Running head: HEALING TRAUMA THROUGH CONNECTION 1alfredadler.edu/sites/default/files/Pamela Jo Reed...

Running head: HEALING TRAUMA THROUGH CONNECTION 1

Healing Trauma through Presence and Connection

An Experiential Project

Presented to

The Faculty of Adler Graduate School

____________

In Partial Fulfillment of the Requirements for

The Degree of Master of Arts in

Adlerian Counseling and Psychotherapy

____________

By

Pamela Jo Reed

____________

Chair: Richard E. Close, DMin, LPCC, LMFT

Reader: Craig Balfany, MPS, ATR-BC

____________

May 2017

© 2017 Pamela Jo Reed. All rights reserved.

HEALING TRAUMA THROUGH CONNECTION 2

Abstract

In this paper, a model for healing trauma that integrates theories from Alfred Adler, Carl Jung,

Viktor Frankl, Carl Rogers, and others is proposed. The foundation of this model is a belief

system that in order to fully heal trauma in an individual, it is necessary for an individual to

understand their purpose and core message (i.e., “kerygma”) for the world. Trauma disconnects

individuals from their kerygma and makes the disconnections visible. Evidence-based practices

for the treatment of post-traumatic stress disorder (PTSD) are reviewed, along with alternative

medicine approaches to healing trauma. Provided at the end of this review, is an outline of a

non-profit organization focused on this model, called The Kerygma Project. The appendices

provide a series of mandala images which portray the model graphically, a business plan that

describes more detail on bringing this concept to a reality, and a list of forms that will be used to

evaluate this model’s approach to healing trauma.

Keywords: trauma, healing, purpose, kerygma, true self, EMDR, Brainspotting, CPT, PE,

chakra, logotherapy, person-centered, strengths-based, PTSD, attachment, meaning-making, post

traumatic growth, sensorimotor, somatic experiencing


Acknowledgements

I would like to express sincere gratitude to my chairperson and mentor, Dr. Richard E.

Close for his invaluable support and guidance in the planning and implementation of this project

and for introducing me to the concept of “kerygma”. I would also like to convey my deep

appreciation for Dr. Darell Shaffer and Laconia Koerner with whom I have working to envision a

new way of thinking about healing trauma.


Dedication

To my husband, Joe, whose unconditional love has helped me to find my true self, and to

my son, Joey, who teaches me every day what it means to be truly present and connected.

And to Ellen Pence, who passed away on January 6, 2012 from cancer. Before she died,

Ellen encouraged me to seek out my true calling. And so, I did.


Table of Contents

Abstract ........................................................................................................................................... 2

Acknowledgements ......................................................................................................................... 3

Dedication ....................................................................................................................................... 4

Introduction ..................................................................................................................................... 7

Overview of Trauma ................................................................................................................... 8

Defining trauma ....................................................................................................................... 8

History of diagnosing trauma (DSM-I through DSM-V) ........................................................ 8

Current Evidence-Based Treatments for PTSD ............................................................................ 10

Cognitive Processing Therapy (CPT) .................................................................................... 11

Prolonged Exposure therapy (PE) ......................................................................................... 12

EMDR .................................................................................................................................... 12

Physiology of Trauma ............................................................................................................... 13

Holistic Approach to Trauma........................................................................................................ 15

Adlerian Approach to Trauma................................................................................................... 15

Adlerian five life tasks ........................................................................................................... 17

Social interest ........................................................................................................................ 17

Alternative Medicine and Trauma............................................................................................. 18

The chakra system ................................................................................................................. 18

Table 1. The Chakra Systems ............................................................................................... 18

A Connection and Presence Model for Trauma ............................................................................ 20

Connections in Trauma Healing ................................................................................................ 20

Mandala image of connections .............................................................................................. 20

Attachment theory and connection ........................................................................................ 22

Attachment and trauma .......................................................................................................... 23

Attachment theory and therapeutic presence ......................................................................... 24

Presence in Healing Trauma ..................................................................................................... 25

The presence of mind ............................................................................................................ 26

The presence of body ............................................................................................................. 29

Table 2. Cognitive versus Somatic Approaches to Trauma ................................................. 32

The presence of spirit ............................................................................................................ 33

The Kerygma Project .................................................................................................................... 39

Finding One’s True Self After Trauma ..................................................................................... 39


Sense of self. ........................................................................................................................ 39

Table 3. The Kerygma Project Services ............................................................................... 41

Mission statement. ................................................................................................................. 41

Assessments and outcomes measurements ............................................................................ 41

Conclusion .................................................................................................................................... 43

References ..................................................................................................................................... 45

Appendix A: Mandala Images ...................................................................................................... 55

Mandala of “Healing Trauma through Presence and Connection” ........................................... 56










Appendix B: Business Plan ........................................................................................................... 67

Appendix C: Client and Provider Forms ...................................................................................... 78


Healing Trauma through Presence and Connection

Introduction

There has been a recent surge of interest in healing trauma and research in this area is on

the forefront of studying holistic modalities and multi-disciplinary approaches. Complementary

therapies and interventions are increasingly explored as new information from research in

neuroscience and the plasticity of the brain emerges. As Bessel van der Kolk (2014) states,

“after trauma the world is experienced through a different nervous system” (p. 53). Because the

effects of trauma adversely affect so many aspects of an individual’s physiology, “it is critical for

trauma treatment to engage the entire organism, body, mind and brain” (p. 53).

Many individuals experience a traumatic event during their lifetime. Estimates show that

“roughly 50%-60% of the U.S. population is exposed to traumatic stress but only 5-10%

develop posttraumatic stress disorder (PTSD)” (Duncan, Miller, Wampold & Hubble, 2010, p.

87). With the majority of the US population experiencing a traumatic event during their lifetime,

“examining the consequences of trauma exposure is important” (Perera & Frazier, 2013, p. 26).

It is essential for a practitioner to be competent in their field of specialization and especially so in

the field of trauma, which is rapidly changing. The fields of psychology and mental health are

now recognizing the value of integrating different disciplines to their healing protocols. There

are many more modalities that are being researched for the treatment of trauma, including yoga,

meditation, mindfulness, and somatic therapy.

Healing trauma through a model of presence and connection focuses on the person’s

“wholeness”. The mandala images shown in Appendix A outline the essence of this idea—that

by combining integrative and complementary approaches to healing the mind, body and spirit,

while employing the Adlerian five life tasks as a structure (i.e., community, love, work, self,


universe) (Dreikurs & Mosak, 1966, 1967; Mosak & Dreikurs, 1967), a web of connections exist

which make up an individual’s network, with their core message and individuality at the center.

Trauma exposes the disconnections that can happen as a result of its impact—the fundamental

premise of this paper is that an individual can be re-connected through presence and an ultimate

search for their true self.

Overview of Trauma

Defining trauma. A spectrum of traumatic “disorders” exists, and as Herman (1997)

notes, range “from the effects of a single overwhelming event that generally involve a threat to

life or a close personal encounter with violence and death” (p. 33) to the “more complicated

effects of prolonged and repeated abuse” (p. 3). According to Herman (1997), the manifestations

of trauma have commonalities and therefore the steps in the recovery process are similar (i.e.,

“establishing safety, reconstructing the trauma story, and restoring the connection between

survivors and their community” (p. 3)). Trauma can disorient individuals’ sense of “control,

connection and meaning”—traumatic events are extraordinary because they “overwhelm the

ordinary adaptations to life (Herman, 1997, p. 33).

History of diagnosing trauma (DSM-I through DSM-V). The original Diagnostic and

Statistical Manual of Mental Disorders (DSM) manual was published in 1952 by the American

Psychiatric Association (APA). The intent of this publication was to provide a guide to mental

health practitioners for diagnosing psychological disorders using a classification system. The

DSM was updated in 1968 (DSM-II), 1980 (DSM III), 1987 (DSM-III-R), 1994 (DSM-IV), 2000

(DSM-IV-TR) and most recently in 2013 (DSM-V). It was not until the DSM-III was published

in 1980 that the APA added Post Traumatic Stress Disorder (PTSD) to its classification scheme

changing the concept of trauma from one of being “an individual weakness” to an experience


“outside of the individual” (Friedman, 2016). The most current version of the DSM, the DSM-V

(2013), includes “evidence-based revisions to PTSD diagnostic criteria” and is now classified

under a new category entitled “Trauma- and Stressor-Related Disorders” (Friedman, 2016).

Posttraumatic Stress Disorder. An individual suffering from PTSD meets the following

criteria, as outlined in the DSM-V (Department of Veterans Affairs, 2017; American Psychiatric

Association, 2013):

Criterion A (one required). The person was exposed to: death, threatened death, actual or

threatened serious injury, or actual or threatened sexual violence, in the following way(s): (a)

Direct exposure; (b) Witnessing the trauma; (c) Learning that a relative or close friend was

exposed to a trauma; (d) Indirect exposure to aversive details of the trauma, usually in the course

of professional duties (e.g., first responders, medics).

Criterion B (one required). The traumatic event is persistently re-experienced, in the

following way(s): (a) Intrusive thoughts; (b) Nightmares; (c) Flashbacks; (d) Emotional distress

after exposure to traumatic reminders; (e) Physical reactivity after exposure to traumatic

reminders.

Criterion C (one required). Avoidance of trauma-related stimuli after the trauma, in the

following way(s): (a) Trauma-related thoughts or feelings; (b) Trauma-related reminders.

Criterion D (two required). Negative thoughts or feelings that began or worsened after

the trauma, in the following way(s): (a) Inability to recall key features of the trauma; (b) Overly

negative thoughts and assumptions about oneself or the world; (c) Exaggerated blame of self or

others for causing the trauma; (d) Negative affect; (e) Decreased interest in activities; (f) Feeling

isolated; (g) Difficulty experiencing positive affect.


Criterion E (two required). Trauma-related arousal and reactivity that began or worsened

after the trauma, in the following way(s): (a) Irritability or aggression; (b) Risky or destructive

behavior; (c) Hypervigilance; (d) Heightened startle reaction; (e) Difficulty concentrating; (f)

Difficulty sleeping.

Criterion F (required). Symptoms last for more than 1 month.

Criterion G (required). Symptoms create distress or functional impairment (e.g., social,

occupational).

Criterion H (required). Symptoms are not due to medication, substance use, or other

illness.

Briere and Scott (2015) assert that the definition of “trauma” in the DSM-V is limiting.

They assert that “an event is traumatic if it is extremely upsetting, at least temporarily

overwhelms the individual’s internal resources, and produces lasting psychological symptoms”

(p. 10). This definition includes both psychological and physiological injury.

Current Evidence-Based Treatments for PTSD

In Hundt, Harik, Barrera, Cully, and Stanley (2016), the authors note three evidence-

based practices (EBPs) for PTSD that “are recognized as first-line treatments for trauma by the

American Psychological Association (APA), the National Institute for Clinical Excellence

(NICE) and the Department of Veteran Affairs/Department of Defense” (p. 728). These EBPs

are Cognitive Processing Therapy (CPT), Prolonged Exposure (PE) and Eye Movement

Desensitization and Reprocessing (EMDR) therapy.

Repeatedly writing and talking about the details of the traumatic memory are central

therapeutic elements of both CPT and PE (Mott, Galovski, Walsh, & Elwood, 2015, p. 47).


Cognitive Processing Therapy (CPT). Cognitive Processing Therapy is a form of

cognitive behavioral therapy that was developed by Patricia Resick specifically to treat PTSD in

sexual assault survivors (Briere & Scott, 2015; Galovski & Gloth, 2015; GoodTherapy.org,

2016). Cognitive Processing Therapy teaches the client to identify inaccurate thoughts and

beliefs around the traumatic event. These thoughts and beliefs are termed “stuck points”—once

identified, the therapist and client work together to arrive at more accurate, alternative thoughts.

At the same time, the client engages with the memory and “has the opportunity to process natural

affect associated with the memory” (Galovski & Gloth, 2015, p. 105). Briere and Scott (2015)

note that “as these negative assumptions are reevaluated, a more affirming and empowering

model of self and others frequently takes place” (p. 153).

Cognitive Processing Therapy ties into the physiology of trauma in that “when a person

experiences a stimulus that elicits memories of a traumatic event, a fear network is activated in

the memory” (GoodTherapy.org, 2016, History and Development, para. 1). The person attempts

to avoid this fear, but ends up maintaining the fear instead. Cognitive Processing Therapy

asserts that “repeated exposure to the traumatic memory in a safe, therapeutic environment is an

important step in the process of accepting this fear and thus becoming able to perceive it as less

powerful” (GoodTherapy.org, 2016, History and Development, para. 1).

Cognitive Processing Therapy typically takes place over 12 sessions and lasts 3 months

and can be conducted in either an individual or group format (Galovski & Gloth, 2015;

GoodTherapy.org, 2016). There are four main phases to the CPT approach, which include the

following: (1) psychoeducation; (2) identifying belief systems around trauma; (3) successfully

questioning and challenging belief systems; and (4) learning ways new belief systems can

change trauma (GoodTherapy.org, 2016).


Prolonged Exposure therapy (PE). Wolf et al. (2015) note that Prolonged Exposure

therapy (PE) is also cognitive-behaviorally based, and like CPT, has four main components or

phases: (1) psychoeducation; (2) repeated exposure to trauma-related situations or triggers that

are commonly avoided by individual; (3) “repeated imaginal exposure to traumatic memories”,

and (d) discussion and processing subsequent to imaginal exposures in order to “facilitate

emotional processing and corrective learning” (p. 341). Autonomic activation is considered a

successful component of an individual’s ability to “unlearn” their traumatic responses. In

addition, emotional engagement is an important predictor of treatment success (Wangelin &

Tuerk, 2015, p. 928).

Wangelin and Tuerk (2015) looked at the physiological responses individuals exhibited

subsequent to trauma imagery. They found that the individuals (i.e., combat veterans) who had

been diagnosed with PTSD and began PE therapy, showed significant decreases in the

physiological measures (i.e., heart rate and skin conductance).

Briere and Scott (2015) argue that the PE model “reflects concerns that such activities

can exceed the affect regulation capacities of individuals with more severe or complex” PTSD

symptoms (p. 169). They suggest that prolonged exposure treatment occur within the

“therapeutic window”, which “refers to a psychological midpoint between inadequate and

overwhelming activation of trauma-related emotion during treatment” (p. 169). It is within this

window, that therapy can be most effective—it is a matter of determining, and having experience

with, recognizing where this is and to have the ability to bring an individual back to a “safe”

place, if overwhelmed.

EMDR. Eye Movement Desensitization and Reprocessing (EMDR) was the first somatic

approach recognized as evidence-based treatment in the United States in 2010 (Kelley, 2017).


EMDR’s theoretical framework has its roots in Adaptive Information Processing (AIP) which

was founded by Francine Shapiro. Adaptive Information Processing involves orienting

responses (ORs) which transform previous negative experiences by integrating them into

positive emotional and cognitive representations. Eye movements may help induce ORs. It is

thought that EMDR therapy can help to facilitate access to traumatic memories so that the

information processing centers of the brain are enhanced and then new information, such as more

adaptive and relaxed body responses, can be reintegrated into the memory or memories. It is a

way of releasing some or most of the emotional responses to a memory and rebuilding the

memory without the pain attached to it.

A study by Chen et al. (2014) is touted as the first meta-analysis performed on clinical

studies looking at how EMDR therapy affects symptoms of PTSD, as well as depression and

anxiety, over the past 20 years. A quantitative meta-analysis was performed on 26 different

randomized controlled trials in total. The efficacy analysis of this study showed that the overall

reduction in symptoms associated with PTSD, depression and anxiety subsequent to EMDR

therapy was “significant” and had a “moderate effect size”. Since persons with PTSD have

difficulty with, or are unable to, manage their traumatic memories, this type of therapy provides

a mechanism to enable the person to create new, adaptive connections that improve their

symptoms, leading to an increase in positive emotions.

Physiology of Trauma

Peter Levine (1997) noted that “the roots of trauma lie in our instinctual physiologies…as

a result, it is through our bodies, as well as our minds, that we discover the key to healing” (p.

34). In order to determine the course of healing the body, we need to understand the physiology

behind trauma.


Bessel van der Kolk (2014) in his book, The Body Keeps the Score, highlights an

important aspect of the brain and trauma. He states, “images of past trauma activate the right

hemisphere of the brain and deactivate the left…when something reminds people of the past,

their right brain reacts as if the traumatic event were happening in the present” (pp. 44-45). In

addition, the presence of stress hormones during trauma is a normal response that is meant to be

temporary. However, “the stress hormones of traumatized people…take much longer to return to

baseline and spike quickly and disproportionately in response to mildly stressful stimuli” (p. 46).

Levine (2010) posits that an individual’s capacity for self-regulation is what allows them

to manage states of arousal and difficult emotions, “providing the basis for the balance between

authentic autonomy and healthy social engagement” (p. 13) and a sense of safety.

Dan Siegel surmises that “long before children have the language and conceptual tools

to process experience, negative or even traumatic patterns of interaction are incorporated in

the brain, the functioning of their psyche, and even in the molecules that control the

expression of their genes” (Siegel & Srouge, 2011, The Clinical Relevance of Attachment

Theory and Research, para. 1). In Norman Doidge’s book, The Brain That Changes

Itself (2007) Doidge discusses research studies done with giant marine snails. These studies

showed that after administering “shocks” to the snail, the snail learned to avoid them and its

nervous system changed through an enhancement of the synaptic connections between the

sensory and motor neurons. This study was the first to show that learning led to

neuroplasticity (i.e., strengthening the connections between neurons). When researchers

repeated the shocks in a short period of time, the snails became “sensitized” and developed

“learned fear” which was a “tendency to overreact to more benign stimuli” (p. 219).

Neuroplasticity and the idea that the brain can change itself gives hope to those who have


experienced trauma. Siegel and Srouge (2011) illuminate this notion by stating that “one role

of a therapist is to bring awareness to such patterns and then intentionally create new pathways

for clients to take as they unlearn their long-established habits” (The Clinical Relevance of

Attachment Theory and Research, para. 1).

There are three main structures in the brain that are recognized in the physiological

response to trauma. A hallmark feature of PTSD is reduced size of the hippocampus. The

hippocampus is implicated in the control of stress responses and memory, and is one of the most

adaptive parts of the brain (Sperry, 2016). Another structure of the brain, the amygdala, is

“involved in emotional processing and fear responses…[it] is hyper-responsive to the cues and

reminders of trauma in those with PTSD” (Sperry, 2016, p. 164). The third significant structure

is the medial prefrontal cortex (PFC) which “exerts inhibitory control over stress responses and

emotional reactivity in part by its connections with the amygdala” (p. 164).

Holistic Approach to Trauma

Adlerian Approach to Trauma

In speaking of the unity of the person and the importance of treating the whole

individual, Adler said: "It is always necessary to look for these reciprocal actions of the mind on

the body, for both of them are parts of the whole with which we are concerned" (Ansbacher &

Ansbacher, 1956, p. 225). Sweeney and Witmar (1991) further expound on this by stating that

“any part of the person could only be understood by understanding the unified, indivisible

whole” (p. 527).

From an Adlerian perspective, anxiety is a “fear of defeat”. In Ansbacher and

Ansbacher (1956), Adler states that the “fear of defeat is the only reason for the will to escape.

At the same time, it is the hardest of all reasons to admit” (p. 276). This will to escape or the


need to “run away” from situations in life may be “greatly strengthened and safeguarded by

the addition of anxiety” (p. 277). Social interest plays a role here in that an individual can be

so disconnected from others that any change in their status quo can bring about fear. This fear

can then extend itself to all relationships of human life (Reed, 2016).

Similar to an Adlerian perspective on anxiety and its relation to social interest, Hjertaas

(2009) discusses “basic anxiety” and that this can be viewed as a fear of not belonging. He

states that a “person with basic anxiety has to abandon most things connected with

interpersonal life in order to maintain a sense of security” (p. 49). In addition, many people

with anxiety have “feelings of inadequacy and inferiority…[which] constitute the primary

reason the person is sure that they cannot cope with a given situation” (p. 49). An individual

will attempt to control or manage their anxiety through various strategies. The most common

strategy is to withdraw from others and keep distance (both emotional and physical) from

others in spite of their desire to belong (Hjertaas, 2009; Reed, 2016).

When referring to trauma, Alfred Adler called it “shock”, not unlike the term “shell-

shock” that was coined for combat veterans who had experienced symptoms of trauma after

World War I. Adler stated that “we do not suffer from the shock of our experiences—the so-

called trauma—but we make out of them” (Ansbacher & Ansbacher, 1956, p. 208).

Adler said, “The more rigid the conviction, the greater the chance that some can be

traumatized” (Sperry, 2016, p. 166). An individual who is more rigid and inflexible within their

lifestyle may be more easily traumatized. The Adlerian perception is that these individuals will

safeguard themselves by clinging to the trauma as a form of distance-seeking (Sperry, 2016)—“it

is as if they believe that if they never move past that particular point in time, they can prevent the

traumatic event from happening again” (p. 166).


Adlerian five life tasks. Griffith and Powers (2007) outline the three “unavoidable”

tasks as observed by Adler. Adler saw them as “three problems [that] are irrevocably set before

every individual” (p. 64). They are (1) “the social task of living as one amongst others; (2) “the

work task” and that living on earth “made possible by the work of others, demands that we offer

something in exchange” and (3) “the love task” in that “each human being…must meet the

challenge of sexual cooperation, on which depends the future of humanity” (p. 64).

Rudolf Dreikurs and Harold Mosak, of the Alfred Institute of Chicago, proposed two

additional life tasks: (4) the fourth life task which is that an individual is “required to get along

with himself, how to deal with himself” (Griffith & Powers, 2007, p. 21-22) and (5) the fifth life

task, which is “the need to adjust to the problems beyond the mere existence on this earth and to

find meaning in our lives, to realize significance of human existence through transcendental and

spiritual involvement” (p. 22).

Social interest. Adler defined the term “social interest” as “the innate aptitude through

which the individual becomes responsive to reality, which is primarily the social situation”

(Ansbacher & Ansbacher, 1956, p. 133) and believed that social interest includes the ability “to

see with the eyes of another, to hear with the ears of another, to feel with the heart of another” (p.

135).

Adler (1969) maintained that “social feeling is actually a cosmic feeling…which lives in

us, which we cannot dismiss entirely and which gives us ability to empathize with things which

lie outside the body” (p. 73). As Sweeney and Witmer (1991) explain in their paper on social

interest, that “we are affected…by how we interpret and give meaning to what happens” (p. 530)

and that the “spiritual, inner component of self” is a significant factor in our response to either


real or imagined threats to our overall “well-being or social stature, as any other element of our

makeup” (p. 530).

Alternative Medicine and Trauma

Anodea Judith (2004) believes that “we live in a culture in which our ‘aliveness’ is

compromised and is taken for granted (p. ix). Some feel this compromise as a “rift” and

therefore work to heal themselves and find their life’s purpose. Judith (2004) calls this “the

journey of individuation and awakening” (p. ix) and that “the chakra system is a map for that

journey” (p. ix).

The chakra system. According to Judith (2004), “in order to understand a human being,

we have to examine the flow of energy through the system” (p. 9) and that “our understanding of

the chakras comes from a pattern analysis of energy flowing through a person’s body, behavior

and environment” (p. 9). Table 1 outlines the seven different chakra systems, their location in

the body along with their central themes and identity.

Chakra

System Name Location in Body

Central

Theme

Orientation to

Self Identity

One Root Base of spine Survival Self-preservation Physical

Two Sacral Abdomen, genitals, hips, low back Sexuality, emotions Self-gratification Emotional

Three Solar Plexus Solar Plexus Power, will Self-definition Ego

Four Heart Heart area Love, relationships Self-acceptance Social

Five Throat Throat Communication Self-expression Creative

Six Forehead Brow Intuition, Imagination Self-reflection Archetypal

Seven Crown Top of head, cerebral cortex Awareness Self-knowledge Universal

Table 1. The Chakra Systems (after Judith, 2004)

Judith (2004) discusses the development of the chakra system in both childhood and as an

adult, one being largely unconscious, while the other conscious. Judith states that “having an

awareness (chakra seven) of the body (charka one) allows us to differentiate from the body” (p.


45) which enables an individual to operate on the body and the physical world. The process of

individuation can evolve through the chakras.

Root chakra. The first chakra, the root chakra, centers around survival and its

completion indicates both “independence and self-sufficiency” (Judith, 2004, p. 47). This

chakra’s energy focuses on family and group safety and security, the ability to provide for life’s

necessities, the ability to stand up for one’s self, feeling at home and social and familial law and

order (Myss, 1996, p. 97).

Sacral chakra. The second chakra, the sacral chakra, centers around the formation of

sexual relationships and the “satisfaction of emotional needs” (Judith, 2004, p. 47). This

chakra’s energy focuses on blame and guilt, money and sex, power and control, creativity and

ethics and honor in relationships (Myss, 1996, p. 97).

Solar plexus chakra. The third chakra, the solar plexus chakra, centers around a

movement from dependency toward that of the creation of one’s own purpose. This chakra’s

energy focuses on trust, fear and intimidation, self-esteem, self-confidence, self-respect, care of

oneself and others, responsibility for making decisions, sensitivity to criticism and personal

honor (Myss, 1996, p. 97).

Heart chakra. The fourth chakra, the heart chakra, focuses on relationships and how an

individual perceives themselves within the framework of interpersonal relationships. Carl Jung

looked at the fourth chakra as the “midlife beginning of individuation, focused initially on the

balance between inner masculine and feminine, or animus and anima” (Judith, 2004, p. 48). This

chakra focuses on love and hatred, resentment and bitterness, grief and anger, self-centeredness,

loneliness and commitment, forgiveness and compassion, and hope and trust (Myss, 1996, p. 99).


Throat chakra. The fifth chakra, the throat chakra, centers around communication and

one’s personal contribution toward the community. It is a stage of creative expression and

“helps coalesce issues experienced in the previous stages” (Judith, 2004, p. 48). This chakra

focuses on the choice and strength of will, personal expression, following one’s dream, using

personal power to create, addiction, judgment and criticism, faith and knowledge and the

capacity to make decisions (Myss, 1996, p. 99).

Forehead chakra. The sixth chakra, the forehead chakra, is a stage of introversion and

reflection. It is a stage of exploration into areas such as “mythology, religion and philosophy”

(Judith, 2004, p. 48). This chakra focuses on self-evaluation, truth, intellectual abilities, feelings

of adequacy, openness to the ideas of others, ability to learn from experience and emotional

intelligence (Myss, 1996, p. 99).

Crown chakra. The seventh chakra, the crown chakra, is a “time of wisdom, spiritual

understanding, knowledge and teaching” (Judith, 2004, p. 48). It is in this stage that in

individual brings together all that they have learned up to this point in their life and passes it on

to others. This chakra focuses on the ability to trust life, values, ethics and courage,

humanitarianism, selflessness, ability to see the larger pattern, faith and inspiration, and

spirituality and devotion (Myss, 1996, p. 101).

A Connection and Presence Model for Trauma

Connections in Trauma Healing

Mandala image of connections. Carl Jung referred to a mandala as “the psychological

expression of the totality of the self” and that it is “a template for the mind, a state of peace and

order, a resolution of the chaos within” (Barreda, 2003, para. 1). Jung believed that the mandala

“compensates the disorder and confusion of the psychic state—namely, through the construction


of a central point to which everything is related” (Barreda, 2003, para. 2) and that this “central

point is the absolute seat of the self, the anchor for all the extraneous elements of your

environment and your psyche” (Barreda, 2003, para. 3). In the presence and connection model,

this central point is an individual’s core message, or “kerygma”.

Body - mind connection. The notion is that by being connected with one’s own body, a

person is forced to be present with their body. By connecting with one’s body, a person can

become more fully present with their body and in turn recognize that they are not in the

traumatic situation any longer. The modalities that may help with this connection include

acupuncture, EMDR, yoga, sensorimotor psychotherapy and somatic experiencing, among many

others.

Community - soul connection. For someone to truly share their story with another

person, there needs to be presence and connection. This is the central theme of Client-Centered

therapy wherein the therapist shows unconditional positive regard toward that client—they allow

the space in which the client can tell their story. This also involves connections with other

human beings through dance, music, or other kinesthetic practices of disciplines. We connect

with one another in each other’s presence.

Self - love connection. This connection is something that can get lost in trauma. Trauma

can disconnect a person from their love relationships and family members, as well as their own

skills and gifts that enables the “work” they do. The modalities involved in this connection

include meditation, spiritual direction, and other disciplines. It is through this connection that

posttraumatic growth may be possible.

Vocation – transcendence connection. The assumption here is that the presence and

recognition of something bigger than ourselves is necessary for total healing from trauma. Our


uniqueness and the sense of our specific gifts to offer the world as our “work” can get inhibited

by trauma. Victor Frankl’s logotherapy is an example of this—one’s life needs to have purpose

in order to survive.

Attachment theory and connection. Attachment theory was developed by John Bowlby

in 1982 (Levy, Ellison, Scott & Bernecker, 2011). The underlying principle here is that through

the bond of a caregiver, an individual develops the ability to regulate their emotions, particularly

when in emotional distress. An individual’s attachment style refers to the characteristic ways in

which they operate within, and relate to, their caregivers (Levy et al., 2011).

Attachment types. Children exhibit one of four patterns of attachment that are formed in

response to the context of their early experiences with caregivers: (1) secure; (2) avoidant; (3)

resistant or ambivalent; or (4) disorganized. The attachment patterns that manifest in adults are:

(1) secure; (2) preoccupied; (3) dismissing; or (4) disorganized (Becker-Weidman, 2009; Ogle &

Rubin, 2015). As Ogle and Rubin (2015) articulate, “over time, these beliefs become

internalized and shape mental representations of the self and others in close relationships, which

in turn influence how individuals perceive and cope with objective and subjective threats

throughout the life course” (p. 324).

Secure attachment. Adults with secure attachment tend to be (a) open, collaborative,

compliant, committed, and proactive in treatment, (b) trusting of therapists, and (c) able to

integrate therapists’ recommendations (Levy et al., 2011, p. 195). They have the capacity to

view others with few distortions and value relationships and emotions (Becker-Weidman, 2009).

Preoccupied attachment. Adults with preoccupied attachment characteristics tend to be

interpersonally engaged. However, their narratives lack coherence and these individuals “tend to


be preoccupied with or by past attachment relationships and experiences” (Becker-Weidman,

2009).

Dismissing attachment. Adults with a dismissing attachment style “are often resistant to

treatment, have difficulty asking for help, and retreat from help when it is offered” (Levy et al.,

2011, p. 195). Their “narratives tend to be general, nonspecific and excessively brief” (Becker-

Weidman, 2009).

Disorganized attachment. The adult with a disorganized pattern of attachment has often

experienced chronic early maltreatment within a caregiving relationship and may be described as

having significant dysfunction in their capacity to form emotionally meaningful relationships and

attachments (Becker-Weidman, 2009). In addition, disorganized attachment develops if a

caregiver is both the source of trauma and the only source of potential comfort. It is this type of

attachment that has been shown to be related to traumatic experiences, especially those with

caregivers (Maltby & Hall, 2012).

Attachment and trauma. Maltby and Hall (2012) examined the interactions between

trauma, attachment and spirituality to ultimately provide a way of addressing these interactions

through psychotherapy. There are both implicit and explicit processing systems within our

brains. The explicit system processing information slowly and deliberately and is responsible for

our behaviors that are intentional. The implicit system processes information quickly and

unconsciously. Attachment-related information is processed predominantly by the implicit

system.

In both disorganized attachment and the experiences of complex traumatic stress, there is

a breakdown between the implicit and explicit memory systems such that it becomes impossible

to create a narrative, or spiritual story, by which to exist. Therefore, the goal of therapy is to


address the interactions of trauma, attachment and spirituality in order to align the implicit and

explicit memories. The theory holds that relationships with others and with the greater universe

[and God] will be significantly and positively affected.

Attachment theory and therapeutic presence. Bowlby, trained as a psychologist and

psychiatrist, believed it was important for the “therapist to become a reliable and trustworthy

companion in the patient’s exploration of his or her experiences” (Levy et al., 2011, p. 193). In a

sense, the therapist develops a positive attachment style with the individual.

A study by Levy et al. (2011) showed that “clients’ attachment security also tends to be

positively associated with therapeutic alliance” (p. 201). Levy et al. (2011) noted that an

individual’s attachment style “will provide important clues as to how the patient is likely to

respond in treatment and to the therapist” (p. 201). In fact, Levy et al. (2011) asserts that

“attachment style can be modified during treatment” and “could be considered a goal of

treatment” (p. 201).

Wylie and Turner (2011) assert that “the therapeutic connection happens…through a

relational unconscious in which one unconscious mind communicates with another unconscious

mind” and that this is a paradox—i.e., “the therapist must consciously create the conditions

under which their unconscious mind takes over and communicates with the unconscious mind of

the client” (p. 18). In essence, “the therapist isn’t just an observer of the client’s emotional

journey or even a disinterested guide, but a fellow traveler, resonating with the client’s sadness,

anger, and anxiety” (p. 11).

A fundamental basis for attachment-based psychotherapy is that the client can experience

a change in their own attachment processing through a positive attachment experience with the

therapist. Through this relationship and the alignment of the implicit and explicit processing


systems of the brain, traumatic memories can be integrated into the person as a transformative

experience bringing them into a feeling of being whole (Maltby & Hall, 2012).

Adler’s view is consistent with research in attachment theory. There is much empirical

evidence for the notion that a child’s early experience drives their development. For a child

who exhibits anxious/resistant attachment there is an increase in the probability of anxiety

disorders (Hiertaas, 2009; Reed 2016; Siegel & Srouge, 2011).

Presence in Healing Trauma

The term “presence” in this model refers to (1) the presence of mind (with a practitioner)

through counseling approaches that are client-centered and strengths-based; (2) the presence of

body (with oneself) by aiding clients with dissociative experiences through modalities such as

Somatic Experiencing, EMDR, and Brainspotting; and (3) the presence of spirit (with purpose)

that includes the connection between trauma and spirituality (i.e., the value of purpose in healing

which can lead to post-traumatic growth) and meaning-making in trauma.

It has been noted that more than the theoretical orientation of the therapist, the

receptiveness, availability and authenticity of the therapist is what gives power to the healing

process for a client. To be fully present with a client, a therapist needs to detach from his- or

herself and his or her thoughts concerning theory and fully embrace the experience and

uniqueness of the client. It is like the concept of unconditional love. A therapist allows him- or

herself to see the person in front of them only as how they are presenting themselves and their

thoughts and emotions with no judgement attached. There is the space between which two

people who are fully present with one another that allows for healing to take place.

Geller and Greenberg (2002) developed a foundation for a working model on therapeutic

presence from outcomes of their study that included three different “emergent domains”: (1) the


preparation involved to achieve a sense of presence by the therapist before seeing a client; (2) the

process that a therapist goes through while engaged with a client in session in order to maintain

presence; and (3) the actual experience of presence by the therapist during the session with a

client. For the process domain (2), three different subcategories were developed which include

the following: (a) receptivity; (b) inwardly attending; and (c) extending and contact. These

subcategories reflect how the therapist receives the client’s experience and processes that

experience within their own selves, and then outwardly expresses resonance and connection with

the client as one human being to another. This receptivity can be expressed as “listening with

one’s eyes”. It is, as the authors also suggest, “seeing through all perceptions in a sense.” There

is enhanced intuitiveness, timelessness and an enhanced awareness that accompanies true

presence between a therapist and a client. It is a state of being in the moment without distraction

to anything else. Geller and Greenberg (2002) say that “with presence, the therapist is as close

as possible to the client’s experience while maintaining a sense of self as separate and whole” (p.

84).

The presence of mind. The presence of mind may involve the presence of another (i.e.,

counselor) to share the trauma narrative with the individual who has experienced trauma.

Person-centered therapy. With a person-centered approach, the therapist allows the

client to lead the conversation in the direction they are comfortable pursuing. Research and

literature on a person-centered approach to trauma is very limited. Carrick (2014) aimed to look

at therapists’ views of this type of approach (from a qualitative perspective) when working with

clients who are in crisis. This is a non-directive approach and this study looked at how this type

of approach may be helpful for clients who have experienced trauma. The qualitative interviews

resulted in some key points to consider regarding the use of a person-centered approach to


trauma. Firstly, the therapists who were interviewed overwhelmingly “valued crisis work” and

felt they were able to engage more deeply with their clients who were in crisis and that they were

able to establish more of a “real” connection with them. This connection seemed to take longer

with non-crisis clients than with clients in crisis. There is a hesitancy to use diagnostic labels

among person-centered therapists. Even though the clients in crisis may meet the criteria for

PTSD, the therapists’ main concerns were not to reduce clients’ levels of distress, but to maintain

their focus on the connection and relationship between the therapist-client and subsequent post-

traumatic growth and meaning that can potentially result from trauma.

According to Carl Rogers, person-centered therapy was developed as a way to facilitate

clients toward becoming a “fully functioning” being. The term “fully functioning” in Rogers’

mind was a person who was constantly changing, constantly in process. This means that all

aspects of the person’s self is accepted, including the trauma, and that the person is fully

immersed in the present and experiences the present moment to its fullest. The therapist is the

instrument through which treatment is provided (Joseph, 2015; Sommers-Flanagan, 2015, p.

100). Building trust and the close relationship with the client is the first step and of the utmost

importance (Reed, 2017).

There is certain level of depth that is experienced by clients in crisis as well as the

therapists who work with these clients. It is as if they have seen the world from a completely

different lens and are struggling with the meaning of life and their existence. It is at this level

that a deep connection can be made between the client and therapist, and through this connection

a space for healing is created. In a crisis, Carl Rogers believed that the traumatized individual’s

self-concept changes, and in addition to that change, he or she also experiences “threat”. This


can affect an individual’s perception of reality as both their internal and external worlds undergo

a shift (Carrick, 2014; Reed, 2017).

Strengths-based approach to trauma. People are inherently self-healers. People may

consider why traumatic events might have occurred, identify heretofore unrecognized strengths,

and develop new skills that might lead to developing new ways of seeing themselves and the

trauma. By embracing the belief that trauma-related reactions are adaptive, therapists can begin

relationships with clients from a hopeful, strengths-based stance that builds upon the belief that

their responses to traumatic experiences reflect creativity, self-preservation, and determination.

Therapists may develop intervention and coping strategies that are more likely to fit their client’s

strengths and resources. In addition to shaping beliefs about acceptable forms of help-seeking

behavior and healing practices, culture can provide a source of strength, unique coping strategies,

and specific resources (Reed, 2017; Slattery & Park, 2015; Substance Abuse and Mental Health

Services Administration (SAMHSA), 2014).

A strengths-based, resilience-minded approach lets trauma survivors begin to

acknowledge and appreciate their fortitude and the behaviors that help them survive. Fostering

individual strengths is a key step in prevention when working with people who have been

exposed to trauma. It is also an essential intervention strategy—one that builds on the

individual’s existing resources and views him or her as a resourceful, resilient survivor.

Individuals who have experienced trauma develop many strategies and behaviors to adapt to its

emotional, cognitive, spiritual, and physical consequences. It is important for providers to

engage in interventions using a balanced approach that targets the strengths clients have

developed to survive their experiences and to thrive (Reed, 2017; SAMHSA, 2014).


Knowing a client’s strengths can help therapists understand, redefine, and reframe the

client’s presenting problems and challenges. By focusing and building on an individual’s

strengths, therapists and other behavioral health professionals can shift the focus from “What is

wrong with you?” to “What has worked for you?” It moves attention away from trauma-related

problems and toward a perspective that honors and uses adaptive behaviors and strengths to

move clients along in recovery (Reed, 2017; SAMHSA, 2014).

The presence of body. The trauma “triggers” that survivors experience can send them

down a cascade of physiological reactions as their system goes into hypervigilance and the

sympathetic nervous system is activated. To help alleviate this cascade, trauma survivors can

learn to stay present in the moment and allow themselves and their bodies to understand and

realize that they are not experiencing the trauma now. Movement therapies that involve the

mind-body connection, such as yoga, can aid in the ability to stay focused on the present.

Yoga. Bessel van der Kolk, MD, a leading expert in the field of trauma studies and

posttraumatic stress disorder, is the founder of Center for Trauma in Massachusetts and provides

a framework based on how the “body heals itself” with regard to trauma (van der Kolk, 2014).

Allowing oneself to be present through a mind-body modality such as yoga, aids in reducing the

symptoms of trauma by fostering that connection to confirm that they are no longer in the

traumatic situation.

Gurda (2016) proposes that “the theory of why yoga works as a therapy for PTSD is

rooted in neurobiological research that indicates traumatic experiences leave lasting ‘imprints’ in

an individual’s sensory and hormonal systems” (p. 781). This results in individuals

“continuously experiencing a traumatic state, which causes them to lose their orientation to

themselves and the world” (p. 781). The theory behind the efficacy of yoga for the reduction of


PTSD symptoms is that it helps “traumatized bodies take effective action and regain natural

movement through physical practice” (p. 781).

A study by Rhodes, Spinazzola, and van der Kolk (2016) suggests that the frequency of

the yoga practice correlates to decreases in the symptoms associated with PTSD (i.e., more

frequent yoga practice over extended periods of time may reduce the perceived symptoms of

PTSD and depression).

In another study by Mitchell (2014), results showed that the “yoga group had significant

decreases in PTSD symptoms, including reexperiencing and hyperarousal symptoms,

specifically” (p. 126). However, “no significant differences in symptoms were observed

between the intervention and the control groups” (p. 126). These results prompted the authors to

consider factors that were common to both groups that may have contributed to this finding (i.e.,

reduction in PTSD symptoms by both the study and control groups). They surmised that regular

group assessment meetings that were offered to both groups may have provided an element of

behavioral activation for participants, and that the “warm and empathic attention from the study

team may have had a positive impact on participant symptoms” (p. 126).

Sensorimotor therapy. As our understanding of trauma increases, there has been an

expanding awareness of the somatic treatment of clients who have experienced trauma and

trauma-related stress, such as that associated with PTSD. Pat Ogden, PhD is a pioneer in

sensorimotor psychotherapy and has argued that a relationship exists between cognitive and

emotional processing and sensorimotor processing. This processing is kept “alive” in traumatic

memories due to the theory that trauma is stored as “procedural memory”; i.e., this type of

memory involves “conditioned sensorimotor responses” that can be activated through various

internal or external prompts. This interaction keeps the trauma memory alive, as if it is still


happening in the present. The theoretical basis of Ogden’s sensorimotor psychotherapy is that

the cognitive, affective, and somatic responses to trauma need to be integrated into a person’s

body to become whole again. It is, in its essence, a holistic approach to treating trauma (Ogden,

2015).

A study by Langmuir, Kirsh, and Classen (2012) included 10 women (ages 31-65) with a

history of interpersonal trauma. The goal of the study was to teach the participants various skills

that would aid in their sense of stabilization and reduce their PTSD symptoms, specifically

dissociation. The method utilized was a 20-session group intervention based on the principles of

somatic psychotherapy. The results of this study provided preliminary evidence that a therapy

group based upon sensorimotor psychotherapy techniques aimed at helping clients reconnect

with their body awareness may reduce trauma symptoms.

Somatic Experiencing. Somatic Experiencing® (SE™) is a “potent psychobiological

method for resolving trauma symptoms and relieving chronic stress” that is “designed to resolve

traumatic stress and increase the capacity to negotiate stress and trauma” (Kelley, 2017). Peter

Levine, PhD, the founder of SE, asked the question “why is it that animals in the wild, who are

repeatedly exposed to life-threatening events, don’t develop the symptoms of PTSD like

humans?” (Kelley, 2017). The answer, he discovered, was that “all animals (including humans)

have a natural ‘immunity’ to the long-term, debilitating effects of trauma” (Kelley, 2017). Dr.

Levine discusses how “somatic therapies broaden traditional approaches to trauma treatment”

(See Table 2). According to Levine, “CBT significantly reduces symptoms short-term but

mounting research suggests long-term there are high relapse rates and clinical ineffectiveness for

some disorders” (Kelley, 2017).


Cognitive Approaches Somatic Approaches

Focus on how thoughts influence emotions and

behaviors (“top-down”)

Focus on how the body influences thoughts,

emotions and behaviors (“bottom-up”)

Help identify distorted cognitive beliefs and

maladaptive behaviors

Help people become aware of body sensations and

procedural memories

Target reduction of symptoms Target underlying dysregulation in the nervous

system that causes and maintains symptoms

Help create more adaptive self-beliefs and

behaviors

Help create a greater control of debilitating

symptoms and unconscious dynamics

Rely on insight and behavior change Rely on body awareness and physiological

regulation

Table 2. Cognitive versus Somatic Approaches to Trauma (after Kelley, 2017)

Brainspotting. Brainspotting is a brain-based method of working through the blockage

in the traumatic memory without the use of words. It uses an individual’s natural capacity to

self-heal by following a “brainspot”, which is the position of the eye in the visual field that is

associated with the activation of trauma. Clients become attuned to their inner experience as

they release emotions that are typically out of their consciousness. Therapists trained in

Brainspotting can recognize when the blockage has been cleared.

Brainspotting is a brain-based dual-attunement model of treatment (Gurda, 2016, p. 784)

and was discovered in 2003 by David Grand, Ph.D. In his book on Brainspotting, Grand (2013)

affirms that “Brainspotting is built on a model where the therapist simultaneously attunes to the

client and the client’s brain processes” which contrasts with EMDR wherein “the therapeutic

alliance and attuned relationship with the client does not receive enough attention” (p. 3). Grand

was utilizing EMDR with his patients when he discovered the technique of Brainspotting. He

modified the normal pace of the dual attunement used in EMDR and stopped his movements

when an individual’s gaze was at a spot where their eyes began to “wobble”. It is theorized that


it is at this particular point (at which the individual’s gaze is fixed and begins to “wobble”) that

the brain has anchored the location of the trauma.

The theoretical explanation of Brainspotting is that “brainspots (i.e., specific eye

positions) are physiological subsystems related to the energetic and emotional activation of a

trauma and facilitate direct access to the autonomic and limbic systems” (Gurda, 2016, p. 375).

By processing the trauma while focused on these brainspots the resolution of traumatic

experiences can take place. From a neurophysiological perspective, it is hypothesized that the

brainspots and bilateral stimulation of the brain “down-regulate the amygdala, facilitate

homeostasis, and result in deconditioning of maladaptive response patterns, thus enabling the

body’s innate tendency toward self-healing” (Gurda, 2016, p. 375) and subsequent release of the

trauma. Brainspotting utilizes “internal resources of strength and groundedness” (Gurda, 2016,

p. 375) to allow movement back and forth between positive states and trauma states in order to

contain the processing of trauma.

The presence of spirit. Kick and McNitt (2016) define spirituality as an “individual’s

existential relationship with God (or perceived transcendence)” (p. 103) and that it is “connected

to having a sense of purpose” (p. 104). This connection brings individuals to a sense they are a

part of something bigger, to a larger “whole”. There is a “yearning within the human being for

meaning, for that which is greater than the encapsulated individual” (de Castella & Simmonds,

2013, p. 537).

Along with the idea that spirituality is a connection with something greater than

ourselves, spirituality can also be seen as a law of the universe which is a communication with a

higher power and the greater community of others when an individual is true to their core

message (i.e., true to their self). The universe responds to this truth and synchronicity is created.


Carl Jung (1960) writes that “synchronistic events rest on the simultaneous occurrence of two

different psychic states” and that one of these states is a “normal, probable state, and the other,

the critical experience, is the one that cannot be derived causally from the first” (p. 28-29).

Synchronicity can be described as “an unexpected content which is directly or indirectly

connected with some objective external event [coinciding] with the ordinary psychic state” (p.

29).

Trauma and spirituality. Kick and McNitt (2016) elucidate the idea that “stories are a

critical mechanism in our ability to transform our lives, including our lives after trauma” (p.

108), and that “eliciting a view of spirituality…helps create a narrative of the trauma story” (p.

103). Creating a narrative of the trauma story including “spiritual beliefs can assist clients in

finding meaning…to the traumatic event” (p. 104). An individual’s spirituality and their

narrative about the trauma “may achieve their transformative nature due to [their] ability to have

contact with ‘possible’ selves” (p. 108).

Spirituality and therapy for trauma. De Castella and Simmonds (2013) state that the

“integration between spiritual, and personal or psychological growth has been recognized as

important for healthy development” (p. 549). Currier, Holland and Drescher (2015) note that

“whether working with trauma survivors or otherwise, therapists seldom receive formal training

for addressing spirituality in their work” (p. 58). A study by Currier, Holland, and Drescher

(2015) supports the utility of a spiritually integrative perspective on combat-related PTSD and

reports that it “represents the first attempt to demonstrate that domains of spirituality have

important prognostic value for persons seeking treatment for this condition” (p. 63).

Logotherapy. Viktor Frankl developed the theory and practice of logotherapy. Frankl

(2006) writes that “logos is a Greek word that denotes ‘meaning’ (p. 98) and that “this striving to


find meaning in one’s life is the primary motivational force in man” (p. 99). In logotherapy, an

individual is “confronted with and reoriented toward the meaning of life” (p. 98) and “this

meaning is unique and specific” in that it can only be fulfilled by the individual. “Only then

does it achieve a significance which will satisfy his own will to meaning” (p. 99).

Meaning-making in trauma. Adler stated that “meanings are not determined by

situations, but we determine ourselves by the meanings we give to situations” (Ansbacher &

Ansbacher, 1956, p. 208), which refers “to the lifestyle” (Sperry, 2016, p. 165). Trauma is an

event so discrepant from a person’s meaning system that it alters or damages that person’s

meaning system (Slattery & Park, 2015). Kick and McNitt (2010) explain that “trauma places

individuals beyond their normal systems of meaning, strains current methods of coping, and

disrupts psychosocial functioning” (p. 103).

Trauma affects many people’s physical, spiritual, and psychological well-being,

interfering with their ability to connect with something larger than themselves. Meaning

comprises not only beliefs but also identity, values, goals and sense of purpose. People with

PTSD have difficulty consolidating trauma into their current meaning system. Meaning systems

provide the general framework through which individuals structure their lives (global meaning),

guiding their appraisals of specific encounters with their environment (appraised meaning).

Global meaning has an emotional aspect, which refers to the extent to which people experience a

sense of meaning, purpose in life, or connection to something greater than themselves (Slattery

& Park, 2015, p. 127-129). The meaning-making process helps people reduce their sense of

discrepancy between appraised and global meanings and restore a sense of the world as

meaningful and their lives as worthwhile and having purpose. When meaning-making is


successful, it can result in improved well-being as well as perceptions of posttraumatic growth or

positive life-changes (Slattery & Park, 2015, p. 131-134).

Vilenica, Shakespeare-Finch, and Obst (2013) explored the process of meaning-making

in healing and growth after childhood sexual assault. Individuals who experience childhood

sexual assault (CSA) are more likely than other trauma survivors to not only develop PTSD, but

to endure PTSD symptoms over a lifetime. This article presents two case studies of CSA and

their similarities in pathways to healing, which involved the process of making meaning out of

their experiences. One of the most damaging aftereffects of CSA is an individual’s loss of

connection with themselves. In addition, to this loss of connection, the connection is

supplemented with negative beliefs about themselves and the world. Being able to re-establish

this connection to themselves is paramount to healing. “Meaning making” in this article refers to

a process of transformation—one in which the individual reconstructs themselves in order to see

themselves as whole by obtaining a consistent view between themselves and the world (internal

and external coexistence). Both groups of women experienced a change in their core beliefs. It

is through developing a new set of beliefs that individuals can see their experience from a new

perspective.

Post-traumatic growth. De Castella and Simmonds (2013) state that “survivors of

trauma often experience a sense of fundamental change in themselves and their worldview as

they struggle to integrate their experiences into their lives and work to rebuild their assumptive

world” (p. 549). A study by de Castella and Simmonds (2013) found that “for some people, the

experience of trauma may stimulate a search for meaning that is conducive to increased spiritual

and personal growth” (p. 553). Some of the study participants discussed the “importance of

deliberately confronting and experiencing the pain of their trauma in order to grow deeper and


stronger”, which is profoundly in contrast with their perception that there is “culture of

avoidance in our society”—these participants chose to “accept suffering and to embrace difficult

experiences for the purposes of healing and growth” (p. 545) and give example to the idea that

trauma survivors can experience “a more profound sense of meaning and purpose in life, a

deeper sense of spirituality, and strengthened faith” (p. 537).

The term “post-traumatic growth” (PTG) was initially coined by Richard Tedeschi and

Lawrence Calhoun back in 1995 in order to describe positive changes that people describe

subsequent to experiencing adverse events or trauma. PTG encompasses three broad categories

of positive change: (1) relationships have deepened in a way and to a level that was not

previously experienced; (2) self-concepts change to include for example, a greater sense of

strength and wisdom; and (3) life philosophies and sense of meaning have changed (Joseph,

2015; Werdel, Dy-Liacco, Ciarrocchi, Wicks, & Breslford, 2014). Post-traumatic growth “refers

to the capacity of some people to not only return to their pre-trauma level of functioning, but also

to use their experiences as a springboard to further personal growth” (de Castella & Simmonds,

2013, p. 537).

According to Joseph (2015), people are inherently motivated toward PTG and stress

related symptoms post-trauma is a normal and natural process for how a body would respond to

trauma. The person-centered approach to therapy may help facilitate PTG. Joseph (2015)

explored the idea of a person-centered approach (PCA) to treating psychological trauma and how

a PCA can be related to PTG. The PCA is not currently recognized to a great extent for treating

trauma and Joseph (2015) attempts to bridge the gap between PCA with PTG by first opening a

dialogue supporting the idea that PCA is a valuable approach to treating trauma. By allowing the


client to direct themselves through the presence of an attuned therapist, healing and the potential

for posttraumatic growth can take place.

Not everyone who experiences trauma will experience PTG. It has been shown that PTG

correlates with a variety of environment and personal factors. These factors include the level of

distress, social support, personality, and how an individual’s personality affects their perception

of traumatic experiences. A study by Werdel et al. (2014) found that the positive or negative

emotions that are formed post-trauma are dependent upon (1) individual personalities; (2) social

support, (3) mature faith, and (4) absence in the belief of a punishing “God”. This study found

that it was with this last belief system (i.e., belief in a punishing or absent “God”) that

contributed the most significantly with regard to the process of PTG.

This study highlights the potential need to include a spirituality assessment as part of the

intake process when working with clients who have experienced trauma. In addition to the

intake assessment, an individual’s sense of spirituality and how they have incorporated this into

their belief system and sense of self and the world could prove invaluable to therapy and aiding

in the client’s healing process.

Creating a narrative around trauma. “There are two major ways that the client can

remember and, to some extent, reexperience traumatic events during the process of treatment: (1)

by describing them in detail; and (2) by writing about them” (Briere & Scott, 2015, p. 156).

Briere and Scott (2015) go on to state that though “it is likely that narrative coherence is a sign of

clinical improvement, it also appears that the development of an integrated version of one’s

trauma has a positive effect on recovery” (pp. 159-160) and that “increased coherence is directly

associated with reduction in posttraumatic symptoms” (p. 159).


Becoming aware of our belief system (and mistaken beliefs) is the first step to change.

When these beliefs are connected to specific events and stories it allows for the possibility of

seeing these beliefs as formed from a sense of survival. By incorporating alternative or new

beliefs that resonate with the individual as being “true”, a sense of self can be reimagined and

experienced.

The Kerygma Project

Finding One’s True Self After Trauma

The essence of The Kerygma Project is the belief that everyone has a message to give the

world that resonates with their true self. When one lives from their true self, the world aligns

with them in synchronicity. This is a law of the universe and the essence of spirituality. Trauma

can create a perceived disconnection from one’s true self. This perception can be transformed

through integration of the trauma into one’s being.

Sense of self. A sense of self is tied to the notion of knowing one’s “kerygma” or core

message. At the core of every human being, there is something that makes each individual

unique. It defines us. Once an individual becomes aware of what that is, doors to synchronicity

can be opened. One’s uniqueness can be stolen through trauma or devalued by our society. By

finding the deeper reasons for hiding the “self”, an individual can begin to find their “home”

within themselves and live from there. The goal is to make “a home that we ourselves can

inhabit, of investing our deepest passions in ideas that we ourselves can wear out” (Heisig, 1997,

p. 267).

There is a sense that our world isn’t “real” or “enough” when we are not living from our

true selves. Heisig (1997) notes that “ultimately the only true Self is the eternal quest of the


Self” (Heisig, 1997, p. 267). People need to learn how to distinguish between what they believe

about themselves and what they have been made to believe (Heisig, 1997).

Traumatic events often lead individuals to a sense of self that is one of “incompetence,

inferiority, degradation, depersonalization, or identity diffusion” (Horowitz, 2015, p. 193).

Therapists can help individuals control their symptoms, improve their emotional regulation, and

achieve a sense of PTG in their own identity as well as their relationships “by facilitating

narrative structures about new aspects of the self and how existing self-schemas are harmonized”

(p. 193)

Defining kerygma. The term “kerygma” is defined in this experiential project as the core

message everyone possesses that resonates with how they see the world. A kerygma is a

declaration to oneself regarding an individual’s purpose in how they navigate through the world,

according to their lifestyle.

Organization of The Kerygma Project. The Kerygma Project is an idea for a non-profit

center that would provide direct services as well as an educational and training center on holistic

and spiritual approaches to treating trauma, offering learning opportunities to students and

professionals. This center will be sensitive to the needs of an increasingly multicultural

Minnesota. First, the model itself draws from the healing traditions of other cultures. Second,

the center will design its services in consultation with a Diversity and Multicultural expert. In

addition, this non-profit center will partner with other non-profits in whatever ways are

congruent with its mission statement to serve community needs.

Three different areas of The Kerygma Project are envisioned. Each area would have its

own source of funding (See Table 3).


Direct Services Education and Training Consultation

Counseling, SE Trauma healing trainings Consult with organizations to

implement the philosophy and

tools around trauma and its

healing

EMDR, Brainspotting Professional Conferences

Body Work (e.g., yoga, acupuncture) Continuing Education

Table 3. The Kerygma Project Services

Core values. The following core values have been proposed for The Kerygma Project at

the time of this writing: (1) We believe everyone has a message to give the world that resonates

with their true self. We believe that when we live from our true self, the world aligns with us in

synchronicity; (2) We believe that trauma creates a perceived disconnection from our true self.

We believe this perception can be transformed through integration of the trauma into our beings;

(3) We believe that everyone should have access to healing from trauma and that finding one’s

true self is transcultural; (4) We believe there is no one path to healing trauma and each

individual will have their own journey and timeline; (5) We believe that integrative and holistic

care involves a team of practitioners and healers who align themselves with each other and the

individual’s kerygma (i.e., core message) in order to guide them toward a life of quality and

contribution; (6) We believe that spirituality is an important element for healing trauma; and (7)

We believe that spirituality is a law of the universe that communicates with a higher power and

the greater community of others when an individual is aligned with their true self.

Mission statement. The following mission statement has been proposed for The Kerygma

Project at the time of this writing: The mission of The Kerygma Project is to provide education

and training on the importance of spirituality in the integrated approach to healing trauma and

that every individual has a core message for the world that aligns with their true self.

Assessments and outcomes measurements. Multiple assessments and outcomes

measurements tools will be utilized for The Kerygma Project. A list of forms is provided in

Appendix C.


Data collection and feedback procedures. Data will be collected from forms for intake

procedures that will include a section on spirituality, trauma and grief assessments to be gathered

and monitored at designated time intervals, as well as a Post Traumatic Growth inventory and the

Changes in Outlook Questionnaire which will be given at longer intervals, perhaps every 6

months, depending on the client. Outcomes measurements will be collected using both the

Session Rating Scale (given to client at end of each session) and the Outcomes Rating Scale

(given to client on monthly or bi-monthly basis) (Reed, 2017).

Data will also be collected at the end of each client’s treatment for practice-based

evidence. Practice-based evidence includes “not only gathering data on how treatment is working

for a particular client and therapist pairing but also then providing feedback to the therapist about

the client’s improvement” (Sommers-Flanagan, 2015, p. 104). This informs future treatment

through a collaboration process between the client and the therapist to determine what the client

needs as they move through the healing process (Reed, 2017).

When obtaining feedback from a client, it is important to keep in mind that healing is a

process, not an event. Therefore, feedback received at the end of treatment involves a

comprehensive evaluation from the client around questions such as the following:

1. What did this journey look like for you?

2. What was most helpful?

3. What was not helpful? (Reed, 2017)

Outcomes management and evaluation. Outcomes management encompasses the

following: (1) Designating activities that use the client’s actual response to treatment, the

outcome, to improve the treatment response of individual clients and (2) The administrators’

collective use of summed data across clients to make decisions for the benefit of future clients


(Duncan, Miller, Wampold, & Hubble, 2009). Questions, such as the following, will be asked in

order to evaluate The Kerygma Project’s model for healing trauma:

1. Are clients being helped?

2. What methods, interventions, and programs are most helpful for clients?

3. How satisfied are clients with services received?

4. What are the long-term effects of counseling programs and services?

5. What impact do the services and programs have on the larger social system?

6. What are the most effective uses of program staff?

7. How well are program objectives being met? (Astramovich & Coker, 2007, p. 166; Reed,

2017)

Process summary. The intake process will include not only the use of intake forms, but

also the use of the mandala (see Appendix A), to walk client’s through areas of disconnection.

Therapists will use both person-centered and strengths-based approaches with clients and

assessments to evaluate clients’ current states and areas for future growth. The therapist and

client will collaborate on goals for treatment, and data will be collected on the client’s

perspective for each session using the Session and Outcome Rating Scales. The treatment plan

will be adjusted as the client moves through the healing process, continually looking at the

client’s core message (i.e., kerygma) (Reed, 2017).

Conclusion

Healing trauma through a model of presence and connection focuses on an individual’s

core message and what it means to be “whole”. It involves the combination of integrative and

complementary approaches to healing and the connections that exist between the mind, body and

spirit and the five life tasks of Adlerian theory. Because of its impact, trauma exposes the


disconnections that can happen within an individual. The Kerygma Project offers a new way of

looking at healing trauma—this model lives within a mandala image for which individuals can

relate to and envision a new way of being. A truly integrative approach to healing trauma

involves reconnection through presence and an ultimate search for one’s true self. The Kerygma

Project brings this notion to realization.


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APPENDICES


Appendix A: Mandala Images


Mandala of “Healing Trauma through Presence and Connection”

Figure 1 of 10 of Mandala

Figure 1. Beginning mandala representing an alternative medicine focus of mind, body and

spirit, along with the Adlerian five life tasks of love, community, vocation, self and

transcendence. These all connect to and through a person’s core message, represented in the

center of the mandala.




Figure 2. The modalities that can exist between each of the connections made by the mind,

body, spirit and the Adlerian five life tasks.




Figure 3. The first chakra, the root chakra, is added to the model to highlight its connection to

the mind and body between which it is embedded in the mandala.




Figure 4. The second chakra, the sacral chakra, is added to the model to highlight its

connection to the body and community between which it is embedded in the mandala.




Figure 5. The third chakra, the solar plexus chakra, is added to the model to highlight its

connection to the community and one’s vocation between which it is embedded in the

mandala.




Figure 6. The fourth chakra, the heart chakra, is added to the model to highlight its connection

to one’s vocation and love and relationships between which it is embedded in the mandala.




Figure 7. The fifth chakra, the throat chakra, is added to the model to highlight its connection

to love and relationships and the mind between which it is embedded in the mandala.




Figure 8. The sixth chakra, the forehead chakra, is added to the model to highlight its

connection to the mind and soul between which it is embedded in the mandala.




Figure 9. The seventh chakra, the crown chakra, is added to the model to highlight its

connection to the soul and transcendence between which it is embedded in the mandala.




Figure 10. This final and complete image of the mandala shows the final triangle at the top,

which is the true self—this is achieved by going through the stages of self around the

perimeter of the mandala back up to transcendence. Treating trauma from the holistic

perspective of mind-body-spirit and the five life tasks of work, love and family, community,

deeper self, and transcendence can serve as a foundation for self-discovery and wholeness. For

some individuals working through trauma can open opportunities for profound growth in the

life tasks. The model also includes the chakra system by integrating them into each

connection. These connections ultimately point toward a person’s true self and the “core

message” they have for the world.


Appendix B: Business Plan


Business Plan for The Kerygma Project (p. 1 of 10)


Appendix C: Client and Provider Forms


Client and Provider Forms for The Kerygma Project (p. 1 of 2)

The following list of forms is not all-inclusive. However, this list gives an overview of the types

of assessments and outcomes measurements tools that will be utilized for The Kerygma Project.

Intake Form – This form will provide practitioners with the appropriate background information

on each client. The form will include, but not necessarily be limited to the following categories:

Presenting problems, personal treatment goals, current symptoms, suicidal ideation, past

medical and psychiatric history, family history, substance and tobacco use, educational

history, occupational history, relationship history and spiritual life.

The Kiersey Temperament Sorter (KTS-II) – This is a personality assessment that utilizes 70

questions to help individuals discover their personality type. This assessment is based on the

Kiersey Temperament Theory developed by Dr. David Kiersey (Kiersey.com, n.d.).

Attachment Style Questionnaire – This questionnaire is designed to measure an individual’s

attachment style (i.e., the way in which they relate to others in the context of intimate

relationships). This questionnaire was based on the “Experience in Close Relationships (ECR)

questionnaire first published in 1998” (Levine & Heller, 2012, p. 39-47).

Adult Attachment Interview Protocol (AAI) – This assessment is an interview that a

practitioner gives to a client to understand more about the client’s childhood experiences and

how these experiences may have affected their adult personality. The questions focus mainly on

the client’s early childhood, but also include questions on their adolescent experiences and

current presenting problems (George, Kaplan & Main, 1985).

Meaning of Life Questionnaire (MLQ) – This assessment was developed at the University of

Minnesota and asks questions about an individual’s perception of what makes life important to

them. Answers are on a Likert scale ranging from 1 (Absolutely True) to 7 (Absolutely Untrue)

(Steger, n.d.).

Life Style Inventory (LSI) – This assessment was developed as a “user friendly” form to record

aspects of an individual’s lifestyle (as defined by Alfred Adler). This form includes categories of

sibling constellation and shared traits and/or interests, childhood physical development,

elementary school information, childhood gender and sexual information, childhood social

relationships, parental relationships during childhood, additional parental figures and adult

models, and early recollections (Mosak & Shulman, 1988).

Social Interest Index (SII) – This assessment tool measures a client’s level of social interest.

Social interest is a term developed by Alfred Adler that can be defined as “a sense of social

feeling toward all humankind, and the essence of social interest is the valuing of something

outside the self” (i.e., “a true absence of self-centeredness”) (Leak, 2006, p. 443) and is

“manifested in the life tasks of friendship, love and work” (p. 443). The SII is designed to

measure an individual’s level of social interest in these life tasks.


Client and Provider Forms for The Kerygma Project (p. 2 of 2)

The PTSD Checklist for DSM-5 (PCL-5) – This checklist delineates a list of presenting

problems that clients may experience in response to a traumatic experience. A Likert scale is

utilized with scores ranging from “0” (Not at all) to “4” (Extremely) (Weathers, 2013).

Traumatic Grief Inventory – This assessment addresses symptoms that clients may be

experiencing after suffering from a traumatic loss of a loved one. These symptoms range from

emotional numbing to re-experiencing the loss and are similar to, but not the same as those found

in post-traumatic stress disorder (PTSD). A Likert scale is used for the client to assess the

experiencing of symptoms ranging from a score of “0” to indicate “never” to a score of “4” to

indicate “always” (Prigerson, 2009).

Post Traumatic Growth Inventory – This assessment is a self-report questionnaire that asks

clients to rate the extent to which they have “grown” as a result of experiencing a traumatic event

or situation. There are five categories of questions that include: (1) relating to others; (2) new

possibilities; (3) personal strength; (4) spiritual change; and (5) appreciation for life (Tedeschi &

Calhoun, 1996).

Changes in Outlook Questionnaire (CiOQ) – This assessment is a self-report questionnaire

that lists 28 items for clients to rate regarding the extent to which they have experienced both

positive and negative changes as a result of experiencing a traumatic event or situation (Joseph,

Williams & Yule, 1993).

Session Rating Scale (SRS) – This rating scale is an assessment tool to be used by each client to

rate each therapy session. There are four categories to the assessment which include (1)

Relationship; (2) Goals and Topics; (3) Approach or Method; and (4) Overall. The client places a

mark on a line that represents a range of response (Miller & Duncan, 2002).

Outcome Rating Scale (ORS) – This rating scale is an assessment tool to be used by each client

on a weekly basis. There are four categories that are assessed by the client to indicate how they

have been feeling with regard to four categories. These categories are: (1) Individually (personal

well-being); (2) Interpersonally (family, close relationships); (3) Socially (work, school,

friendships); and (4) Overall (general sense of well-being). The client places a mark on a line at a

point between the far-left side of a line that represents having experienced low levels to the far-

right side of the line representing experiencing high levels (Miller, Duncan & Johnson, 2000).

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