ABSTRACT
This chapter expounds in detail the collaborative construction of the trauma-informed, emotion-focused formulation at heart of the Comprehend, Cope and Connect (CCC) approach. The formulation process is tracked through two of the illustrative case examples, who had received diagnoses of chronic, recurring depression and Borderline/ Emotionally Unstable Personality Disorder respectively, diagrams included. The case example who had received a psychotic diagnosis had not yet reached a stage where explicit formulation of this nature was possible. It is frequently important to delay formulation in case of psychosis until the person is ready to hear it, and engagement is the pressing challenge in this case. The formulation first identifies the unbearable emotion, the felt sense behind dysfunctional coping (e.g. depressive withdrawal, self-harm, etc.). Immediate circumstances leading to breakdown, and past circumstances that have become entangled with these, because of the way that trauma intrudes into the present, are then named, as explained in the previous session in terms of differential processing. To ensure the individual is met holistically, strengths and faith/spirituality are explored. The behavioural maintaining cycles are then identified. Breaking these provides the content of clear behavioural goals to be pursued during the intervention stage of the therapy that comes next.
