Ginny Hurney, LCSW-C

Facing a Real Threat of Death,

Using Bonding Psychotherapy to Overcome Trauma

By Ginny Hurney, LCSW-C, Teaching Fellow

A twenty-year-old traumatized client came in for therapy after she had been held-up at knifepoint while working alone in a card shop. She had spent most of the night, after filing a police report, crying hysterically with her Mom and boyfriend. The client had been in individual therapy with me during High School before leaving for college. Her Mom, also my client and well versed in the BP Process, made herself available since deep emotional release work and bonding are done only in a group setting of at least two clients.

After the client went over the details of the hold-up with me, she called her Mom into the session for support. The client felt comfortable with her tears, but anger and fear were difficult for her to feel and express. Thus, I started by having the client work on a therapeutic exercise developed by Skip and Marilyn Ellis, BP Teaching Fellows. The Four Levels of Anger exercise simulates the human developmental stages of anger and helps people who are blocked at expressing this emotion. The exercise is designed to help clients learn to express their anger in group, so they can then be more comfortable and appropriate expressing it in their lives.

The client stood across from Mom at arm's length and started with Level I, the Infant Level when we are truly helpless and dependent on our caretakers. Both Mom and client got down on their elbows and knees, head bowed to the ground while repeating, “I'm helpless, it's hopeless, there is nothing I can do”. For Level II they got up on their knees, faced each other and yelled, “It's your fault, you did it,” releasing more energy than at Level I. This level is at the Toddler Stage, with no awareness of their actions, full of “you did it” toward the other person who is preventing them from doing what they want to do. At Levels I and II, internal dialogue goes on in their head and keeps them out of their body. The difference between Levels I and II is that in Level I there is no connection to another person, on Level II they are face to face, without eye contact.

Level III is full body release of rage done while standing, facing their partner and directing the emotion toward the other who represents the person they feel has done them wrong. This level is a “getting even” anger that is developmentally that of an Adolescent. However, instead of using Mom to direct her Level III anger at, the client felt more comfortable directing her rage at an empty chair on which I placed a large stuffed gorilla. At this point the client was able to go deeper into her feelings directing them at the man who had attacked her. When a client is not familiar with hearing themselves express loud rage, the sound of their scream can be overwhelming and frightening. For support I screamed with her and helped her get over her embarrassment of releasing “kill rage”, “I'll get you for doing that to me”. After releasing her rage, she felt terror and started shaking and crying. The screaming helped her unlock and release her primary emotion of fear of death. For support, her Mom held her while they were standing. At this level there is no internal dialogue as the body took over the inhibitions of her mind and her body released the deeper emotions.

Level IV, the Mature Adult, would normally follow Level III. However, I thought it was more appropriate to help her move deeper into and through her fear. The mature response to her being held up was to be afraid and she was helpless in that situation which posed a real threat of death. Thus her terror was immediate and needed to be worked through.

Therefore, I went into the Fear-Power Exercise developed by George Rynick, a BP Teaching Fellow. With the Fear Power Exercise she stood opposite Mom and they held hands, looked at each other and yelled, “I'm scared, I'm scared, I'm scared” getting louder each time until the fear was felt in their body and was heard in their voices. After a few minutes of releasing the fear they started jumping up and down excitedly while still yelling. The jumping releases the frozen energy of the fear, and moves it to an expression of power, exhilaration and empowerment. She was able to release feelings of helplessness and regain a sense of control over herself. Once they were finished jumping and started feeling the joy of the release, they hugged each other. The client started to smile and looked relieved and relaxed.

In the last part of the session Mom nurtured her daughter sitting on the sofa and holding her on her lap. This is a more relaxing form of bonding and relieves the strain of hugging while standing. In this more relaxed and intimate position the client took in love and did cognitive restructuring by telling all the significant people in her life, “I'm a powerful woman and I'm lovable”. Saying this positive affirmation with feeling several times she started to reprogram her thinking from the victim stance to that of a powerful, assertive woman. After a few more minutes of positive affirmation and feeling Mom's love and support, she was finished with the session and felt good.

The last intervention of being nurtured while affirming herself and being affirmed by others, allowed the client to fill the space that had been created by releasing her fear and anger, with love and power. This affirmation, taken from the Incredibly Lovable Exercise developed by Marilyn Ellis, was done with Mom and myself. Normally it is done in a small group of 4-5 where one person is put into the center with the other participants connecting to the person in the middle and repeating, “You are incredibly lovable, you have always been incredibly lovable, you always will be incredibly lovable, and your true nature is love”. This powerful exercise often brings clients to grin from ear to ear or to tears of pain and joy from hearing what they have always wanted to be told. They almost always leave feeling good and filled up with positive energy.

This fifty-minute session was a clear example of how powerful the BP process can be as a way to cut through cognitive defenses and emotional trauma to produce positive change. For the client to go from feeling scared and traumatized by the threat of being killed and totally helpless to smiling, feeling good and empowered in one session was remarkable. She came to a safe place with safe people, Mom and myself, and was feeling her power and a sense of relief. This transformation was accelerated by the full body expression done through the Four Levels of Anger and the Fear Power exercises, followed by nurturing and taking in with the Incredibly Lovable exercise.

In the next session we discussed how she was doing since the last session. She reported feeling less fear and anger. However, she had not gone back to work and wasn't sure if she could ever work there again. Thus, I felt it was important to complete the Four Levels of Anger Exercise with the last Level IV, so she could move past wanting revenge, (Level III). Level IV is full body release at the Adult Level done with a full scream that is about ourself and no one else. It is a release of energy, without blame or revenge. We offer the energy of the anger up to God, the universe, or our higher power, knowing that releasing anger without hurting someone else or ourselves ultimately makes us feel good. A new insight about ourselves often comes after this level of release, an added benefit. This client's insight was that she had done the correct thing by not resisting her attacker and was indeed a powerful woman. After 2 weeks she was able to resume working at the card shop without trauma, while being more aware of the possibility of danger.

Referencing the Emotional Schema Work presented by Konni Stauss and Skip Ellis, I could see that her Primary emotion was a real and immediate fear of annihilation/death. She was traumatized and experienced the same neuromuscular lock in her body that she did as a four-year-old. These feelings of annihilation, helplessness, and lack of safety, were what she experienced when she heard Mom and Dad fighting before and during their divorce. Back then she was flooded with feelings and not able to experience them safely or be nurtured. As a child and in the card shop she truly was helpless and had a real fear of annihilation. If she hadn't been able to work through her current trauma it would have confirmed and cemented her cumulative relationship trauma from childhood, causing future problems in her adult life.

The typical dysfunctional cognitions formed from childhood trauma about self are, “I am helpless, I will die, I can't survive”. Dysfunctional cognitions about others are, “They will annihilate/kill me”. These thoughts were present and appropriate when she was attacked. Through the use of schema work it is important to separate history from the here-and-now, and deal with the present life trauma. Otherwise, the historic cumulative relationship trauma can make it impossible to cope with what happens in real life today. Having her mother present in her sessions helped her relate to her historic childhood trauma as well as the current crisis. In working on her current crisis she was also working on her early history that was re-experienced with Mom.

Creating safety within self is necessary to utilize and process one's emotions, particularly in trauma. With Mom's and my support she felt safe enough to go into her emotions, release them and reclaim her power. Konni's research shows that in order to work through a highly emotional situation we have to have sufficient “processual activation”. Processual activation, unique to BP, involves first experiencing and releasing the emotions of the situation in the here-and-now. Then when combined with bonding, (emotional openness and physical closeness with safety) and cognitive restructuring through positive affirmations, therapeutic change is able to happen. This work can make a permanent change in a person's ability to successfully process emotionally traumatizing events and gave her a resource she can draw on for the rest of her life.

Five years later I had a follow up session with the client to see if she had any residual trauma. On the day of her appointment she told her colleagues about her attack and the ensuing two therapy sessions. She said she felt excited sharing her experience with her colleagues and having a chance to review them with me. This excitement demonstrates the permanence of the trauma having been worked through. She said she remembers feeling traumatized before the session and not wanting to go back to work. She reported feeling calm and more at peace after the first session. After the second session she was able to go back to work at the card shop. She never worked alone again and was more cautious when she walked to her car at night. Currently, the client is a social worker having completed her Master's Degree, lives on her own, and is doing well in her life. She has been able to build more safety in her life by advancing professionally as a social worker into a safer job situation.

In this case, the activation of her emotional trauma, with cognitive reprocessing, while bonding and taking in a corrective experience, worked well. The exercises created by Skip and Marilyn Ellis, and George Rynick, accelerated the process. Having her Mother with her and having spent two years in therapy with me created the safety she needed to complete this experience in only two sessions.

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