Attachment trauma can leave clients on constant alert for threats . . .
. . . which can make processing traumatic memories incredibly difficult.
So in the video below, Deborah Lee, DClinPsy, shares how she worked with one client who was severely neglected in her childhood.
She’ll walk you through the imagery exercise she used to reduce feelings of threat before helping this client process her flashbacks of being abandoned.
Have a look.
She had lots of trauma symptoms – she had PTSD, and she had lots of flashbacks to memories of being neglected and abandoned and frightened. But we helped her through that. She went to our compassionate resilience group, which is a 12-session group with other women, to develop her self-compassion. We used the group format mostly for developing self-compassion because it just lends itself very nicely to affiliation and connectedness.
So, having been through the compassionate resilience group, she then came into my one-on-one therapy and had sixteen sessions of trauma memory work. First, we narrated the whole story – so we got the framework of the whole story, the roadmap. Then we focused in on the particular flashbacks and nightmares that she was suffering from. And with each flashback and nightmare, we systematically recalibrated the meaning by bringing in a compassionate perspective and a compassionate emotional felt sense, using imagery.
An example of that was, she had a memory of being left alone when she was about five or six and feeling very ashamed. She’d gone to school and at the end of the day, the little children would sit on the bench with their little rucksacks waiting for their parents to pick them up. But no one came for her. And no one could get ahold of her parents. She was eventually taken into social care for the night because no one came. And she finds that a really shaming memory because there was no greater shame for her than to not matter to anyone. It didn’t even cross anyone’s mind that she needed to be picked up.
So, we developed a caregiving imagery. In fact, we used a “perfect nurturer” imagery for her, too. And I said, “What was it, or what is it, that you think you would need, in that memory, that would make that a different, more helpful, more healing experience?”
She said, “Nothing much. I just want them to turn up at the doors, go up to me, give me a big hug, and just take me home and make me my favorite kind of sandwich, and just cuddle me. That’s what I want.” I said, “Okay.” She didn’t mind about changing memories as such, because you can do what you like with memories. You don’t have to keep them accurate to the cause because you’re changing the emotional felt sense.
What we did was we engaged her in the exercises of breathing – so we settled her mind, we brought her imagery online. And this is really important that we bring in the compassionate imagery first, and then we say, “Right, let’s bring the trauma memory – the memory of you being alone – to this mind state.”
And this is really important that we bring the compassionate system online first before we invite the trauma memory to the conscious mind that relives it. It’s really important because that’s when you can keep it engaged and it can do its work. If you do it the other way around, it is incredibly difficult to bring compassionate imagery into a highly threatened trauma mind. It won’t have any of it. So, it’s important you get it that way around.
So, we brought her perfect nurturing felt sense online, and I just invited her to relive that memory. So through a traditional reliving exposure paradigm, “Let’s go over it as if it were happening again. But this time, we’ve worked out, this is what your ‘perfect nurturer’ is going to do in the imagery.” And what happens quite typically is that the emotional sense just dissipates, it just changes, because the compassionate system keeps the threat out so that you can bring new emotional insights into the experience.
So that’s when you get the reintegration and the update of the emotional felt sense. That’s effective. You’ve got to put that into a different language. The hippocampus is engaged and you’re bringing in the threat memory and integrating it and contextualizing it with a new emotional felt sense and popping it away in the long-term memory store. That’s ultimately what’s happening. Threat just doesn’t feel threatening when you have the compassionate system online because they’re reciprocally inhibitory. You can’t have them both at the same time. It’s important you get that one on first before you bring the threat to that state.
We very systematically worked through all her key flashbacks and memories that caused her distress, by using either imagery rescripting or flashback updates. And then at the end of having gone through the key emotional experiences, we did a couple of things. We wrote some letters to her parents and compassionate letters about her, as she felt, finally speaking her truth. She didn’t send the letters – they were symbolic. But she voiced, from a compassionate perspective, her experience of her childhood. We also wrote a compassionate account of her life through the lens of her self-compassion.
And that became the symbolic ending of the journey, where the book – if I do it visually – the traumatized chapter goes from being opened, thrusted in your face, defining everything you see, to being closed on the shelf – a sad part of my life, but no longer dominating the version of me that I want to be.”
To get more strategies for working with attachment ruptures, have a look at this short course featuring Bessel van der Kolk, MD; Pat Ogden, PhD; Allan Schore, PhD; Dan Siegel, MD; and Ruth Lanius, MD, PhD.
Now we’d like to hear from you. How might you use this imagery exercise to help your clients who have experienced attachment trauma? Please let us know by leaving a comment below.
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