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In the last two entries, we explored the importance of helping clients feel an increased sense of safety in the therapy process. This not only strengthens the therapeutic relationship, but it ensures that deeper, more trauma-based material is processed within a context that is genuinely healing for the client rather than re-traumatizing. The challenge of installing safety happens on several levels simultaneously. We have already addressed the external safety that comes from dynamics in the office and the therapeutic relationship. “Internal” safety relates to the client’s “felt sense” and subjective inner processes that serve as an emotional barometer for them throughout the process.
There are many strategies that can be used to help clients access the emotional, cognitive, and somatic experiences that unfold during a session. Obviously, step one involves helping the client to turn their focus inward so they can begin to notice and monitor those processes. This is not always easy, especially for trauma survivors who understandably have learned that hyper-vigilance and the ability to externally track what’s going on around them are the best ways to stay a half a step ahead of potentially threatening scenarios. In these cases, helping clients to nonjudgmentally notice their breathing can be a place to start. Breath work is a good option because it’s always available to clients, can anchor them, and can be used to activate their parasympathetic system, evoking a state of calm. Simply encouraging them to notice the sensation of breath, the difference between inhaling and exhaling across their chest or belly, and placing one hand on their heart and one hand on their stomach as they breath can evoke a feeling of being held and comforted.
Try suggesting that the space in front of clients' closed eyes is safe space for them to be in. Then offer them the opportunity to visualize a place-real or imagined- that they associate with soothing, quiet, still, or calm. Oftentimes, the notion of a “safe place” feels so foreign to clients that using other words synonymous with “safe’ can yield more of a response. If internally visualizing a comfortable place is too challenging, invite clients to either draw an image of safety using line, shape, and color, write a description of a peaceful place, or do a collage of a safe place from magazine pictures. Once that image is created the experience can be deepened by adding an “inner protector” that can offer positive or soothing affirmations inside. The inner protector can be someone from their past who was genuinely supportive, an introjected version of the therapist, a spiritual resource, even a pet.
Inner safety is greatly enhanced when clients feel a sense of competence about regulating and managing their affective states. Modalities such as the tapping exercises that come from Emotional Freedom Technique, movement that allows for the expression of emotions, yoga poses that either empower or soothe, art therapy techniques that provide safe vehicles for the discharge or communication of painful thoughts and feelings, and guided imagery that can help dial down overwhelming affect are all great options. Therapists need to be sensitive to the reality that trauma survivors need and deserve a lot of support in turning inward. It is a new experience for them to discover and trust that their bodies can be resources for comfort and empowerment rather than warehouses of painful memories and shame.
Taking the time to work on both internal and external safety can make all the difference in the extent to which clients can work through their trauma with a sense of optimism, reassurance, trust, competence, and self-compassion.
For Part One in this series, click here. For Part Two, click here.
