I wrote this out for a masters level clinical social work class that I teach and thought some of its principles are applicable to our convo’s here. If not, well, whatever:

(Note: This is a specific step in trauma focused CBT which comes after the child went through the crucial therapeutic step of creating his or her trauma narrative)

As always, notes are appreciated

1. Be ready.
Before the first session of cognitive processing, review the trauma narrative to plan for the session. Remember, cognitive processing involves challenging thoughts and beliefs that the child may firmly believe; it’s not a simple matter of just telling them new information. Therefore, review the child’s thoughts that were written down or verbalized, looking for examples that may be inaccurate or unhelpful (though it’s also great to identify thoughts that are accurate and praise and reinforce them).

2. Re-read the trauma narrative with particular attention to thoughts
In session, go over the trauma narrative. As each thought that was written down (or verbalized) is expressed, inquire about whether that thought was accurate and helpful. For some unhelpful or inaccurate thoughts, the client will be able to identify how his or her perceptions have changed since the event. For others, additional discussion will be necessary. You should pay close attention for thoughts or beliefs that reflect shame, guilt or responsibility for the trauma or its consequences, self-esteem, trust in others, and current and/or future safety. This is not, of course, an exhaustive list.
3. Challenge unhelpful or inaccurate cognitions
It’s important to recognize that cognitive processing interventions are NOT simply “having a talk with” a client, or “arguing away” a person’s unhelpful or inaccurate beliefs. Rather, these interventions challenge and engage the client in a process that examines his or her thoughts and beliefs. There are several effective ways of challenging thoughts, and no one technique is likely to be successful with all issues, or with all children. Therefore, it is best to learn how to address cognitive errors using numerous methods. The most common method is called “progressive logical questioning,” which is sometimes also referred to as “Socratic questioning.” This technique, common in cognitive psychotherapies, employs a series of questions designed to draw out clients’ unhelpful or inaccurate cognitions to their logical conclusions. In most cases, these conclusions are very undesirable or downright silly (“I can never have any friends ever again for the rest of my life” or “I will be traumatized again and again every day for the rest of my life, even though that has not happened to me so far.”), even though they may seem real to clients.

4. Employ role playing or experiential exercises
Other techniques that can engage clients in the process of examining their cognitions about the trauma involve role-playing or perspective-taking activities. These can be employed with children of all ages, though some modifications are likely to be necessary with younger children who lack the capacity to think about their own mental processes.

Best friend role play
Useful for clients who exhibit unrealistic levels of responsibility or shame related to the trauma. Very simply, the client is instructed to take on the role of his or her best friend, and the therapist takes on the role of the client. The task is to have the client/best-friend counsel the therapist/client regarding the client’s cognitions. (Other roles besides “best friend” can accomplish the same basic goal—parent, therapist, etc.)

Now and then role play
In this exercise, the client is asked to ‘go back in time’ to give him or herself advice about what to do about the trauma before and/or after it happens. The therapist can either play the role of the client “then,” or the client can act out both parts.

Responsibility pie
The child is asked to draw a pie chart and assign “pieces” of various sizes to different individuals who might bear some responsibility for the trauma (e.g., the perpetrator, non-offending family members, the client). The client may assign pieces and sizes to whomever he or she wants, and the size of the piece corresponds to that person’s percent of responsibility for the trauma. The therapist can then discuss the relative sizes of pie pieces with the client and use this as an exercise to help the client verbalize his or her thinking about why the trauma happened. A revised pie can be drawn if the client’s thinking about responsibility changes.

Talk show host role play
The client assumes the role of advice-giving talk-show host or radio psychologist. The therapist (and/or other family members) takes the role of callers seeking advice regarding their own experiences with trauma. The “callers’” questions address areas of particular concern for the client.

As a tribaloonist, I got a little stuck right at the beginning with the parenthesis. Creating a “trauma narrative” seems a necessary step in therapy but should be considered a full restructuring of the victim’s perceptions. I don’t mean distorting or fabricating them… more like re-formatting them.

Even an adult experiencing a trauma is unlikely to be in a state of narration. Recall Mr. Nv’s stretcher scene… the puzzling state of un-narrated wakefulness… where there was an entirely different and more primal kind of memory process going on. In a state of alarm of terror (or anthestesia), Hippo and Now will ramp up their frame rates for faster perception. The Cinema View’s flow will exceed our ability to have any Post-Cinema perception of it and incapacitate our narrative abilty. We will perceive our immediate four perceptions or likely even less as the Cinema system emphasizes speed over detail.

With the perceptual flow’s speed increased, emotional triggers and associations become more primal and childlike. More thoughtful, complex and mature associations become unavailable for use. Their long nyeep chains are too slow to run at the heightened frame rate. Thus, the experience plays to one’s primal emotional character and creates memories retriggered by very quick and simple cues. They cannot be recalled as normal memories while at a normal rate of flow unless some kind of guidance narrative is applied or otherwise created.

Obviously, some kind of alternative experience is taking place or why bother with the trauma classification?

And these bits stuck out…

Challenge unhelpful or inaccurate cognitions

Break the nyeep chains and rewrite the NEXT cues.

…younger children who lack the capacity to think about their own mental processes.

… have undeveloped Post-Cinema perception and no narrative ability.

Responsibility pie

An example of a perceptual narrative… the pie represents placing thoughts in a RAM space where one can see all the responsibilities at once. Narrations than can then be created from them. This is beating the Chunk Limit with a Libet Pie.

Talk show host role play

Exercises the victim’s capacity to create narratives about their own memories and new experiences.

The therapist plays (and keeps playing) Mr. Flashlight for the victims until they can be Mr. Flashlight on their own and maintain a stable narration even in the face of their traumatic triggers.

Nhoj Morley - 27 June 2012 04:32 PM

As a tribaloonist, I got a little stuck right at the beginning with the parenthesis. Creating a “trauma narrative” seems a necessary step in therapy but should be considered a full restructuring of the victim’s perceptions. I don’t mean distorting or fabricating them… more like re-formatting them.

Even an adult experiencing a trauma is unlikely to be in a state of narration. Recall Mr. Nv’s stretcher scene… the puzzling state of un-narrated wakefulness… where there was an entirely different and more primal kind of memory process going on. In a state of alarm of terror (or anthestesia), Hippo and Now will ramp up their frame rates for faster perception. The Cinema View’s flow will exceed our ability to have any Post-Cinema perception of it and incapacitate our narrative abilty. We will perceive our immediate four perceptions or likely even less as the Cinema system emphasizes speed over detail.

With the perceptual flow’s speed increased, emotional triggers and associations become more primal and childlike. More thoughtful, complex and mature associations become unavailable for use. Their long nyeep chains are too slow to run at the heightened frame rate. Thus, the experience plays to one’s primal emotional character and creates memories retriggered by very quick and simple cues. They cannot be recalled as normal memories while at a normal rate of flow unless some kind of guidance narrative is applied or otherwise created.

Obviously, some kind of alternative experience is taking place or why bother with the trauma classification?

 

And these bits stuck out…

Challenge unhelpful or inaccurate cognitions

Break the nyeep chains and rewrite the NEXT cues.

…younger children who lack the capacity to think about their own mental processes.

… have undeveloped Post-Cinema perception and no narrative ability.

Responsibility pie

An example of a perceptual narrative… the pie represents placing thoughts in a RAM space where one can see all the responsibilities at once. Narrations than can then be created from them. This is beating the Chunk Limit with a Libet Pie.

Talk show host role play

Exercises the victim’s capacity to create narratives about their own memories and new experiences.

The therapist plays (and keeps playing) Mr. Flashlight for the victims until they can be Mr. Flashlight on their own and maintain a stable narration even in the face of their traumatic triggers.

I’m close to being able to dialogue with you using your language. But I may need some assistance. I know this is a weird request, but can you create a glossary of all your terms so I have somewhere to clarify when I lose myself?

It is not weird. It is a frequent request. I often make it, too.

I will give that another go. The terms could use some concise illuminating. For the moment, I can only provide illumination to floral display cases.

What light level at what Kelvin will give the best sensation of a red rose? What would Qualia say?

I’ve been compiling triune notes from Nhoj’s posts here in the Psychology section, but lack sufficient free time these days. Summer in general is difficult for me and especially so for the time being. I was sort of counting on others to help compile some of Nhoj’s posts, but so far no one has done so.

To matters at hand—briefly—I remain a little confused about the role of the bridge. But much subtlety surrounds the matter, and I’m not able to formulate a directly worded question. So I’ll just write a few sentences sentences and hope for more free time very soon.

Nhoj, our mutual friend, Mr. Walliser, had a stroke a couple of years before he died. The stroke blinded him partially and it also destroyed much but not all of his ability to form new memories. Most of his friends bailed socially on him and his wife but I lived in his building and appreciated him for his intellect even post-stroke. His pre-stroke memories remained intact and so did his conversation talents as long as you could forgive him stumbling now and then for a word. He seemed entirely sensible and rational. He was as humorous as he’d previously been. He was smart enough to dictate an entire novel and even did so, though it ended up not up to the standard his literary agent demanded. He couldn’t form new memories readily. I remember one time sitting with him in his den when the phone rang. He picked it up and talked with the caller for a couple of minutes. After he hung up, I asked him what the person had said, as I could tell that it was the person who scheduled his Lighthouse reading sessions. His response was, What phone call, Dave? What sort of bridge did Blair have?

Sorry if I’m leaving things hanging, but my noncyber “talents” are needed at the moment.

I think you managed to pare a forest down to an orchard. I will try a single tree.
18 key phrases with 3 or 4 sentence definitions.

Nhoj Morley - 29 June 2012 08:13 PM

I think you managed to pare a forest down to an orchard. I will try a single tree.
18 key phrases with 3 or 4 sentence definitions.

Oh goody, think that’s the starting point we all needed for assured clarity.

Nhoj Morley - 29 June 2012 08:13 PM

I think you managed to pare a forest down to an orchard. I will try a single tree.
18 key phrases with 3 or 4 sentence definitions.

I’m pumped!