Step 3: Help Your Patients Learn to Express Their Inner Experience
This is the third step in trauma treatment from Bessel van der Kolk’s Four Concrete Steps for Working with Trauma. “Help your patients learn to express their inner experience”.
This is where treatment starts to come together in my opinion. The first two steps are vital for this to happen; having experienced self-regulation and exploring self-empowerment. Without these tools, your inner world could be frightening and sometimes impossible to touch. It is our jobs as professionals to be aware of where are client are at and their ability to manage what comes up. Without the first two parts, it is easy to retraumatize and cause harm. If your client begins to experience his trauma, it is imperative that you help him stay in contact with you. No closing their eyes or turning away, make them stay with you. Have them touch their horse, feel warmth, or something similar.
The relationship with their equine partner is a great place to begin to connect with their inner experience and express what they feel. At the Institute we practice Gestalt EAP, which means we work in the present moment and create experiments to assist our client in experiencing themselves in relationship to another. For example, if you have a victim of sexual abuse, and you notice that his horse partner is constantly in his bubble, you could do an experiment instructing him to stand very close to his horse, taking a breath and becoming aware of what he is feeling in his body. Then taking a few steps back and noticing if anything changed. It is important that your client is in relationship with her horse as this unfolds, otherwise, the horse becomes an “it” or as some people say “a tool”.
Please note, this is vastly different from having your client do an exercise and then speaking about it afterwards. Our goals at the Institute is to assist our clients in being in their bodies, feeling their emotions and being able to experience security as the stay in consistent relationship with others and their environment.
Advice: If your client is having a difficult time connecting to his horse, it is helpful to do some exercises with him, focused on connecting with you, the facilitator.
For support or questions, contact The Institute for EAP. We offer mentorship, supervision, web based and on location trainings.
This is the second article in a series inspired by an interview with Bessel van der Kolk. In my practice I see a lot of trauma clients and his Four Concrete Steps for Working with Trauma is a great outline for the work we do and teach at IEAP.
“The core of trauma treatment is something is happening to you that you interpret as being frightening, and you can change the sensation by moving, breathing, tapping, and touching (or not touching).” Bessel van der Kolk
When you have a traumatic experience you are a victim of circumstances and depending on your reaction to the event, your brain and body change. The second step in treating trauma is shifting from being a continuous victim of what your brain and body perceives as danger and learning that you are, to some extent, in charge of your physiological system.
In the first step, self-regulation, I spoke to breath work, and sharing breaths with a horse. Creating this experiment for your client gives them an opportunity to self regulate and also brings them closer to self empowerment.
I cannot speak about empowerment without touching on the vast difference in feeling powerful and having “power over”. We do not need to have power over another being to be powerful. “Power over” comes from fear, and when working with trauma, perpetuating fear, could be damaging.
In my practice, and at IEAP, we work from a relationship perspective. Moving a horse without being in contact with him, does nothing but create separation. Horses just like people, are not tools to be exploited for our own gain.
When taking this approach, we do a lot of work around creating opportunities for clients to be in contact with their equine partner. Most clients have no idea what being in contact is and how they experience it. Often times with trauma clients, contact is frightening, which is why it is much easier to do with a horse than a human.
So here’s a way to work on self-empowerment in an EAP session.
Place a horse or two in an arena or round pen prior to your client arriving. Instruct her/him to enter the arena, very slowly walk towards a horse and stop when she notices any physical changes or emotional shifts, or when the horse makes a noticeable change. At that time ask her/him what they are aware of (in the moment). If there is arousal, have them take some deep breaths with extended exhales, move their body to where they can feel relaxed. Maybe that means outside the arena. The goal here is for your client to notice changes, have an opportunity to shift and through that experience feel in control. Maybe your client will make it all the way to a horse, maybe not. The experiment is about self empowerment through awareness of internal shifts and taking effective action. Contact with the horse will be the next step but this cannot be achieved without the client first having an experience of themselves in their environment.
As a therapist, be aware of what your horses are doing. Let them guide the session and listen to what they have to say. Keep creating experiments based on the information they are giving you.
There are infinite exercises that can be done on or off the horse with your clients, many that will help instill self-empowerment and heal trauma. If you are interested in training and mentoring, contact our office.
I came across an interview with Bessel van der Kolk, who is one of my inspirations when it comes to treating trauma. As I read it, I noticed that it outlines most of what I do in my Gestalt Equine Psychotherapy practice. It does not include attachment which is one of the keys in my experience, but the Four Concrete Steps for Working with Trauma is a great article. I have included a link to the article at the bottom of the page. As I read the piece I was inspired to share how these four steps are used in my EAP practice.
Before I dive into these four steps, I feel it’s important to state that our herd is seen as co-therapist. Our experiments and experiences are done in relationship with our horses and never “to them”. They are not tools for us to use, rather partners in healing.
Number one is self-regulation. “The issue of self-regulation needs to become front and center in the treatment of trauma.”, Dr. van der Kolk.
Most trauma clients, and truthfully, a large percentage of my clients, struggle with self-regulation. In the beginning, simply taking a few breaths, and extending their exhale, can shift their emotional state. Bringing awareness to how they feel prior to taking breaths and then afterwards, gives my clients an opportunity to see that they are not powerless and can modulate arousal. Controlling breathing in this way triggers the parasympathetic nervous system to come online and counter our sympathetic nervous system’s fight or flight response to daily stresses or trauma responses. In effect, the relaxation response is the anti-fight or flight response.
One way I create this experience, is instructing my client to lean into her horse partner, placing her body against the horse’s belly, and matching her breath to her horse. This creates an opening for her to relate to her horse through touch, it slows down her breath, and allows for connection to self and horse. Another way to have this experience is through your legs while mounted. I’ll instruct my client to focus on her legs, feel the horse's breath through her legs. Often times with trauma, clients state that they can’t feel their legs and therefor not the horses breath. I then suggest to imagine feeling it and start to follow it. Weather the client consciously feels their partner's breath or not, the results are very similar. Their breathing slows down, and energy is brought into their body.
I love watching the response from the horses when we do experiments like this. Often there is a big exhale, some licking and chewing and lowering of the head. If this doesn’t happen, and the horse walks away mid experiment, we work with that. Trust your herd, and allow them space to lead the session.
Next week, I will write about the second step, self-empowerment. If you have any questions, or would like support with your EAP practice, please contact us.