CLIENT’S PERSPECTIVE ACROSS THE STAGES OF TREATMENT

Stage 1: Establishing safety, stabilization, and orientation to the present

“It was a relief to begin therapy without having my traumatic early experiences and relationships stirred up in a way that left me unable to function for days. I also found it relieving not to be taught techniques that required me to override or force my system into a particular window of tolerance. The techniques hadn’t helped in past therapy as I dissociated from the information when I was triggered.

Gradually, I began to experience small shifts in state. Markers from the present helped me develop an initial sense of regulation and understand, at an implicit level, that I had survived, even though the past felt like now. The therapist’s respect for my need for distance, rather than warmth or closeness, helped reduce my terror of connection.

I began to say ‘no.’ Switching between different aspects of myself became more conscious, and I started to understand that I was not simply a collection of separate fragments. I was a whole person who had survived extremely difficult experiences.”

Stage 2: Processing the past and developing greater integration

“Beginning to experience that the past was over was profound. I started to have moments of being here and now, in a life that was different from the one in which the trauma occurred. I became more aware of, and accepting toward, the adaptations my system had developed in response to a hostile environment.

Shame, self-hatred, suicidal wishes, and states of ‘living death’ began to diminish. The swings between hyperarousal and hypo-arousal, flop and freeze, also became less intense. I became conscious of survival adaptations like care-giving, intellectualisation, being invisible and appeasing and the shifts between different aspects of myself became less extreme. Sending a text after sessions often helped me identify and put words to experiences that had previously been implicit. The therapist’s response provided connection and reinforced the experience that I was not alone.

I also became increasingly aware of my body and began to recognize bodily states and signals that had previously been difficult to notice or tolerate.”

Stage 3: Trauma integration, relational connection, and movement toward living

“Integrating the terror held in implicit experience felt like visiting ‘hell’ while also experiencing compassion and connection. It has released me- I am not alone. Being witnessed and understood, and having the full horror of what happened acknowledged, has been life-changing. I feel that I have finally been found—that I have been given a place to land and be welcomed into life.

The tone and sound of the therapist’s voice repeating the markers helped anchor me in the present, like being tied by a rope to the present when processing early pre-verbal trauma and neglect.

I have gradually begun to reintegrate dissociated aspects like grief and sadness, as well as primal rage. I have learned to understand anger as a healthy ‘no’ response to injustice. I can now say ‘my anger’ and recognize that expressing ‘no’ does not necessarily mean losing connection.

During this Stage, I established self-regulating and health-promoting practices spontaneously. Coping and numbing strategies are no longer necessary in the same way. I can withdraw when needed, regulate my state, and care for myself. I can ask for what I need.

I am learning that being visible does not inevitably mean being attacked. The compulsion to take care of others, submit, and appease them has substantially reduced. I am increasingly able to recognize that other people are responsible for themselves.

I can remain present with interoceptive signals and implicit somatic sensations. I am now more able to be mindful and can experience moments of simply ‘being’ and appreciating beautiful or pleasurable experiences.

I am alive and beginning to move toward the possibility of thriving. I feel that I have been to the bottom of the valley of the shadow of death and am now emerging with the knowledge that I survived, that I am not alone, and that life can be good.”