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Treating Attachment Trauma with Compassionate Imagery, with Deborah Lee, DClinPsy

30 Comments

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.

 

 

Click here for full transcript
“I worked with this lovely woman who had a very difficult childhood, where she was neglected and witnessed a lot of physical abuse between her parents and her other elder brothers and sisters. She was never physically abused, but she was totally neglected. Her brain was developed in a void – nothing, no one comes, no one rescues, no one makes it better. So, that’s her attachment learning.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 hear more from Deborah (and other top experts like Chris Germer, PhD; Jack Kornfield, PhD; Kristin Neff, PhD; Paul Gilbert, PhD; Ron Siegel, PsyD; and more) about how compassion-based practices can enhance our work with trauma, have a look at this short course.

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.

If you found this helpful, here are a few more resources you might be interested in:

How to Rebuild Secure Attachment After Trauma

Treating Attachment Trauma

Treating Trauma with Compassion-Based Therapies

 

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Related Posts: Compassion, Healing Trauma

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30 Comments

  1. Sheila Murray, Counseling, Choteau, MT, USA says

    Thank you. Helpful perspective of bringing the compassionate state of mind on board before working with traumatic memories.

    Reply
  2. Eva Kuczewski-Anderson, Psychotherapy, DE says

    Very helpful, thank you! Bringing in the felt sense is ver crucial in this work.

    Reply
  3. billur ugursal, Psychology, CA says

    Very helpful strategy to bring calmness, centeredness prior to tackling the troublesome flashbacks. Thank you,

    Reply
  4. Renée Glick, Psychotherapy, Los Angeles , CA, USA says

    Very good, useful insight here! It is an easy mistake to make, but one hard to reverse especially if client has trust issues.
    A subtle tweak but an important one!
    -Not going into the trauma memory before bringing the compassionate system online with a question of what would have made it a good or better experience and introducing a new nurturing element. THEN engaging the memory, creating and activating a new emotional felt sense. Yes!

    Reply
  5. Brad Reed, Counseling, Vancouver, WA, USA says

    Fascinating video!

    Reply
  6. Rosa W., Psychotherapy, BE says

    This is just GREAT!!! I did it the other way around and it does help sometimes but not always. It is not very strong. I am definitely going to turn it around as proposed and I am very curious about the results!

    Reply
  7. Lorraine LaPointe, CA says

    Can you hear and feel the voices of your hurting Parts? I trust you’ll find a compatible therapist who can help you to release this pain.

    Everything is “fantasy” when you understand the mind is what attributes meaning to EVERYTHING… reality is “believed-in imagination plus the meaning given”. We know this because when doing brain surgery, probing and stimulating particular areas of the grey matter produces smells and visualizations that don’t ‘exist’ for others, but are experienced as real to the patient.

    So, I believe Attachments and trauma are meanings our mind has made to events experienced and the people who are around us.

    For example:
    A client spent 40 years believing her the woman who abused her mercilessly, was her Mother. After discovering adoption papers, her whole perspective changed. She was then abused by “some woman” who had used her only as a source of income. Suddenly, there was no expectation of “mothering” from this person and the release of pain from memories was much easier.

    Reply
  8. Lisa Maria Walton, Marriage/Family Therapy, CA, USA says

    I would like to offer the perspective of “somatic therapeutic practices” in either conjunction w/talk therapy, or a stand alone intervention. Somatic psychotherapy works w/the body and mind, unlocking trauma from the “reptilian” part of the brain. Talk therapy in most instances is helpful in navigating life’s challenges (accessing the prefrontal cortex-the thinking brain), but when addressing trauma, the work is tailored to the emotional brain, hidden deeply in the regions that are felt to play an important role in PTSD include hippocampus, amygdala.

    Reply
  9. Erica Schwing, Another Field, NL says

    She is not denying it. It is not to distort. You have to understand the physiology of trauma related memory being stored. If it is not processed in the right way it gets stuck with the painful feeling. The memory gets stored in our brain with the feeling. And what EMDR for instance and this kind of theory tries to do is to actively engage other parts of the brain to try to re-store that memory with a less negative load on it. It is a part of the processing of the memory. It took me quite a while to understand this, but it makes sense. The memory and feeling are sort of disconnected. And then the traumatic memory can be re-stored without the negative feeling load with it. It is not about denying at all. Quite the contrary.

    Reply
  10. Christine Urja Refalo, Psychotherapy, AU says

    I’d like to do the compassion group with Deborah. Is this possible to do this online?

    Reply
    • NICABM Staff says

      Hi Christine, unfortunately we do not offer any online groups with Dr. Lee.

      Reply
  11. Maggie Hess, Psychotherapy, GB says

    Highly sensitive piece of work, beautiful.

    Reply
  12. Maggie Hession, Psychotherapy, GB says

    From my understanding, the emotional pain has been acknowledged and empathically contained, it’s now available for transforming.

    The therapist has understood the emotional impact of the neglect and the shame attached to it. It hasn’t been denied but worked with, sounds like EMDR. She’s talking about memory being malleable the emotional charge attached to the imagery is being overwritten, de-sensitised.

    Reply
  13. Colleen Harris, Clergy, Spring, TX, USA says

    This method is very much like techniques we use in Christian Inner Healing sessions. The Immanuel Approach or Immanuel Presence developed by Dr. Karl Lehman is most useful in establishing through visual imagery being in a compassionate beautiful place. They are then coached to ask Jesus to join them in the image. Once he joins then, we have them ask, “Jesus, what do you appreciate about me?” He always answers and we have the client relate to us the conversation. Then we coach the client to tell Jesus what they appreciate about Him in that moment. The opposite of what they appreciate about him is usually the source of their trauma. We then ask the person when was the first time they remember experiencing something like that. We coach them to be back in that memory and look around to see where Jesus is. What is he doing? What does he want them to know? What lie did they come to believe at that time? What is the truth, Jesus?
    It is absolutely incredible what God will do with these trauma memories. He just steps in and fixes them without having the person trying to imagine the perfect scenario.
    In any event, I would love for you to interview Dr. Karl Lehman and Dr. Jim Wilder, who have developed this incredible way to bring emotional healing based on neurobiology and faith.
    I am thoroughly enjoying the trauma series and all you offer. I am not a professional, but a volunteer in a non-profit who does this type of prayer ministry. I learn everything I can and am very familiar with Bessel’s work as well as Peter Levine’s work. I try to take advantage of y our offers as much as I can possibly afford since I am a widow on social security.
    Thank you for all you do.

    Reply
    • Ginette Olsen, Counseling, USA says

      Thanks Colleen for your sharing. As a psychotherapist for over 20 years, I have integrated specialized prayer (or transformational) in my synergetic clinical approach, referring clients to well trained and boundary honoring practitioners. When I attended basic EMDR training (12+ years ago) I had tears identifying the similarity of process and outcomes of the approach with Immanuel and/orTransformational prayer approaches. The latter case, including a direct divine presence, as you mentioned.
      Also, Wilder’s NeuroTheology is a consistent contributor to developmental trauma recovery, growth and meaning/joy/relationship making.
      Ginette Olsen, MEd, PhD, LPC/LMHC

      Reply
  14. Sibylle von de Fenn, Psychotherapy, FR says

    Great work!

    Reply
  15. Joanne Sunshower, Another Field, Overland Park, KS, USA says

    A Peer Counseling method called Re-Evaluation Counseling, formally launched in the 1970’s, discovered many of these principles. This method along with practices developed during the same period in feminist support groups have served my re-orientation for the past 50 years–affordable & accessible, while learning the empowering discipline & ability to act both as healing witness & healing client.

    Reply
  16. Yolaine Arsenault, Psychotherapy, CA says

    Great simple explanation of something quite complex

    Reply
  17. Robin Trewartha, Psychology, GB says

    Or could it be a unique client/therapist ‘protocol’, April? Sounded a safe and held process to me. I find clients can differentiate denial and affirmatory actions when they are consulted. Clients are often a minimised or discounted part in the change process. The ‘letter writing’ is, in my experience, a good way to counter that tendency.

    Reply
  18. Peggy Winkel, Other, USA says

    Beautiful work! Thank you!

    Reply
  19. Sara Beach, Teacher, Aurora , IL, USA says

    As a PreK teacher trainer and coach for teachers who work with traumatized kids, I would like to bring this idea forward into the teaching relationship, by helping teachers understand the amazing power of a “compassionate felt sense.” I would want them to consider that without retraumatizing children by making them remember/talk about their experiences, they could routinely encourage imagery of compassionate, protective care, and teach children that they can carry that imagery with them. Teachers do explicitly teach little ones that “when you feel scared you can…..xyz…” so it seems to me that encouraging children to imagine a compassionate protector—perhaps a character —when they feel scared or sad, and then together basking in that “felt sense,” would be really powerful. Finally, calling up that character and the related felt sense at stressful times of day or whenever a child becomes dysregulated, could be extremely helpful.

    Reply
  20. Vivienne Collis, Counseling, GB says

    I would probably use Lifespan Integration here, to calm the distressed Child and use the Timeline process to integrate her with her Adult Self today.

    Reply
  21. MARYAM RUSSON says

    Very insightful. compassionate Imagery is a powerful technique to neutralize that emotion.

    Reply
  22. Karen says

    I cannot speak for anyone else but I can share some of my experience with compassion and imagery. Many years ago, before I became a psychotherapist, I was in therapy with someone schooled in psychosynthesis, which helped me articulate what it was I had deeply wanted to happen with my own trauma experience. I neither felt deluded nor that my original experience was denied in any way. In fact, it was enormously helpful in giving me hope, that I could be an instrument of change, that there wasn’t just one way of experiencing life, either in the past, present or future.

    Reply
    • JUDY WINTERS, RENO, NV, USA says

      thank goodness I am counting on that. dr mate and others mirror this person’s work and its success. I believe it.

      Reply
  23. Paul Wanio, Psychotherapy, West Palm Beach, FL, USA says

    I believe it is a transformation, rather than a denial. Similar to forgiveness not being forgetting, but a new perspective. When transformed, there is no need to deny.

    Reply
    • Kim Wallant, Counseling, Montville, ME, USA says

      Yes, transforming a traumatic event into an occurrence that has a positive outcome. Re-storying the past to empower the survivor.

      Reply
  24. Judith Schacht, CA says

    I am very impressed with dr. Lee’s work, and her presence with the client and her ability to explain how the process works.

    Reply
  25. April Lyn, Marriage/Family Therapy, USA says

    Wondering which protocol/method was used? Was this EMDR, PE, CPT, or trauma narrative reprocessing? I really appreciated this step of self compassion imagery, so useful, and so healing. Thanks for sharing.

    Reply
    • Karen Miller, Psychotherapy, Housatonic, MA, USA says

      Thank you Deborah Lee! Using compassion and imagery with attachment trauma seems like a highly humane and effective way to be present with and help our clients. It’s like watching plants moving towards the light. And it gives people the ability to create whatever image they need that is appropriate and really key for them.

      And thank you Ruth for having her. Any more of this type of work, exploring attachment and compassionate therapy?

      Reply

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