By Judy Byrne, EFT Master
EFT is a brilliant way to work with people with Post Traumatic Stress. It can be gentle, compared with anything else yet invented. It works better than anything else yet discovered. But there are things we need to think about before we do. The most important of them is – safety, safety, safety.
The first safety is for clients. People who are already damaged by their experience of trauma do not need to be further traumatized by inept therapy. They can be.
The second safety is also theirs – their perception of it. They need not only to be safe but to feel safe with us. It is a big stretch for a traumatized client to trust anyone, let alone trust anyone enough to do therapy. Nothing will happen until they do.
The third safety is our own. Working with trauma is tough for therapists as well as for clients. And it can be dangerous. When you watch the film Operation Emotional Freedom you will hear Carol Look say she doesn’t know how she would have coped with hearing some of what she heard making it had she not been able to tap on herself at the same time. We are just so lucky we can keep ourselves safer than therapists working any other way because we can tap on ourselves as we work.
Everyone who uses EFT needs to know how to work with trauma. Even if we say we know trauma is not for us and never knowingly work with seriously traumatised clients, people we are working with will suddenly access or reveal trauma. It may happen, too, when we are working on ourselves. We need to be prepared. That does not mean we should be knowingly treading into the trauma minefield without knowing more than just how to tap.
EFT is a therapy tool. It needs to be embedded in a therapeutic structure, and never more than when we are working with trauma. Post Traumatic Stress (PTS)* is not work for newbie EFTers or newbie therapists with or without EFT.
Besides first getting plenty of therapy hours under our belts, if we are interested in working with trauma we need to educate ourselves thoroughly about it. The books listed below are a possible starting place. When we know enough, it can become part of our keeping-clients-safe strategy to be able to explain to them with conviction that theirs is a normal response to an abnormal event.
Put simply, when ordinarily awful things happen to us we mull over them. We talk about them. In time we give ourselves some kind of a story about them – they happened, they are over, and we are not going to let them ruin the rest of our lives. Every time we recall a memory we revise it so what we store again is not the same what we retrieved. When it is in long-term memory we can still revise it from time to time, but we can move on.
Traumatic memories are stored in a more primitive way in the brain, without much language access, and usually with all the sensory information still attached. For example, when someone recalls a trauma a strong smell may still be part of the memory. The same smell from an unrelated source may be enough to trigger a flashback. Or a car back-firing may bring an instant reaction as if to a bullet being fired. Body sensations, too, can start an instant seemingly-inexplicable re-living of the original trauma, or of all the feelings that went with it. Or the trauma scene can just flash back into awareness without any apparent trigger.
Somehow EFT manages to move primitively-frozen trauma memories into processed long-term memory. Clients will often notice and comment on this. They may say something like: “That now seems longer ago than it did half an hour ago.” Or “it seems to have faded now.”
How tapping does it is still something of a mystery. It may be as simple as incorporating new information into the memory when it is retrieved. We may remember while now feeling physically relaxed. Maybe our unconscious minds get the message that we cannot be relaxed and in real danger at the same time, so when they store the memory again it has a different assessment of current danger attached to it. Maybe that is part of the story. We believe trauma is downloaded into every cell of the body. Maybe the explanation is to do with vibrational level and how that affects each cell. Maybe it works at several levels, and maybe there is more we have not yet even glimpsed. Fortunately, we do not need to know for it to work.
And however it works, there are safety considerations we need to think about when we use it. Here are some of them:
Rapport. We shouldn’t even start any processing until we have it.
Brake before accelerator. We need to teach clients tapping on small stuff before we get going on the bigger issues. It reassures them and makes them safer if they have a way to deal with emotions that come up outside our offices.
Identify and build internal and external resources. When a group of people are involved in a trauma some go on to suffer flashbacks and nightmares and hypervigilance, even to the point where they qualify for a diagnosis of PTSD. Others don’t. One of the predictors of which group someone will fall into is their psychological health before the traumatizing event happened. And traumatized people recover better if they have a good social support network. But in the aftermath of trauma some people are inclined to withdraw from their support networks, unless they are actively encouraged not to.
Others alienate them by drinking too much, using drugs – attempts at self-medication for their pain. Or by behaviours like withdrawal or by explosive anger.
Probe – gently – for relevant history. Clinical experience is starting to confirm that a predictor of how likely a trauma victim will be to suffer PTSD is having had some degree of trauma or at least very negative experience previously. Servicemen with a lot of negative childhood experiences, for example, seem to be more likely to be seriously traumatized by war experiences. So be asking and listening – sensitively.
We need to be careful how and even if we broach this explicitly. There is considerable scope for ruining rapport here. Clients may feel diminished or that their experience is being minimized or that the trauma perpetrator is being let off the hook if they think we are suggesting they only have the post trauma problems they do because they had an unhappy childhood or were previously damaged in some way.
Put the client in the driving seat and make it clear that we have done so. We need to promise we will not do anything until the client is ready. We need to promise we will stop as soon as they want. It is sensible to set up a physical stop signal. The word “stop” can be unclear if we are not sure whether a client is saying it to us or to or someone present in their imagination/memory at that minute.
Adjust therapy to client, not client to therapy. I think the aim of all therapy is to get, as much as possible, into the client’s world and work there. In trauma this is even more imperative. We need to be prepared to forget everything theoretical we have ever learned and follow the client. That may mean just listening for a long time. Listening while we both tap on the karate chop point is good when clients are ready to do that.
Use safe places . It is wise for us help clients to remember or invent a place where they have felt safe and to go there, in imagination, during and between therapy sessions. In therapy sessions, going (in imagination ) to a safe place is an option when a client wants to stop processing a memory and take a break. Going to a safe place may be easier than coming right back into the room. Ask. But you need to have practised this with a client in advance. Make sure you teach them to build the safe place in as many senses as they can – what it looks like, what it sounds like, what it feels like plus smell and taste when they are relevant.
Use present tense safe places. If we are working with old memories, say from childhood, it is better not to take the client back to that time looking for a safe place. Anywhere might have the wrong associations. A safer safe place may be present day. This is also a good homework exercise – for clients to go there from time to time on their own. Again It does not have to be a real place.
Watch clients eyes. This means we need trauma clients to keep their eyes open as much as they can. They may have coped by dissociating, which may be their best option short-term. To process trauma memories, we want them to be associated. If their eyes are closed we do not know which they are.
Help clients to be in their bodies. Trauma clients sometimes get through the days by keeping out of their bodies. This may be a smart survival strategy in the short-term but EFT works better when people can locate the relevant physical symptoms as well as emotions. An exercise that helps people connect with their bodies is to imagine putting the body on every day, like pulling on all-over body-stocking. Or we can ask clients to spend a few minutes a day just noticing what is going on in their bodies at that moment. It is a start.
Go way beyond tearless trauma. The tearless trauma technique (like the movie technique but with guessed SUDS) is good for dealing with bigger negative memories. But it is not the ultimate. Negative memories can be in the next room, behind a curtain, behind bullet-proof glass, in a spaceship on the edge of the universe, buried in an imaginary trauma vault while we tap on them. We should be as far as the client needs from the memory to start with.
Tapping without knowing. Remember we can tap on specific memories without knowing what they are. A client may be safer not telling, or not telling until the emotion around the memory has come down some. And it may be safer for us as therapists not to have heard the details if it is not necessary to the client. We shouldn’t feel we always have to know.
Get mentoring/supervision. Therapists always benefit (and so do their clients) if we set up a real safe space for ourselves to off-load as well as to have someone help us look at our work and our reactions to it, and to keep a healthy perspective. This is never more true than when working with trauma.
Remember, helping others clear trauma can be at the cost of our secondary traumatization if we do not look after our own safety as we go. And that doesn’t help anybody – clients or ourselves.
*To clarify, when I use the term Post Traumatic Stress I include Post Traumatic Stress Disorder ( PTSD.) But PTSD has a very specific meaning in DSM-IV, the manual researchers, psychiatrists and psychologists use to make sure they are all singing from the same hymn sheet. People can be suffering deeply post-trauma without quite meeting the DMS criteria for PTSD but clearly have PTS.
Trauma resources
Reading:
Understanding Trauma and Dissociation – a guide for therapists, patients and loved ones by Lynn Mary Karjala (clear, easy-to-read and covers Dissociative Identify Disorder – which used to be called Multiple Personality Disorder – as well as PTSD).
EFT for PTSD by Gary Craig (and others)
The Body Remembers – the psychophysiology of trauma and trauma treatment by Babette Rothschild (highly recommended, comprehensive textbook.)
Light in the Heart of Darkness – EMDR and the treatment of war and terrorism survivors by Stephen M. Silver and Susan Rogers (excellent for insights on specifically war trauma, and most of it just as relevant for EFT as for EMDR)
Traumatic Stress – the Effects of Overwhelming experience on Mind, body and society by Bessel A van der Kolk et al eds. (the ultimate textbook on the subject)
On DVD:
I have a DVD plus handout on working with trauma with EFT made at my presentation to the EFT International Masterclass 2009 available from my website which is http://www.judybyrne.co.uk There you will also find three DVDs including much more about working with negative memories.
Contact details: Judy Byrne offers therapy in person and by skype/telephone, EFT training and therapist mentoring. She is also co-organiser of the EFT International Masterclass 2010 at which you can meet 14 of the EFT Founding Masters which is booking now on http://www.eftmasterclass.com. Contact Judy on info@judybyrne.co.uk or via her website http://www.judybyrne.co.uk
Pingback: Mental Disorders 101