Trauma Therapy: Afterthoughts
is a review of a twelve day workshop on Somatic Trauma Therapy by
Babette Rothschild, originally published in the Journal of the Association
of Chiron Therapists in 1997
completed Babette's Somatic Trauma Therapy course eight months ago.
I want to reflect here on specific aspects of the theory and
practice which have affected me and influenced my thinking and work.
In particular I shall explore: the nature of the containment it
offers; definitions of trauma; the usefulness of calibrating autonomic
activity and mapping its function and symbolic meaning; and building
ego through muscle tensing.
experience as a client
did two pieces of work with me in the group as demonstrations of
technique, one near the beginning of the training, and another a
year later during the final section of the course. They made a lasting
impact on me, as significant as a range of other therapeutic encounters
I have experience in ten years of individual therapy and training
groups, at Chiron and elsewhere.
can remember them clearly - this it itself is important because
my memory of events in the past, even quite recent past, is often
not very vivid. The two pieces of work both centred on my experience
of giving birth, which I chose because it was a recent event and
had traumatic elements to it, but also because of its overwhelming
importance in my life.
told the story of my experience of sixteen hours in labour. During
this narrative, Babette stopped me frequently to gather further
information, to help me pay attention to my body, to slow me down,
and to encourage and support grounding and containment. Being interrupted
so often was quite challenging for me as a client, but it is crucial
to the external regulation that the trauma therapist provides. The
acceleration of process - thinking quickly, being flooded with
images - is symptomatic of sympathetic nervous system (SNS) activity.
From a biodynamic point of view it makes sense to slow down the
headlong pace so that the story itself can be 'digested'. This braking
cuts through the self-enclosure - also characteristic of narcissism
- which re-enacts the sense of profound isolation that is a mark
I like about Babette's technique is the exact calibration of autonomic
focussed on my autonomic signals, and selected the wetness/dryness
of my tongue as a marker to gauge my shifts in and out of sympathetic
When my autonomic signals showed that both sympathetic and
parasympathetic systems were becoming strongly activated - the defining
criteria of a 'traumatic' state - she would work to ground me and
lessen the anxiety before continuing. As a therapist I have found
this mapping of autonomic activity the single most useful tool from
There are of course all kinds of ways of assessing a client's
state - behaviour, language, countertransference, and undoubtedly
we are subliminally aware of autonomic signals anyway as body psychotherapists
- but the framework of the theory of autonomic functioning made
it very concrete, particularly in precisely defining the 'edge'
of a process.
help contain my process and integrate autonomically, Babette would
slow me down, and sometimes asked me to talk about Melissa in the
present. The fact that the outcome of the birth was good - I had
a beautiful healthy little girl - made it the perfect anchor to
ground me as the anxiety level rose. This was extremely effective
- the moment I thought of Melissa, I would start smiling and relaxing.
This technique of choosing an anchor - a safe subject with strong
positive associations - is one that most conflicts with our training
at Chiron. Rather than following a process, it is a strategic deflection
designed to reduce the charge. I found this highly structured, cognitive
style of working quite alien to my intuitions and impulses as a
therapist. Despite experiencing its effectiveness, I have not used
it with clients. Where there is a need for strong containment, I
am much more likely to use a here and now interpretation.
also paid close attention to muscle tonus, and distribution of body
awareness. She frequently asked me about my perception of my body.
In my case, a key marker was the relaxation and contraction of the
muscles in my belly, specifically the rectus abdominus. Another
technique used to help me brake was muscle tensing. This is a deliberate
contracting of specific muscles which helps build a physical, muscular
sense of containment. I was very struck by the effectiveness and
simplicity of this. It has had a significant influence on my thinking
about muscle and its relation to ego and I have integrated muscle
tensing into my work as a massage therapist.
other major tool of trauma work is the use of the SIBAM model (Sensation,
Image, Behaviour, Affect, Meaning). This is used to chart the degree
of fragmentation in the client - a traumatised client will have
major aspects missing, such as affect, or sensation or image. Often
there is a lot of 'meaning' - ie. beliefs or decisions made during
or after the trauma which can dominate and restrict the person's
life. Babette picked up on the beliefs implicit in my narrative
- particularly around success/failure, abandonment, and aggression
- and challenged these on a cognitive level.
particular kind of containment
remarkable effect of Babette's technique was that I began to remember
more details of the whole experience - especially sensory details
like colours and smells, sounds, as well as conversations and aspects
of my internal process. This was significant because usually when
I retrieve memories they are fairly global, feeling-centred, with
perhaps one or two clear pictorial details, but I have never experienced
remembering specific sensory detail so precisely. At the end I felt
a sense of containment that was also subtley distinct from other
experiences I have had of feeling contained. I felt slightly toned
in my muscle, with an overall evenness in my awareness of my body.
I felt in my head - in my mind - an almost physical sense of integration,
as if my corpus callosum (a thick connection of nerve fibres connecting
left and right hemispheres of the brain) were a muscle that had
been worked a bit. I had a fantasy that my left and right brain
had become more integrated.
want to compare this experience of feeling contained with two other
kinds of experience of containment. Obviously the kinds of containment
I describe overlap but I am attempting to distinguish them by emphasising
their bodily nature here. Most familiar to me is the sense of being
held, of having let go of something, of feeling a bit lighter, of
being able to breathe more easily, of feeling relaxed. Another version
is a post-vegetative-upheaval state, where there has been either
a strong discharge, or an intense barely bearable experience of
internal conflict, which I have somehow survived. This experience
carries with it a sense of huge internal re-organisation on a vegetative
and muscular level. I associate the former state more with my individual
therapy, where my therapist works mainly through interpretation.
The second state I associate with other therapeutic experiences
I have had at Chiron on some occasions, although not that often,
and certainly less often than the first kind of just feeling held.
It characterizes one aspect of body psychotherapy, where the emotional
charge is allowed to intensify and structuring or interpreting
may be secondary.