When I first started therapy in 2006, I didn’t know much about trauma and nothing about ‘the three phase approach’. My counsellor didn’t know much more. So although I’d like to say that we started by carefully doing the Phase 1 work of safety and stabilisation, the reality was a great deal messier than that.
Much has been written about the work in therapy in stages I and II of the phase-oriented approach to treating trauma, but less so about the third stage. The work in phase III aims to consolidate the gains acquired in the early stages and to apply these to everyday life in order to develop ‘a life worth living’.
Phase 2 of the three-phase approach is the aspect of trauma therapy that is most geared towards facing and resolving the intrusive traumatic memories that plague a trauma survivor’s life and manifest in forms such as flashbacks, physiological dysregulation, avoidance, numbing and re-experiencing.
When trauma survivors try to talk about what happened to them, often it is triggering and destabilising to do so. The three phase approach to treating trauma takes this into account. Phase one focuses on safety and stabilisation and this articles explains what is involved.
I want to fight her, I really do. She’s just not rising to it.
‘I see your suffering,’ she says, the words melodic and gentle. Now she’s looking at me, and she’s evidently not scared of me. She’s wiping down the space between us with tenderness. ‘Tell me about your suffering.’ Something about her softness breaks my aggression and I look down, and sigh. There’s pain in that sigh. It burns to breathe in again.
‘How can I help you?’ the therapist asks me. ‘What do you need from me?’
I look at her closely, examining her features, whilst also looking through her, to make sure I don’t connect too closely.
First the fear: Is this a trick? What does she mean? What does she want? Why is she saying this?
Then the shame: What right have I to be helped?
And afterwards, the sadness: No-one has ever offered to help me.
Three emotions in three seconds.