A new publication by Dr Scott Giacomucci – Trauma Survivor’s Inner Role Atom: A Clinical Map for Posttraumatic Growth
The Journal of Psychodrama, Sociometry, and Group Psychotherapy.
Abstract:
The treatment of posttraumatic stress disorder and other trauma-related maladies requires psychotherapists to be equipped with a dependable clinical map that can guide them through the difficulties of trauma therapy. The Therapeutic Spiral Model—a clinically sophisticated and research-supported adaptation of classical psychodrama that has been used in over 30 countries—comes equipped with a comprehensive clinical map called the Trauma Survivor’s Inner Role Atom (TSIRA), which emphasizes safety, containment, and strengths. The Trauma Survivor’s Inner Role Atom provides a guide to intrapsychic structural change conceptualized in the simplicity of role theory while drawing from continued developments in neuroscience research. It offers a triune map beginning with prescriptive roles to build strengths, connection, accurate observation, containment, and safety. The trauma roles offered by the model’s intrapsychic trauma triangle are explored only after the prescriptive roles have been established, with the clinical functions of each demonstrated. And finally, the transformative roles—the internal manifestation of posttraumatic growth—emerge and are integrated as a completion of the clinical map’s three spirals. The implementation of this inner role atom as a clinical map prevents retraumatization while providing emotional regulation to protagonists and the group, keeping them within their window of tolerance.
Trauma exists upon a continuum or a spectrum.
There are experiences that we often describe as capital “T” Traumas, and other experiences
that we refer to as lower-case “t” traumas. Both can be equally disruptive in
one’s life, especially when experienced over and over again. One of every four
adults, and one of every two children, that experience a traumatic event will develop
PTSD symptoms.
It seems appropriate that PTSD and trauma are
often responded to with denial or dissociation – attempts to defend or protect
one’s self from the vulnerability and reality of surviving a traumatic event. However,
in order to fully recover from trauma and PTSD, one must come to a place of
acceptance of their past. Post-Traumatic Stress Disorder (PTSD) is one of the
most poorly understood mental health disorders. Interestingly, it is also one
of the few diagnoses which asks, “what happened to you?” rather than “what is
wrong with you?”.
What Is
Trauma?
According to Dr. Peter Levine, an expert on
traumatic stress:
“Trauma is a basic
rupture – loss of connection to ourselves, our families, and the world. The loss, although enormous, is difficult to
appreciate because it happens gradually. We adjust to these slight changes,
sometimes without taking notice of them at all…although the source of
tremendous distress and dysfunction, it (trauma) is not an ailment or a
disease, but the by-product of an instinctively instigated, altered state of
consciousness. We enter this altered state let us call it “survival mode”
when we perceive that our lives are being threatened. If we are overwhelmed by
the threat and are unable to successfully defend ourselves, we can become stuck
in survival mode. This highly aroused state is designed solely to enable
short-term defensive actions; but left untreated over time, it begins to form
the symptoms of trauma. These symptoms can invade every aspect of our lives.”
One of the most effective ways to evaluate if
you have been traumatized is to answer these simple questions about a
significant incident: when you remember the incident, is the memory exactly the
same every time? Or, is the memory fragmented or difficult to recall?
If an answer is yes, then the memory is likely
a traumatic one. By no means does one
traumatic memory constitute a diagnosis of PTSD; however, it does indicate that
the traumatic event has been stored in an unprocessed manner and continues to
cause you distress or require the defense of dissociation to avoid fully
accepting what happened.
What is
a PTSD Diagnosis?
The Diagnostic and Statistical Manual of Mental Disorders or DSM5, offers multiple criteria for a PTSD diagnosis.
The first criterion relates to the actual trauma:
Directly experiencing the traumatic event(s)
Witnessing, in person, the event(s) as it occurred to others
Learning that the traumatic event(s) occurred to a close family member or friend
Experiencing repeated or extreme exposure to aversive details of the traumatic event(s); this does not apply to exposure through media such as television, movies, or pictures
The next four criteria for PTSD are outlined in this graphic:
According to Levine, “The symptoms of trauma may be continually present or they may come and go. They may even surface after being hidden for decades. Usually, symptoms do not occur individually, but in clusters grow increasingly complex over time. Unfortunately, they become less and less connected with the original traumatic experience, making it increasingly difficult to trace the symptoms to their cause, and easier to deny the importance of the traumatic event in one’s life. However, if we pay attention to these symptoms, for what they are – internal wake up calls – we can address and begin to heal our trauma.”
Experiencing trauma and/or PTSD is not rare
or uncommon. While many may suggest seeking treatment is a sign of weakness, we
would argue that it is a tremendously courageous act. Though it may not feel
possible at times, many trauma survivors report that they experienced growth
and positive changes after a traumatic experience and/or the treatment of PTSD –
this has been termed Post-Traumatic Growth.
Post-Traumatic Growth is not a new idea, it exists within all legends, myths, and holy books throughout time. The phenomenon of growing after hardship is quite common – nevertheless still remarkable. There are five common domains of post traumatic growth which include a new sense of personal strength, new possibilities, new appreciation of life, stronger emphasis on relationships, and spiritual/religious/existential changes. Even more hopeful, is the fact that around 2/3rds of trauma survivors report experiencing post-traumatic growth, making it more likely statistically than PTSD. After experiencing trauma, you are actually more likely to growth from it than to develop PTSD!
If you or someone you love may be impacted by trauma or post-traumatic stress, reach out to us for help at 610-203-2877
Trauma interrupts our natural rhythms (biologically, psychologically, socially, and spiritually). Our responses to trauma can create barriers to accessing our natural ability to heal.
The mission of the Phoenix Center revolves around helping individuals and groups access their autonomous healing centers and grow after trauma.
Post Traumatic Growth in one of these 5 domains is actually statistically more likely to occur after a traumatic event than Post Traumatic Stress Disorder (PTSD)!
1/4th adults that experience a trauma will develop PTSD (or every other child) while around 2/3rds report post traumatic growth in at least one of these five domains!
Phoenix Center’s Director/Founder, Dr. Scott Giacomucci, was recognized as a Top 100 Healthcare Leader this year by the International Forum on Advancements in Healthcare!
Check out our website to see how our approach to treatment and therapy is different than traditional talk therapy- www.PhoenixTraumaCenter.com
Another workshop in experiential therapy focused on supervised practice for trainees working towards certifications through the International Society of Experiential Professionals (www.ExperientialProfessionals.com)
In the photo below, see ‘the Sociometry of Sociometry’, a floor check warming up participants to facilitate experiential processes!
“Working Experientially with Defenses in Addiction and Trauma Treatment” presentation today at Pinelands Recovery Center of Medford by Dr. Scott Giacomucci.
Today’s workshop, the fourth of a training series, focused on defense mechanisms. We used Sociometry & Psychodrama to explore the psychological functions of defenses and how they are used in active addiction, in relation to trauma, and in treatment or recovery.
In the photo you can see our warm-up of using “soul cards” to represent and concretize the part of self called the Manager of Defenses in TSM psychodrama. This internal role gives us the capacity to recognize our defenses, consciously choose when they are needed, and contain them when they are unnecessary or maladaptive.
For more information about bringing Scott to your agency for training, email him here – Scott@PhoenixTraumaCenter.com
Check out the most recent publications by Phoenix Center for Experiential Trauma Therapy staff:
“Experiential Addiction Treatment: Creating Positive Connection through Sociometry and Therapeutic Spiral Model Safety Structures” by Mirmont Staff Scott Giacomucci, Sharon Gera, Darrell Briggs, and Kim Bass. This article is open access to the public in the journal of Addiction and Addictive Disorders: Access the Article Here.
“Being in two places at once: renegotiating traumatic experience through the surplus reality of psychodrama” by Scott Giacomucci & Amy Stone in the Journal of Social Work with Groups: Access the Article Here.
Giacomucci, S. (2018). Traveling as Spontaneity Training: If you want to become a psychodramatist, travel the world! International Group Psychotherapies and Psychodrama Journal. 4(1): 34-41: Access the Article Here
Giacomucci, S. (2018). Social Work and Sociometry: An Integration of Theory and Clinical Practice. The Pennsylvania Social Worker, 39(1), 14-16. Access the Article Here
Giacomucci, S. (2018). Social work and sociometry: Integrating history, theory, and practice. The Clinical Voice, pp. 15–16. Richboro, PA: Pennsylvania Society for Clinical Social Work. Access the Article Here
I am proud to announce that Amy Stone, MSS, LSW has accepted a position with Giacomucci & Walker, LLC. There are very few people that I would trust to maintain the quality and integrity of my business. Amy is an incredibly talented psychotherapist who finds deep joy and purpose in her work.
Amy has been helping people recover from addiction for over 20 years. She earned her Masters is Social Services with a clinical concentration from Bryn Mawr College. Additionally, she completed her EMDR basic training and has accrued over 500 hours of training in experiential trauma therapy, psychodrama, and the Therapeutic Spiral Model.
She is accepting new clients and specializes in experiential trauma work, sexual trauma, substance abuse, and relationships.
“Asking for help demonstrates bravery and is an action step toward a new experience in life. I have been helping individuals recover from addiction for over twenty years. Now, I assist clients to grow and heal from abuse, neglect, traumas and move through rough patches in life. I recognize the importance of this work, but believe curiosity and laughter can be part of the therapeutic process as well as tears, grief and anger. I use a variety of methods that can go beyond traditional talk-therapy. I’m trained in the experiential methods of EMDR and psychodrama, and both are effective treatments for trauma and PTSD. Transformation and change are often possible and I am honored to witness this daily.”
I am proud to announce that Amy Stone, MSS, LSW has accepted a position with Giacomucci & Walker, LLC. There are very few people that I would trust to maintain the quality and integrity of my business. Amy is an incredibly talented psychotherapist who finds deep joy and purpose in her work.
