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Psychodynamic Foundations of Bioenergetic Analysis

Experiencing, Understanding and Healing the Body and the Mind
2-4 Joining and Gilding – Healing Paths for Complex Post-Traumatic Stress Disorders | Zusammenfügen und Vergolden
Volume 1 Part 2: Body-Work in Practice Chapter 2.4

Joining and Gilding

Healing Paths for Complex Post-Traumatic Stress Disorders
Regina Trotz

First, a brief definition of trauma and the various stages of (complex) post-traumatic stress disorder is given, followed by the neurophysiological principles that are necessary for understanding early developmental disorders and later dissociation processes. The basics of trauma processing are then explained, in particular the ability to self-regulate and resource orientation. The inner attitude of the psychotherapist is identified as an essential key to working with people with complex PTSD, and three basic methods of trauma processing are presented: grounding, titration and pulsation. Short case vignettes from therapeutic practice, a client’s self-experience report, and a call for a trauma-sensitive society round off the essay.

Link to the original publication at Routledge

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  • Post-traumatic stress disorder (PTSD) occurs when those affected are unable to process traumatizing experiences either somatically or psychologically.
  • Individual resources, positive previous experiences, and attachment security influence the processing of traumatizing experiences and can prevent the development of PTSD.
  • Complex PTSD or a dissociative identity structure develop when no appropriate psychophysical structures could be formed in early childhood due to threats or a lack of attention or care, and/or because the traumatic situation is caused by people, lasts a long time and has no – subjectively perceived – prospect of help.
  • In a dissociative identity structure, the self is fragmented. The psychological mechanism of splitting ensures the survival of the person affected.
  • For the therapy of a complex PTSD or a dissociative identity structure, the therapist must acknowledge in an authentic way that the client, as a »trauma survivor«, has an immense inventory of resources.
  • A cooperative understanding of the therapeutic work is essential for the sufficient security of all the client’s inner parts. In particular, therapist and client must agree that the knowledge of both is needed, that the therapist remains a human counterpart (who listens to and acknowledges criticism), that the client’s survival strategies are carefully explored, and that the healing process is shaped together.
  • Since unintegrated personality parts play a decisive role in the case of a dissociative identity structure, it is highly recommended that not only the everyday person, but also the various inner parts are included in the therapeutic process, e.g., by using plural formulations or targeted addresses (»Does anyone else know anything about this situation?«, »Is there anyone else who felt this?«). The therapist’s feelings of countertransference such as fear, numbness, anger, confusion or pain can also be indications of split-off personality parts.
  • In every case of complex PTSD, there is a connection between fear and immobility. Decoupling them is a central key to therapeutic success. By expressing the hidden aggression in a mindful, bodily way, it can be transformed into a resource of strength.
  • Grounding exercises serve to stabilize the client, enhance their self-regulation abilities and practice a reasonably secure self-perception. If feelings threaten to become »too much«, the bridge to grounding exercises that have already been practiced and/or the empathetic touch of a regulated counterpart can help.
  • With pulsation techniques, the client is carefully confronted with traumatic experiences, but can return to safe, bodily anchored islands of consciousness at any time.
  • Titration techniques involve working through a specific situation from the then-and-there in tiny memory steps by processing the body’s perceptions and feelings in the Here and Now. In the process, the psychophysical system learns to »go through« the experience, i.e., not to get stuck in numbness, fear or anger and to achieve a flow of energy, warmth and self-empowerment.
  • In Trauma Therapy, the goal is to be able to remember the experiences suffered in an affectively distanced form as a completed past. The prerequisites for this are that the previous therapeutic process has enabled the client to lead a stable everyday life, that the client has broken off contact with the perpetrators as far as possible and that the client has learned to safely employ their self-regulatory skills.

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Regina Trotz
Regina Trotz

Regina Trotz, born 1962, psychologist and psychotherapist, bioenergetic analyst, works in private practice in Vienna and Bad Aussee (Austria).

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