TH Working with trauma via the completion of psychophysiological reactions

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Version of text: v0-1002 / 18.01.2020 (I am sorry for a bad quality of English in this note. I will try to create a better version and put it here later.)

Pavel Kornienko (Moscow, Russia) — psychologist, psychodramatist, psychodrama trainer and supervisor. Member of IAGP. Head and lead trainer of long-term professional psychodrama education programs in Moscow, Ryazan, Chisinau (Republic of Moldova) and other cities. Head of “Contemporary Psychodrama Workshop” School (Moscow). More about the author: https://psy-education.ru/link-en/pavel-kornienko


01. What is a psychotraumatic event?

An event, which had happened with client and making damage to their mental wellness. We need to separate psychotraumatic events from a bad childhood environment where the client grew up. Consequences of a bad childhood environment usually need a long-time psychotherapy. But in case consequences of psychotraumatic events need short-time therapy (half the time). Some examples of psychotraumatic events: car accident, the lost of an important person, a deadly situation, sexual or physical abuse, public shame, and etc… All certain events, which had damaged client’s mental wellness, and the psyche can’t repair itself.

02. How we can understand some experience as a psychotraumatic event?

Usually a psychotraumatic event has two types of consequences, and we need to find one or both of them. 1) Changes in quality of mental wellness after some event. 2) Any intrusion symptoms. The most common: some memories of psychotraumatic event activate strong feelings, identical to those survived in the past situation

03. Is this type of work a psychodrama?

I think yes, but there is some difference. Working with psychotraumatic events I don’t use the role reverse, I usually don’t need it. But in case of an another type of work, when I work with consequences of a bad childhood environment, I need the role reverse, and the full set of psychodrama techniques.

04. Four layers of client’s emotions after psychotraumatic event.

  • L1. Emotions, which had started in the psychotraumatic event. Which had felt in special moments of the psychotraumatic episode. For example: panic, helplessness, shame…
  • L2. Emotions, which are starting when the person understand the fact of the psychotraumatic event. For example: a feeling whйen the client is understanding that his mother has died; a feeling when the client is understanding that a sexual abuse was happened with himself.
  • L3. Emotions of avoidance. The most common, it is emotion of fear, a fear to remember and feel emotions of 1st and 2nd layers.
  • L4. Protective emotions. For example, it is an aggression to abuser which is felt by person, because feeling the aggression is more comfortable than feeling the helplessness.

In my work, I am focusing on the 1st and 2nd layers of client’s emotions. But I work with 2nd layer always after working with emotions of 1st layer. The be st way to do the psychotherapy work with emotions of 1st layer is working with a psychotraumatic episode (timeline of psychotraumatic event).

05. Work with a psychotraumatic episode.

The main ideas of this work: Trauma is the cumulative result of interrupted reactions in psychotraumatic episode. Psychotherapy of psychotraumatic event is to search interrupted reactions and to help them to be finished.

In my work I am exploring step by step the timeline of psychotraumatic event and searching all moments when the client’s psyche has any reactions (emotion, intension, shock, disorientate state, …). And when we found one of them, we need help client to relive it and to finish it without interruption. And here we need to know the main types of reactions and types of interruptions (detailed in the table below).

06. The most common types of reactions and interruptions of them.

THeng-trauma-short-table.png

07. Work with act of perception.

Any reaction is triggering by some act of perception (for example: a viewed scaring episode, listened angry voice, imagined consequences in close future, etc.) At first we usually need to find an act of perception, if we need to find a reaction which was interrupted. For example, we can use this questions to find act of perception:

  • What did you see the first? (…answer…) Is this image runs this reaction?
  • What image or word was running this reaction in that situation?

And when the act of perception has found, we can be searching for certain reactions:

  • When you had saw [known act of perception], what first intention did you have?
  • When you had saw [known act of perception], what first words did you want to say?

Act of perception was triggering this reaction in the psychotraumatic episode, and it is triggering it on therapy session, when we are remembering it.

08. What are the roots of this type of work?

I think this work is not something unique. Parts of it we can find in different types of traumatherapy. The work with suppressed affect (iA) we know from the body-oriented psychotherapy in a very long time. The work with interrupted actions (iB) I get from gestalt-therapist Elena Petrova. The work with wrong responses (iC) comes from my practice and it is very psychodramatic, because the classic role reverse usually is good for this type of reaction interruption. Others types of interruptions (iN, iG, iS, iU) need much more time for explain it.

I will be glad for any comments and questions about this note.


Pavel Kornienko, Facebook