NYC Psychotherapist Blog

power by WikipediaMindmap

Wednesday, August 22, 2012

Mind-Body Oriented Psychotherapy: Healing Trauma Creatively

Trauma can create emotional scars that can last a life time.  For many people suffering with trauma that occurred years ago, the emotional effects can feel as strong now as they did when the trauma originally occurred. 

Mind-Body Psychotherapy: Healing Trauma with New Symbolic Memories

Often, talk therapy is of limited help to overcome trauma.  You can gain an intellectual understanding about the trauma, but talk therapy doesn't always heal the trauma.  This often causes psychotherapy clients to feel that there's something wrong with them because they're still feeling traumatized even after they've completed talk therapy. Some forms of mind-body oriented psychotherapy can heal trauma by helping the client to create a new symbolic memory.

Clinical hypnosis, Somatic Experiencing, and Psychomotor therapy are among the forms of mind-body psychotherapy that help clients to overcome trauma through the creation of new symbolic memories.   Each of these treatment modalities approaches the creation of new symbolic memories in a different way.

At first glance, the idea of creating a new symbolic memory might sound strange, and you might wonder how someone would go about doing this.  But, in reality, it's not strange at all. 

But, first, before I explain what new symbolic memories are, I want to stress that creating a new symbolic memory is in no way negating the original memory.

In other words, the purpose of creating a new symbolic memory is not a way of saying that the original memory never occurred.

Mind-Body Psychotherapy: Healing Trauma with New Symbolic Memories

When we work on creating a new symbolic memory, the purpose is to providing emotional healing.  

The client and the therapist are aware at all times of what originally occurred in the trauma. 

The new symbolic memory, which is created in collaboration between the therapist and the client, is a new embodied experience, which often includes imagining helpful allies (either real or imagined) and other helpful aspects that were not available in the original traumatic memory.

The following composite vignette, which is a combination of many different cases with all identifying information changed to protect confidentiality, illustrates how trauma can be healed through the creation of a new symbolic memory:

John came to therapy because he never mourned the loss of his father, who died when John was 16 years old.  He loved his father very much and missed him, but he never allowed himself to grieve for his father, who died very unexpectedly.

Healing Trauma with New Symbolic Memories

John remembers coming home one afternoon, after hanging out with his friends, and finding his mother crying in the living room.  His mother told him that his father had a massive heart attack at work and he died immediately.  John was shocked.  He felt the tears welling up inside him, but before he could shed a tear, his mother said to him, "Now, John, you can't cry.  You're the man of the house now, and you need to be strong."

From that moment on, John felt the emotional burden that was placed on him, and he stopped himself from crying as he braced himself to be "the man" in his family.  He didn't want to disappoint his mother, and he felt he had to be "strong" for his younger brothers and sisters.

Years later, as an adult, John realized that his mother, although well meaning, had placed an unreasonable burden on him.  After all, he was only a boy at the time.  He also realized that not mourning had kept him in a kind of emotional limbo with regard to the loss of his father.  In the past, he attended talk therapy, hoping to finally release the feelings he had been holding onto for more than 20 years.  But, although he gained intellectual insight into what happened, he still couldn't allow himself to cry and mourn.

After taking a personal history and working on resource development (i.e., coping skills), John and I worked on his memory of the day his father died.  Using a combination of Somatic Experiencing and clinical hypnosis, we went back to the original memory.


Throughout the process, John was in control at all times.  He said he felt alert and in a very relaxed state.  He was aware of what he felt in the  original memory as well as everything that was going on in the therapy room in the here-and-now.  This is called having a dual awareness (an awareness of the memory as well as the here-and-now), and this is essential for this type of work.

When we got to the part when John's mother told him that he shouldn't cry because he had to be "the man" in the family, I asked John who he would have liked to have with him at the time to help him.  I asked him to choose someone, either real or imagined, who could have helped him at that point to feel his feelings and to advocate for him with his mother.

John thought for a moment, and then he chose his Uncle Paul, his mother's brother.  He said his Uncle Paul was a very kind man and he had always felt close to his mother's brother.  He also knew that his mother admired her brother very much and he had a big influence on her.  So, when we went back to the part when his mother told John not to cry, John imagined what it would feel like to have his Uncle Paul standing next to him with his arm around him.

To make this experience as vivid as possible, we slowed down the process and I asked Paul to sense what it feels like to have Uncle Paul's arm around him on a physical and emotional level.  We took a few minutes to develop and amplify these physical and emotional feelings so Paul could experience fully the support he was getting from his uncle.

While John was sensing into this experience, he and I worked closely together to ensure that he felt safe and secure at all times.  He agreed to let me know if he became uncomfortable in any way.  I also observed his body language as well as his breathing, facial expression, changes in color, and other signs to ensure that he was comfortable in the experience.  I noticed that as he settled into the experience of his uncle being there for him, he looked more relaxed and he was breathing more easily.

When the therapist observes the client in this way, it's called "micro tracking" and this is an important part of the work.  The therapist must be attuned to what's happening with the client throughout the process.

Once John felt fully in the experience of being emotionally supported by his Uncle Paul, I asked him what he would like his uncle to say to his mother so that John would be allowed to feel his feelings.  John thought about this for a moment, and then said, "I'd like him to talk to her and tell her to let me cry--that it's normal, whether it's a teenage boy or anyone else, to cry when you lose your father.  He's he only one that my mother would listen to."

So, we went with that, and John imagined his Uncle Paul gently telling his mother that it's okay for John to cry.  John imagined Uncle Paul being gentle but firm about it.  Since John's mother admired and respected her brother, it was believable that she would listen to him.  John took a moment to feel this and he was able to tell me that he felt a great burden lifted from his shoulders and a tightness that was released from his chest.

Then, he told me that, in his mind's eye, he saw his mother back off and allow John to feel his feelings.  He felt like he was on the verge of crying, but something was holding him back.  I sensed that John might be concerned that his mother also needed someone to comfort her, but rather than suggest this to John, I asked him to sense into his body and ask himself what he thought might be holding him back.

I could tell, from watching him, that John was thinking about it rather than sensing into his body to find the answer.  So, I guided him to ask his body what was needed.  Now, this might sound strange, but it's no different than asking someone to use their intuition or to tap into their unconscious to sense what's needed.  The point is for the client to find the answer inside rather than just giving an answer that seems logical.  Certainly, logic has its place, but logic alone will often only get you so far, especially when dealing with trauma.

After a few minutes, John said he didn't feel he could allow himself to cry unless his mother was also being supported by someone.  So, I asked him who could be there for his mother.  He considered this for a few moments, and then he said his mother would be most comforted by her older sister.  So, we brought his maternal aunt into the scene, and he imagined his aunt sitting with his mother and comforting her.

Once John felt that his mother was being taken care of as well, and John had his uncle to comfort him, he allowed himself to cry in the session for the loss of his father.  This was the first time ever that John was able to cry.  All the emotion that had blocked inside of him came pouring out.  But rather than feeling overwhelmed, as he had always imagined he would feel if he allowed himself to cry, John said he felt a great sense of relief.  He felt secure and supported in the treatment room with me and he felt supported in the new symbolic memory by his Uncle Paul.

Afterwards, when we were talking about the experience, John said he could still feel his uncle's love and emotional support.  He knew that this new symbolic memory was not the original memory and that we were not saying we were in any way changing the original memory.  But he had a new, healing experience of that time.

In days and weeks that followed, we checked back in with the original memory.  I wanted to make sure that the work we did was more than just a one-time "feel good" experience and that John had actually internalized the new symbolic memory on an emotional as well as a visceral level.

Healing Trauma with New Symbolic Memories

John told me that the original memory no longer felt traumatic to him.  He felt loved and supported, as if he had actually gotten what he needed at the time.  He was also relieved to mourn his father.  From there, we worked on internalizing his father in other ways, including remembering all the good times he had with his father.  Prior to healing the trauma, John was too stuck emotionally to feel these positive experiences.

Getting Help in Therapy
As always, I want to emphasize that clinical hypnosis and Somatic Experiencing are not "magic bullets."  Often, trauma can have many layers and it's not centralized in one memory.  Also, in order to do this work, the client must have the emotional resources to begin the trauma work.

In the example that I gave, for the sake of simplicity, I provided a vignette where the new symbolic experience worked in one session.  But this isn't always the case.  There can be many obstacles in doing this type of work that might need to be worked through.  This can take time.

Everyone is different, and there's no way to know in advance how a client will respond.  In the example that I gave, John was able to maintain dual awareness of the here-and-now as well as the memory.  If he was someone who became very dissociated during the experience, we might not able to work in this way or we might need to modify the work.

For some clients, who are naturally resilient and have strong internal resources, only a few sessions might be required for resource development prior to working on a new symbolic memory.  For other clients, who might have a long history of multiple traumas with little in the way of internal or external resources, it might take months of resource development.

It's also essential in this kind of work that the client and therapist have a good therapeutic rapport.  Clients with traumatic backgrounds often take a while to be able to build trust with a therapist, especially if they experienced serious breaches of trust or boundary violations as part of their personal history.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, Somatic Experiencing and EMDR therapist.  I have helped many clients to overcome trauma.

I work with individual adults and couples.

To find out about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.