The Fractal Spiral Model in Integrative Trauma Processing

The Fractal Spiral Model in Integrative Trauma Processing

Pierre-Henri Garnier (Nantes University Hospital Centre, Nantes, France) and Jean-Pierre Courtial (University of Nantes, Nantes, France)
DOI: 10.4018/IJANtTI.2015100102
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This article applies the integrative spiral model of psychotherapy described by Laub and Weiner (2013) to the case of a patient who suffered a near-drowning experience. An enhancement to the model is put forward based on actor-network theory (Law, 1999, Latour, 2005), giving it a fractal (same pattern at different scales or details level) structure and “centralisation/densification” dynamic. The process of centralisation converges the risk of death from a traumatic event towards a central node within the association network of self-awareness. This central node is then able to develop a reassuring ‘counter-centre', which is gradually densified through the relationship and complicity shared with the therapist during the therapy.
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Some psychotherapies called “Integrative Trauma Processing” (Laud and Weiner, 2013) aim to liberate patients from a traumatic experience by helping to construct an awareness of self that is able to resist the fear instigated by the traumatic event. To do so, the patient relives a threat related to this event in conjunction with the opposing feeling of safety. To start with, the patient is caught in a sort of fragmentation resulting from the trauma, but from this split can emerge a fragment of a new and less vulnerable awareness of self. The process begins again, taking this new fragment as a starting point, and with a narrower gap between the opposite polarities. This “integrative” therapy can be represented as a spiralling dialectical process (Laub and Weiner, 2013). This process involves the dialectical management of two opposing aspects – i.e. in interaction within a dynamic of thesis/antithesis/synthesis and not of static opposition – that underlie the traumatic experience. Threat versus safety can be seen as a horizontal movement of the therapeutic spiral (Figure 1). The vertical movement expresses the upward convergence of the process towards a new, coherent and consistent awareness of self beyond opposition to the incompatible aspects at the base of the spiral. The spiral is then ascendant, narrowing towards the top, thereby expressing the narrowing gap between the opposing polarities from a complementary perspective.

Figure 1.

The psychotherapy spiral (adapted from Laub & Weiner, 2013, p 27)


In this way, trauma therapy can be seen to present three aspects: a close patient/therapist relationship, able to induce a feeling of safety and security; a ‘mindful dual awareness’; and an integrative process. Laub and Weiner (2013) identify this approach with human psychology, as well as with the Yin/Yang opposition of Oriental philosophy. In Laub and Weiner’ opinion, it can be applied to pathologies other than post-traumatic stress.

The trauma therapy case presented here – treated by hypnosis by P.H.Garnier – follows this schema closely. This paper suggests enhancing the spiral model with the inclusion of Actor-network Theory (Law and Hassard, 1999, Latour, 2005, Akrich, Callon and Latour, 2006), and will explain the dialectical process through the concepts of words network, such as density and centrality of most connected word clusters. An actor-network is a cultural pattern that is efficient only through the elements (namely words) it associates and the way these elements are associated. It, thus, works differently from rational tools (scientific concepts or apparatus) using pure causality. In order to highlight the dynamic of associated words, a convenient tool is thus to compute word clusters below a certain number of word sizes and to study the clusters morphological properties. A central word actor-network or cluster rules many situations and corresponding behaviours. A dense word actor-network or cluster defines with precision the behaviour it accounts for. We have successfully used this method called co-word analysis (Callon & al., 1983) for many cases of scientific discoveries (Courtial, 1994). Scientific knowledge is made of objects, the final state of centrifugal actor-network (for example an electron) in as far as this actor-network (as concept as well as observed object) tries to embody the same properties (available in the same way for everybody) over space and time. Scientific knowledge building (science in action, Latour, 1987) is made of a socio-cognitive process of emerging actor-network, first more central than dense or more dense than central and then increasing in density (densifying) or centrality. The traditional way of thinking builds rather centripetal actor-network constructing subjects i-e leading everybody to act as required by the cultural context, rather than objects (Latour, 1996). For instance initiatory rites make young men become warriors.


Actor-Networks And Health

Hennion (2010), about treatment for drug addiction, has described under which circumstances methadone could be substituted to heroin: the condition for that was that, through an attachment link, the therapist and the methadone belong to a common actor-network.

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