Doing Psychotherapy by Robin Shapiro

Author:Robin Shapiro
Language: eng
Format: epub
Tags: Epub3
Publisher: W. W. Norton & Company

Treating Complex Trauma

When the trauma or the attachment snafu occurs early and often—or later, but on and on for years—people’s brains lay down wide neural highways of reaction to the subsequent, overwhelming emotions. When triggered by current situations or emotions, clients reflexively shift into their earlier trauma-time states or into their later coping ones. What might you see?

• Spacing out. What do you do? Gently say, “Come back. Connect right here and now with me. You and I will hold that feeling together” and “What was that feeling you had right before you went away?” or “Feel inside for the feeling that sent you away.”

• Needy young parts. “Let’s get that adult you (the ANP) back in the room to help hold these little ones who really need a loving adult around. I’ll coach you on the best ways to hold them. And if you don’t want to hold them, let’s put them in the healing place we imagined with the best caregiver we can imagine. This caregiver will hold them, play with them, feed them, and guard them every moment that you are awake, and every moment that you are asleep. As these kid parts of you are responded to every moment, they will start to know that they are loveable, loved, safe, and adorable — exactly what we wish they could have learned the first time around.”

• Angry, defensive parts who don’t want to have anything to do with this stupid therapy that’s bringing up the terrible feelings. “Notice I’m right here with you and your anger. It makes sense that you don’t want to feel this stuff. Who would? I’m right here to help you build up your feeling muscles to hold this stuff and then get rid of it, forever. For right now, feel the anger and feel the old stuff and the big feelings that set them off.”

• Totally dissociated parts (DID/tertiary dissociation). When the client turns to you on the fifth session and says, “Who are you?” and “Where is this?” (and they’re not demented), the client has reached the “Oh, s—t!” moment of therapy, which also means your client most likely has dissociative identity disorder. If this happens, you need to (re)introduce yourself and your function briefly, find out who and what age the presenting part of your client is, tell them that you will definitely talk to them later, and then tell them, authoritatively, “At the count of three, I will snap my fingers and the part of you that came into the room at the beginning of the session will reappear. 1, 2, 3, [snap!]” And when the part of the client you know reappears, ask “Do you know what just happened?” They often don’t, and then you’re both off on a new therapeutic path.

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