INITIAL PHASE AND THERAPEUTIC PRESENCE IN TRAUMA THERAPY

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

During the first sessions, before a strong therapeutic alliance is formed, contact with the therapist itself can generate very disturbing feelings and sensations, and activate various traumatic memories and fears associated with attachment relationships. Despite the fact that a person who suffers from the consequences of mental trauma independently seeks therapeutic help due to their psychological problems, the need to talk about themselves can cause a high level of alertness and provoke negative affects. Often, people who have experienced traumatic situations are overwhelmed with a sense of fear, guilt and shame that prevent them from fully revealing their own world of inner experiences, in addition, severe trauma often blocks the ability to describe their experience in words. People who have experienced a traumatic situation, especially the trauma of violence, approach the therapist with great caution, unconsciously asking questions: "Can you believe this?", "Will you accept me?", "Can you bear my pain, my complaint, my animosity or leave me? "," Are you able to endure those strong feelings that I myself repulse? " is my anger a right to exist? "," Will you evaluate and condemn me, as my family did?"

It is not uncommon for people to confess that they have concerns about whether therapy will destroy their fragile pillars of everyday existence. In addition, some degree of indiscretion and lack of real experience in trauma therapy by some specialists form ideas about trauma therapy that are very far from reality. The main mistake, in my opinion, is over-focusing on the response model, which can be seen as the focus of therapy, which can indeed lead to undesirable effects. If the response model is used thoughtlessly and prematurely, therapy can become violent and lead to additional trauma for the client. In this regard, the first stage of therapy is so important and cannot be forced by ambitions for a speedy healing.

Effective work in psychotherapy is possible only when the client feels safe in the relationship with his therapist. Research shows that therapeutic presence is essential for the formation of positive therapeutic relationships and effective therapy.

Shari Geller [1] is the first to consider the empirical foundations of therapeutic presence, including its neurophysiological foundations. The author translates this knowledge into clinical skills and practices that can be used by therapists of all schools to nurture and develop a therapeutic presence.

Therapeutic presence is about being in the moment, being receptive and attuned to the client on several levels. When therapists are in the moment and attuned to their clients, their receptive and safe presence sends clients a neurophysiological message that they are accepted, felt and heard, which creates a sense of security.

Customers who have experienced a traumatic event feel insecure even in absolute safety situations. Their expectations of the world are dominated by fear and a willingness to defend themselves. At this time, their sympathetic nervous system is excited, and if it is overexcited, protection in the form of numbness can be activated.

Therapists who are able to reach out to clients in the form of a calming presence activate a social interaction system that promotes calming. This therapeutic presence creates a mutual experience of security between the therapist and the client, which allows the latter to be involved in the therapeutic work.

According to Geller, therapeutic presence is a method or way of conducting therapy, which includes: a) openness and sensitivity to the client's experience, attunement to his verbal and non-verbal expression; b) internal attunement to resonance with the client's current experiences; c) expanding and maintaining contact through both verbal and non-verbal expression.

Techniques and methods of facilitating contact (according to Geller):

- prosody of voice and rhythm of speech;

- sympathetic facial expressions;

- a direct kind look;

- open posture with a forward bend;

- visual concentration and attention directed to the client.

The therapeutic presence helps the therapist regulate his own reactivity so that he can maintain a genuine connection with the client. A safe therapeutic environment promotes the development of new neural connections in the client, which, in turn, aids in the restoration of disturbed attachments and ensures the social interactions necessary for health and development.

A Practical Guide to Developing Therapeutic Presence / Shari Geller