A view of trauma from the perspective of different psychotherapeutic paradigms. How to «work through» trauma? Part 1

We have a broadcast ready, in which both my colleague Anna Nechaeva and I participated. I hope that the information about trauma that we managed to present will be useful and relevant to you.

07 April, 2024

Maria Dolgopolova: I'm Maria Dolgopolova. I'm very glad to see all of you today. I am a clinical psychologist. At the moment, I am actively blogging on practical psychology issues. I have also been trained as a gestalt therapist and analytical psychologist, and I continue my development in these professional communities. I wanted to touch upon the topic of trauma because I thought it was a very important topic, and we never seem to get far from it in practice. Some people accumulate traumas from the past, and modern reality can bring new traumatic experiences every day... So, this is one of the key and very interesting questions: how to deal with one's own traumatic experience? How can it be addressed in practice? My trusted colleague, whom I have known since university, has embarked on learning a new method that was created specifically to work with trauma, and I really wanted to ask her about it and share what I know myself. So, that's my introduction.

Anna Nechaeva: I also welcome everyone! My name is Anna Nechaeva, I am a psychologist, gestalt therapist, and now also an EMDR therapist, or in the Russian manner, a DPDG therapist. So far, not much is known about this direction here; it's somewhat shrouded in mystery. Indeed, it's a promising method, approved by the WHO, having undergone many studies, and today I will also talk about it. And I also like talking about my favorite gestalt, it's like a foundation. I am keen on gestalt philosophy, it's very close to me, the methodology. And it's worth combining these methods, I'm experimenting with that right now. I have a second identity – I'm also involved in contemporary art. So, that's another important part of my identity. I highly value Masha as a person and trust her as a professional. I have attended Masha's various seminars, and it was always very interesting to listen to her profound insights. Masha suggested this topic, which I gladly supported because it really seems very relevant to me. Trauma is quite a broad concept; there is acute trauma leading to PTSD, and there can be a more general heavy life experience that somehow affects us. In any case, everyone has accumulated their own baggage. So, I think this topic resonates with everyone to some extent. It's interesting to discuss it from different perspectives.

Maria Dolgopolova: Thank you. Listen, I suggest starting, perhaps, with some initial definition of what we will understand as trauma in this broadcast. And I think it's okay if our definitions turn out to be different. I have defined for myself some working definition that helps me and that I will rely on in all my further reflections today. So, what is trauma for you?

Anna Nechaeva: Actually, some kind of EMDR approach to trauma resonates with me here. And accordingly, trauma is a certain reaction of our psyche to some extreme impact, a reaction characterized by a high level of arousal. That is, it's something that the internal system cannot process in a good adaptive way because the situation that occurred caused a reaction that does not fall within the window of tolerance, that is, the ability to process, to tolerate this incoming information.

In this sense, it's quite a broad definition, I think, and I like it because it allows for individuality. For someone, one event will be traumatic, for someone else, another event, because everyone has their own window of tolerance, and it also depends on a specific situation, on a specific moment.

Maria Dolgopolova: Yes. Well, despite not being an EMDR therapist, basically, in psychoanalysis, a similar definition resonates with me. And in gestalt therapy too, every individual throughout their life processes the entire flow of incoming emotional information, mental information, various life events we encounter. And it may happen that some life experience itself is stressful and discomforting for us. But even stressful and discomforting life experiences can be adaptively perceived, adaptively processed by our defense mechanisms. And then, despite this discomfort, we move on, we somehow forget about it. Maybe we get upset that we had an unpleasant day, but nothing more in the long run. However, some experience, either in childhood or adulthood, may be beyond the capabilities of our psyche, and then we talk about some post-traumatic reactions, and they can persist, accumulate, shape our entire adult life, or at least a significant part of it, even though the events may have occurred quite some time ago.

Anna Nechaeva: Yes, I think it all converges here.

Maria Dolgopolova: I made a “mistake” this morning. I was preparing for our interview and thinking about what I want to say about trauma, about how to work with it, and all that. And, to my great regret… I led a course on self-harm two years ago. There was a whole section of slides specifically on self-harm and trauma. And while I was writing this section, I wrote to myself a big note about how I work with trauma. And even during the self-harm course, it was a bit of a trap because, well, I don't know about you, Anna, but it's really hard for me to talk in short about trauma. I mean, you have to deal with it so much, so often, from so many different angles. And in this note of mine about how I believe we should work with trauma… created after reading and studying what I have studied and read. So, this note doesn't fit into any frameworks, of course, and I'll have to extract it. Even when I was delivering the self-harm course, I just saved the Word file, I managed to talk only about something that fit into the setting. And there was the annotation for the Word file: "in general, I believe that trauma should be addressed like this." And it was such a lengthy thing.

Anna Nechaeva: Well, I think in the end, it's more or less the foundation of our work. Of course, there are other big chunks, but in general, you could retell the entire psychotherapy, how to work in general. Therefore, of course, I don't have any kind of manual initially, I wasn't prepared, and this broadcast assumes a very general approach, and at the same time... I wanted to highlight some noteworthy points, share some thoughts on this matter. So, of course, we won't have a fundamental conversation about trauma today. The topic is really very broad. But somehow from the perspective of different approaches to discuss its understanding, common things, and how it can interestingly manifest in a person's life. I also want to talk about that.

Maria Dolgopolova: Let's anyway mention a couple of quick things, from gestalt, before we went into discussion about EMDR, what touched you? What did you find useful? What did you most take with you regarding trauma?

Anna Nechaeva: I really like the very humanistic supportive view in Gestalt, on trauma, and on the formation of various maladaptive patterns, strategies. Initially, it was all believed as “creative adaptation”. That is, the organism always tries to adapt in the best possible way to the conditions in which it developed.

If we take early traumatic experiences that happen to a child, to a person as they grow up, it's some very intense, extreme experience that affects the sense of safety emotionally or physically, to which you need to adapt very quickly and sharply, you need to survive. And a person finds his own ways to overcome this experience and further, to minimize the risk of its occurrence. That is, here's an interesting thing from the gestalt point of view, that on the one hand, we know that the organism strives to complete the situation, to “complete the gestalt”, just as the phrase goes. And a traumatic situation often becomes precisely this situation that did not manage to end normally in a favorable way for the person.

On the other hand, there is the opposite tendency to avoid some traumatic experience. It's the experience that a person gained from trauma. So, a person is between these two tendencies. On the one hand, striving to find some resolution to the feelings, strong experiences. And on the other hand, avoiding this experience.

And if we return to the story about creative adaptation, any symptom with which we work in the present, which could have been caused by traumatic events, was originally a “creative adaptation”, something that the organism at that moment, in the best possible way, could find for itself, and now it's actually something harmful, maladaptive for the person. And how can we rebuild this?

Maria Dolgopolova: I just remembered, while you were talking, a little piece that I would pick up from psychoanalysis. From psychoanalysis, from the very old, Freudian first psychoanalysis, he touched one aspect that has a great significance today. And indeed, there is such a paradox that when something traumatic happens to a person, people frequently prefer not to talk about it. And even in my practice, if someone comes with a heavy family experience, with some very difficult relationships with their parents, but if it's really an experience of violence, and much more, such clients often start talking about their parents very late, they start talking about their family very late.

And if, perhaps, in TV series on psychotherapy, it is portrayed that a person comes and is ready to talk about their difficulties with their parents, then this mostly happens in cases of moderate problems. There are some resentments, there are some other dissatisfactions, maybe there are current conflicts, parents intruding... But for a person to come to a psychologist and really start talking about it, the degree of these problems must be moderate. If there was something extremely traumatic, then, from my experience, people often talk about it very slowly, it's difficult for them to touch these memories, they try to avoid them, and so on.

But what does Freudian psychoanalysis have to do with this? One of his early theories was that despite, perhaps, some moments when a person doesn't want to talk about traumatic events, he may strongly strive to reproduce traumas in real behavior. That is, when you say, "let's talk about your father." He says, "I had good relations with my father, you know."

And this is a phrase that means, "I'm not ready to talk about this ever again." Basically, “ask me again in a year, and hardly anything will change”. But in real behavior, a person may choose some very rejecting, or very dangerous, very unreliable people, maybe with some serious mental problems, and so on. In general, as if a person in real behavior, despite not being ready to talk about his dad, to remember his dad or something else, he chooses people with shortcomings that most closely duplicate the dad he refuses to remember. Well, Freud came up with a very simple theory that we just want to replay our traumas and “win”, finally, against the fate. When we are more fully empowered, not in childhood, not so helpless, but in adulthood, we want to play the same roulette, the same game again and finally win it and close our issues related to vulnerability, discomfort, years of accumulated pain.

So, it's such an interesting paradox. The stronger the trauma, the less we want to talk about it, the more tendency there will be to reproduce it in everyday reality.

Anna Nechaeva: Indeed, it's astonishing. I'm also now thinking about my therapeutic experience somehow. Sometimes it happens that a person realizes that he had very heavy traumatic relationships with the parents, for example, but he doesn't want to talk about it, it's very difficult for him, he really pushes it away.

In my practice, there were situations when people, for example, asked me: "can I write it?" That is, they can't, for example, say it. And this doesn't happen right away, it's after some time, establishing a very trusting contact, when it's not possible to speak it out even with words, just like that, right? It only comes out in writing. Well, and here, rather, it's very difficult for a person to come into contact with this pain, with the shame, with the vulnerability.

And sometimes, when a person is really so disconnected from it, as you say, "the relations with my parents were good." There are also enough examples of this, when initially the client says, "yes, everything is fine, a normal family, good relations." And then only after a year or two of therapy does it start to open up, what was really there, and what significance, what influence it had on the person. And this often becomes a surprise even for the person himself. It was so important then to protect oneself, so much at different points, this cycle of contact was interrupted, this experience is somewhere "I don't even let it in." Yeah. And I also think it's an interesting point about the connection between psychoanalysis and gestalt, about the striving for this resolution of some sort, about the fact that it seeks some resolution. Maybe you don't see it that way, by the way, it's interesting, maybe you see more of a difference?

Maria Dolgopolova: For me, Gestalt and psychoanalysis don't contradict each other in lots of aspects. At least the way they intersect in my mind, it's a completely consistent picture. And indeed, I think maybe psychoanalysis, well, historically, it delved much earlier into the topic of attachment, the connection between trauma and attachment issues. I still think that despite all the later research, initially it was an achievement of psychoanalysts to understand this connection and start talking about it.

Let'us assume... One of the very popular ideas and concepts nowadays... We have a child, and we can read a lot of literature that anything in his life can traumatize him. I don't know, not enough milk in the breast can traumatize him, an abusive caregiver in daycare can traumatize him, anything and everything can traumatize this child. And the more literature you read, the more you know what specifically can traumatize him. But despite all this, we have this saving grace in this world, that close people in emotional attachment actually increase and provide the child's ability to process stressful experiences. Roughly speaking... Parents can almost infinitely expand this ability of the child, turn it into... If the child had to cope alone, most likely everything would quickly exceed his processing capacity, and everything would start to coalesce into such a heavily traumatizing experience. But if the parents stay close, if they have a secure attachment with their child, then they help the child process this experience. And the child's ability to cope with stressful experiences becomes very significant. And that's why very often we are forced to work with the traumas of adult people precisely when, for these adult people, while they were children, their parents did not become such a guide. We help process this experience and turn it from traumatic to ordinary. Yes, you have an abusive caregiver, but in our area, for example, there's only one daycare like that, and in the next one, maybe we can't immediately switch, but let's see how we'll deal with it. And even if just a parent somehow transmits how they would handle this situation, how they would cope with it, children's adaptive abilities increase many times over. And very often I come across the fact that responsible parents, if they, God forbid, come to the conclusion that they need to divorce, they are then simply horrified by the fact that it can break their children's psyche. And this will indeed create trials for their children in any case. But parents can do incredibly many things to ensure that this experience remains potentially traumatic but does not disrupt anything in the psychological development of these children we're talking about.

About me

Maria Dolgopolova – a certified clinical and a jungian psychologist (Moscow Association of Analytical Psychology, an IAAP training candidate studying in CGJung Institute in Zurich) with a background in gestalt therapy (Moscow Institute of Gestalt and Psychodrama, Gestalt Associates Training Los Angeles) and in psychoanalysis of object relations.


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