Healing Trauma in Group Settings

The Art of Co-Leader Attunement

Stephanie Wise, Emily Nash

• Publisher: Routledge
• Year: 2019
• eBook ISBN: 9781351673198
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

Healing Trauma in Group Settings offers a unique focus on the highly valuable role of attuned co-leader relationships in the practice of healing trauma.

Drawing on their extensive experience of co-leadership, the authors demonstrate how to maximize the potential for effective trauma work while remaining attuned to the needs of individual group members and the group as a whole. With case studies, transcripts, and vignettes interwoven throughout, chapters suggest ways in which clinicians can model co-leader relationships as a means for developing a sense of interpersonal safety, exploring difficult material, and building opportunities for healing to take place.

Demonstrating how concepts of attunement can be utilized in real-world settings, Healing Trauma in Group Settings enables mental health professionals to forge connections with clients while drawing on the potential of co-leadership in group therapy.

Part 1 Co-Leading and Attunement

Chapter 1

The Role of Co-Leader Attunement in Service to Healing

Stephanie Wise

Introduction

Healing from trauma is an arduous and lengthy process. The grip of terror can be tenacious, entrenched, and merciless. Our patients and clients courageously risk traversing through the fear, loss, and pain imposed upon them from devastating forces outside their control. For those therapists who work in isolation with traumatized people in group settings, the healing journeys embarked upon may challenge the capacities of a single group leader to hold the weight of guiding the entire therapeutic process. Being “in it” with our clients, jointly facing the perils of rupture, abandonment, betrayal, and sometimes unabridged evil, can bring even the most seasoned therapists to their knees.

It is with concern for therapists and clients alike that we explore the need for co-leadership as a means to effectively work with trauma in group settings. As Judith Herman reminds us, “Just as no survivor can recover alone, no therapist can work with trauma alone” (Herman, 1992, p. 141).

What is it about having two mutually attuned leaders that enhances the therapeutic climate and increases the potential for healing trauma within the group experience? In what ways does the co-leader relationship provide essential support for the therapists working with trauma?

We have found in our years of practice together that co-leading trauma groups offers many rich gains for both the clients and therapists. In fact, working as a therapeutic dyad has become our method of choice. For example, one major benefit for therapists in partnership can be a kind of inoculation to the ravages of the trauma material that comes up in sessions. Vicarious traumatization is a potential outcome for many a therapist exposed to the painful stories and ongoing suffering of clients. Sharing the weight and oversight of the therapy experience with a supportive, attuned partner challenges typical therapist isolation. This, in turn, may help prevent the development of an internal breeding ground for trauma to fester. Another benefit can be the attenuation of accumulated encounters with traumatic material. Few of us see only one traumatized patient and certainly in the group setting the numbers are significantly increased. The depth and breadth of engagement with trauma is substantial. Having an attuned partner protects, stabilizes, and defends against overwhelm.

Working well as partners is not the simple sum of one plus one. Co-leadership requires numerous levels of attunement to augment the prospects for effective healing to take place. The therapeutic environment, enriched through a range of relationships between co-therapists and group members, engenders multiple possibilities for healthy transformation. With two therapists co-leading trauma groups, the intricacy of the attunement equation is compounded as the dimension of the healing work twists and turns in many directions at once.

Co-Leader Attunement – Trust

What we mean by attunement of co-leaders is embodied in the basic concept of trust. As Joshua Wolf Shenk stated, “When you feel trust, the writer George Saunders told me, you know the other guy is going to cover your back. You can just throw yourself over the cliff because you know you’re going to be caught” (Shenk, 2014, p. 33). While this may seem obvious, deconstructing the components of trust as we have experienced through our work together is relevant to understanding how attunement comes about. For purposes of developing and maintaining attunement between partners, we have found three over-arching interlocking core values at the heart of the trusting co-leader relationship: relational congruence, mutual respect, and an integrative vision to the work. All three need to be present for co-leader trust to ensue.

A trusting relationship is hard won. It is a felt experience born of a conscious commitment to honoring and protecting the integrity of the other. As we reflect on the many co-leader relationships we have had over the years, we agree that the presence of trust enabled us to do our most effective work. Trust solidifies and grows as co-therapists support one another through rocky terrain and negotiate moments of discord and disruption. Trust engenders safety and security when feeling lost or inadequate.

When trust is a natural component of the co-leader relationship, therapeutic capacities feel most alive. Confidence in knowing the partners are fully present for each other becomes an act of creation in that it inspires expansion of possibilities for our clients. A trusting connection allows for the freedom to try new ideas, to make mistakes, and to not have worries or fears of feeling judged or shamed. When trust is betrayed or undermined, the integrity of the therapeutic dyad is vulnerable to rupture and even disintegration. The parallel negative implications for our trauma clients when trust is absent is evident and so it is imperative that co-leaders find their way to genuine trust to best serve the overall healing process.

Central to the existence of dyadic attunement is the living experience of trust. Attunement represents both the means to arriving at and the state of being within a trusting relationship. This does not happen in a durational way without the attention and nurturance of both people in the co-leader relationship. And so, as partners we look for ways to get to an inner place of a trusting alliance, as well as ways to sustain it. Attunement as a process is ongoing, continually renewing, and aspirational.

Core Values

Relational Congruence

Emily: Our relationship began on a plane. It was our first work assignment together. We were on our way to join a team of eight others to work with a community of educators following the devastation of Hurricane Katrina. I have little memory of the content of the conversation that passed between us but a vivid memory of feeling the rush of what we can call “coming from the same place.” Both of us had over thirty years of work in our field. We had, over time, evolved a way of thinking that informed how we approached our work. We had drawn from the inspiration of mentors and colleagues. We had been in the trenches as clients taking our own healing journeys. We had also both struggled through very challenging relationships with others in our field – disconnects of values, intentions, approaches in the work. All this we brought to our first meeting. It didn’t take long for us to begin to delight in the discovery of a shared understanding of what was most important to each of us in the work we did. Not specific techniques nor content, but a deeper philosophical meeting of the minds.

Though our meeting of minds began serendipitously 30,000 feet in the air, we intentionally continued to learn more about each other and how our collaborative relationship might evolve. Through what we call “arts and conversation,” we set about using creative means and dialogue in exploring, expanding, and refining our ideas about co-leading. We understood that we did not have to hold identical views or respond exactly alike or in any way be less than authentic with each other. In fact, we both appreciated that complementary strengths and vulnerabilities were often of benefit to group co-leadership.

What we learned over time about each other was that our core values, deeply held beliefs, and ways of responding to and being with other human beings resonated between us. One realization that we both shared was what Carl Rogers referred to in his book, A Way of Being, as creating a “growth promoting” environment for therapy (Rogers, 1980, p. 115). He considered two basic conditions as essential to the development of a climate of optimal emotional growth and transformation for clients: genuineness and acceptance. We had both historically placed these fundamental humanistic principles as central to our own clinical work and profoundly appreciated finding this out about each other.

There were, of course, other meetings of mind, as well as times of disagreements. But the intention was never in being perfectly aligned. The true worth was the journey we took together embodying relational congruence as a synergistic means to remain attuned in service to maintaining trust between us and our clients. Our values and destiny became inexorably linked.

As time went on, we carried out our conversations during any time we could find to communicate. Looking back, these were exploratory discussions as we probed the depth and breadth of our beliefs and experiences. At a certain point in our conversations, we recognized questions we both had about our work running trauma groups. One evening, after running a trauma training group together, Stephanie mentioned,

I am beginning to appreciate more and more the difference it makes to run trauma groups with a partner. So many of my experiences have been doing this work alone which can feel so isolating. I keep asking myself if it is in the best interest of the clients to run these groups alone.

Emily responded,

Actually, I’ve been working with partners almost my entire professional career and I’ve often felt deeply connected in those partnerships. But what has been absent is a codification why some things in the co-leader relationship worked, and others didn’t. And how important focusing on the relationship itself would be.

What is so obvious to us now was startling and exciting to us at that time. That the co-leader relationship was an entity unto itself and needed the same kind of attention as any meaningful relationship needs to grow and evolve. We were aware that having two leaders did not automatically add to the “growth promoting environment” (Rogers, 1980, p. 115), that they were not necessarily working the room together in sync, attuned, and mutually supportive. At times, partnerships fell flat, were rife with competition, and not necessarily cohesive.

As we teased out many thoughts over the next months and years, we more deeply explored various theories, approaches, and especially important to us, our personal attitudes about working with clients. How we are, is inseparable from who we are, and trauma clients are exquisitely sensitive to the signals we give and our attitudes towards every person in the room including each other. These principles became foundationally important as integral to our core value of relational congruence.

What we ultimately came to understand was that how we feel about clients consciously or unconsciously needs to be at all times rooted in principles of genuineness, compassionate acceptance, empathic resonance, and dignity. When we are genuine, we openly bring our authentic selves to each moment of engagement. Compassionate acceptance is the unconditional welcoming of the complexities each person brings as they enter our group experience. Empathic resonance is our capacity to bridge and step into the emotional world of the other. We consider dignity a birthright that counterbalances the erosion, desecration, desperation, and shame experienced by so many of our trauma clients.

And so, what was born from the fruits of our experiences working together, our observations about what was and was not effective, our deep conversations well into the night and our personal sharing, were our fundamental beliefs about co-facilitation. We found that a humanistic essence satisfied aligning our values most effectively. To this day, we attempt to remain rooted in these values as a natural way of our being regardless of context, techniques, population. We recognize the effort and consciousness required, as therapists, to challenge our more habitual and instinctive responses that most of us experience in everyday life. When we inevitably veer from responding in ways that are true to these values, we remind ourselves to commit to reflection and self-understanding in the service to overcome whatever personal obstacles may have derailed us.

We strive to provide a safe and compassionate atmosphere for confronting what might otherwise cause us to defend, deny, or retreat. Lest our verbiage becomes empty and academic, as co-leaders we commit to walking this walk. If we speak of the importance of dignity and diminish the other, or wave the flag of acceptance and judge, we are not living the experience we promote. Engaging personally in this process becomes for us, as attuned co-leaders, our struggle and our ultimate reward.

Mutual Respect

Mutual respect can be both noble and filled with a spirit of joy. The interplay between partners invites an openness of thoughts and feelings. It lays fertile ground for new concepts to flourish because there is no shame interfering with budding ideas. It is principled, as interpersonal behaviors and words are conscious, deliberate, and with good intention.

Mutual respect resides in the here and now as an “in the moment” exchange. This is a kind of relational currency for co-leaders, which honors the humanity of both persons within the partnership. While respect for another person may be a given as part of one’s basic social value system, mutual respect within the professional frame develops over time as a co-created entity derived from consistent shared observation and experience.

When mutual respect thrives, we give conscious thought to both, how we communicate honest feedback to the other, as well as our openness to the thoughts and observations of the other. Challenging moments are not threatening. A therapeutic faux pas becomes an opportunity to learn rather than a personal failing. No fault, no blame. Just deepening the understanding of moments lived together.

Of course, it is hard to ignore the history each of us brings to the partnerships. Over time, we share our stories with our partners including the traumas and triggers. Mutual respect avoids activating known triggers at all costs. Mutuality suffers horrifically when we are cavalier with the known vulnerabilities of others. This is the face of betrayal. In fact, we have never seen a partnership fully repair back to that joyful and noble place once such a betrayal has taken place.

Stephanie: Many years ago, we were working at a therapeutic training on an island in Greece. There were several therapists in our group most of whom had traveled and worked together previously. On these sorts of gigs, it is typical to work hard all day and then stay up late at night talking into the wee hours about every conceivable topic. Naturally, sharing intimately helped us feel safely contained within the familiar world from which we came.

On the day we were leaving we had a long drive to the rudimentary lit...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of figures
• List of Contributors
• Preface
• Acknowledgements
• Prologue: An Invitation – Stephanie Wise
• PART 1: Co-Leading and Attunement
• PART 2: Real World Settings
• Epilogue: An Appreciation – Stephanie Wise
• Index