Model for trauma debriefing **

This model is primarily for use with non current ongoing trauma or very recent trauma (less than 4 months old). With very recent trauma one needs to use a different therapeutic approach

1. Use the facts and feelings technique as a method to open up the work and get the debriefing or grieving process moving. Usually no more than 5 to 6 sessions would be needed for this

2. Behavioural contracts that are relevant to the trauma. Assess trauma and changes in behaviour and thus make the relevant contracts.

3. Life script decisions. Identify new decisions and script decision reinforcement. Client to become aware of these and the use of 2 chair.

4. Identify the body script correlates using the tensiongram technique. This can assist the the facts and feelings process and the life script decision process.

5. Identify secondary gain of the client. This will exist to some extent and on occasions will play a significant role.

Recent examples:

Agoraphobic woman controlling her husband whom she feels insecure in her relationship with. As she became more and more house bound she discovered that she by and large could keep tabs on him. He had a job where he was out and about on the road most of the day. When ever she needed something done that involved going out of the house he would have to do it for her. It allowed her to gain more control and power in her marriage. So the agoraphobia is unlikely to be cured unless one also deals with the relationship problems.

The most common type of secondary gain is with the stroke deprived person. When one is bereaved, depressed, suffers panic attacks and so on most often others will respond with some kind of Nurturing Parent response. They will be kind and caring and giving and understanding to the person and their ‘illness’. If the person is from a stroke deprived background where they got very few positive strokes then this will be most appealing. They discover that their neurosis brings them this love and kindness they have craved their whole life. Thus one needs to deal with the stroke deprivation as much as the depression or panic attacks.

A recent example of a client I was working with. Her son had died a few years ago and she stated:

”In a way I don’t want the pain to go away. I don’t ever not want to miss him! I don’t get why I have to be without him??”

The secondary gain is that the emotional pain gives a connection with the deceased. The Child ego state can kind of trick itself that the person is kind of not dead if they can still feel the pain for him.

In such circumstances one needs to change the usual process in the ‘Goodbye work’. This work is where the person emotionally and cognitively says goodbye to the ‘lost’ object. That maybe a loved one, a pet, an item such as a house or a car, or a job, a limb and so forth. Any animate or inanimate object that the person has formed a psychological attachment to.

The usual process is for the person to express the feelings about the loss and the object. There is usually an array of emotions and these get expressed in a number of sessions in a variety of ways. The final point is when the feelings are dealt with and then the person is in a position to make the cognitive shift and accept the fact that the person is gone forever. This is the Child ego state cognitively accepting the facts, not the Adult ego state acceptance.

We all are capable of magical thinking and this can at times confuse our grieving

The problem with the secondary gain expressed above is that it is the pain that keeps the connection in the first place. So doing the usual goodbye work would increase the problem. The release of emotion usually will reduce the psychological connection to the deceased but in this instance it could be increasing it or at least supporting the connection. One would need to reverse the usual process and do the cognitive acceptance (a least to some degree) before the emotional release.

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