Using Expressive Modalities to Connect with and Soothe

Using Expressive Modalities to Connect with and Soothe Traumatized Parts Lisa Ferentz, LCSW-C, DAPA 410 -486 -0351 www. lisaferentz. com Do not reprint without permission from the author

Traumatic experiences are NOT stored in Broca’s Area (the part of the brain associated with language). They are stored visually and viscerally. Therefore, only relying on “talk therapy” is not sufficient in helping clients access the trauma narratives of exiled parts or firefighters that do “protective” behaviors in response to the trauma.

We need to incorporate strategies that evoke visual imagery such as drawing, collaging, sand tray, guided visualizations. As well as strategies that connect clients to their bodies such as movement, “focusing, ” EFT, and breath work. These expressive modalities allow us to work on a “deeper level” so true unburdening and healing can occur.

art therapy modalities • drawing/collaging/working with sand can evoke and validate memories as well as new insights • makes trauma experiences tangible: “more real” • allows for the acknowledgment and honoring of all parts inside • provides safer way to discharge emotions, which can calm down and reassure firefighter or manager parts • a safer way to“tell without talking” • provides a way to process material and insights at later sessions • helps to contain overwhelming emotions • allows therapist to bear witness to trauma

“With art therapy we have a clear, concrete way of demonstrating acceptance, by accepting the client’s image. If I show you I can sit with or be present with whatever comes up on the paper, chances are you will also understand that I can be present with your pain, your “ugly” memories, your scary dreams, your deepest fears. ” “Little Windows into Art Therapy, ” Deborah Schroder, 2005

working with art • artwork should be dated and kept in it’s own “chart. ” • clients should be given the option of taking art home or containing it in your office • taking a picture of art on a cellphone is a great way to capture the work and have clients use it outside of sessions • never interpret your clients’ art- always ask them what they see, feel on their bodies, etc. • have clients give their art a title • “hold safe space” in session while client works • use art in subsequent sessions to witness clients’ progress

mapping • inviting client to identify all of the managers, exiles, and firefighters within their system • using shape, size, color or actual drawings of persona to represent parts inside • identifying parts that protect, engage in destructive behaviors, hold trauma memories, control, hold symptoms, etc. • striving for cooperation rather than internal conflict or polarization • once parts are individually identified, client can map whole system- where parts are in relation to each other • a first step in establishing safety before addressing treatment issues with specific parts

Always include the acknowledgement and awareness of the “wisest part” This can be translated as SELF- conceptualized with Dick Schwartz’s 8 C’s: COMPASSION CLARITY CURIOSITY CALM CREATIVE CONNECTEDNESS COURAGEOUS COOPERATIVE

Mapping parts in relation to each other gives information about alliances, polarization, etc.

As parts are honored through mapping, you can build in journaling exercises that begin to give each part a voice. Looking at a tangible image of a part can help to jumpstart the journaling process for clients.

two-handed dialogue (exiled part and manager part) • Why? You have • I feel alone and everything you could scared. . want, you have no • I’m alone because YOU reason to feel alone. . never pay attention to • I’m busy. Work is me. . demanding and so are • What about me? You the kids. . said you would make • You’re right, I got so time for ME and you caught up in never do. . everything else. .

two-handed dialogue • Are you willing to spend time with me? • It’s too busy. You are so busy running and helping everyone else that I always feel left out and anxious. . • I want to be with you, all you have to is slow down and go inside… • Maybe. I guess so. I thought you’d be okay if I was successful and made enough money… • You’re right. Jesus, it’s like when dad was so busy, he never had time to play with me. . • O. k. I promise to try…

Using “focusing” and somatic awareness to deepen the connection with internal parts • invite client to “notice” where they feel sensation on their body as they identify and describe a particular part • ask where that part “lives” on their body • distinguish between what they “think” or “feel” and access sensations such as: heavy, tingling, tight, collapsed, expansive • add temperature ( warm/cool) • add color/colors

Using “focusing” and somatic awareness to deepen the connection with internal parts • as client notices body sensation, temperature, and color, invite them to connect emotions and cognitions to the experience • “if the sensation could talk what would it say? ” (a right brain way to have “part” talk) • reinforce that in the future, this part can be re -accessed by focusing on body location, sensation, and color • explore creative ways to “externalize’ the experience

Identifying Dorothy’s “wisest” part • sensation across my chest, wrapping around my shoulders • feels open, light, and tingly • feels warm • golden color • emotion: calm, compassionate • thoughts: I am loveable and worthwhile and deserve to be treated with respect • gold colored sweater to wear on my shoulders when I want to access my wisdom

creating safe places for parts • clients often need to be convinced of the value of providing all parts with an internal sense of safety • feeling safe may not be normalized for them in their daily lives • they initially resist creating safe places for firefighter parts that scare them or exiled parts they have been ignoring. • manager parts might claim “they don’t need a safe place” • traumatized clients often want to move ahead before safety is established, unconsciously re-enacting a lack of safety in the past • safe places should not be equated with “hiding places” from childhood abuse or anything punitive

Check which parts should/ should not be involved in any work you are doing. For parts that should not be involved, invite them to go to safe places inside, without disregarding or alienating them. Remember to re-claim those parts after more difficult work is done. The more you have parts “listen” the more integrated and collaborative the experience can be for clients

Using breathing to regulate affect and create self-soothing * inhale-3, hold-3, exhale-5 *substitute counting with soothing words *inhale-close fist, exhale-open fist *hand breathing with hand on heart, hand on stomach *add figure 8 rock

“containment strategies” • reassures clients and helping professionals that “emotional and cognitive flooding” will not occur • helps clients feel a greater sense of control over their trauma material and “acting out” parts • strengthens a sense of boundaries • introduces notion of “working through” or “re-telling” without being re-traumatized • increases client’s ability to return to the “outside world” after session and function appropriately

containment • turning affect/trauma material into colors and shapes • putting the color/shape into another internal container • checking for an inner sense of safety • adding additional layers of containment, if necessary

Mark’s containment • emotion: despair • shape and color: black, lump of coal, the size of a large fist • container: bury it in a swimming pool filled with white sand • additional container: heavy, black tarp covering the whole sand pit • additional container: braided ropes to hold down the tarp • now it feels adequately contained

containment • making a collage or drawing internal “containers” to store affect and trauma material • writing down untenable emotion, trauma memory or facts related to the assault and storing the paper in an actual container (a purse, a box, an envelope, a Tupperware container, a drawer with a lock on it, etc. )

You can also incorporate Sensorimotor strategies to enhance a visceral feeling of containment and self-soothing for any part. .

Somatic resourcing (Pat Ogden 2011) • • • Taking a breath Expanding the chest/Re-aligning the spine Putting both feet on the floor Standing up Pushing away Distributing weight evenly on the feet Pressing crossed arms against inside of thighs Thumb hold Crossed arm hold

EFT: Emotional Freedom Technique Gary Craig • based on Chinese meridian/ acupressure points on the body • identify a negative feeling/something that is bothering you • notice where you feel it on your body • rate the intensity from 1 -10 • name the feeling • the feeling is “nervous electrical energy” that is stuck on the body • tapping “cleans out” the blocked energy

EFT protocol • Identify a feeling to work on and rate the level of intensity • “set up” by starting with “karate chop” point and saying, Right now I feel______, and I deeply and completely accept myself“ • inhale and exhale • continue to focus on the feeling and pair it with remaining pressure points on the body • rate the level of intensity • continue to repeat the sets until the intensity drops down to a 1

pacing with “scaling” • create a subjective template from 0 -10 • 0= feeling totally neutral, not disturbed by emotion/memory at all • 10= completely overwhelmed by the emotion/memory • ask client to identify the thoughts, feelings, body sensations that accompany 0 -10 • Have an agreement with the part you are working with and/or wisest part that you will “put on the brakes”when the client reaches a “ 5” (or whatever number begins to feel unmanageable for them)

treatment approaches… • Identify and honor all parts in the system • increase internal safety by creating safe places for ALL parts • give parts safer, alternative ways to have a voice and get their needs met • foster internal cooperation rather than conflict/competition/polarization • incorporate creative modalities that access visual and visceral experiences to reconnect with exiled parts and trauma narrative

Your efficacy as a professional is contingent upon the extent to which you personally take care of yourself- and all of your parts!