promote resilience and posttraumatic growth.
Keywords: wounded healer, recovery, resilience, posttraumatic growth, stigma
The wounded healer is an archetype that suggests that healing
power emerges from the healer’s own woundedness (Guggenbuhl-
Craig, 1971; Nouwen, 1972; Sedgwick, 1994), and that the
wounded healer embodies transformative qualities relevant to un-
derstanding recovery processes (Briere, 1992; Miller & Baldwin,
2000). In this review, we explore what it means to be a wounded
healer, particularly, in terms of how this intersects with one’s
professional identity. In one sense, all therapists have had painful
experiences, have confronted adversity, or have experienced phys-
ical or emotional suffering, and therefore have some degree of
woundedness. The wounded healer paradigm suggests that
wounded and healer can be represented as a duality rather than a
dichotomy. Woundedness lies on a continuum, and the wounded
healer paradigm focuses not on the degree of woundedness but on
the ability to draw on woundedness in the service of healing.
Goethe wrote that our own suffering prepares us to appreciate the
suffering of others (cited in Jackson, 2001). The therapist’s own
past or present wounds can facilitate empathic connection with
clients and the positive use of countertransference in therapy
(Gelso & Hayes, 2007). The paradigm of the wounded healer
suggests that it is the activation of the wounded-healer duality for
both the therapist and the patient that constructively informs the
healing process (Guggenbuhl-Craig, 1971; Miller & Baldwin,
2000; Sedgwick, 2001). As Gelso and Hayes (2007) explain:
“Therapists who deny their own conflicts and vulnerabilities are at
risk of projecting onto patients the persona of ‘the wounded one’
and seeing themselves as ‘the one who is healed’ (p. 107). If such
a dichotomous perception becomes entrenched in the therapy
relationship, therapists can have difficulty accessing their own
experiences of suffering and vulnerability to empathize with the
client. Such splitting can also result in a lack of acknowledgment
and encouragement of the client’s own healing powers, fostering
dependency (Gelso & Hayes, 2007). Importantly, being wounded
in itself does not produce the potential to heal; rather, healing
potential is generated through the process of recovery. Thus, the
more healers can understand their own wounds and journey of
recovery, the better position they are in to guide others through
such a process, while recognizing that each person’s journey is
unique.
It is important to differentiate between the wounded healer and
the impaired professional. The latter refers to therapists who are
wounded and whose personal distress adversely impacts their
clinical work (Jackson, 2001). Thus, it is critical that a therapist’s
wounds are mostly healed, or at least understood and processed
sufficiently, to prevent them from interfering with therapy and the
therapeutic relationship (Gelso & Hayes, 2007). However, there
has been very limited prior research addressing how therapists’
own recovery processes influence the work they do with clients
and how therapists know that they have healed sufficiently to
practice responsibly. The ambiguity regarding the degree to which
the therapists’ own wounds have healed presents a dilemma for
both the wounded healer and other professionals. Psychologists’
ethical responsibility to notice, address, and monitor impairment in
colleagues (i.e., gatekeeping responsibilities) complicates the issue
of engaging in open dialogue about how a colleague’s or super-
visee’s wounds positively influence or interfere with their work.
The wounded healers’ concerns often pertain to potential stigma if
the nature of the wound is disclosed and judgment by colleagues
regarding their competence to practice. These concerns can result
This article was published Online First September 10, 2012.
Noga Zerubavel and Margaret O’Dougherty Wright, Department of
Psychology, Miami University.
Correspondence concerning this article should be addressed to Noga
Zerubavel, Department of Psychology, 90 North Patterson Ave, Psy-
chology Building, Miami University, Oxford, OH 45056. E-mail:
zeruban@muohio.edu
Psychotherapy © 2012 American Psychological Association
2012, Vol. 49, No. 4, 482–491 0033-3204/12/$12.00 DOI: 10.1037/a0027824
482
in secrecy, self-stigma, and shame. Thus, there has been a relative
silence around the topic of wounded healers.
A central aim of this review is to raise concern over the absence
of dialogue regarding the wounded healer, emphasizing the im-
portance of developing the safety needed for the wounded healer to
bring concerns to supervisors and consultants. Using such re-
sources for support is critical to assessing, containing, and pro-
cessing aspects of woundedness relevant to clinical work (Smith &
Moss, 2009). By synthesizing the limited available literature in this
area and highlighting areas to explore further, we hope to invite
psychologists to engage in further discussion of wounded healers
and the inherent related dilemmas. In Part 1, we provide an
historical overview of the wounded healer construct and present a
framework for understanding healer woundedness, delineating
characteristics of wounds and how these factors can impact a
wounded healer’s recovery trajectory and clinical work. We ex-
plore corresponding professional perceptions of stigma and/or
support, and ethical issues pertaining to gatekeeping responsibili-
ties. In Part 2, we discuss implications for training and practice.
We review various types of disclosure and highlight the costs
inherent in stigmatizing disclosure, given the potential need for the
wounded healer to seek consultation/supervision to clarify issues,
access support, and, in some cases, address impairment. We ad-
dress the incongruence between psychotherapists’ responses to
healer woundedness and our profession’s espoused values and
ideals, and provide recommendations for improving professional
responses to wounded healers.
Part 1: Dialogue and Silence About Wounded Healers
Within Psychology
The construct of the wounded healer has existed for over 2500
years and has its origins in Greek mythology and shamanistic
traditions (Groesbeck, 1975; Kirmayer, 2003). Images of the
wounded healer permeate religion, philosophy, and art, but also
have a place in psychotherapy, counseling, and medicine, denoting
a powerful duality of woundedness and healing within the thera-
peutic relationship. Jung was the first psychotherapist to reference
the archetype of the wounded healer, drawing from Greek mythol-
ogy and exploring applications to psychology (Jackson, 2001;
Kirmayer, 2003). In his early writings, Jung described therapists’
personal struggles as a contamination that must be eliminated,
using the metaphor of a surgeon’s clean hands, yet later in his
career, his conceptualization shifted, and he wrote that “only the
wounded physician heals” (Jung, 1963, p. 134).
The wounded healer construct has often been misunderstood,
discounted, or romanticized, and has received minimal academic
attention. However, it has been well documented that many psy-
chotherapists arrive at their profession of choice through a journey
that involves a history of pain or suffering (Barnett, 2007; Farber,
Manevich, Metzger, & Saypol, 2005). Childhood experiences of
woundedness have been cited as a primary motivation for becom-
ing a therapist (Barnett, 2007; Sussman, 2007). Not surprisingly, a
high percentage of therapists (75%–87%, in contrast to 25% of the
general population) have also participated in therapy, some to meet
required training needs, but many to seek help for psychological,
interpersonal, or substance abuse problems (Norcross & Conner,
2005; Orlinsky, Schofield, Schroder, & Kazantzis, 2011).
Although for the most part there has not been a great deal of
academic attention paid to the construct of the wounded healer,
there have been a number of references to it in prior research. The
most common mention of the wounded healer is in the form of a
passing comment about the personal experiences that drew the
therapist to this particular career (Barnett, 2007; Farber et al.,
2005; Williams & Sommer, 1995). At times, the wounded healer’s
recovery is discussed in parenthetical comments that refer to
unresolved or unprocessed material, or to “hopefully” resolved or
processed material, revealing that psychologists are uncertain and
cautious about whether, in fact, recovery has occurred. For exam-
ple, Chu (1998) writes in his book on trauma:
Why, then, do we do this work? Undoubtedly, some reasons are
personal. Many of us have had our own painful experiences of feeling
lost, victimized, or disenfranchised. We identify with our patients
(hopefully not too strongly) and we use our own experiences (hope-
fully not too prominently) in our work (p. 207, italics added).
Similarly, Gil (1988) says that wounded healers are “familiar
with the difficulties that survivors face, having experienced these
difficulties themselves and (one hopes) having worked through
them” (p. 275, italics added). These comments poignantly reveal
the challenge of establishing certainty about the extent to which
wounded healers are able to draw from wounds appropriately in
therapy. Indeed, there have been surprisingly few detailed reports
about what it means for a therapist to process, resolve, or recover
from a wound in such a way that it might enhance, rather than
interfere with, providing effective psychotherapy. Psychologists
are often wary about the recovery status of the wounded healer—at
worst, we judge, and at best, we worry.
In some areas of mental health treatment, the wounded healer is
recognized for playing a distinctive role as a provider. In alcohol
and substance abuse treatment, it is common—perhaps even pre-
ferred—for the counselor to have struggled with and overcome
addiction (Jackson, 2001). It is said that those who have “been
there” are the ones who truly know what recovery involves. Based
on their personal experiences, they are often thought to have higher
credibility regarding the recovery process and to have deeper
empathic connections with their clients (White, 2000). Similarly,
in the field of eating disorders, there has been recent attention to
the possible benefits and challenges that arise when therapists who
have personally recovered from eating disorders disclose to this
client group (Bloomgarden & Mennuti, 2009a; Costin & Johnson,
2002).
The limited prior research that has examined these issues has
explored the potential for positive and negative effects of wound-
edness on clinical work (Briere, 1992; Gil, 1988; Sedgwick, 1994).
Commonly cited positive effects include a greater ability to em-
pathize with clients, a deeper understanding of painful experi-
ences, heightened appreciation for how difficult therapy can be,
more patience and tolerance when progress is slow, and greater
faith in the therapeutic process (Gelso & Hayes, 2007; Gilroy,
Carroll, & Murra, 2001). Although the therapist’s own wounds
may be activated during psychotherapy sessions, they can poten-
tially be used to promote self-healing within the client (Miller &
Baldwin, 2000; Sedgwick, 2001). Research indicates that the
wounded healer’s countertransference can have a positive influ-
ence on therapy (Fauth, 2006; Gelso & Hayes, 2007; Sedgwick,
1994). Briere (1992) emphasizes that sufficiently recovered
483
WOUNDED HEALER
wounded healers may make uniquely talented therapists. Com-
monly noted negative effects include decreased ability to be emo-
tionally present, poorly managed countertransference, overidenti-
fication, projection, and having a personal agenda regarding the
therapy process (Briere, 1992; Gil, 1988). The greatest concern
pertains to boundary confusion or violation (Briere, 1992). In
addition, some literature has examined disclosure to clients, in
terms of positive and negative effects, which is discussed later in
this review. Finally, researchers have consistently noted in studies
of compassion fatigue that wounded healers are more vulnerable
than other therapists to being traumatized by the clinical work
itself (Pearlman, 1995; Salston & Figley, 2003).
However, psychological literature has most often not examined
the topic of the wounded healer in depth; it is often only alluded to,
or given a brief mention that pales in comparison to the depth that
other topics have received. For instance, in her 301-page book on
treating adult survivors of childhood abuse, Gil (1988) does have
a chapter (at the end of the book) on the therapist survivor, but this
chapter is actually only 2
1
2
pages. Reference to the wounded
healer is often set apart structurally from other material, appearing
in the epilogue or afterword (e.g., Chu, 1998; Freyd, 1996), al-
though some authors do make their woundedness an integral part
of their message (e.g., Frankl, 1959; Westerlund, 1992). Given this
brief coverage, many unaddressed issues remain. For instance, it
appears that early in therapists’ careers, and particularly during
training, it feels riskier to disclose woundedness (Bloomgarden &
Mennuti, 2009a; Sawyer, 2011; Stratton, Kellaway, & Rottini,
2007). The influence of career phase was evident in Jung’s work:
his early writings describe therapists’ personal struggles as con-
tamination to eliminate, whereas later his conceptualization shifted
dramatically to highlight the importance of the healer’s own
wounds for fostering healing in the client (Sedgwick, 1994). Sadly,
early in psychologists’ careers may be the most important time for
dialogue about this topic, but the perceived risk of an adverse
professional consequence may appear greatest at this time.
Factors Preventing Dialogue and Contributing to
Wariness Regarding Wounded Healers
Psychologists do not respond to all wounded healers consis-
tently, making it challenging for wounded healers to navigate
decisions about speaking openly about their wounds. We propose
that perceptions of the significance of a healer’s woundedness may
vary on the basis of two dimensions: (1) characteristics of the
wound itself (i.e., relevant stigma, social taboos) and (2) the scar
that the healer bears (i.e., how marked the healer is by the wound
and how fully recovered the healer is). Both aspects are critical to
understanding psychologists’ varied response to wounded healers.
By developing a framework that articulates these factors, we hope
to improve psychologists’ ability to acknowledge and dialogue
about perceptions of and responses to the wounded healer. We use
the analogy of a physical wound to guide the development of our
framework, using the scar to represent what is left after the wound
heals—the sequelae of the wound and the degree of markedness
left behind by the wound. This may encompass how a person
handles feeling wounded, copes with distress, responds to triggers,
or how visibly emotional struggles manifest. The treatment of a
physical wound has clear procedures: it is important to care for the
wounds, to clean them, and check on them. This involves keeping
wounds covered when there is danger of infection, but allowing
them enough air that they may heal. Danieli (1994) speaks of
therapists processing their own traumas as cleaning pus from their
wounds. Even after a wound has healed, there is usually a scar (i.e.,
a lasting mark of woundedness) that lingers behind. Although the
wound is no longer raw, open, and vulnerable to infection, a scar
may still be a painful reminder of the wound. We speculate that
when psychologists approach the wounded healer with wariness or
doubt, there is an implied assumption that the wound has not truly
healed, or that if it has, the scar is still only a scab, vulnerable to
reopening.
Social and self stigma associated with characteristics of the
wound. Past research on wounded healers has rarely discussed
specific characteristics of the wound that might provide a frame-
work for understanding divergent responses of stigma versus sup-
port. Wounding experiences differ on the basis of the nature,
severity, and chronicity of the wound (e.g., time limited or ongoing
struggles, a physical or psychological problem, a guarded or be-
nign prognosis). In addition, the stigma associated with particular
types of wounds is likely to have a significant effect on both the
degree of comfort wounded healers experience regarding disclo-
sure of their wounds and the response they receive from other
professionals when they do disclose.
There has been a great deal of prior research examining the
qualities represented in mental and physical health problems that
appear to be related to stigma. Past research suggests that the social
stigma of mental health problems is related to the following
factors: visibility, dangerousness, treatability, and extent to which
relationships are disrupted (Day, Edgren, & Eshleman, 2007). In
general, people prefer to distance themselves from individuals with
mental health problems on the basis of perceptions of dangerous-
ness, personal responsibility/blame, but interestingly, not severity
(Feldman & Crandall, 2007). For individuals whose wounds are
related to physical health, degree of contagion is also a source of
stigma and can lead to others distancing themselves (Bishop, Alva,
Cantu, & Rittiman, 1991). Consequently, awareness of the stigma
associated with one’s condition, both generally in the culture and
specifically within the profession, is associated with humiliation,
shame, and disgrace (Hinshaw & Stier, 2008). This can lead to
efforts to conceal the wound, as well as social isolation, negative
mood, lower self-esteem, and self-consciousness (Pachankis,
2007). The stigma of mental illness, broadly perceived throughout
society, has a strong effect on individuals’ willingness to seek
treatment for mental illness due to feelings of anxiety, fear and
shame (Dinos, Stevens, Serfaty, Weich, & King, 2004; Hinshaw &
Stier, 2008). Individuals who receive stigmatized treatment may
internalize the negative stereotypes (self-stigma) that they perceive
in their environment (Watson, Corrigan, Larson, & Sells, 2007).
This can result in a perceived need to hide one’s wounds in order
to avoid stigma, a reluctance to speak openly when one struggles,
and finally, a concern about the stigmatizing effects of seeking
treatment. For therapists struggling with ongoing wounds, the risk
of disclosure to other professionals may appear too great, partic-
ularly if the therapist has internalized self-stigma associated with
his or her wound and/or perceives that colleagues hold stigmatiz-
ing beliefs.
It is important to recognize that psychologists are embedded
within a larger social context and are influenced by widely held
social beliefs (Schulze, 2007). We suggest that despite the fact that
484 ZERUBAVEL AND WRIGHT
psychologists may not espouse the public’s views on mental health
issues when approaching their clients struggles, they might ap-
proach their own and their colleagues’ wounds in a manner more
consistent with social stigma. We propose that when psychologists
move from a guiding role, typically associated with the stance of
a therapist (e.g., accepting, supporting, validating), to a gatekeep-
ing role (e.g., acting as representatives of the profession, protecting
clients, and screening out those who may potentially do harm;
Falender, Collins, & Shafranske, 2009), the impact of the social
stigma of specific wounds may increase.
Psychologists’ varying responses of stigma and support may be
best understood as reflecting social stigma related to specific
characteristics of the wound. Perceptions of dangerousness influ-
ence wariness, as carrying a diagnosis of schizophrenia is per-
ceived differently from panic disorder, given the association be-
tween psychosis and dangerousness. The visibility of the wound
depends on whether symptoms are overt or covert, and whether or
not the wounded healer makes disclosures regarding wounds that
can be concealed. With regard to treatability, colleagues might
respond quite differently to a therapist’s disclosure of depression
in contrast to a disclosure of a personality disorder diagnosis,
which carries a poorer prognosis for recovery. Finally, the issue of
personal responsibility/blame is important, because people often
harshly judge and/or condemn individuals who have engaged in
acts that horrify them. As such, when a therapist has caused harm
to another person (e.g., accidentally causing a death; Anonymous,
2007) or seems to be responsible for his or her own fate (e.g.,
staying in a domestic violence relationship), the degree of stigma
associated with the wound may be even higher. The social stigma
and the self-stigma associated with some wounds can serve to
alienate and silence the wounded healer, making trainees and
professionals feel that only secrecy protects them from stigma or
judgment.
Another important factor that impacts a wounded healer’s com-
fort in disclosing his or her woundedness is the existence of
relevant social conspiracies of silence, which maintain that certain
types of wounds are taboo (e.g., being a victim of incest; Butler,
1978; Herman, 1992) or disgraceful (e.g., harming another person;
Anonymous, 2007). These types of woundedness, which fall
within the realm of “unspeakables” or “unmentionables,” are rel-
egated to the social domain of “some things are better left unsaid”
(Zerubavel, 2006, p. 76). Conspiracies of silence convey to a
wounded healer who bears a “taboo” wound that privacy and
silence are the wisest approaches with colleagues. Conspiracies of
silence have also been identified in the absence of discussion
regarding countertransference to trauma (Danieli, 1994) and com-
passion fatigue (Figley, 2002). Therapists might fear criticism and
judgment from colleagues if they openly discuss wounds or strug-
gles that are “unmentionables.” Consequently, they may be more
apt to maintain cultural imperatives, such as participating in the
conspiracy of silence around these issues. The influence of stigma
and conspiracies of silence clarifies the lack of discussion regard-
ing wounded healers. Research on these social influences provides
support for the two factors we hypothesized as influencing the
tendency toward wariness regarding the wounded healer: (1) social
stigma associated with characteristics of the wound, and (2) per-
ceptions of the scar the healer currently bears (e.g., concern re-
garding fragility or continuing symptoms), highlighting uncer-
tainty regarding the present and/or future functioning of the
wounded healer.
Recovery trajectories: The uncertain stability of the
wounded healer’s recovery. Recovery is not necessarily linear
or, when achieved, permanent, contributing to the complexity of
assessing a wounded healer’s recovery status. While psychologists
can assess the wounded healer’s history of functioning, there is,
inevitably, uncertainty about the wounded healer’s future trajec-
tory. We propose four different types of future trajectories that
might characterize therapists who have struggled with a significant
wound: (1) a trajectory anticipating recovery over time; (2) a
trajectory characterized by posttraumatic growth; (3) a relapse
trajectory, anticipating fluctuations and setbacks; and (4) a chronic
dysfunction trajectory anticipating continuous symptom-related
struggles (see Figure 1). It should be noted that these four trajec-
tories are presented to illustrate the variability that is possible in
recovery trajectories and are only some of the many trajectories of
recovery that might occur. Because recovery processes are dy-
namic and include various trajectories, there is inherent uncertainty
regarding an individual’s future psychological functioning (How-
ard, 2006). Articulating this ambiguity helps to clarify the wariness
and suspicion that wounded healers often encounter professionally.
The uncertainty regarding wounded healers’ future functioning
provides a framework for understanding the challenges faced by
supervisors/consultants in responding to them. We suggest that
professional wariness toward wounded healers is based on concern
for relapse and regarding chronic dysfunction. The key issue for
wounded healers, and for other professionals, is whether or not the
manifestations of the wound interfere with or enhance their ability
to provide effective and appropriate therapy.
Chronic dysfunction and relapse trajectories: The dilemma
of gatekeeping. It is critical to understand the tension inherent
in the uncertainty of recovery trajectories (Howard, 2006), and
how this might impact the stigma or support a wounded healer
receives from other professionals. Uncertainty regarding the
wounded healers’ future functioning elicits doubt: we do not know
how fully recovered a person is when we meet him or her, nor do
we know where he or she will be in the future. The problematic
question evoked by this uncertainty is whether recovery is perma-
nent/stable, temporary/fragile, or not achieved at all (Howard,
2006). If perceptions of the healer’s wounds and the nature of
recovery lead to a fear that the wounds could easily become active
again (e.g., a recurring depressive episode or an addiction relapse),
concern regarding the stability of recovery is foremost. For those
therapists who struggle with chronic and enduring symptoms (e.g.,
dysthymia), concerns relate to the degree to which the symptoms
interfere with optimal clinical functioning and currently impact
energy, concentration, judgment, and empathy. Some wounded
healers might have a chronic condition with continuous symptoms
that do not interfere with therapy. For example, an individual who
is struggling with a continuing physical health problem may find
that it does not interfere with clinical work. We emphasize that the
uncertainty of the wounded healer’s recovery is threatening for
both the wounded healer and other psychologists, raising issues
pertaining to competence in clinical practice.
Recovery and posttraumatic growth trajectories: Benefits of
the healer’s woundedness. Significantly, woundedness is not
only a risk factor—when wounds are properly tended and appro-
priately treated, some healers may derive benefit from their
485
WOUNDED HEALER
woundedness (Briere, 1992). In accordance with the archetypal
notion of healing through the wound, some therapists use their
woundedness to promote recovery in their clients. The wounded
healer’s concurrent forces of woundedness and healing become a
catalyst for healing within the client (Groesbeck, 1975; Sedgwick,
1994), as well as vice versa (Miller & Baldwin, 2000). Sedgwick
(1994) suggests that in the therapist’s working through of coun-
tertransference, therapeutic gains can occur for both therapist and
client, even when the countertransference reaction is not shared
with the client. The healer’s woundedness can be beneficial as an
internal reference point for understanding a client’s pain (Hayes,
2002). If the therapist uses self-disclosure appropriately, the
wounded healer’s resilience may also instill hope of healing and
recovery (Kirmayer, 2003; Miller & Baldwin, 2000). Finally, for
many therapists, the work of therapy itself can be healing and
restorative.
Many wounded healers view their difficult experiences as hav-
ing been transformative, leading to profound growth personally
and professionally. Calhoun and Tedeschi (2006) have captured
this possibility in their exploration of the posttraumatic growth that
can occur as a result of coping effectively with traumatic experi-
ences. They describe five domains in which growth or positive
transformation are often reported following successful engagement
with traumatic experiences: (1) viewing the self as simultaneously
vulnerable and strong; (2) discovering new potential; (3) reporting
an enhanced appreciation for life; (4) developing a deeper sense of
purpose and meaning; and (5) having deeper interpersonal con-
nections and greater empathy. Growth in these domains can foster
within the wounded healer a deeper insight regarding the nature of
the client’s struggles and optimism regarding the client’s ultimate
outcome. However, it is especially critical for the wounded healer
to guard against overidentification with the client and to remain
aware that no journey of recovery is the same as another (Gelso &
Hayes, 2007).
Clinical Psychology’s Predicament:
The Gatekeeper’s Role
From the perspective of our professional gatekeeping responsi-
bilities, psychologists may choose to err toward wariness regarding
the woundedness of colleagues, and may be especially concerned
when wounds are disclosed by trainees. It is likely that more
established psychotherapists, who have observable track records of
competent functioning, can more readily risk being open about
their wounds. They do not have to work as hard to convince the
members of their profession of their recovery status. This allows
therapists with many years of experience to feel greater safety
identifying as wounded. However, given the importance of dia-
logue about how one’s wounds are affecting one’s work as a
therapist, waiting until late in therapists’ careers to explore these
issues seems very problematic. Trainees may be in particular need
of support and guidance regarding these issues in order to provide
appropriate treatment to clients.
Concerns about the wounded healer often focus on poorly
managed countertransference and professional impairment (Gelso
& Hayes, 2007; Sherman, 1996; Smith & Moss, 2009). Supervi-
sors and peers have historically been reluctant to inquire about and
intervene when they have concerns regarding a colleague’s or
Figure 1. Variability in recovery trajectories over time following the experience of a wound. Note: The
trajectories shown here represent one possible manifestation of each trajectory. The figure is meant to illustrate
the variability of trajectories rather than to depict a static image of each particular trajectory.
486 ZERUBAVEL AND WRIGHT
trainee’s possible distress or impairment (Smith & Moss, 2009).
Many factors exacerbate this reluctance, including lack of knowl-
edge about how to appropriately inquire about and respond to
concerns, uncertainty about one’s professional responsibility to do
so, reluctance to intrude, belief that intervention might result in a
negative outcome for the colleague or trainee (e.g., termination,
loss of license), and/or fear of personal risk to the self (e.g.,
litigation, loss of friends; Floyd, Myszka, & Orr, 1998; Smith &
Moss, 2009). The line between “distress” and “impairment” is also
difficult to determine, which creates uncertainty about whether or
when to intervene, strengthening potentially detrimental avoidance
of the issue. Furthermore, throughout training and in professional
practice, there is little encouragement to express concerns about
oneself or to acknowledge areas in which one is struggling in
clinical work. Ironically, psychotherapists have often displayed an
unfortunate tendency to neglect their own needs and their own
wellness (American Psychological Association, 2000; Smith &
Moss, 2009).
It is critical to acknowledge that, over the course of one’s life,
each of us is vulnerable to personal distress, burnout, or difficulty
functioning at work (American Psychological Association, 2000).
Supervisors and consultants are encouraged to create space for
discussion of psychological difficulties and work-related stressors,
providing recommendations for addressing burnout or impairment
as necessary (Ladany, Friedlander, & Nelson, 2005). When super-
vision or consultation promotes silence and secret distress, an
opportunity to dialogue about struggles and promote healing is
lost. Psychological theories regarding recovery support approach-
ing wounds with care, diligent tending, and a belief in the ability
of wounds to heal. If the wounded healer’s most important needs
are to be addressed through professional support (e.g., supervision
regarding countertransference, personal therapy), then it is an
important ethical consideration that psychologists provide a safe
space that invites seeking support. It is important to remember that
even when a wounded healer is in great distress, the transactional
and dynamic nature of resilience allows for profound shifts to
occur on the basis of the response that is given to him/her, as well
as the person’s own active engagement with the unresolved issues
(Lepore & Revenson, 2006; Masten & Wright, 2010). Avoidance,
silence, secrecy, and shame are leading contributors to relapse,
chronic dysfunction, and failure to recover from a variety of
traumatic events and mental health difficulties (Chaudoir & Fisher,
2010; Courtois, 2010; Hinshaw & Stier, 2008).
Part 2: Implications for Training and Practice
Risks and Benefits of Disclosing Woundedness
For a wounded healer to access support or consult about issues
related to practicing as a wounded healer, some degree of disclo-
sure to another professional (e.g., personal therapist, supervisor,
and/or colleague) may be necessary. The decision to disclose
woundedness is complicated to navigate and may be motivated by
a variety of factors (see Chaudoir & Fisher, 2010). We do not
advocate disclosure; rather, we emphasize the fundamental impor-
tance of having disclosure as a viable option for wounded healers
in need of support. We believe that it is problematic if our
profession has developed an atmosphere in which it is stigmatizing
to acknowledge vulnerability or woundedness. Such a milieu puts
wounded healers at greater risk of unaddressed impairment by
precluding opportunities to assess the impact of woundedness and
to suggest intervention when needed. Those who have studied
impaired functioning and distress among psychotherapists have
stressed the importance of destigmatizing seeking outside support
in the form of supervision, consultation, or personal therapy
(Deutsch, 1985; Sherman, 1996; Smith & Moss, 2009; Zur, 2009).
Wounded healers may disclose to varying degrees and in multiple
contexts: personal life (e.g., friends, family), professional context
(e.g., colleagues, professors, supervisors, clients), and the general
public. We focus here on disclosure in professional and public
spheres.
Disclosure to clients. The topic of disclosure to clients has
recently received some attention after many years of neglect
(Baldwin, 2000; Bloomgarden & Mennuti, 2009b; Zur, 2009)
and guidelines have been developed regarding making disclo-
sures to clients (Bloomgarden & Mennuti, 2009a; Geller, 2003;
Knox & Hill, 2003). Before making a disclosure to a client,
therapists need to examine their motivations, making sure that
the disclosure is made for the benefit of the client, rather than
to meet the therapist’s own needs. Therapists can start with
small disclosures (e.g., vacation plans), noting the client’s
response to receiving personal information (Geller, 2003).
Guidelines recommend that the therapist seek supervision or
consultation before making a disclosure of the therapist’s own
prior struggles, but this assumes that the therapist feels safe
taking such a risk. Finally, it is suggested that disclosures only
be made to clients if the issue is resolved and processed. Of
course, this raises the elusive question of what “resolved”
means.
A therapist may discuss woundedness in a nonspecific manner,
making reference to a journey of recovery through “difficult
times” or “times of great suffering.” In contrast, the decision to
make a more specific disclosure to a client involves sensitive
considerations. The effect of a disclosure on a client may be
positive or negative. On the positive side, disclosure of the healer’s
woundedness invites clients to access their own inner healers
(Hayes, 2002), connecting woundedness and healing (Miller &
Baldwin, 2000). In fact, clients’ “own healing resources may be
evoked by their recognition of the healer’s vulnerability” (Kir-
mayer, 2003, p. 251). When the client observes the wounded
healer duality in the therapist, recovery may seem more possible.
A disclosure may redistribute power in therapy, as both therapist
and client have shared with one another in an authentic manner
(Kirmayer, 2003; Knox & Hill, 2003). A disclosure also demon-
strates the therapist’s willingness to engage with difficult material,
giving the client permission to share more. On the other hand,
disclosure may have a negative effect on a client. The client may
prefer not to have personal information about the therapist, or the
disclosure may focus attention inappropriately on the therapist
(Gil, 1988).
Bloomgarden and Mennuti (2009a) discuss the importance of
not sharing with clients any information that one does not want
known within the professional context (e.g., among colleagues,
supervisors). Bloomgarden gives the example of choosing not to
share with clients her own history of an eating disorder until she
was comfortable disclosing this in the work setting, noting that
while therapists are bound by confidentiality, clients are not, and
should never be put in the position of keeping a therapist’s secret.
487
WOUNDED HEALER
Intriguingly, a qualitative study and a number of personal accounts
from wounded healers revealed that therapists report feeling more
comfortable sharing their own woundedness with clients rather
than with colleagues and peers (Bloomgarden & Mennuti, 2009b;
Wright, Seltmann, Telepak, & Matusek, 2012), presenting a pre-
dicament around seeking consultation or supervision before dis-
closure to a client.
Disclosure to other professionals. In contrast with the
detailed guidelines available for disclosure to clients, there is a
notable absence of discussion or research on navigating deci-
sions about disclosure to other professionals or “going public”
about woundedness. There appears to be implicit agreement
within Psychology that it is risky to disclose woundedness—
those who disclose risk stigma, judgment, or overt hostility
from other professionals. Descriptions of such negative conse-
quences have been detailed in a variety of courageous first
person narratives (e.g., Bassman, 2007; Freyd, 1996; Jamison,
1995; Rippere & Williams, 1985). The stigma of disclosing
woundedness may prevent psychotherapists from seeking help
for their distress (Deutsch, 1985), the very thing that might help
(Danieli, 1994; Schoener, 2005). A common fear is that wound-
edness will be misconstrued as impairment (Sherman, 1996).
Receiving official evaluations of clinical competency compli-
cates the risks associated with a disclosure of woundedness for
trainees and early career psychologists. Supervisees who are
receiving middle-of-the-road or negative evaluations may find
it too risky to make disclosures. In fact, these therapists may be
the most in need of guidance around how to handle clinically
relevant manifestations of wounds. In contrast to personal
woundedness, vicarious traumatization is not rare for psychol-
ogists to disclose. Figley (2006) compiled the autobiographies
of pioneer trauma scholars, asking how they became drawn to
study trauma. Some reported personal histories of trauma; many
more reported being affected by the suffering of others. Per-
haps, it is safer or less stigmatizing to identify as having been
impacted by the traumatic experiences of others.
Disclosure in the public sphere. Some wounded healers take
on roles as educators or advocates through disclosure in the public
sphere (e.g., Bloomgarden & Mennuti, 2009b; Carey, 2011;
Frankl, 1959; Freyd, 1996; Jamison, 1995; Sawyer, 2011; West-
erlund, 1992). In these forums, disclosures may be made to the
general public, including the professional realm in the greater
public domain. For example, Linehan’s recent identification as a
wounded healer appeared on the front page of The New York
Times, such that therapists read about her disclosure along with
other members of the public (Carey, 2011). Wounded healers may
use their uniquely informed perspectives to become advocates
and/or activists (Adame, 2009; Bassman, 2007; Westerlund,
1992). The wounded healer’s public retention of these multiple
identities may allow those who are wounded to envision the
potential healer within themselves (Miller & Baldwin, 2000), thus
providing inspiration. Disclosure in the public sphere changes the
nature of the revelation. When this information is public, valuable
information is available to clients in therapist selection (Gil, 1988).
While the relevance of woundedness to the relationship may
unfold and change throughout the duration of therapy, the disclo-
sure itself does not have to be negotiated.
Recommendations for Fostering Resilience and
Cultivating Support
Our profession has not yet resolved the tendency to reject,
silence, or stigmatize the wounded healer. It is curious that psy-
chotherapists, who choose a life of bearing witness, at times have
great discomfort with another therapist’s woundedness. Psycholo-
gists’ cautious focus on the potential for impairment seems to
hinder the very foundational responses that we champion with
clients (Cushway, 1996). With wounded clients, we normalize the
struggles and guide them through a process of growth, recovery, or
healing. We encourage the unshrouding of silence and offer re-
sponses of empathy and support. Yet, we do not approach our
wounded colleagues with the same warmth and support. Instead,
our profession seems to promote silence around a healer’s wound-
edness, perhaps to protect against stigma or doubt regarding pro-
fessional competence (Bloomgarden & Mennuti, 2009a; Rippere
& Williams, 1985; Sussman, 2007).
This silence must be broken in order to support the wounded
healer in navigating issues of recovery, management of counter-
transference, and seeking help when necessary. This includes
questioning the incongruence between how our profession regards
woundedness in its clients and its practitioners. This is relevant any
time that a wounded healer confides in a mentor, advisor, super-
visor, or consultant. Psychotherapists are especially well posi-
tioned to be political advocates for the wounded and to improve
the way that our society views mental health struggles (Adame,
2009; Bassman, 2007; Feldman & Crandall, 2007; Schulze, 2007)
by clarifying misperceptions about mental illness, educating about
stigma, and speaking about healing and recovery. This type of
advocacy is congruent with the values of our profession, yet the
wounded healer often does not receive such support. We propose
that the discrepancy between our values about client woundedness
and our responses to the healer’s woundedness comes from social
stigma and wariness due to uncertainty regarding the stability of
the wounded healer’s recovery.
We can create environments that are conducive to promoting
resilience for wounded healers. Fostered in contexts of openness
and support, rather than secrecy and avoidance, dialogue and
exploration are the most effective approaches to assessing and
reducing impairment (Sherman, 1996). By being aware of and
curious about our internal responses of blame, fear, or concern for
relapse, we become less apt to stereotype or stigmatize the
wounded healer and more able to respond in a caring and support-
ive manner, while also cleaning and checking wounds.
To perform gatekeeping responsibilities properly, supervisors
and consultants must be able to differentiate between a current
problem that has led to impairment and a disclosure of a personal
struggle or wound that is not adversely impacting the psychother-
apist’s professional role. Thus, disclosures may require an assess-
ment of the wounded healer’s current functioning and clinical
work. To do this, the supervisor or colleague must be able to
identify when and if the therapist is exhibiting impaired function-
ing that has resulted in ineffective or harmful services or has
crossed boundaries inappropriately. The supervisor or colleague
can also invite discussion of what steps have been taken to foster
recovery and how the person has been able to draw positively from
the wound. In assessing the degree of resolution or recovery,
visibility of a scar does not necessarily indicate impairment. It may
488 ZERUBAVEL AND WRIGHT
be evident, for instance during disclosure to a supervisor, that there
is still pain associated with the wound. The presence of an emo-
tional reaction does not indicate lack of resolution, although con-
tainment of affect is required to consider disclosure to clients. It is
important that the therapist has confidence about his or her ability
to modulate emotional reactions and has learned to cope effec-
tively with cognitive and affective responses to triggers. The
supervisor or consultant might ask questions such as: What do you
experience when a client brings up something related to this issue?
What do you typically do in a session to manage your personal
reactions? Have your reactions produced any adverse effects on
the therapy relationship? When has this occurred and how did you
cope with this?
Training programs and clinical workplaces can improve the
status quo by cultivating supportive responses to wounded healers
and differentiating between disclosure of woundedness and need
for intervention or requests for help. This requires that distressed
professionals who experience difficulty functioning are not “de-
monized,” and that these topics are discussed openly “in a com-
passionate, nonpunitive manner” (Smith & Moss, 2009, p. 12).
Workplaces can train with an assumption of healer woundedness,
normalizing that this may be from personal history or from the
work itself, conceptualizing vicarious traumatization as an “occu-
pational hazard” rather than a result of therapist “inadequacy”
(Pearlman, 1995, p. 52). Therapist supervision or consultation
groups focused on processing countertransference can facilitate
identifying, containing, and coping with countertransference reac-
tions (Danieli, 1994). Continuing education may also provide a
forum for exploring issues related to woundedness (Smith & Moss,
2009). Wounded healers have reported that professional support
can come in a variety of ways: being part of a clinical team that
included ongoing interpersonal process work, participating in
weekly peer consultation groups, continuing education opportuni-
ties relevant to one’s domain of practice, and engaging in ongoing
or periodic personal therapy (Wright et al., 2012). However, many
also noted that it was sometimes a struggle to find a truly support-
ive, helpful, and safe supervision group.
In training, didactic coursework and clinical supervision provide
opportunities for dialogue about countertransference and impaired
functioning (Gelso & Hayes, 2007; Sherman, 1996). Creating
safety allows wounded healers to broach and explore issues, and
supervisors will then be better able to assess whether woundedness
is negatively impacting clinical work. Supervisors are in an opti-
mal position to distinguish between woundedness and impairment,
as they see supervisees’ behavior across contexts (e.g., with cli-
ents, colleagues, and in supervision; Ladany et al., 2005). Personal
therapy or other interventions can be encouraged as needed. Train-
ing programs can develop environments that facilitate thoughtful
discussion of disclosures, stressing the importance of knowing
when and whom to ask for help, identifying impairment, and
articulating need for support. Ideally, training is a context in which
personal awareness and self-exploration are encouraged, struggles
are supported, and myths of therapist invulnerability are debunked
(Cushway, 1996). Wounded healers are more likely to cultivate
trajectories of recovery within models that normalize therapist
stressors and countertransference issues, encourage seeking con-
sultation and/or personal therapy, and integrate attention to com-
passion fatigue, therapist well-being, and self-care (Cushway,
1996; Pearlman, 1995).
Attention to self-care and one’s own well-being (e.g., regular
exercise, yoga, eating well and getting enough sleep, spending
time with friends, establishing boundaries between one’s personal
and professional life, and making time for fun activities) are
critical to the wounded healer’s psychological health (Figley,
2002; Pearlman, 1995; Wright et al., 2012). In a qualitative study,
wounded healers all recognized the value of self-care practices in
preventing a reemergence of psychological distress or burnout
(Wright et al., 2012). However, they also acknowledged that
self-care did not come easily; it took time to accomplish these
goals, and incorporating these activities into a busy professional
life was, for many, an ongoing struggle.
Conclusion
We hope that the framework we have laid out here facilitates
dialogue about the wounded healer. We encourage an approach to
wounded healers in which we lead with openness, curiosity, and
exploration, assuming possibilities of resilience, while also con-
sidering and responding to concerns of relapse or chronic diffi-
culty. It is important that psychologists acknowledge that recovery
takes time and is an ongoing process and support wounded healers
in taking the time they need to recover when setbacks occur. We
can cultivate this openness by learning from wounded healers
about their recovery thus far, as well as how fragile or stable they
perceive it to be. Rather than distancing or silencing wounded
healers with our wariness, if we can tolerate the uncertainty of
recovery trajectories, we are more apt to promote recovery stabil-
ity. It is critical that we convey sensitivity, compassion, and
concern for wounded healers, and offer them support and guidance
if needed. We believe that the issues raised are applicable to a
broad definition of woundedness, including physical and mental
health problems, family of origin dysfunction, traumatic life ex-
periences, the microaggressions and overt discrimination faced by
psychotherapists who have a marginalized identity (e.g., racial/
ethnic/religious/sexual minority group membership), and many
other types of woundedness. We hope further research addresses
professional issues specific to a variety of types of wounds.
We advocate for willingness to acknowledge woundedness and
tend to wounds through open dialogue, providing support in ac-
cessing consultation and personal therapy when needed. To that
end, it is critical to have an environment that is not experienced as
shaming or stigmatizing; rather, the focus needs to be on identi-
fication of resources needed to promote the psychological well-
being of wounded healers. We can cultivate an environment of
greater safety by addressing woundedness in a balanced manner,
not only as a risk, but also a potential benefit for therapists. The
wounded healer represents not only pain and suffering, but also the
possibility of resilience, posttraumatic growth, and the ability to
use the knowledge acquired through one’s own suffering in the
service of clients’ recovery. Ultimately, the goal of psychotherapy
is to heal the wounded. The paradigm of the wounded healer may
offer a unique and valuable perspective for clients, clinical train-
ing, and our field, if we are indeed willing to explore it.
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Accepted February 16, 2012
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WOUNDED HEALER
... The healer's own wounds are seen as source of their therapeutic capacity and as possessing transforming properties, crucial to comprehend and promote the processes of recovery (Nouwen, 1979;Sedgwick, 1994). This shared experience of vulnerability and healing can enhance the therapeutic relationship, fostering a deeper connection between the healer and the person seeking support (Gelso & Hayes, 2007;Zerubavel & Wright, 2012). Not surprisingly, a large proportion of therapists (75-87%) have undergone therapy, compared to 25% of the general population. ...
... Although some have done so to fulfil training requirements, several have reported that they underwent psychological treatment driven by personal reasons, including the need to address personal or interpersonal problems (Norcross & Conner, 2005;Orlinsky et al., 2011). Zerubavel and Wright (2012) have drawn a fundamental distinction between wounded healers and impaired professionals. Such distinction lies in the way practitioners navigate and utilize their personal struggles within their professional realm. ...
... For instance, Cvetovac and Adame (2017) reported a series of therapists' concerns about the impact of their wounds on clinical work, including struggles in being present in their interactions with patients and colleagues, feeling overwhelmed, difficulties in concentration as well as effort in examining their own reactions in terms of countertransference and identification with their patients, in order to prevent harm in their clinical work: in other words, the wounded healer might become a wounding healer (Farber, 2016). Zerubavel and Wright (2012) acknowledged that experiences following a wound vary according on its type, degree, and duration (e.g., temporary or permanent challenges, a physical or psychological problem, a guarded or benign prognosis). Furthermore, the stigma attached to specific kinds of adversities may have a significant impact on how comfortable therapists feel about disclosing their wounds and how other professionals treat them when they do. ...
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Motivations to become psychotherapists have long been associated with the concept of the wounded healer, which posits that practitioners entering the field of mental health often do so as a result of their own personal struggles and challenges. Early difficulties and wounds are seen as a source of healers’ capacity to comprehend and promote the processes of recovery, fostering a deeper connection between the healer and the person seeking support. Nevertheless, other factors not directly linked with early adversities have been posited to have an influence on the development of motivations towards pursuing a career in the psychological field. The present work aimed to review available empirical literature on the motivations to become psychotherapists, encompassing the concept of the wounded healer as well as other possible factors shaping practitioners’ career choice. Three main domains of motivations have been addressed within the wounded healer framework: dysfunctional caregiving, negative personal experiences in the family of origin, and other early relational issues. Additionally, two other main domains, namely self-oriented and altruistic motivations, have been identified, and the concept of the healing healer was proposed to underline both the self-oriented healing process that a person may undergo while becoming a therapist, as well as the altruistic attitude in providing healing care towards others. Results were discussed addressing possible links between conscious and unconscious motivations to become therapists as well as in terms of clinical implications for practitioners in the field of clinical psychology.
... Tęsiant toliau, šis tyrimas, pritariantis kitų autorių darbams ir juos praplečiantis, parodė, jog gedinčiam psichoterapeutui dažnai tenka dorotis su terapijų metu kylančiu psichologiniu skausmu ir sunkiais netekties prisiminimais, kuriuos aktualizuoja klientų pasakojimai (Cvetovac & Adame, 2017;Kouriatis & Brown, 2014;Zerubavel & Wright, 2012). Psichoterapeutai gali veidrodiniu principu susitapatinti su kliento jausmais, todėl tai gali paveikti ir jų naudojamas terapines intervencijas. ...
... Autoriai nurodo, kad įsitraukimas į darbą gali "palaikyti" gedintį psichoterapeutą (Horwell, 2019), nors kiti sako, jog darbas, tapęs įveikos mechanizmu po artimojo netekties, gali kelti pavojų neišgedėti su netektimi susijusios krizės (Kouriatis & Brown, 2014;Swinden, 2021). Kiti šio tyrimo radiniai taip pat sutinka su atradimais, kad gedulo išgyvenimas skatina savistabą, savianalizę, poreikį perdirbti savo identitetą bei asmeninio pažeidžiamumo ir trapumo priėmimą (Broadbent, 2011;Broadbent, 2013;Cvetovac & Adame, 2017;Horwell, 2019;Kouriatis & Brown, 2014;Zerubavel & Wright, 2012), o artimojo netekties integravimas skatina pasaulėžiūros, socialinės tapatybės suvokimo pokyčius (Broadbent, 2011;Broadbent, 2013;De Santis, 2015) ir netekčių gyvenime įprasminimo paieškas (Johnson, 2011). Todėl gyvenimo patirtys ir jų sprendimo būdai, įveikos bei pasekmės neišvengiamai formuoja ir psichoterapeuto profesinį vaidmenį, paremtą jo asmenybe. ...
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The article presents the significance of the experience of bereavement for psychotherapists in their therapeutic work. This issue has not been studied much in the world and has not been raised in Lithuania yet. Paradoxically, the „psychotherapist working on his/her own“ has not been an interesting object of research so far, and so far researchers are mainly interested in the effectiveness of the psychotherapy, the question how psychotherapist feels after the crisis experience and how it affects his/her work remains in the shadows. Thus, the aim of the research presented in this paper is to uncover and systematically describe the implications of psychotherapists’ experience of bereavement for their work with psychotherapy clients. A qualitative research strategy was chosen for the study, data were collected using in-depth semistructured interviews, and analysed using Thematic Analysis. Seven psychotherapists who had experienced the loss of a loved one during the course of their psychotherapeutic work participated in the study. Three themes and seven subthemes were identified in the study, revealing the multilayered nature of experiences in their psychotherapeutic work. Although all the psychotherapists had integrated the loss of a loved one in one way or another and felt personally grown up, this had undoubtedly left traces in their therapeutic work and was experienced as a personal and professional challenge.
... Dawn further explored how engaging with client trauma disclosure can be "costly," as difficult or traumatic clinician experiences can be exacerbated or brought to the fore, remembered and felt as part of bearing witness to client trauma. Known colloquially as a wounded healer, clinicians often come to the work of therapy based on their own therapeutic, traumatic, or otherwise painful experiences (Zerubavel & Wright, 2012). The physical, emotional, mental, and relational toll of trauma disclosure on the MFT may in part be understood as connected to the ways in which personal experiences, or wounds, are touched or enlivened by the client's traumatic material. ...
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This study explores the embodied experiences of pre-licensed marriage and family therapists (MFTs) during in-session instances of client trauma disclosure through poetical analysis. Informed by Karen Barad’s agential realism, interviews with novice MFTs (N = 11) were examined, considering evocative moments or moments of “aliveness” where the material-discursive body of the therapist was impacted by disclosure. Poetical analyses highlighted how pre-licensed MFTs embody and experience disclosure physiologically, emotionally, cognitively, and relationally, underscoring the layered ways in which therapists respond to client trauma. Eleven poems depict the embodied experience of trauma disclosure, based on the researcher’s hearing of MFTs’ experiences of client trauma disclosure. Understanding the multiplicative experiences of therapists during trauma disclosure may aid in normalizing the breadth of responses that come with relationally engaging with and holding space for trauma-affected clients and serve as an introduction to the varied and evocative experiences of trauma disclosure for therapists in training.
... Concepts of 'wounded healer' and 'impaired practitioner' emerge from this literature. A wounded healer's ability for empathy is heightened by their own experiences, while an impaired practitioner may be vulnerable to re-traumatisation by encounters with clinical material that is similar to their history and may struggle to access appropriate support due to stigma attached to disclosing mental health difficulties (Conchar and Repper, 2014;Cvetovac and Adame, 2017;Zerubavel and Wright, 2012). Richards et al. (2016) suggest that mental health practitioners with mental health needs may have two separate and unintegrated identities of 'patient' and 'professional'. ...
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Little is known about dialectical behaviour therapists’ (DBT) own experiences of mental health issues or being experts by experience. Quantitative exploratory methodology surveyed DBT therapists about their own experiences of mental health issues. Questionnaires were varied and far-reaching including collection of data on demographics as well as mental health experiences and disclosures of difficulties, Adverse childhood experiences, quality of life, attitudes towards people with borderline personality disorder (BPD), and a measure of internalised stigma and stigma resistance for people who endorsed a formal mental health diagnosis. Ninety-four people responded, 92 of whom identified as a practising DBT; 80 endorsed a history of or current mental health difficulties. This exploratory research, based on responses from 94 DBT therapists, expands knowledge on the relevance of ‘wounded healer/impaired practitioner’ concepts for practitioners of DBT and raises issues related to consultation team and a duty of care towards DBT therapists. Low response rate makes it difficult to generalise these findings. Respondents were predominantly white, female, heterosexual therapists earning well above the median and mean incomes in the UK. Additionally, respondents were not asked to define the functions and modes of their DBT practice. Key learning aims (1) Readers will learn about the treatment relationship within a DBT context. (2) Readers will learn about the concepts of wounded healer and impaired practitioner as well as the related issue of stigma. (3) Readers will learn about the experiences of mental health issues of 94 DBT therapists.
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In Shared Traumatic Reality (STR), therapists and patients face similar threats, leading to increased stress and blurred personal-professional boundaries for healthcare providers. It impacts everyone in the community, as witnessed in the southern region of Israel. The challenge for caregivers aiding displaced individuals was unique—providing therapy while caring for their children. STR poses challenges but also growth opportunities. Experiencing trauma firsthand offers insights, fostering professional and personal development. Despite the difficulties of handling loss and traumatic stories, this reality demands new coping mechanisms for healthcare providers to grow through adversity. Community involvement aids professional empowerment amidst STR, reinforcing therapists’ identification with patients. This new reality reveals remarkable resilience among those who endured tragedies, offering lessons in vicarious resilience. The concept of the wounded healer (WH) reflects how personal trauma can enhance therapeutic abilities by profoundly empathizing with patients’ pain. Navigating personal hardships is crucial to avoid projecting onto patients during therapy. The WH's identification with patient trauma strengthens the therapeutic bond, leading to better outcomes.
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Background Adoption research has tended to focus on associated emotional and developmental challenges. There is little research on how adoptees experience counselling training and its personal and professional impact on adoptees. The aim of this qualitative study was to explore the counselling training experiences of four counsellors who were adopted as babies (under 1 year of age). Methods One‐to‐one semi‐structured interviews were conducted with two psychodynamically trained counsellors and two integratively trained counsellors. Interpretative phenomenological analysis was used to analyse the training experiences of adoptees, and the personal and professional impact of training. Findings Four group experiential themes were identified: disclosure; place in world; relationships; and reflexivity. Implications for Practice The findings contribute to the growing body of research on counsellor training and provide insights into adoptees' experiences of counselling training. These insights enable improvements in the provision of such training by counselling training providers to adoptees, and in the provision of the specialist training either required or recommended to provide adoption support. The research also furthers the understanding of adoptees' experiences more generally and may also help noncounsellor adoptees deal with issues perceived as related to their adoption as well as others who face similar issues, due to their own lived experiences. Conclusion Both modalities of counselling training helped participants deal with difficulties presented by their adoptions, in particular regarding identity and relationships, affording opportunities for growth and healing.
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This paper begins by introducing the mythical origins of the wounded healer ethos and its relevance to therapy practice today. As a counselling psychologist in training, I consider my relationship with the wounded healer paradigm, and my position of discomfort in embracing the language of wounds and healing as applied to human suffering. This unease prompts a journey of deconstruction, probing the idea of therapists as healers. I visit authors from counselling psychology, critical psychology and psychoanalysis, who contribute diverse narratives of the role and influence of therapists, ranging from professional helper to malign deathmaker. I end with a return to the wounded healer ethos, holding this position lightly, as one of multiple complex and challenging narratives of being a therapeutic helper.
Chapter
Professionals providing abortion counseling face the intricate task of navigating the convergence of personal and professional experiences that can influence their provision of services. This perspective demands a nuanced understanding cultivated through self-of-the-therapist work that clinical components encompass identifying and managing countertransference and disclosure. Effectively negotiating this intersection between personal and professional experiences is imperative within a sociopolitical climate that may impose constraints on the provision of care, irrespective of alignment or conflict with the practitioner’s personal beliefs. Failure to adequately address such clinical components could negatively influence patient care, yielding adverse clinical outcomes.
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Background The wounded healer concept refers to healthcare providers who, in the past, have had similar experiences to those of their clients and now draw on these challenging experiences to assist their clients. This study explored the positive traits of nurses with chronic cardiovascular diseases who transitioned to wounded healers. Methods A qualitative content analysis study was conducted within hospitals in Tehran, Iran, between November 2023 and March 2024. Sampling was conducted using a purposive sampling method in accordance with the study objectives and inclusion criteria. The data were collected through semi-structured face-to-face interviews. Twenty-three participants, comprising 16 females and 7 males, participated in the interviews. Data analysis was conducted by employing a qualitative content analysis approach, including creating codes, subcategories, generic categories, and main categories. MAXQDA v20 software was utilized to facilitate the analysis process. Results The data analysis revealed one main category that aligned with the research question: the positive traits of a wounded healer nurse, consisting of three generic categories: (1) traits related to interpersonal and professional relationships; (2) traits related to the professional dimension; and (3) traits related to the personal dimension. wounded healer nurses demonstrate positive traits that enhance patient care. Conclusions The findings of this study have important implications for nursing practice and education. By identifying the positive traits exhibited by nurses as wounded healers affected by chronic cardiovascular diseases, nursing programs can emphasize and strengthen these qualities to convert challenges into opportunities and bridge the theory-practice gap.
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Fiziksel ve psikolojik acı deneyimleri olan ve bunları diğer insanların yararı için kullanan bireyler "yaralı şifacı" olarak nitelendirilmektedir. Acı deneyimler bireyi hemşirelik, hekimlik gibi yardım edici meslekleri seçmeye yöneltebilir. Bilinçaltı yardım etme isteği/gayreti hastalara karşı şefkat ve empati duyulmasını kolaylaştırabildiği gibi, aşırı derecede olduğunda tükenmişlik ve depresyona neden olabilir. Bu yüzden sağlık çalışanlarının hasta ile ilişkisine yön verebilen ve mesleki uygulamalarını etkileyebilen yaralı şifacı kavramının açığa kavuşturulması önemlidir. Bu çalışmada "yaralı şifacı" kavramının açıklanması amaçlanmıştır. Walker ve Avant’ın kavram analizi yöntemi kullanılan bu çalışma Ocak- Nisan 2023 tarihleri arasında yapılmıştır. Literatür incelemesi Web of Science, Pubmed, ScienceOpen, Google Akademik ve Ulakbim veri tabanlarında "yaralı, yaralı şifacı, şifa, şifa vermek, iyileştirmek, wounded, healer, wounded healer, concept analysis, psychiatry" anahtar kelimeleri kullanılarak yapılmıştır. Yaralı şifacı ile ilgili erişim sağlanabilen 6 Türkçe makale, 17 İngilizce makale, 1 Türkçe kitap, 1 İngilizce kitap ile Türk Dil Kurumu Sözlüğü ve Oxford Learner’s Dictionaries incelenmiştir. Kavram analizine göre; yaralı şifacı kavramının, genel olarak kendiliğin iyileştirici gücünü kullanma ile ilişkili olduğu belirlenmiştir. Tanımlayıcı özellikleri; farkında olmak, empati, çaba, yaralı şifacının iyileşmesi ve dönüşüm olarak sıralanmıştır. Kavramın hazırlayıcı özellikleri; yaşanmış acı deneyim, duyguları ifade etmek ve kendini tanımak olarak belirtilmiştir. Hazırlayıcı özelliklerin sonucunda da kendini anlama ve kendiliğin terapötik kullanımı becerilerinin gerçekleşebildiği vurgulanmıştır. Sonuç olarak acı deneyimin birey için dönüştürücü ve iyileştirici olmasında bu deneyimi fark etmek, kabul etmek ve bununla ilgili duyguları ifade etmek önemlidir. Bu çalışma sağlık profesyonellerine kendini tanıma/anlama ve kendiliğin terapötik kullanımı konusunda yol gösterici olabilir.
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In this volume, distinguished contributors explore the multifaceted nature of the psychotherapy of psychotherapists from “both sides of the couch.” The first-person narratives, clinical wisdom, and research findings gathered together in this title offer guidance about providing effective treatments to therapist-patients. Part I presents multiple theoretical positions that justify and guide the work of therapists’ therapists. In Part II, eminent therapists write eloquently and intimately about their own experiences as patients. Their personal reflections offer valuable insights about what is healing and educational about psychotherapy. These narratives are followed by several chapters reviewing scientific research on therapists in personal therapy, including the first report of relevant findings from a major international survey of psychotherapists. In Part III, celebrated therapists from different theoretical orientations offer guidance on conducting therapy with fellow therapists. They reflect on the many challenges, dilemmas, and rewards that arise when two people do the same work. Their chapters offer wisdom and warnings about such issues as power dynamics, boundary maintenance, therapist self-disclosure, the termination process, and the post-termination phase of the relationship.
Chapter
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This chapter strives to explain the diversity of human responses to stressful life events, particularly traumatic events, which we ordinarily expect to overwhelm people's coping resources. That is, we are concerned with understanding human resilience and a particular form of resilience, posttraumatic growth (PTG), in the face of adversity. We review personal and environmental concomitants of resilience and examine how people might develop a capacity for resilience in the face of extreme stressors. We also consider the relation of resilience to transformative experiences, particularly growth, in the aftermath of stress. Key words: trauma, stress, resilience, postraumatic growth, transformation
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Professional impairment creates concern among colleagues, yet often there is no clear plan for help. Although many state psychological associations have developed programs for assisting psychologists, how practitioners view these programs is unknown. Of a random sample of 633 surveyed psychologists, 48% identified behaviors suggestive of impairment, experiences addressing concerns with colleagues, and opinions and knowledge about their state's program. Respondents believed 10% of colleagues to be impaired and indicated that they would most likely use informal methods for expressing concern. Utilization and knowledge of the colleague assistance program were related to length of licensure and membership in the state psychological association.
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While recent autobiographical accounts of women psychotherapists with depressive illnesses have provided vivid and compelling portraits of therapists' experiences in therapy (e.g., Jamison, 1995; Manning, 1995), further research is needed to clarify the impact that depression and its treatment have upon both collegial relationships and clinical practice. A subset of the membership of the Association for Women in Psychology (AWP) was surveyed concerning therapists' experiences with depression and its treatment. Of 220 respondents, 76% reported some form of depressive illness. Eighty-five percent of respondents indicated that they participated in personal therapy. When evaluating their clinical work, respondents reported both positive and negative consequences resulting from their depression. While some respondents noted improvement in collegial relationships, many felt judged and avoided.
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Countertransference and the Therapist's Inner Experience explores the inner world of the psychotherapist and its influences on the relationship between psychotherapist and patient. This relationship is a major element determining the success of psychotherapy, in addition to determining how and to what extent psychotherapy works with each individual patient. Authors Charles J. Gelso and Jeffrey A. Hayes present the history and current status of countertransference, offer a theoretically integrative conception, and focus on how psychotherapists can manage countertransference in a way that benefits the therapeutic process.
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The fable of the Emperor's New Clothes is a classic example of a conspiracy of silence, a situation where everyone refuses to acknowledge an obvious truth. But the denial of social realities - whether incest, alcoholism, corruption, or even genocide - is no fairy tale. This book sheds light on the social and political underpinnings of silence and denial - the keeping of "open secrets." The author shows that conspiracies of silence exist at every level of society, ranging from small groups to large corporations, from personal friendships to politics. He also shows how such conspiracies evolve, illuminating the social pressures that cause people to deny what is right before their eyes. We see how each conspirator's denial is symbiotically complemented by the others', and learn that silence is usually more intense when there are more people conspiring - and especially when there are significant power differences among them. The author concludes by showing that the longer we ignore "elephants," the larger they loom in our minds, as each avoidance triggers an even greater spiral of denial. Drawing on examples from newspapers and comedy shows to novels, children's stories, and film, the book travels back and forth across different levels of social life, and from everyday moments to large-scale historical events. At its core, it helps us understand why we ignore truths that are known to all of us.