Table 4 Themes and master themes across cases

Master theme I: P managing interactions with T through self-effacing and submissive behaviours

 (A) P feeling rebuked by T; P non-assertive to avoid verbal abuse; P becoming submissive

 (B) P fearing to fail therapy and upset T; P other-orienting to find ‘correct’ answers

 (C) P feeling violated by T; P contempting T but pretending to participate; P increased self-contempt

 (D) P submitting to T to gain approval

 (E) P attempting to self-assert; P fears hurting T with increased guilt; P withdrawing assertive attempts

 (F) P experiencing T as too forceful; P becoming overwhelmed and passive

Master Theme II: P preferring either closeness or distance to T to be able to open up

 (G) P distancing from T to be able to open up about affect-laden, trauma-related topics

 (H) T self-disclosing; P feeling closeness/blurred professional boundaries; P more interested and opening up

 (I) T providing reciprocity and intonation; P feeling close and trusting; P opening up

Master theme III: P joining T’s verbal, reflective interventions and detaching from T’s experiential techniques during trauma work

 (J) P becoming overwhelmed during associative trauma-related processing; P emotionally unavailable to T

 (K) T and P reflecting on P’s post-trauma responses; P staying with the topic; P increasing understanding of self