IncreasingIdentityandRelationalFunctioning

Identityandrelationaldisturbancesareoftenassociatedit'sahistoryofongoing

andseverechildhoodabuseandneglect.Theseissuesarealsooftenviewedas

evidenceofapersonalitydisorder,suchasborderlinepersonalitydisorder.Often,

cognitivebehavioraltraumatherapiesfocusontreatingcognitiveandposttraumatic

stresssymptoms.Itisrecommendedthatinterventionsthattreatproblemsinidentity

andinterpersonalfunctioningarealsoincludedintreatmentasmanysurvivorsof

multipletraumaspresentwithsignificantdifficultiesintheseareas.

Thosewhosurviveearlyandseverechildhoodtraumasoftenexpressproblems

associatedwithconnectingwiththeirinternalselfandhavingaselfofselfingeneral.

Ithasbeenthoughtthatthesedifficultiesdevelopinthefirstyearsoflifewithissues

intheparentchildattachment.Thiscanbepresentedinvariousways,includingnot

beingabletodetermineone'sownneeds,predictingone'sownreactionsorbehavior

invarioussituations,notabletohaveadirectaccesstoapositivesenseofself,and

beingabletomaintainaconsistentidentityinthecontextofstrongemotionsorwhen

pressuredbyothers.

Thetherapeuticrelationshipcanbeverypowerfulintreatingtheseidentify

disturbances.Itcanprovidetheclientwithasafe,comfortablespacetoallowtheir

identitytoevolve.Itisimportantfortheclienttofeelsafeintherapy,bothphysically
andpsychologically.Thetherapistshouldrespecttheclientsboundaries,be

noninvasive,andreliabletoshowtheclientthereisasenseofstabilityandsecurity

withthetherapist.Iftheseconditionsareset,theclientismorelikelytoexploretheir

interns,thoughts,feelings,andexperiences.Itistobenotedthatapersonwhohas

dealtwithseveretraumamaybeintherapyforsometimebeforetheyfeelitissafeto

examinetheirinternalprocessesintherapy.

Itisalsoimportantforthetherapisttosupportaclientsselfvalidityand

encouragetheirselfexploration.Thetherapistshouldvisibleaccepttheclientsneeds

andperceptionsasvalid.Thetherapistshouldnotargueandattempttocorrectthe

clientsperceptions,butinsteadthetherapistshouldworkwiththeclientsothatthe

clientisabletoquestiontheirownincorrectassumptionsandworkthroughthem.This

alsoallowstheclientsneedstobeattheforefrontoftherapyasopposedtowhatthe

therapistwants.Thisclientfocusedenvironmentisalsodifferentthanmostcasesof

childhoodabuse,wheretheattentionisfocusedontheabusersneeds.Allowingthe

clienttofocusontheirneedsleadstofacilitatingselfexploration.Identitytrainingis

aninterventionwhichprovidesthesurvivortoreallydiscoverwhattheyfeel,separate

fromwhatothersthinkandfeel.Themoreaclientisaskedabouttheirinternal

experiencethroughtreatment,themoretheclientisabletobecomeincreasinglyself

aware.
 Relationalfunctioningisshapedinearlychildhoodbyhowtheyrelateto

others.Theseearlyinferencesabouttheselfandothersgenerateageneralizedsetof

assumptionsandexpectationsofothers,calledinternalworkingmodels.These

implicitmemoriescantriggeraclientbasedonsomeenvironmentaland/orexternal

stimuli.Activationofthesememoriescanhelpaclientworkthroughtheirnegative

emotionsassociatedwithacertaintraumamemory.

Thereareseveralwaysofunpackingpasttrauma.Withexposure,theclientis

treatedwiththerapeuticstimuli.Theexposureistitratedtotheclientsprogressasto

notoverwhelmtheclient.Activationisusedtoelicitemotionalreactionsofrelational

trauma.Disparityisusedtochallengetheclientsideassurroundingtheirabuseand

howtheyrelatetoother.Forinstance,ifaclienthasdifficulttimetrustingmenand

hasamaletherapist,theclientmaylearnthatnotallmenareuntrustworthy.Itmay

takesometimeforclienttocometoacceptthathermaletherapistisasafeperson,but

itwouldchangehowshefeelsaboutmeningeneral.Counterconditioningisa

phenomenonthatmarriestheclientactivedistressed,whilesimultaneouslyreceiving

positiveregardfromthetherapist.Itcanhelpprovetheclient,thatthetherapistcan

beacaringandsupportivepersonintheirlives.Thishelpstheclientcreateanaffinity

forthetherapist.However,thetherapistmustbewarynottodotoomuchhand

holding,astheclientcandevelopintounhealthypatternsofattachment.Last,
desensitizationistherepeatedexposuretorelationaltraumamemoriesintandemwith

positiveregardandcounterconditioning.Thepurposeofdesensitizationandother

processesisthecessationofnegativeemotionalresponses,overwritingthose

traumaticemotionswithpositiveones,andfinally,revisingoldrelationalpatterns.