Psychoanalytic psychotherapy with migrant war victims: transference and countertransference issues

This report raises questions about the relevance of the psychoanalytic theory and method with migrant war victims, and addresses the issue of personal limits of the psychotherapist who treats these often very ill patients. A clinical vignette and its psychoanalytic understanding introduce the question of transference and counter- transference in the therapeutic work with traumatized war victims. Psychological treatment of war victims is a very important issue. On the one hand, patients who have been tortured or otherwise traumatized are often considered to be reluctant to accept psychological help, even if they are severely disturbed. On the other hand, the psychotherapists who agree to work with such patients must be prepared to face very specific difficulties. Psychoanalytic psychotherapy may be very efficient in treating war victims, but requires not only motivated but, above all, well-trained therapists. Otherwise, the therapist may become the next victim of the patient's trauma and, for his or her own sake, work towards immediate repression instead of working through the traumatic event ending up in the repetition compulsion.