Members Download A Simple Clinical Action Map to Heal PTSD

The therapeutic spiral model (TSM) is an innovative and effective model of experiential psychotherapy to treat individual and collective trauma around the world. The TSM is the perfect weaving of neurobiology, attachment theory, and clinically modified psychodrama interventions to release people from the disturbing symptoms of post-traumatic stress disorder (PTSD; Hudgins, 2007, in press). At its core, the TSM provides a clear clinical action map of the internal roles that are needed to face trauma and its aftermath successfully, for post-traumatic growth and recovery in today’s world. The map, which is known as the “trauma survivor’s internal role atom” or TSIRA, was developed from an integration of classical psychodrama and gestalt therapy theories of personality, psychological functioning, and action methods in the early to mid-1990s (Hudgins, 2000). Now the TSIRA can provide a clinically tested map of internal roles and active clinical action interventions for all experiential psychotherapists, educators and others in the world of global health and trauma therapy (Hudgins, Drucker, & Metcalf, 1998; Hudgins & Drucker, 1998; Hudgins, Culbertson, & Hug, 2009; Hudgins & Toscani, 2013; Perry, Saby, Wenos, Hudgins, & Baller, 2016).

The latest research in interpersonal neurobiology (Cozolino, 2014, 2016) and attachment theory (Siegel, 2012) shows that experiential methods are a treatment of choice for people with PTSD and other trauma-related problems of living (van der Kolk, 2014). However, many psychotherapists are just starting to use experiential methods, and of these, most are technique driven. There are workshops where therapists can learn the trauma-related techniques of EMDR (eye movement desensitization and reprocessing), somatic re-experiencing, EFT (emotionally focused therapy), and other forms of tested experiential methods of change, as well as short courses on the protocols for installation. In these models, in most cases, the therapist, coach, or guide uses experiential interventions to change specific aspects of PTSD (American Psychiatric Association, 2013), rather than focusing on the whole person. What most therapists still lack is an overarching view of experiential change itself—a view that provides a sense of understanding and support for different experiential techniques over long-term work or in settings other than where they were originally learned.

Experiential psychotherapists need a clinical guide to use these action techniques safely and effectively to treat trauma, addictions, eating disorders, and other psychological problems caused by experiences of neglect, trauma, violence, and loss. The TSIRA has long provided a simple clinical action map of the internal roles needed to support experiential techniques of all kinds with confidence and competence. The TSM’s internal role map follows a sequence of prescriptive roles that provide for self-regulation, resilience training, and improvement in distress tolerance. The TSM trauma triangle shows how is internalized as the victim and perpetrator, and the unique role of abandoning authority. Here, the TSIRA shows the creation of the role of appropriate authority to keep spontaneity and creativity alive during and after traumatic experiences. Finally, roles of transformation and integration are fully realized in people, and they can again trust their inner source of spontaneity and creativity and live life to the fullest each and every day, despite having experienced neglect, trauma, or addiction (and the fear of life that led to that in the past).

Classical psychodrama (Moreno & Moreno, 1959) and gestalt therapy (Perls, Hefferline, & Goodman, 1951) provide a humanistic and positive view of psychological functioning and what is needed to reach maximum growth and potential for a fully creative life. The TSM integrates the best of both of these theoretical foundations and takes them one step further by using the TSIRA to provide a step-by-step map of internal roles for working with developmental or acute trauma and addiction. One of my favorite messages from J. L. Moreno’s formidable book, Who shall survive? Foundations of sociometry, group psychotherapy and sociodrama (1953) is that only the “spontaneous” shall survive. This message holds true today when now, more than ever, we all need to learn to live a life of spontaneity and creativity as trauma surrounds us all at some level, no matter how fortunate we are in life.

At the heart of TSM is the role of the sleeping awakening child. In the TSIRA, this role is one of the goals of all TSM work. The role is described as holding all the authentic part of the self that went to sleep at the time of trauma, yet still holds all one’s creativity, unique gifts, and true path. The sleeping awakening role waits until people make their external life safe enough to be awakened and come alive. Often, during a TSM psychodrama or experiential exercise, people are asked to visualize and then talk to this part of themselves. An action healing team member is placed in a nice soft bed of pillows and blankets and put in the middle of the circle of safety (Cox, 2001, cited in Hudgins, 2014), sleeping soundly, filled with grace. Group members are invited to come up individually and as a group to help awaken this perfect part of themselves and welcome their unique gifts into their hearts. It is a powerful and moving moment of miracles before your eyes as you see yourself and others wake up your own authentic self with spontaneity and creativity. Imagine the scene, and hear and feel what is said or witnessed in a TSM drama with words such as: Wake up little one. I am making it safe enough for you to use your gifts. What are your gifts? We need them in this time of trauma. Hello. Here I am. This is the essence of TSM—and the TSIRA provides the roadmap to reach this state of post-traumatic growth and recovery each and every time in experiential psychotherapy.

References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Corey, G. (2012). Theory and practice of group counseling. Belmont, CA: Brooks/Cole, Cengage Learning.

Cozolino, L. J. (2014). The neuroscience of human relationships: Attachment and the developing social brain. New York, NY: Norton.

Cozolino, L. J. (2016). Why therapy works: Using our minds to change our brains. New York, NY: Norton.

Hudgins, K. (2000). The therapeutic spiral model to treat PTSD in action. In P. F. Kellermann & M. K. Hudgins (Eds.), Psychodrama with trauma survivors: Acting out your pain (pp. 229–254). London, United Kingdom: Jessica Kingsley Publishers.

Hudgins, K. (2007). Clinical foundations of the therapeutic spiral mode: Theoretical orientations and principles of change. In C. Baim, J. Burmeister, & M. Maciel (Eds.), Psychodrama: Advances in theory and practice (pp. 175–188). London, United Kingdom: Routledge.

Hudgins, K. (2014). Six safety action structures. Retrieved from http://drkatehudgins.com/articles_links_research

Hudgins, K. (in press). PTSD unites the world: Prevention, intervention and training in the therapeutic spiral model. In C. E. Stout (Ed.), Why global health matters: How to (actually) make the world a better place [eBook]. Retrieved from http://www.whyglobalhealthmatters.org/

Hudgins, M. K., Culbertson, R., & Hug, E. (2009). Action against trauma: A trainer’s manual for community leaders following traumatic stress. Charlottesville, VA: University of Virginia, Foundation for the Humanities, Institute on Violence and Culture.

Hudgins, M. K., & Drucker, K. (1998). The containing double as part of the therapeutic spiral model for treating trauma survivors. The International Journal of Action Methods, 51, 63–74.

Hudgins, M. K., Drucker, K., & Metcalf, K. (2000). The containing double: A clinically effective psychodrama intervention for PTSD. The British Journal of Psychodrama and Sociodrama, 15, 58–77. Retrieved from http://drkatehudgins.com/yahoo_site_admin1/assets/docs/Containing_DoubleBPA_Article.173173224.pdf

Hudgins, K., & Toscani, F. (Eds.) (2013). Healing world trauma with the therapeutic spiral model: Psychodramatic stories from the frontlines. London, United Kingdom: Jessica Kingsley Publishers.

Moreno, J. L. (1953). Who shall survive? Foundations of sociometry, group psychotherapy and sociodrama. Beacon, NY: Beacon House.

Moreno, J. L., & Moreno, Z. T. (1959). Psychodrama (Vol. 2). Beacon, NY: Beacon House.

Perls, F. S., Hefferline, R. F., & Goodman, P. (1951). Gestalt therapy: Excitement and growth in the human personality. Gouldsboro, ME: The Gestalt Journal Press.   

Perry, R., Saby, K., Wenos, J. Z., Hudgins, K., & Baller, S. (2016). Psychodrama intervention for female service members using the therapeutic spiral model. The Journal of Psychodrama, Sociometry and Group Psychotherapy, 64, 11–23. doi:10.12926/0731-1273-64.1.11

Siegel, D. (2012). The developing mind: How relationships and the brain interact to shape who we are. New York, NY: Guilford Press.

Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York, NY: Penguin.