Restoring the sanctuary of the valued self: Working with post traumatic stress in brief dynamic therapy

Abstract

Drawing principally from the conceptual framework of Horowitz the author outlines an effective method of working within a short-time frame to enable staff who have been traumatised in their working roles to restore a sense self-coherence and self-esteem with a resulting lessening of symptoms of Post Traumatic Stress. A traumatic event is seen to result in the activation of dormant enduring schemas emanating from childhood that are at odds with established adult internal working models of self and other that hitherto have formed the basis of an individual’s view of himself and others. This in turn results in a disruption to an individual’s sense of a coherent narrative and a concomitant fracturing of the sanctuary of the valued sense of self. Restoring a meaningful and coherent narrative, through processing the story of the trauma, and re-schematising, is highlighted as a key feature of therapeutic restoration. Grieving the loss of meaning that arises from the trauma in a way that is approached carefully to lessen the likelihood of emotional flooding which can otherwise overwhelm defences and retraumatise the client, is also seen to be a key aspect of healing and restoring the sanctuary of the valued self. These themes are illustrated by two case examples and three short vignettes.