Guest Blog by Jane Cooke.
There has been a focus on trauma-oriented work and ‘treatment’ in recent Powys conferences. You can watch Jacqui Dillon at the Powys Stronger in Partnership conference last year here and you can watch Sami Timimi at the Finding Meaning in Psychosis conference in March 2014 here.
There has been a focus on trauma-oriented work and ‘treatment’ in recent Powys conferences. You can watch Jacqui Dillon at the Powys Stronger in Partnership conference last year here and you can watch Sami Timimi at the Finding Meaning in Psychosis conference in March 2014 here.
One of my roles in life (when I’m not working within PAVO’s mental health team) is as a counsellor/psychotherapist. I have a
trauma-oriented approach which has been reinforced by listening to these
speakers and by reading around the subject.
A trauma-oriented approach, as advocated by Sami Timimi, is
a gentle way of beginning work that enables a person to feel safe and able to
gradually build up a personal sense of control over their own boundaries and in
time over responses to events or reminders that can lead to upsetting and
overwhelming reactions. Even if a person doesn’t identify trauma as being
relevant to them and why they come for therapy, this approach is empowering and
helpful anyway. (It is not about
forcefully inducing ‘catharsis’, re-living the situation, ‘facing up to it’ or
any other similar techniques which can be re-traumatising or even abusive in
themselves.)
Sami Timimi is a psychiatrist and a founding member of recently established Council for Evidence-Based Psychiatry. He believes that working in a
trauma-oriented way makes sense for most people who come into contact with
mental health services. Much more sense than identifying ‘pathology’, symptoms
and ascribing a diagnosis; all of which generally ignore the story, the
experience of the person, how it is that they are who they are.
There are two writers who I have found very helpful and
their work complements each other. Both Judith Herman and Peter Levine are
concerned that people (clients, patients, service users, survivors) gain/regain
their own sense of personal power and agency as they recover from their
trauma/s.
Peter Levine has written a number of books about trauma. One
of his books “Healing Trauma” is a slim self-help book with a CD covering a
programme of exercises that anyone can follow to help overcome the neurological
‘holding’ of trauma. It is, he says “for restoring the wisdom of your body”. He does caution that professional help may
still be required. An empowering way of working could be therapist and client working
together with the book and exercises, keeping the client in control of the
work.
‘Trauma’ is a word we use in everyday speech, but paradoxically in relation to emotional
well-being there is a limited perception that trauma has to relate to major events
that are, for example, combat situations, witnessing extreme violence, being in danger of one’s
life or experiencing sexual violence or abuse in childhood or adulthood.
However, as Peter Levine says “People, especially children, can be overwhelmed
by what we usually think of as common everyday events …The fact is that, over
time, a series of seemingly minor mishaps can have a damaging effect on a
person. Trauma does not have to stem from
a major catastrophe” (his italics).
There is increasing evidence for this. So, for example,
bullying, repeatedly not getting your needs for love and positive attention
met, feeling fear regularly such as maybe a frightening walk to school, regular contact with a
frightening , threatening teacher or relative; being regularly shamed by
powerful people when you are young. Many
things can build up to create a response in the nervous system which then needs
to be ‘taught’ to respond to the here and now and to recognise/feel current sources of support and comfort,
including your own capacity to support
and nurture yourself.
Jacqui Dillon (a survivor of childhood sexual abuse) told us
how much she had been influenced and empowered by Judith Herman’s book “Trauma
and Recovery”. Herman looks at the way in which women’s (and children’s)
experiences of violence, fear, captivity (and you can be captive in all senses without
the doors being locked) and powerlessness in the domestic and community realm
have been seen as variously: natural, bought on by the victim themselves,
exaggerated and overcome-able by normal
acts of will. She looks at the way in which their experiences are minimised and
belittled. “Social judgement of
chronically traumatized people tends to be extremely harsh” .She also looks at ways
of working with people who have experienced trauma. Judith Herman has a
framework for recovery from trauma. There has to be in her experience, in
sequence (and returned to as often as necessary) Safety, Remembrance and Mourning and Reconnection. This works very well with Peter Levine’s work which
in the early stages emphasises ways of achieving an inner sense of safety, and of
course actual safety in daily life is essential.
Judith Herman is very
clear that therapists need good training and good support, this is work that can
be complex and challenging.
There are many books about trauma; I would recommend these
two. They are compassionate and well-grounded in research and experience. They
are as much for the person recovering from trauma as they are for therapists
and other workers.
Judith Herman’s “Trauma
and Recovery provides a radical, community oriented approach to recognising
trauma in the lives of women in particular as well as a way of working that can
lead to recovery.
Peter Levine’s book is a gentle, practical self-help book
(although he does not minimise the need for professional support as well).
Between them they are a very good ‘starter kit’ to this
subject whether you are a health professional, or someone who has experienced, is experiencing, trauma – and you
could very well, of course, be both.
Trauma and Recovery. Judith Herman. Pandora
ISBN 978-086358-430-5
Healing Trauma. Peter Levine. Sounds True ISBN
978-1-59179-658-9
Written by Jane Cooke
Member of PAVO Mental Health Team: jane.cooke@pavo.org.uk
And when not working for PAVO....
Gestalt therapist, ecotherapist and interpersonal skills trainer. Jane.cooke@heartfeltwork.co.uk
