Therapist response

I learned from reading about it and from my own experience that the response of the therapist is key to moving forward in therapy.  I was blessed with my first counselor that delivered just the right mix of validation, encouragement and teaching new skills.  Later experiences I had one not believe me, another tell me to tell my story without all the emotion, and one that I handled her with kid gloves because I realized that when she said she didn’t have a lot of experience with trauma therapy she was right.  I could sense that she wanted to be encouraging and validating but some of my mild experiences I watched her shy away from talking about the uglies.  Now, I am on my own and haven’t been in counseling for years.  I miss my first counselor and then I would think about the things he told me in different situations and his voice starts to overwrite the negative tape that plays in my head.  I’m going to share what the Best Practices recommends:

https://www.blueknot.org.au/Workers-Practitioners/For-Health-Professionals/Resources-for-Health-Professionals/Best-Practice-Guidelines

 

4.3 Responding appropriately and safely to disclosure

A primary goal of self-trauma therapy is to avoid overwhelming the client, while at the same time facilitating exposure to traumatic material so it can be desensitised and integrated (Briere, 2004). Effective therapeutic responses occur on a continuum, between interventions devoted to a greater awareness of potentially threatening, but therapeutically important material (exposure), and those that support and solidify previous progress (consolidation). Consolidation is concerned with safety and involves activities that reduce arousal and ground the client in the here and now (Briere, 2004).

‘Active listening skills’

Most survivors of abuse find talking, in general, cathartic and talking about the pain caused by their abuse history useful in particular. Therapists who listen to the survivor, ask clarifying questions, name the survivor’s experiences, and do not overly challenge what the survivor says, help the survivor make the most progress. Once the relationship is well-established, it may be appropriate to offer interpretations, but until then, it is most therapeutic to point out contradictions but not offer opinions as to their possible psychological origins. Active, direct participation in validating the survivor’s perceptions, feelings, and experiences, in addition to acknowledging the information being shared, and checking to make sure it is appropriately understood, are all important parts of treatment. Often, simply repeating what the survivor has said out loud helps to validate her/his thoughts and feelings in ways that they have never been validated before. Simple but powerful, this may be the best approach a therapist can take even if the survivor is not ready to deal with other issues at that time (Walker, 1994, van Loon & Kralik, 2005a).

In addition, research shows that ‘ignoring the disclosure’ or ‘rushing them’ is experienced as particularly harmful by survivors of child abuse (Josephson & Fong-Beyette, 1987). Elie Wiesel a Holocaust Survivor is quoted as saying “What hurts the victim most is not the cruelty of the oppressor, but the silence of the bystander”. This is also true for the survivor of childhood abuse who discloses and is met with silence, or tells and is not believed, or tells and sees no further supportive action as a result of disclosing (cited in van Loon & Kralik, 2005a).

 

Several psych words my need definitions.

desensitized  – process of small dose exposure to a trigger in a safe environment allowing the client to process information.  I’ve done this with several triggers.

cathartic – providing psychological relief through the open expression of strong emotions; causing catharsis. “Crying is a cathartic release” (Online dictionary)

 

You can see by the listing of references that these ideas are shared by several different psychology authors.

Not every therapist has the skill and talent for reassuring while pushing the client forward.  It is much like a cha-cha one step forward two steps back…step to the side and spin around to give it another try.  No one I ever talked to had a straight linear progression.  There are moves forward, time to gather resources and times they fall back.  One of the fall back times my counselor asked me the advantage of hitting bottom yet again.  I joked, “It is familiar territory.”  He laughed shook his head and reminded me that I know how to get out again.  It is an on going cycle of moving forward, grounding, regrouping, resting, moving forward again.  For a long time I would beat myself up for having set backs.  Now I know it is part of the process and after a rest I’ll go again.

 

Therapy progress

 

 

 

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