Healing World Trauma with the Therapeutic Spiral Model. Группа авторов

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      Foreword

      Therapeutic Spiral Model as a Type of Psychotherapeutic “Heart Surgery”

      As the authors demonstrate and describe in the first few chapters, trauma is qualitatively different from ordinary neurosis and as such it requires a more intensive approach. The treatment of Post Traumatic Stress Disorder (PTSD) hardly responds to talk therapy. The therapy that counters this complex must be correspondingly deep and more elaborate. I view it from my background as a physician—some people respond to medicines, and some people need major surgery. For trauma, the Therapeutic Spiral Method™ (TSM) offers a complex of techniques that represents the equivalent of heart surgery for trauma survivors.

      About 22 years ago Kate started this work, with Francesca coming in 20 years ago to co-develop TSM as a clinical model of experiential work that integrates the best of psychodrama with other action processes. Several articles, chapters in books, and books have been written since then, and many colleagues have found this approach relevant and effective. Since 1995 TSM has been brought to the international scene and this book offers a further report about how the process has matured and been adapted for use by different populations.

      One of the problems of classical psychodrama is that if it isn’t used with great wisdom, it has the potential to re-traumatize the main player (the protagonist, the one whose drama is being explored). TSM has the advantages of using psychodramatic methods while also meticulously avoiding the pitfalls of re-traumatization. Indeed, this approach specifically works with the fragility and defenses in a way that makes use of the many developments in psychotherapy, including more recent trends that integrate neurobiology. The point is to help the clients or main players to develop skills that can help them better integrate all that was dissociated.

      Being a retired psychiatrist who was trained at a time and place when psychotherapy was a key component, and becoming interested in comparing the underlying elements in psychotherapy as I sought to generate a rationale for my maverick venturing into psychodrama, I enjoy noticing the parallels. Even though there are precursors, I do consider this work to be truly innovative!

      At the core of TSM is the Trauma Survivor’s Intrapsychic Role Atom (TSIRA), a template of roles that the client or protagonist carries within. It involves the notion of adding supportive and creative roles to the protagonist’s role repertoire. But there are other roles, too: trauma-based roles and transformative roles. The TSIRA is thus an active application of what psychoanalysts call “object relations theory.” We all unconsciously imagine and play out scenes deep in our minds; we “hear” at some deep level what the significant others would “say”; we “see” the expressions on their faces. And then we compare this more or less with the real responses and sometimes dismiss what is really being said.

      The TSIRA makes this more explicit, identifies other roles that for most people remain vague, even unconscious, and, by naming them, calls them into active operation. It can give more power to positive inner functions and help to neutralize the power of negative introjects. This is sometimes a creative process, suggesting, for example, the presence and operation of an inner, neutral observer (the Observing Ego role) in people for whom that role had never operated. Creating such a role might help to replace old mental habits of negative self-judging. People can be helped to generate and cultivate these internal supports. Healthy people do this to some degree, and, indeed, that may account for a good deal of why they are mentally healthy! Troubled people have had no modeling, and the culture doesn’t lay out how to do this. However, creating positive inner roles is noted in the chapters on applied role theory in my Foundations of Psychodrama (4th edition, 2000). And with TSM these positive roles are “prescribed” in the TSIRA before approaching any trauma material.

      In TSM two processes meet and reinforce each other: experiential learning (including un-learning old patterns and dysfunctional but deeply held values while re-learning more refined and life-affirming values and skills) and the power of support by others (the TSM action team and the group itself). Lest this seem obvious, note that for much of early life most people are acculturated into a type of learning that is instructional rather than experiential, and a type of learning that is individualistic and even competitive rather than collaborative. So discovering that others can help (and want to help) and in turn appreciate that by doing this process the client is helping СКАЧАТЬ