European Journal of Psychotherapy & Counselling

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Broken mirror: The intertwining of therapist and

client stories of childhood sexual abuse (CSA)

Reena Shah

To cite this article: Reena Shah (2017) Broken mirror: The intertwining of therapist and client
stories of childhood sexual abuse (CSA), European Journal of Psychotherapy & Counselling, 19:4,
343-356, DOI: 10.1080/13642537.2017.1386225

To link to this article: https://doi.org/10.1080/13642537.2017.1386225

Published online: 12 Oct 2017.

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European Journal of Psychotherapy & Counselling, 2017
VOL. 19, NO. 4, 343–356
https://doi.org/10.1080/13642537.2017.1386225

Broken mirror: The intertwining of therapist and

client stories of childhood sexual abuse (CSA)
Reena Shah
Psychotherapy and Counselling, The Minster Centre, London, UK

ABSTRACT
In recent years, there has been a great deal of attention given to the potential
increased risk of vicarious traumatisation (VT) for clinicians with a history of
childhood sexual abuse.
I am curious about whether the silencing, which has been ubiquitous within
society, is also prevalent within the therapeutic profession. I wonder if therapists
with a history of abuse feel they have to bracket their experience, and if this limits
the potential for positive transformation.
In this paper, I draw upon my narrative study of therapists with a history of abuse.
The methodology followed was narrative inquiry with two therapists in addition
to an autoethnography. I used ‘narrative analysis’ to analyse the data. The findings
of the study covered themes of transgenerational trauma, ‘the wounded healer’,
caregivers’ responsibility in communal cultures and dissociation.
In this paper, I will consider the part dissociation plays when there is a shared
history of trauma, and the ways in which dissociative enactments within the
consulting room themselves may be part of the mutual healing. For this paper,
only extracts from interviews with one of my participants will be included.

CONTACT  Reena Shah  [email protected]

© 2017 Informa UK Limited, trading as Taylor & Francis Group
344   R. SHAH

Der gebrochene Spiegel: Das intereienandergreigene von

­Therapeut und Klient Geschichten von Klienten vom Sexuellem
Missbrauch in der Kindheit
ABSTRAKT
In den vergangen Jahren wurde viel Aufmerksamkeit auf das potentielle erhöhte
Risiko von nachempfundenen Traumata für Ärzte mit einer Geschichte vom
Sexuellen Kindheitstrauma.
Ich. In neugierig ob das Schweige, welches sehr allgegenwärtig in der Gesellschaft
ist, auch in Therapeutischen Kreisen vorhanden ist. Ich frage mich ob Therapeuten
mit einer Missbrauchserfahrung sich so fühlen, dass sie Ihre Erfahrungen absondern
müssen und ob dies die Gelegenheit absondert für eine Positive Transformation.
In diesem Dokument Bezieher ich mich auf meine eigene Geschichte über
Therapeuten mit ihren eigenen Erfahrung von Missbrauch. Die angewandte
Methodologie ist narrative Erfragung mit zwei Therapeuten sowie eine
auoethnographie. Ich benutze ‘narrative Analysis’ um die gesammelten Daten zu
analysieren. Die Ergebnisse der Studie ergaben Themen von Transgenerstionalem
Trauma, ‘ der verletzte Heiler’, Pflegekraft, Verantwortung in kommunalen Kulturen
und Dissoziation.
In diesem Dokument erläutere ich über den Teil wo geteilte Geschichte eine Rolle
spielt Disoziation und die Art und Weisen wie das dissoziatives Ausspielen da diese
einen Teil ausmachen könnte von der allgemeinen Heilung. Für dieses Dokuemnt
wird nur ein Auszug von den geführten Interviews wo nur ein Schüler teilnimmt.

EL ESPEJO ROTO: EL entrecruzamiento de historias de abuso

­sexual en la niñez, entre el terapeuta y el cliente
Recientemente se ha prestado mucha atención al aumento del riesgo potencial de
la traumatización vicaria (TV) para los terapeutas que tienen una historia de abuso
sexual durante su niñez (ASN). Me pregunto si el silenciamiento que ha sido ubicuo
dentro de la sociedad, prevalece también dentro de la profesión de psicoterapia,
y también si los psicoterapeutas con historia de abuso sexual sienten que deben
poner sus experincias entre paréntesis y si ésto a su vez, limita el potencial para
una transferencia positiva.
En este artículo me baso en mi estudio narrativo de terapeutas con historia de
abuso. La metodología fue la encuensta narrativa con dos terapeutas en adición
a una auto-etnografía. Utilisé el análisis narrativo para analizar los datos. Los
resultados cubrieron temas de trauma transgeneracional, ''el cuidador herido'', la
responsabilidad de los cuidadores en culturas comunales y disociación.
En este artículo consideraré la parte que la disociación juega cuando hay una
historia compartida de trauma, y la manera en la cual las actuaciones disociativas
dentro del consultorio, podrínan formar parte de un proceso de sanación mutua.
Se incluirá sólamente resúmenes de las entrevistas con uno de los participantes.
 EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING   345

Lo specchio spezzato: l'intreccio di storie del terapeuta e di clienti

vittime di abusi sessuali nell’infanzia (CSA)
Negli ultimi anni molta attenzione è stata dedicata al rischio di potenziale aumento
della traumatizzazione vicaria (VT) per i clinici con una storia di abuso sessuale
infantile (CSA).
Sono interessato a comprendere se l’oblio, così onnipresente nella nostra società,
caratterizzi anche la professione psicoterapeutica. Mi chiedo se i terapeuti con una
storia di abuso abbiano la necessità di mettere tra parentesi la loro esperienza e
se questo limita la possibilità di trasformazioni positive.
In questo contributo mi focalizzo su uno studio narrativo relativo a terapeuti
con una storia di abuso. La metodologia seguita è l'indagine narrativa con due
terapisti oltre ad un'autoetnografia. Ho usato l'analisi narrativa per esaminare i dati.
I risultati dello studio hanno riguardato il trauma transgenerazionale, ‘il guaritore
ferito’, la responsabilità dei caregiver nelle culture collettive e la dissociazione.
Considererò la dissociazione in presenza di una storia condivisa del trauma e le
modalità in cui la dissociazione all'interno della stanza di consultazione può essere
un aspetto della reciproca guarigione. In questo contributo saranno inclusi solo
estratti di interviste con uno dei soggetti che hanno preso parte allo studio.

Miroir brisé: l’entremêlement des histoires d’abus sexuels dans

l’enfance du thérapeute et du client
Récemment, une attention toute particulière a été portée au risque potentiel de
traumatisme secondaire (VT) chez les cliniciens avec un passé d’abus sexuel dans
l’enfance (CSA).
Je suis curieuse de savoir si le silence, omniprésent socialement, est également
prévalent au sein de la profession. Je me demande si les thérapeutes avec un passé
d’abus ont le sentiment qu’ils doivent mettre leur expérience entre parenthèses
et si cela limite la possibilité d’une transformation positive.
Dans cet article, je m’inspire de mon étude narrative portant sur les thérapeutes
ayant subi des abus. Une enquête narrative auprès de deux thérapeutes
combinée à une auto-ethnographie a constitué la méthodologie de cette étude.
J’ai utilisé ‘l’analyse narrative’ pour analyser les données. Les résultats de cette
étude englobent les thèmes suivants  : le traumatisme transgénérationnel, ‘le
guérisseur meurtri’, la responsabilité de ceux qui prodiguent les soins au sein des
communautés culturelles, et la dissociation.
Dans cet article, je considère le rôle que joue la dissociation lorsqu’il y a une histoire
de trauma partagée et les manières dont les mises en actes dissociatives au sein de
la relation thérapeutique peuvent faire partie d’une guérison mutuelle. Pour cet
article, sont inclus des extraits de mon entretien avec un seul de mes participants.
346   R. SHAH

Σπασμένος καθρέφτης: Η αλληλεμπλοκή του θεραπευτή και των

ιστοριών των πελατών για την παιδική σεξουαλική κακοποίηση
ΠΕΡΊΛΗΨΗ
Τα τελευταία χρόνια έχει δοθεί μεγάλη προσοχή στην πιθανότητα αυξημένου
κινδύνου επανατραυματισμού «από δεύτερο χέρι» στους κλινικούς με ιστορικό
παιδικής σεξουαλικής κακοποίησης. 
Με απασχολεί το ερώτημα γύρω από το κατά πόσο η σιωπή, που είναι διαδεδομένη
στο κοινωνικό πλαίσιο, επικρατεί επίσης στο θεραπευτικό επάγγελμα. Αναρωτιέμαι
αν οι θεραπευτές με ιστορικό κακοποίησης αισθάνονται ότι πρέπει να βάλουν
στην άκρη την εμπειρία τους και αν αυτό περιορίζει τη δυνατότητα για θετική
μεταμόρφωση.
Σε αυτό το άρθρο αντλώ από την αφηγηματική μου έρευνα με θεραπευτές με
ιστορικό κακοποίησης. Η μεθοδολογία που ακολουθήθηκε ήταν η αφηγηματική
στην οποία για δύο θεραπευτές αξιοποιήθηκε επιπρόσθετα η προσέγγιση της
αυτοεθνογραφίας. Χρησιμοποίησα την «αφηγηματική ανάλυση» για την ανάλυση
των δεδομένων. Τα ευρήματα της έρευνας κάλυψαν θέματα που αφορούν το
διαγενεακό τραύμα, «τον πληγωμένο φροντιστή», την ευθύνη των φροντιστών
σε συλλογικές κοινότητες, και τη διάσχιση. Σε αυτό το άρθρο θα συζητήσω τον
ρόλο που διαδραματίζει η διάσχιση όταν υπάρχει μια κοινή ιστορία τραύματος
και τους τρόπους με τους οποίους οι διασχιστικές εκδραματίσεις κατά τη διάρκεια
της συνεδρίας μπορεί να λειτουργήσουν ως μέρος μια αμοιβαίας επούλωσης.
Σε αυτό το άρθρο, περιλαμβάνοντα αποσπάσματα μόνο από μια συνέντευξη με
έναν συμμετέχοντα.

ARTICLE HISTORY  Received 15 January 2017; Accepted 11 September 2017

KEYWORDS  Narrative inquiry; vicarious traumatisation; childhood sexual abuse; dissociation;
autoethnography
HAUPTWÖRTER  narrative Forschung; nachempfundenes Trauma; Kindheits Sexuelles Missbrauch;
Dissoziation; Autoetnographie
PALABRAS CLAVE  encuesta narrativa; traumatización vicaria; abuso sexual en la niñez; disociación;
autoetnografía
PAROLE CHIAVE  Intervista narrativa; Traumatizzazione vicaria; Abuso sessuale infantile; Dissociazione;
Autoetnografia
MOTS-CLÉS  enquête narrative; traumatisme secondaire; abus sexuel dans l’enfance Dissociation; Auto-
ethnographie
ΛΈΞΕΙΣ-ΚΛΕΙΔΙΆ  Αφηγηματική έρευνα; Επανατραυματισμός «από δεύτερο χέρι»; Σεξουαλική
κακοποίηση κατά την παιδική ηλι

Introduction
One of the core components of my study included an autoethnography. I use the
term autoethnography to mean autobiography with an ethnographic dimension
using the following definition:Autoethnography is an autobiographical genre of
writing and research that displays multiple layers of consciousness, connecting
the personal to the cultural. (Ellis & Bochner, 2000, p. 739)
 EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING   347

Consistent with autoethnography, this paper is written in the first person,

in order to encourage the reader to enter and recall the stories emotionally
and cognitively (Ellis & Rawicki, 2013), and to bring the reader closer to my
experience.
In this paper, I will be sharing research I conducted using narrative inquiry.
I have chosen to focus on themes of silence and dissociation, but rather than
share my findings, I believe that the most effective way of making sense through
narrative inquiry is to ‘think about’ the stories (Polkinghorne, 1988) and ‘think
and feel with’ the stories (Frank, 2013). I will draw upon my own autoethnog-
raphy and narrative conversations with another therapist, Anna (anonymised)
who has a personal history of abuse.
In the paper, I will be exploring dissociation from a range of perspectives,
and I will be considering how the defence against shame is a core component
of dissociation. I will also illustrate how working with embodiment can help
both client and therapist to make deeper contact and to be less dissociated in
their process.
Dissociation is a major failure of integration that interferes with and changes
our sense of self and our personality (Boone, Steele, & Van der Haart, 2011). I will
be exploring dissociative process in this paper where a full integration of affect
is not available. A term originally coined by Janet (1907), dissociation is a key
hallmark of trauma, and is now widely recognised as a normal coping mecha-
nism for many survivors of childhood sexual abuse (CSA) (Herman, 1992; Howell,
2013; Van der Kolk, 2015). I noticed that in the process of preparing this paper,
I dissociated a great deal—I went ‘into my head’ to avoid feeling the associated
anxiety—my language regarding subjectivity became muddled—sometimes ‘I’,
sometimes ‘we’ … However in the actual conversations with the therapists who
participated in the research (my participants), I don’t believe I did dissociate.
Could this point towards the importance of the dialogical nature of our work
as therapists and researchers when working with dissociation?

Anna
Anna is a psychotherapist who was molested in a lift by a stranger when she was
an eight-year-old child. As Anna told me her story, she frequently struggled to
find the words, feeling ‘frozen’, something she felt mirrored her primary feeling
when the abuse occurred. There were occasions when she felt thwarted in her
usual eloquence as her sentences became a jumble. I am presenting Anna’s
words in a stanza form to ‘capture the rhythm and poetic quality of the spoken
word that allows the reader to appreciate their narrative structure, meaning
and emotional impact’ (Etherington, 2008, p. 60). Anna told me that what she
remembers is:
348   R. SHAH

The feeling of calm

It happened so quickly
Anybody could have come down
That’s what happened
Somebody was coming downstairs
You know he must have been
Nervous, or anxious,
But in my memory, it lasts a lot longer than …,

And it’s calm,

In my memory it’s calm,
And his voice was authoritative but gentle but didn’t …,
Not rough, not scary in my memory.
So, and that in itself is disturbing,
That there was a gentleness to it
Which, I couldn’t really understand what it was.
So he, um, asked me to do that or made me do that.

And then somebody was coming down the stairs

So he pressed on the button to the next floor
And got out of the lift
And I was left in the lift
And I pressed to the 4th floor.
Anna recognises that she had dissociated and that this dissociation probably
began as she was coming down the stairs to enter the lift with her abuser. When
she came out of her dissociative state and ran to her home in floods of tears,
her mother appropriated the story to mollify Anna:
She explained to me that that there was something wrong with this guy’s mind
that he was a bit crazy, that there was something wrong with him but that what
had happened was that he thought I was pretty and he liked me. And that that’s
why that happened, and I think what she was trying to do, was downplay the
aggression and not make me feel that somebody had wanted to hurt me but I
think that it was a very confusing thing to say.
Anna has struggled ever since to claim this story as her own, and is aware of her
potential to dissociate when with her clients.
Anna told me the first time a client brought her story of her childhood abuse,
Anna ‘froze’. She was stunned at the similarity in their stories: her client was
molested by a man, also in a confined space in a public area.
As the client told her the story, Anna had a slight feeling of being aggressed:
she told me she was aware of thinking,
 EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING   349

This is something big, this is something shocking, it’s something painful, and I’m
in this role, I’m here, stuck in this chair, having to listen to it, and I don’t know
what to do with it.
Anna also realised she had a powerful impulse to make placatory remarks which
strongly echoed her mother’s words in the immediate aftermath of her abuse. As
Anna and her client talked about what might have been going on in the abuser’s
mind, she felt the urge to minimise it as her own mother had. However, she caught
the impulse before a dissociative re-enactment (an unconscious replay of the
original experience between Anna and her mother) ensued, and instead engaged
with her own feelings of stuckness and helplessness. Davies and Frawley (1994)
highlight the potential risk of clinicians, who themselves are survivors, preserving
an identification with their own nonabusive parents who were blind to the abuse
going on before their eyes. In this moment, Anna was able to notice this identifi-
cation within her countertransferential response and try an alternative response.
As she allowed herself to feel ‘done to’, albeit in the less sinister setting of the
therapy room, she was able to access some compassion for her own ‘inner child’:
The adult in me felt compassionate for the little girl in her, and for the adult in her,
and angry on her behalf.
Anna experienced a form of healing through a shared experience with this client,
which hadn’t been available through her own therapy. It seemed particularly
true with this story, as it was such a secret place, one she hadn’t felt able to
process with anyone else.
She was able to say to both her client and herself the words that her mother
hadn’t said:
A terrible thing which should never have happened to a little girl. You were a little
girl and he was an adult.
Anna takes a deep sigh as she tells me of the relief she experienced once she
had said these words, about an experience which had been brushed under the
carpet only days after the event occurred.
Anna’s story shows many layers of dissociation: her struggle to find words in
telling me her story, her frozen stance with her client, and, perhaps her abuser’s
dissociative state (calmness) when he assaulted Anna. The abuse, depicted in
stanza form here, suggests something other-worldly about the experience.
Though Anna had had many years of personal therapy, she had not explored
this part of her experience, struggling to own the reality that she had been a
victim of abuse. Importantly, whilst Anna was drawn to adopting a position of
‘strength’ in comforting her client and dissociating, she chose to allow herself to
feel impacted, both by her client’s story, and by her own sense of helplessness.
Anna’s initial impulse, with her client, to respond as her own mother had, indi-
cates a type of ‘mimicry’ (Howell, 2014) which Ferenczi (1949) believed was a dis-
sociative identification with the aggressor. I believe that the relief Anna describes
is that she is able to re-appropriate her story and say the words that should have
been said, and somehow break the bond with the aggressor within her.
350   R. SHAH

Defence against shame as a barrier to therapists’ engagement with

their own traumatic history
Shame is often considered to be the most insidious and confusing affect when
working with abuse and trauma (DeYoung, 2015; Rothschild, 2000; Tangney &
Dearing, 2011). The pull towards working in the helping professions, may be a
flight away from ourselves and our own vulnerability, accompanied by the fan-
tasy of rescuing the other. In the psychotherapeutic profession, we credentialise
ourselves with our resilience and set ‘unrealistic expectations for ourselves and
each other about professional detachment and “neutrality” [which] can create
a barrier of shame that prevents the honest disclosure of the pain and anxiety
of the work’ (Saakvitne, 2002, p. 446).
Vicarious traumatisation (VT) describes secondary trauma symptoms which
occur through relationship with a survivor of trauma (Pearlman & Mac Ian, 1995).
I wonder if many therapists working with survivors of abuse defend against
their own shame and against the risk of VT, by keeping a safe distance from
their own history, believing this distancing will be at the service of their clients
and themselves.

My autoethnography: Shame and silence

For me, in conjunction with the abuse occurring when my cognition was not fully
developed, I had the added complication of growing up with two languages.
Part of my silence about my abuse was that I was caught between two cultures.
Having been brought up with some internalised colonial racism towards my
language and culture, I was convinced that the ‘me’ that participated in these
illicit night-time encounters was wrapped up in the shame of being Asian, and
therefore definitely not something which could be talked about. Instead, this
part of me, for which I took total responsibility, was split off.
As I researched my own experience autoethnographically, what struck me
powerfully was that even though I have done a great deal of processing of the
abuse, there is still an extraordinary amount of shame that remains lodged in
my body. As I wrote my story, I was burning with shame—somehow unable to
integrate the cognitive understanding that they violated and used me with my
embodied felt sense of being responsible for my sexualised behaviour as a child.
As I reflected on the layers of shame, secrecy, badness and silence, it became
understandable that I needed to dissociate from these parts of my experience, in
order to ‘help’ the other. Yet, it is this very silence which might facilitate ongoing
abuse. Mucci, in highlighting the significance of memory in healing, points to
the destructive power of silence in CSA:
Silence in particular, together with the blurring of boundaries we mentioned in our
discussion of the knowing and not knowing of trauma, is what is going to cause
the transmission of unconscious material from one generation to the other (and
this happens both in massive social trauma and in incest). (Mucci, 2014, p. 37)
 EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING   351

The power of embodiment

One of the most powerful and transformative aspects of my work with my clients
has been to work in an embodied way. The body is the site of our abuse, the
site of our shame, and because of this, for many adult survivors, dissociation
helps us survive. Given that working directly with the body can be extremely
triggering for people who have been abused, my starting point is to work on
how we can regulate the autonomic nervous system. In the following vignette,
I have combined different embodied encounters with clients to share an insight
of how the work affected me:
She was silent and her nose was reddening, always a sign that there was a lot of
upset which she didn’t want to reveal. I gently enquired as to what she was feel-
ing. Looking embarrassed, she admitted that she felt hurt by me: she felt that I’d
attacked her and misunderstood her motives. I felt a knot tightening in my belly – I
was mortified that I’d caused so much pain – we were now both feeling the pain.
She wanted to walk out, or go to one of her dissociative coping mechanisms (have
a large drink). I asked if we could remain and breathe through it.
She heard my breathing slow down, we both placed our feet firmly on the ground,
and as we breathed deeply and allowed the oxygen to nourish us, I felt more
forgiving and compassionate towards the punitive parts of myself and wondered
if she did as well.
She talked of hating her body and wanting to punish it, by abusing it with drugs,
by starving it of nourishment, by stupefying it with alcohol, by picking at it till
the skin was raw.
She saw the anguish in my face at the prospect of her wishing to hurt herself this
way. It felt important to have the capacity to hold her psychologically, to acknowl-
edge how pain can lead to these self-punishing behaviours, and that it can also
deeply impact her therapist who loves her.
Though she didn’t cry, her eyes were moist and she rubbed them incessantly. With
this indication that she was now in a gentler dialogue with her emotions, I felt a
softening inside of me – like a knot was loosening.

Critique
Whilst I have illustrated in this paper how coming closer to our own wounds
when working as survivor-therapists can support the therapeutic process, there
remain strong arguments against this. A number of writers caution that bound-
ary issues remain a greater issue for survivor-therapists (Little & Hamby, 1996;
Maroda, 2010). I believe that these issues are more likely to occur when clinicians
bracket their experience and act unconsciously.
Davies and Frawley (1994) suggest that survivor-therapists may habitually
occupy a particular countertransference position, being locked in a masochistic
role, disavowing their own abusiveness by ‘unconsciously agreeing that those
patients will enact those feelings for them’ (Davies & Frawley, 1994, p. 166). In
this paper, I have illustrated how the enactments where we own our abusive
energy can be healing for our clients.
352   R. SHAH

The risk of VT continues to cast a long shadow over the field. Pearlman
and Mac Ian (1995) study which is most often quoted is contradicted by more
recent studies (Chouliara, Hutchison, & Karatzias, 2009; Jenkins, Mitchell, Baird,
Whitfield, & Meyer, 2011; Van Deusen & Way, 2006) which all concluded that
there was no additional risk of VT for clinicians with a history of CSA. My concern
remains that the belief that survivor-therapists have not worked through their
material fully, contributes to a silencing within the profession.

Methodological and epistemological limitations of this study

It is apparent that the findings of my study are based on a very small-scale
qualitative research project, and a larger study would clearly be of great merit.
I set out briefly below, why I chose narrative inquiry and analysis for this study.
In my view, narrative inquiry is not endeavouring to arrive at an objective
truth: rather through working with the participants and hearing their stories,
my own truth within the autoethnography is enriched. This illuminates a tension
I have felt between providing a platform for the participant’s voice, following
a narrative inquiry approach, and acknowledging that all of the re-storying is
from my perspective, and in many ways, thickens my own story. It could be
argued that the participants’ stories presented here remain concretely within
the frame of autoethnography. Kideckel (1997) writes of autoethnography as
political resistance when describing oppressed communities. In this sense, I am
interested in whether this study might indicate yet another oppressed commu-
nity (the survivor-therapist community), bound together not by geography or
ethnicity but by their personal histories. This small study is an attempt to turn
the tide against the silence of CSA within the therapist community, giving voice
to three people out of ‘the silent millions of people who have never achieved
fame or notoriety’ (Evans, 1999, p. 137).
I am departing from a heuristic perspective where there is an essence to be
arrived at (Moustakas, 1990). I believe that the narratives depicted are ‘recon-
structions of the person’s experiences, remembered and told at a particular point
in their lives, to a particular researcher/audience and for a particular purpose’
(Etherington, 2008, p. 29).
I am also cautious of the interpretive element of research and depart from
Smith’s notion of the double hermeneutic in interpretive phenomenological
analysis(Smith, Flowers, & Larkin, 2009). Rather than prioritising the hermeneutic
significance of the researcher’s interpretation, I believe that starting with the
research conversation itself, there is shared sense-making, as there is within a
therapeutic encounter.

Ethical considerations
Underpinned by the key ethical principles of beneficence, non-maleficence,
autonomy and fidelity (Beauchamp & Childress, 1994; Bond, 2004), I have tried to
 EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING   353

strike a balance between the need to protect my clients’ anonymity (particularly

as they would be considered vulnerable adults), whilst also sharing stories that
are true to my participants’ experiences—and evocative. I chose to write about
my experiences of working with my clients in such a way that whilst the events
themselves are true, the characteristics of my clients have been blended so that
they cannot be easily identified.
The likelihood of my participants sharing stories of their client work was an
ethical consideration. My participants adopted a pseudonym from the outset
so that we would have multiple opportunities to protect their and their clients’
confidentiality. When I sent my participants the first drafts of their stories, we
considered how best to further disguise their identities. As much as I wanted
to add some ethnographic colour to the two accounts, we agreed that to pro-
tect the therapists’ and as a corollary, their clients’ confidentiality, I would keep
location, culture, ethnicity and class specifics out of the narratives.
The fact that my participants are themselves practitioners indicates they have
a strong capacity for self-reflection, and addresses the ethics of working with
potentially retraumatising material; my criteria also required that they are in
ongoing personal therapy. I obtained informed consent from my participants,
but I was also guided by Josselson (2007) in adopting an ethical stance towards
the research, and being mindful of the risks, pitfalls and limitations and not
overly rely on the procedural aspects such as gaining informed consent.
As I had decided to give the narratives prominence in this paper, it would
have felt incongruent if my participants couldn’t be involved in shaping their
own stories. Josselson (2007) suggests that where giving a voice is a primary
imperative, the researcher sees their own role as a collaborator and conduit
and would therefore invite full participation from the participant in writing the
narrative.

Suggestions for future research

As well as larger scale studies, what is apparent from my literature review is that
the nuance of the therapeutic encounters can be missed when considering
themes of dissociation with survivor-therapists working with survivors of CSA,
Further qualitative, narrative studies could help to break the silencing within the
profession. I also believe that studies which have a strong emotional component
facilitate collaborative witnessing which is of particular transformational value
in the field of CSA—a trauma which occurred without witness.

Summary
Unsurprisingly, both Anna and I described feeling a deep level of empathy with
our clients’ experiences. I wonder if our access to these deep wounds in our-
selves, alongside the ability to reflect upon them symbolically, creates a space
for our clients so that we can gently nudge them towards talking about their
354   R. SHAH

experience. The tension that I experience, in my vignette where the client feels
hurt by me, is to ensure that we don’t dissociate from the part of ourselves which
may be aligned with the abuser within us. Because my identification with the
survivor is so strong, it feels painful to think that I might be causing hurt to my
clients. Yet, these enactments are necessary, as they enable the client to feel the
pain of being a victim, but in a safe setting where they can also find a well of
compassion for that child. I distinguish ‘enactment’ here from an unconscious,
unprocessed re-enactment, offering that it is the reflection and sense-making
by both therapist and client that is possible, after an enactment, which can
offer the healing.
Anna struggled with language at times during the research; I believe that
these dissociative moments are part of the ‘field’—and that it is these cracks
which give us a real sense of her story and her work with her clients. In sharing
the narratives of two therapist-survivors, I have tried to illustrate the importance
of therapists or researchers coming towards the horror of the client’s experience,
whilst being in full contact with their own history. Rather than leading to vicari-
ous traumatisation, this deep contact with the clinician’s own history can allow
positive transformation through the facilitation of a deep sense of resonance.

Disclosure statement
No potential conflict of interest was reported by the author.

Notes on contributor
Reena Shah is a lecturer in counselling at the College of Haringey, Enfield and North East
London, and is a tutor in psychotherapy and counselling at the Minster Centre. With a
specialism in working with trauma, the author’s research interests include childhood
sexual abuse, transgenerational trauma, and trauma within communal cultures.

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