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In response to the editors' invitation, I thought it might be useful to share some observations on the nature of traumatic experience. My perspective is that of a relationally oriented integrationist with a special interest in trauma treatment. Recent research findings in the neuroscience of attachment, memory, and dissociation are also of interest to me because of their treatment implications. One of the most far-reaching discoveries concerns the malleability of memory. Whenever an old memory is brought up into “working memory” (i.e., awareness), it is possible to change it in the presence of a disaffirming alternative (Schiller et al., 2010). Here is the gateway to therapeutic action in trauma: What can be remembered may be changed when an emotionally experienced alternative is present in conjunction with a re-evoked traumatic memory. From an integrationist perspective, this suggests there are many forms of corrective emotional experience that possibly involve a common neurological mechanism (Schiller et al., 2010; Toomey & Ecker, 2007; Ecker & Toomey, 2008; Toomey & Ecker, 2009).
Integrative theory and practice have been thoughtfully explored by Wachtel (1977, 1987, 2008, 2011) and by Frank (1999). Their work reflects a belief I share, that psychoanalysis is robust, continually evolving, and can assimilate and accommodate new ways of conceptualizing our clinical work. I believe
that the approaches described here lend themselves to a higher level of integration that avoids the collapse into what a concerned colleague termed “shallow technical eclecticism.”
In this paper I will describe how two approaches to facilitating therapeutic action, Eye Movement Desensitization and Reprocessing (EMDR; F. Shapiro, 2001) and the use of somatic imagery, adapted from Somatic Experiencing (Levine & Frederick, 1997) and Sensorimotor Psychotherapy (Ogden, 2009), might be integrated into psychotherapy with Louise, whose interview with Paul Wachtel provides a common point of refe