Emotionally Focused Individual Therapy for Trauma

Posted on by Wendy E. Smith, MA, LMHC

At the beginning of my career, I trained with Les Greenberg, the pioneer of Emotion-Focused Therapy for individuals, as well as Roy Hodgson, in the use of the method for clearing up unfinished business and working with shame and anxiety.  Recently I have circled back and am receiving further training, mainly from Leanne Campbell, in the use of Emotionally Focused Individual Therapy (EFIT) for trauma treatment.  EFIT, developed by Sue Johnson, is the latest incarnation of Greenberg’s early work.

In this method, we reshape pivotal traumatic moments in the past that are affecting reactions in the present.  We do this by creating emotional encounters, often between the client’s current self and a younger version of the self, that allow for expanding their view of self and other and releasing emotion that the young self was unable to process without the presence of a caring adult.  Key to this work is the presence of the attuned therapist to provide support for the client who provides support for the young self.

Although the methods differ somewhat, this approach for treating trauma jibes very well with Janina Fisher’s parts work described in an earlier post.  Probably because it is so reminiscent of my early training with Greenberg and Hodgson, I am finding EFIT fits best for me as a therapist.

Thanks are due to the clients who have worked with me as I hone my EFIT for trauma skills.

 

 

Janina Fisher’s Method for “Healing the Fragmented Selves of Trauma Survivors”

Posted on by Wendy E. Smith, MA, LMHC

For years I have been searching for the right method of trauma treatment for me and my clients with complex developmental trauma.  I am, therefore, very excited to have been learning of late, from Janina Fisher’s latest book and from an online course with her, about helping clients overcome the “internal self-alienation” that can result from such ongoing traumatic experiences as childhood neglect or abuse.

Fisher uses the Structural Dissociation model as the basis for her understanding of trauma symptoms.  This model theorizes that, when trauma occurs, the personality splits into a “going on with normal life” portion of the self and trauma-related parts of the personality which are formed as coping mechanisms to deal with overwhelming experiences.  These parts are: fight, flight, freeze, submit and attach.

Clients with traumatic symptoms blend with one part or another at different times and think that they are that part, rather than a larger self that contains all the parts.  Thus, they may be overcome with anger (fight) at one moment and just want to escape (flight) at another moment.  This internal chaos is very confusing and distressing for clients and can also be confusing to therapists!

Using wisdom gleaned from Schwartz’s Internal Family Systems model and from Sensorimotor Psychotherapy, Fisher demonstrates how to help clients “unblend” from their parts by helping them see their parts via the light of mindfulness.  She then helps them get to know and befriend their parts so that the parts (which are stuck back in the age of childhood in which they were formed) can be brought up to date and get what they needed back then from the client’s adult self now.  In this way the personality gradually re-integrates and trauma symptoms subside.

I am particularly excited by this method of trauma treatment because it jibes well with the attachment basis and techniques of Emotion-Focused therapy which I have been using for years and because trauma can be healed without the pain and suffering of re-experiencing traumatic memories.

The Shame Critic and the Anxiety Machine

Posted on by Wendy E. Smith, MA, LMHC

According to Les Greenberg, Ph.D.,  the creator of Emotion-Focused Therapy, there are two kinds of inner voices that cause problems in people’s interior worlds, often just outside of their awareness.

One of these voices is what I have come to call the “shame critic”. This is the voice that tells people what is wrong with them, often in the most damning of terms. When people don’t realize that it is their shame critic that is talking to them, they tend to hear its words as “the truth”, and the result is they feel crappy about themselves–crappy and ashamed.  And, since shame is such a painful feeling, people with an active shame critic often become depressed.

The other  inner voice is what I call the “anxiety machine”.  This voice produces anxiety by telling people all the things they should be afraid of.  It has a very active imagination and comes up with all sorts of scary scenarios to warn people about.  People with an active anxiety machine in their heads often can’t relax or sleep.  They may feel exhausted, and their necks and jaws may ache.

So, if the result of these inner voices speaking to us is so emotionally destructive, why do they do what they do?  The answer usually is that they came into being early in life, often modeled after the voices of parents or other authority figures, in order to protect the child who has been hurt from further hurt, or the child who has been neglected from getting into trouble when she finds herself having to deal with situations above her developmental level.

If our shame critic gives us a good walloping for making a mistake, the logic of the critic goes, especially if the mistake is the kind that may lead to others’ disapproval or rejection, then perhaps we won’t make that mistake again, and will therefore not suffer the painful results.  If our anxiety critic warns us about every possible bad outcome that might occur, then we will be really, really careful and maybe not get into situations in which we are over our heads and maybe, just maybe, be able to avert interpersonal and other disasters.

After the shame critic and the anxiety machine get created in childhood, they just keep  on going, causing  emotional problems for adults who no longer need their protection.  These inner voices may be well-intentioned, but their effects are deleterious.

In working with these inner voices, Emotion-Focused therapists like me first help clients to become aware of them, and then create in-session experiences in which the part that has to listen to the inner voice, the “experiencing self”, and the voice itself can come to a better understanding of each other.  Once shame critics and anxiety machines realize the actual impact of their actions, they are often quite willing to soften their approach, or even stop talking altogether.  Often, after such therapeutic work, all that it takes to get one or both of these inner voices to pipe down in real time is a reminder from the client about the in-session agreement that was made.

 

Independence versus Interdependence in Relationship

Posted on by Wendy E. Smith, MA, LMHC

A lot of times, when couples come in to see me, one or both of the partners will have the idea that a problem in the relationship is that one or both of the partners is too dependent on the other. Often, in this regard, the partners will use the term “co-dependence” which has come into the vernacular from addiction theory and become sort of a dirty word.

Partners have the idea that a strong person stands on his own two feet and does not need things from his partner, and that needing things is “weak”. Certainly, being able to stand on one’s own two feet is a good and important life skill that helps us in many arenas, and through many challenges, of life. However, the whole purpose of being in a relationship is actually to be able to lean on another person and not go through life alone. Through our adult relationships, we get our attachment needs (those that earlier in life were hopefully met by our parents) met. Thus, when we are scared. we can reach for reassurance, when we are hurt, we can reach for comfort, when we feel ashamed, we can reach for acceptance and validation.

When both partners feel secure in a relationship (and here I often put the tips of my fingers together to form an A-frame shape) and can lean into the relationship for support, then the structure of the relationship is strong. In fact, a lot of the work we do in Emotionally Focused Couples Therapy is to help partners learn to reach for what they need from their partner and respond to their partner’s reaches in kind.

And here we get to the crux of the matter. The truth is that relationship distress occurs when partners are too scared to reach for what they need from each other. Instead, they try to get their attachment needs met through indirect means that lead to confusion, arguing, pursuit and withdrawal, and distance, instead of the result they are hoping for.  And, when there is distress in the relationship, it becomes even scarier to reach and lean in.  In fact, it takes a whole lot of courage.  It actually takes a lot more strength to learn to be interdependent with one’s partner than to stand separately on one’s own two feet.  Personal strength in relationship leads to interdependence which leads to a stronger relationship.  Independence, it turns out, is not all that it’s cracked up to be.

Book Recommendation for Childhood Trauma Survivors: Not the Price of Admission by Laura S. Brown, Ph.D.

Posted on by Wendy E. Smith, MA, LMHC

On a trip to New York and back, I recently read Laura Brown’s excellent book for survivors of childhood abuse and neglect (including emotional abuse and neglect):  Not the Price of Admission:  Healthy Relationships after Childhood Trauma.  Here is part of a review by Kathy Steele from the back cover of Brown’s book that I think captures the essence of this book well:

“Laura Brown… has given us a book that is delightfully authentic and readable, chock full of humor, honesty, compassion, and–most importantly–realistic hope. How can people who have been terribly hurt by their caretakers in childhood ever learn to trust and love again?  Dr. Brown explores this agonizing question with refreshing clarity, sharing stories that illustrate tough issues and realistic solutions.  She truly gets the impossible dilemma of desperately wanting emotional intimacy, yet being paralyzed by a belief that you are unlovable, and mired in the deep mistrust and  confusion that only profound betrayal can engender.  Dr. Brown offers realistic and compassionate pathways to (re)learn how to take the tough but essential risks of authentic connection with the right kind of people, so you no longer find you have to pay a price for love.”

In particular, Brown explains how to raise or lower the volume of one’s “cheater detectors”, depending on which way they have been miscalibrated as the result of adverse childhood experience, and how to determine which people are and are not trustworthy.  She also explores how to set new boundaries so as not to continue to pay a price for participation in relationships with reliable people who never wanted the survivor to pay such a price in the first place, and end (or not get involved in) relationships with people who are likely to re-traumatize the survivor.

Brown clearly articulates how the predicaments survivors find themselves in came to be and are not their faults, and also how to start taking responsibility for changing them.  Survivors are likely to find this book eye-opening, affirming, useful and empowering.