This episode focuses on different types of distress that may appear in trauma work and explores the types of distress that are most productive to metabolize.

In many transformational trauma therapies, at least part of what we are doing is transforming the distress encoded in the memory.  There is distress in almost any individual traumatic memory. However, that’s not the only distress that may be present.  One question that the therapist may want to ask is: what distress is productive to try to metabolize and what might be a goose chase.  Cleary, we want to metabolize the distress that is in the memory, but if too much memory comes into awareness or if memory comes with too much intensity, the system—which is designed for protection and containment—may have strong defenses against that much memory content showing up.

Prisoner scenario #1

Prisoner scenario #2

How this looks in Flash Therapy

How this looks in EMDR Therapy

Strategies to more effectively “walk a memory out” with clients with complex trauma

In EMDR:

In the Four Blinks Version of Flash:

The Folger’s Coffee Can Full of Black Powder metaphor.

Many times, the most efficient ways to process memories is to take a single step/spoon full at a time.  Complete that step/bite.  Take the next.

What Do Container Resources Do?

Long story short, containers help you expedite the process of returning difficult content to the limbic brain.   Library metaphor. Containers very often are a cognitive strategy or intention not to engage with something right now.  A container can also be a somatic strategy, because if we only address the cognitive aspects of rumination we may be leaving a lot of distress in the body, which can reactivate the mind.

Containers are also a helpful ritual in pivoting away from activation.  It’s a ritual that signifies something to parts.  However, the reasons why we need to container matter.  Many, many, problems with containment come from the assumptions that clients make about what containment means… what it means to current functioning, what it means for their past, and what it means for their recovery.  For example, many clients say “wait a minute, Tom… I have locked this stuff up all of my life… I come to see you to get it all out… and you’re telling me to do something I’m coming to you stop doing.”

Again, we need to explain that the reasons why we container are very important.  All of these are good/healthy/adaptive reasons for containing something that has been activated:

Ultimately, we want to emphasize that it’s okay to container because we have a plan to resolve this issue in an effective way at a later date (a transformational psychotherapy)

Ways that are not a good idea to use in containment, since parts may react to the implications of these approaches (although clearly these are preferred methods by some parts):

Containment is one of the best adaptations of human evolution.  The limbic brain is a container.  I tell my clients that the reason we’re not all in the psychiatric hospital all of the time is because of the containering qualities of the limbic brain.  We are information processing systems and when we encounter information that we cannot assimilate because we were too shut down, too overwhelmed, or lacked the needed adaptive information at the time, it is helpful to have a place to put it until we can try again to assimilate it.  Clients often come to us with a lot of ambivalence about carrying a lot of containered experiences.  On one hand, they have been consciously and unconsciously trying to process (or at least manage) this information using incredibly ineffective strategies likely all of their lives.  One the other, they have visceral experiences (all of them bad) from trying to purposefully interact with containered information.  Containering isn’t a neutral activity.  Asking a client to simply let go of information that is both existentially salient and intractable is not a neutral ask.  Everything we container, past interactions with container, past strategies to try to process trauma, and the fact that we are carrying stuff that needs containment are all implicated in what makes purposeful containment difficult for many clients with complex trauma. 

Strategies for managing flashbacks in session and between sessions.

Effective time management strategies in EMDR Therapy.

The AIP Model

· The Difficult Stuff Connects to Right Now/Existing Adaptive Information

· Enough Adaptive Information Must Be Present

· You Can’t Easily Connect Maladaptive Information to Maladaptive Information

· What’s Complex About Complex Trauma Related to the AIP Model?

o A Different Way of Thinking About Complex Trauma

o Mountain Ranges of Adaptive Information vs Mountain Ranges of Maladaptive Information

The Mount Everest Metaphor

· You Cannot Metabolize a Trauma the Size of Mount Everest into Adaptive Information the Size of a Walnut—You Can’t

· Where to Start with Complex Trauma?

o Where Not to Start

o Types of Targets that Make Good Early Targets with Complex Trauma

The Whale Metaphor

· What are the Whales?

· What is the Size of the Client’s Boat?

· You Cannot Land a Whale into a Canoe

· Helping the Client Build a Bigger Boat

· What Clients Learn when Working with “Smaller” Wounds First

o Test the Gear

o Learn How to Notice Effectively

o They Learn that the Can Heal

o Healing Builds Adaptive Information/Makes the Boat Bigger

· If the Client in a Canoe Connects to a Whale we Need a Strong Pair of Scissors to Safely Disconnect

The relationship between negative cognitions and blocking beliefs.

Dip Your Toe In: Phase One