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.
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.
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.
If your client is convinced that to overcome his 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.
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:
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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