On the last track, we discussed three techniques to help a PTSD client cope
with their triggers: trigger coping questionnaire, writing, and
abdominal breathing exercise.
A vital part of the healing process, as you are well
aware, is the client’s
detailed recall of the traumatic events.
On this track, we will examine
techniques to help your client recall the trauma safely and accurately: memory
prompts, revisiting the scene of the trauma, talking to others, and artistic
outlets. Also, we will discuss self-forgiveness and its
relation to the recall process. On this track, we will examine PTSD resulting
from sexual abuse and natural disasters.
4 Techniques to Recall Trauma Safely and Accurately
#1 Memory Prompts
The first technique that I have found useful for client trauma recall is memory prompts. This includes photographs or journal entries that the
client had made around the time of the trauma. One of the more difficult
issues to address is what kind of pictures is least harmful
to the client’s healing process.
For instance, Lydia was abused
by her father when she was 11. Pictures of her abuser might harm Lydia
more than help her. Her therapist Marion left this decision entirely
up to Lydia. Forcing her to look at pictures of her father might send
her into shock or extreme flashbacks that could put serious risk to her health. In
this case, Lydia preferred to look at pictures of herself at that age.
she studied these photographs, Marion asked Lydia to consider such questions
as: "What was I like then? What did I feel like? What
was I interested in? How did I change?"
To these questions,
Lydia answered, "When I was 11, I liked to play soccer. I was a tomboy and always had my hair in braids or a ponytail, because having it down
made me look girly. I didn’t really know a lot about how people
were. I didn’t know they did things like what my dad did. In
fact, I didn’t even really know what my dad was doing at the time, or
whether it was good or bad. Just that I didn’t like it." Through
memory prompts, clients like Lydia can gain a broader perspective of the type
of person they were at the time of the trauma.
#2 Revisiting the Scene of the Trauma
The second technique that I suggest to my clients to aid in their recall
is revisiting the scene of the trauma. By seeing objects involved with the
trauma, clients can more easily stimulate their memory. However, this
can be an extremely hazardous journey if the client is not prepared for the
reactions he or she may undergo. If your client is prone to debilitating
flashbacks that may incapacitate him or her for days or weeks on end, a visit
to the scene of the trauma is strongly advised against.
Stephen had survived
a flood that completely decimated his home and all his belongings. After
a few months of therapy, Stephen expressed to me the wish to go and see the
site where his house used to stand. To prepare Stephen for this shock,
I asked him first to vividly recollect his house and write down all the precious
objects that were swept away during the flood. Because Stephen could
successfully do this without any risk to his health, I thought it suitable
for him to visit the site.
We talked at length about the emotions he
would most probably feel: regret, nostalgia, longing, helplessness, sadness,
and anger. Once again, because Stephen’s trauma did not involve
severe emotional or physical losses, I believed he could confront the scene
of the trauma beneficially. However, I undertake this action with extreme
caution and concern for the client’s current emotional stability.
#3 Talking to Others
In addition to memory prompts and revisiting the scene of the trauma, many
of my clients have reported successful recall after talking with
workers involved with the trauma or simply other survivors. However,
I take the same precautions here as I do when considering whether or not
a client could visit the scene of the trauma.
Would the client be able
to deal with additional anger, grief, and possible disappointment at this
stage in their healing? Are they under any current stresses or are
feeling vulnerable or overwhelmed for other reasons?
I find it useful
to go over specific goals for clients who wish to make contact with others
involved in the trauma. I generally tell my clients not to expect these
individuals to provide them with unconditional love or emotional support. I
also emphasize the importance of keeping the line of questioning neutral,
only related to specific details about the events and without emotional investment.
#4 Artistic Outlets
The fourth technique that my clients have found useful in recalling their trauma
is through artistic outlets. These include writing,
painting, music, play acting, storytelling, and any other ways that involve
their creative talents. I emphasize that the quality of the artwork is not
important but rather the actual act of making the artwork.
a PTSD client I treated, used dance to try and recall the emotions that overwhelmed
her during her sexual abuse. At the same time, Flor also found the means to overcome her feelings of shame resulting from her trauma. Flor
stated, "Instead of feeling as though my body was dirty or a thing
of evil, dancing helped me feel that I could produce something beautiful."
In addition to memory prompts, revisiting the scene of the trauma, talking
to others, and artistic outlets, a vital step in the recall process is
the client’s willingness to forgive themselves. By
forgiving themselves, clients can let go of feelings of guilt and shame that
they experience as a result of their choices and behaviors during the trauma.
ask my clients to complete the four step "Self-Forgiveness
Examination" to help them identify any feelings of guilt that
they still may be harboring.
- Looking back over the trauma, for which behaviors, attitudes, and feelings
do you still castigate or blame yourself?
- What would it take for you to forgive yourself for some of these behaviors,
attitudes, and feelings?
- Is it possible for you to do whatever you have listed above so that you
can forgive yourself? If so, what is keeping you from pursuing whatever
you need in order to make peace with this part of your past?
- Is there information you need that you might never be able to obtain
before you can forgive yourself? If so, your options are to try to forgive
yourself anyway or to continue to punish yourself. Who are you helping
and what good are you doing in this world by punishing yourself? Who
would you harm if you forgave yourself?
I have also found this self-examination beneficial for clients who are suffering
from survivor’s guilt, which we discussed on track 6.
On this track, we discussed techniques to help your client recall the trauma
safely and accurately: memory prompts, revisiting the scene of
the trauma, talking to others, and artistic outlets. Also,
we discussed self-forgiveness and its relation to the recall process.
On the next track, we will present challenges in helping
clients recall their emotions during their trauma: resistant clients,
risks, and unresolved grief and anger.
Online Continuing Education QUESTION
What are four techniques that could help your client recall the trauma safely
To select and enter your answer go to .