Wounded Versus Non-Wounded Healers and Substance Abuse Treatment: Countertransference Considerations

Abstract

In the substance use treatment field, as many as 60-70% of individuals who were formerly substance users, serve as treatment providers, or wounded healers. A wounded healer, or someone who has overcome his/her history of distress, represents the notion that individuals who have faced and overcome adversity may have special sensitivities and skills and a deep empathy and understanding for helping others experiencing the same adversity. However because a wounded healer shares an identity relationship (a conscious or unconscious perception of self) with his/her client, there is also great potential for complex countertransference. Because psychotherapy is a relationship between two people, a therapist and a client, the impact of the therapist and his/her own countertransference experiences cannot be ignored. A therapist is an active participant in a complex transference-countertransference dynamic.

In substance use treatment, the quality of the therapeutic relationship is a significant predictor of positive outcomes. Certain countertransference enactments, however, are related to poorer working alliance. Unfortunately, there is little attention in the literature about the countertransference of wounded versus non-wounded healer clinicians working with substance using clients. This dissertation, utilizing qualitative research methods, sought to uncover whether and how wounded healer status affects countertransference differentially between and within social work pracitioner and nonsocial work practitioner groups. Additionally, social work education, ethics and policy issues related to the findings are discussed.