I can still remember sitting with a particular client in a therapy session. It was relatively early in my psychology training, and this young woman had been coming in to work on a range of issues including drug dependency and anxiety problems.
Over a number of sessions it became clear she had experienced an incredible amount of trauma early in her life. Although she would not go into detail, there were very distinct periods of her life she was terrified of revisiting; she avoided them as if creeping around an exposed manhole in the footpath.
Through the course of treatment we were able to explore her drug use in great detail. She was engaging and responsive when discussing her regular use of multiple drugs, even becoming lively and animated when recounting activities she would take part in while high. There seemed to be little shame present. There was motivation to change, and she didn’t appear overly proud of her wild lifestyle, but there was a definite absence of fear.
Our conversations then extended to her anxiety. She would comment that she felt it was holding her back from living life, keeping her in a frightening and uncertain prison inside her own head. This was a part of her life she hated, but accepted as unavoidable. I was able to help her understand and manage her anxious thoughts, and explore alternative ways of thinking, behaving and living. Again I noted that she was able to talk about these issues in a forthright way, remaining engaged and, from my perspective, present. She would occasionally become upset, frustrated, even animated at times, but always real.
I remember talking to my supervisor, noting that although her therapy seemed to be going well, there was something that remained unspoken. He assured me that we could support her healing and help her lead a more fulfilling life, regardless of whether or not she ever decided to talk about her trauma.
I struggled with this notion: how could someone hope to overcome their traumatic experiences if they never talked about them? He assured me that the time to talk about such things was when (and if) she brought them up, and that forcing the issue would be counterproductive, and potentially hinder her progress.
So therapy continued and the young woman became more confident in managing her anxiety and drug use. She hadn’t completely quit everything - complete abstinence was never her goal - but she felt she could manage her cravings better, and use drugs in less harmful ways.
Then, during one session, when we were processing a particularly anxious moment from the previous week, she mentioned the specific memory that had triggered her anxiety. It was a memory from her childhood that had occurred while she was sleeping over at a friend’s house, a memory that clearly distressed her greatly.
This was as far as the conversation went. At that point she froze. Her eyes glazed over, her gaze became distant and we lost all eye contact. Her face shifted from neutral to concerned. Her body shifted as well: she became hunched in her chair, almost in a protective posture.
This lasted about fifteen minutes. The whole time, all I could do was to reassure her about where she was, who she and I were, and that she was safe, never quite knowing how much of what I was saying was registering with her.
After this she became present in the room again. I asked her if she could describe anything about the experience she’d just had. We avoided talking about the specific memories, but concentrated on what the experience ‘felt’ like. She said she’d felt paralysed, like being trapped somehow. She’d wanted to run away, but hadn’t been able to move a muscle, or scream for help.
I asked her, ‘Could you hear anything I was saying to you just then?’
‘Sort of,’ she replied.
‘And what do you recall?’ I asked.
‘I could hear you talking, but couldn’t really make out the words. It felt like you were at the end of a really long tunnel and I couldn’t understand what you were saying. It was muffled and echoey,’ she explained.
Again I described the session to my supervisor, who nodded knowingly.
I remember commenting: ‘Everything up until this point she has been able to talk about, even if it appears to upset her. This subject was different. It was almost like she was rendered completely speechless’.
‘Not almost like,’ he said.
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