May 21, 2023

A "Dip Your Toe In" Approach to Calm Scene with Clients with Complex Trauma

16 minutes

In this podcast, I propose a very simple modification to your calm scene mindfulness exercise when clients have struggled with exercises like this: outsource the calm scene to a YouTube video. We may be able to use the video as a bridge resource. Bridge resources are accommodations to standard resources that take into account the difficulties that clients may have with visualization, focus, self-judgment related to the visualization, and allow us to do a version of the resource that lets clients “get to the other side” of the resource rather than falling into the “canyon” of the resource.

What’s important, eventually in a resource, is that the client has a shift in affective state in a way that feels safe and tolerable to their parts. When clients struggle to visualize, a video library of 17 billion videos immediately accessible to the client’s computers, laptops, tablets, and smartphones is a portable resource we should have been teaching for a while. When it comes to calm scenes or calm processes, there is no inherent reason why that experience has to be fully imagined in order for it to be experienced. We want to appreciate the difficulty of the cognitive “ask” of having a client with severe trauma conjure water, waves, sky, clouds, sand, buildings, breeze, smell of ocean air, seagulls, etc, etc. It’s a heavy lift, as has been discovered by many therapists who try to develop an imaginary calm scene with clients with severe trauma.

What are the Goals of Calm Scene?

Help the client develop a brake pedal that can be used in reprocessing and between sessions to help manage and regulate whatever may come up.

Widen window of tolerance. A client that has skills to manage distress may have the ability to tolerate some distress.

Develop and support adaptive information, including agency, adaptive dissociation, and the ability to purposefully disconnect from an activating process. Pivot to something more adaptive.

What are the Difficulties of Calm Scene?

Imagination can be difficult when their heads are running like a jet engine.

Slowing down and not attending to the therapy room can be triggering.

For some clients, positive affect (particularly positive affect in the presence of a therapist can cause parts to respond strongly with a counterreaction).

Classic problem with the calm scene is that abusers show up in imagination.

How Can Outsourcing the Calm Scene to YouTube Help Us?

It may let us do one version of the resource when the client has struggled to do the resource at all.

It may be less dissociative and more focused since what the client is “tuning into” is actually happening (as a video) in the present.

Clients are accustomed to this type of distraction from rumination, so their nervous system probably has already flagged it as relatively safe.

Depending on how it is viewed, it allows us to both “co-tune” into the scene and explore each other’s responses to particular elements of the scene in a more concrete way.

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By Thomas Zimmerman

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