Working with patients such as Anna has led me to a specific discovery: there are acoustic markers which indicate whether a patient is immersed in a state of creative interpersonal relatedness, or triggered into a traumatic memory system. When a patient is immersed in an atmosphere of intersubjective mutuality, the narration features a sing-song, rhythmical and tuneful form of speech. The interactions with the therapist will be improvisatory, playful, the melodic contour that of musical question-answer sequences. When the patient is catapulted into a traumatic memory system, speech becomes monotone and disjointed. An attuned therapist will respond differently to a patient triggered into traumatic memory: the therapist will not match the traumatic monotone but tend to use more soothing vocalisations.
Similarly a therapist will not match the fast tempo of an anxious patient but will speak soothingly with a musical quality usually spanning a falling minor third, falling perfect fifth or octave. In this paper I will explain the acoustics of the voice. When we attune to each other we literally attune to one another’s overtones. Being in tune acoustically avoids dissonant overtones which are known to create distress: literal disharmony which actually creates disturbances in the sympathetic nervous system. Embedded in my paper is the research background of others working in this field; including Stern, Trevarthen, Malloch, Beebe, and Meares. All this informs the actuality of the moment-to-moment interactions of patient and therapist. Clinical application will be interspersed with video recordings of a mother-baby interaction featuring primary intersubjectivity and proto-symbolising through vocal attunement.
Awareness of trauma to children was first codified as the “battered baby syndrome” by Henry Kempe in 1962. While Accident & Emergency Departments, paediatricians and social workers remain alert to these presentations, it seems that child sexual abuse and the range of emotional abuse particularly in disorders of Attachment, have come to the fore in psychotherapy. The sequelae of physical abuse are not always highlighted in the discussions of Complex Trauma but occur, as expected, often in association with other forms of abuse.
Evolutionary change can now be studied at extraordinary scales; and these scales involve increasing evidence of semiotic (or sign based) expansion in telodynamic systems – systems which appear oriented to goals and even to self-correction (Shapiro 2011; Deacon 2012). Here I wish to explore how the emergence of the human self can be understood as an expansion of meaning potential, in particular, as a product of a ‘strategy’ of doubling and differentiation. My argument reviews the role of semiotic behaviour from bacteria to the collective consciousness that underpins human language. I further argue that the ‘stages’ of differentiation – e.g.. head to tail; top vs. underneath; right to left symmetry; hemispheric brains – all employ a double with differentiated function.
Therapy requires the patient and therapist to be in a mutually aware relationship. An underlying characteristic of this relationship is that both parties aim towards ‘feeling felt’. The human necessity for ‘feeling felt’ is at the very beginning of the human journey. In a sensitive caregiver-infant relationship the infant and caregiver ‘take in’ the other’s inner state through giving their awareness purposefully to the other’s communicative gestures. This ‘taking in’ is confirmed moment-by-moment through the ‘giving back’ (mirroring) of these gestures. But for the relationship to be alive, in the giving back there must also be the addition of the other person’s inner state. In adulthood this intersubjectively shaped storytelling, created through gestures and words, characterises the space where trauma can be healed in relationship.
Suicide is a major risk in Australia. In 2007, 1,881 people died by suicide. People bereaved by suicide must construct personal meaning about the death, decode the intentions of the deceased and receive and process a range of attitudes and beliefs about suicide from their social networks, from the supportive to the stigmatising.
In our work as therapists we constantly seek to develop our patients’ capacity for relatedness. Spiritual seeking in its purest forms is the pursuit of levels of development beyond the aims of most psychotherapy patients, but is understandable as a profound extension of this capacity in relation to both humanity and the divine.
This presentation, "Responding to the needs of consumers with complex trauma histories a consumer perspective" focuses on the needs of adult survivors of child abuse, highlighting the frequent