In order to describe to you how PBSP psychotherapy works with trauma, there are some general features of this method I need to describe. The first general principle is that PBSP is designed to help clients construct new virtual memories. I will not go into the brain research that confirms this, but, the idea is that current consciousness is constructed out of memory. My current experience of my world is a construction made of memory. Memory gives meaning to current experience by virtue of the fact that it is our memories that define our current experience. This fact is demonstrated by the terrible disease of Alzheimer’s. As people lose more memory, the more dysfunctional they become. For PBSP this means that in order for psychotherapy to help change a person’s current experience (“I’m not loveable,” “I’ll never find meaningful work,” and so on) something has to change in their memories. Obviously, we can’t literally go back in time machines and change our life experiences. But we can do something that is almost as good which is to purposively create a virtual memory. This is done through role playing.
A unit of therapy in PBSP is called a “structure.” A structure is a creation of a ritual space. In this space is represented, via role players – which can either be actual group members or objects such as pillows – who represent emotionally charged persons and events in the person’s life. Sometimes, perhaps particularly with severe trauma, the emotional “charge” happens first with no known context. This happened to me with a woman who was referred to me by her therapist because they were stuck and her therapist thought she would benefit from a structure. No sooner had this client began to tell me her story, when her hands and arms began to flap back and forth in what looked to me like an expression of helpless terror. As her hands were shaking she was looking at them and saying, with considerable fright, “What’s this, what’s this? Why are my hands shaking?” I suggested to her that she was experiencing what we call an “unbounded” emotion, which is emotion that has never been formulated into a meaningful experience and never interacted with. I asked her if she would like what we call a “containment” figure which is a role player who represents a person who would be with them physically while they are feeling the feeling. She agreed to this, and the figure put her hands on the outside of the clients flailing hands so that the movement would be contained. This calmed her down just enough that she could begin to give the context for her feelings. I don’t want to say too much here, to protect confidentiality, but I’ll just say that she had what sounded like a psychotic mother married to an abusive man (step-father to my client as a five-year-old).
As soon as she identified this history her mother and step-father were represented (she choose some pillows, one to represent her mother, the other to represent her step-father). When such enrolling, as we call this process, occurs when the client is in the midst of feeling their feelings as they remember such events, the enrolled figures take on a surprising reality. Since she was already feeling her feelings in the form of her hands shaking, I was prepared to offer her right away an antidote figure, which is essentially a reversal of the negative history. In this case, I wondered if she would like to enroll a protection figure, which, had that figure been back there then – at the time of the memory, in this case when she was five – this figure would have protected her from the physical abuse she suffered from her step-father. This figure has to be made up in conjunction with the client so that it is a believable figure. We came up with an ideal child protection worker. She chooses a male to represent this figure. Such a protection figure is placed between the client and the source of danger, facing the source of danger. In this case, the source of danger was her step-father. She placed the protection figure so that she could not see the pillow representing her step-father. I suggested that she might like to hear her protection figure say, “If I had been back there then, when were five, I would have said to your step-father, “I will not let you harm her.”” She thought that was a wonderful idea and I instructed the protection figure to say those words.
Let me pause here to mention two critical facts. One is in this method we are very careful to track with the clients’ time-line. This is why I had the protection figure say, “If I had been back there then, when you were five.” This creates two pictures in her mind. One is the actual memory which includes her remembered feelings of terror. The next is the new picture of someone being there with her back then. Not in the present, but back then. The second fact is that I am constantly “microtracking” tracking her, which is a kind of active listening with a twist. When I microtrack, I enroll in the air a hypothetical figure who had he or she been there back then, would have seen what the client was feeling. So, in this case, one such statement would have been, “If there was a witness back there then, the witness would have said, I see how terrified you felt when your step-father threaten to hit you.” The skill of accurately microtracking, which entails reading the clients’ body, particularly their face, is difficult to learn and requires hours of practice. Probably for most people, hundreds of hours of practice. When the witness statement is accurate, it does not interrupt the flow of the dialogue what so ever and in fact usually deepens the clients’ memories of the experience.
Going back to the structure, after the protection figure said the words he was instructed to say, I could see the clients’ hands calm down. I microtracked, “The witness figure would say, I see how calmed you feel to be protected by your protection figure.” She agreed. I then had the protection figure say, “If I had been back there then, you could have always felt this safe.”
This was the essence of one structure. When there is abuse, which is defined as any negative interaction that has a penetrating quality, such as being hit, sexually abused, mean words being said, where, in other words, the boundaries of the body/ego are violated, the first order of business is to establish safety. Next we move on to more complete reversals. In this case, ideal parents. When we use the word “ideals” we don’t mean to imply total perfection. The word “ideal” more refers to the time frame and signifies an enrolled character who would have been in the person’s past and would have prevented the negative history from happening in the first place. We are always clear with the client that we are making up such ideal figures. We are making them up so they can have something of a physical interaction with images. With this client, she was able, eventually, to enroll ideal parents who were madly in love with each other. The father would never hit the client, or the clients’ ideal mother, and in fact would be a source of protection for the client.
In this scene, the client is sitting in between to people who have enrolled as her ideal mother and father. From this position we follow the bodily clues about what she yearned to have. Things like, it would safe to put her head on her father’s shoulder. These actual physical interactions with the ideal figures are a big part of the “motor” part of psychomotor. We had to work a few more structures before she could get to this point. In particular, we had to work with the fact that this client had a childhood fantasy that it was her job to protect her actual mother and her actual siblings from the step-fathers abuse. This entailed dong what we call, “holes in roles” structures. In these structures her actual mother and siblings get structures where they get their own protection figures. If you can picture this, the client observes her actual mother, represented by a pillow, getting a protection figure. We call this, “making a movie.” In this movie, her mother’s protection figure steps out of the movie and says to the client, “If I had been back there then, it would have been my job to protect your mother, not yours,” and then steps back into the movie. Until this step is taken, the client cannot take in the full healing scene with her ideal figures.
PBSP psychotherapy, structure work, is by design, extremely experiential and, thereby, difficult to describe. (There are two books I’m aware of that have described structure work in more detail than I have here. Gus Napier’s book, “The fragile Bond,” and Maggie Scarf’s, “Secrets, Lies, Betrayals: The body/mind connection.”) I’ve recently been working a with a trainer in my gym workouts. When my trainer introduces an exercise he will often use his hands to guide my body into the proper posture. This gives me proprioceptive information about how to hold my body position to both exercise the target muscles and to prevent injury. The goal of a structure is for the client to put themselves in a position that they can proprioceptively feel in their body, what it would have felt like if they had a different history. This is how we create new, virtual memories.