Trauma therapy, aided by revolutionary neuroscientific understandings, has been very successful over the last 20 years or so, and has expanded enormously. New trauma therapies have proliferated, new tools, techniques and methodolgies have been developed, the reach and scope of treatable conditions has been extended and public and scientific acclaim (NICE guidelines) as well as financial success have followed (Ecker, 2012; Levine, 1997; Kalsched, 1996; Rothschild, 2000; Schore, 2003; van der Kolk, 1996).
Having extended their reach beyond the traditional focus on critical incident debriefing and single-event trauma, the modern trauma therapies, however, have reached a threshold. Increasingly, trauma therapists come into supervision distraught, frustrated and despirited because it is not working as it ‘should’.
Supervisees report that clients who initially present with circumscribed single-event trauma either cannot or do not respond well to standard trauma techniques like finding a safe place, body scans, mindfulness, or learning techniques for self-soothing. Many clients, although apparently desperate, fail to cooperate or exhibit active resistance. Some push and test the boundaries of therapy (e.g. demanding contact in between sessions), question or criticise the therapist, and generally create an atmosphere of suspicion and mistrust. Or they just fail to get better in terms of the reduction of trauma symptoms.
In response to these unexpected problems, therapists report confusion or incompetence, shock or frustration, or - when more intense - feeling powerless, used or worthless. Occasionally therapists make sense of their response in terms of vicarious traumatisation.
This paper is a collaboration between Morit Heitzler and Michael Soth from our shared vantage point as supervisors. Morit has been practising a variety of trauma therapies since the mid-1990s, integrating Babette Rothschild’s Somatic Trauma Therapy, E.M.D.R, Sensorimotor Therapy, Somatic Experiencing, Trauma Constellations and various other trauma therapies. Michael is known for integrating humanistic and psychoanalytic traditions to bring a more comprehensive embodied understanding to the relational vicissitudes of therapy (Soth 2005a).