Beruflich Dokumente
Kultur Dokumente
Identityandrelationaldisturbancesareoftenassociatedit'sahistoryofongoing
andseverechildhoodabuseandneglect.Theseissuesarealsooftenviewedas
evidenceofapersonalitydisorder,suchasborderlinepersonalitydisorder.Often,
cognitivebehavioraltraumatherapiesfocusontreatingcognitiveandposttraumatic
stresssymptoms.Itisrecommendedthatinterventionsthattreatproblemsinidentity
andinterpersonalfunctioningarealsoincludedintreatmentasmanysurvivorsof
multipletraumaspresentwithsignificantdifficultiesintheseareas.
Thosewhosurviveearlyandseverechildhoodtraumasoftenexpressproblems
associatedwithconnectingwiththeirinternalselfandhavingaselfofselfingeneral.
Ithasbeenthoughtthatthesedifficultiesdevelopinthefirstyearsoflifewithissues
intheparentchildattachment.Thiscanbepresentedinvariousways,includingnot
beingabletodetermineone'sownneeds,predictingone'sownreactionsorbehavior
invarioussituations,notabletohaveadirectaccesstoapositivesenseofself,and
beingabletomaintainaconsistentidentityinthecontextofstrongemotionsorwhen
pressuredbyothers.
Thetherapeuticrelationshipcanbeverypowerfulintreatingtheseidentify
disturbances.Itcanprovidetheclientwithasafe,comfortablespacetoallowtheir
identitytoevolve.Itisimportantfortheclienttofeelsafeintherapy,bothphysically
andpsychologically.Thetherapistshouldrespecttheclientsboundaries,be
noninvasive,andreliabletoshowtheclientthereisasenseofstabilityandsecurity
withthetherapist.Iftheseconditionsareset,theclientismorelikelytoexploretheir
interns,thoughts,feelings,andexperiences.Itistobenotedthatapersonwhohas
dealtwithseveretraumamaybeintherapyforsometimebeforetheyfeelitissafeto
examinetheirinternalprocessesintherapy.
Itisalsoimportantforthetherapisttosupportaclientsselfvalidityand
encouragetheirselfexploration.Thetherapistshouldvisibleaccepttheclientsneeds
andperceptionsasvalid.Thetherapistshouldnotargueandattempttocorrectthe
clientsperceptions,butinsteadthetherapistshouldworkwiththeclientsothatthe
clientisabletoquestiontheirownincorrectassumptionsandworkthroughthem.This
alsoallowstheclientsneedstobeattheforefrontoftherapyasopposedtowhatthe
therapistwants.Thisclientfocusedenvironmentisalsodifferentthanmostcasesof
childhoodabuse,wheretheattentionisfocusedontheabusersneeds.Allowingthe
clienttofocusontheirneedsleadstofacilitatingselfexploration.Identitytrainingis
aninterventionwhichprovidesthesurvivortoreallydiscoverwhattheyfeel,separate
fromwhatothersthinkandfeel.Themoreaclientisaskedabouttheirinternal
experiencethroughtreatment,themoretheclientisabletobecomeincreasinglyself
aware.
Relationalfunctioningisshapedinearlychildhoodbyhowtheyrelateto
others.Theseearlyinferencesabouttheselfandothersgenerateageneralizedsetof
assumptionsandexpectationsofothers,calledinternalworkingmodels.These
implicitmemoriescantriggeraclientbasedonsomeenvironmentaland/orexternal
stimuli.Activationofthesememoriescanhelpaclientworkthroughtheirnegative
emotionsassociatedwithacertaintraumamemory.
Thereareseveralwaysofunpackingpasttrauma.Withexposure,theclientis
treatedwiththerapeuticstimuli.Theexposureistitratedtotheclientsprogressasto
notoverwhelmtheclient.Activationisusedtoelicitemotionalreactionsofrelational
trauma.Disparityisusedtochallengetheclientsideassurroundingtheirabuseand
howtheyrelatetoother.Forinstance,ifaclienthasdifficulttimetrustingmenand
hasamaletherapist,theclientmaylearnthatnotallmenareuntrustworthy.Itmay
takesometimeforclienttocometoacceptthathermaletherapistisasafeperson,but
itwouldchangehowshefeelsaboutmeningeneral.Counterconditioningisa
phenomenonthatmarriestheclientactivedistressed,whilesimultaneouslyreceiving
positiveregardfromthetherapist.Itcanhelpprovetheclient,thatthetherapistcan
beacaringandsupportivepersonintheirlives.Thishelpstheclientcreateanaffinity
forthetherapist.However,thetherapistmustbewarynottodotoomuchhand
holding,astheclientcandevelopintounhealthypatternsofattachment.Last,
desensitizationistherepeatedexposuretorelationaltraumamemoriesintandemwith
positiveregardandcounterconditioning.Thepurposeofdesensitizationandother
processesisthecessationofnegativeemotionalresponses,overwritingthose
traumaticemotionswithpositiveones,andfinally,revisingoldrelationalpatterns.