Men are not disturbed by things
but by the view which they take on them
.
– Epictetus

Note. For ease of writing, I am using the pronoun ‘he’ for client without any reference to gender.

In solution-focused therapy (SFT) the therapist deliberately avoids making assumptions about the causes of psychological problems. Instead of allocating time to ‘understanding’ the roots and causes of problems, the therapist focuses on the future helping the client become clear about what changes they want to accomplish and then assisting the client to generate ideas of how to reach those goals.

Students of SFT often ask, how can this method, which is primarily future-orientated, be used to help clients heal from severe traumatic life experiences, or problems deeply rooted in the past. What follows is a collection of ideas and methods that are intended to shed light on this question.

CHOICE OF TERM TO REFER TO THE ADVERSE EVENT

The word “trauma” carries a lot of connotations. For many of us it holds the idea that the event has caused some kind of permanent damage to the individual. Alternative words, or phrases, that also refer to difficult life events can, therefore, be more useful in referring to hardship than the medical term “trauma”. Alternatives include such words and phrases as “ordeal”, “torment” “trial” “shitty thing” “crime” “incident” “period of suffering” “accident” “fate” “difficult period” etc.

  • These days in professional language we often talk about traumatic or stressful life events, but what word would you want to use for this thing that happened to you?

ASSUME A NOT-KNOWING POSITION

When clients report about traumatic life events, the therapist can remain neutral and refrain from making the assumption that the client’s current problems are causally connected to the past traumatic life events.

Client: “Do you think I have these problems because of what I have told you about what happened to me when I was a child.”

Therapist: “It’s possible but it’s hard to know for sure. Many people have similar problems even if they have never experienced anything like what you experienced as a child. So, I guess it’s hard to know for sure.”

In current mental health culture professionals tend to assume that there must be a causal link between the client’s current problems and his past traumatic life experiences. Questioning this conventional wisdom can help clients by instilling hope. After all, if the current problem is not believed to be caused by the past traumatic event, it might be easier to solve, as compared to if it is believed to be caused by something that happened in the past that cannot be changed.

UTILIZE THE CLIENT’S BELIEF TO FORMULATE GOALS FOR THERAPY

If your client is convinced that to overcome his[1] current problem, it is necessary for him to focus on his traumatic memories, you can use his belief to help him formulate his goals for therapy.

Client: “I need to face my past traumatic experiences to find happiness in my life.”

Therapist: “Suppose you do face your traumatic experiences and you succeed in doing it well, what positive changes do you imagine that it will have on your life? What will be different? How will other people notice the change?”

The idea with this approach is to invite the client to become aware of what specific changes he would want to see in the future. Once the client has defined the goal of therapy, the option is likely to open that the stated desired changes can also be achieved through other means.

FACILITATE CLIENT’S NATURAL RECOVERY PROCESS

Recovery from adverse life experiences is a natural healing process that starts right after the adverse event is over. You can facilitate this process by helping the client become aware of the steps of recovery he has already taken and by assisting him in envisioning the subsequent steps of recovery. Useful questions include:

  • Where would you say you are in your recovery process if one stands for how you felt right after it happened and 10 for having the feeling that you have fully recovered from your experience?
  • What have you done to move from one to where you are now?
  • Who has helped you to recover from one to where you are now? In what way?
  • What thoughts have you found helpful?
  • What have you done that’s been helpful?
  • What will be a sure sign for you that you have progressed one step on the recovery scale?
  • Who will be the first person to notice that you have progressed one step on the recovery scale? How will he/she notice that?
  • What will need to happen for you to feel that you have fully recovered from your experience?
  • How would other people notice that you have fully recovered from your experience?

IDENTIFY RECOVERY STRATEGIES YOUR CLIENT HAS USED PREVIOUSLY SUCCESSFULLY

Most people experience not only one but several adverse life events during their life time. A useful therapeutic approach is to remind clients of the fact that most likely they have recovered from adverse life events before and that during those times they have most likely already developed coping strategies that have worked for them. Simply reminding oneself of one’s own recovery strategies that one has successfully utilized in the past can be enough to help the client know what to do to move on in recovering from the life event that is currently being discussed.

  • Have you had difficult life experiences before? How have you coped with them?
  • What coping strategies have you used before that have worked for you?
  • You were quite young at the time when you came up with that coping strategy? How do you explain it? How did you come up with such a smart coping strategy?
  • Do you think you could use some of the same strategies you have used successfully before in your life to deal with the event we are talking about now?

APPRECIATE THE COPING STRATEGIES YOUR CLIENT USED DURING THE ADVERSE LIFE EVENT

You can contribute to the client’s recovery process by helping the client appreciate the various strategies that he used to cope with the adverse event at the time it took place. This entails finding out the details of how your client responded: what he thought, what he said, and what he did at the time of the experience. Ask your client questions related to event with a focus on how he handled the situation and how he was thoughtful, brave, clever, patient, heroic or helpful to others.

  • What did you do in the situation that turned out to be the right thing to do? How did you come to think of doing just that?
  • How did you help others in the situation? How were you able to do that?
  • What did you think in that situation that may have helped you to survive or endure the situation?
  • How did you protect yourself? What did you do defend yourself?
  • How did you maintain your dignity?
  • What did you think or do that helped you feel in control?
  • How did you use your imagination to cope with the situation?
  • How do you explain that you were able to do those things at the time?

HELP YOUR CLIENT FEEL GRATEFUL FOR THE SUPPORT AND HELP THAT HE HAS RECEIVED FROM OTHER PEOPLE

People who have had adverse life events are often grateful to those people who have helped them or supported them in one way or the other either during the time of the event, or in recovering from it. By showing interest to how other people have helped or supported the client, you can reinforce your client’s feelings of gratitude.

  • Who helped or supported you at the time of the event? How did they do it?
  • What did they do or say that was helpful to you?
  • Do you feel grateful to them?
  • Have you expressed your gratefulness to them in some way?
  • How would you want to express your gratefulness to them?
  • How do you imagine it would make them feel?
  • How do you imagine it would make you feel?
  • Have you expressed your gratefulness to them in some way?
  • Who has helped or supported you after the event? How have they done it?
  • Do you feel grateful to them?
  • Have you expressed your gratefulness to them in some way?
  • How would you want to express your gratefulness to them?
  • How do you imagine it would make them feel?
  • How do you imagine it would make you feel?

FIND OUT HOW YOUR CLIENT HAS HELPED OTHER PEOPLE WHO HAVE GONE THROUGH SIMILAR EXPERIENCES

Many people who experience adverse life events are willing to help and support other people who have had similar experiences in their life. You can support your client’s healing process by appreciating the many ways in which your client has helped – or wishes to help – other people with similar experiences. In this way you can acknowledge your client’s feelings of compassion and caring for other people.

  • Have you met anyone who has had similar experiences in their life?
  • Have you been able to help or support other people who have had similar experiences in their life? How have you done it?
  • What have you done to them that may have been helpful for them?
  • What have you said to them that may have been useful to them?
  • In the future, when you feel that you have fully recovered, would you want to help other people who have had similar experiences in their life? What would you want to say to them? How would you want to help them?

HELP YOUR CLIENT OVERCOME OF INTRUDING MEMORIES

If your client suffers from nightmares, flashbacks or intruding memories related to his adverse experience, you can explain to him that intruding memories tend to change over time. Tell your client, that usually intruding memories become less intense, less disturbing or more neutral with time. If your client accepts your view, you can now help him accelerate the process by asking him how his nightmares, flashbacks or intruding memories have already changed and how he imagines that they will continue to change with time.

  • How have your intruding memories already changed to become less unpleasant as time has gone by?
  • Presuming that your intruding memories will continue to become less unpleasant over time, how do you imagine that they will change?
  • Supposing your intruding memories will continue to change until they become quite neutral, what will they be like at that point?

INVITE YOUR CLIENT TO IMAGINE A HEALING CELEBRATION

You can facilitate your client’s healing process by inviting him to imagine that one day in the future he has healed from his experience and that he feels so relieved that he wants to celebrate his healing in some way. Helping your client to develop a detailed fantasy of such a celebration is a subtle and pleasant way generate hope and activate your client’s own resources.

  • What would be sure signs for you that would tell you that you have healed from what has happened to you?
  • And if those signs were there, would you be relieved and happy?
  • Would you be so relieved and happy that you could think of celebrating your recovery in some way?
  • Suppose you did celebrate in some way, how would you want to do it?
  • Who would you want to invite?
  • Suppose you could invite also persons who would not be able to attend (because they are deceased, living far away, or perhaps not even born yet), who else would you invite?
  • What would you write on the invitation letter?
  • Suppose you would give a speech about your recovery at some point during the celebration, what would you say?
  • Suppose you would thank your guests for their help and support? What would you thank them for?
  • Suppose one of your guests would approach to you and ask you, ‘how did you do it?” what do you think you would you answer?

EXPLORE YOUR CLIENT’S PERSONAL GROWTH

In addition to various psychological problems adverse life events can sometimes also kindle personal growth, at least the subjective experience of it. Exploring aspects of personal growth that your client associates to his adverse life experience may be a way for you to help your client distance from the pain and misery of his experience.

  • Has the experience affected you in some way positively as a person?
  • Has it perhaps made you in some way wiser, more compassionate or more spiritual as a person?
  • Has someone else noticed such changes in you? What would they say if I asked them the same question?
  • Have you felt that your experience has lead you to feel closer to other people or that it is has become easier for you to understand other people?

It impossible for most people to think of their adverse life events as learning experiences when the experience is still fresh in their mind, but as time goes by – and it may take years – it often becomes possible for them to see that they have not only suffered but also gained something from their experience. Therefore, it is advisable to present these kinds of questions with what could be called “looking back from the future” frame.

  • When one day you are much older than today, and your grandchild comes to you and wants to talk with you about something awful that happened to her, what would you say to her? What do you think you might have learned from your own experience that you could teach your grandchild?

FOCUS ON THE RELIEF PART OF YOUR CLIENT’S EXPERIENCE

Often when people endure adverse life events their memory of the event is like a drama, or narrative with a beginning, middle and end. Sometimes this the last part of the memory, the end, includes a scene with a strong element of relief – a happy ending so to say. For example, a storm subsides, the victim is rescued from the danger or the person escapes the torture. Focusing in the conversation with your client on the relief part of the memory, rather than the more distressing parts of the memory, may help your client develop an emotionally more neutral or a more healing mental image of what happened to him.

  • Tell me more about how it all ended?
  • How did you feel when it was over?
  • What was the first thing you did when it stopped?
  • Was there something you yourself did to make it stop?
  • How do you explain that it finally came to an end?
  • Who are you thankful to for putting an end to it?

HELP YOUR CLIENT LET GO OF GUILT OR REMORSE

It is not uncommon for people who have been through traumatic events to feel irrational guilt for all kinds of things such as having caused the event, not having done their best to prevent it, or not having helped others enough. Attempts to explain to your client that such feelings of guilt are unjustified, and irrational are often to no avail. Another approach, that may work better, is to normalize your clients guilt feelings, to acknowledge them as such and then focus on helping him to think of what to do to make up for the guilt.

  • What could you do to make it up for the person who you feel suffered because of you?
  • How could you make it up for her now that she is no longer alive? Is there anything you can do for her post-mortem?
  • Suppose it would be possible for you to talk to the person who you feel guilty towards? What would you want to tell her? How do you imagine that she would respond? What would she need to tell you for you to be able to let go of your guilt feelings?

FACILITATE READINESS TO FORGIVE

Adverse life events can lead to intense feelings of resentment towards individuals or groups of people seen as responsible for the traumatic life event. If this is the case, your client may benefit from letting go of his resentment by forgiving those he holds responsible for the adverse event or, if forgiving seems too far-fetched to your client, simply by “letting go of the past”, “putting matters to rest” or “putting things behind”. Here are some questions that you can use to facilitate this natural process.

  • Suppose this person who did this wrong thing to you approached you some day and wanted to apologise to you for what she did to you. What would she need to tell you to make you want to talk to her?
  • Suppose this person said she would want to apologize to you for what she did to you. How would she need to express her apology for you to want to listen to her?
  • Suppose this person said that if it was possible, she would be willing to do just about anything to apologize and compensate for what she has done. What would you want her to do?
  • If such an exchange took place between you and her, how would it make you feel and what positive effects would it have on your life?
  • I can understand that right now it is totally impossible for you to understand why she did this to you. But as time goes by, and little by little what happened to you becomes just one of the pearls in you chain of memories, you may be able to look back with different eyes. What do you imagine you will then think about her reasons for doing what she did to you?

REGARD YOUR CLIENT’S ADVERSE LIFE EVENT AS A MEMORY THAT CAN CHANGE

It may be useful to think that traumatic events, as such, do not cause psychological problems. The traumatic event happened in the past and is presently long gone. What is remaining, and possibly causing problems for the client, is not the past event itself but the client’s memory of what happened in the past. In other words, the client is not suffering from the after effects of his past event, but from the current effects of a memory related to the past event. This is a significant distinction because most of would agree that memories are easier to modify than actual events that have happened in the past.

  • In what way has your memory of what happened to you changed over time?
  • How do you hope your memory of what happened to you will change (or continue to change)?
  • If the memory of what happened to you gradually fades, which parts of it would you like to keep, and which parts would you want to allow to fade?
  • If this memory of what happened to you would not have any impact on your life, how would your life be different? What would you be doing, that you are not doing now, if the memory didn’t have any impact on your life?
  • Give me an example of something that usually reminds you of what happened to you bringing your memory back? If that thing happens in the future, what would you want your brain to reminded you of instead?

INVITE YOUR CLIENT TO APPRECIATE THE POSSIBLE POSITIVE CONSEQUENCES OF THE ADVERSE EVENT

Sometimes dreadful things that happen to people have unexpected positive consequences such as when a person meets his future wife or husband in the hospital where he or she has been taken after a serious car accident.

  • Is there something good that has happened to you in your life that would probably not have happened had this thing not happened to you?
  • Is there anything else that has happened to you that would probably not have happened if that thing had not happened to you?

Becoming aware of the irony of life, of the fact that awful events can have unpredictable positive repercussions in one’s life, can help to ease one’s pain and suffering and to help one see one’s life from a more matter-of-fact and balanced vantage point.

ALLOW YOUR CLIENT TO SHARE WITH YOU ONE OR MORE AMUSING DETAILS RELATED TO THE ADVERSE LIFE EVENT

Mention to your client that when people who have been through gruesome life events look back to what happened to them, they sometimes surprise themselves by recalling absurd details of their experience that amuse them. If this idea seems to resonate in your client, allow him to so share with you any such recollections. Even in the most horrendous experiences there is often some details that are absurd, or outright funny, and sharing such details with another person can be helpful in terms of healing from the trauma.

  • Do you have any recollections of anything absurd, crazy or funny that happened at the time of the event?

The saying goes that as years go by, the tragedies of our life tend to transform into comedies of the past. This does not happen overnight but being able to see some such details in the experience will most likely accelerate that natural process.

SOURCES

Furman, B. It is never too late to have a happy childhood. Brief Therapy Press, London 1998.

Hydén, M., Gadd, D and Wade A. (Eds.) Response based approaches to the study of interpersonal violence. Springer, 2016.

O’Hanlon B. Quick steps to resolving trauma. Norton, New York 2011.

Watzlawick, P. Weakland, J. H. and Fisch, R. Change: Principles of problem formation and problem resolution. Norton, New York 1974 and 2011.

Saul J. Collective trauma, collective healing: promoting community resilience in the aftermath of disaster. Routledge, New York 2014.

Dolan, Y. One small step: moving beyond trauma and therapy to a life of joy. Authors Choice Press, Lincoln 1998, 2000.

Fiske, H. Hope in Action. Solution-focused conversations about suicide. Routledge, New York 2008.

De Jong, P. and Kim Berg I. Interviewing in Crisis situations. Chapter 10 in:  Interviewing for solutions (fourth edition). Brooks/Cole, Belmont 2012.

Van der Kolk, B. The body keeps the score: Brain, mind and body in the healing of trauma. Penguin books, New York 2014.

White, M. Trauma and Narrative Therapy. A workshop recorded at the International Trauma Studies Program in New York City on April 1, 2007. https://vimeo.com/user5430709

Connie, E. Using Solution Focused Brief Therapy to Treat Trauma. Webinar on October 10, 2017. https://www.youtube.com/watch?v=JtTQ682D7qE