IntegrativeTraumaTherapy
3CPDWorkshopsinOxfordwithMoritHeitzler
Workshop2(28Jan.2017):RelationalComplicationsinTraumaTherapy
Workshop3(25Mar.2017):TowardsIntegrativeTraumaTherapy
Aretheseworkshopsforme?
Theseworkshopsaredesignedforpractisingcounsellorsandtherapistswhohavesomeprevious
trainingandexperiencewithtraumawork.Theymightbestbedescribedas‘intermediate’workshops,
fortherapistswhohavecompletedbasictraininginoneofthemoderntraumatherapies(likeSomatic
TraumaTherapy(BabetteRothschild),SomaticExperiencing(PeterLevine),SensorimotorTherapy(Pat
Ogden),EMDR,NARMorsimilarintegrativehybridorcombinationsofapproaches).Ifyouhavebeen
practisingsuchtraumatherapiesforawhile,youwillhavefoundamixtureofresultsandoutcomes.
TheseCPDworkshopswillsupportyouintakingthenextstepandhelpyoutodeepen,diversifyand
enhanceyourexistingpractice.Morithasbeendevelopinganintegrativeapproachtotraumaworkthat
drawsonallthevarioustraumaapproacheswithinanoverallrelationalperspective.
Doyouexperiencetheseobstacleswithyourclients?
Ifsomeofyourtraumaclientsshowresistance,manifeststucknessorgetcaughtinhiddendissociation
orre-traumatisationdynamics,oryouencounterunexpectedruptures,impassesorenactments,these
workshopsareforyou.
Ifsomeofyourtraumaclientsdonotrespondwelloronlyveryslowlytothekindofapproachthatyou
knowworkswellwithotherclients,whatarethefactorsthatcanaccountforthesedifferences?
Ifsomeofyourtraumaclientsarehavingnegativereactionsagainstyouorthetreatment,oryoudetect
thatanatmosphereofmistrust,shameorscepticisminterfereswiththework,howcanwetacklethese
obstacles?
Attheendofthisdocument,youcanfindsomebackgroundregardingtherationaleforoffering
theseworkshops,coveringthefollowingquestions:
•Therelationalsubtletiesunderpinningtheworkingalliance
•Whydoweneedanintegrationoftraumatherapies?
•Arethenewsomatictraumaandenergytherapiessuitableforcomplexanddevelopmentaltrauma?
•Integratingsomatic-embodiedandpsychodynamicperspectives
•TreatmentandtheRelationalContainer
•Thesubjectiveandrelationalfoundationsof‘treatment’
•Vicarioustraumatisationandthetherapist’sownbodymind
Workshop1:TraumaTherapy–TreatmentandRelationship
Inthisworkshopwewillattendtoyourcurrentmodels,understandingandtechniqueswhichyouareusingto
addresstraumainyourclients’process.WewillestablishtheneuroscientificandbodymindbasisforPTSDand
traumasymptoms,asabasisforsomaticinterventions,anddevelopasharedoverviewoverthevarioustrauma
therapiesavailable.Wewillthenattendtothevariousrelationalstancestherapistsaredrawntotakewhen
workingwithtraumaandtherewillbespaceforyoutoreflectonyourownrelationalstancesastheymanifestin
yourpractice.
Workshop2:RelationalComplicationsinTraumaTherapy
Throughcaseexamplesandrole-playswewillinvestigatetheinterweavingofpastandcurrenttraumaandhow
thiscomplicatesthetherapeuticprocess.Focussingondifficultcasesandrelationaldynamics,wewillenquireinto
thedevelopmentalrootsoftransferenceissuesandhowtheyaffecttheworkingalliance.Wewilltrytounderstand
thedramatriangleintermsofinternalobjectrelations,tohelpusfocusontheclient’sinnermanifestationsof
viciouscycleswhichtendtoslowdownrecoveryfromtrauma.Boththeclient’sdemandsfortreatmentand‘cure’
aswellastheirscepticismandresistancetotheprocessandtheirapparent‘refusal’togetbetterwillbeexplored.
Byattendingtoenactmentsastheyoccurinthepresentedcaseexamples,wewilldeepenourtheoreticaland
practicalunderstandingofhowtheycreateimpassesanddilemmasforthetherapist.
Workshop3:TowardsIntegrativeTraumaTherapy
Inthisfinalworkshopintheseries,youwillhaveopportunitiestointegrateyourlearningintoyourown
therapeuticstyle,byexperimentingwithdifferentrelationalpositionsandresponses,onthebasisofadeeper
appreciationthatboth‘one-person’and‘two-person’stanceshavetheirrespectivedangersaswellaspotentials.
Wewillexplorerelationalityasinherentlyconflicted,andhowyoumanagethetensioninyourownpractice.This
willenableyoutoapplythesameprinciplestoyourworkonanongoingbasis,helpingyoureflectuponand
anticipatepotentialenactmentsemergingwithinthetherapeuticdynamic.Thiswillgiveyouacomprehensive
foundationforunderstandingthepotentiallyproductiveaswellascounterproductiveeffectsofavarietyof
therapeuticinterventions,regardlessofparticularmethodandapproach.
AbouttheworkshopfacilitatorMoritHeitzler:
Morithasbeendevelopinganintegrative,embodiedandrelationalapproach
totraumatherapyforthelast20years.Shebegantoencountertheseissues
inherpracticelongbeforetheybecamewidelyapparent,andengagedwith
thesedilemmasattherootoftraumatherapyinawaywhichhashelpedher
forgearobustintegration.Overtheyears,shehasgivenmanypresentations
whichaddresstransference-countertransferencedynamicsintraumawork,
andthedangersandtransformativepotentialofdestructiveenactments.
Sheisknownforusingherownbodyandembodimentasaresourcein
survivingsuchenactmentsandturningthemintodeeperunderstandingof
herclient’sinnerworldaswellasthetherapeuticprocess.Thisperspective
nowunderpinshersupervisionoftraumatherapistsandshedslighton
commonruptures,stucknessandfailuresoftreatment,especiallycasesof
inadvertentre-traumatisation.
Dates,Times,Venue,Cost:
Dates:
Sat.19November2016
Sat.28January2017
Sat.25March2017
Venue:
AsianCulturalCentre
ManzilWay,OxfordOX41GH,UK
Times:
10.00-17.00
Cost:
£100perday(£90ifbookedby9/1/2017)
Moreinformation:
Forallqueries,contact:[email protected]
Website:www.integra-cpd.co.uk
Dedicatedpage: http://www.integra-cpd.co.uk/integrative-trauma-therapy-3-cpd-workshops-in-oxford-with-morit-heitzler/
Morit’swebsite: http://www.heitzler.co.uk
Aretheseworkshopsforme?
Theseworkshopsaredesignedforpractising
counsellorsandtherapistswhohavesomeprevious
trainingandexperiencewithtraumawork.
Theymightbestbedescribedas‘intermediate’
workshops,fortherapistswhohavecompletedbasic
traininginoneofthemoderntraumatherapies(like
SomaticTraumaTherapy(BabetteRothschild),
SomaticExperiencing(PeterLevine),Sensorimotor
Therapy(PatOgden),EMDR,NARMorsimilar
integrativehybridorcombinationsofapproaches).
Ifyouhavebeenpractisingsuchtraumatherapiesfor
awhile,youwillhavefoundamixtureofresultsand
outcomes.
Therelationalsubtletiesunderpinningthe
workingalliance
Althoughmanyofthesemoderntherapiesclaimtobe
comprehensive,oftenpresentingthemselvesas
applicabletoallkindsoftrauma,thisisnotwhatwe
findinpractice.Humanbeingspresentcomplexities
thatnoprotocolormanualcanlegislatefor,
especiallywhenitcomestothe–oftenunconscious-
internalweboftraumareactionsandassociationsin
thepsyche.Itisintheseveryindividualresponsesto
thetherapyandtothetherapistthatcomplications
arisewhicharenotcateredforbytheoryand
technique.
Theclientreads–ormis-reads–thetherapist’sfacial
expressions,theirspeed,timingandintonation,their
gesturesandpostures,andscanstheseforthe
warmth,professionalism,acceptance,knowledgeor
encouragementtheymightcontain,orconverselyfor
thecoldness,lackofcare,judgement,shameor
impatiencewhichtheclientmayhavecometoexpect
fromothers.
Itistheclient’ssubliminalreadingofsuchcuesand
messageswhichinfusesthetherapeuticinteraction
withrelationaldimensionsthatcanmakeorbreak
thetreatment,butthatarenotnecessarilypartofthe
manual.Itistheseall-too-humansubtletieswhich
eitherprovideafoundationforaproductiveworking
alliance,orcreatedoubtandambivalence,orleadto
outrightruptures,regardlessofhowcompetentthe
practitioner,orhowappropriatethetreatment
procedureinandofitself.
Whydoweneedanintegrationof trauma
therapies?
Traumatherapiestendtofallintoafew
recogniseablecategoriesalongaspectrumofthe
therapist’srelationalposition,intermsoftheydefine
themselvesandtheirpublicpresentation:
•
•
someofthenewtraumatherapiesdefine
themselvesastreatments,withclearprotocols
andprocedures,administeredbya
knowledgeableexpert;herethetherapistis
understood-bybothparties-asan
authoritativeanddirectivedoctorfigure,
requiringcooperation;
insomeothertherapiestheatmosphereismore
orientedtowardshealingandrecoverythrough
thetherapist’snurturingpresence;herethe
therapistispositionedinamoremotherlyrole,
stillanexpertoranauthority,butwithan
emphasisonfeelingandsupport.
Becausetraumamakesusfeelhelplessand
regressed,thetherapisttakingamotherlyorfatherly
re-parentingrolecanbeveryhelpfulandoftenthisis
necessarytoestablishaworkingallianceatall.
However,developmentaltraumamakesanykindof
re-parentingtaskmorecomplicated,asthe
psychoanalytictraditionteachesus.Eveninsingle
eventtrauma,theinternaliseddramatriangleof
victim,persecutor,rescuercanbecomeconstellated
inthetherapy,andcomplicateswhatmight
otherwisebeamorestraightforwardhelpingor
healingrelationship.
Wecannottakeitforgrantedthattheclientwill
experiencethetherapist’sauthorityasbenign.This
hasseriousimplicationsfortheworkingallianceand
forthesuccessofthetreatment.Whenthetherapist’s
authoritativeinterventionsanddirectionsare
receivedbytheclientthroughthelensof
transferentialcomplications,themethodsand
techniquesofthevarioustraumatherapiescannotbe
expectedtoworkinthesamewaythatinprinciple
weknowtheycan.Thenthesametechniquesthatwe
canusuallysopowerfullyrelyonarenotsufficientto
overcomestuckness,resistance,dissociationand
avoidance.
Itisthenthatarelationalintegrationofdifferent
therapeuticapproachesandperspectivesbecomes
increasinglynecessaryandhelpful.Thedifferent
traditionsandperspectives,andtheirdifferent
relationalunderpinnings,complementandcrossfertiliseeachotherinawaywhichgivesusas
therapistsmoreflexibility,robustnessandresilience.
Thiscanmakeabigdifferencetotheeffectivenessof
ourwork.
Arethenewsomatictraumaandenergy
therapiessuitableforcomplexand
developmentaltrauma?
Overrecentyears,thenewsomatictraumatherapies
andtheenergytherapieshavebeenextendingtheir
reachbeyondclearlydefinedsingle-eventtrauma
laterinlifetoincludeearlyanddevelopmental
trauma.Thisextensionhasbeendrivenforwardon
theassumptionthatthesameprinciplesapplytoall
traumaandtoalltraumatherapy.However,
increasinglywefindthatthisisaflawedassumption:
ithingesonthequestionwhethertheclienthasa
healthy,non-traumatisedpersonalitystructureinthe
firstplacethatwillallowthemtoformatrusting
attachmenttoatherapist.Withoutthatbond,we
cannotassumetheclient’sreadinessandwillingness
toreceivethetherapist’sinterventions,however
competentandeffectivetheseareinprinciple.
Incomplextrauma,theissueoftransference
becomesunavoidable,astheclientislikelyto
interactwiththetherapistviatheirtraumatising
earlyblueprintforrelating.Theclientthenperceives
andexperiencesthetherapistthroughthelensofthat
blueprint.Thistendstocomplicatetheworking
allianceandcanunderminethetherapeuticprocess
inawaythatisnotsufficientlyattendedtointhe
recentlydevelopedtraumatherapies.Therefore,
earlydevelopmentaltraumaconstitutesaqualitative
differencetosingle-eventtrauma.Psychodynamic
approacheshave,ofcourse,alwaysappreciatedthe
transferencedimension,buthavenotworked
sufficientlythroughthebody.
Integratingsomatic-embodiedand
psychodynamicperspectives
Therefore,anintegrationbetweensomaticand
embodiedapproachesontheonehandand
psychodynamicperspectivesontheotheris
becomingcrucialinthefieldoftraumatherapy.We
increasinglyunderstandhowevenclearly
circumscribedsingle-eventtraumacantriggerearly
developmentaltraumaunconsciouslyandcomplicate
andde-railtreatment,evenwhenonthesurfaceit
appearsfairlystraightforward.
Psychodynamicandother‘talkingtherapy’
practitionerscanbenefitfromthesomatictherapies
insituationswhereclients’reflectivecapacitiesare
limited,aslanguageandothercognitivefunctionsare
impairedbyunconsciousorunspokentrauma.The
client’smindisthennotfullyavailablefor
interpretation,collaborativeexplorationor
associativeplay,astraumaticfreezingand
dissociationaredominant,andtalkingtherapy
doesn’treachdeeplyenoughintotheclient’s
experience.
TreatmentandtheRelationalContainer
Ifastraumatherapistswecancombinepowerful
methodsandsomatictechniquesontheonehand
andanawarenessoftheworkingallianceandthe
client’sreactionagainsttherapeuticauthorityonthe
other,ourcapacitytoco-createthekindofrelational
containernecessaryfortheworktakesaquantum
leap.Tosomeextentthisalsodependsonthe
therapist’sawarenessoftheirownbodyand
embodiment,astherelationalcontainerdepends
stronglyon‘right-brain-to-right-brain’attunement.
Thisisonlyavailabletothetherapistwhois
connectedwithherownsubtleandsubliminal
physicalandneurologicalresponses.
InherpracticeMorithasfoundthattheeffectiveness
ofbothEMDRandsomatictraumatherapy
interventionscruciallydependsonthetimingofprereflexivecommunication,andthesynchronisation
betweentheclient’sandtherapist’sautonomous
nervoussystems.Thedifferencebetweenan
interventionwhichelicitsarelievingreleaseof
feelingontheonehand,orasuggestionwhich
triggersintheclientare-traumatisingimplosionon
theothermayonlybeacoupleofseconds.
Thetherapistwantstobesoattunedtothe
intensifyingarousalintheclient’sbodymindthat
theycanofferanexpressiveandinteractively
regulatingchannelforitbeforeitcantipintoan
internalrollercoaster.Intervenetooearly,andthe
therapistisseenasanxiousandover-controlling;on
theotherhand,intervenetoolateandtheclient’s
autonomicprocesshas–lemming-like–takenitself
overacliffintoatraumaticpattern.Thiskindof
attunementisonlypossibleifthetherapistis
sufficientlyattunedtoherownneurophysiological
andvegetativeprocessesthatshecanmicro-track
herownarousalandshut-down.
However,manytherapists–especiallywhentheir
initialtrainingwasinoneofthe‘talkingtherapies’-
aretoohabituallydisembodiedthemselvesand
remainlargelyunawareoftheclient’s-andmoreso
theirown-subliminalandenergeticprocessesto
createthatkindofmoment-to-momentbondand
responsiveness.Asaresult,treatmentstendtolack
spontaneityandsignificantmomentsaremissed,
givingtheclientasensethattheyareindeedbeing
‘treated’,butinasomewhatformulaicfashion.
Fortunately,inMorit’sexperience,manytherapists
canlearnquitequicklytoextendtheirusual
emotionalsensitivitiesintothesomaticandenergetic
realm.
Thesubjectiveandrelationalfoundations
of‘treatment’
Vicarioustraumatisationandthe
therapist’sownbodymind
Howeverappropriatethetheoreticalmodelsand
practicaltechniquesarethatweuseintraumawork,
theseareonlyaseffectiveasthepre-andnon-verbal
bonds,thereciprocalemotionalattunementandthe
mutualintersubjectiveunderstandingwhichthetwo
humanbodymindsinthetherapeuticrelationship
canco-create.It’sthemeetingbetweenthesetwo
idiosyncratic,uniquesubjectivitieswhich–forbetter
orforworse–providesthefoundationfor
‘treatment’.Byignoring–orattemptingtoremove-
theunpredictablesubjectivehumanfactorfrom
treatment,wedestroytheessenceofwhatmakes
therapywork.Ofcourse,thetherapist’sidentityis
notfreefromitsownwoundsandtraumasand
shadowaspects–howcantherapybemadetowork
whenallwehaveathandisthefrail,imperfect
instrumentofthetherapist’shumanself?
Therecognitionthattraumatherapyishazardousfor
thepractitionerisnowwidelyestablished,butitis
muchlessclearwhatwecandoaboutit.Unlike
medicalpractitionerswhotendtolearntodissociate
fromtheirpatientsandthepaintheyencounter,we
donotwanttoloseourrelationalsensitivity.But
unlesswecanlearntorecognisethesymptoms,
effectsandemotionalloadofthetherapeutic
position,wecannoteffectivelyprocessanddigestthe
bodymindimpactweexperiencethroughexposureto
ourclients’trauma.Understandingsomatic
resonance,projectiveidentificationandevacuationof
dissociatedtraumastateshelpsusbecomeawareof
theconsequencesofunconsciousprocessesinthe
therapeuticrelationship,andtheconflictsweare
likelytoabsorbinourwork.
Thetherapistcannotbe–infact,forattunementand
mutualidentificationtowork:mustnotbe–
invulnerable,‘allsorted’,plainclinicallyeffective,
administeringthesameuniformtreatmenttoeach
client,whateverthemanualsays.However,the
therapist’snon-objectivesubjectivitydoesengender
allkindsofrelationalvicissitudeswhichweneedto
findwaysofapprehending:howdowemonitorand
bringawarenesstotheintersubjectivemesscocreatedwhenthearrowoftheclient’swounding
seeksandfindsandhitsthetherapist’swounding?
Itisherethatdifferentiatedbodymindawareness
takesusbeyondmentalspeculationintoarealmof
embodiedexperiencewherewehaveawholerealm
ofotherwiseignoredandneglectedinformationthat
makesthecomplextaskoftracking‘right-brain-toright-brain’attunementlessimpossible.
Trackingandprocessingtheseunconscious
dynamics,wegainpreciousinsightintoourclient’s
innerworldandtheirinternalrelationships,which
providethebackgroundcontextinwhichrecovery
andhealingoccur.Thisallowsustounderstandmore
deeplyhowcurrentandpasttraumainterlinkand
generateprotectivemechanismswhichblockand
slowdowntreatment.
©2016-MoritHeitzler&MichaelSoth