Many practitioners are applying psychodynamic principles to the work they do, even when treatment doesn't conform to the traditional frame. Cleopatra Victoria, M.A., MFT uses psychodynamic principles in short-term work with trauma victims.

Recently I was asked to provide group and individual sessions, on-site, for a retail establishment whose employees had experienced a holdup at gunpoint. Besides private practice, I do this work frequently, so the request was not unusual. There was one problem. All the employees spoke Spanish and they could not locate a Spanish-speaking therapist on such short notice. I explained that my Spanish was basic, certainly not enough to conduct an intake or session. The intervention seemed critical, so we decided that with the aid of a bilingual employee, I would run the sessions. 

It was with anxiety, fear, and excitement that I hurriedly checked out some basic translation dictionaries from the library to refresh myself (after all, the word for gun, pistola, was never taught in my basic Spanish classes) and drove to the site. We assembled our first group. "Gracias. Es voluntario. Privado. Hablas o no hablas — no necesario." This was my attempt at informed consent. The insurance company had provided a handout on trauma, written in Spanish, which I easily read aloud, and then asked individuals about their "reacción emocional" and "cardíaco rapido"? 

After a while, the employees began speaking rapidly and fluently about their experience of the holdup. I could only comprehend about twenty percent of what was being said. (When I told this to a colleague, he remarked that, even in English, he only understands about twenty percent of what his patients say!) What I did understand, I echoed back — "puerta abierto" (open door), providing a basic amount of mirroring. Later, the catharsis in the room was evident. In this case, holding and containment were everything. And I only had to be a "good enough" therapist — not a perfect one who spoke perfect Spanish. Gracias a Dios! 

Cleopatra Victoria, M.A., MFT

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