TRAUMATIC EXPERIENCE IN THERAPEUTIC RELATIONS

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

Mental trauma - can be obtained as a result of an emergency that threatens life and health, during which a person experienced horror, helplessness and the inability to escape or defend himself. Trauma, with no less serious consequences, can be received in relationships with other people: physical, emotional, sexual abuse, rejection / neglect in the family. Traumatic situations overload conventional security systems that provide the person with feelings of control over the connection and meaning. Traumatic reactions occur when actions do not produce the desired results. When neither fight nor flight is possible, there is only one thing left - to run away from your defenseless state, but no longer by actions in the real world, but by changing the state of consciousness.

In whatever approach the therapy of traumatic experience is conducted, it pursues the same goals: the regulation of affect, the correction of the picture of the world, the creation of new meanings that make it possible to process and integrate the traumatic experience in such a way that the "I" of the traumatic person is felt and perceived by him as more holistic, positive and empowered, building a sense of autonomy and control over one's life.

Success in achieving these goals depends largely on the creation of new interpersonal relationships characterized by trust and the formation of secure attachments. The effects of trauma and secure attachment are exactly the opposite:

- traumatic experience overwhelms with fear and helplessness, causes a feeling of danger and unpredictability of the world around, and a secure attachment brings a feeling of comfort;

-traumatic experience brings emotional chaos, secure attachment contributes to the regulation and integration of affect;

- a traumatic experience cuts off a coherent and coordinated sense of one's own I, reliable attachment contributes to personal integration;

-traumatic experience undermines the sense of control, while secure attachment promotes a sense of stability;

- traumatic experience holds in the past and does not provide an opportunity to develop new adequate ways of adapting to new life conditions, reliable attachment provides openness to new experience and the development of new coping strategies;

-traumatic experience makes it difficult to make informed decisions about changing anything, dictated by the need, secure attachment provides the ability to take a deliberate risk based on forecasts and planning;

-traumatic experience destroys the ability to form close relationships, secure attachment is the foundation of the ability to build close relationships.

The therapeutic environment, first of all, should become that safe haven in which it is possible "to touch the wound (…), to find again what is lost, shaken or forgotten and to want again what I can no longer, namely the completeness of the reality possible for me" (A. Langle).

The main experiences in trauma are feelings of loss of power over one's life, oneself, and isolation from other people. Thus, the basis for overcoming trauma for the injured person is to regain control over their lives and build new human connections. Overcoming trauma can only be done in the context of a relationship; it cannot be done in isolation. In new connections, the traumatized person restores mental functions that were deformed as a result of the traumatic event. New relationships can restore the ability to trust, be proactive, restore their identity and privacy. The therapeutic relationship is unique in several aspects: the purpose of this relationship is to renew the client, in order to achieve this goal, the therapist becomes an ally of the client, puts his knowledge, skills and experience at the client's disposal; By entering into a relationship with a client, the therapist commits to respecting the client's autonomy.

Clients who suffer from traumatic experiences tend to form the traumatic transfer trauma inherent in the nature. Emotional responses to a person in power - anger, fear, shame, and the desire to control are almost inevitable in the therapeutic process.

The traumatic transference also reflects the experience of helplessness. At the moment of injury, the victim is completely defenseless, unable to defend herself, and feels completely abandoned. The paradox is that the more intense the feeling of defenselessness, the more insistent the demand for protection and the need for an almighty rescuer. With his helplessness, the traumatized client forces the therapist into this rescue role. When the therapist does not demonstrate an impeccable performance in the role of the rescuer, then the client will feel anger, and often expresses a desire to withdraw from therapy.

The complexity of the therapeutic relationship with the traumatized client also lies in the fact that no matter how much the client wants to trust the professionalism and kind attitude of the therapist, he is not able to do this, since his ability to trust is overwhelmed by the traumatic experience. The traumatized client is constantly torn apart by controversy and suspicion about the therapist. Often the client tends to withhold the details of his traumatic experience, because he is convinced that the therapist is not able to bear the whole story of the terrible event.

Traumatized clients often attribute to the therapist the motives that led the abuser to commit the crime. Long-term experience with the abuser changes the natural ways of building relationships with other people, the whole arsenal of contact with other people is aimed at protecting oneself from the nightmare of violence.

Traumatized clients are very sensitive to the therapist's “weakness”, his sincerity and ability to be in genuine contact with the client's inner world, which has been shattered. Clients scrutinize every gesture, gaze and word of the therapist. They consistently and stubbornly distort the therapist's motives and, at times, become completely overwhelmed by suspicion of the therapist's malicious motivation. The therapist who has not tracked that he is already drawn into the dynamics of the dominance-submission relationship may unconsciously reproduce the demeaning / offensive / abusive attitude inherent in the client's traumatic experience. Such dynamics of relations is described in the most detail as a mechanism of psychological defense - projective identification of the client. Thus, the abuser plays a shadow role in this interaction, and the ghosts of the client's past do not leave the space of the therapeutic relationship for a long time. Here is the most distant illustration possible, which I received permission to publicly share from my client, who had been in therapy for 2 years. When inviting a client to enter the office, I always close the door with a key. My 25 client, who had been subjected to severe physical beatings and sophisticated bullying by his mother for a long time, confessed to me that the sound of the key turning in the lock behind his back made him come to his senses for a long time before starting to talk to me. “I sit down on a chair and see this key in your hands, you hold it for a while, then put it on the table, I realized that at that moment I am calming down. Until then, I’m just afraid of you and don’t believe you. My mother came to kindergarten for me always drunk. On the way, she insulted me, sometimes she could push me, but as soon as we entered the apartment and she closed the door with a key, she started beating me until she calmed down and started crying.”

In cases where the primary trauma is known, an eerie similarity can be found between it and its reconstruction in therapy. The reconstruction of the relationship with the abuser is most evident in the sexualized transference. Such clients are confident that they can only be valuable to another person as a sexual object.

The best way to avoid overreacting to a traumatized client is to be alert outside the therapeutic relationship. A safe environment creates a safe space in which work with traumatic experiences can take place.

Clients with traumatic experiences are in dire need of understanding the importance of personal boundaries and their formation, we are talking about internal and external stable, but flexible boundaries. Well-built boundaries in therapeutic contact provide for the gradual building of the client's personal boundaries, as well as his increasing ability to adequately perceive the boundaries and autonomy of another person, without experiencing a sense of rejection and unnecessary.