Three Phases of Healing
An Integrated Approach
Bottom-up / Top-down Processing
Three Phases of Healing
The goal of trauma therapy is to live a happier life. Sometimes that means sharing details and processing early experiences. We can often resolve current difficulties by working in present time without exploring memories of past events. Sufficient safety, stability and both the capacity and willingness to endure difficult emotional experiences are necessary before we can fully process traumatic memories. While phase one is always first, we may focus on aspects of phase three before processing traumatic memories. And sometimes our life improves by accepting the past while being committed to living with integrity and congruity with our values.
Build Safety and Stability
Integrate into Life
Healing can only occur in the context of safety and stability. The goal of phase one is an acceptable quality of everyday life. This means that the client experiences an underlying sense of emotional regulation despite the normal ups and downs of life. The work of phase one is to provide a reliable container from which to operate. Phase one is the foundation of effective trauma healing and should not be rushed or skipped in pursuit of the trauma narrative.
Processing and desensitization of traumatic memories is the goal of phase two. Working from the stable foundation established in phase one, these memories will likely stimulate reactivity that is tolerable and are less likely to induced regressive states. Being grounded in the safety of the present moment makes processing the memories manageable. In many cases the actual processing of traumatic memories is either very limited or entirely unnecessary.
Phase three is the container for integrating success and increased capacity in everyday life. Integrating therapeutic progress in everyday life is the focus of phase three, yet if the therapy is effective, it should be a constant element throughout the process. When our client shares they have applied skills and insights from our sessions to situations in their life is an indication of phase three success. In phase three we continue to support our client to enjoy and improve the quality of their lives.
Building on your strengths is far more therapeutic than focusing on your wounds. I start with getting to know you and your strengths and then bring into awareness where you are challenged without making your difficulties the focus of therapy. We establish a safe and stable connection before processing challenging feelings, thoughts and beliefs. We only dig around in the past when it helps resolve issues in the present.
When your nervous system is whacked-out it affects how you feel and think. When your identity as a person is stressed it affects how you feel in your heart and body. We dance with this complex relationship of body and mind using mindful awareness and good old common sense.
The strategies that helped us feel safe as children became obstacles to our happiness as adults. By exploring what gets in the way of what we say we want, we discover those strategies. And once we can see them, we can making choices about using them.
My approach brings self-regulation to a resource-oriented, non-regressive, psychodynamically informed non-pathologizing approach that emphasizes connection to the parts of ourselves that are organized, coherent and functional.
Bottom-Up Repair of Early Trauma
Traditional psychotherapy focused on talking about thoughts and feelings and, for the most part, ignored body-based experience. We now understand that trauma affects both mind and body and contemporary approaches have adapted to work with both. We speak of working top-down and bottom-up. Top-down refers to placing attention of thoughts, emotions, sensations, and then the deeper aspects of neurophysiology and energetics. Working bottom-up refers to starting with attention to the energetics and neurophysiology and then to sensations, emotions and thoughts. Successful trauma repair uses both bottom-up and top-down practices to address the complexities of identity and the disorganized physiology.
The short video below provides an excellent description of the consequences of early developmental trauma on brain development and some of what must happen to repair the early insults and develop new habits and perspectives.