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Elina Krima

PTSD

Posted by: Caroline Duggan,23rd August, 2020

Case Study – Maria

I worked with Maria who had suffered childhood trauma. She was now pregnant and expecting her first child and was feeling scared about repeating the trauma. Although longing for a child, she was experiencing panic. Sub-consciously she identified with both her unborn child and her persecutory mother, expected things to go badly wrong She wanted to calm and regulate her emotions. We worked first for Maria to feel safe in the room. People who have suffered trauma don’t feel safe in new environments for some considerable period of time. The work involved helping Maria to orientate to the room and to me. I encouraged her to use her senses to sense what did and did not feel right. It took time she had lost some connection with her gut feeling and intuition so did not automatically trust either herself or me. We experimented to see what felt right in terms of distance from me, standing, sitting or lying, the amount of light or darkness in the room whether she felt better covered or not. I encouraged her to speak up for what she needed as often people who have experienced childhood trauma feel stifled when they feel in a one-down position in a power relationship. When she felt safe enough she lay on a mattress and I did some gentle enquiry into her moment by moment experience. We identified body sensations she felt when her fight/flight/ freeze mechanisms were kicking in. This meant we could find processes to help her regulate when such body/mind processes were arising. When feeling safe we identified a symbol she could hold in future when panic symptoms arose. Maria chose a pendant she wore around her neck. Because she was feeling relaxed when she touched the pendant in the session, it would trigger the relaxation response in future when panic arose. Her body memory now would identify the sense of safety she experienced in the therapy room with the pendant and would help her to regulate her emotional distress.

Maria went on to have a good enough experience of childbirth and being a mother. All these processes took some time and patience and often there was one step forward and two steps back as we negotiated a relationship in which Maria felt I was trustworthy enough to help her feel able to let go of some of her habitual fight/flight/freeze responses and to come to be able to discriminate and chose other responses that were much more helpful to her such as kindness when she felt fear arising and patience when she felt self-critical.

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