PTSD Transference in Therapy: How the Wounded Knowingly or Unknowingly Wound Others

traumatised woman

The headline is usually about the behavior itself. A father who flies into rage at minor things. A spouse who constantly accuses their partner of being untrustworthy, despite no evidence. A person who keeps finding themselves in abusive relationships over and over. The natural assumption is that these are choices, that people are deliberately hurting others or making bad decisions.

But look deeper and you’ll find something far more complicated. These patterns rarely stem from conscious intent to cause harm. Instead, they come from the unconscious mind, trying desperately to resolve something that was never fully processed, to gain control over something that once left them powerless, to protect against dangers that may no longer exist. The person caught in these patterns often feels just as confused by their own behavior as everyone around them.

This reaction is the reality of trauma reenactment and projection. People who have been traumatized don’t typically wake up and decide to inflict their pain on others, especially those intent on trying to help them. Instead, they’re caught in an unconscious psychological Groundhog Day that compels them to repeat, oftentimes angry, violent, and manipulative patterns. Comprehending these mechanisms is vital, not to excuse harmful behavior, but to address it at its source rather than just reacting to surface symptoms.

The Drive to Repeat What Hurt Us

One of the strangest things about human psychology is our tendency to recreate the very experiences that damaged us in the first place. Sigmund Freud called this repetition compulsion, and it remains one of the most perplexing aspects of trauma recovery.

Here’s how it works. Someone who was abandoned repeatedly as a child might find themselves, as an adult, behaving in ways that push partners away. They’re not doing this because they want to be abandoned again. The unconscious mind is actually trying to master the original trauma by creating a scenario where it can “do it differently this time” and get a better outcome. The problem is that this rarely happens. Instead, they end up repeating the same emotional experience with different people in different circumstances.

The brain is essentially trying to rewrite history. On an unconscious level, there’s a driven belief that if the situation can be recreated, this time it will turn out differently. This time, the person will be strong enough, smart enough, or prepared enough to prevent the bad outcome. This is what researchers mean when they talk about the perpetual illusion of “achieving mastery” over trauma.

But mastery through reenactment doesn’t actually work. Studies have found that people who rely on this mechanism tend to lead traumatized lives, repeating the same painful patterns in different contexts. The reenactment itself becomes another trauma that needs to be processed, creating a cycle that can persist for decades.

What makes this particularly troubling is that the person in the middle of it often has no conscious awareness of what they’re doing. They don’t see that their behavior is recreating the dynamics of an earlier trauma. They know they keep ending up in the same bad situations and can’t understand why. They blame bad luck, other people, or circumstances beyond their control, never realizing they’re following a script written years or decades ago by experiences they may not even fully remember.

Trauma can lead to long-term changes in how the brain responds to stress. When someone who’s been traumatized faces a new stressful situation, their brain can experience it as a return of the original trauma rather than as a distinct event.

This illustrates why someone might repeatedly return to an abusive partner or be the architect of toxic workplace dynamics in a new job. The pattern is predictable, and at an unconscious level, predictability feels like control. And absolute control, somehow, is safe.

grieving-man

Projecting the Past Onto the Present

Projection works differently but causes just as much damage in relationships. This is when someone unconsciously attributes their own unacceptable feelings, thoughts, or impulses to harm another person. In trauma survivors, projection often involves seeing the characteristics of past abusers in new, innocent people.

Here’s what this looks like in practice. Someone who was severely criticized as a child may, as an adult, interpret any feedback as harsh judgment even when it’s offered gently and constructively. They project their own harsh internal critic onto others, believing that everyone is judging them as harshly as they judge themselves.

Or consider someone who experienced betrayal in a past relationship. The sufferer interprets innocent behaviors as threatening. A partner coming home late from work becomes evidence of cheating. A forgotten phone call becomes proof of abandonment. The person is reacting not to what’s actually happening in the present but to what happened in the past.

Projection serves a specific psychological function. It temporarily relieves the person from having to acknowledge their own difficult emotions. If you’re struggling with anger but can’t accept that about yourself, you might project that anger onto your partner and accuse them of being angry. This trigger shifts the uncomfortable feeling outward, making it someone else’s problem instead of yours.

The person doing the projecting genuinely believes that others are doing or feeling these things. The projection happens at an unconscious level. They sincerely perceive the threat, judgment, or hostility they’re attributing to others, even though it originates from within themselves.

Studies have found that people with PTSD who rely heavily on immature defenses like projection tend to have worse outcomes overall. They experience more psychological distress, more difficulty in relationships, and are more likely to develop additional mental health problems.

The Altered Threat Detector

Trauma fundamentally changes how the brain assesses safety and danger. The amygdala, which serves as the brain’s threat detection system, becomes overactive. It starts seeing threats, and thus, opportunities to punish, compulsively and irresistibly, to stop. The state of persistent hyperarousal is what drives many of the personal and professional problems that trauma survivors experience.

In relationships and trauma work, this manifests as severe irritability and unprovoked anger. Partners, family members, and mental health professionals often describe feeling like they’re walking on eggshells. They never know what will trigger an explosive reaction. A question asked that’s too hard to answer honestly. These ordinary interactions can set off disproportionate responses because the traumatized person’s brain is interpreting them as threats.

The person in the middle of this often feels terrible about their reactions afterward. They recognize that their coworker wasn’t attacking them by asking for a status update. But in the moment, the physiological response takes over. The amygdala hijacks rational thinking, and the person reacts from a place of perceived danger rather than actual circumstances.

The Control Paradox in Healing

All of these patterns share a common thread. They’re attempts to regain control over experiences that once left someone feeling mortally powerless. This juncture is where things get particularly complicated in treatment settings.

Trauma, by definition, involves a situation in which external and internal resources are inadequate to cope with a threat. The person was overwhelmed. Helpless. Unable to protect themselves. That experience of powerlessness can be as damaging as the actual traumatic event itself.

So it makes perfect sense that trauma survivors would develop strong needs to control their environment and their experiences. Control feels like safety. If they can predict and manage every variable, they may be able to prevent bad things from happening again. The need for control becomes woven into how they approach everything, including their own recovery.

It’s where I see the pattern play out repeatedly with clients in the Sleep Recovery program. The deep brain anxiety protocol requires something that feels alien to many trauma survivors. It requires surrender. Not surrender in the sense of giving up, but surrender in the sense of letting go of the need to micromanage every aspect of the process and allowing something to work on their nervous system at a level they can’t consciously control.

For someone whose survival has depended on maintaining tight control, this feels unacceptable. The entire system is built around the belief that control equals safety and letting go equals danger. Being asked to surrender to a process, to trust that something can help without dictating every moment of it, triggers every defense mechanism they’ve built up.

This is about the time when you see the resistance emerge in all its forms. Some clients lash out verbally. Others will outright try to destroy the practitioner publicly. They become angry, critical of the process, hypercritical of the practitioner, and find fault with every aspect of the program. It’s the “fight” response showing up in treatment. Their nervous system perceives the invitation to surrender as a threat, and they attack to regain a sense of control.

Others use manipulation. They present themselves as compliant while secretly sabotaging. They might go through the motions during sessions while internally resisting the entire time. They maintain the illusion of participation because they know that’s what’s expected, but they never actually allow the process to work.

A prevalent pattern involves clients who appear to improve, but primarily for someone else’s benefit. A spouse gave them an ultimatum, and they’re going to show improvement to get the spouse off their back. But it’s surface-level. They report feeling better. They say the right things. Then mysteriously, everything gets worse again. The anxiety surges return. Sleep becomes terrible. And they have a ready explanation: “The program’s not working anymore.”

In most cases, these clients genuinely may not realize what they’re doing. The part of them that survived trauma by maintaining control is stronger than the part that wants to heal. So they sabotage their own recovery while believing it’s the treatment that’s failing.

The complaints often have a factitious quality. “The anxiety is so bad, I can’t sleep again.” But when you dig into what’s actually happening, the pattern becomes clear. The symptoms mysteriously worsen right when real progress was about to happen, right when the nervous system was beginning to relax its guard, right when surrender was becoming a real possibility.

It’s the crux of the paradox. The thing that helps them heal is the thing their system struggles to resist. Letting go of control, allowing vulnerability, and trusting a process. These are the very things that trauma taught them were dangerous.

recovery insomnia

Why This Matters More Than Intent

It’s essential to be clear about something. Understanding these mechanisms is not the same as excusing harmful behavior. A person can be both a trauma survivor and accountable for their actions. The two aren’t mutually exclusive.

But understanding what’s driving the behavior matters enormously for how we address it. If we focus on surface actions without recognizing the underlying mechanisms, we end up treating symptoms rather than causes. We might get temporary compliance or behavior modification, but we don’t get actual healing.

Someone caught in repetition compulsion needs to see the pattern. The client needs to recognize how they’re unconsciously recreating dynamics from earlier traumas. Then they need to build new neural pathways, new ways of relating to others that aren’t based on those old scripts.

Talk therapy alone often isn’t enough. The person’s amygdala has been conditioned to respond to specific cues with a full threat response. That conditioning needs to be processed, which is where approaches like brainwave entrainment, somatic therapy, and other body-based interventions come in.

And the control issues that lead to treatment resistance need to be understood as protective mechanisms. When a client sabotages their own recovery, the question isn’t “Why are they being difficult?” The question is, “What is this part of them protecting?” Usually, it’s protecting against the vulnerability that healing requires. It’s protecting against the possibility of disappointment if treatment doesn’t work. It’s defending against the terrifying prospect of actually feeling safe, because safety is an unfamiliar state that the nervous system doesn’t trust.

But here’s where the resistance often becomes most visible. The invitation to allow this kind of deep nervous system work requires exactly what trauma survivors struggle with most. Trust. Surrender. Vulnerability. The willingness to not control every aspect of the process.

Some people can eventually access the willingness necessary. They reach a point where the cost of staying in their familiar patterns outweighs their fear of change. They take the risk of letting go, and when they do, fundamental transformation becomes not only possible, but probable. Their sleep improves. Their anxiety decreases. Their relationships become more stable. The patterns that have been running their life start to shift.

Others can’t get there. The protective part is too strong. It will sabotage recovery over and over rather than allow the vulnerability that healing requires. These are often the people who go from one treatment to another, always finding reasons why nothing works. The real issue isn’t that the treatments don’t work. It’s that they can’t let the treatments work because doing so would require surrendering control, which their system won’t allow.

This doesn’t mean these people are hopeless. It means they need a different approach, one that works more gradually with their defenses rather than trying to bypass them. It means building safety slowly over time until surrender becomes possible. It means respecting that the resistance is there for a reason, even as we work to help the person move beyond it.

The Practitioner’s Purpose

For those of us who work with trauma survivors, these patterns show up constantly. We see clients who would benefit enormously from treatment if they could just let themselves engage with it entirely. We watch people sabotage their own recovery in ways that seem almost willful. We experience the frustration of working harder than the client appears willing to work for their own healing.

The temptation is to see this as the client’s fault. They’re not really committed. They don’t actually want to get better. They’re wasting our time and their own. But this perspective misses what’s actually happening.

When a client lashes out verbally before, during, and after sessions, they’re not attacking us personally. They’re reacting to the perceived threat that vulnerability represents. When they manipulate or pretend to improve, they’re trying to maintain control in the only way they know how. When they sabotage their progress with factitious complaints, their protective part has decided that the risk of actual healing is too significant.

Our job isn’t to take this personally or to battle with their defenses. Our job is to understand what these defenses are protecting and to create conditions in which it is safe to lower them gradually. This understanding requires patience. And all healers can and will lose patience on occasion. This false belief that practitioners don’t possess human emotions is ridiculous at best, and syphilitic at worst.

The work of trauma recovery isn’t linear. People make progress, then regress. They let their guard down, then retreat into old patterns. They take steps toward healing, then sabotage their own progress out of fear. It’s normal. It’s just part of the process. The question isn’t whether these healings will happen ideally, or whether we, client and practitioner alike, will find the common ground needed to find freedom from this horrific condition.