Countertransference in the care of refugees

Contratransferencia en la atención a refugiados

Dutch organisations, dealing with refugees and war victims, started a course ten years ago to help professionals deal with the effect of the trauma-stories of their clients. During the course, actors play the role of the refugee or war-victim. The participants have to do an intake with the so-called clients while the rest of the group observes the play. The course is based on the work of Wilson and Lindy, Daniëli and McCann and Pearlman.

The aim of the course is to prevent burnout in professionals. During the ten year period, the course has been improved. Still the main theme is the impact of trauma. For many professionals, the caseload consists of clients who come from abroad, so it is thought that culture/race differences also play an important role in the counter transference-reactions.

In this presentation, ideas will be given and the impact of cultural differences discussed, as an addition to the counter transference debate in the care for refugees. A case study of an African client will be presented. Several models of counter transference will be applied to this case.

The client has a history of several psychiatric admissions and withdraws more and more from reality. He sticks fanatically to his religious beliefs, trying to overcome his cultural bereavement. Most important factors which provoke reactions and counter-reactions are:

• the traumatic experiences of the client
• the cultural and colour differences between professional and client
• the impact of the treatment on the asylum procedure

As will be described, refugees challenge the beliefs and values of Western professionals. During the presentation an active cooperation of the audience will be requested to share their experiences and views on the relation between cultural differences and counter transference.