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Creativity and Trauma - 3/5

Working imaginatively with what a client brings, rather than interpreting it, can help us to amplify unconscious material and explore feelings. This, argues Sarah Van Gogh, is where real change lies. In the next two parts of her series on creativity and trauma, she presents case extracts that reveal how imaginary dialogue helped a client with chronic back pain.

 

As Louis Cozolino has it, ‘Intellectual insight is the booby prize of psychotherapy’ (The Neuroscience of Human Relationships, 2006). Understanding on its own rarely fosters sustainable, deep-seated changes in the way we feel about ourselves, or how we behave in the world. This means that working effectively with what arises from a client’s imagination is never so much about offering the client interpretations and analyses of figures, dreams, images, metaphors etc. It is much more about helping the client to amplify whatever their unconscious has presented so as to explore the feelings and sensations that they evoke.

I have found that colleagues who are not used to explicitly including imaginative processes in their work are perfectly aware of why this can be helpful. What they tell me they need more input on is the ‘how’. So over the next two blogs I have attempted to give an account, in some detail, of how opening a dialogue with an imagined figure helped a client to explore her physical pain.

In one session, Shaz, a middle-aged woman of Pakistani heritage, sat in silence with her eyes closed. She was concentrating on the chronic pain in her shoulders that she often felt. I asked her if she noticed any associations or images coming to her, as she did so.

Shaz: “It’s like a huge figure is standing behind me and pressing down on my shoulders with their hands. Their finger tips are really gripping my shoulder muscles, really digging into me.”

Me: “That sounds so uncomfortable.”

Shaz: “Mmm. Yes. It is.”

Me: “Are you ok to stay with this a bit?”

Shaz: “Yes, it’s ok. It’s sort of interesting to think of the pain like that. But… Oh! It is really… it does really hurt now.”

Me: “Right. So do you feel like there’s something your body would want to do in response to that gripping feeling which is so painful?”

Shaz had previously described her relationship to her father and her elder brother to me. She had experienced them both as overbearing and rigid towards her when she was growing up.

Shaz: “Oh, I feel like… like I just want to shrug his hands off!” She raised both shoulders a fraction as she said this.

Me: “Could you imagine doing such a thing?”

Shaz: (With a sigh) “I could try but it’s just like… he wouldn’t budge, there’d be no point. I could shrug his hands off, they might go for a moment, but then he’d just clamp down again, harder than before.”

Me: “Yes, I see. I wonder… Would you be up for trying something else? Something that would involve opening a dialogue with him?”

Shaz: (Cautiously) “Ok.”

Telling her we could stop at any time, I then wondered what would happen if Shaz could ask this figure what he wanted – why he thought he had to grip her so tight?

There was a pause, while Shaz, with her eyes closed, and frowning in part-pain, part-concentration, was silent.

Shaz: (A pink flush suddenly drenched her cheeks and throat in a rush of blood to those areas). “He says he’s just got to. He says, ‘Don’t ask. I’ve got you now. I’m never going to let you go’.” A few tears slid out from under her closed eyelids.

Me: “He sounds very determined. How is it to hear him say this to you?”

Shaz: “Awful. Terrifying. I just feel helpless. I feel… like… he’s never going to let me go. Never let me be free of him.”

There were more tears.

Me: “Yes. That sounds so painful.” Pause. “Would you be able to tell him how you feel?”

There was a long pause now. In the silence, Shaz’s demeanour began to change a little. The expression on her face seemed ever so slightly less distressed and had a tinge of curiosity about it.

Shaz: “He says… he says, he knows. He knows that’s how it feels. He says, it is scary, but that’s better than if he wasn’t here. Better for me.”

Me: “That sounds interesting. Could you ask him to say more about that?”

Another pause, while Shaz and her dark figure dialogued in her imagination.

Shaz: “He says he’s only here to protect me. It’s for my own good. He says he has to keep hold of me to keep me safe. He’s only gripping me so hard to keep me away from… the worse things he knows are out there.”

Me: “Right. Gosh. And how does that feel to hear?”

Shaz: (Slightly wiggling her shoulders) “It’s ok. It’s sort of… I mean it’s funny, but I feel less… It’s as if, it helps knowing that he thinks he’s helping.”

Me: “Yes, I can hear that. That he’s trying to protect you. It’s just he’s doing it a bit too forcefully.”

The use of Shaz’s imagination was helping her to be in a more conscious relationship with the parts of her that held so much of her trouble and pain. In next week’s blog, the dialogue with the figure continues, revealing more to Shaz about what is going on in her inner world, and how that links to past trauma.

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Sarah Van Gogh

Before training as a counsellor 20 years ago, Sarah worked in the fields of Theatre-in-Education and community health outreach. She now works in private practice, and is one of the trainers on the counselling diploma at the Re-Vision Centre in London.

She also worked for 7 years as a counsellor and trainer at Survivors UK, a service for men who have experienced sexual violation. Her book Helping Male Survivors of Sexual Violation to Recover – Stories From Therapy was published by Jessica Kingsley in 2018. She is the co-editor with Chris Robertson of Transformation in Troubled Times published by TransPersonal Press in 2018. She writes a regular column for the BACP Private Practice Journal.

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