Given that the target selected for dissolution was the problem-defining construct, “I’m helplessly trapped in this car that is carrying me to my death,” the therapist recognized that the technique of empowered re-enactment, widely used by trauma therapists (see, for example, Ogden, Minton, & Pain, 2006), would fit this clinical moment well because re-enactment can create a vivid experience of having power to protect oneself in a scene in which one initially felt completely powerless. In such re-enactment work, consideration of whether or not Brenda at eight years of age could have been more assertively self-protective would not at all be involved because the technique consists only of juxtaposing her original and persisting emotional knowledge of herself—being powerlessly trapped—and a present opposite experience that sharply contradicts that knowledge.
With Brenda already immersed in and re-experiencing the original scene of being in the lurching car’s back seat and heading toward the bridge, the therapist moved naturally into the re-enactment by saying,
“I’m going to help you through this situation in a whole new way.”
The re-enactment took less than four minutes and developed as follows.
Th:
In that scene I want you to start to scream at your father, if necessary, “Stop the car right now! I’ve got to get out! I can’t stay in this car!”
[Loudly] Stop the car! Dad, stop the car, I’m getting out! [Voice
Cl: tone is somewhat stiff, as if the re-enactment at this early point is feeling contrived and not emotionally real to her yet.]
Th: Make him stop the car.
Cl: [Louder] Stop the car! Stop! I’m getting out!
Th: This is too dangerous.
Cl: This is too dangerous! I’m getting out! Stop!
Th: Does he stop it yet? Is he taking you seriously yet?
Cl: Not exactly.
Th: Keep going! Do what you’ve got to do!
Cl:
[Very loudly] Stop! Stop the car! I’m opening the door! That’s making him stop. [Voice tone indicates that the action feels emotionally real to her.]
Th: Good. Great. You’re doing it! Keep going.
Cl: Stop! I’m getting out! He stopped when I opened the door.
Th: Great! Run out!
Cl: I’m on the wrong side, I’m on the traffic side.
Th: Okay.
Cl: I have to climb over my sister—
Th: Go ahead.
Cl: —and open her door. I’m getting out! I got out. I got out of the car. They want me to get back in.
Th: No.
Cl: My mother is yelling at me, “Get back in the car!”
Th:Take care of yourself! It’s too scary for you in that car. It’s traumatic.
Cl: No! No! No! I’m not getting in! Send a taxi for me.
Th:What needs to be said? “He’s going to kill us!” “How can you let him drive like that?” “You’re not protecting us!”
Cl: Yes.
Th: What do you need to say?
Cl:
[Suddenly crying; loudly through her tears] How could you do this? We’re going to die, don’t you get it? God, I hate you! Go get out of here! Leave! You get in the car! I’m not getting in.
Th: Great!
Cl: I’m not getting in. I’m not getting back in the car. Fuck you.
Th: Great.
Cl:
Fuck you. You get back in the fucking car. Now I’m walking in the other direction. Oh God, I hate her so much. I hate my mother for this.
Th: Feel it, feel it.
Cl:
I hate her. I want her to get in the car and die. I hate her for this.
I’m walking the other way. And my mother’s yelling, “You get back in this car!” No! No! Fuck you! You get back in the car! I’m leaving!
Th: Good.
Cl: And I won’t get back in the car.
Th: Good. Good, you’re really protecting yourself.
Cl: But she—they’re bigger than me and they’re starting to drag me.
Th: Then scream for help. Get some other adults to protect you.
Cl: [Screaming:] NO! NO! NO! I won’t get back in the car!
NOOOOOOO!
Th: Somebody help me, my father’s driving drunk!
Cl: Help! Help! My father’s driving drunk! HEEELLPP!
Th: Good!
Cl: Other adults are coming.
Th:Good—of course they will. Tell them; tell them what’s happening.
Cl:
My father’s driving drunk! I won’t get back in the car. There he is; he’s drunk. We’re careening around the road; I’m not getting back in the car. [Pause.] They call the police.
Th: They call the police; great.
Cl: The police are coming. And they won’t let him drive.
Th: That’s right.
Cl:
And they won’t make me get back in the car. [This utterance and her next two are the moments when her new experience of having the power to protect herself feels sufficiently true and reliable to serve as a contradictory knowing that is
juxtaposing with and dissolving the constructs of
powerlessness and mortal danger originally linked to this context of approaching a bridge in the car.]
Th: That’s right. Are the police coming?
Cl: They’re there. And I’ll never get in the car with him drunk again.
Th: Good.
Cl: And they can’t make me.
Th: Right.
The empowered re-enactment was complete at that point. It had guided Brenda from her experience of the target problem-defining construct—the emotional learning that consisted of I am helplessly trapped in this car— to an intense disconfirming experience of contradictory knowledge of having the power and freedom to get out of the car immediately for safety. A juxtaposition of those two incompatible knowings had taken place decisively and repeatedly, though tacitly, within the re-enactment. It is best practice, however, to guide an explicit experience of the juxtaposition, continuing and completing the work as follows.
Th:
You’ve done a wonderful job of protecting yourself and keeping yourself safe in this situation. Take a moment to simply feel good about using your power and freedom to protect yourself like this.
[Pause, 20 seconds] And you can also reflect back on how at first you had been feeling so powerless to get yourself out of that car, and feeling helplessly trapped in it; but this experience you’ve now had is so different, because now you’re so aware of having the power and freedom to protect yourself like this.
[Pause, 20 seconds] And you can keep that awareness as you get ready to open your eyes and come back into the room with me.
Outcome
In her next session, 11 days later, Brenda said, “I’ve been much less scared since last session … I’ve been thinking, well, something must have really shifted … It really strikes me that something has shifted. I haven’t been hugely afraid of doing this performance. I’m somewhat
afraid; I think I’m normally afraid. I think anybody in my position would have some—concern or trepidation. But I think it’s normal and manageable.” Later she added, “I really think that session last week
— there was a way that I was always psychically sitting in that back seat in the car, trying to hold on to something. To not have that responsibility now, of controlling a careening car, is very freeing … I’m in a good place to be doing this show, thank God.” These are clear markers of non-reactivation and symptom cessation.
She said she wanted to call for another session only if needed. She did so four months later for one session on other matters and in that session said her performance had gone well. After that it was again four months between each of her next two sessions, which were her last.
The fact that Brenda’s stage fright was dispelled by transforming the stored, frozen memory of helplessness in the car confirmed that each episode of stage fright had been a flashback of the memory of that terrifying ride (an affective flashback as distinct from a perceptual-memory flashback; her perceptual memory began emerging during the in-session dreamwork). In the session following the re-enactment work, the therapist asked Brenda if she was aware of how or why approaching the performance resembled and retriggered the memory of approaching the bridge in that car. The shared, triggering feature was now clear to her immediately; she explained that the two approaches were “the same, because once I’m on either one—the bridge or the stage—I can’t get off.”
In that same session she described a dream since the re-enactment session in which she is saying goodbye to family and others who are with her at a table outdoors in a “colorful, enlivening” mood and setting. “This was very powerful, saying goodbye to my parents and more particularly my father … just profound saying goodbye and … I was crying, but it wasn’t sad exactly, just touching, very touching … I was just going away, going away someplace. It has a very positive kind of feel … There was a way that the dream was really empowering, like I was making a break. And I wonder that I would have that dream after getting out of the back seat of that car … Saying
goodbye and getting the life-force back—there was just something very empowering about that.”
This dream continued a major theme that developed during the re-enactment, in addition to the physical escape from the car: Brenda’s powerless confinement in that life-threatening car at age eight was but one manifestation of her powerless confinement in a family system that felt life-threatening to her in its own ways. As with the frozen experience of being trapped in the car, her implicit emotional knowledge of being trapped in that family system had persisted intact into adulthood. In the re-enactment, her experience of her adult, current power to refute and differentiate from the rules and roles dictated to her by her parents was itself new contradictory knowledge. The dream consists of various markers of transformational change of Brenda’s implicit model of herself as powerless to exit the prison of her parents’ attachment rules, a big shift of separation/individuation.