46 International Journal of Cultic Studies ■ Vol. 10, 2019
During the first phase of treatment, Sarah’s
stability and access to resources was the priority.
Initially, attending to her basic needs was not
only the most pragmatic approach, but also one
that aligned with Herman’s (2015/1992)
triphasic model of trauma recovery. Following
the intake assessment, our first goal was to
obtain academic accommodations through the
university. Sarah met with a rehabilitation-
counseling case worker who assessed her
symptoms and provided her with a letter for her
course instructors that indicated Sarah was to
receive excused absences and extended time to
complete assignments and tests.
Once Sarah had obtained academic
accommodations, she met with a student
advocate who helped her to understand the
financial costs that were applied to her
university bursar’s account and the status of her
financial aid. The advocate set up a meeting
between Sarah and a financial-aid advisor, who
then helped her to obtain multiple scholarships
and a loan to cover the costs of attending
classes. After multiple meetings with advocates
and advisors, Sarah obtained enough financial
aid to be able to register for courses.
Sarah stated that both she and her husband were
struggling to find work. Sarah met with an
advocate through campus career services who
helped her to create a resume and apply for
multiple student jobs and work-study positions
on campus. Sarah also utilized this resource to
role play and further develop her interview
skills. To ensure that Sarah and her family’s
basic needs were met, I assisted Sarah in
completing the applications for Medicaid, the
Supplemental Nutrition Assistance Program
(SNAP), and Women, Infants, and Children
(WIC) benefits.
Phase 1: Psychological Resources
After the first four sessions, Sarah stated that she
felt she had the resources she needed to be
successful as a student, and that she wished to
begin addressing the panic attacks, nightmares,
and distress she experienced as a result of her
traumatic memories. At that point, her primary
focus in treatment shifted from building access
to resources needed for daily living to
developing both tolerance to distress and coping
skills.
I obtained Sarah’s permission to introduce her to
some of the models for understanding
posttrauma reactions. Sarah and I reviewed
Porges’s (2004) polyvagal theory, exploring
how Sarah was presently experiencing fight,
flight, and immobilization in response to trauma
reminders. Sarah and I discussed how her body
seemed to unconsciously detect whether an
individual or situation was safe or unsafe, with
the body perceiving the majority of stimuli as
threatening. We explored early signs that her
autonomic nervous system was beginning to
react, and also identified the related trauma
triggers (Levine, 1997). Identifying triggers
enabled me to begin inducing these reactions in
session, and for Sara to practice coping
strategies (e.g., mindful breathing coupled with
grounding exercises, leaning in to the somatic
and emotional experience).
Phase 2: Trauma Processing
Each of Sarah’s counseling sessions included a
review of the status of resources and current
needs before we engaged in any traumatic
material. Phase 2 consisted of processing
traumatic material while creating a “trauma
narrative” (Herman, 2015/1992) that brought
together multiple fragments to create a cohesive
chronology of events. During each session, I
asked Sarah whether she had had a distressing
memory surface over the previous week. She
usually reported three to five fragmented
memories that had caused particular distress,
either through adrenaline-inducing nightmares
or from newly identified trauma reminders.
Van der Kolk’s (1996) model of the
fragmentation of trauma memory provided Sarah
and me with a means for understanding how her
memories were stored and recalled. Each time
Sarah reexperienced a traumatic memory, she
would recall only a couple of pieces perceived
through touch, taste, smell, feel, or hearing. Van
der Kolk (1996) explained this phenomenon to
be the result of the fragmented nature of trauma
memories. During a traumatic experience, the
individual’s threshold for affect and distress are
surpassed, and the mind fragments the memories
and fails to process them into declarative
During the first phase of treatment, Sarah’s
stability and access to resources was the priority.
Initially, attending to her basic needs was not
only the most pragmatic approach, but also one
that aligned with Herman’s (2015/1992)
triphasic model of trauma recovery. Following
the intake assessment, our first goal was to
obtain academic accommodations through the
university. Sarah met with a rehabilitation-
counseling case worker who assessed her
symptoms and provided her with a letter for her
course instructors that indicated Sarah was to
receive excused absences and extended time to
complete assignments and tests.
Once Sarah had obtained academic
accommodations, she met with a student
advocate who helped her to understand the
financial costs that were applied to her
university bursar’s account and the status of her
financial aid. The advocate set up a meeting
between Sarah and a financial-aid advisor, who
then helped her to obtain multiple scholarships
and a loan to cover the costs of attending
classes. After multiple meetings with advocates
and advisors, Sarah obtained enough financial
aid to be able to register for courses.
Sarah stated that both she and her husband were
struggling to find work. Sarah met with an
advocate through campus career services who
helped her to create a resume and apply for
multiple student jobs and work-study positions
on campus. Sarah also utilized this resource to
role play and further develop her interview
skills. To ensure that Sarah and her family’s
basic needs were met, I assisted Sarah in
completing the applications for Medicaid, the
Supplemental Nutrition Assistance Program
(SNAP), and Women, Infants, and Children
(WIC) benefits.
Phase 1: Psychological Resources
After the first four sessions, Sarah stated that she
felt she had the resources she needed to be
successful as a student, and that she wished to
begin addressing the panic attacks, nightmares,
and distress she experienced as a result of her
traumatic memories. At that point, her primary
focus in treatment shifted from building access
to resources needed for daily living to
developing both tolerance to distress and coping
skills.
I obtained Sarah’s permission to introduce her to
some of the models for understanding
posttrauma reactions. Sarah and I reviewed
Porges’s (2004) polyvagal theory, exploring
how Sarah was presently experiencing fight,
flight, and immobilization in response to trauma
reminders. Sarah and I discussed how her body
seemed to unconsciously detect whether an
individual or situation was safe or unsafe, with
the body perceiving the majority of stimuli as
threatening. We explored early signs that her
autonomic nervous system was beginning to
react, and also identified the related trauma
triggers (Levine, 1997). Identifying triggers
enabled me to begin inducing these reactions in
session, and for Sara to practice coping
strategies (e.g., mindful breathing coupled with
grounding exercises, leaning in to the somatic
and emotional experience).
Phase 2: Trauma Processing
Each of Sarah’s counseling sessions included a
review of the status of resources and current
needs before we engaged in any traumatic
material. Phase 2 consisted of processing
traumatic material while creating a “trauma
narrative” (Herman, 2015/1992) that brought
together multiple fragments to create a cohesive
chronology of events. During each session, I
asked Sarah whether she had had a distressing
memory surface over the previous week. She
usually reported three to five fragmented
memories that had caused particular distress,
either through adrenaline-inducing nightmares
or from newly identified trauma reminders.
Van der Kolk’s (1996) model of the
fragmentation of trauma memory provided Sarah
and me with a means for understanding how her
memories were stored and recalled. Each time
Sarah reexperienced a traumatic memory, she
would recall only a couple of pieces perceived
through touch, taste, smell, feel, or hearing. Van
der Kolk (1996) explained this phenomenon to
be the result of the fragmented nature of trauma
memories. During a traumatic experience, the
individual’s threshold for affect and distress are
surpassed, and the mind fragments the memories
and fails to process them into declarative
