Healing World Trauma with the Therapeutic Spiral Model. Группа авторов

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СКАЧАТЬ 6, Dr. Cho guides you through an exploration of the Team structure and the TSM international certification training process from a Taiwanese perspective. For full information on the current International Certification Training Program in Trauma Therapy using the Therapeutic Spiral Model, please visit the Therapeutic Spiral Institute (TSI) website: www.drkatehudgins.com.

      The Six TSM Safety Action Structures

      To create controlled clinical action and warm-up, we developed a modality of Six Safety Action Structures (Cox 2001), adapted from classical psychodrama, art therapy, and Jungian-oriented sandtray, that are used in all TSM workshops. These Structures provide for: 1) assessment; 2) connection; 3) containment; and 4) narrative labeling of trauma—before we begin our first Prescriptive Role dramas.

      Group members often find these clinically controlled warm-up structures tremendously powerful since they help them to move safely and more deeply into their trauma material with a sense of containment and a growing connection to other group members. The Structures teach them the opposite of their PTSD experiences of intrusive flashbacks, body memories, and intense emotions, so they can trust that TSM is a safe, experiential method. Clinically speaking, each TSM Safety Action Structure serves a specific purpose that is explained below.

      The Setting

      As people come into a TSM workshop, the first thing they see is a pile of brightly colored scarves in various textures and sizes. Around the scarves are inspirational cards with a combination of images and a few words on the front of the cards. A circle of chairs completes the picture. Art supplies are off to the side on a table.

      First Safety Action Structure: The Observing Ego (OE)

      The clinical purpose of the inspirational cards is to create a role that is a neutral, non-judgmental, observing, and sensitive witness to self. This is the most important role to establish with someone who has experienced trauma and violence because they always have an internal voice of self-blame, shame, and self-criticism. The Observing Ego (OE) role is established to begin to change that negative voice. It also connects with the pure cognitive mind, providing a place for the director to role-reverse the protagonist if s/he gets overwhelmed with too much emotion or becomes dissociated and unable to stay present.

      The OE cards are introduced by asking group members to pick up one or more cards that they think will serve as a good witness, a good neutral voice to help them throughout the day’s workshop. Forming pairs, they then discuss why they picked their cards and how the essences of the cards might help them. To expand the sociometry, the director or AL may ask several additional questions as people change pairs, or build small groups of four or more. They then put the cards on a wall where they will serve as a physical place for the OE to stand in a drama, if needed.

      The second day is the Trauma Day in TSM workshops, so we use cards that are purely projective images without any words. The instructions are to pick one or more OE cards to help group members to see and share their traumas without judgment. Again, they share in pairs and/or small groups and then put them up on the walls. Since the third day is the day of Transformation, the cards now contain more words and fewer images to emphasize that transformation includes bringing change into language and meaning-making. The cards and their associated words create a new story so that group members can remember and anchor it into the left-brain to help to guide the future.

      Second Safety Action Structure: Circle of Safety

      The clinical purpose of the Circle of Safety is twofold. First, it is designed to create the actual stage for TSM dramas. More importantly, it is used to demonstrate visually to group members the idea of containment of trauma through strength building. Once the circle is created from scarves representing strengths on the first day of a workshop, the Team makes sure that it stays fully contained throughout the entire workshop. Whenever someone uses a scarf during a drama or an exercise, a Team member joins other scarves to close the gap. This teaches group members that they can keep a boundary against intrusive thoughts, images, and body memories by using their strengths. As the workshop goes on, it is interesting to watch the amount of attention paid by group members to keeping the circle intact.

      After we have established the circle by naming and enacting personal, interpersonal and transpersonal strengths, the director asks the group to mill around inside the circle, acknowledging this as the group’s experiencing space, an emotional container. She or he then asks them to step outside the circle into the observing space, making clear to group members that both are equally important in TSM—the cognitive and emotional must be balanced so that the brain is not overwhelmed and re-traumatized in dramas.

      Third Safety Action Structure: Spectragrams

      The third Safety Action Structure in TSM serves the clinical purpose of assessment. A Spectragram is a “fun and quick” action structure for the group to make connections, to learn about each other, and also for the Team to assess strengths and weaknesses, especially in a client group that has come for personal healing or therapy. A minimum of three or four Spectragrams, up to six or seven, can be done depending on how much information will be needed.

      A Spectragram is an imaginary line between two opposite poles. One TAE stands at one end of this line, taking one polarity and another TAE at the other end. The usual first criterion is to learn about the level of experience with action methods. The direction is given thus:

      Stand at this end of the line if you have a lot of experience with action methods and at this other end of the line if this is your first time with action methods. If you have some experience but not a lot, stand in the middle. Please talk to the people around you so you know where you fit on the line.

      Or, another way we have given these same directions, but with a little humor to make things less threatening, is that the director will explain how the Spectragram works, appointing TAEs to occupy each end of the spectrum. Each TAE will say:

      I am Zerka Moreno and I stand at this end. If you feel you have as much experience with action methods, then place yourself with me.

      I am invisible; I have never even seen or heard of action methods so I’m not here. If you are not here either, then join me.

      Whatever method you employ, this technique gets people up and moving their bodies, in closer proximity than they had been before. It also has them verbally interacting with each other since they have to find out where to place themselves.

      Depending on the group and as they get warmed up, the director might ask group members to identify with statements as deep as:

      •I am very excited to be here vs. I am scared to death to be here.

      •I come with a lot of hope of receiving help here vs. I am in despair of receiving help.

      •I am very suicidal right now vs. I have never thought of hurting myself.

      As part of the containment structure of TSM, it is most important that you end your set of statements with the last one or two being positive criteria. For example, some of the positive statements might be:

      •I have at least one person who has helped me in life vs. I have a lot of people who have helped me.

      •I have helped at least one person in my life vs. I have helped a lot of people in my life.

      •I have at least one person who needs me to get better vs. I have many people who want me to get better.

      Usually, at this point we will take a break in the workshop structure and let people talk to each other, have a СКАЧАТЬ