Dissociation – we all do it. You drive to somewhere, and arrive realising you didn’t consciously observe usual landmarks. This we deem normal and not harmful to ourselves or others.
When dissociation is extreme, behaviours that happen during an episode may not be remembered by the client – rendering them vulnerable in many cases, and perhaps in a tricky legal situation.
Peter is a very informed psychotherapist who saw the need for training with traumatised clients. Their presentation by the client in the room very often needs managing and calming, long before any work could be done.
In extreme cases, a client may be so physiological in flight (vs fight) mode but then moves to another 2 levels [Hyper freeze – deer in headlights] {Hypo freeze – may look dead and be nearly dead}, that their body completely shuts down – and this is a medical emergency.
With very vulnerable clients, Peter gave examples with role-plays of how to bring them ‘back into the room/present moment’ by distracting/earthing them – eg asking them if they can hear traffic passing by, ask them what colour the door is. This breaks the trance like state they may be in, and back to being more present.
Dissociation, when severe, can be very complex and may take a considerable number of sessions for trust to build between client and therapist, so the client doesn’t feel the need to lean away from the therapist when painful feelings/ thoughts/body responses occur.
Peter did an incredible job of sharing how delicate the work needs to be – how a short term allocation of a typical 6 sessions is not a conducive way to work with clients who dissociate, as the slow rapport building is a crucial first step before working up to doing therapeutic and challenging work.
The evening was very well received. Peter’s knowledge, research and experience were very much appreciated by all.
Thank you Peter.
Sinead Mitchell