First Posted on August 14, 2010 by alisonball

There are no simple solutions in psychotherapy. Strategies that can help the person in any moment of stress may arise but generally they arise almost spontaneously as a product of greater self awareness. These are the strategies that have the most hope of working. People have frequently read all the techniques in books or been given them by previous therapists but, with greater safety and self awareness now they tend to say- “I just found myself acting differently” or perhaps trying something they had long known about. There is much more to in depth work than strategies. So I want to give you some thoughts that throw some light on the psychotherapeutic process from a book I have been reading in this last week- “Wounded By Reality- Understanding and Treating Adult Onset Trauma.” by Ghislaine Boulanger (2007). Myself and the members of our association (The Australian Association of Somatic Psychotherapists) do not necessarily title ourselves “trauma therapists” or what we do as  ”trauma therapy” but in fact, all of our learning means that we are uniquely qualified to carry out such work and bearing in mind the “somatic” is intrinsic to working with traumatised people.

Of course in this book Ghislaine is talking about her work with people traumatised say, by the Twin Towers tragedy in the US. These situations and suffering of the people concerned may be extreme but, in my mind the extremes serve to help us see most clearly the processes that operate with many of the people who come to see us for what seems, on the surface, to be less extreme trauma. Boulanger writes (p.123):”It is our job to contain and detoxify the terror, to make sense of the sensations, fragmented memories, and the overwhelming affect that appear to have incapacitated the thinking process”. And Boulanger quotes Fonagy et al (2002) ( See below* ) in talking about the fact that, with those who have been traumatised, empathy or mirroring their internal state or their emotions is not enough.

My take on what they say is that the therapist must offer a different external mind as a container that has not and will not be destroyed by what, for the traumatised person, is unthinkable and unbearable. Only when both parties are gradually found to be able to survive this process  over and over again can the traumatised person take in to themselves the reality of their own experience. They can then become their own witness to their own personal experience and put that experience into the context of their whole life.

Boulanger goes on to say: “When we approach this work with survivors armed with over determined theories and formulae that explain away traumatic reactions, we are also armed against taking that patient’s experience into ourselves and allowing our minds and ourselves to be temporarily undone. Trying to force meaning on trauma prematurely demeans the survivor’s experience; meaning must emerge from the process, it cannot be imposed.” (p.128). Such a process takes time and a constant trusted relationship- quick fixes do not do it! As Boulanger writes: ” … glimpsing, groping, penetrating and reevaluating the experience is what we must do if we are to construct a new meaning for the patient.” (p. 126)

Boulanger G. (2007) Wounded By Reality- Understanding and Treating Adult Onset Trauma. The Analytic Press London.

*Fonagy et al (2002) Affect Regulation, Mentalization, and the Development of the Self. New York: Other Press.