A few years ago a client of mine disclosed several episodes of physical and sexual abuse. Emily was a very intelligent young lady with a great sense of humor who had become depressed as a result of these traumas and was using alcohol as a way to cope. The alcohol abuse, though intended to medicate painful memories, actually opened the door to more abuse. By the time Emily arrived at Sunrise Residential Treatment Center she had also begun cutting herself and had developed an eating disorder – all reactions to the trauma of her past abuse.
In treating trauma, the therapist’s first job is to develop a relationship where there is love, safety, and trust. Without that foundation, not much can happen. I favor a trauma treatment approach that combines the models described by Joe Dispenza and John Briere, both of which take into account new information on brain development as well as new research on complex trauma treatment. The first step is to provide a milieu in which the patient feels safe enough to disclose. The act of storytelling activates negative emotions and beliefs that are encoded in the associated memories.
These scary, painful emotions and beliefs are now being felt in an environment of safety, support and love. The pain of the past is incongruent with the safety of the present, creating disparity. Joe Dispenza explains that this situation causes new emotions to be encoded with the old memories to, in a sense, neurologically reset emotions associated with past events. This process is repeated until the new emotions render the experience no longer threatening. John Briere talks about the concept of counter conditioning wherein emotional responses fade when those responses are repeatedly not reinforced. Engaging memories of traumatic events in these new ways creates new neurological connections to past events. As patients learn and do more positive things for themselves and others in a safe interpersonal and milieu-based context, they create new neurological connections, feelings, attitudes and ways of being.
Early on, Emily talked openly only about her abusive boyfriend and her rape at the age of twelve. She could see how her boyfriend’­s mistreatment of her was his fault. But, as is typical of abuse victims, she had come to believe that she was a bad person who deserved the abuse. Regarding the rape, she told me that she thought the boy was cute and she wanted him to like her. Therefore, she reasoned, the rape was her fault. She drank alcohol at the beach so he wouldn’­t think she was too young for him, and he took advantage of that.
In therapy, Emily had to learn to accurately assign responsibility in order to be able to let go or forgive. It was a while before she told me about the 30-year-old man who had raped her in a hotel room. She told me that was drunk again and on her way to passing out. We worked through these memories of trauma using the same techniques we’­d used to work through traumas disclosed earlier. In the safe context we’d created, Emily made a symbolic three-headed “monster” out of clothes and things around the house and wrote a letter to the three men who had hurt her. We took her “monster” out to the wilderness and she read her letter and put it in the monster’s hand. Emily then destroyed the monster and left it in the woods to establish that the monster was in the past and she was done carrying it with her in the present. Emily credits this event for putting lasting closure on her post-traumatic distress. She would eventually volunteer to present with me on the subject of trauma treatment at a national conference of therapists.
Emily is one of many young women I’ve worked with who have been liberated from disabling post-traumatic symptoms using these approaches. Neurologically re-conditioning memories can be a powerful therapy when administered in a safe and loving therapeutic milieu.