Beruflich Dokumente
Kultur Dokumente
1214 September 2003, Melbourne, Australia
Tools for Treating Survivors
Dr Lindsey Fairfield
Introduction
With a Graduate Diploma in Counselling, I am not as academically qualified as many of my
readers. However, I have many years as a research scientist (clarifying objective problems)
and as a woman dealing with the aftereffects of childhood sexual assault and emotional
isolation (clarifying subjective problems). I have experience from the client perspective of a
wide range of therapeutic methods. I want to share with you the core process that made the
critical difference to my recovery. I now use it with, and teach it to my clients. It is easy to
facilitate and a client can become skilled in its personal use.
For simplicity, I use the pronoun "she" for the client. Nearly all women with whom I have
worked respond well to the process. However, it seems less effective with men, who appear
to have a slightly different response to childhood hardship.
There are several other skills that are essential to recovery and I will outline two of these
briefly. Details are given in my book "Volcanoes: Recovery from Rage" available from me or
from Indra Publishers, Melbourne. The skills need to be learned in a definite sequence. The
piece I present here is in the middle of sequence. You may then see that a client needs some
mastery of more basic skills before this one is safe and effective, and that some other skills can
only be learned after.
Addressing the "trauma tapes"
A survivor's most obvious problem is that she has strong and unpleasant feelings in the
present. However, the events with which those feelings are congruent are in the past (i.e.
classic Post Traumatic Stress Disorder). The child dissociated from the feelings; the events
may even be "forgotten". However, the feelings remain, encapsulated, and replay whenever
triggered. The feelings were dissociated at the time because they were overwhelming and
they remained dissociated because there was no assistance and no safe place for the child to
express them. It is my belief that a child will survive most forms of trauma and remain
emotionally healthy so long as the reality of the events and the feelings of the child are
acknowledged and validated. For any adult who still suffers from past trauma, it is a safe
assumption that this acknowledgement and validation did not happen. Further, one can
safely assume that there was a pattern of emotional neglect and/or abuse in the child's world.
For the suffering adult, the events still need to be acknowledged and feelings validated. The
tricky bit is that the feelings need also to be reconnected carefully to the original event and left
there in the past. Age regression and a total reexperience of a traumatic event from the
child's perspective runs a high risk of simply retraumatising the client. I offer an alternative.
It is based on a Neuro Linguist Programming process called "Change Personal History"
(Bandler & Grinder, 1979) in which there are many possible variations. I offer you a skeleton
that will cope with a majority of situations.
The process asks for detailed recall of memories and feelings, and the client will naturally
enter a light trance as in a guided visualisation. However, the counsellor only guides the
process, the content comes entirely from the client.
Use of the process is indicated when the client relates a current event to which she has
responded with strong feelings that appear to be disproportionate or incongruent with the
present stimulus. This suggests a "tape". I use the word "tape" with a similar meaning to that
in Transactional Analysis (T.A.): the client is responding to present events as if the scenario
were the same as one that she experienced as a child. The counsellor needs to listen as to a
child. Acknowledge and clarify the feelings, using simple basic language: hurt, frightened,
angry, disgusted, ashamed are the common ones associated with trauma tapes. Listening in
this way, as to a child's feelings and interpretations, you will begin to get a picture of the
original event, but this is for the client to discover, not for you to guess.
Identify the trigger: "What happened just before you felt ... ?" Clarify so far as possible the
nature of the trigger. Who: e.g. is it important that the person involved is an authority
figure/an important relationship? What: e.g. was it a specific action, tone of voice, specific
words? Where: e.g. are there critical environmental factors e.g. dark, alone? Summarise,
avoiding current identities and get agreement: e.g. "So when someone who is .... uses the
words ... you feel ....."
Ask the client to focus on the feelings and allow her mind to float backwards in time to find
another event recently, while still an adult when the same or similar feelings were present
in response to a similar trigger. Check the description of the feelings and the nature of the
trigger. Repeat this a few times, going backwards in time, and watch for a change; both the
feeling response and the trigger may have evolved over time.
When the pattern is stable, ask the client to "drop way back" to when she was a child.
However, as soon as an event is located, she is to place it the child and the event at a safe
distance. The other side of the room is usually sufficient.
Note that the client must be able to control whether a past event is recalled from the
associated or dissociated position. This is a one of the skills that must be in place before this
process can be performed safely and effectively.
Elicit a description of the scene. Acknowledge the appalling nature of the events and that
"the child needs help".
Instruct the client to, in fantasy, enter the scene as the "child's future self" or "Fairy
Godmother". The counsellor now puts words into the mouth of the "future self" to be
repeated to the child. Ask the client, at each step, to report back the child's reactions.
• "I am your future self, your Fairy Godmother, and I've come because I know you need
help." Report back.
• "I know just how you feel .... [name the feelings previously identified]." Report back: the
response is usually relief "someone understands me".
• Acknowledge the events: "You feel .... because ...."
• "What would help you most in this situation, knowing that I am totally magical and can
give you anything (e.g. a play mate, a protective energy field), help you do anything (e.g.
tell someone, run away, punish the perpetrator). I can simply take you away from here to
live with me if that is what you would like." Report back. Enrich the detail: nature of
friend, colour of energy field, tell who, run where, punish how, travel with me how
(magic bubble, flying carpet, like superman). Report back.
• Give the child what she wants. If the wish is to be taken away, make an elaborate fantasy
of the journey, eventually settling the child in a safe place, preferably the client's present
home. Report back. Add anything else that is needed.
The aim is to separate the Child (in the T.A. sense) from the Adult, so that the Adult's
resources remain available when the Child is upset, and the Child's feelings (especially
helplessness) can be acknowledged and ameliorated using the Adult's help, understanding
and language.
• "Now ask the child, or intuit for the child, what conclusions did she draw about herself
or about the world from having been in that awful situation? How did she make sense
of it?" Report back. The conclusion is usually a grand generalisation: "I am bad"; "It's all
my fault"; "The world is a dangerous place"; "I can't trust anybody".
• Establish a signal system so that the Child can call for help. However, explain to the Child
that: "I (the Adult) will always notice the signal. But I may not come immediately because
the moments when you (the Child) panic, may be exactly the moments when I need to
defend both of us in the outside world. I will come [by this process] as soon as it is safe."
• Establish "a contract": the present Adult's job is to love and protect; the Child's job is to
enjoy herself and learn about how the world is now.
• Bid farewell to the Child (another present is a good idea) and return to external reality.
Note that every step involves acknowledgement of the child's feelings before any change is
made. In particular, acknowledgement and careful contradiction of the child's conclusions
works towards changing the (often unconscious and) debilitating beliefs about herself, her
responsibilities, her selfworth and her innate abilities.
Having completed this process, drop the subject. On no account return to the current event in
which the feelings (and probably, as a result, the behaviour) were an inappropriate or over
reaction.
Language of feelings
To manage the above process, a client needs at least a moderately "well wired" emotional
system. She must be able to recognise and report (in her own words) how she feels. In cases
of abuse, the child's feelings were disregarded. The result is usually that her emotional
responses are confused or suppressed the adult continues to believe that her emotional
responses are wrong. Hence, it is vital that all feelings are accepted and named non
judgementally, as fact. This is especially true when the feelings are not congruent with the
provoking event (as seen by the counsellor). To fail to do so is to repeat the error of the
childhood caregivers who did not attend adequately to the emotional education of the child
and did not respond appropriately at the time of the trauma. You also miss a valuable
opportunity to discover and repair the damage caused by that neglect. You will find that the
feelings are always understandable when relocated in the situation to which they belong.
The counsellor can rewire the system by providing the missing feedback. Play Therapy does
this with children. The therapist simply observes and names the feelings nonjudgmentally,
as facts possibly adding a "because" phrase: "George is angry because John just took the
truck." The effect on the children, as recorded by Axline, is extraordinary. The effect on
adults takes a little longer to manifest but is equally amazing. In my groups, which are more
structured and didactic than individual counselling, I used a graded series of exercises to
illicit (very gently at first) the desired affect and train the Adult/"future self"/Fairy
Godmother to name, mirror and respond as described by Kohut.
So as you watch your client, name whatever appears to be happening at the moment. "You
seem ashamed/angry/frightened/distressed." Naming with acceptance releases the
suppression and whatever affect was before it in the sequence may then surface to be
acknowledged in its turn, all the way back to beginning of the sequence usually hurt
distress. Such sequences run very fast and out of awareness. They result in many of the
bizarre and inappropriate responses displayed by survivors. Constant naming and
acceptance helps the client to slow the sequence down and eventually separate the feelings,
so that each can operate separately and appropriately.
Double Binds
A double bind is a situation in which, for a child, there is no possible behaviour that will
avoid the feeling of being "bad". Any abuse situation has this element. The authority figure
enters the private physical or emotional space of the child and behaves inappropriately. The
abuse feels bad. To oppose the abuse is labeled "bad". The child can neither defend herself
nor run away.
While the child was truly helpless, the adult can defend herself or leave but does not.
Instead the adult is caught again and again in the helplessness of the child.
These are tapes but particularly nasty ones. A counsellor needs to be aware of them because
they can be innocently activated by the counsellor and will seriously damage the relationship.
The client also needs to be taught that she has the right to defend herself. And someone must
teach her the skills to do that.
A short summary of the three most deadly: I call them the Feelings, Personal Space and
Safety double binds.
Feelings. Be very wary of using a "why" question in counselling. Keep the word for situations
where there is physical, rational answer easily available to the person asked. In matters of
feelings and behaviour in response to strong feelings, a "why" question has no answer that a
survivor will be able to muster. "Why" (applied to feelings or behaviours) usually means in
essence "Why are you different from me?" The survivor hears it as reprimand and a demand
to justify wrong behaviour which is impossible to do in the emotive situations in which she
is turning to you for help. She mentally adds such phrases as: "I am bad/weird/strange." or
"I have done something wrong." or "I should be whatever you want." She has acute
perception (that was accurate in the childhood situation) of what is expected, and her
automatic response is to feel she must conform with that expectation. Since the counselling
room is supposed to be a safe place to express and explore how she feels, the likely responses
are confusion, anger or shame.
Rather than "why", use any of the other question words: who, how, what, where, when.
These indicate acceptance and the willingness to explore further. I teach my clients an
automatic defense to any "why" question: "Does that cause you a problem?" If it was an
honest question (not the criticism that the survivor tends to hear), the questioner can
rephrase. If it is an implicit criticism, the implicit answer is that: "unless my behaviour does
cause you a problem, I do not need to justify myself or change".
Personal Space: A survivor of abuse has been in a situation where a person claiming the right
to do so has entered her personal physical or emotional space and behaved inappropriately.
A child has no response: she cannot defend herself; she cannot run away. Further, the
survivor's attempts to tell what happened or express feelings about it have been perpetually
denied, ignored, minimised or disbelieved. This is a severe secondary trauma that the
counsellor should avoid repeating.
In counselling, the client grants you the right to enter into her emotional space. If you ask a
personal question (enter the personal emotional space) and then, in response to the answer,
you appear (to the client) to show shock, disbelief or disapproval, you have repeated that
secondary trauma and in an environment which was supposed to be safe. The client's
response may well be withdrawal or anger. The relationship may be seriously damaged.
Ultimately, the client needs to learn that noone may enter her personal or emotional space
without her permission she has the right to say "no". Anyone who behaves disrespectfully
while inside her personal space is not a friend. They should be informed what is acceptable
and, if the disrespectful behaviour continues, told to leave and, in the future, refused entry.
She needs automatic defense phrases such as: "No"; "I do not wish to answer that question";
"I don't want/feel like doing that"; "I am not comfortable with what is happening. Stop.";
"I'll think about it and get back to you"; "I find that disrespectful of my feelings in the matter."
SafetyTrust: Where there is abuse, the child's needs are sacrificed to those of the adult.
Instead of the adult taking responsibility for protecting the child, the child becomes
responsible for the safety of the adult. She placates an abuser. She does not seek outside help
(tell the family secrets). She defends one parent against attacks from the other. She becomes
the physical or emotional caretaker of the family.
The adult survivor tends to trust totally (as a child should be able to trust a parent) or not at
all. A counsellor is if the relationship works bequeathed total trust. Inevitably, at some
point, you will appear to fail. If the client has the courage to object to what you have done (or
not done), and you justify yourself in terms of your needs, you have reproduced the adult
child relationship. It may be illuminating, and you may mange to repair the relationship. But
it is better avoided.
Ultimately, the client needs to learn that: as an adult, she is responsible for her own safety;
that trust is earned in small steps; that people can be trusted in some areas but not others; that
almost everybody will let her down sometimes. She must learn to trust herself and her own
resources to weather the bumps.
A general guideline is to remember that you are in a private space that is very different from
your own. What a survivor says or does will often surprise you. When a response to what
you have said or done is unexpected, approach with a mental question: "What is the client's
perspective/expectation/belief that she responds this way?" Should you activate a tape
(especially if it may contain a double bind) and the client becomes angry, illogical or with
drawn, a request such as: "Would you tell me from your perspective what just happened?"
can often reopen the dialogue and defuse a potentially damaging situation.
The programming produced by double binds is pervasive. Continual acknowledgement of
the Child and Adult parts is useful: acknowledge the Child's feelings and restricted skills;
assert the Adult's right to defend herself, and help her to learn the skills to do so. Remember
that a survivor is programmed to believe that what you call "assertiveness or defense" is not
permitted for her. It may be useful to suggest that it is now her job to protect both herself and
the Child otherwise she is guilty of the same failure as the "bad guys" from the past.
References
Axline, Virginia M. (1964) Dibs, in search of self, personality development in play therapy
Houghton, Mifflin (Boston)
Axline, Virginia M. (1969) Play Therapy Ballantine Books (New York). The first edition of this
book was published in 1947.
Bandler, Richard & Grinder, John (1979) Frogs into Princes Real People Press (Utah)
Fairfield, Lindsey (1999) Volcanoes: Recovery from Rage distributed by Indra Publishing
(Melbourne)
Kaufman, Gershen (1989) The Psychology of Shame Springer (New York)
Kohut, Heinz (1971) The Analysis of the Self. Hogarth (London) International library
616.8582 2
Kohut, Heinz (1977) The Restoration of the Self. Universities Press (New York)