Those who work with traumatized people have found that these clients need to reconnect to their own inner worlds. In these cases, clients are often frozen or, depending on the depth of the trauma and the immediate response to that trauma, have an outward, hypervigilant fight-or-flight approach to their experiences.
Cases of problematic attachment are based on this type of fight or flight response, regardless of whether it is due to a large T-trauma (ie a catastrophic accident or abuse) or a small T-trauma (ie multiple experiences of neglect or abuse ) is based. . As a result, these customers are unable to securely bond with others.
Building security through action-oriented coordination
In cases of attachment problems, the first task in counseling is to increase reassurance through a focus on empathic, concerted responses related to the client's primary learning path (see David Mars and the Center for Transformative Therapy for more information Training center).
In a chapter entitled “The creative connection: A holistic expressive art process” in the book Basics of Expression Art Therapy (1999), Natalie Rogers defined empathy as “the perception of the world through the eyes, ears and the heart of the other person. "She noted that this understanding is conveyed through our words as well as through our body language:" Body language, although normally given and received unconsciously, provides a feeling of security and comfort. "As we were using this opportunity for empathic co- Offer regulation, we also pursue well-founded approaches to get back to safety if the fear is too high.
In addition to sound approaches, it is often useful to initiate action-based responses that are shared by the advisor to encourage collaboration and coordination. These can range from very simple to complex.
The following is offered as an example:
Expressive art: Both the client and the advisor respond to a piece of music with lines and colors. Then each person can respond to the other person's artwork through lines and colors. Note that there is no interpretation of the art experience, just sharing a visual response to music and sharing the experience of that response.
Breathing work: In addition to the client, the counselor can model and practice basic and simple breathing work in order to facilitate the client's access to more inner peace and space.
Role-playing games: Participation in simple role-playing games can offer alternative action-based responses to challenging interpersonal situations
The choice of action-based approaches depends on the needs and inclinations of the client, but these approaches all serve to convey empathy and expand interpersonal resonance. As Allan Schore (2013), a neuroscientist who has studied brain activity during attachment experiences, would describe these approaches create opportunities for communication between the right hemisphere and the right brain (the basis for attachment experiences).
As the client and counselor create along with these practices, the client builds a repertoire of action-based responses. The client can then begin to trigger some of these action-based responses when triggered by a memory of a traumatic event. This increases the customer's feeling of internal security.
Build resistance by breaking and repairing attachments
Once security is developed along with basic attunement and the ability to choose constructive action, there is an opportunity to build a more robust and mature bond through the counseling relationship. This can be achieved through a process of intentionally and unintentionally breaking and repairing this bondage developed in counseling.
In her book chapter "Dyadic Regulation and Experience Work with Emotions and Kinship in Trauma and Unorganized Attachment" (originally published in Healing Trauma: Attachment, Trauma, Brain and Mind, 2003) Diana Fosha articulated the way in which counselors can help begin to take great care to interpret and confront the expectation that this can lead to temporary breaks in empathy. This empathy can be carefully repaired and restored in the session through the articulation of the feeling and the expression of understanding. A hypothetical example:
Counselor: "I wonder if you went back to your medical books with such great zeal last week because your partner asked for more intimacy and that is scary for you."
This confrontation can be experienced as a temporary interruption of empathy. However, if the counselor and client can sense and articulate the client's immediate experience during this break, this can lead to a deeper understanding of that experience. This deeper understanding can lead to a more mature connection and possibly the experience of a return to empathic attunement. These experiences can be internalized again and again, which leads to a more empathic connection with the client's inner self.
Client: “When you say this, you get the feeling that you are trying to get me to go through things that I don't want to go through after my last terrible relationship. You don't really care about me. … You just want to see how I move on. "
Counselor: "I hear you say that my view of using your studies to keep your distance feels like I'm pushing you, and it feels like I don't understand how scary that is. Do I have the right? "
Customer: "Yes, that's right. You don't really understand how scary it is."
Counselor: "Can you tell me more about how scary it is?"
The repair may not be immediate, but careful listening, commitment, and articulation can make feelings of fear and vulnerability more accessible. This experience makes repairing empathic breaks (intentionally and unintentionally) caused in a mature relationship inevitable. As Fosha explained, the experience of repair in the context of confrontation and deeper understanding provides evidence that differences or misunderstandings can ultimately lead to a deeper connection.
This experience can lay the foundation for a greater capacity and patience for real connections as well as for greater internalized empathy. As a result, the client experiences more breaks and the relational commitment necessary for the repair.
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Building self-regulation through emotional flexibility
In addition to internalized empathy, resilience to breakages and repairs also creates a sense of security – the security of living close to emotions and working on translating vague feelings into words. This requires developing a sense of "unconditional kindness," as John Welwood described it (Towards a Psychology of Awakening), towards the emotions that arise during the rupture and repair. As consultants, we model this friendliness towards emotions when they come, both during voting periods and during experiences of rupture.
When clients have more experience with naming feelings in simple and difficult interpersonal situations, this promotes greater self-reflection. With practice, this results in a "self" system that can modulate a range of affects with emotions that can be incorporated into adaptive responses.
Schore noted in Affect Regulation and the Repair of Self (2003) that through this process of self-regulation, the client “develops the ability to flexibly regulate emotional states through interactions with other people”. This increased flexibility in expressing emotions allows the client to productively practice emotional regulation in the real world.
Building authority through help for others
It is very useful for customers to see themselves not only as someone who is being helped, but also as someone who is helping others. George Vaillant reminds us that indulging in our clients' understandable desire for “mother” or “father” is not as helpful as it is for them to develop and strengthen their own “parenting” capacities with others internalize.
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Clients who have been repeatedly traumatized are often frozen in the role of "helper", but through their help they develop an active response to others, often in the face of anxiety. Acting in the face of triggered fear creates new neural pathways for responses to triggering events (as described in "A Call to Action" Overcoming Fear Through Active Coping "by Joseph LeDoux and Jack Gorman).
When clients listen to others and develop adaptive responses to others, they also practice emotional flexibility and regulation. It is wonderful to practice developing self-esteem with an empathetic counselor. It can be even more rewarding to practice these skills with someone who may not have that much to give and who challenges and expands our adaptive responses – within the realm of reason. Early entry into the community as a helper and participant is often best done in a supportive environment such as a peer support group or a well-structured community initiative or learning environment.
Help and prosocial behavior promote trust in help. Ervin Staub cites several studies that show that children and adults become more helpful once they start helping. This increased comfort in helping is generally received positively in peer milieus, and the helping person feels a sense of appreciation – and, if all goes well, a feeling of community.
We propose that the ability to practice responding in helpful, emotionally regulated ways in the real world is as important as counseling on the path to mature bonding.
Four examples of help options
The following are four brief examples of milieu attitudes that provide an opportunity to help and observe others and to articulate feelings that develop during participation.
Example 1: Roots of empathy
Schools in Canada and New Zealand have developed a program for young children called Roots of Empathy. In this program, a group of children is selected to have a parent-baby dyad in their room each month. Before each visit, the class prepares for the new developmental stage of the baby and dyad. At each visit, children are encouraged to observe closely how the baby communicates, almost always with an open curiosity about their surroundings, and how the parents read their baby's needs.
After the visit, the children take part in discussions, works of art, dramas and diary writing about what they have learned. The natural generosity of children is expressed when they use art, music and drama to give gifts to babies and parents. Visits continue once a month throughout the year.
In this context difficult questions arise like: "What if you were a tyrant one day?" and "If no one has really loved you, can you still be a good father?" When the children discuss observations of the parent-child dyad, they gain insight into their own feelings and those of others, which leads to greater empathy.
David was 9 years old and had some form of autism. His parents told the program director that until the year Roots of Empathy came into his classroom, David hadn't been invited to a birthday party by any of his classmates. This year he was invited to three birthday parties. (For more information, see Roots of Compassion: Changing the World from Child to Child by Mary Gordon.)
Example 2: The project courage and moral choice
One program that focuses on developing empathy for older teens is the Courage and Moral Choice Project, which was developed in our Maine schools. During this project, students heard stories about aid in disastrous conditions, such as during Hurricane Katrina. They participated in group discussions after hearing these stories, where they could share their own stories of times when they or someone in their neighborhood or family took the risk of helping someone.
Students were encouraged to express their own stories and the stories of others through art, song, essays, and poetry. This work was shared with the larger community at a school board meeting and university conference. After giving a presentation at a conference, one student approached a second student involved in the presentation and apologized for harassing and bullied her earlier in school. The second student forgave the first student and expressed understanding that these years were tough for both of them.
Example 3: Active training for spectators
Many student life programs have established active audience training to help college students prepare for reinforcement when they see their peers being harassed or bullied. Ervin Staub originally developed active spectator training for schools and government agencies to prevent a sense of isolation in the event a person suffers a violation.
The training raises awareness among community members, but suggests a path to a sense of freedom of choice in the event a person feels the pain of knowing that a friend or community member is being targeted.
Example 4: Transformative couples therapy
A final example of the integration of bonds cultivated in counseling and connections into natural support systems is David Mars' transformative couples therapy (TCT). TCT is an approach to couples work where partners can deepen their bond with each other by providing empathic support while processing the unspoken feelings from experiences they may have left behind in fight or flight mode. TCT provides examples of how previous individual counseling work can be expanded into a collaborative environment.
These opportunities are mentioned to provide examples of programs that encourage empathic connection, self-expression, listening, and a sense of agency. These integrated experiences support the counseling work to develop the capacity for mature attachment.
Conclusion
When working with people who have experienced either a "small T" or a "large T" trauma, it is important to include them in action-based responses that are a healing alternative to the fight, flight, or freeze response represent. Building an agency in the form of fostering connections with their inner world (through security developed through grounding and attunement) and the outside world (through repaired breaks in the therapeutic alliance and as "helper") is vital.
So that the client can establish a connection to his inner world, security is built up in a therapeutic alliance that focuses on empathic, coordinated reactions and action-based grounding techniques. This allows the clinician to challenge the client, creating slight breaks in empathy that can be repaired to develop a more mature bond through the return to empathic attunement. These breaks and repairs provide practice for increased capacity and patience in real-life situations. More patience increases the empathy and connectedness of customers with their inner world and the internalized security of sitting with unpleasant sensations and experiences, which increases both internal and external resilience and freedom of choice.
At the same time as building internal determination, Balance offers the client the opportunity to further expand his agency. This is best achieved by encouraging the client (the person who was initially helped) to help others in the context of a well-structured environment. With the balance between "the one who has been helped" and "the helper", the client develops and internalizes his or her "parenting" ability so that the individuation cannot be "parenting".
Greater internal and external connection and competence heals attachment wounds both inside and outside the doctor's office.
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Adele Baruch is Chair and Associate Professor in the Advisory Education Department at the University of Southern Maine. She practiced couples and individual counseling for 15 years before starting teaching. She has focused her scholarship on healthy adjustment and developed an action research project on courage and moral choices in Maine. Contact her at [email protected].
Ashley Higgins is a clinical advisor at the Glickman Family Center for Child and Adolescent Psychiatry at Spring Harbor Hospital in southern Maine. As a licensed professional counselor, her primary clinical interest includes integrative and strengths-based modalities for the management of attachment trauma; Family systems; and wilderness therapies. Contact them at [email protected]
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Opinions and statements in articles appearing on CT Online should not be assumed to reflect the opinions of the editors or guidelines of the American Counseling Association.
