The following experiential exercises for helping groups, both inpatient and outpatient, to process issues of trauma and grief are taken from both The Living Stage and RTR Relationship Trauma Repair by Tian Dayton, both available at HCIBOOKS.com
1. To provide a visual context through which to identify the developmental progression of trauma.
2. To see where traumas may have clustered in life or where there was little to no trauma.
3. To allow clients and therapists to identify where development may have been arrested or gone off track.
4. To identify points of strength and resilience.
5. To bring to consciousness how trauma breeds trauma, connecting related traumas so that one can see the full impact, not just of one traumatic event, but of a string of related traumas.
6. To put life experience back into a context and place traumatic experience into real rather than
Notes to Therapist: This exercise is core to the entire model. The Trauma Time Line allows clients to get a basic sense of how trauma may have clustered in their lives and which parts of their lives were relatively free of trauma. Trauma that occurs early in a child’s life may impact their later development. The Trauma Time Line can reveal how early trauma patterns may have continued to be recreated throughout client’s lives. Trauma can also create loss of memory and context. The trauma time line helps clients to place experiences that they may have pushed out of consciousness back into the overall framework of their lives. As clients articulate and share painful feeling/memories that may have been previously inaccessible, they are able to attach words to their experience and elevate unconscious experience to a conscious level. This is not the end but the beginning of treatment, the beginning of living and processing emotion differently. Trauma will not be resolved overnight nor once and for all, rather, through this process, clients will learn the skills of translating pow- erful, unconscious feelings into words, to talk about feelings without imploding, exploding, or self-med- icating. Painful memories will continue to come forward for a long time and new life challenges will arise. The idea is to learn to process emotions consciously rather than repress or split off pain. In this way, the same life can be experienced differently, situations that once might have blown up creating more trauma can be handled in such a way as to engender learning, personal growth, and strengthen resolve and resilience instead.
1. Ask participants to go to the Trauma Time Line exercise in their Personal Journals
(in RTR or to use a piece of paper and draw a line along the bottom of it with lines jutting upwards to fill in).
2. Ask group members to recall events, situations, or behaviors from their families that have felt
traumatic to them, that hurt or frightened them very much or caused them to shut down.
3. Have them locate these events on their appropriate place along the time-line.
4. Share the time-lines and invite clients to make observations as to what they see in their own
5. Next, lay out large note cards along the floor in a time line progression of five year intervals to match
the Trauma Time Line, e.g., cards will say 5, 10, 15, 20, 25, etc.
6. Invite group members to go to a place along the Time Line on the floor where they feel they have
unresolved issues (they can just choose that place that they are presently most “aware” of and feeling the most intensely as there may well be several). This will naturally align and allow people who are emotionally tender around the same developmental stage to stand near each other.
7. Invite them share with those nearest to them on the Trauma Time Line, thus allowing them to 1) begin to talk “from that age and emotional and psychological space in time,” 2) give that part of themselves a voice and 3) receive identification and support. Note: this will help to break the pain of isolation and is itself a full exercise. You can do this for more than one stage, e.g., go to another time, etc., though more than two will likely be overwhelming and one can feel very sufficient.
8. After time line work is finished, either go back to seats and share about the entire process to create closure or proceed with one or both of the following two options 1) journaling 2) psychodrama.
“Mentally reverse roles” with yourself anywhere along the Trauma Time Line continu- um and write a journal entry speaking “as” that part of self. E.g., “I am Shahara, I am eight years old and I am . . .” or “I am Hank, I am around thirteen and I just . . .” After you have completed your journal entry “answer back” from your “adult role” of today. In other words, begin a journaling dialogue between these two parts, your childhood self and your adult self, and allow your adult to help your child or adoles-cent self learn to talk about their experience rather than hide it from your adult self and allow your adult self to listen to, support, and guide your child self. This is a cornerstone activity. It is designed to teach you to carry on a dialogue with your “child self” so that you will…
1) integrate your child and adolescent “selves” into your adult self,
2) learn the difference between a “child” or “adolescent” state of mind and an “adult” state of mind
3) teach your child self to translate his/her powerful emotions into words and talk about them rather than simply act them out or medicate them and
4) develop the habit of listening to the feelings your child self is trying to articulate and place them within an adult framework BEFORE you blurt them out in their “triggered” or “un-thought-through” state. You are learning to let your think- ing brain translate the powerful emotions and sensorial impressions stored in your limbic brain into words so that feelings can be reflected upon and put into a thoughtful and intelligent framework.
1. Setup two chairs facing each other,one representing theclient at thea ge represented in their journal entry, the other their adult self.
2. Invite the client to sit in one chair representing themselves at the age of their journal entry and ask them to read their journal entry out loud or let them simply spontaneously talk as their younger self.
3. When they are finished reading it (or talking), invite them to “reverse roles,” sit in the “adult self” chair and respond to the younger self or, if you know how to do role-plays, reverse roles continually and have a dialogue between the child self and the adult self.
The idea here is to develop this link from the child to the adult self so that in future, when the child self is feeling strong feelings, she will look to the adult self to help manage and regulate those feelings through holding, insight, and understanding rather than have the child self move straight into talking and action from a frustrated, “young” and immature place without mature reflection and understanding. Here we’re developing new, more mature ego functions.
Process 2 Stages of Grief: Where Am I in My Own Process of Working Through Grief Issues?
1. To allow group members to identify which stage or stages of the grief process they might be in.
2. To allow group members to identify with, feel supported by and learn from each other.
3. To create a safe format in which to deal with issues of grief and loss.
4. To make conscious and process grief-related issues.
Notes to Therapist:
This exercise is meant to introduce the concept that grieving is a process, not a one time event, that grieving happens in stages that can be 1) experienced in order 2) experienced out of order or 3) cycled through over and over again. The stages in this exercise are based on the seminal work on attachment and loss by British psychoanalyst, Jonathon Bowlby. They relate to the loss of any bonded attachment figure and I extend their use to include either an aspect of self (“time,” self-respect, a normal childhood, a comfortable family, etc.), or a substance or behavior (alcohol, drugs, food, sex, cigarettes, and so on). Anything that a client feels a need to grieve is fair game. Again, the idea is to help clients to slow down and understand that grief is a process that they need to walk through over and over again, that it will likely not be “cured” once and for all but that it will lessen, take up less emotional space, and feel less unconscious as it is faced and worked through.
Simply experiencing shut-off emotions, translating them into words, sharing them and having them witnessed by others is a powerfully healing experience, and these exercises are designed to be a sort of living ritual that encourages that process to occur. Once the subject of grief is opened up, it can be as if a flood gate opens and pain, tears, anger, and despair pour through it. Grief is a critical stage in terms of trauma resolution, clients may feel a powerful shift from emotional numbness, unconsciousness, and fear and shut down and into an overwhelming feeling of loss—but they will soon experience profound relief as they share and feel less alone in their pain. At this point, they simply need space and support to tolerate the powerful and often unconscious emotions that are surfacing.
1. Assign one stage of the grief process, as adapted from Jonathon Bowlby, to each of the four corners
of the working area or stage. For example, the northeast corner of the room represents the stage of numbness, etc. Designate a space somewhere on the floor to represent “other“ so that anyone who feels they are experiencing something outside of what is mentioned can stand on that and later share about their specific experience.
2. Invite group members to go to the area of the floor that best represents where they feel they are in their grieving process related to the issue they are working with, e.g., loss of a person, of a part of their lives, of a substance, of self, of family, and so forth. They may be in any stage as relates to this issue.
3. Ask whoever wishes to share why they chose to stand where they are standing. Note: group members can share one at a time so the entire group can hear or in subgroups with those who are standing next to them. They will be standing in” sociometric alignment,” e.g., those in anger will be standing next to those in anger, those in yearning and searching will be standing next to each other, and so on.
4. Next, ask group members if there is a part of the grieving process they feel afraid of and wish to avoid.
5. Invite group members to share a sentence or two about why they are standing where they are standing.
Process 3 Grief Graph/Spectrogram: How Much/How Little am I Feeling?
1. To discern “levels of emotional intensity” so that clients can understand how much or how little of
any particular emotion they may be experiencing.
2. To work with the pain, sadness, and anger that can drive depression, anxiety, and relapse.
3. To make unconscious material conscious by experiencing the frozen feelings that are blocking real
4. To allow group members to identify with and connect with each other.
1. Draw an imaginary line dividing the room down the middle, showing group members where it is as you
2. Explain to the participants that each end of the room represents an extreme and that 50% is the mid-
point: for example, one end of the room is 0% and the other 100%.
3. Now choose some of the questions from the list below that feel are relevant to your particular group
and ask participants to stand at whatever point along the continuum that feels right for them in response.
• How much yearning do you feel?
• How much sadness do you feel?
• How much anger do you feel?
• How much unresolved emotion do you feel surrounding this loss?
• How blocked are you from getting in touch with your genuine feelings involved in this issue?
Notes to Therapist:
The purpose of the Grief Spectrogram is
1) to educate clients about grief symptoms,
2) help them to self identify as to how much of any one symptom they may be experiencing, and then
3) connect them to each other through identification and sharing. The exercise places the locus of control within each group mem- ber in terms of self-identifying where they are on the continuum in relationship to each symptom.
Both trauma and grief are on a continuum; individuals will vary considerably as to how they experience even the same trauma depending on previously identified factors. Consequently their level of grief, sadness, anger, disruption and so on will depend upon the individual. The spectrogram allows clients to assess themselves. Clients may move around if they change their minds as to where they belong as sharing progresses.
UNIT 3—Processing Grief: Unblocking Pain; Unlocking Tears 61
• How disrupted in your daily routines do you feel?
• How much fear of the future do you feel? • How much trouble are you having organizing yourself?
• How uninterested in your life do you feel?
• How much do you feel your grief has contributed to your becoming a deeper person?
• How much old, unresolved grief is being activated and remembered as a result of this
• How tired do you feel?
• How much hope do you feel about your life and the future?
• How much regret do you feel?
• How much self-recrimination do you feel?
• How much shame or embarrassment do you feel?
• How much depression do you feel?
4. After each question, allow people to spontaneously share feelings that come up for them while doing this exercise, either with the group at large or, if the group is large, in subgroups with those who are next to them on the spectrogram. You can do a mixture of forms of sharing; that is, on one question you can let the group share in the large group and on another they can share in subgroups with those who are standing near them along the spectrogram. I generally allow the group to choose however they would like to share by simply asking, “Would you like to share in the large group or subgroups on this one?”
5. Repeat this process for as many questions as can be absorbed, generally three or four will be plenty but you can do more if the group wishes.
6. Next, invite group members to go to their Personal Journals to “write a letter.” Write a letter beginning with Dear_____ and ending with an appropriate closing.
Note: If the therapist is not comfortable directing the role-play in Process 4, letters can be shared in group, subgroups or read to an empty chair or role-player. In this case, you can skip Process 4 and go to Process 5 after working with letters.
JOURNALING: Letter Writing
• Write a letter to whom you wish to say good-bye.
• Write a letter to yourself at a particular
time of life that you may be letting go of.
• Write a letter to a substance or behavior
that you’re giving up. Write a letter to a role or part of yourself.
(e.g., a role, the role of the addict) that you’re saying good-bye to. Other: this can allow for personal adaptation of letters, “Write what you need to write to bring closure and relief.”
(The use of a grief spectrogram is an adaptation developed by Ronny Halpren,
MSW, Bereavement Coordinator for the Carbini Hospice in New York City.)
Process 4 Empty Chair/Vignettes/Letter Writing: Making It Real: Making It Relational
1. To say good-bye fully to someone who has left one’s life.
2. To release that person, place, relationship, part of life or part of self and move on in one’s life.
3. To say good-bye to a substance or behavior
4. To say good-bye to a part of the self or a period in one’s life.
1. Invite the protagonist to share briefly a sentence or two about the person, behavior, substance, or
part of herself, etc., that she wishes to say good-bye to.
2. Invite her to choose a person or to use an empty chair to represent the person, substance of, part of
3. Invite the protagonist to fully say good-bye. Encourage the protagonist to be specific, saying good-
bye, in detail, to all that she will miss.
4. If it seems appropriate or helpful, allow her to say what she will not miss.
5. The protagonist can reverse roles with the person, substance, or part of self, etc., whenever
6. Ask the protagonist to finish the good-bye in any way she wishes.
7. Allow plenty of time for sharing in the group.
If the protagonist is saying good-bye to a lost person or even a part of the self, setting the scene can also be part of the role-play. The protagonist may wish to be in any type of setting, either real or imagined.
Notes to Therapist:
This exercise allows pain to be shared, personalized, and placed into context. It is amazing to witness how much feeling can arise when talking to an “empty chair” that is, of course, not empty at all but filled with the felt presence of another person from the client’s life. It is a testimony to the power of the introject or carried presence within us of another person and how real they become through this exercise. There will be significant grief, along with the relief, when giving up a substance or compulsive behavior. Protagonists may benefit from talking to the substance or behavior, embodying it, speaking as it so that they can pass through that feared boundary between becoming it and never getting out again. Protagonists may also want to talk to a part of themselves that they are letting go of “the fun drunk,” the “life of the party,” the “bad person,” etc.
Use doubling (see The Living Stage pages 36-38) to allow the protagonist to give words to what may be too difficult to say from their own role and role reversal so that 1) the protagonist can experience actually ‘standing in the shoes’ of the other person and 2) so that the protagonist can have the opportunity, if they wish it, to say something “as” that other person that they may long to hear (note: this should not be expect- ed, but it can happen and it can be very healing if it does).
The setting can be a funeral, a deathbed, a park scene, a field of flowers, or anywhere the protagonist may choose. The idea is to say good-bye fully wherever it works best. If life did not offer an opportunity for the protagonist to say good-bye and put closure on the relationship, psychodrama can allow that to happen.
Note: Clients may also write “letters” in their personal journal or on emotionexplorer.com that may be shared in group.
Process 5 Guided Imagery: Unblocking Grief: Letting the Tears Flow
Notes to Therapist:
Guided imagery takes us into both the superconscious and the subconscious realm. The superconcious realm is generally reassuring and soothing and is a “mental place” where new behaviors and lifestyles can easily be imagined and “practiced” through use of the creative imagination. The subconscious realm can bring forward emotions and mental imagery that can be more painful to experience. Ideally, the environ- ment when listening to a guided imagery is quiet, comfortable, and relaxed and the music soothing enough so that listeners will feel relatively safe in experiencing what may feel like unsafe emotions.
As we develop a “safe container” within we can better learn to tolerate the kinds of painful, disequalibrating emotions and longings associated with grief. And we can experience them in a measured and manageable fashion. Much of our pain in life comes as much from avoiding difficult emotions as actually experiencing them. Guided imagery allows for a reasonably safe experience of avoided, split off, or repressed emotions so that they can be felt, made sense of and incorporated into the self-system with new insight and meaning attached to them, as well as a sense of relief at having actually felt ones heretofore unfelt but known inner world.
1. To learn the skills of self-soothing and self-regulation and to develop a feeling of relative safety in
experiencing split off emotions associated with grief.
2. To allow difficult emotions to arise and be “witnessed” by the thinking mind without taking action,
acting out, or self-medicating.
3. To allow limbic or body memories to emerge, be felt, and made sense of by the thinking mind so that
they can be reincorporated into one’s sense of self with new understanding.
4. To process the painful sets of emotions associated with grief.
5. To give grief a contained “process” through music and guided imagery.
1. Invite clients to lie comfortably all over the floor, make pillows available to put under heads if they
wish for them. Invite clients to “uncross arms and legs, allow legs to flop out naturally to the sides, and palms of hands facing the ceiling.” Some clients may wish to sit in chairs, if they do, so ask them to sit with their spine in an elongated, comfortable position that’s easily sustained.
2. Play the guided imagery: Processing Grief: Unblocking Pain: Unlocking Tears. Guided imageries can bring up feelings, some people may seem visibly moved while others may have trouble lying still or keeping their eyes closed. Just allow people to be where they are as they listen.
3. When it’s over either:
A. Invite clients to share about what came up in the large group or in small
subgroups. Grief is a powerful experience and clients may need to continue to pour out pain for
some time once they have come in touch with it.
B.Let clients go to an exercise in their journal from Unit3,the more ways in which clients can
release their grief the better, journaling allows clients to translate their pain into words which can be very healing. Letter writing is a very effective form of journaling allowing clients to say what they need to say to another person, a part of themselves, or a substance they are letting go of. Letters and other exercises can be written in group and shared in small groups if desired.