Psychotrauma, State, Setting

Table of Content

1 Introduction 15
1.1 Preliminary Note for Colleagues 15
1.2 Preliminary Note for Clients 17
1.3 The Complex Importance of a Comprehensive Treatment and a
Reduction of Complex Traumatizations 18
2 Theoretical Background 21
2.1 Interdisciplinary Connections between Important Fields of Research
and Psychotraumatology 21
2.1.1 Preliminary Note Regarding the Connection between
Physical Sciences and Psychotraumatology 21
2.1.2 Connections with and Translations from Neurobiology 21
2.1.3 Connections with and Translations from Comparative
Psychobiology 27
2.1.4 Connections with and Translations from Prenatal, Perinatal,
and Postnatal Birth Research 31
2.1.5 Connections with and Translations from Infant Research
and Attachment Research 34
2.2 A Selection of Conceptually Adopted Constructs, Empirical
Interpretations, and My Own Drafts for the Development of the
SPIM-20-CTP 39
2.2.1 Preliminary Note Regarding the Connection with and
Importance of Brain-Physiological and Psycho-Dynamic
Traumata Circles 39
2.2.2 Regarding the Uniformity and Reciprocity of Complex
Psychotrauma Symptoms, State Appearances, and Shapings
of Settings 40
2.2.3 On the Correlation of Transferences, Introjects, and Implants
in Regulation States 44
Regarding Category 1: Situation-Flexible States 47
Regarding Category 2: Elastic Habitual States 49
Regarding Category 3: Transference States 50
Regarding Category 4: Introject States 52
Regarding Category 5: Implant States 54
Regarding Category 6: Programming States 59
2.2.4 Hypotheses Regarding the Reciprocity between a Brain-
Physiological and Psychological Regulation Cross-Linking 63
2.2.5 On the Position of the Psychotrauma within the Framework
of Psycho-Dynamic Regulation and the Regulation-
Specific Development 67
2.2.6 Regarding the Difference between Transference and
Countertransference when Treating Complexly Traumatized
Patients 72
2.2.7 The Benefit of Psychological Concepts of Externalization
for Psychotrauma Therapy 75
2.2.8 The Advantage of Using “Beseelbare” Therapy Objects
within the Framework of Transparent Treatment Structures
in Psychotrauma Therapy 79
2.2.9 The Importance of a Fundamentally Body-Specific and
Action-Specific Orientation for Psychotrauma Therapy 83
2.2.10 Regard the Terms of Abreaction, Closing of Activity-Specific
Arcs, and Final Physical Actions and Interactions in
Psychotrauma Therapy 86
2.2.11 Regarding the Importance of Supporting Touches in Psychotrauma
Therapy 91
2.2.12 Regarding the Particular Benefit of Infantile Play for Psychotrauma
Therapy 93
2.2.13 How Traumatic is it to Work Out a Psychotrauma? 96
2.2.14 With Which Quality Can a Psychotrauma be Remembered?
99
2.2.15 When and How is a Psychotrauma Therapy Finished? 101
3 Description of the SPIM-20-CTP with Manualized Materials
and Case Vignettes 105
3.1 Preliminary Note Regarding the Development of the SPIM-20-
CTP 105
3.2 The Current Treatment Criteria of the SPIM-20-CTP 106
Criteria of the SPIM-20-CTP 106
Explanations of the Criteria of the SPIM-20-CTP 107
3.3 The Treatment Phases of the SPIM-20-CTP during the Whole
Therapy Process 112
3.4 The Empirical Treatment Phases of an Individual Session or of a
Group Therapy Unit in the SPIM-20-CTP 116
3.5 Regarding Psycho-Education in the Therapy Concept of the
SPIM-20-CTP with Case Vignettes 118
3.5.1 Preliminary Note 118
3.5.2 Catalogue of Terms of the SPIM-20-CTP 118
Abreaction 118
Alterego 120
“Beseelbare” Therapy Objects 120
Dissociation 121
Dissociative Identity Disorder 122
Flashback 122
Implant 123
Introject 123
Introject – Transference Dynamics 124
Introject – Transference Reversal 125
Intrusion 125
Complex Traumatization – Other Dissociative Disorders,
Not Specified in More Detail 126
Concentrated Structured Activity-Specific Performances
for Psychotrauma Exposition 126
Body Movement Orientation 127
Victim 127
Paralysis of the Victim or Victim Behavior 128
Programming 128
Setting 129
State 129
Switch 129
Perpetrator 130
Perpetrator Behavior 130
Trauma or Psychotrauma 130
Lifting the Trauma 131
Trauma Orientation 131
Trauma Shaping 131
Triggers 132
Transference 132
Transference – Introject Reversal 133
3.5.3. Manualized Handouts for Clients 133
3.5.3.1 Preliminary Note on How to Deal with the
Handouts 133
Bulletin for Complex Traumatized Patients 134
3.5.3.2. Bulletin for Complex Traumatized Patients with
an Orientation Help for Switching Exercises 134
3.5.3.3 Exercise Leaflet for Psycho-Physical Relief 137
3.5.3.4 Trigger Leaflet and Self-Help Leaflet 139
3.5.3.5 Curriculum Vitae and Therapy Reports for Complex
Traumatized Patients 142
3.5.3.6 Basal Psychodynamics Leaflet 148
3.5.3.7 Trauma Maps and Resource Maps 152
3.5.3.8 Relationship Category Leaflet 156
3.5.3.9 Structural Graphs for Internal Parts 158
3.5.3.10 Structured Diary 164
3.5.3.11 Generation Questionnaire 166
3.5.3.12 Introject-Generation Scheme 171
3.5.3.13 Play Contract and Minutes 174
3.5.4. Manualized Handouts for Therapists 178
3.5.4.1 Preliminary Note on How to Deal with the
Therapists’ Handouts 178
3.5.4.2 Psychotherapy Agreement for Individual and
Group Therapy 178
3.5.4.3 Basal Minutes of Sessions – Individual Therapy 182
3.5.4.4 Basal Minutes of Sequences – Group Therapy 186
3.5.4.5 Minutes of the Differentiated Graduated Training
of Regulation Scripts 190
4 Manualized Representation of Settings of the SPIM-20-CTP
with Case Vignettes 194
4.1 Preliminary Note on How to Deal with Setting-Specific Indications
and Instructions 194
4.2 Settings of Therapy Phase I: Stabilization and Psycho-Education 195
4.2.1 Basic Settings for Demonstrating the Psychodynamics 195
4.2.1.1 Settings for Establishing a Relationship with
Contact Sticks 195
4.2.1.2 Setting for Deepening a Relationship with the
Holding Rocker Rope and the Back Mat 198
4.2.1.3 Settings for Comparison Purposes and Variations
of Stages of Regression with Gymnastic Ball
Dialogues and Swing Settings 201
4.2.1.4 Settings for a Restorative and Diagnostic Regulation
of Affects with Bags, Clubs, Blocks, and
Other Objects 204
4.2.2 Restorative Settings for Enhancing Insights into Internal
Regulation 209
4.2.2.1 Symbolizing Gestalt Therapeutic Work Settings
With Regard to External Persons and Parts of the
Internal Structure with Drawings, Sculptures,
Stuffed Animals, and “Beseelbare” Objects 209
4.2.2.2 Settings for Diagnostic Play with Stuffed Animals,
Resource- and Solution-Orientedly 212
4.2.2.3 Settings for a Diagnostic, Resource and Solution-
Oriented Representation of and Work on the
Internal Structure in the Form of Introject-Transference,
Regulation Script-Differentiation, and
Introject-Generation Schemes 214
4.2.2.4 Settings for a Regulation of Affects with Statements
of “Beseelbare” Therapy Objects (Black
Giant Bag, Red Giant Block, White Wall, Yellow
Bag, and Similar Means) 216
4.2.3 Course Group Settings for an Introduction to a Joint
Development Orientation in the Psychotrauma Treatment 218
4.2.3.1 Concept of the Course Group Therapy 218
4.2.3.2 Settings for Establishing a Contact, Deepening a
Relationship, and Enhancing a Regressive Group
Work 220
4.2.3.3 Settings for a Joint Regulation of Affects 221
4.2.4 Settings for Dealing with Reference Persons at the Beginning
of the Therapy 222
4.2.4.1 Inclusion of Every Kind of Partnership 222
4.2.4.2 Dealing with Parents and Other Reference Persons
as Conflict Partners (Letters, Conversation
for Establishing Boundaries, Generation Interview) 223
4.3 Settings of Therapy Phase II: Psychodynamic Work on and Exposition
of Psychotrauma 224
4.3.1 Advanced Settings for a Psychodynamic Deepening of the
Internal Regulation Work 224
4.3.1.1 Enhancement of Regulation States with a Positive
Transference (Subsequent Nurturing with
Mother’s Womb Tub, Sick Persons’ Tub, Nest
Bag, Throne Bed, Horse To Cling To, Hammock,
Cuddling Egg, Cave) 224
4.3.1.2 Work on Regulation States with a Negative
Transference (Bag-Club Accusation, Phobics’
Tub and Depression Tub) 229
4.3.1.3 Work on Individual Regulation States with a
Negative Introjection (Questioning of Introject) 232
4.3.1.4 Work on Interlinked Regulation States with a
Negative Introjection (Island Work) 234
4.3.1.5 Dealing with Extreme Affects (Murderous Rage
and the Like) in Advanced Psychotrauma Therapy 237
4.3.2 Advanced Settings for Psychotrauma Exposition Work 240
4.3.2.1 Concept for a Concentrated, Structured Activity-
Related Performance for Psychotrauma Exposition 240
4.3.2.2 Spontaneous Extensions of Individual Performances
241
4.3.2.3 Planned Extensions of Individual Performances
with a Concentrated, Structured Activity-Related
Performance for Psychotrauma Exposition 244
4.3.2.4 Combination of Various Exposition Settings with
a Concentrated, Structured Activity-Related
Performance for Psychotrauma Exposition 247
4.3.3 Long-Term Group Settings for Using Joint Development
Resources and for Coping with the Psychotrauma 250
4.3.3.1 Concept of a Long-Term Group Therapy 250
4.3.3.2 Enhancement of Regulation States with a Positive
Transference (Hammock, Hover Belt, Hands Bed) 252
4.3.3.3 Work on Regulation States with a Negative
Transference (Black Giant Bag, Red Giant Block,
Tug Rope, and Similar Objects) 254
4.3.3.4 Work on Individual Regulation States with Negative
Introjection (Introject Cage) 256
4.3.3.5 Work on Interlinked Regulation States with
Negative Introjection (Introject Kaleidoscope) 260
4.3.3.6 Work on Extreme Affects (Murderous Rage and
the Like) in an Advanced Group 263
4.3.4 Settings for Dealing with Reference Persons in Connection
with an Advanced Development of the Therapy 264
4.3.4.1 A More Intensive Inclusion of Partnerships and
Family 264
4.3.4.2 Dealing with Parents and Other Reference
Persons as Conflict Partners (Conversation for
Confrontation Purposes) 265
4.4 Settings of Therapy Phase III: Integration and Farewell 267
4.4.1 Preliminary Note on Settings in the Integration and Detachment
Process (Level of Consultation) 267
4.4.2 Reality-Oriented Demand-Specific Settings 268
4.4.2.1 Tasks for Self-Balancing (Bodies of Rules, Self-
Epicrisis) 268
4.4.2.2 Settings for a Context-Related and an Inner
Strengthening of Modification Successes (Repetitions
of Settings, Self-Direction Settings) 268
4.4.2.3 Role Play Training for Coping with External
Demands (Conversations about Professional
Interests and Personal Courage, and the Like 269
4.4.3 Self-Help Groups’ Concepts (Subject Groups, Play
Groups, Late Course Groups) 269
4.4.4 Dealing with Reference Persons Towards the End of the
Therapy 271
4.4.4.1 Inclusion of Partners and the Family (Family
Council) 271
4.4.4.2 Dealing with Parents, Relatives, or Other Important
Reference Persons as Conflict Partners
(Optional Visits, Conversation about Adult
Needs, Guardianship and Death, Multi-Generation
Conversation) 271
4.5 Photographic Documentation of Case Vignettes 275
5 Evaluation of the Treatment Approach of the SPIM-20-CTP 283
5.1 Preliminary Note 283
5.2 Investigation Design and Description of Random Samples 284
5.3 Statements Regarding the Movements to be Noted in Connection
with the Random Samples 293
5.4 Evaluations with the BSI of All Points of Measurement 293
5.5 Evaluations with the Satisfaction Questionnaire 296
5.5.1 Analyses, on the basis of the Satisfaction Questionnaire’s
Satisfaction Scales, of All Points of Measurement 296
5.5.2 Analyses in the Diagnosis Groups and Setting Groups 302
5.5.3 Categorized Surveys of Open Response Structures in the
Satisfaction Questionnaire (ZFB) in Connection with the
Post-Measurements and Catamnesis Measurements 305
5.5.3.1 Regarding the Use of “Beseelbare” Therapy
Objects – the Importance of Aggression Settings,
Dialogue Settings, and Subsequent Nurturing
Settings 305
5.5.3.2 Regarding the Experience of Helpful, Nice, and
Terrible Therapy Situations 309
6 Summary and Outlook of the Book 318
7 Materials Referring to the SPIM-20-CTP Approach 323
8 Further Training Regarding the SPIM-20-CTP Approach 325
9 Translation Glossary 327
10 Bibliography 328