ABSTRACT

As discussed previously, complex trauma clients typically make emergency contacts, unless they are working hard as therapist pleasers and viewing you as a potential abuser. And, of course, there is content in a first crisis. Something sets offa crisis or an emergency. Our clients have repetitive problems with emotional dysregulation. They have multiple triggers. Any one, or a combination of triggers can provoke the first crisis contact. For those new to complex trauma therapy, the following are some of the potential triggers for crises:

Outside stimuli that are similar to traumatizing events. The classic example is the July 4th fireworks taken for incoming shelling by the traumatized veteran. But it can be varied kinds of outside stimuli—sounds, the physical configuration of a space, tones of voice, conversations about sensitive topics. Whatever the stimulus, it pushes the “play” button on the stored fear responses in the client’s limbic system.

Somatic triggers such as bodily feelings or memories arising without the attached context.

Anniversary reaction to a particular time of the year during which traumatizing events happened. Halloween reactions, reactions to the time of summer camp, and reactions to specific holidays all fit here.

Interpersonal relationship triggers: Our clients are especially sensitive to changes in the status of relationships, and these can be both positive and negative changes. Coldness/withdrawal of a love 98object is often extremely provoking, throwing the client back to the time when there was no consistent attachment, with the same panic that we have seen in the insecurely attached infant. But increases in warm feelings can also provoke a crisis. I have seen a client enter therapy because, after being frozen in the insecure/dismissive position, they began to feel loved by a partner who stood by them for many years. The feelings of being loved began to penetrate, and the client became terrified.

Whatever the content of the crisis, there is also a relational process within the therapy. The crisis poses a series of questions for the therapist-client relationship:

Will you be there for me outside of the normal hours of business? Do I matter enough?

Can you actually aid me to feel safe when I am completely panicked? Can you help me return to a state of reasonable, manageable calm?

Can the parts of me that know I do not deserve any thoughtful holding get you to abandon me like everyone else? Indeed, I am expecting to be left alone with my pain, and I know many ways of coping, which present the illusion of control. What can you provide that is more satisfactory than cutting, drinking, sexual acting out, hurting others? All these things have kept me alive, after all.

Can I blow you away with the extent of my pain? Is this something that you can imagine feeling? Will it destroy you? After all, I destroyed my parents and many lovers because of how hateful I am.

Can I blow you away with my rage? You’ve never seen rage like mine. I can devour the earth like one of those monsters in the video games that spits fire and shoots death rays through my arms. Do you really want to stand in the way of the death rays? You better get out while the getting’s good. I’ve destroyed better therapists than you!

Well, if you can understand my pain and my collapse and my dysregulation, then will you be my Mommy? I always wanted a Mommy like you!

99Well, if you can understand my sorrow, will you be the Daddy I never had? Do I have to do all those sex things to keep you here? I’m very good at them! Want to see?

I’ll bet my chaos can drive you nuts. Just let me show you how chaotic life can be! I’ll make you feel just what it was like when I was a kid having to take care of Mom while she drugged, and have sex with Daddy so he’d give us the money for food.

Watch me spin! You fix it!

I’ve had this loaded gun in my desk drawer since I was 14. Have you got anything to make me want to give it up? Well then, can I give it to you?

Any therapist working with complex trauma can likely add to the foregoing list. Is there a commonality that we can learn from in the relational meaning of the client’s first crisis, however presented?