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Transference and Counter-Transference Reactions

Clinicians who conduct physical and psychological evaluations should be aware of the potential emotional reactions that evaluations of severe trauma may elicit in the interviewee and interviewer. These emotional reactions are known as transference and countertransference.


Transference refers to the feelings a survivor has towards the clinician that relate to past experiences but which are misunderstood as directed towards the clinician personally. Common transference considerations may include the following:


The clinician’s emotional response to the torture survivor, known as counter-transference, also may affect the psychological evaluation. When listening to individuals speak of their torture, clinicians should expect to have emotional responses themselves. Understanding these personal reactions is crucial because they can have an impact on one’s ability to evaluate and address the physical and psychological consequences of torture. Counter-transference reactions may include:

Most clinicians agree that many countertransference reactions are not merely examples of distortion but are important sources of information about the psychological state of the torture victim. The clinician’s effectiveness can be compromised when counter-transference is acted upon rather than reflected upon. Clinicians engaged in the evaluation and treatment of torture victims are advised to examine counter-transference and obtain supervision and consultation from a colleague, if possible. Individual and group support may aslo help to prevent and/or mitigate secondary traumatisation and/or burn-out reactions that are commonly experienced by clinicians.