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 Section 11 Recalling Emotions During Trauma
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 In the last section, we discussed techniques to help your      client recall the trauma safely and accurately:  memory prompts, revisiting      the scene of the trauma, talking to others, and artistic outlets. Also,    we will discuss self-forgiveness and its relation to the recall process.   While in the last section, we reviewed ways to help the      client recall their trauma objectively. Now, we’ll discuss means of      helping the client recall the trauma as an emotional participant. 
 In      this section, we will present challenges in helping clients recall their emotions      during their trauma:  resistant clients, risks, and unresolved grief      and anger.  Also    in this section, we will discuss PTSD resulting from sexual abuse.
 
 3 Challenges to Recalling Emotions
 ♦ #1 Resistant ClientsFirst, we will discuss clients who are resistant to face their emotions.  Many    people would stereotypically apply this characteristic of resistance to emotions    to men only, but I have found that women may be just as resistant as men.  Usually,    this resistance stems from two fears:  a fear of suffering and    a fear of losing control of    oneself.
 
 The fear of suffering is understandable because    many clients do not wish to relive the feelings of terror, anger, and helplessness    that they experienced during the trauma. Those clients who are impaired    by the fear of loss of control create this fear through a defense mechanism designed to protect them from ever feeling powerless again. The    overwhelming influence of emotions can recreate the climatic helplessness they    felt during the trauma.
 ♦ Technique:  Counting MethodMatt was a PTSD client of mine who had a fear of losing control if he recalled      the emotions he experienced while he was being sexually abused by his      uncle.  Matt      stated, "Look.  I put all that shit into a little box and the      box doesn’t need to be opened.  I’m in charge of myself      now, not my emotions.  That little box does not need to      be opened."
 
 I asked Matt if he was scared of the potential loss      of control and he said, "Yeah.   Maybe.  It sucks, you know?  To      know that someone or something else has control of you."  To help      introduce Matt slowly into emotional recall, I used the "Counting      Method".  I feel that this exercise is an excellent way      to help resistant clients begin to emotionally recall their trauma because      it puts a time limit on the recall.
 
 I explained to Matt that he would      get one hundred seconds, which I would count out loud, to recall a traumatic      memory and emotionally immerse himself into the memory before I bring him      back to reality.  That way, any loss of control will last no longer      than 100 seconds.
 
  
    I recommend scheduling this exercise at the beginning of the session so        that you have enough time to discuss the emotions and recall during the rest        of the session.I then identified which traumatic memory Matt wished to work on.  He        decided on one which recalled a Thanksgiving dinner, after which his uncle        abused him.I asked Matt to only recall the memory mentally and not to speak of what        he was remembering.I began counting from 1 to 100, keeping my eyes on the clock and counting        off one number each second.At 93 or 94, I said, "Back here" to assist Matt’s return        to reality.If the client appears dazed or confused, he or she has been able to recollect        a trauma.  Matt looked moved and upset, so I knew that he had successfully        recalled the trauma.Next, we reflected on the emotions Matt underwent and tried to end on        a positive note.  I stated, "You did well.  You remembered        and were able to turn on the emotional memory tape and turn it off." As you can see, even resistant clients can learn to recall their emotions    with the right technique.  I feel that the Counting Method greatly    facilitated Matt’s first emotional recall. ♦ #2 RisksSecond, we will discuss risks involved when clients reflect    on their emotions.   Some clients are never truly ready to confront the    emotions associated with the trauma.  It is up to you, the therapist,    to decide if the client can truly handle the shock that could result from such    a step.
 
 You might want to consider:
 (1) The current emotional stability    of the client;
 (2) Whether or not painful emotional recall will undo months of    therapy; and
 (3) How well the client has handled the mental recall    of the trauma.
 I suggest using the Counting Method that    we described earlier on in this section to "test the emotional waters".  
 However,    should the client begin to react negatively, there are a few warning signs to be aware of:
 a. Fainting    spells
 b. Hallucinations
 c. Total immobilization    for more than two to three hours
 d. Feelings    of being out of touch with reality
 e. Self-mutilation    or the urge to harm themselves
 f. Suicidal    or homicidal thoughts or behaviors
 g. Being unable    to function at all for more than a day
 
 If you notice any of these reactions in your emotional-recall client, I recommend    ceasing the recall.
 ♦  #3 Unresolved Grief and AngerIn addition to resistant clients and risks, the third issue to keep in mind      during emotional recall is the unresolved grief or anger the      client is experiencing.  I have found that the psychological source      of PTSD is usually these two emotions.  Some experts report that one      is more responsible than the other.  I believe that it greatly depends      on the client and the nature of the trauma.
 
 In most cases, however,      anger and grief are closely related to each other.  On one hand, the      losses endured generate a great deal of anger while on the other the anger      could be directed at the cause or causes of the personal losses.  Because      anger induces feelings of power, clients fighting disempowerment generally      exhibit more anger and have yet to address their grief.
 
 Conversely,      those clients experiencing grief have already accepted that      they are powerless in their environment and have given up any thought of      regaining control.  Essentially, these clients have victimized themselves.  We      will discuss grief and anger more thoroughly in the next section.
 In this section, we discussed challenges in helping clients recall their emotions    during their trauma:  resistant clients, risks, and unresolved    grief and anger.   In the next section, we will  more closely examine      aspects of clients who are suffering from unresolved anger:  how they      deal with their anger, the targets at which they direct their anger, and      forgiving their targets.Reviewed 2023
 
 Peer-Reviewed Journal Article References:
 Beck, J. G., Reich, C. M., Woodward, M. J., Olsen, S. A., Jones, J. M., & Patton, S. C. (2015). How do negative emotions relate to dysfunctional posttrauma cognitions? An examination of interpersonal trauma survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 7(1), 3–10.
 
 Lancaster, S. L., Melka, S. E., & Rodriguez, B. F. (2011). Emotional predictors of PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 3(4), 313–317.
 
 Lehrner, A., & Yehuda, R. (2018). Trauma across generations and paths to adaptation and resilience. Psychological Trauma: Theory, Research, Practice, and Policy, 10(1), 22–29.
 
 Mott, J. M., Galovski, T. E., Walsh, R. M., & Elwood, L. S. (2015). Change in trauma narratives and perceived recall ability over a course of cognitive processing therapy for PTSD. Traumatology, 21(1), 47–54.
 
 Taylor, S., Charura, D., Williams, G., Shaw, M., Allan, J., Cohen, E., Meth, F., & O'Dwyer, L. (2020). Loss, grief, and growth: An interpretative phenomenological analysis of experiences of trauma in asylum seekers and refugees. Traumatology. Advance online publication.
 
 Tsvieli, N., & Diamond, G. M. (2018). Therapist interventions and emotional processing in attachment-based family therapy for unresolved anger. Psychotherapy, 55(3), 289–297.
 QUESTION 11  What are three challenges in helping clients recall their emotions during the trauma? To select and enter your answer go to .
 
 
 
 
 
 
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