Spoštovana ga. Bašič,

Izredno sem vesel za ta forum, da obstaja. Rad bi nekaj informacij zase. Zanima me, kako pri sebi prepoznati znake zlorabe, če se v času ko bi se le-ta dogajala, ne bi zavedal. S tem mislim na zelo rano otroštvo. Nekje do 3 leta. Sedaj sem star 25 let. Naj povem še to, da sem dokaj zaprte narave, sramežljiv, bojim se kakšne nove situacije, kjer je na preizkušnji moja osebnost.., bojim se, da nisem sposoben ljubiti nikogar, stike navežem bolj počasi. Menim, da je to zaradi šibke samozavesti, ali kaj. Starša sta se ločila, ko sem bil star 8,5 let. Ne vem, kaj je to družina…Tega dogodka se sploh več ne spominjam – kot da sem ga potisnil čisto v podzavest…
Zavedam se, da ne živim dovolj polno življenje, oz. me določene stvari pri temu zelo ovirajo…
Za zlorabo sumim očeta, ki je drugač zelo dober človek, vendar me je nekaj pri njemu vedno motilo.
Kaj bi mi svetovali – verjetno bi bilo dobro, da se oglasim pri psihiatru?

Ali si le domišljam, ali pa je le kaj na tem??
Najlepša hvala za odgovore pa oprostite za zmeden post. Če še potrebujete kakšne informacije mi samo sporočite.

Xenon

Glede na svoje izkušnje ti lahko povem, da obstaja velika verjetnost za zlorabo. Jest sem bila posiljena pri 14 letih in ravno tako kot ti je tudi meni padla samozavest in imela sem probleme z navezovanjem novih stikov. Samo ti veš, kako se počutiš ob očetu. Morda pa gre samo za nelagodnost zaradi ločitve.
Mislim, da bi ti lažje pomagal kak psihiater, ki bi ti s pomočjo tvoje zavesti na ta leta pomagal dognati resnico. Vedno pa pomaga pogovor. Pa nja bo s komerkoli.

Upam da boš uspel rešiti svoj problem na zate najboljši način. LP

Zelo rano otroštvo – moja izkušnja faz odkrivanja in faz zdravljenja posledic spolne zlorabe v zelo ranem otroštvu.

Od kar sem se zavedal samega sebe, sem do pred par let nazaj živel kot zombie /živi mrtvec/.

V zraku je kot da bi lebdel le moj intelekt. Ločen od vsega in brez vsake moči.

Že od pubertete dalje pa sem se v strahu pred spolnostjo še bolj umaknil pred drugimi v knjige in intelektualiziranje. Do zaključka fakultete, ko sem bil star toliko kot ti, Xenon.

Po končani fakulteti sem se odločil pod pretvezo duhovne rasti vključiti v samopomočno skupino Sanje Rozman, ki mi je nudila varno okolje, da sem lahko postopoma prišel do svojih lastnih občutkov brez intelektualiziranja. Zaradi mojega dlakocepskega intelektualiziranja (podobnega Megaboy-u nekje v tem forumu, ki je tudi razjezil ostale na forumu), s katerim sem se branil pred podoživljanjem prevelike količine bolečih občutkov, ki jim s tedanjimi notranjimi močmi na čustveni in telesni ravni ne bi bil kos, sem nehote oteževal izražanje čustev tudi ostalim članom skupine.

Vse do preboja. Preboj se je zgodil, ko sem se počutil dovolj okrepljen, da sem se iz vse duše zjokal pred ljudmi, ki sem jim zdaj že dovolj zaupal in so bili z mano v skupini že nekaj let.

Predvsem pa sem že zaupal sebi. Obiskovati sem začel izobraževanja iz transakcijske analize in terapije, delavnice iz gestalt terapije in ostalih telesno-duševno-duhovno orientiranih načinov terapevtskega dela s seboj – dokler nisem postal kos nenavadnim odzivom mojega telesa.

Denimo ob gledanju filmov o spolnih zlorabah otrok se je moje telo začelo kar samo od sebe tresti, grlo se mi je samo od sebe napelo v krč, skozi moja usta pa se je (ne po moji želji in volji) izvil krik obupanega otroka, nad katerim se je še moj intelekt zgrozil in bi se lahko zjokal iz sočutja do tega otroka, po zvenu še najbolj podoben joku majhnega otroka oz. dojenčka, moje noge pa so otrdevale v šoku in skozi kinestetični (t.j. mišično »gibalni«) spomin mojega anusa se je spustila bolečina kot bi šel skozi mene vlak.

Ker sem se bal, da bi mi voditeljica skupine rekla, da to ni enakovredno pravemu “spominjanju” in da to “nič ne pomeni” oz., da bi utegnila zanikati pomen “spominjanja”, sem iz strahu pred morebitnim izdajstvom zaupanja raje prenehal hoditi v skupino. Delal sam raje sam. Z vso empatijo, ki sem jo pridobil v toku terapevtskega dela na samem sebi. Ta mi je pomagala.

Moje “spominjanje” in hkratno “predelovanje” nepredelanih občutkov ni nikoli potekalo prek verbalnih, vizualnih, avditornih idr kanalov kot se običajno skozi fleshbacke vračajo spomini na preživeto, recimo v filmih, pri meni so se spomini vedno vračali edino na kinestetični način, kar me je vsakič tako utrudilo, kot bi šel res vlak čez mene.

Po več kot tridesetih letih / toliko sem namreč bil star v tej fazi / sem skozi podoživljanje in empatijo do sebe presegal nepredelane občutke, ki so mi prej onemogočali zares živeti življenje.

Po vsakem “spominjanju” in “predelavi” sem prihajal končno do občutka, da postajam vendarle živ.

Izkušal sem notranjo razdvojenost med željo, da bi odkril, kdo je bil storilec in si povrnil moč s tem, da bi lahko na glas povedal, kaj vse sem moral dati skozi zaradi njega in ga videl na sodišču prositi za odpuščanje, da sem moral vse to dati skozi zaradi njega, sodišče pa bi ga obsodilo na 20 let zapora, na drugi strani pa strahom pred tem, če bi se izkazalo, da je to bil storilec nekdo od najbližjih sorodnikov in pred neželenimi posledicami.

Čutil sem razočaranje nad tem, da bi v obeh primerih bilo zame toliko slabih kolikor dobrih posledic, v prvem primeru, če se ne bi nikoli “spomnil” oz. vsaj uganil na osnovi kinestetičnih spominov in odzivov v bližini te osebe kdo je bil storilec in ga prisilil, da to prizna in ga videl obsojenega, si ne bi pridobil nazaj moje moči, v drugem primeru pa bi si pridobil nazaj občutek moči, ko bi ga videl obsojenega za vse to, kar sem moral dati skozi zaradi njega, vendar bi se pojavilo hkrati veliko neželenih posledic.

Občasno sem se lotil branja strani preživelih spolno zlorabo v otroštvu, ki jih je veliko na internetu, kupil prek interneta kakšno knjigo o posledicah spolne zlorabe, eno sem potem, ko sem se udeležil pri njih izobraževanja za prostovoljce, podaril Katji Bašič oz. Združenju proti spolnemu zlorabljanju, kjer si jo lahko izposodiš. Imajo tudi druge knjige.

Nisem pa še našel nobene take izkušnje pri drugih, ki bi se dogodila v najzgodnejše dobi otroštva in ki bi zato doživljali edino kinestetične “spomine”, želel oz. moral sem vedeti, če so šli tudi oni skozi take faze in kako so prišli do končne faze ozdravitve in povrnitve občutka notranje moči in dostojanstva in stanja za svojo resnico.

Končno – kar je bila moja namera in hkrati pretveza s katero sem samega sebe prepričal, da sem pred leti poiskal samopomočno skupino iz katere sem pozneje sicer izstopil – sem najbrž zrasel do točke, da čutim, da bi vse to vendarle lahko presegel tako, da bi pridobil moč na konstruktiven način tako, da bi za druge – tudi zate Xenon – , ki imajo simptome spolne zlorabe v najzgodnejšem otroštvu in ki na internetu iščejo nekoga, ki je šel sam skozi to skozi kar so šli sami, s svojo pripovedo storil »nekaj dobrega«.

Lepo pozdravljam tudi Katjo Bašič. Hvala za priložnost, da sem povedal svojo izkušnjo.

Samo, tudi Tebi hvala za vse povedano in lep pozdrav. Zdravo in srečno leto 2003 pa seveda Tebi in vsem udeležencem foruma. Katja

Zaupajte svojim občutkom, obenem pa upoštevajte, da boste tudi ob pomoči drugih , v vam sprejemljivem ritmu dolgo odstirali tančico za tančico , ki prekriva vaše zgodnje otroštvo.Pri tem vsi potrebujemo veliko poguma in pogosto tudi podpore .V kolikor je za vas to sprejemljivo , bi se o tem lažje pogovarjala z vami, kot obširno pisala. Morda bi se lahko oglasili na pogovor. V kolikor je to za vas prehitro ali sedaj ali na sploh nesprejemljivo, mi to sporočite in se bova naprej brala. Morda pa bi lahko kot pripomček vzeli za začetek v branje tudi knjigo Pogum za okrevanje. Katja

Draga Katja,

Zanima me, ali lahko priporočite (oz. vsaj poznate) kakšno terapevtko ali terapevta, ki zna (ne le da ima izobrazbo potrebno za izvajanje psihoterapevtsekga dela, ampak predvsem to, da je osebnostno-čustveno zmožen(!)) zdraviti na naslednji način. Gre za način, ki zahteva od terapevta zmožnost, da: prvič) zazna neverbalne signale močnih skorajda neznosnih nepredelanih čustev; drugič) polno začuti ta čustva (vsaj v toku ure), ki mu jih pacient začasno ”preda”; tretjič) pa na neverbalni ravni pokaže, da se jih da sprejeti, predelati in s tem omogoči, da isto stori tudi pacient. Terapevtka sama pa ne sme imeti tovrstnih nepredelanih čustev, kar bi to onemogočalo dobro terapevtsko delo.

Tu je članek psihoterapevtke, ki opisuje tovrstno delo:

Title: The Use of the Dyadic Affective-state Relationship (ASR) in the Treatment of the Post-Traumatic Stress Disordered Adult Molested as a Child

Author: Judy McLaughlin-Ryan

Schore (1994) whose research has highlighted the importance of right-brain communications in psychotherapy, notes that most research on psychotherapy focuses on what the patient says during session, often utilizing transcripts. Schore (1994) asserts: ”Such samples totally delete the essential ‘hidden’ prosodic cues and visuoaffective transactions that are communicated between patient and therapist. I suggest that the almost exclusive focus of research on verbal and cognitive rather than nonverbal and affective psychotherapeutic events has severely restricted our deeper understanding of the dyadic therapy process. In essence, studying only left hemispheric activities can never elucidate the mechanisms of the socioemotional disorders that arise from limitations of right hemispheric affect regulation.” (p. 469)

In this paper, I will present an approach to therapy I use with adult patients who were molested as children (AMACs) who suffer from post-traumatic stress disorder (PTSD).

This approach uses right-brain-to-right-brain communications that serve an affect-regulating function for the patient. Among the goals of this paper is to describe how trauma early in life may cause biological trauma to the brain, including the disruption of verbal encoding of experience. An additional goal of this paper is to describe a three-step technique that may, based on the current understanding that the brain retains some plastic capacities well into adulthood (Shore, 1994), alter this process. This technique will be illustrated with case vignettes.

It is my observation and belief that, most often, AMACs suffering from PTDS seek therapy primarily for an affect driven and state-regulated dyadic experience (which I am referring to as an affective-state relationship [ASR]) that addresses the affect and state dysregulated symptomatology of PTSD. These patients are seeking a relationship with an affectively responsive and intuitively involved “other” (the therapist) in which they will be able to explore their extreme, yet adaptive, emotional and psychobiological states, which emerged early in life in order to survive their trauma and which altered their natural drive responses. For effective treatment to occur, the therapist needs to navigate through many territories in which dysregulation occurs for both the therapist and the patient.

The PTSD/AMAC’s problems with attachment and self-regulation stem from the type, severity, and timing of the trauma. Sexual abuse at the hands of caregivers early in life triggers conflicting emotions—arousal and interest in the caregiver paired with fear, terror, fight, flight, despair, humiliation—at a time when brain development is occurring. Additionally, natural temperamental systems of drive are altered. Unlike a singular experience that may result in PTSD, such as being at the effect of a bank robbery, for the AMAC, more often than not, the sexual abuse occurred frequently over a prolonged period and severely impacted right-brain development, thereby disrupting normal regulating and attachment-oriented responses and, as Schore (1996) has noted, disrupting the expression and processing of both emotional information and nonverbal communication.

A feature of PTSD, which may appear to the therapist initially as a symptom of problems with impulse control, is what I call the “impulsive adaptive function.” This pervasive symptom of impulsivity is, I believe, how the patient adjusted to his original life supportive drives to survive the trauma. Although these same impulses in adulthood cause problems for the survivors, originally, I believe, their construction was adaptive and helpful.

Lichtenberg (1989) and Jones (1995) describe motivational systems that are relevant to working with traumatized patients. Lichtenberg (1989) defines five motivational systems: (a) physiological; (b) attachment; (c) exploration/assertion; (d) withdrawal, or antagonism in response to aversive events; and (e) sensual/sexual pleasure. Jones (1995) proposes a motivational system that he describes as the aggressive/competitive. Identification by the therapist and the patient of which motivational system a patient is using at any particular point provides a window both to the methods the patient used to survive his or her trauma and to the original (before trauma) motivational systems that lay dormant in the patient, ready for reclamation once he or she comes to understand the use of their current motivational systems as a reaction to trauma. I have observed in treatment the reduction of learned trauma-related responses and the emergence of natural drive responses.

When impulsivity manifests in the treatment dyad, particularly nonverbal impulsivity, it can appear as a surge of inappropriate and spontaneous reactivity. It can cause massive dysregulation for both the therapist and the patient. Yet if the therapist can ride this wave, he or she will have a peek into the survivor’s internalized history.

I believe that the “impulsive adaptive function” is directly related to the dysregulation of the trauma and not particularly related to the patient’s current environment and relationships. Survivors react to triggers that remind them of the trauma with both hyperarousal, as though they are in an emergency, and at the same time numbing, punctuated by hyperarousal, which result in an inability to use affect states as signals to respond effectively and efficiently. The response of survivors is to go from stimulus to response without assessing what is really going on (Krystal, 1978). These psychobiological trauma-based affects, states, motivational systems, and impulses are stored within the patient’s nonverbal right-brain emotional systems and are communicated to the therapist nonverbally. The therapist needs to utilize this information as though it were a “word.” This adaptive response, as I have observed its development throughout the course of treatment, initially appears as impulsive, by which I mean disruptive to the treatment due to how dysregulating its appearance or presence becomes to both the therapist and the client. Yet when the response is welcomed by the therapist, understood, and metabolized by surrendering to it through state, affective, and somatic experiences, eventually the adaptive response of the client is seen as a method whereby the patient adapted and altered his or her natural drive responses, which are unconscious, presymbolic, procedural, and somatic. These responses involve both affect and state to survive trauma and in adulthood traumatic triggers or signals. And their appearances in treatment need to be welcomed.

An example of how understanding impulsivity can be effective in psychotherapy is the case of Uma. She had been sexually abused by her father from infancy until age 10. The reoccurring ritual was for Uma’s mother to get Uma interested in and excited about family outings or other exciting treats as a precursor to the abuse. Uma learned to dissociate and deny any and all feeling about her abuse. As an adult, she engaged in severe sadomasochistic relationships. After a period of abstaining from engaging in sadomasochism, she began to do very well in treatment. Her mood was more stabilized, she was less depressed, and she felt happy for the first time in her life. About 4 months later, all of a sudden, she became severely suicidal, enraged, and contemptuous of me. She humiliated me, shamed me, and blamed her suicidal feelings on me. She attributed them to my failure in treating her and said her demise would be my fault, a therapist’s living nightmare. My dread increased. I did what was needed ethically and legally, but most importantly, I felt such a deep sense of helplessness and shock, as well as incompetence and shame. This event appeared so “impulsive,” there were no apparent triggers. Only months later did I learn that Uma needed me to understand the state of helplessness she experienced before she herself could move from relationships based on aggression and sadomasochism to relationships based on attachment. Her capacity to physiologically respond to closeness with dissociation mixed with inflicting and receiving sexual pain was transformed into responses to closeness colored with responses of attachment. She became attached to me after effectively communicating to me her own underlying sense of helplessness, dread, despair, and massive confusion.

The therapeutic approach that I am proposing for the treatment of the PTSD/AMAC is in three steps. In Step 1, the therapist needs to be receptive to the patient’s dysregulated states and affective experiences, thus visiting the patient’s traumatically adjusted adaptive responses. In Step 2, the therapist needs to mobilize and regulate the dysregulated state by experiencing the dysregulation and then exiting those feelings and bodily experiences by responding with increased or decreased arousal and/or increased or decreased calming (i.e., soothing, restoration, conservation). Finally, in Step 3, the therapist needs to deliver back to the patient the regulated state through an interactive dyadic state and affectively regulated right-brain-to-right-brain communication.

When I use the words “receive,” “became a tenant or a resident of, ” “visit,” “became a guest,” “acquiesce,” I am referring to Step 1, describing the fraction of a second wherein the patient communicates an internal experience to the therapist through soma and affect, using nonverbal right-brain communications (e.g., vocal rhythm tones and sounds; a variety of gazes and looks: gaze averts, still gazes, hypergazes, constricted pupils, dilated pupils; gustatory responses: stomach making noises, feeling like vomiting; muscleloskeletal responses: arching 90 degrees, 180-degree turns, posturing, jumping, running, hopping, feelings, or affects). If this experience is received by the therapist through a unilateral bridge of receptivity from patient to therapist through the medium of soma and affect, the right brain, the therapist will experience some of the patient’s unconscious, fertile, and critical information including early adaptive impulsive responses and information about the patient’s unedited, unfiltered internal experience. Therefore the therapist must receive it first and then begin to sort it out during and after experiencing it, while involving a bilateral affective-state exchange. This method of therapy embodies a template for the repair of the patient’s primitive parts, which during this phase of treatment are unresponsive to symbolic or reflective thought. As Michael Robbins’s (1993) paradigm so eloquently suggests, therapists cannot necessarily assume that their patients possess an internalized representation of cognitive-affective experiences or representations of self from representations of others. Furthermore, one cannot assume that the patient has the capacity for appropriate, adaptive self-regulatory functioning, let alone the ability to move from primary process to reflective or interpretive experiences. This requires that the therapist is attuned not so much to the overt behavior of the client as to the internal states of the client, as Schore (1996) points out: ”With the advent of neurobiological studies, we are now able to support with neurobiological evidence a method of treatment that makes possible positive outcomes for primarily nonverbally equipped patients who have trauma stored in the right brain.”

According to Schore (1994,1997a), in early development, the caregiver functions as a psychobiological regulator of the behavior and physiology of the developing brain of the infant. The maturation of homeostatic regulatory systems in the right frontolimbic cortex is dependent on the quality of the psychobiological attachment. If there is unregulated interactive stress and prolonged episodes of heightened levels of negative affect (fear, humiliation, shame, despair, anger, rage, intense excitement, and arousal)—which is the core of trauma and sexual abuse—this will result in a growth-inhibiting environment that disrupts the experience-dependent development of the prefrontal system.

The reason this information is critical in adult treatment, particularly with AMAC PTSDs, is that there is anatomical evidence that the prefrontal limbic cortex retains some of the plastic capacities of early development. Specifically, changes in the right orbitofrontal cortex and its subcortical connections have been detected in patients as a result of successful psychological treatment (Schore, 1997b). This finding provides support for the efficacy of psychotherapy, in particular therapy that focuses on the affect-state-regulated relationship of patient and therapist (which Schore, 1997b, describes as “reciprocal mutual influence”) that mobilizes fundamental modes of development and continuance of previously interrupted developmental processes. Schore (1997b) asserts:
”Experience-dependent plastic changes in the nervous system remain throughout the lifespan. In fact, there is now very specific evidence that the prefrontal limbic cortex . . . retains the plastic capacities of early development. The orbital frontal areas of the limbic system, even in adulthood, continue to express anatomical and biochemical features observed in early development, and this properly allows for structural changes that result from psychotherapeutic treatment.” (p. 16)
Nonverbal interactions take place at preconscious-unconscious levels and are represented in the right-hemisphere-to-right-hemisphere communications that are involved in the expression and processing of emotional information and in nonverbal communications (Schore, 1996). This processing reads traffic of visual signals and prosodic auditory signals that effect emotions. This psychobiological communication system is a mechanism thought to be responsible for mediation of attachment. These informational systems occur as fast-acting, automatic, regulated and unregulated emotional states in relation to the patient and therapist. This right-hemispheric activity is dominant for the interactive transfer of affect and state.

To further illustrate this process as well as integrate the three-step process, I will describe the case of Jane. Jane entered treatment with acute PTSD. Not long after our work began, Jane started describing some explicit memories of her mother using toys to penetrate her while changing her undergarments when she was 3 years old. At one point, while I was listening to Jane, I found it impossible to move my arms (Step 1). I felt immobilized, paralyzed, and numbed. Then I began to notice my feeling state. I felt overwhelming helplessness. The patient began discussing horrifying images, and I wanted to run out of the room. I sat with these sensations. Jane kept talking. I noticed Jane was in a mildly dissociative state and appeared to feel very little about what she was describing. I (Step 2) stayed with the feelings I was experiencing. I did not talk, but instead I moved, groaned, grunted, sighed, squirmed, and experienced my feelings and my bodily changes. I did not interpret. Then, toward the end of the session, I began to implement self-regulating, self-soothing, containing behaviors, which served a grounding function. For example, I told her we would now get ready for her to go back into the world and would therefore discuss everyday events, like what time it was, what her daily plans were, and what she will wear that evening. At that point, I realized I still could not move. I was unable to get up, my forearms were paralyzed. I mentioned this, in a very soothing voice, “Oh my, Oh my goodness, my arms won’t move. Hmmm, curious.” The prosody of my voice indicated that all was well, as though a breeze had just moved over my face. I (Step 2) then calmed myself further (something Jane could not do during her trauma), began moving my fingers, slowly regaining enough movement to stand. All through this I was self-regulating. I said good night and so did Jane. This turned out to be a significant moment in the treatment, which later resulted in Jane’s being able to affectively experience what in the session just described she had communicated to me through nonverbal process.

Jane was well aware of her ability to withdraw in response to trauma. She had no skills to self-regulate, or access to other adaptive responses (i.e., assertion, aggression, attachment). Soon after the session in which I became immobilized, Jane said that she had had a similar experience in her youth; she described an incident of her mother binding her arms when her father had oral sex with her. As a young girl, she had learned to paralyze her arms, and more generally, she learned how to play dead and deaden parts of her body. She referred to this adaptive self-regulatory, primary process, state-adjusting event as her “body game.” I never responded to Jane’s description of her “body game” with words. But at some point, it became apparent that Jane was aware that her state had a profound impact on me. Jane then felt safe enough to experience the helplessness and terror that she had stored in her adaptive unconscious state. After that point, I never experienced such immobility with Jane again. It had been mobilized and—in a dyadic-state-regulated manner experienced by me, the listener of her internal world—dysregulated, reregulated and dyadically communicated. The nonverbal, affective-state communication was not received as misattunement and polarization, but as an opportunity to better understand Jane’s internal state and affective world. I was attuned within a millisecond of Jane’s internal world of helplessness and immobilization.

Jane did not have the capacity to move from dissociation or negative states for prolonged periods of time. Oftentimes after sessions that included flashbacks or episodes of amplified negative states, she would remain for days in a somewhat dysregulated state. Sometimes autoregulation was only achieved by complete isolation and withdrawal. This gravely affected her ability to have relationships and or to work. But after this dyadic experience I had with her, whereby I attempted to autoregulate with her there in the room, Jane began to display behaviors that indicated that she had an increased ability to enter dysregulated states, receive regulatory responses from me, and then internalize and, after time, autoregulate within a shorter period of time. Her impulsive response to survive primarily by withdrawal began to shift to a more assertive/aggressive capacity with an increased ability to experience attachment.

As described earlier, Jane labeled her response to trauma her “body game.” Interestingly, after the session in which I became immobilized, Jane’s experience of the “body game” changed. Paralysis and freezing gave way to screaming, sweating, and a desire to fight the perpetrator. The latter was concretized as a metaphorical protector: the “body game buster,” who took the form of a burly monster who would kill off the parents during the trauma. While she was experiencing the identification with the aggressor, this gave her access to a survival mechanism that she had not formerly experienced. It, most importantly, mobilized an amplification of the aroused state and deamplified for Jane her former response of playing dead (conservation and restoration as means of survival). At this point, her sessions were filled with laugher. Needless to say, her deep depression began to lift. Jane never acted out on the identification with the aggressor, but she did utilize this part of her newfound physiological capacity and brain chemistry to work creatively as a graphic artist. Additionally, she now had the ability to respond competitively and had the capacity to feel a modicum of attachment.

Jane was in therapy with me for six years, and upon leaving therapy had a profoundly positive life. The “body game” was transformed into horrific computer graphic images, which Jane created for a major film studio. She became involved in an intimate relationship. She continues to send me letters and photos, and computer images, of course.

The following case illustrates the ASR technique when treating PTSD/AMACs. The clinical phenomena presented below are nonverbal, right-brain communications that, while impulsive and affectively and physiologically extreme, are not responsive to reflection, left-brain word-driven communications, but need to be metabolized through the affective right-brain-to-right-brain dyad.

Jason’s father was a seemingly good father, upstanding citizen, and businessman. But at night when Jason was 5-12 years old, his father would penetrate him anally. Jason’s father would remind Jason that this was because he loved him and he had to teach him to “pay his debt,” because he was a child, the only way he could pay his dad was by doing “his responsibility.” Jason talked about this from the onset of treatment in a dissociated and numb state with flat affect.

Jason’s “impulsive adaptive functions” manifested in enactments of withdrawal from his attachment to me surrounding payment of fees and keeping appointments. Regarding the former, he would have excuses for not paying at the end of sessions, such as forgetting his checkbook and wallet. Around the issue of keeping appointments, he would cancel less than 48 hours before appointments, even at times calling at the last minute, or he would forget his weekly scheduled time.

As treatment progressed, I (Step 1) began to be receptive to Jason’s dysregulated states and affective experiences, and I thought that with time I would understand them as Jason’s traumatically adjusted adaptive response to feelings of rage, anger, contempt, and helplessness, paired with states of numbness, exhaustion, flight responses, fight responses, and many others. Interestingly, all of these acquiescences to dysregulated states occurred during procedural exchanges regarding Jason’s payments and appointments. I (Step 2) mobilized these states and affects in session without discussion. For example, when I told him he needed to pay as agreed, I was terrified, palms sweating. He did pay. Afterwards, I doubted my abilities as a therapist; I had fantasies of terminating the treatment or perhaps not charging him at all, in order to avoid feeling this thalamic dread (Bion, 1990), but I continued to mobilize these complex responses. And then, while addressing payment and scheduling, I made efforts to regulate my state. This required delivering (Step 3) mobilizing assertion, soothing my own withdrawal responses, and continued attachment to Jason instead of being frozen in the terror. The verbal content was not about my extreme reactions.

When acquiescing to Jason’s states and affects, I understood that I was experiencing a sample of his experience. Therefore, I cherished and held the interactions in highest regard.

After about 6 months, Jason began to have an assortment of his own state and feeling reactions to payments and scheduling. Of note, this shift coincided with the mobilization of his state and affect when talking about his father’s penetration of him. He manifested less withdrawal and hyperarousal and more interest, assertion, excitement, and aggression. His tone became loud; his eyes began darting back and forth; he stared at me with intense confrontation and anger. Concurrently, Jason learned to regulate his mobilized states as well as his feelings, and he developed an ability to self-sooth. Jason had stored these feelings that were triggered in regard to attachment with caring paired with torture. Had I not held to our original scheduling and financial agreements, I would have been unconsciously defending and colluding with Jason. Although this content area provoked acute terror in me, after this phase of treatment, its value was clear to me. It was apparent that Jason eventually trusted that his paying me did not mean one of us would be the victim and the other the perpetrator, but it enabled him caring and some healing instead. Therefore, there was an unpairing of terror and the therapy-related procedures of paying and scheduling. Finally, responsibility acquired a different meaning to Jason, freeing him from unconsciously and impulsively reacting to responsibilities from the perspective of his trauma.

The point here is: I (Step 1) momentarily became a tenant in Jason’s depressed state and dissociation. I then (Step 2) moved and mobilized to a state of assertion, interest, and excitement, where I was able (Step 3) to regulate enough to take care of myself and my practice, enforcing fees and scheduling. This regulated state was apparent through the content of fee and scheduling. He then paid without conflict and showed up without problem. But I needed to reside in his state and affect in order to effectively receive the nonverbal content Jason was sending me.

In closing, I think that heightened dyadic state and affective levels need to take place in treatment to accomplish repair. It is my belief that if this is an element of the therapy, the treatment may serve as a reparative relationship in which the patient can further heal his or her trauma. The therapist needs to experience the patient’s symptomatology from a secondary position because the original trauma happened to the patient not the therapist. From this perspective, the therapist can facilitate the growth of self-regulation for the patient through the therapist’s alterations in physiological responses acquired by engaging in what Shore (1997b) describes as “reciprocal mutual influence,” or what Bion (1962) refers to as “reverie,” or what Marcus (1998) discusses as the analyst maintaining a state of reverie so the analyst’s unconscious will be able to hear the patient’s unconscious. This is possible because the therapist has a feeling for how it was for the client and can offer state and affective alternatives to reactions that the patient had to his or her trauma. Repair is done through the therapist’s ability to self-regulate and then feed that self-regulation back to the patient through preverbal right-brain-to-right-brain experience. Finally, if the therapist can resist initially using words as a primary intervention, when affectively dysregulated and reregulated exchanges are occurring during the right-brain-to-right-brain communication, the therapist will have a greater understanding of how the trauma was internalized by the patient. For effective treatment, the therapist cannot deny the existence of these presymbolic experiences, only to have the client need to escalate with increased impulsivity, chronic acute dysregulation, and negative attachment styles in treatment, which are efforts by the patient to drive information into the therapist because the original sending of information was not received. The patient is concurrently hoping the experience will be repaired and the rupture will be noticed. The therapist needs to notice, experience, and, as an attuned caregiver, feed back only what is palatable to the patient through affect and state during periods of treatment where nonverbal communication is critical. I have utilized this process of treatment, implementing the affective exchange, and I have experienced it as a positive treatment modality with positive results. The usage of words has been secondary during these points of heightened affective-state communications.

References:

Bion, W. R. (1962). Learning from experience. London: Heinemann.

Bion, W. R. (1990). W. R. Bion Brazilian lectures. 1973. Sao Paulo, 1974. Rio de Janeiro/Sao Paulo. New York, Brunner/Mazel. First published 1990 London, Karnac Books.

Jones, J. M. (1995). Affects as process: An inquiry into the centrality of affect in psychological life. Hillsdale, NJ: The Analytic Press.

Krystal, H. (1978). Trauma and affects. Psychoanalytic Study of the Child, 33, 81-116.

Lichtenberg, J. (1989). Psychoanalysis and motivation. Hillsdale, NJ: The Analytic Press.

Robbins, M. (1993). The mental organization of primitive personalities and its treatment implications. Journal of The American Psychoanalytic Association, 44, 755-785.

Schore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Hillsdale, NJ: Erlbaum.

Schore, A. N. (1996). The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Development and Psychopathology, 8, 59-87.

Schore, A. N. (1997a). Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Development and Psychopathology, 9, 595-631.

Schore, A. N. (1997b, March). Psychobiological affect regulation: An essential mechanism of both development and psychoanalytic treatment. Paper presented at American Psychological Association 17th Annual Division 39 Meeting, Denver, Colorado.

Lep pozdrav,
Samo

Članek, ki ste ga priložili, sem prebrala z zanimanjem. Opisana terpevtska metoda se zdi podobna oz. vsebuje precej elementov razvojne psihodinamske terapije, ki temelji na diadnem odnosu med klientom in terapevtom in transferu.
Neverbalno komunikacijo kot tehniko zdravljenja pa uporabljajo predvsem razne vrste umetnostne terapije, npr. glasbena, likovna… Obe obliki sta prisotni in se izvajata tudi pri nas.
Lp.

Spoštovana Alenka,

Najprej se vam lepo zahvaljujem se vam za vašo pripravljenost najti odgovor na moje vprašanje.

——————————————————————————————
Vrstice, ki sledijo prosim ne vzemite osebno kot odgovor na vaš prijazen poskus odgovora, ampak le kot moje splošno razmišljanje in razpoloženje v zvezi s to temo.

Zanimalo me je (in še vedno me zanima) predvsem priporočilo oz. informacija, ki se nanaša na ”kdo” (konkretna oseba) in ne na ”način” (metodo, ki temelji na transferu in kontratransferu v diadi terapevt-klient, čeprav je tudi ”način” pomemben, vendar ne toliko kolikor je pomemben konkreten ”kdo”, ki kot konkreten človek stoji zadaj, s svojo osebnostjo).

Namreč, naj pojasnim, iz lastnih izkušenj (a) v treningih za bodoče psihoterapevte (bil sem udeleženec raznih začetnih tečajev in delavnic) in (b) v dejanski terapiji pri terapevtih/kah, ki so se vsak spoznali na izbrane psihoterapevtske ”načine” od psihoanalitskih in psihodinamično objektno-relacijskih preko vedenjsko in kognitivno orientiranih pa do bolj humanističnih kot so gestalt, psihodrama, transakcijska analiza, psihosinteza, umetnostna terapija, realitetna terapija, hipnoterapevtsko orientiranih kot so ericksonovska uporaba sugestij, nevrolingvistično programiranje in EMDR (Eye Movement Desensitization and Reprocessing), telesno orientiranih terapij od neo-reichovskega Lowena in njegove bioenergetike, metod Pierrakosa in Brennerjeve do trans-personalno orientiranih terapij, lahko v zvezi z vsemi ”načini” zatrdno ugotavljam naslednje:

1) veliko bolje za kliente bi bilo, če bi se usposabljanja za psihoterapevte usmerjala v specializacijo za določene ciljne skupine klientov, namesto kot sedaj v določene ”načine” dela, saj prestop od dela s klientom, ki trpi za nevrozo, k delu s klientom, ki trpi za PTSD (post-travmatskim stresnim sindromom) zahteva veliko večjo spremembo v delu kot jo zahteva prestop iz enega ”načina” v drugega;

2) veliko bolj kot izbrani ”način” oziroma bolj ali manj vešče kombiniranje elementov iz različnih ”načinov” je kvaliteta terapevtskega dela konsistentno odvisna od osebnostno-čustvenih zmožnosti konkretnega psihoterapevta/ke kot človeka. Namreč ”način” ni ta, ki stoji ob strani klientu;

3) vedno je ”kdo” (t.j. konkreten psihoterapevt/ka kot človek) ta, ki bodisi stoji ali pa ne. Ker lahko zanj oziroma zanjo – kot konkretnega človeka – proces postane: ”(…)a therapist’s living nightmare”, kot zadane žebljico na glavico v desetem stavku v desetem odstavku avtorica omenjenega članka.

4) vedno je ”kdo” (t.j. konkreten psihoterapevt/ka kot človek) ta, ki začuti kar je začutila sama avtorica: ”My dread increased. I did what was needed ethically and legally, but most importantly, I felt such a deep sense of helplessness and shock, as well as incompetence and shame.”…Deal with it.

Med vrsticami je razbrati zdrav kritičen odnos do psihoterapije in v strokovnem smislu se strinjam z vašimi pogledi.
V kolikor pa se sam kot klient oz. oseba, ki potrebuje pomoč loteva iskanja terapevta na tak način, da stroko kot tako razvrednoti že vnaprej (s tem, da je teoretično podrobno obvlada in išče pomanjkljivosti) dvomim, da gre za resnično pripravljenost delati na sebi v pravi smeri. Gre zgolj za kompenzacijo lastne narcisistične patologije.

Pri človeku, ki mu lahko zaupam (zaupam mu kot človeku, ker ima ustrezno dojemanje sebe prvenstveno kot človeka in sekundarno kot “pomočnika po poklicu”!), čeprav sem pred leti že tudi z njegove strani doživel rahlo izdajstvo zaupanja v toku zdravljenja, sem medtem, ko sem tule na forumu poskusil povedati kaj iščem in česa ne maram od pomočnikov, že našel ustrezno pomoč.
Natanko zaradi tega zaupanja sem lahko v zadnjem tednu naredil pri tem človeku enega izmed pomembnejših korakov naprej v zdravljenju posledic travme izdajstva, ki leži v jedru travme zlorabe s strani močnejšega človeka, odraslega, ki naj bi mu otrok neomejeno zaupal, pa je to zaupanje izdal in otroka zlorabil.

Zaupam lahko le človeku, ki se identificira s tem, kar je sam dosegel v toku lastnega zdravljenja oz. dela na sebi in kar je naredil iz sebe kot človeškega bitja ter če name gleda kot na sočloveka, s katerim je v istem čolnu.

Večina “strokovnjakov” se preveč identificira s svojim statusom “profesionalnega pomočnika”, kar gre žal tako daleč, da so pripravljeni tako kot Alenka, če si le kdo drzne zamenjati vrstni red vrednot v vrednotni hierarhiji tako, da namesto sledečega vrstnega reda: a) strokovnost, b) človečnost postavi na prvo mesto človečnost, strokovnost pa raz-vrednoti s tem, da jo postavi nižje, in skuša strgati z njih masko “profesionalnega pomočnika” ZATO, ker pod to masko išče pravo vrednoto, t.j. njihovo človečnost, tega človeka diskvalificirati kot resničnega iskalca pomoči. Dokler omenjenega prevrednotenja hierarhije vrednot “profesionalni pomočniki” ne bodo sposobni narediti sami zase,
do takrat – welcome to the club v isti čoln z ostalimi ljudmi –
najprej potrebujejo pomoč oni sami, da bodo nekoč sposobni
zares pomagati drugim ljudem, t.j. svojemu sočloveku, ki se nahaja
v istem čolnu z njimi. Lahko pa tudi še naprej vztrajajo pri svoji
hierarhiji vrednot, ki jim omogoča, da – kot dobro opiše Alice Miller – sočloveka dojemajo kot nemogočega pacienta.

Če ste pripravljeni narediti ta premik v glavi in
sestopiti iz pozicije moči in priznati, da se v istem čolnu,
potem vam priporočam knjigo o subtilni zlorabi zaupanja
povezani s pozicijo povzdigovanja ‘pomočnika’ kot človeka
nad ‘pomaganca’ kot človeka, ki jo je napisal nekdanji
predsednik mednarodne zveze analitikov jungovske smeri
Adolf Craig-Guggenbuhl iz Zuricha (“Pomoč ali premoč:
psihologija in patologija medčloveških odnosov pri delu z ljudmi”,
prevedena je v slovenščino), predvsem pa delo na samem sebi,
kajti nihče izmed nas ni nemogoči pacient, ne mi, ne vi.

O nujnosti tega premika govori posredno tudi tale recenzija knjige
o travmi izdajstva zaupanja, ki je v jedru travme spolne
zlorabe v otroštvu, in njenem zdravljenju:

Revew of the XX part of
Judith Herman’s book “Trauma and Recovery”

Understanding trauma and post traumatic stress:
phases of trauma healing — the healing relationship

A review by Cristina Casanova

Judith Herman in her book “Trauma and Recovery”
discusses at length some of the most obvious
difficulties encountered both by the patient and the counselor
as they form their therapeutic alliance.

Traumatic Transference

A relationship between a therapist and a trauma victim can often take on an
intense mood of survival because the victim’s perception of authority
has been distorted by the experience of terror.

Kernberg speaks of it “as if the patient’s life
depends on
keeping the therapist under control.”

As Eric Lister observes:
“The terror is as though that
the patient and therapist convene
in the presence of yet another person.
The third image is the victimizer, who
demanded silence and whose
command is not being broken.”

Besides the experience of terror, the other core experience
in the life of the traumatized person
is that of
hopelessness.

This experience of feeling utterly abandoned
also permeates her later relationships.

Judith Herman writes, “The greater the
patient’s emotional conviction of helplessness
and abandonment, the more desperately
she feels the need for an omnipotent rescuer.
Often she casts the therapist in this role. She
may develop intensely idealized expectations
of the therapist. The idealization of the therapist
protects the patient, in fantasy, against reliving
the terror of the trauma.

In one successful case, both the patient
and the therapist came to understand
[It is not the ‘understanding’ and ‘interpretation’ which are just
left-brain functions – what is needed for successful therapy of trauma,
but rather something else – see the first article above, S.K.]
the terror (which is) at the source of the patient’s demand for rescue.

The therapist might say:
‘It’s frightening to need someone
so much
and not to be able to control them.’

The patient was moved and continued
this thought: ‘It’s frightening because
you can kill me with what you say…
or by not caring or by leaving.’

The therapist then added: ‘We can see why
you need me to be perfect.'”

When the therapists or counselors
fall short of meeting the projected
perfect fantasies of the traumatized person,
many victims react with rage and fury at the
counselor or caregiver.

The feeling of trust has been badly
damaged in the traumatized person.

In most counseling relationships,
the building of trust is the cornerstone
of the relationship between patient and counselor.

As a survivor enters a counseling relationship,
she is challenged by her suspicions and doubts.

Deep inside she feels that the
therapist or counselor
cannot tolerate the
horror and pain
of her story.

When the abuse or trauma has been
sustained over a long period of time,
there are complex transference responses.

Being subjected to a long-term connection
with the abuser, the survivor lives with fears –
not only of further abuse, but also that
she will not be able to protect herself from it.

Herman explains, “Chronically traumatized
patients have an exquisite attunement to
unconscious and nonverbal communication.

Accustomed over a long time to reading their
captor’s emotional and cognitive states,
survivors bring this ability into the therapy relationship.

The patient scrutinizes the therapist’s
*every word and gesture, in an attempt to protect herself
from the hostile reactions she expects.*

Drawn into the dynamics of dominance and
submission, the therapist may inadvertently
reenact aspects of the abusive relationship.

When the original trauma is known,
the therapist may find
an uncanny similarity
between the
original trauma and
its reenactment in therapy.”

We can find an example
of this in Frank
Putnan’s description
of a patient with multiple
personality…

“As a child, the patient had been repeatedly
tied up and forced to perform fellatio
on her father. During her last hospitalization,
she became severely suicidal and anorexic.
The staff members tried to feed her through
a naso-gastric tube,
but she kept pulling it out.
Consequently, they felt compelled to place her
in four-way restraints.

The patient was now tied to her bed and
having a tube forced down her throat –
all in the name of saving her life.

Once the similarity of
this therapeutic
intervention
to her earlier abuse
was pointed out to all parties,
it became possible to
discontinue the forced
feedings.”

Traumatic Countertransference

Trauma is infectious.

Traumatic countertransference
describes the common occurrence wherein
therapists working with trauma feel not only
emotionally overwhelmed, but also share the
patient’s rage and despair

[and somatic responses to a trauma,
– see above in the first article,
S.K.]

Working with traumatized people can put
the therapist’s own psychological health at risk.

It is important to realize that trauma counseling
is not for everyone.

Strong countertransference is one reason why
therapists or counselors
should join groups of other therapists
working with the same issues.

There are several ways that the therapist can
be affected. Hearing horrific accounts of
human cruelty will unavoidably begin to
erode the therapist’s basic faith in
the goodness of humanity.

[The therapist needs 1) to experience the
somatic reactions in her own body to this
betrayal of faith/trust, then 2) be self-regulated
and 3) self-soothed in the presence of the patient,
see above in the first article, S.K.)

It may even cause the therapist to progressively
become more distrustful of others.

The hopelessness of the patient is easily communicated
to the counselor who may, in turn, begin to experience
feelings of helplessness.

Besides identifying with the patient’s hopelessness,
the therapist can also easily share in the patient’s rage.

Herman observes that “through empathic identification,
the therapist may also become aware of the
depths of the patient’s rage and may become
fearful of the patient.

Once again, this countertransference reaction,
if unanalyzed [not unanalyzed, but
un-autoregulated and un-selfsoothed
in the presence of the patient!!!! –see
here in the first article, S.K.], can lead
to actions that dis-empower the patient.

At one extreme, the therapist may preempt
the patient’s anger with her own, or at the
other extreme, she may become too deferential
toward the patient’s anger.

The case of Kelly, a survivor of childhood abuse,
illustrates the error of adopting a
placating stance toward the patient:

Kelly, a 40-year-old woman with a long
history of stormy relationships and
unsuccessful psychotherapy, began a
new therapy relationship with a goal
of ‘getting out my anger.’

She persuaded her therapist that only
unconditional acceptance of her anger
could help her develop trust.

In session after session, Kelly berated
the therapist, who felt intimidated
and unable to set limits.

Instead of developing trust,
Kelly came to see the therapist
as inept and incompetent. [If
the therapist would be autoregulated and
self-soothed in the presence of the patient,
the therapy would be a success, S.K.]

She complained that the therapist was just like her mother,
who had helplessly tolerated her father’s violence in the family.”

Profound grief can be very contagious.
The therapist, in the role of the enlightened
witness [The trauma therapist can
not be merely the enlightened witness, but
the experiencer and the self-soother
first of all!!!!], may need sufficient support
for herself.

The psychiatrist Richard Mollica
tells of the infection of grief of the
staff of the Indo-Chinese Refugee Clinic:
“During the first year, the major task of
treatment was to cope with the hopelessness
of our patients. We learned that the hopeless
feelings were extremely contagious. As our
experience deepened, a natural sense of humor
and affection began to develop between
ourselves and our patients. The funeral atmosphere
was finally broken — not only after we witnessed
that some of our patients had improved, but also
after the staff recognized that many of our patients
were infecting us with their hopelessness.”

The therapist is not only at risk of suffering
painful feelings by identifying with the painful
feelings of the patient, but is also at risk of feeling
shocked at finding herself prone to identifying
with the abuser.

Sarah Haley, a therapist working with
war veterans says: “The first task of treatment
is for the therapist to confront his/her own
sadistic feelings, not only in response to the
patient, but in terms of his/her own potential,
as well. The therapist must be able to envision
the possibility that under extreme physical and
psychic stress, or in an atmosphere of over-license
and encouragement, he/she too, might very well murder.”

Judith Herman recommends that in order
to build a healing relationship where transference
and countertransference obstacles are minimized,
it is important to have clear goals, rules and
boundaries
[the therapist however needs to stay open
to the right kind of ‘countertransference’ or
more appropriately to the unilateral
right-brain-to-right-brain attunement!!!!
–see the first article above, S.K.],
as well as a good support system
for the therapist.

—————————————————————————————————

Mogoče pa nisi doživel spolne zlorabe, ampak si le jezen na starše zaradi ločitve? Zakaj kriviš očeta in ne matere? Kdo je odšel od doma? Ali si vprašal mamo o možnosti zlorabe? Mogoče nočeš priznat, kako močna je bolečina zaradi ločitve?

Čeprav je preteklo že veliko vode od takrat, ko ste napisali svoj post, upam, da še spremljate ta forum. Sama sem ga našla šele pred nekaj dnevi in ga kar požiram.

Odkar pomnim zase, me zanimajo teme o spolni zlorabi otrok. Ko sem brala vaše pismo, pa me je dobesedno zvilo. Kot da bi brala svoje lastne misli. Že dolgo živim v nekem strahu, da sem bila tudi sama žrtev zlorabe, nekoč davno v ranem otroštvu. Nobeni realnih spominov nimam na to, samo hude slutnje in cel kup klasičnih simptomov – občutke sramu, gnusa do spolnosti, kot da je nekaj umazanega, prehranjevalne motnje, ki se vlečejo že 15 let Spomnim se, da se kot otrok niti pod razno in pod nobenim pogojem nisem hotela pred nikomer sleči, niti pred svojo mamo. In to, kar ste opisali v enem odstavku: da se ob omembi spolne zlorabe kakšnega otroka začnem kar tresti od groze, utrip mi podivja, gre mi na jok, pograbi me občutek besa, jeze, nemoči. Pred kakšnega pol leta je moja mama mimogrede o nekem svoje bivšem sodelavcu izjavila, da je nekoč izjavil, da se mu zdi normalno, da nategne otroka, ki se nag sprehaja ali igra v njegovi bližini. Ko sem to slišala, sem se skoraj onesvestila. Kaj sem začutila ob tej mimogrede omenjeni izjavi, se ne da opisati z besedami. Več dni se nisem mogla pomiriti.

Zdaj imam 31 let, sem poročena, imam dokaj normalno življenje, tudi spolno. Ampak nek čuden občutek ves čas ostaja. In prav obsedena sem v skrbi za svoje otroke. Vedno, ko gredo otroci kam na počitnice, na obisk, včasih celo ko gredo v vrtec, me grabi panika, da jim bo kdo kaj naredil, jih zlorabil. Bojim se jih puščati same tudi s svoji ožjimi sorodniki. Vedno, ko niso ob meni, imam občutke tesnobnosti. Ker se zavedam, da jih moram kam pustiti, jih s težkim srcem pustim, ampak sem ves čas živčna, napeta.

Enako kot vas, me trgata dve želji, izvedeti resnico in hud strah, da je storilec kdo od mojih bližnjih. Pa tudi jaz tlačim svojo čustveno plat osebnosti v ozadje in se skrivam za svojim intelektom. Dostop do mojih čustev imajo samo moji otroci, delno še mož, pa tudi on ne toliko, kot si zasluži. Imam občutek, da v mojem življenju nekaj ni končano in da ne bom zadovoljna sama s seboj, dokler tega ne razčistim.

Samo v kolikor se boš odločil za ponovno terapevtsko obravnavo, bi ti na podlagi osebnih izkušenj močno odsvetovala psihodinamske terapevte.

Sama sem imela z njimi zelo slabe izkušnje. Tako na skupini kot individualno.

Med njimi je kar nekaj nekdanjih psihiatričnih bolnikov.

Sama sem imela tudi izkušnjo, da je terapevtka na meni zdravila svoje nepredelane teme.

Prav tako je znanih kar nekaj zgodb,kjer so psihodinamski terapevti klienta retravmatizirali do te točke da je pristal v psihiatrični ustanovi.

Zato pazi nase in poslušaj svoje občutke.