What is Relational Trauma Therapy?

Relational Trauma Therapy combines psychomotor skill training and system-oriented group-process. The two methods are used for building a skill-level individually and in a group or dyad, that supports mutual regulation of emotions and arousal-states - especially those states, that have been held in isolation and dissociation.

Traumatic events are part of life. Human beings and other pack animals have a natural capacity to live through traumatic impact, come out on the other side and continue living with an integration of what has happened. So why do we need trauam therapy?

The potential for natural trauma-healing is often only released partially or not at all. After traumatic impact many people are facing the challenge - consciously or unconsciously - that aspects of what happened both externally and internally never got met, regulated or integrated in the personality.
Trauma-therapy supports natural trauma-healing to happen - and relational trauma therapy is especially focused on mutual regulation of states, that have never been regulated before, as a central component to healing.
If we have access - after traumatic impact - to contact where both careseekers and caregivers are capable of meeting the story and the survival-reactions and participate in mutual regulation of them - then the states get regulated and we don't need to incapsulate them or dissociate them.

Participating in this kind of contact is challenging. It challenges our attachment-patterns - and often also our perception of reality.
Trauma-reactions and trauma-memories are not being met, when they go beyound what we in our personality want to know about ourselves, others and life.
The goal in Relational Trauma Therapy is to widen the capacity of the personality, so we can participate in mutual arousal-regulation and through that natural trauma-healing - both as careseekers and caregivers - building contexts, where states that have been held in isolation and dissociation can become mutually regulated.
This process can open the potential for experiencing "post-traumatic growth" PTG, which according to Calhoun & Tedeschi shows up as change in our relationship to ourselves, other people and our philosophy of life.

Psychomotor skill training (ROST) increases our capacity for self-regulation. Patterns of tension and of low energy/giving up in the muscles (hyper- and hypo-response) are addressed - and the principle of "dosing" is key in the skill training. Participants and clients (and therapists) are trained in "dosing" bodily exercises, so they are adapted to each individual, each part of the body, each inner state. Through that process patterns and states impacted by both tension and low energy are adressed equally, which supports integration of new learning in the individual. In the same time a system is built, where the norm is, that high and low intensity (hyper- and hypo-phonmenons) are included on equal terms, which leads to dominance- and submission-patterns staying more in the background. The skill training holds a focus on concrete body-sensations and emotions - and the ability to differentiate emotionally loaded experiences built on predictions or assumptions from factual sensations.
In the video on the homepage of this website, you can see an example of psychomotor skill training as it was presented in a body-psychotherapy conference - you can read about the groupdynamic aspects of the skill training in "Polarizing or integrating differences?" - and you can read more about ROST (Resouce Oriented Skill Training) and the process of dosing in "What is ROST?" or in articles you find under Litterature.

The systems-oriented approach to working with a group or a dyad also holds skill-training:
- training in limbic resonance with oneself and others - resonance with emotions and arousal-states, resonance with hyper- as well as hypo-arousal
- training the capacity to shift between resonating with oneself and somebody else - and through that regulating contact
- training the capacity for not taking what happens externally and internally only personally - seeing the collective aspect of experiences
- training in separating here and now oriented perception from predictions about the future based on experiences in the past
- training a neutral verbal language based in orientation in factual reality
With this training - in cooperation with psychomotor self-regulatory skills - the potential opens up for everybody in a group (or a dyad) to participate in mutual regulation of emotions and arousal-states. States can be circulated in a system (group, dyad etc), so nobody is carrying a state alone - and nobody is sitting with the impossible task of trying to regulate a powerful emotional state alone.
The method Functional Subgrouping - developed in SCT, Systems Centered Therapy, is used in this process - adapted to a trauma-therapeutic context.
This handout describes Functional Subgrouping as it is used in this context.

Specific bodily methodology has been developed to work with regulation of high arousal-states - both hyper- and hypo-arousal. We work with regulation of fear (flight), anger/rage (fight), disgust (revulsion-reflex), collapse, freeze etc. In "About survivalreactions" you can get a fuller picture of the map of survival-reactions we work with and sources of inspiration behind the map.
Differentiation in three degrees of stress-reactions is key - and methods have been developed to work specifically with 2nd and 3rd degree stress-reactions. 2nd degree reactions are undertood as being organized and having a clear focused goal (for example the goal of getting away - or the goal of winning over the opponent). They can be released bodily. 3rd degree reactions are understood as being disorganized and chaotic and methods focusing on bodily release are in our experience contra-indicated. They don't work in relation to these radical states. We work with building up a capacity to witness the states - externalization being one component in this process.

"The landing-process" after having been exposed to traumatic impact or to trauma-reactions is a core part of any kind of trauma therapy. How is safety re-established - or established for the first time? How do we provide space for and regulate the emotions and thoughts that emerge in the landing-process - and in the crisis after traumatic impact?
In Relational Trauma Therapy we focus on "Optimizing safety" through psychomotor skill training, through training in regulating contact and through mutual regulation of both arousal-states and emotions in a group or a dyad.
Read here to see the list of basic emotions, we work with - and how they are differentiated from both survivalreactions and thought-feelings.

The name "Relational Trauma Therapy" is new. It emerged in the fall 2014 - after a 2-year phase, where the trainergroup connected to our Scandinavian training in trauma-therapy had focused on the integration between understanding attachment- and trauma-patterns. I offered workshops on "Trauma and attachment" and "Attachment and arousal-regulation" in Denmark, Norway, Sweden, England and Canada.
The trauma therapy training was widened with a 3rd level titled "Trauma and attachment". (This training level happened for the first time in Scandinavia in the fall 2014 - and is now running in a shorter format in Vancouver).
When including attachment-theory and focus on mutual arousal-regulation something feel into place. The relational aspect of the approach has been lifted up - it has been there all the way through, but it is now more clearly visible in the description of the approach - both theoretically and practically.

Access to mutual arousal-regulation is in my experience a crucial factor in impacting if trauma-reactions get regulated in a natural flow or if they get incapsulated and become part of defensive trauma-patterns. The challenge in processing trauma lies just as much with those who have been exposed to something highly charged as with those who meet the trauma-survivor afterwards. For both parts the challenge is to stay present and in contact when meeting states that go beyound the repertoire of the personality. It is a mutual project for careseekers and caregivers to develop this potential. And it points to a radical aspect of the therapist-role, when working with trauma. The therapist's capacity for self-regulation and for participation in mutual regulation of trauma-states is a deciding factor to what kind of processing and healing you can offer to clients or groups. That is the primary focus in Relational Trauma Therapy.
Read more in the article "From automatic reactivity to mutual arousal-regulation" (will be posted in the fall 2015 on this website).

"Relational Trauma Therapy" relates to the traditions called Relational Psychotherapy and Relational Body Psychotherapy.
Relational Psychotherapy emerged in the 1980's as a significant new development within traditional psychoanalysis. Attachment-theory and objectrelations-theory are the foundation behind the method-development. The relational viewpoint points to, that a self cannot fully exist, or even less be understood, outside of relational contexts - independent of others. (Quote from Asaf Rolef Ben-Shahar). Concepts like intersubjectivity and resonance er key - and a view of the therapist-role, that includes the therapist's sensations, experiences, emotions etc as a valuable and real part of the therapeutic space. The therapist is litterally in the boat in the therapeutic process. Psychotherapy is understood as a mutual process.
Through Relational Psychotherapy this branch of psychoanalysis has opened up to inspiration from humanistic psychology - and in some cases also from body-psychotherapy.
And vice versa - some body-psychotherapeutic approaches are naming themselves Relational Bodypsychotherapy. I have met this approach in British and Israeli body-psychotherapists.
In the following article you can read an introduction to a conference in Cambridge in 2007 titled "The client and I". The conference introduced Relational Psychotherapy - with presenters from psychoanalysis, body-psychotherapy and attachment-oriented psychotherapy. The article gives a short introduction to Relational Psychotherapy.

Another reference is the following book, that give a thorough entry into the history behind Relational Psychotherapy - and that introduces Relational Bodypsychotherapy: Asaf Rolef Ben-Shahar: Touching the Relational Edge. Karnac 2014

I feel connected to Relational Psychotherapy and especially to Relational Body-psychotherapy. As trauma-therapist I experience a radicality in my therapist-role - I am litterally in the boat together with the people I work with - I participate in mutual arousal-regulation no matter if the states are "mine" or "the other's". This radicality is in my understanding confirmed in the way the therapist-role is understood in Relational Psychotherapy.

You can read more About Relational Trauma Therapy here. This text is used to introduce the approach in traininggroups in Relational Trauma Therapy.