International Journal of Cultic Studies ■ Vol. 10, 2019 43
specific sensations associated with body
memories.
Miller (2012) has described body memories as
bodily sensations experienced in the present that
have no current biomedical cause, and that are
directly related to some aspect of trauma.
Persons with developmental trauma are also
more likely to experience an overall lack of
connection with their bodies and affective states
(Levine, 1997). They may struggle to read their
environment and interpret external cues that
indicate other’s intentions. The inability to
adequately interpret the intentions of others,
combined with stressful stimuli that remind
individuals of the trauma, cause those with DTD
to feel “constantly on guard, frightened and
over-reactive” (van der Kolk et al., 2009, p. 11).
DTD attends to the many unique concerns and
symptoms presented by persons who have
experienced ritual abuse. The case study that
follows uses DTD as an organizing framework
within which to understand how the client’s
presenting complaints harkened back to her
traumatic experiences. Following the case study,
an impact statement gives voice to the influence
“Sarah” has had on my professional practice as a
therapist, and on my personal experience.
The Triphasic Model of Recovery:
Organizing Framework for Treatment in
Counseling
As context for the case study, I organized the
client’s treatment using Herman’s (2015/1992)
triphasic model of trauma recovery. Per phase 1
of the model, initial counseling sessions focused
on gathering information and helping the client
build resources and internal resiliency. During
phase 2, the focus shifted toward the processing
of traumatic memory, with the client and me
working collaboratively to identify fragments of
memory and create a cohesive narrative of the
experience. The second portion of phase 2
consisted of exploring together the ways that the
client had derived meaning from her traumatic
experience, and the related aftereffects.
I further enhanced Herman’s (2015/1992)
organizing framework through the use of
additional counseling interventions. These other
interventions included psychoeducation
regarding the fragmentation of traumatic
memory (van der Kolk, 1996) and identification
of body memories using somatic experiencing
(Levine, 1997). Using cognitive behavioral
therapy strategies (Beck, 1995), I identified and
challenged the client’s core beliefs and thought
processes that had been altered by the traumatic
experiences.
The triphasic model provided a recursive means
for organizing therapy. When the client
experienced increased distress or overwhelming
feelings during trauma processing (phase 2), I
would realign interventions to focus solely on
building resources (phase 1). Returning to phase
1, sessions would focus on increasing client
access to both physical resources (i.e., food,
shelter, safety) and internal resources (i.e.,
ability to self-regulate strong affective states and
navigate interpersonal relationships). Once the
client reported a return to baseline homeostasis
and seemed to adequately regulate emotions and
symptoms, treatment would again focus on the
processing of memories and the dentification
and reframing of irrational beliefs.
Case Introduction and Presenting
Complaints: The Case of “Sarah”
The following case study describes the treatment
of “Sarah,” a 27-year-old Hispanic female with a
history of childhood incest perpetrated by her
mother, and ritual abuse perpetrated by members
of the cults in which her mother participated.
Sarah presented to counseling with recurring
panic attacks, and the inability to fall asleep and
stay asleep. Sarah also reported somatic distress
for which no biomedical cause could be
determined. She reported being diagnosed with
autism spectrum disorder (ASD) around age 7
and stated that she hoped counseling could help
her “learn to function.”
History
Sarah grew up in the Southwest United States,
within walking distance of the Mexican-
American border. She described her hometown
as riddled with violence, organized crime, and
corruption that spilled over from a neighboring
city in Mexico. At home, she lived with her
father, a civilian contractor for the military, and
her mother, who stayed at home to care for
specific sensations associated with body
memories.
Miller (2012) has described body memories as
bodily sensations experienced in the present that
have no current biomedical cause, and that are
directly related to some aspect of trauma.
Persons with developmental trauma are also
more likely to experience an overall lack of
connection with their bodies and affective states
(Levine, 1997). They may struggle to read their
environment and interpret external cues that
indicate other’s intentions. The inability to
adequately interpret the intentions of others,
combined with stressful stimuli that remind
individuals of the trauma, cause those with DTD
to feel “constantly on guard, frightened and
over-reactive” (van der Kolk et al., 2009, p. 11).
DTD attends to the many unique concerns and
symptoms presented by persons who have
experienced ritual abuse. The case study that
follows uses DTD as an organizing framework
within which to understand how the client’s
presenting complaints harkened back to her
traumatic experiences. Following the case study,
an impact statement gives voice to the influence
“Sarah” has had on my professional practice as a
therapist, and on my personal experience.
The Triphasic Model of Recovery:
Organizing Framework for Treatment in
Counseling
As context for the case study, I organized the
client’s treatment using Herman’s (2015/1992)
triphasic model of trauma recovery. Per phase 1
of the model, initial counseling sessions focused
on gathering information and helping the client
build resources and internal resiliency. During
phase 2, the focus shifted toward the processing
of traumatic memory, with the client and me
working collaboratively to identify fragments of
memory and create a cohesive narrative of the
experience. The second portion of phase 2
consisted of exploring together the ways that the
client had derived meaning from her traumatic
experience, and the related aftereffects.
I further enhanced Herman’s (2015/1992)
organizing framework through the use of
additional counseling interventions. These other
interventions included psychoeducation
regarding the fragmentation of traumatic
memory (van der Kolk, 1996) and identification
of body memories using somatic experiencing
(Levine, 1997). Using cognitive behavioral
therapy strategies (Beck, 1995), I identified and
challenged the client’s core beliefs and thought
processes that had been altered by the traumatic
experiences.
The triphasic model provided a recursive means
for organizing therapy. When the client
experienced increased distress or overwhelming
feelings during trauma processing (phase 2), I
would realign interventions to focus solely on
building resources (phase 1). Returning to phase
1, sessions would focus on increasing client
access to both physical resources (i.e., food,
shelter, safety) and internal resources (i.e.,
ability to self-regulate strong affective states and
navigate interpersonal relationships). Once the
client reported a return to baseline homeostasis
and seemed to adequately regulate emotions and
symptoms, treatment would again focus on the
processing of memories and the dentification
and reframing of irrational beliefs.
Case Introduction and Presenting
Complaints: The Case of “Sarah”
The following case study describes the treatment
of “Sarah,” a 27-year-old Hispanic female with a
history of childhood incest perpetrated by her
mother, and ritual abuse perpetrated by members
of the cults in which her mother participated.
Sarah presented to counseling with recurring
panic attacks, and the inability to fall asleep and
stay asleep. Sarah also reported somatic distress
for which no biomedical cause could be
determined. She reported being diagnosed with
autism spectrum disorder (ASD) around age 7
and stated that she hoped counseling could help
her “learn to function.”
History
Sarah grew up in the Southwest United States,
within walking distance of the Mexican-
American border. She described her hometown
as riddled with violence, organized crime, and
corruption that spilled over from a neighboring
city in Mexico. At home, she lived with her
father, a civilian contractor for the military, and
her mother, who stayed at home to care for
