Combining Expressive Writing with an Affect- and Attachment-Focused Psychotherapeutic Approach in the Treatment of a Single-Incident Trauma Survivor: The Case of "Grace"

Abstract

The idea of using a phase-oriented model in the treatment of trauma is an established one. The first phase aims to establish safety, stabilization, and trust before moving onto the second phase, which involves more direct and intensive processing of trauma. The third phase serves to consolidate and integrate the gains made in treatment. The purpose of this study is to determine whether utilizing a phase-oriented model that combines Accelerated Experiential Dynamic Psychotherapy (AEDP), an affect and attachment-focused experiential treatment, with expressive writing enhanced the treatment of "Grace," a single-incident trauma survivor. While both AEDP and expressive writing are well developed methods, their combination has not been tried before. Focusing on a survivor of a single-incident trauma was chosen to best implement the goal of writing about a concrete traumatic event. In line with the three-phase approach, the "AEDPWriting" model first utilizes AEDP to build a secure attachment as well as affect tolerance, setting the stage for deeper exploration of a patient's traumatic history. Second, the expressive writing component then builds on this base by directly addressing the traumatic incident and processing it in a deeper and more comprehensive manner. Finally, utilizing both the AEDP and expressive writing approaches, the third phase involves reflection on the work done, consolidation, and celebration of the patient's true self state of being.

AEDP and Cultural Competence in Developmental Trauma Treatment

“…Vigoda Gonzales compares her paper to the earlier work of Pass (2012), which combined AEDP with a writing intervention. She notes that the two cases, both utilizing AEDP in trauma work, differed in that the Pass case would be considered a single-incident trauma occurring in the life of a person with a history of more secure attachments.…”

Assimilative and Theoretical Integration in the Treatment of a Trauma Survivor

“…It is worth noting that the format of the dissertation (Pass, 2010) on which Pass's article is based is especially appropriate for doctoral students in practitioner-oriented programs in clinical and counseling psychology to consider. It combines quantitative and qualitative method, clinical and research features, and a structured and well-defined presentation format (Fishman, 2005a(Fishman, , 2005b.…”

“…The case of Grace (Pass, 2012) illustrates the concept of assimilative integration in so far as it incorporates an expressive writing technique into Accelerated Experiential Dynamic Psychotherapy, which is itself a theoretical integration of psychodynamic and experiential approaches. …”

Assimilative Integration in the Treatment of Trauma

“…The psychotherapy offered by Erica Pass (2012) in the case of Grace consisted of a combination of Accelerated Experiential Dynamic Psychotherapy (AEDP; Fosha, 2002) and Expressive Writing (Pennebaker, 2004). AEDP is, itself, an example of psychotherapy integration in that it can be classified as theoretical integration because of the blending of psychodynamic psychotherapy and humanistic/experiential psychotherapy.…”