Psychotherapy for massively traumatized refugees: the therapist variable

In the treatment of severe posttraumatic stress disorder (PTSD), much emphasis is put on techniques, especially behavioral therapies. Such techniques negate the importance of the therapist as an individual in the treatment of complex PTSD as presented in severely traumatized refugees. The specific difficulties encountered by this population and the therapist responses are discussed: the need to tell the trauma story and the therapist's ability to listen; the patient's need for constancy and therapist's ability to stay; the patient's need to give and the therapist's ability to receive; the patient's problem with evil and the therapist's ability to believe. Case examples illustrate the approach and then discuss how generalizable this experience is to other populations. Research implications are suggested.