“Common-Fate”: Therapists’ Benefits and Perils in Conducting Child Therapy Following the Shared Traumatic Reality of War

Abstract

In this study we examine the experiences of 70 therapists who treated children identified as suffering from posttraumatic distress following the shared traumatic reality of war (the Second Lebanon War between Israel and Hezbollah). The data are based mainly on qualitative research methods: focus groups, therapy narratives, and “member-checking” interviews, supplemented by quantitative data from questionnaires. Nearly all the therapists reported being affected by the war and half of them reported additional vicarious traumatization resulting from exposure to the children’s experiences. Therapy work with children was experienced as particularly challenging, yet involving high levels of work satisfaction. The perception of an intergenerational and concurrent “common-fate” between the therapists and the children contributed to increased empathy and the forming of an emotionally intense and care-giving relationship with the children. The therapy focused mostly on emphasizing the children’s strengths and building strategies for coping, and provided the therapists with a sense of agency and helpfulness. It also allowed the therapists an opportunity to rework their own traumatic childhood memories that tended to emerge unexpectedly during the sessions. Concurrently, posttraumatic distress experienced by the therapists seemed to present a potential barrier for their therapeutic availability and to lead to a defensive avoidance of the children’s painful memories. Therapists found the work itself, in addition to the use of individual psychotherapy, supervision, and peer-support to be helpful in coping with their primary and secondary traumatic reactions.