How To Do TRT Phases Three and Four For Spouses, Parents, Children, Adult Children, and Other Partners of Chemically Dependent People

This pamphlet is the third TRT instructional aid for those involved with chemically dependent people. It explains how to do both the third and fourth phases of TRT. The pamphlet number is: I-E

This material is for TRT participants. It also provides family members and friends information about the TRT program so that their support for the participant may be enhanced. The TRT Educational Program, including this material, is not intended for general interest reading. It is not a solicitation to engage in TRT. Neither is it authorization to provide TRT to anyone. TRT is authorized for use only under the supervision and facilitation of a Certified TRT Counselor. The authors of TRT, and or their designates, are the TRT certifying authority.

© 1988 Collins & Carson

 

Welcome To TRT

Phases Three and Four

Throughout the period in which trauma goes unreconciled, most people believe they were responsible for that trauma’s occurrence. Almost everyone has these thoughts at some level, even though the truth is that most people do nm bring the trauma on themselves. As we have stated before, our view is that thoughts of self-blame are a natural attempt on the part of the person to bring some feeling of control to a situation in which control has in actuality been lost. The most frequent reflection of this phenomenon’s interference with everyday life is the feeling of guilt.

As the effects of the trauma continue unabated, the person’s survival behaviors contradict the victim’s beliefs about appropriate behavior. In so doing, guilt feelings are fortified. More contradictions naturally result in more loss, increasing the emotional pain and creating an even greater need for the illusion of control. The principal adaptation by many victims of trauma at this juncture is to begin to believe that these ways of acting are reflections of ingrained traits of their character and indicators of their own mental illness. Even worse, in their most profound view of themselves, some begin to believe that they are “bad” or “evil” people. Consequently, even when TRT Phases One and Two have helped people to identify and then begin to reconcile the loss that resulted directly from the trauma-causing intrusion, there often remains the damage to the psyche caused by the depreciating elements of the survival responses. The problem is that the remaining aspects of the “Survivor,” developed in response to the trauma, will lobby with the portion of the psyche that is healing, trying to persuade it to accept the Survivor’s depreciated view (self-blaming) of the “Person” instead of the correct view of innocence that is experienced through the loss-resolution process. Unless the losses resulting from the survival behaviors also are reconciled, the Survivor’s view will usually prevail at least to the extent of making the healing process seem incomplete. To provide for this very important reconciliation so that the healing process can be experienced as complete is the purpose of TRT’s Phases Three and Four.

TRT Phase Three

Phase Three functions almost the same as Phase One. However, whereas that phase identified the source of the behaviors that precipitated the original loss, Phase Three identifies the survival behaviors and thoughts that have fostered the additional hurt. There are several other differences between the two TRT phases that must be kept in mind. First, Phase Three does not require as extensive concentration of thought or profound introspection as did Phase One. All that is necessary now is that the list of survival responses (both thoughts and behaviors) be copied as written from the fifth column of the Matrix. The writer may add optional descriptions of survival response if he or she desires (an example will be provided later). Second, you should not add times, feelings, emotional states or places to your writing as you did in Phase One. Phase Three is only a transitional stage in which you are assisted in framing your responses, not a time to dwell on or emphasize them for the purpose of improving your awareness of how you act so that you can change your behavior. If we try to improve our “awareness” for purposes other than loss resolution at this point in the program, the tendency is to begin to blame ourselves again (see Appendix). As you may be starting to see, blame and judgment and an intense emphasis on change are anathemas to loss resolution.

The third difference between Phases One and Three involves writing format and workspace. Be sure to copy the survival-response list onto a separate worksheet. (An example of Phase Three is demonstrated in the next instruction on how to use the worksheet to complete Phase Four.) List one experience under the other so that considerable margins remain to the right of each entry. We will use those margins in Phase Four. Once the list is completed, check with your TR T counselor for an appropriate time to read what you have written. In addition, as we have said before, be sure always to check with your counselor if you have any questions about this or any phase of TRT.

Phase Four

The fourth phase of TRT is similar in some respects to the second phase in that the matrix format is again used. However, instead of five columns, the matrix for this phase has only three. They are, from left to right:

TRT Phase Four

 fig1ph3general
“I laughed at his drunkenness and made light of it. I played like it was funny.We ask you to begin Phase Four by turning your list of survival responses described in the previous phase into a worksheet. Writing on the form again should pose no problems. For a sample of how to use the worksheet, we are going to borrow material for the third and fourth phases from the book, Trauma Resolution Therapy TRT); A Structured and Experiential Approach to the Reconciliation of Loss. In that book (primarily written for counselors) composite examples of people affected by different kinds of trauma-causing events were followed. The one we are reprinting here is the example of a woman who is the spouse of an alcoholic. The first column of her worksheet as developed from her third-phase work follows:

I apologized to my friends and attempted to cover up for the drunk behavior.

I made excuses to them about why the man I was marrying drank so much.

I began to withdraw and play like it wasn’t happening.

I began to pretend that he loved me and the children, even when he was out drinking.

I packed my bags and wanted to leave. I stayed.

Instead of leaving I began to pretend it wasn’t happening.

I tried to take care of him when he was passed out. Then I left him there and tried to detach from the reality that he was lying passed out in the tub.

I tried to carry him out of the yard. Then I covered him up. Later, we both ignored that it had happened.

I ignored my beating and then apologized to him for causing it. I forgot that the battering experience happened. I started having affairs.

I began to believe there was no such thing as hope. I wanted to get away. I wanted him to die.

I helped him select another car as if he had never run into a train. I lived as if it had never happened.

I confronted him about urinating in the closet. I began then to question myself. Cleaned the clothes in the closet. I lied to the people at the cleaners about my coat.

I promised I would leave but stayed.

On the second day I forgot that it happened. I began to be a part of what I was beginning to believe was an animal experience.

I began to take control of our family’s life. I borrowed money and ran the finances.

I assumed the responsibilities of raising the children alone. I continued to lie to everyone about where he was. I yelled at him later.

I cleaned up my husband’s urine in the bedroom. I cleaned up his vomit repeatedly.

I continued to stay in the marriage against my judgment. I increased the frequency of extramarital sexual encounters. I began to see sex with my husband as a repulsive and degrading experience.

I played like he wasn’t in trouble with the law. I asked the stranger to leave and played like my husband hadn’t brought him into the house.

I wanted to kill my husband. I planned how to kill him when I realized he was having sex with Lori.

The following day, I denied that it had happened at all.

I covered up his nudity in front of the children. Took care of him.

Played like it hadn’t happened.

I wanted to kill him after the beating on New Year’s Day.

Then I wanted to escape.

I began to believe I was not human at all. ”
After copying the fifth column of the Matrix, she had added to the third phase (now the worksheet for Phase Four) the following:

“From a more general perspective:

I acted differently than I ever believed I would act.

I didn’t place my children first in my life. The alcoholism was first,

Sometimes I reacted verbally and physically toward the children rather than toward Ken.

. ~

I seemed to have become another person throughout the experience. I became obsessed with controlling him.

I lived in degradation such as I never conceptualized I would ever live in.”

 

The first column of the Phase Four worksheet then consolidates the individual responses into like groups to create a much smaller listing of various categories of responses. This is done by starting at the top of the worksheet and progressing down the list, placing the responses, depending on their characteristics, into similar categories by assigning numbers in sequence. Each expression that represents a new or different category of response is given a new number.

For example, the first response obviously would be new and so far unduplicated. Consequently, we would place the number (1) in the margin to the right. The second sentence in the first response is at least partially new, so we give it a number also:

 

Categories

“I laughed at his drunkenness and made light of it.”                              (1)

“I played like it was funny.”                                                                            (2)

The second set of survival reactions taken from the first matrix also represents two new and different kinds of responses. Consequently, we give them each a number as well:

“I apologized to my friends”                                                                            (3)

“I attempted to cover up for the drunk behavior”                                       (4)

The next response is not entirely new. It describes the use of excuses, which is new but which closely parallels her apology described in (3). Depending on your and your counselor’s view, you can create a new category (“excuse”), or you can place this response in the apology category already described as (3). Either way will be effective in the continuing TRT process. For purposes of demonstration, we will consider the “excuses” as parallel to the “apologies” and so will place the number that identifies the apology response (3) next to the excuse response. The worksheet then appears:

 

Categories
I laughed at his drunkenness and made light of it (1)
I played like it was funny (2)
I apologized to my friends…and (3)
attempted to cover up for the drunk behavior (4)
I made excuses to them about why the man I was marrying drank so much (3)

As we continue down the worksheet, we discover new categories of response but also find considerable duplication. The completed worksheet from this example might look like this:

 

I began to withdraw …and (5)
played like it wasn’t happening (2)
I began to pretend that he loved me and the children, even when he was out drinking (2)
I packed my bags and wanted to leave. I stayed (6)
Instead of leaving I began to pretend it wasn’t happening (2)
I tried to take care of him when he was passed out (7)
Then I left him there and tried to detach from the reality that he was lying passed out in the tub. (2)
I tried to carry him out of the yard. Then I covered him up. (7)
Later, we both ignored what had happened. (2)
I ignored my beating … and . (2)
then apologized to him for causing it. (3)
I forgot that the battering experience happened. (8)
I started having affairs. (9)
I began to believe there was no such thing as hope. I wanted to get away. (10)
I wanted him to die. (11)
I helped him select another car as if he had never run into a train. (7)
I lived as if it had never happened. [forgot rather than pretended] (8)
I confronted him about urinating in the closet. (12)
I began then to question myself. (13)
Cleaned the clothes in the closet. (7)
I lied to the people at the cleaners about my coat. (14)
I promised I would leave but stayed. (6)
On the second day I forgot that it happened. (8)
I began to be a part of what I was beginning to believe was an animal experience. (15)
I began to take control of our family’s life. I borrowed money and ran the finances. (7)
I assumed the responsibilities of raising the children alone. (7)
I continued to lie to everyone about where he was. (14)
I yelled at him later. (12)
I cleaned up my husband’s urine in the bedroom. I cleaned up his vomit repeatedly. (7)
I continued to stay in the marriage against my judgment. (6)
I increased the frequency of extramarital sexual encounters. (9)
I began to see sex with my husband as a repulsive and degrading experience. . (12)
I played like he wasn’t in trouble with the law. (2)
I asked the stranger to leave and played like my husband hadn’t brought him into the house. (2)
I wanted to kill my husband. (11)
I planned how to kill him when I realized he was having sex with Lori [the woman's daughter] (11)
The following day, I denied that it had happened at all. (2)
I covered up his nudity in front of the children. Took care of him. (7)
I Played like it hadn’t happened. (2)
I wanted to kill him after the beating on New Year’s Day. (11)
Then I wanted to escape. (16)
I began to believe I was not human at all.” (15)
From a more general perspective:
I acted differently than I ever believed I would act. (17)
I didn’t place my children first in my life. The alcoholism was first. (18)
Sometimes I reacted verbally and physically toward the children rather than toward Ken. (19)
I seemed to have become another person throughout the experience. I became obsessed with controlling him. (20)
I lived in degradation such as I never conceptualized that I would ever live.” (15)

The way that you consolidate your survival responses may be considerably different from the way we do it, because the division and combination of the responses will depend on their individual meanings to you. Such differences are not a problem. If you have additional questions, be sure to ask your TRT counselor.

Once the consolidation is complete, the next step is to list the different categories in the Phase Four Matrix all the way down the first column. Remember, this matrix is three columns across, rather than five, and focuses only on the initial survival response, the values contradicted by that response and the loss sustained as a consequence of the contradiction. To illustrate, the first seven categories of responses in the example we have been using are reduced to simplified descriptions:

fig2ph3-4spousesIn summary, the function of the numerical system is simply to provide a way to identify similar survival responses and to discern the frequency with which each was used. From this identification, the loss resulting from those responses can be identified, setting the stage for its reconciliation.

As you can see, some of the categories, such as (l), comprise only a single response, whereas others, such as (2), are indicated repeatedly. The significance of these differences in terms of loss resolution-is that when you begin to work across the matrix, those responses repeated most often usually will be found to reflect the greatest contradictions and subsequent loss.

Even though Phases Two and Four both identify and help to reconcile loss, there is an important difference between the two. The second phase addresses loss on an extremely specific level: exact trauma-causing behaviors are correlated with the particular emotions experienced, values contradicted, loss sustained and immediate survival response made. Through that approach, loss is not only reconciled at individual levels, but also through the wider view that comes from seeing the myriad events as a single life experience. The result of that approach is a rigorous, uncompromising confrontation of the heart of the trauma. In Phase Four, however, we are looking only at the remnants of the trauma. This is what happened to us. Phase Four is about how we adapted and then, how we were changed by the trauma. Had there not been an original trauma, there would be nothing now to write about. Consequently, we approach this phase with special care and ask that you give that same special care to yourself.

The special care (exemplified in the use of “categories” by the fourth phase) is intended to provide you with some distance from the necessary experience of survival change and adaptation by purposefully making the survival behaviors more generalized. Consequently, when you fill in the rest of the fourth phase matrix, think in terms of what values were contradicted. If for example, “pretending the trauma wasn’t happening” was a response of your own, your matrix would reflect a summary or overview of your values and beliefs about the prospective denial of trauma-causing events.

Identification of loss should be handled similarly to that of contradicted values. An example of the category (2)’ s application to the Phase Four Matrix follows.

 

 

TRT Phase Four


fig3ph3-4spousesAppendix

When the Phase Four Matrix is completed, arrange with your counselor to share it with your group. Of special note, whereas the predominant feelings surrounding Phase Two were of anger and shame, the general experience most often reflected at this juncture of TRT is the deep sadness and sorrow that accompanies all true mourning. Again, it is important to maintain your close contact with your TRT counselor. He or she will assist you in sharing as much of the matrix in each sitting as is’ believed to be appropriate for your individual needs. Once the reading has been completed, you will be ready to enter the last phase of TRT.

TRT and Behavioral Therapy

TRT does not exist in an information vacuum. There are many other methods of therapy, both professional and self-assistance, available through the various helping elements of society. Almost all of these approaches proliferate within the media as well. We believe each of these methods has value given its own limits and goals. However, each can also create problems when used inappropriately with TRT. One of the most prevalent methodologies, a cognitive and behavioral approach frequently utilized in the chemical dependency field, has a special significance for Phase Three of TRT in that it directly conflicts with TRT’s loss resolution efforts. TRT participants exposed to both TRT and the other approach ‘may become confused unless the differences between the two approaches are explained.

The conflict between TRT’ s third phase and the cognitive-behavioral method comes from the latter program’s interpretation of survival responses as dysfunctions. Unlike TRT, the behavioral approach does not recognize the necessary utility of the survival responses in protecting the Person from the internally retained trauma. In other words, where the trauma is seen as the problem in TRT, the behavioral-cognitive approach argues that the survival responses are or have become the problem. Consequently, from the. behavioral-cognitive perspective, survival responses are viewed as character defects, personality disorders, maladaptive defenses, indicators of sickness or improperly learned ways of interacting, depending on the interpreter’s training. A natural objective of that approach, then, is to help people become aware of the different patterns of behavior that are considered to be unproductive (dysfunctional) with the idea that once these patterns of learned dysfunction are understood, the individual can recognize his or her defects or disorders and then change those characteristics or ways of behaving or learn new ways to interact. The goal is an improved quality of life.

Where the behavioral program intends to change the way people act, the single purpose of TRT is the resolution of loss. Phases Three and Four of TRT are no exceptions to this rule, as they are designed only to help resolve the loss resulting from the survival response to the trauma. When survival responses are identified in Phase, Three, the intent is to describe instances in which they contradict the individual’s system of values and belief so that whatever loss was sustained can be identified and reconciled. There is no need to change the survival behaviors, as they usually are already beginning to dissipate as a result of the loss resolution process completed in Phases One and Two. In the TRT approach, there also is no therapeutic need to describe the survival responses as defects in character, compulsive disorders, maladaptive defenses, learned dysfunctional interactional patterns of behavior or indicators of sickness. Rather, survival responses can be seen for what they are: an ongoing trauma-caused decision-making process that is naturally born out of the shock of the assault and a process that is always following the unreconciled trauma’s direction. Rather than diverting attention from the trauma to the survival responses by thinking of those responses as bad and subsequently in need of change, the survival responses are seen instead as providing necessary and valuable assistance that paradoxically also tend to pit the person’s best strengths against himself or herself without that person’s permission. In other words, from the unresolved grief perspective, although the victim of trauma is behaving in ways that most probably do not conform with outside perceptions of the norm as measured by those not directly affected by that same trauma, the survival responses most certainly are offering vital aspects of assistance that the individual has to have for himself or herself given the particular trauma’s reality.

In TRT, victims of trauma, through their talents and abilities to survive, are seen as attempting to resist the trauma-causing assault that is still directed to the heart of their beings. Consequently, TRT is always facilitated with the intent to end the assault itself by resolving the trauma directly and never with the jntent to alter the natural and necessary protective adaptations to the individual’s experience of the trauma.

Summary

The Survivor’s trauma -perpetuated existence is slowly diminished as the trauma is resolved, but not before it attempts to prevent the trauma’s resolution. During these periods of resolution and less dependence on survival methods, other therapeutic views outside of TR T can affect the trauma resolution process. Specifically, some behaviorally oriented programs tend to focus on the survival responses in a way that is different from TRT’s approach. Conflict may result if the TRT participant does not understand the differences. TRT’s treatment of survival responses is not to see those responses as indicators of sickness or dysfunction, but rather solely as indicators of trauma. In TRT, the Survivor is respected for the help it has given the individual during that person’s incapacitation. If this respect and understanding for the person who has survived is not provided (as it is deserved) along with the recognition of the Survivor’s less-productive role, the trauma and loss discovered in these later phases of TRT will be only partially resolved. Providing this sometimes difficult understanding of the Survivor’s often simultaneously productive and less productive accomplishments is one of the most important elements of the next and last phase of TRT. > The next pamplet is the final TRT instructional aid. That pamphlet number is:

 

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