foreign [Music] so similar to the three the different phases of group development we also have three different phases of trauma recovery and just like there's different writers that use different language to talk about the different phases of group development different authors and writers use different language to talk about the different phases of of trauma recovery and this framework goes all the way back to Pierre Janet in 1889 so 130 years ago who created a model for treatment of traumatic stress and their model had three phases stabilization identification and relapse prevention this three-phase model has been mirrored and echoed throughout many other trauma experts and their writings and Frameworks for treating trauma in 1992 we have Judith Herman's famous book on trauma and recovery and Herman describes the three phases as establishing safety remembrance and Mourning and reconnection uh in the seeking safety model these phases are described as safety mourning and reconnection Christine courtois and Ford in their 2016 book treating complex trauma they articulate the phases as safety stabilization and engagement is phase one processing of traumatic memories is phase two and integration or reintegration is phase three therapeutic spiral model of trauma-focused psychodrama describes phase one as being focused on prescriptive roles in psychodrama focused on accurate observation containment and strengths phase two gets focused on trauma-based roles in the psychodrama dealing with victim roles perpetrator roles abandoning Authority roles and phase three is focused on transformative roles in psychodrama roles related to autonomy integration and correction uh EMDR trauma-focused CBT they also have similar three-phase models based on stabilization uh reprocessing of dramatic memories and trauma narrative in phase two and integration consolidation in phase three or future future templates in terms of EMDR now across all these three phases there's some similarities uh phase one tends to be very Here and Now focused on the present moment stabilization psycho-education safety relationship buildings uh psychoeducation considering uh are here and now feelings Sensations and how the trauma from the past is impacting us here and now phase two usually orients on the past and in trauma processing it's on the past trauma in many cases whereas phase three tends to look to the Future that where are we growing what direction are we growing in what are we looking towards in terms of the future or goals what are we trying to integrate in terms of moving towards a vision of our of ourselves in recovery from trauma so present past future so I want to encourage you to consider which of these clinical map phases do you feel best able to facilitate a client or a group in in your work and which of these clinical map phases do you feel like it's most overlooked in your work how does your program or agency incorporate each of these clinical Maps phases into the services that are offered sometimes we can create groups that are more focused on one phase rather than other phases and that can meet trauma survivors where they're at in different aspects of their trauma recovery process for example you might start a trauma group that's more focused on phase one about psychoeducation safety coping skills grounding relationship that intentionally does not go into trauma processing or you might start a trauma group that's focused on phase two that's focused on trauma processing but you would need to make sure that that you screen out participants in the group who are ready for that phase two work and we need to be sure that our trauma treatment programs are also addressing phase three this is the one that I feel like gets most overlooked in the field that um you know sometimes phase one gets overlooked and people want to just Dive Right into trauma processing and talking about the trauma um but I think nowadays we do a good job of that strength space focus and establishing safety before getting to the trauma work but this third phase often gets overlooked that we need to consider post-traumatic growth integration transformation and where are we going from here what does trauma recovery look like rather than only focusing on what the trauma looked like so the next section in chapter two goes into outlining how moranian philosophy is inherently a trauma-informed philosophy and so it's important to keep in mind that Mourinho created his philosophy and his theories uh nearly 100 years before samsa published the an organized trauma-informed care so uh you know this is going back to the 1920s 1930s it wasn't until 1980 that PTSD was recognized as a diagnosis and then it wasn't until 2014 or so that samsa was really putting out publication after publication organizing trauma-informed care and trauma-informed principles into a package of sorts so moranian philosophy didn't get to benefit from all the new information about trauma about Neuroscience about trauma-informed care and Trauma Therapies none of that language was around 100 years ago or 80 years ago when Moreno was creating his ideas nevertheless Iranian philosophy really embodies trauma informed care philosophies in a couple different ways in many different ways really just like trauma-informed care philosophy moranian philosophies is very humanistic it's person-centered it's strengths-based and it really challenges the medical model approach to conceptualizing individuals Moreno believed that we had to consider the larger systems and social forces that individuals are a part of and how these larger social forces had an impact on their health and well-being Iranian philosophies holistic in that it considers the entire person all aspects of the person from their body to their psyche to their Spirit their relationships and to the culture within which they live so Iranian philosophies inherently a holistic philosophy now many people don't realize that Moreno was the first to create a body oriented Psychotherapy so psychodrama was the first body oriented therapy and it emphasized action over talking braino argued that the body remembers what the Mind forgets and this was 70 or 80 years before Bessel Van Der kolk and others started talking about the body keeping the score mourinho's philosophy emphasizes action over talking he says that the word or talking or thinking or analyzing something can only happen after action that action always predates any kind of analysis so he emphasized the importance of action and acting acting out our problems and solutions and then after the action coming back to the integrative part so while psychodrama and moranian philosophy add may appear to emphasize catharsis and and the expression of heavy emotions and it does at times Moreno also argued in his philosophy that every active catharsis alone was not healing unless it was followed up by a catharsis of integration unless there was some sort of transformation some integration New Perspective cognitive restructuring that took place after the catharsis so this inherently follows that three-stage clinical map that we talked about earlier that after trauma processing and catharsis there needs to be some kind of integration the moranian philosophy really emphasizes this even the three phases of a psychodrama group seem to really mirror the three phases of the clinical maps for safe and effective trauma therapy phase one of Marina's method is about warming up and this really coincides with phase one of the trauma clinical Maps it focuses on establishing safety providing connection psycho-education coping skills really engaging the group in kind of lighter gradual way before we move into the more difficult stuff phase two of merino's framework is action where we would do a psychodrama of some sort this is where we would get into addressing the issue at hand and this is where the the catharsis evap reaction would occur this is where you know intense emotions could be processed trauma could be addressed feelings could be released anger sadness or fear or rage but Moreno highlights that phase three is about sharing and about integration this is after the psychodrama the group will come together deroll from the roles they played and share about how that experience was for them and many of the the new insights New Perspectives and the cognitive processing restructuring comes in the sharing phase which seems to mirror that third phase of the clinical map for safe and effective trauma work that's focused on integration the moranian philosophy seems to really emphasize and articulate many of the trauma-informed Care philosophy that came 70 80 90 years later although Moreno didn't have the language to talk about trauma or PTSD most of his work was actually with trauma survivors he worked with sex workers he worked with refugees with immigrants he worked with children he worked with inmates in a prison he worked with youth at a boarding school and then later when he opened up his mental health hospital he worked with folks that were experiencing really severe mental health issues such as psychosis and schizophrenia so mourinho's work was mostly with trauma survivors and so it would make sense that his philosophy might reflect trauma-informed care philosophy to develop decades later so it's important that we consider theories and philosophies many times as practitioners we we tend to focus more so on the interventions and skills and competencies while overlooking underlying theories and philosophies and at the end of his life Moreno was really upset that his methods had become really popular but the underlying Philosophy from which his methods came had been separated from the interventions the people were using role-playing and doubling and role reversal and empty chair and sociometry and socio drama but they weren't using it in conjunction with his underlying mysticism his philosophy and his theories he actually describes it in his autobiography as tearing a child away from its parents and so he really thought it was important that when we're practicing psychodrama that we're using it in conjunction with the underlying theories and philosophy from which the the methods came from now there's a quote I found in a article by Mullen lezic from 2018 that I really like and that I think summarizes the importance of theory compared to techniques or interventions Mullen says that theory teaches us where to head therapeutically and technique teaches us what to do once we arrive there so it's almost like the theory is provides the compass of where we need to go provides a map of what needs to be done and where a journey is going to take us and then the technique are the tools that we use to do the work once we get there and so if we don't have a compass or a map a sense of what kind of Journey we're going on or where we're headed we're going to start using all sorts of tools and techniques out of context when they're not really needed when they might cause harm or when they just might not be most effective so it makes sense that Theory and technique be used in conjunction with each other I think this is one of my biggest criticisms of not just the way Sega drama has been used but of therapists in general I find that many times if I ask a therapist what theory they're conceptualizing their case is from would theoretical orientation they're working from many therapists don't have an answer of course many therapists do have an answer to that and they're really clear about what theories they're using and how they're conceptualizing their cases but it's alarming that many therapists at the same time don't know what theories they're working from and aren't working from any theories they're doing whatever feels right in the moment which is prone to error of course we want to trust our clinical intuition and wisdom but if we're only doing what feels right with the client in the moment we're also really prone to acting on bias counter transference and projection which is likely to read to re-traumatization or just not be helpful for clients so having a balance of theory while also trusting our intuition within the framework of that theory and the techniques I think is the safest way to to provide therapy and especially to treat trauma so I want to challenge you for a moment to consider how do you use Theory to guide your therapeutic approach and interventions which theories are you using to guide your interventions foreign [Music]