Drs. Seritan and Gabbard Reply

To The Editor: We would like to thank Dr. Brenner for his interest in our case conference.

We certainly agree that the impact of the tremendous trauma of being a child survivor of the Holocaust cannot be ameliorated in brief therapy, nor was this claim made in our article. Rather, our case conference depicts one of many possible approaches to the impact of horrific childhood trauma when the therapist is faced with a time-limited treatment. The impetus to write about this extraordinary woman came from deep respect for her experience and resilience and the desire to share her story of survival with others. Contrary to Dr. Brenner’s suggestion, the decision to begin treatment with her was completely unrelated to a wish to write something about her.

The missed opportunity of working through the negative transference in the course of this brief therapy was pointed out in our article (p. 1708). Dr. Gabbard further illustrates how the therapist and the patient partnered in shaping the therapy, with the re-creation of the good mothering experience as the predominant theme in the transference-countertransference dimensions of the treatment.

We share Dr. Brenner’s view that the development of a coherent narrative is a major goal of working with such patients. Although this task was incorporated in the brief therapy reported in our case conference, it was not the centerpiece of Ms. A’s treatment. The main agenda was dealing with loss. As our concluding remarks underline, the patient’s work throughout her therapies has allowed her to remain a strong presence in her family, stay socially active and involved in her community, and continue to grow. Her story of courage and dignity, despite terrible childhood trauma, was our most important message.