Healing World Trauma with the Therapeutic Spiral Model. Группа авторов
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Название: Healing World Trauma with the Therapeutic Spiral Model
Автор: Группа авторов
Издательство: Ingram
Жанр: Медицина
isbn: 9780857007001
isbn:
Additionally, through constant feedback on evaluation forms, therapist follow-up, open discussions in training groups, and shared leadership as trainers, TSM has been able to continue to develop and mature. This book reflects the ways that students and colleagues take TSM and “make it their own,” adding to it their areas of expertise and knowledge—which, in turn, influences the model to change, grow, and develop into an even better system of experiential psychotherapy. The reciprocity, the give-and-take, creates a broader yet more specific base from which to treat PTSD, addiction, eating disorders, and other stress and psychiatric ills in today’s world.
The Spiral Image
The spiral image emerged from Kate’s experience as a clinical psychologist and psychodrama trainer with her own history of sexual trauma. Having had PTSD before it was a diagnostic category, she knew first-hand the internal experience of chaos, of body memories, flashbacks, and other disruptive symptoms that felt like a tornado. When they would come on unexpectedly, the personal experience was one of being buffeted by wild winds swooping in from every direction. As all untreated survivors know, this sense of being totally out of control and helpless is internally generated, unlike the original trauma, which was interpersonal.
Working with trauma survivors as a clinical psychologist, Kate chose a spiral of energy as a way to begin to channel and focus the chaos without repression. She sought to give clients a step toward safety and containment, to move one step from a tornado to a spiral that could begin to be consciously controlled. Kate knew that the chaos could not be immediately stopped, so she taught survivors a tangible and workable tool to anchor them in the here-and-now reality of safety. The tornado now becomes a spiral of energy containment.
Second, timeless images of spirals are found collectively as healing symbols, from ancient cave paintings in France to shamanic use in Native American cultures to modern medicine’s Hermes’ caduceus, which originally had ribbons (TSM ribbons?) instead of serpents winding around the rod. In TSM, the spiraling energy represents the journey of a trauma survivor from hell to healing. Because PTSD, by American Psychiatric Association (APA) definition, is a condition beyond normal human experience, we join with other therapeutic and spiritual traditions in that one of the Spiral’s core threads ties survivors into a transpersonal or spiritual dimension of healing.
TSM also recognizes classical psychodrama, which has as its mode of action the Psychodramatic Spiral (Goldman and Morrison 1984). This spiral is about approaching a drama from periphery to the center—a circular motion of metaphorically walking around and slowly closing in on an issue. While not exactly the same, TSM’s modus operandi is to approach traumatic experiences by setting up strengths and safety first through a series of roles and then, with deepening dramas over time, to descend gradually to the core issue—for safety reasons, never slicing through to the quick.
Spiral Threads
The fabric of TSM is strong, woven by many hands, while the Spiral’s three strands represent the three basic and far-reaching elements of the work—Containment, Experiencing, and Meaning-Making.
Containment: keeps the protagonist and all members of the group in the here-and-now with access to both thinking and feeling. It is an operationalized state of spontaneity, meaning that it allows an appropriate response to whatever appears.
Experiencing: all aspects of the protagonist’s internal and external awareness are presented safely in the here-and-now so that s/he can make spontaneous and creatively healthy decisions to change old situations with new actions.
Meaning-Making: develops a new cohesive, personal narrative that organizes the past in a good way and provides guidance to the future.
The First Spark of TSM: Kate Hudgins’ Story
In 1941, J.L. Moreno, the co-founder of psychodrama, began a training program at St. Elizabeths Hospital in Washington, D.C., in psychodrama and group psychotherapy. Decades later, on a year-long internship funded by the National Institute of Mental Health, Kate had the good fortune to receive clinical training in this modality from Dale Richard Buchanan, Ph.D., TEP, among other well-known and respected clinicians. Below, Kate tells the story of how it was here at St. Elizabeths Hospital that the first creative spark of the Therapeutic Spiral Model emerged accidentally or synchronistically, if you will, in the early 1980s.
Intern Directing: An Action Learning Experience
The structure of the training at St. Elizabeths required that the interns direct one another in personal psychodramas for one training session a week during Intern Directing. It was our only chance to practice on “normal folks” since all of our other directing was with actual inpatients or day-treatment patients at this major psychiatric hospital.
We were near the end of our training year together and, as often happens with intense relationships, the group was struggling with each other interpersonally and in danger of falling apart during the termination phase. For several weeks, our intern group of 12 had been focused on a major interpersonal conflict among three people in the group, the very ones who had become the group’s leaders over time. This conflict was causing considerable disruption, with members having strong feelings and aligning with different sides of a divisive issue that concerned us all.
As Intern Director of the week, I had decided ahead of time that I would lead a metaphorical psychodrama permitting people to express their feelings to get beyond the conflict. This drama would be a type of sociodrama, allowing more of an emotional distance than any one person’s psychodrama. So as my peers entered the psychodrama theatre, I handed them each imaginary guns telling them to “Take their sides and build their forts.” Everyone got into the action structure, laughing in camaraderie, play acting like kids shooting “their enemies” on the other side.
Suddenly, one of our fellow interns rushed to the center of the stage, clearly confused and distressed. He was shouting, “Stop killing the women and children. Stop, stop, stop!” and collapsed in agony on the stage. I was stunned, shocked, and at a complete loss as to what was happening. What we were all witnessing was a psychotic break before our eyes, and I felt I had caused it. This person was a friend of mine, a peer, a private practice therapist who was studying to be a psychodramatist…and he was now lying on the floor writhing in agony. Screaming about killing women and children, he was no longer on the psychodrama stage but was absolutely, totally back in the jungles of Vietnam. His consciousness had slipped into the morass, the jungles, of un-worked-through trauma from his past, and we were there with him.
Taken aback, I turned to my supervisor sitting in the room and asked, “What do I do now?” She replied tautly, “Direct the drama.” I looked around the room at the stunned faces, at the scene lying at my feet, and thought, “What can be done to heal this man?” Not having an answer, I said a silent prayer.
Classical Psychodramatic Healing
The prayer was answered when, spontaneously, another intern threw himself on the stage floor and began to take the role of a psychodramatic Double for the Veteran (Toeman 1948). As Double, he took on the protagonist’s pain and agony, physically, mentally, emotionally, and, yes, spiritually. As Double, he totally immersed himself into the task of reaching into another’s reality and, as he merged himself, the protagonist was no longer alone.
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