Lisa Ferentz – Guilt, Shame & The Trauma Survivor: Integrated Modalities to Move Therapy Forward

Outline

Guilt, Shame and Common Client Misconceptions

• The nature of abuse specific to your client
• Common misconceptions of guilt
• Life experiences that manifest as guilt
• The caretaker as perpetrator
• Attachment and abuse
• ”Participation” guilt in sexual trauma
• Case study: when Susan believed the abuse was her fault

Psychoeducation: Navigating Guilt

• Assess and identify the presence of guilt and shame
• The meaning and function of both guilt and shame as adaptive for survival
• Finding ways to make guilt productive and reparative
• Self-destructive coping behaviors
• From paralyzed to taking extraordinary action
• Reframe symptoms
• Cognitive reframing & behavioral strategies
• Case study: Janet and survivor guilt

Shame: The Root of Who I Am

• The mistake of using guilt and shame interchangeably: for clinician and client
• Pervasive and debilitating: intractability of shame emotions
• When your client presents as “hopeless”
• The trauma survivors’ DSM: dirty, crazy weird, abnormal
• Case study: Alex’s inner critic and its impact on self-worth

Treatment Planning: Techniques from Internal Family Systems (Schwartz)

• Working with parts, the language and clinical benefit
• The Inner Critic: the protector part for future survival
• Exploring the secondary gain of shame and why letting go is complicated

Cognitive and Emotional Antidotes to Shame in the Clinical Setting

• Leading the client to curiosity
• Working with attachment and familial loyalty
• Self-compassion: transformational skills that evoke empathy
• The impact of self-talk
• Writing experiential: the crossroad of a thought

Integrating Creative Modalities to Process Guilt & Shame

• Using art therapeutically – processing clients’ artwork
• Experiential: Body Mapping
• Accessing somatic resources that help reduce guilt and shame
• Experiential: Two-handed writing to increase compassion between parts
• Exploring spirituality and religious observance