Motivations to become psychotherapists: beyond the concept of the wounded healer

Submitted: June 11, 2024
Accepted: August 1, 2024
Published: August 26, 2024
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Motivations to become psychotherapists have long been associated with the concept of the wounded healer, which posits that practitioners entering the field of mental health often do so as a result of their own personal struggles and challenges. Early difficulties and wounds are seen as a source of healers’ capacity to comprehend and promote the processes of recovery, fostering a deeper connection between the healer and the person seeking support. Nevertheless, other factors not directly linked with early adversities have been posited to have an influence on the development of motivations towards pursuing a career in the psychological field. The present work aimed to review available empirical literature on the motivations to become psychotherapists, encompassing the concept of the wounded healer as well as other possible factors shaping practitioners’ career choice. Three main domains of motivations have been addressed within the wounded healer framework: dysfunctional caregiving, negative personal experiences in the family of origin, and other early relational issues. Additionally, two other main domains, namely self-oriented and altruistic motivations, have been identified, and the concept of the healing healer was proposed to underline both the self-oriented healing process that a person may undergo while becoming a therapist, as well as the altruistic attitude in providing healing care towards others. Results were discussed addressing possible links between conscious and unconscious motivations to become therapists as well as in terms of clinical implications for practitioners in the field of clinical psychology.

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Adams, S. A., & Riggs, S. A. (2008). An exploratory study of vicarious trauma among therapist trainees. Training and Education in Professional Psychology, 2(1), 26-34. doi: 10.1037/1931-3918.2.1.26 DOI: https://doi.org/10.1037/1931-3918.2.1.26
Ahmed, N., Barnett, P., Greenburgh, A., Pemovska, T., Stefanidou, T., Lyons, N., ... & Johnson, S. (2023). Mental health in Europe during the COVID-19 pandemic: a systematic review. The Lancet Psychiatry, 10(7), 537-556. doi: 10.1016/S2215-0366(23)00113-X DOI: https://doi.org/10.1016/S2215-0366(23)00113-X
Angermeyer, M. C., Matschinger, H., Carta, M. G., & Schomerus, G. (2014). Changes in the perception of mental illness stigma in Germany over the last two decades. European Psychiatry, 29(6), 390-395. doi: 10.1016/j.eurpsy.2013.10.004 DOI: https://doi.org/10.1016/j.eurpsy.2013.10.004
Barnett, M. (2007). What brings you here? An exploration of the unconscious motivations of those who choose to train and work as psychotherapists and counsellors. Psychodynamic practice, 13(3), 257-274. doi: 10.1080/14753630701455796 DOI: https://doi.org/10.1080/14753630701455796
Barton, H. (2023). Motivations: a study of why some counsellors choose to become counsellors. British Journal of Guidance & Counselling, 1-12. doi: 10.1080/03069885.2022.2142198 DOI: https://doi.org/10.1080/03069885.2022.2142198
Benzi, I. M. A., Carone, N., Parolin, L., Martin-Gagnon, G., Ensink, K., & Fontana, A. (2023). Different epistemic stances for different traumatic experiences: implications for mentalization. Research in Psychotherapy: Psychopathology, Process, and Outcome, 26(3). doi: 10.4081/ripppo.2023.708 DOI: https://doi.org/10.4081/ripppo.2023.708
Campbell, C., Tanzer, M., Saunders, R., Booker, T., Allison, E., Li, E., Nanda, S., Cryer, E., Wang, M., Carvalho, R., Fonagy, P. (2021). Development and validation of a self-report measure of epistemic trust. PLoS ONE, 16(4), e0250264. doi: 10.1371/journal.pone.0250264 DOI: https://doi.org/10.1371/journal.pone.0250264
Colli, A., Tanzilli, A., Dimaggio, G., & Lingiardi, V. (2014). Patient personality and therapist response: An empirical investigation. American Journal of Psychiatry, 171(1), 102-108. doi: 10.1176/appi.ajp.2013.13020224 DOI: https://doi.org/10.1176/appi.ajp.2013.13020224
Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I. A., & Furukawa, T. A. (2021). Psychotherapies for depression: a network meta‐analysis covering efficacy, acceptability and long‐term outcomes of all main treatment types. World Psychiatry, 20(2), 283-293. doi: 10.1002/wps.20860 DOI: https://doi.org/10.1002/wps.20860
Cvetovac, M. E., & Adame, A. L. (2017). The wounded therapist: Understanding the relationship between personal suffering and clinical practice. The Humanistic Psychologist, 45(4), 348. http://dx.doi.org/10.1037/hum0000071 DOI: https://doi.org/10.1037/hum0000071
Del Re, A. C., Flückiger, C., Horvath, A. O., & Wampold, B. E. (2021). Examining therapist effects in the alliance–outcome relationship: A multilevel meta-analysis. Journal of Consulting and Clinical Psychology, 89(5), 371. https://psycnet.apa.org/doi/10.1037/ccp0000637 DOI: https://doi.org/10.1037/ccp0000637
Delgadillo, J., Saxon, D., & Barkham, M. (2018). Associations between therapists’ occupational burnout and their patients’ depression and anxiety treatment outcomes. Depression and anxiety, 35(9), 844-850. doi: 10.1002/da.22766 DOI: https://doi.org/10.1002/da.22766
DiCaccavo, A. (2002). Investigating individuals’ motivations to become counselling psychologists: The influence of early caretaking roles within the family. Psychology and Psychotherapy: Theory, research and practice, 75(4), 463-472. doi: 10.1348/147608302321151943 DOI: https://doi.org/10.1348/147608302321151943
Doran, J. M., Reid Marks, L., Kraha, A., Ameen, E. J., & El-Ghoroury, N. H. (2016). Graduate debt in psychology: A qualitative analysis. Training and Education in Professional Psychology, 10(4), 179-187. https://psycnet.apa.org/doi/10.1037/tep0000132 DOI: https://doi.org/10.1037/tep0000132
Elliott, D. M., & Guy, J. D. (1993). Mental health professionals versus non-mental-health professionals: Childhood trauma and adult functioning. Professional Psychology: Research and Practice, 24(1), 83-90. doi: 10.1037/0735-7028.24.1.83 DOI: https://doi.org/10.1037//0735-7028.24.1.83
Evans-Lacko, S., Corker, E., Williams, P., Henderson, C., & Thornicroft, G. (2014). Effect of the Time to Change anti-stigma campaign on trends in mental-illness-related public stigma among the English population in 2003–13: an analysis of survey data. The Lancet Psychiatry, 1(2), 121-128. doi: 10.1016/S2215-0366(14)70243-3 DOI: https://doi.org/10.1016/S2215-0366(14)70243-3
Farber, S. K. (2016). Celebrating the Wounded Healer Psychotherapist. Taylor & Francis. DOI: https://doi.org/10.4324/9781315683058
Farber, B. A., Manevich, I., Metzger, J., & Saypol, E. (2005). Choosing psychotherapy as a career: Why did we cross that road?. Journal of clinical psychology, 61(8), 1009-1031. DOI: https://doi.org/10.1002/jclp.20174
Fonagy, P., & Campbell, C. (2023). Epistemic trust and mistrust in helping systems. In P. Fonagy & C. Campbell (Eds.), Adaptive Mentalization-Based Integrative Treatment (AMBIT) for people with multiple needs: Applications in practice (p. 61). DOI: https://doi.org/10.1093/med-psych/9780198855910.003.0003
Fussell, F. W., & Bonney, W. C. (1990). A comparative study of childhood experiences of psychotherapists and physicists: Implications for clinical practice. Psychotherapy: Theory, Research, Practice, Training, 27(4), 505. doi: 10.1002/jclp.20174 DOI: https://doi.org/10.1037/0033-3204.27.4.505
Gelso, C. J., & Hayes, J. (2007). Countertransference and the therapist’s inner experience: Perils and possibilities. Routledge. DOI: https://doi.org/10.4324/9780203936979
Gerson, B. (2013). The therapist as a person: Life crises, life choices, life experiences, and their effects on treatment. Routledge.
Gil, E. (1988). Treatment of adult survivors of childhood abuse. Launch Press.
Gilroy, P. J., Carroll, L., & Murra, J. (2001). Does depression affect clinical practice? A survey of women psychotherapists. Women & Therapy, 23(4), 13-30. doi: 10.1300/J015v23n04_02 DOI: https://doi.org/10.1300/J015v23n04_02
Greenberg, D. M., Kolasi, J., Hegsted, C. P., Berkowitz, Y., & Jurist, E. L. (2017). Mentalized affectivity: A new model and assessment of emotion regulation. PloS one, 12(10), e0185264. doi: 10.1371/journal.pone.0185264 DOI: https://doi.org/10.1371/journal.pone.0185264
Guggenbühl-Craig, A. (1971). Power in the Helping Professions. Spring Publications.
Halewood, A., & Tribe, R. (2003). What is the prevalence of narcissistic injury among trainee counselling psychologists?. Psychology and Psychotherapy: Theory, Research and Practice, 76(1), 87-102. doi: 10.1348/14760830260569274 DOI: https://doi.org/10.1348/14760830260569274
Hammer, M. (1972). The theory and practice of psychotherapy with specific disorders. Charles C Thomas.
Heinonen, E., & Nissen-Lie, H. A. (2020). The professional and personal characteristics of effective psychotherapists: A systematic review. Psychotherapy Research, 30(4), 417-432. doi: 10.1080/10503307.2019.1620366 DOI: https://doi.org/10.1080/10503307.2019.1620366
Hill, C. E., Lystrup, A., Kline, K., Gebru, N. M., Birchler, J., Palmer, G., Robinson, J., Um, M., Griffin, S., Lipsky, E., & Pinto-Coelho, K. (2013). Aspiring to become a therapist: Personal strengths and challenges, influences, motivations, and expectations of future psychotherapists. Counselling Psychology Quarterly, 26(3-4), 267-293. doi: 10.1080/09515070.2013.825763 DOI: https://doi.org/10.1080/09515070.2013.825763
Holliday, C., Peacock, F., & Lewoski, C. (2018). Student motivations for undertaking a child and adolescent psychotherapeutic counselling course. British Journal of Guidance & Counselling, 46(6), 647-657. doi: 10.1080/03069885.2017.1309519 DOI: https://doi.org/10.1080/03069885.2017.1309519
Hurşitoglu, O., Findikli, E., Saglam, F., & Doganer, A. (2019). Resident Burnout may be correlated with immature and neurotic ego defenses in a sample from Turkey. Psychiatry and Behavioral Sciences, 9, 69-77. doi: 10.5455/PBS.20181015100722 DOI: https://doi.org/10.5455/PBS.20181015100722
Jung, C. G. (1951). Fundamental Questions of Psychotherapy. Princeton University Press.
Jung, C. G., & Jaffé, A. (1961). Memories, dreams and reflections. New York: Random House, 1963.
Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Self-awareness questions for effective psychotherapists: Helping good psychotherapists become even better. Practice Innovations, 2(4), 163-172. https://psycnet.apa.org/doi/10.1037/pri0000051 DOI: https://doi.org/10.1037/pri0000051
Lingiardi, V. (2018). Diagnosi e destino. Giulio Einaudi editore.
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic Diagnostic Manual: PDM-2. Guilford Publications.
Liotti, M., Spitoni, G. F., Lingiardi, V., Marchetti, A., Speranza, A. M., Valle, A., ... & Giovanardi, G. (2021). Mentalized affectivity in a nutshell: Validation of the Italian version of the Brief-Mentalized Affectivity Scale (B-MAS). Plos one, 16(12), e0260678. doi: 10.1371/journal.pone.0260678 DOI: https://doi.org/10.1371/journal.pone.0260678
Liotti, M., Milesi, A., Spitoni, G. F., Tanzilli, A., Speranza, A. M., Parolin, L., Campbell, C., Fonagy, P., Lingiardi, V., & Giovanardi, G. (2023). Unpacking trust: the Italian validation of the epistemic trust, mistrust, and credulity questionnaire (ETMCQ). PLoS ONE, 18(1), e0280328. doi: 10.1371/journal.pone.0280328 DOI: https://doi.org/10.1371/journal.pone.0280328
Lizarondo, L., Stern, C., Carrier, J., Godfrey, C., Rieger, K., Salmond, S., Apostolo, J., Kirkpatrick, P., & Loveday H. (2020). Chapter 8: Mixed methods systematic reviews. In: Aromataris, E., & Munn, Z. (Eds). JBI Manual for Evidence Synthesis. JBI, 2020. doi: 10.46658/JBIMES-20-09 DOI: https://doi.org/10.46658/JBIRM-19-02
Martin, P. (2010). Celebrating the wounded healer. Counselling Psychology Review, 26(1), 10-19. DOI: https://doi.org/10.53841/bpscpr.2011.26.1.10
McBeath, A. (2019). The motivations of psychotherapists: An in‐depth survey. Counselling and Psychotherapy Research, 19(4), 377-387. doi: 10.1002/capr.12225 DOI: https://doi.org/10.1002/capr.12225
Messina, I., Gelo, O. C., Gullo, S., Sambin, M., Mosconi, A., Fenelli, A., Curto, M., & Orlinsky, D. (2018). Personal background, motivation and interpersonal style of psychotherapy trainees having different theoretical orientations: An Italian contribution to an international collaborative study on psychotherapy training. Counselling and Psychotherapy Research, 18(3), 299-307. doi: 10.1002/capr.12176 DOI: https://doi.org/10.1002/capr.12176
Mihailescu, M., & Neiterman, E. (2019). A scoping review of the literature on the current mental health status of physicians and physicians-in-training in North America. BMC Public Health, 19, 1-8. doi: 10.1186/s12889-019-7661-9 DOI: https://doi.org/10.1186/s12889-019-7661-9
Miller, A. (1979). The drama of the gifted child and the psychoanalyst's narcissistic disturbance. The International Journal of Psycho-analysis, 60(1), 47.
Moore, J., & Jenkins, P. (2012). ‘Coming out’ in therapy? Perceived risks and benefits of self-disclosure of sexual orientation by gay and lesbian therapists to straight clients. Counselling and Psychotherapy Research, 12(4), 308–315. doi: 10.1080/14733145.2012.660973 DOI: https://doi.org/10.1080/14733145.2012.660973
Murphy, R. A., & Halgin, R. P. (1995). Influences on the career choice of psychotherapists. Professional Psychology: Research and Practice, 26(4), 422-426. https://psycnet.apa.org/doi/10.1037/0735-7028.26.4.422 DOI: https://doi.org/10.1037//0735-7028.26.4.422
Newcomb, M., Burton, J., Edwards, N., & Hazelwood, Z. (2015). How Jung’s concept of the wounded healer can guide learning and teaching in social work and human services. Advances in Social Work and Welfare Education, 17(2), 55-69. https://doi/epdf/10.3316/informit.609973077524166
Norcross, J.C., & Connor, K.A. (2005). Psychotherapists entering personal therapy: Their primary reasons and presenting problems. In J.D. Geller, J.C. Norcross & D.E. Orlinsky (Eds.), The psychotherapist’s own psychotherapy: Patient and clinician perspectives (pp. 192–200). Oxford University Press. DOI: https://doi.org/10.1093/med:psych/9780195133943.003.0015
Nouwen, H. J. (1979). The wounded healer: Ministry in contemporary society. Doubleday, New York.
Orlinsky, D. E. (2022). How psychotherapists live: the personal self and private life of professional healers. Routledge. DOI: https://doi.org/10.4324/9781003217572
Orlinsky, D. E., & Rønnestad, M. H. (2005). How therapists develop. A study of therapeutic work and professional growth. American Psychological Association DOI: https://doi.org/10.1037/11157-000
Orlinsky, D. E., Schofield, M. J., Schroder, T., & Kazantzis, N. (2011). Utilization of personal therapy by psychotherapists: A practice‐friendly review and a new study. Journal of clinical psychology, 67(8), 828-842. doi: 10.1002/jclp.20821 DOI: https://doi.org/10.1002/jclp.20821
Pappas, S. (2022). The rise of psychologists. Psychological expertise is in demand everywhere. 2022 Trends Report (Monitor), 53(1), 44. Retrieved from https://www.apa.org/monitor/2022/01/special-rise-psychologists
Popescu, A. L., Dehelean, L., Papava, I., Bredicean, C., Crasovan, D., Hurmuz, M., ... & Barbulescu, A. (2015). Defensive and coping styles for residents in psychiatry. Procedia-Social and Behavioral Sciences, 191, 611-615. doi: 10.1016/j.sbspro.2015.04.440 DOI: https://doi.org/10.1016/j.sbspro.2015.04.440
Racusin, G. R., Abramowitz, S. I., & Winter, W. D. (1981). Becoming a therapist: Family dynamics and career choice. Professional Psychology, 12(2), 271-279. https://psycnet.apa.org/doi/10.1037/0735-7028.12.2.271 DOI: https://doi.org/10.1037//0735-7028.12.2.271
Safi, A., Bents, H., Dinger, U., Ehrenthal, J. C., Ackel-Eisnach, K., Herzog, W., Schauenburg, H., & Nikendei, C. (2017). Psychotherapy training: A comparative qualitative study on motivational factors and personal background of psychodynamic and cognitive behavioural psychotherapy candidates. Journal of Psychotherapy Integration, 27(2), 186-200. https://psycnet.apa.org/doi/10.1037/int0000031 DOI: https://doi.org/10.1037/int0000031
Salston, M., & Figley, C. R. (2003). Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of traumatic stress, 16, 167-174. doi: 10.1023/A:1022899207206 DOI: https://doi.org/10.1023/A:1022899207206
Santomauro, D. F., Herrera, A. M. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., ... & Ferrari, A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet, 398(10312), 1700-1712. doi: 10.1016/S0140-6736(21)02143-7 DOI: https://doi.org/10.1016/S0140-6736(21)02143-7
Schröder, M. (2023). Work Motivation Is Not Generational but Depends on Age and Period. Journal of Business and Psychology, 1-12. doi: 10.1007/s10869-023-09921-8 DOI: https://doi.org/10.1007/s10869-023-09921-8
Sedgwick, D. (2016). The wounded healer: Countertransference from a Jungian perspective. Routledge. DOI: https://doi.org/10.4324/9781315678771
Shafranske, E. P., & Falender, C. A. (2008). Supervision addressing personal factors and countertransference. In C. A. Falender & E. P. Shafranske (Eds.), Casebook for clinical supervision: A competency-based approach (pp. 97–120). American Psychological Association. doi: 10.1037/11792-005 DOI: https://doi.org/10.1037/11792-005
Simionato, G. K., & Simpson, S. (2018). Personal risk factors associated with burnout among psychotherapists: A systematic review of the literature. Journal of clinical psychology, 74(9), 1431-1456. doi: 10.1002/jclp.22615 DOI: https://doi.org/10.1002/jclp.22615
Simionato, G., Simpson, S., & Reid, C. (2019). Burnout as an ethical issue in psychotherapy. Psychotherapy, 56(4), 470-482. https://psycnet.apa.org/doi/10.1037/pst0000261 DOI: https://doi.org/10.1037/pst0000261
Skovholt, T. M., & Rønnestad, M. H. (1992). The evolving professional self: Stages and themes in therapist and counselor development. Wiley
Skowrońska, J. (2018). The psychotherapists’ relation with their own siblings as a factor shaping the therapeutic relation. In M. E. Campbell (Ed.) Siblings (pp. 261-272). Routledge. DOI: https://doi.org/10.4324/9780429480218-20
Sussman, M. B. (1992). A curious calling: Unconscious motivations for practicing psychotherapy. Aronson
Van Hoy, A., & Rzeszutek, M. (2022). Burnout and psychological wellbeing among psychotherapists: a systematic review. Frontiers in Psychology, 13, 928191. doi: 10.3389/fpsyg.2022.928191 DOI: https://doi.org/10.3389/fpsyg.2022.928191
Vostanis, P., & Bell, C. A. (2020). Counselling and psychotherapy post‐COVID‐19. Counselling and psychotherapy research, 20(3), 389-393. doi: 10.1002/capr.12325 DOI: https://doi.org/10.1002/capr.12325
Ward, J., & Winstanley, D. (2005). Coming out at work: Performativity and the recognition and renegotiation of identity. The Sociological Review, 53(3), 447-475. doi: 10.1111/j.1467-954X.2005.00561.x DOI: https://doi.org/10.1111/j.1467-954X.2005.00561.x
Wilcox, M. M., Barbaro-Kukade, L., Pietrantonio, K. R., Franks, D. N., & Davis, B. L. (2021). It takes money to make money: Inequity in psychology graduate student borrowing and financial stressors. Training and Education in Professional Psychology, 15(1), 2-17. https://psycnet.apa.org/doi/10.1037/tep0000294 DOI: https://doi.org/10.1037/tep0000294
Zerubavel, N., & Wright, M. O. D. (2012). The dilemma of the wounded healer. Psychotherapy, 49(4), 482-491. https://psycnet.apa.org/doi/10.1037/a0027824 DOI: https://doi.org/10.1037/a0027824

How to Cite

Cruciani, G., Liotti, M., & Lingiardi, V. (2024). Motivations to become psychotherapists: beyond the concept of the <i>wounded healer</i>. Research in Psychotherapy: Psychopathology, Process and Outcome, 27(2). https://doi.org/10.4081/ripppo.2024.808