Ask Billie

“Billie” Klayman,

Working with the Victims of Trauma

Treating patients who have experienced trauma often takes a toll on the therapist. Whether you are a trainee, intern, newly licensed, or a well-seasoned therapist, emotional and physical fatigue is bound to emerge.

When we speak of trauma, usually it is in the frame of a specific event or repeated traumatic events. In addition, I would like to also include historical trauma. I have treated patients that are Native-American, Afro-American, and Japanese. My mother, who is 89 years young, is the child of the Holocaust, and I have witnessed her historical trauma. The perpetual feelings of trauma that their cultures experienced are still prevalent for them in today’s world. And the continued residual effects of their historical trauma can often feel never ending.

How do we manage the heaviness and counter-transference that will show up for us? As a therapist I must acknowledge there is a good chance the weight of the patient’s narrative is going to show up in the therapy session(s). I also need to be present and mindful of my own unconscious material that will show up as counter-transference. That said, what does the therapist do?

No matter where you are in your journey, it is always important that a therapist get good supervision. If you are in a group supervision and are not getting the time you need, ask for individual supervision as well. Make sure the supervisor is well educated and trained in working with trauma victims. Engaging in your own individual therapy when working with trauma patients, I believe, is a must.

I am including the following resources for you to explore. These resources speak to compassion fatigue, burnout, secondary traumatic stress, and vicarious traumatization. All of these articles and the additional readings available have been very helpful to me in my work with patients that have experienced trauma.

Below is a small list of articles for you to read.

Valerie “Billie” Klayman, M.A., LMFT, an integrative Meaning Centered Therapist, became a supervisor at Antioch University Counseling Center in 2014. Billie initiated a partnership between AUCC and the Culver City Senior Center offering pro-bono therapy and group therapy to members of CCSC. December 2016, Culver City hired Billie to help residents of the community at the Culver City Senior Center. She’s presented on Substance Abuse and Addiction. Billie can be reached at