Articles
Book Review
Experiential Treatment for PTSD
The Therapeutic Spiral Model
By M. Katherine Hudgins, Ph.D., TEP
Reviewed by M. Tamar Berg, MFT
The author presents the Therapeutic Spiral Model (TSM) – Experiential Treatment for people who suffer from severe trauma and Post Traumatic Stress Disorder. Latest research in Neurobiology shows that trauma is stored in the non-verbal, emotional centers of the brain, not accessible in talk therapy.
Kate Hudgins presents theory and research of experiential psychotherapy, which is becoming the treatment of choice for trauma survivors. Classical Psychodrama is the foundation of TSM.
The spiral image is like a DNA model with three interwoven strands. Each strand has a different color: purple – for energy – teal - for experiencing and –rose – for new meaning. This spiral image is introduced to help communication between client and therapist. Trauma survivors are often experiencing flash backs, intruding images, thoughts and feelings. Some say that they feel like being hit by a tornado. The image of a therapeutic spiral gives trauma survivors an alternative perception to the experience of chaos and helps to maintain the structure to balance thinking and feeling and stay present in the moment. The therapist can guide the process into a positive upwardly spiraling direction of attention and focus.
To guide all action intervention TSM uses role theory to map out the trauma survivor’s intrapsychic role atom. Prescriptive, trauma based and transformative roles make up the role atom that guides clinical implementation of experiential interventions.
The author introduces 6 types of dramas, each with their own clinical contract and action structure:
• Restoration and Renewal
• Dreams and Metaphors
• Initial Discovery and accurate Labeling
• Uncovering and Exploring Core Trauma
• Conscious Reexperiencing and Developmental Repair
• Release and Transformation
Although these dramas are listed in a certain sequence, they need not proceed in a linear fashion. The type of drama contracted for between the client and the therapist is determined by the clinical need for safety. Interventions of restoration, observation and containment teach clients to hold traumatic experience in present awareness without using primitive defenses as denial, dissociation and projective identification. Each chapter contains vignettes and case examples.
TSM proposes a trained action trauma team, which would be very effective in a perfect world where costs aren’t an issue. Still I use at least one trained assistant in my psychodrama group for trauma survivors, necessary for some trauma based roles and containment of group members. I highly recommend this comprehensive book and find it elementary for every clinician who treats trauma survivors no matter which theoretical orientation is preferred.
Tamar Berg, MFT
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