Video Transcript:

Whether we like it or not, experiencing trauma is an inevitable part of being human, but so is our capacity to heal from it.  As we learn from part 1 and 2 of this series, unprocessed trauma can leave survivors with lasting adverse effects to their bio, psycho and social functions.  Therefore, any comprehensive healing process for trauma survivors must address these 4 big challenges.  

4 Big Challenges in working with Trauma Survivors

The first and most important challenge is the issue of trust and safety: Trauma isolates and make the person feel alone in their experiences.  This leads to intense, unbearable feelings of shame and guilt, causing them to hide or clam up even before the process can begin.  So the therapist or helper must create a safe space for trauma survivors to show up, feel less alone, connected, and warm up to do the work.  

The second challenge is risk of retraumatization.  This is perhaps the major reason why survivors would prefer to forget or not talk about what happened than to re-open the wound for healing.  While this is understandable, healing cannot occur without processing and integrating those fragmented traumatic materials stored in the right brain and body.  This means re-traumatization can occur if it’s done too quickly or too soon without proper containment to titrate the information flow to the left brain.  Therefore, it’s important to calm and soothe the amygdala and the body throughout the healing process to avoid emotional dysregulation.  The treatment goal isn’t to stimulate an emotional catharsis, but to help the client consciously re-experience, remember, and integrate their traumatic experiences safely at a tolerable pace.  

The third challenge is managing defenses, especially dissociation when the client is overwhelmed by intense emotions and go into uncontrolled regression.  When this happens, any insights or transformation gained during the work is lost since they were not present in their body to integrate it.  So it’s imperative to contain and manage the defenses, keeping the client within their window of tolerance for lasting change.  

The fourth challenge is to strengthen the client enough to handle any uncomfortable or potentially frightening situation, including facing their inner or outer perpetrator if necessary.  This task must be done prior to accessing any deep traumatic material so the client knows they are well supported and resourced in this endeavor.  With access to their own strengths and supports from the group and therapist, the client is then able to break free of those negative internalized trauma-based roles and transform them into empowering ones that foster growth.

Let’s explore how TSM meet these 4 challenges to ensure a safe and effective healing process for trauma survivors.

What is TSM?

TSM stands for Therapeutic Spiral Model, which was created by Kate Hudgins and Francesca Toscani from 1992-1995 as a clinically modified psychodramatic approach for working with people who have experienced trauma.  They drawn on J.L Moreno’s classical psychodrama Role Theory and his theory of spontaneity and creativity to develop a map for treating trauma survivors called the Trauma Survivor’s Intrapsychic Role Atom or TSIRA for short.  Since its inception more than 25 years ago, TSM has been used effectively to heal trauma in over 40 countries across various settings, populations, languages, and cultures.  Its clinical application ranges from large cultural issues such as war and natural disasters to individual issues of eating disorders, addictions, and domestic violence.  Let’s take a closer look.

Safety & Connection first - clinically modified, trauma-focused, strengths based model,, prevent re-traumatization when using experiential methods with trauma survivors

TSM is designed to be a safe, experiential method thanks to its six safety action structures.  These are done in the beginning of every workshop in the following order:  

1. The first structure is setting up the Observing Ego (OE).  “Pick a card that can represents…”. This is a neutral, non-judgmental, no shame/no blame, sensitive witness to help the person stay present throughout the workshop. 
2. The Circle of Safety - Next, group members pick scarves to represent their strengths and placed them in a large circle, creating the circle of safety.  This serves as a visual emotional container for traumatic materials and establish the group’s held space for action, separating it from the observation space outside the circle, where the OE is.  
3. Third is the Spectrograms.  This is a quick and fun assessment tool to help group members warm up for action and build group cohesion.  It uses a set of criteria statements and an imaginary line between 2 opposite poles, moving from strengths to trauma-based criteria and ends with post traumatic growth statements.   
4. Next is the Hands on shoulders.  This 4th structure continues to build safety and group cohesion by asking group members to choose other members to play certain parts of themselves in their drama, like a director casting roles.  This activity helps people learn to make choices and show the connections group members are making with each other in a transparent way, so everyone can work through issues in a safe and open manner.  
5. The 5th safety structure is the Circle Similarities/Step in Sociometry.  This exercise helps group members safely self-disclosure their difficulties and vulnerabilities by posing questions to other members in a contained way.  Doing so breaks the shame of silence and isolation that most trauma survivors feel, so they know they’re not alone in their experiences.  
6. The final safety structure is the Creative Arts Project/Art of Integration.  This is a fun and relaxing way for group members to show their progression throughout the workshop as an art project, individually or collectively.  While the art project can take many forms, the spiral structure of TSM always stay the same, from strengths to defenses and trauma into full transformation.  

Once safety and connection are established among group members, the healing process can begin.  

TSIRA - A Map for Healing

In TSM, the healing process for trauma survivors happens in 3 stages, as detailed by the TSIRA.  

Stage 1 focuses on helping the client develop the ability for non-judgmental observation, strengths and containment with the use of 7 prescribed roles.  These include the observing ego which is the first safety structure I described earlier, three types of strengths (personal, interpersonal, and transpersonal), and 3 containing roles (containing double, body double, and manger of defenses).  Together, theses 7 prescribed roles minimize the potential for re-traumatization and dissociation, and help balance the overwhelming affects from the right brain with cognitive functions of the left brain, ensuring a well-resourced state for the client as they enter into stage 2.  

Stage 2 focuses on using the 7 prescribed roles to help the client process and communicate their trauma story in a safe and contained way.  As you remember from part 2 of this video series, the victim role in the trauma triangle is the one who was wounded and hold the story of the trauma, but has always been criticized, silenced, or neglected by the perpetrator and abandoning authority roles.  Here with proper containment, strengths, and a non-judgmental observing role, the client can put their trauma into a coherent narrative and see how this pattern has been operated within them.  Then decide for themselves, if they want to take the next step and move off the trauma triangle into stage 3 of the healing process.

Stage 3 focuses on transforming the trauma-based roles into new transformative roles that promote post traumatic growth and developmental repair.  This is what happened when the prescribed roles enacted with the trauma-based roles.  A new creative energy spontaneously entered and new roles emerged naturally as part of the healing process.  In TSM, these transformative roles get concretized as the Sleeping-Awakening Child, a non-traumatized part of themselves, Change Agent, Manager of Healthy Defenses, various good enough roles such as the good enough parent and significant other, and the Appropriate and Ultimate Authority roles.  As the client embodied and continue to develop these transformative roles, they’ll be able to internalize a sense of autonomy, empowerment, resiliency, and integration.  Then they can enjoy the wonderful gifts of the Sleeping awakening Child, use the appropriate authority role to set and maintain healthy boundaries without guilt, nurture and soothe their inner wounded child properly as the good enough parent, confidently be in relationship as a good enough significant other, and boldly contribute to the world as the Ultimate Authority.   

As George Eliot once said,  “It's Never Too Late to Be What You Might Have Been.”  

Your transformation awaits.  

So, if you’re ready to get off your trauma triangle and step into a more empowering role, come and experience the transformation by signing up for an upcoming workshop at www.unburdenme.org.  I’d love to see you there.