10/26/22 (Wed)
Treating Relational Trauma ~ Link
[Infographic] How Trauma Can Affect Adult Relationships ~ Link
Here’s a look at the agenda:
- An Important Issue That Must Be Addressed BEFORE You Can Build Your Client’s Relationship Skills
- How to Help Clients Speak For, Not From, Their Wounded Inner Part
- Two Distinct Types of Relational Trauma (and Specific Approaches for Working with Each)
- How to Effectively Work with Male Clients Who Have Suffered Sexual Abuse
- Why Clients Re-Enact Past Relationships (and How to Help Them Stop the Cycle)
Study Guide: https://www.nicabm.com/sample/trauma20-studyguide/?del=10.23.22StudyGuidetoFree
Notes: (10/26/22)
- 1. How Trauma Can Affect Relationships:
- A. What happens when trauma shuts down our social engagement system?:
- Inability to stay in the present moment. Getting triggered.
- We can start to miss or misinterpret interpersonal cues.
- B. What are the two types of trauma that can impact clients’ relationships?:
- a. Intrusive / Violating
- b. Negligence / Abandonment
- C. What are the 5 domains of human experience Real assesses as he asks about nurturing in childhood?
- a. physical
- b. sexual
- c. intellectual
- d. spiritual
- e. emotional
- D. What are the 3 questions Terry Real asks to move a client into trauma work?
- a. The Process:
- i. Bring your client into their functional adult part.
- ii. Extract the adaptive child part.
- iii. Identify the age of the child.
- b. The 3 Questions:
- i. Who did you do this with?
- ii. Who did it to you?
- iii. Who did you do it to and no one stopped you?
- Love them, Teach them, and Limit them (i.e. your child and adaptive parts).
- E. Draw lines to connect the concepts:
- a. Wounded Child (birth ~ 4 to 6 years old): Pre-verbal / Limbic System.
- b. Adaptive Child: Adaptation to Abuse / Runs the Relationships.
- c. Functional Adult: Pre-frontal Cortex / Within Window of Tolerance.
- 2. The Role of the Therapeutic Relationship:
- A. According to Stephen Porges, what can a therapist do to get a client’s social engagement system back online?
- The therapist has to recognize the power of their presence.
- Help to activate the client’s internal self-observation.
- “Rupture & Repair” ~ let the client express when they feel hurt by the therapist.
- Empower the client to say their feelings towards the therapist. e.g. I feel hurt when you said that ……
- 3. Working With Couples:
- A. Please describe a “parts” approach to working with trauma’s impact on intimate relationships.
- Implicit memory can drive trauma responses and disrupt relationships.
- Help clients become mindful of their past and how it’s triggering their present situation.
- Help clients to start speaking for their part, not from their part.
- e.g. I have a part who feels that you are not listening to me.
- Help clients notice and then separate from their parts.
- Help clients learn to listen from a place of compassion.
- B. Please describe how to use a somatic approach to change the body-to-body communication between couples.
- 4. Reenactment Behaviors
- A. Ruth Lanius described how she helped reframe her client’s reenactment behaviors as strength. How might you do this with a client?
- Let’s see how your reenactment has helped you to survive in the past? e.g. childhood sexual abuse survivors start becoming promiscuous in adulthood.
- It protected you to survive. This part can do anything. It’s a great strength to have this part. It helped you to survive.
- How can we now use its great strength in a more productive way in the present time?
- B. How does Fisher help clients develop more awareness of stuck patterns?
- Help clients realize that their body is choosing past bad patterns.
- “Traumatic attachment”.
- 5. Defensive Adaptations to Trauma:
- A. How might you help a client work through the following stress responses when it’s causing a problem in their relationships?
- a. Freeze:
- Educate both parties about “The Freeze Response” ~ Psychoeducation.
- Educate both parties on how to help the person that freezes to get out of the response. Let both parties collaborate together.
- b. Dissociation:
- Help the dissociation client become more present. Teach the other partner on how they can help to ground the dissociating partner by becoming aware of their 5 senses.
- Encourage the partner to help ground the partner that is dissociating.
- c. Collapse / Submit:
- Bring in psychoeducation for both parties.
- Ask a few direct, practical questions. e.g. Ask how both parties will feel once the dynamic changes within the relationship from therapy, e.g. one patient will no longer please/appease, etc.
- Help both parties mentally prepare for the shift in dynamics of their relationship.
- d. Please / Appease:
- If we can’t express our true feelings, then the relationship can not be a genuine one.
- Please / Appease leads to power imbalances within a relationship.
- Let clients know why it was natural for them to develop the please / appease survival response when they were younger.
- Work with the isolation that shame can induce within your clients.