Together beyond trauma

Transcription

1 Together beyond trauma - notes - We say someone has suffered a trauma if it has been through a shock, through a traumatic event that shakes the person's psychic system. For example, the person suffers a serious accident or receives the news that they suffer from an incurable, fatal illness. We can also talk of a trauma in the case of several events that can not be considered traumatic but when they are cumulative, can lead to the same result: the collapse of the psychic system, the defense mechanisms of the person are defeated and there is a sense of being overwhelmed. Examples: Repeated physical abuse from childhood, chronic illness, war situations. A traumatic event affects the person's ability to integrate, and this is why he or she will experience partial or total loss of the event memories, and unconscious acting out of the traumatic scene. The most common defense mechanisms used by a traumatized person are denial and dissociation. In a psychotherapeutic process, the therapeutic relationship has the role of accessing and integrating traumatic experience at the cognitive and affective level and creating a coherent story. In my practice, I found that the following three phases are necessary: 1. Establishing an affective bridge. At this stage the attitude of the therapist is very important and must take into account: a. The client need to be validated, to be believed: sometimes denial as a defensive mechanism is projected onto the therapist and any mistrust expressed or just suggested may be a confirmation that the trauma has not occurred or that it was not all that serious and significant. b. Creating continuity - for example by forming links with the past session or with the beginning of the session - can help "melting" dissociation as a defensive mechanism that prevents access to traumatic experience. Sometimes, the therapist needs to become a live speech recorder for therapy so that the feeling of unity and continuity develops. c. Emotional connection - the client will not feel alone and disoriented. 1

2 d. The therapist's empathy invites the client to understand himself or herself with more openness. e. Active involvement of the therapist. 2. Access and integration of the traumatic experience. At this stage, the client comes out of denial enough to allow the emotional awareness of the abusive experience and its consequences, but so as the level of intensity of the traumatic experience does not trigger dissociation. Very important in this stage is maintaining the relationship between the therapist and the client. 3. Understanding and using the transference. At this stage we can identify and use for therapeutical purposes the following types of transfer: a. good fairy or the idealized parent good child. This type of transfer usually occurs at the beginning of therapy and is characterized by a strong idealization of the therapist. It is important for the therapist to accept idealization because it creates growth and development space for the client and is also necessary for the process of identifying trauma. In the same time, it is desirable that the therapist does not try "hard" to be ideal. As soon as this type of transfer is ending and it is interpreted, the client will face the lost of hope of being magically saved in the present and tolerate the pain of not having been saved in the past. b. abuser - abused is a replay of the stage of trauma and is manifested by subjective feelings of being abused by both the client and the therapist and the recognition of the pattern that occurred during or as a result of the traumatic experience. Even telling traumatic events can lead to the feeling of being abused. c. the uninvolved parent the empty child. This type of transfer can be noticed when the client is disconnected from his or her body or in the relation with the therapist. The therapist may seem uninterested, too busy and generally unavailable. These stages are not completely separate, they overlap or can be reversed, and the therapist-client couple passes through these phases in a proper, non-linear manner, and can return to any one of them at any time. The healing of the traumatized person is characterized by unlocking the moment of maximum insecurity to be experienced in a different way and the transition from action to reflection. We will notice that the person will produce new self-reported narrative, including a 2

3 new coherent narrative of trauma. The healed person will have an increased ability to integrate by placing trauma in the personal past, testing reality, informing and updating life principles, and being in touch with one's own emotions and feelings. Case example. I will shortly present a case where I used a relational approach and I was able to differentiate and work with four types of transference patterns: 3

4 - the abuser in relation to traumatized and scared child: in the beginning of the therapy she was very frightened: she had many periods of time when she would be silent or she would tell about her solved problems in the past. She would want to come closer to me and she was too scared to do that also. My attitude was to stay available for her whether she would want to come closer to me or not. The client told me about the traumatic event after two years in psychotherapy and only then we could understand and interpret together the transferential pattern. - the aunt that loved her very much in relation with the good child: in the beginning of the psychotherapy, my client cosidered me the ideal therapist and everything I d do was perfect in her view. I accepted the transference, interpreting that as expressing the unmet needs from the past and because it creates growth and development space for the client (Hargarden & Sills, 2002). - bad mother, that neglected her, in relation with the angry child: inevitably, I failed to meet her needs all the time: working in a group setting, I was paying attention to somebody else while she was silently needy; she was angry with me for this, but only told me after several moths about her feelings towards me. We made the link with an old scene; I facilitated the expression of her experience of guilt and shame as I admitted I have my own limits. - the uninvolved father in relation with the empty child: I think that this pattern of transference occurred when we had long pauses in therapy. As Bromberg (2001) writes, we do not treat patients to cure them of something that was done to them in the past, rather we are trying to cure them of what they still do to themselves and to others in order to cope with what was done to them in the past. (p. 237) References Bromberg, P. M. (2001). Standing in the spaces: Essays on clinical process, trauma and dissociation. Hillsdale, NJ: The Analytic Press. Cornell, W.F., Olio, K. X. (1992) Consequences of Childhood Bodily Abuse: A Clinical Model for Affective Interventions, Transactional Analysis Journal, Vol. 22, No. 3, pp Hargarden, H., Sills, C., (2002) Transactional Analysis: A Relational Perspective Brunner-Routledge, Hove and New York; 4

5 Stuthridge, J. (2006) Inside Out: A Transactional Analysis Model of Trauma, Transactional Analysis Journal, Vol. 36, No.4, pp