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Psychology of Trauma Etiology's Reversal

Etiotropic Trauma Management reverses psychological etiology by applying the structured psycho dynamic model TRT (Trauma Resolution Therapy). This chapter explains etiology reversal within the context of TRT's application, but without considering the specifics of how TRT is applied. You may find that explanation (and this chapter's description of theory alongside of its correlate application components) under Clinical/ Long-Term Trauma. I recommend that version over this one, as it makes for fairly lengthy abstract description of etiology reversal theory.

TRT Phase One

The first phase of TRT begins the resolution process with the identification of the trauma-causing event, which is responsible for initiating development of the 4 psychological trauma patterns (About/ Theory/ Psychology of Trauma Etiology) in the first place. During this identification, the client sets aside Survivor-initiated coping philosophies adopted as defenses to the retention of the patterns and instead directly addresses the emotional experience created by the traumatic event.

The combination of the writing, reading, and feedback elements of the therapy strengthen the patient's capacity, and initiate the client's interest, to learn all there is to know about the trauma's effects: the patient gains the means and confidence to continue the resolution process until it is completed. That "completion" includes reversal of the etiology: reconciliation/reconstitution of existential identity that was contradicted by the events described in Phase One.

Etiology-reversal of the first etiology is achieved through application of TRT Phase Two. That reversal is the subject of the next section.

TRT Phase Two: 
Overview Etiology One Reversal

TRT resolves psychological trauma by reversing the etiology described in patterns 1 and 3. As indicated in the preceding section, to begin this resolution process, TRT Phase One initiates the resolution effort by identifying the trauma-causing event that created the etiology. This identification then opens the door to the address of the etiology referenced in pattern 1; the reversal is facilitated through the application of Phase Two. Phase Two takes specific steps to reverse the etiology (from now on also referenced as "etiology one") attending this pattern. Those steps include the: Completion of these tasks expunge patterns 1 and 2 from memory, or as explained in the biology section, the identity is reconfigured to its pre trauma existence, but within the context of the current reality. "Reconfiguration" and "expunge" are both functions of learning "what happened" to the psychological management system following, and as a direct consequence of, the effects of the traumatic event.

Phases One and Two also neutralize the paradoxical system of control that defends the trauma; in providing this neutralization, control is regained. The paradox, however, is more suitable for description, the concept is easier to understand, when relating it to the thoughts and behaviors that result from the paradox. We offer this explanation in detail when describing Phase Three's effects on pattern 3, the pattern that retains, in memory, the contradictions to identity caused by the paradox initiated survival thoughts and behaviors (see the next "Phase Three" subsection). Once the explanation of the paradox is more fully provided there, we show how its undoing is also facilitated by Phases One and Two. Consequently, the paradox and the issue of control, although profoundly influenced by Phase Two, are not fully discussed until later.

Parallel Grief Cycles

The reader who has read the previous chapter (About/ Theory/ Psychology of Etiology Reversal) will likely recall that the discussion of parallel grief cycles was postponed because the subject might be more theoretically appropriate when the cycles are seen as a response to the resolution process. I'm going give that explanation here as the cycles relate to the 4 psychological patterns. Then I'll discuss etiology-reversal in detail.

When using the term "grief cycle," it is intended to refer to the repeated and generally sequential occurrence of certain emotions. In the end, all of the emotions, including their experiences, relate to the reconciliation and resolution of 1 or more losses that have a specific relationship to an element of existential identity that has been contradicted by an extraordinary event.

"Grief patterns" would provide the best word choice. However, delineation from the 4 psychological trauma patterns providing the mainstay of the overall ETM theory of psychological trauma and the distinction of the relationship of the grief to the 4 patterns would be made more difficult if "patterns" were used twice.

In the case of psychological trauma, the loss is unexpected. Furthermore, the loss is a consequence of radical, real and sometimes portentous change that demonstrates that the ongoing status of the organism, or some aspect of that status, is in jeopardy.

These losses can be related to the loss of tangible items, for example, a home, loved one, part of the human body, or the body's capacity to function. The loss can also be related to less tangible issues, for example, esteem, worth, and relationship elements like trust, respect, companionship, socialization, an image of what the family is supposed to be, and so forth. If the loss is of tangible items, this kind of loss will also be accompanied by intangible losses. Finally, losses can occur across all dimensions of human psychology to include intrapsychic, interpsychic, and systemic variations of that psychology.

The grief cycle is associated with the loss resolution process to the extent that the individual suffering it is likely to experience, prior to identification of the loss, the emotions of shock, disbelief, confusion, pity, fear, anger, embarrassment, hurt, guilt and sadness. Other losses can produce a re-experience of the same emotions. Consequently, the term "grief cycle" to which we refer is the progression through the emotions described in the previous sentence, and in a general order depicted in the same, with the final component of the progression being the identification, understanding and acceptance of the particular loss being addressed by the progression. The literature is replete with the recognition of such grief cycles and their relationships to various kinds of losses (see About/ Comparison - Contrast and About/ Bibliography).

When an individual completes all of TRT's phases, he or she progresses through 3 general grief cycles related to the reversal of the etiologies referenced to exist in pattern 1 (etiology one) and pattern 3 (etiology 2). For purposes of clarification and codification, we title the grief cycles as: (A), (B), and (C).

The grief cycles are related to and comprise elements of the 4 psychological trauma patterns. We distinguish these cycles from the patterns because such delineation clarifies our observations of the trauma resolution process as it occurs, not just in the application of TRT Phase Two, but in all of the TRT phases. Further clarification of these cycles is provided here.
Parallel Grief Cycle: (A)
The first cycle (A) is related to those losses that result from the initial trauma-causing event. However, the cycle is divided into 2 therapeutic experiences: TRT Phase One and TRT Phase Two. That is, when the individual describes a single trauma causing event, he or she initiates grief cycle (A) and completes the first half of that cycle (A). For example, the emotions usually recorded in the Phase One description are of numbness, shock, disbelief, the state of being unreal, pity, fear (including where appropriate horror and terror), and embarrassment.

When the trauma victim completes the application of the Matrix to that same incident, the second half of the emotions representing grief cycle (A) are experienced. They present for observation.

For more detail, when the person is working in TRT Phase Two, the emotions experienced (while being recorded in writing and then shared when the Matrix is read) are generally anger (rage), hurt, depression, guilt, and sadness. When the losses are identified, experienced and expressed in column 4 of the Matrix, this grief cycle (A) is completed. Consequently, through the use of TRT Phases One and Two, grief cycle (A) is identified, experienced, expressed and then completed for each loss resulting from each initial trauma-causing event. As the reader can probably see, grief cycle A comprises the emotional components to psychological trauma patterns 1 and 2.
Parallel Grief Cycle: (B)
We observed a second grief cycle (B) that is similar to the first, except that the cause of the losses to which the cycle relates are the trauma victim's own behaviors: survival responses (to the initial trauma-causing events) that also contradict values, beliefs, images and realities. This cycle is divided into two groups as cycle A was divided.

In this division, shock, disbelief, the state of being unreal, fear and embarrassment are usually experienced during the first part of the cycle, during the client's use of TRT Phase Three (explained in the referenced section). The emotions comprising the second part of cycle (B) are usually experienced while the trauma victim is completing TRT Phase Four: the identification of contradicted values, beliefs, images and realities and identification, experience, expression and reconciliation of losses resulting from those contradictions. Thus, grief cycle (B) comprises the emotional components of psychological trauma patterns 3 and 4.
Parallel Grief Cycle: (C)
The third grief cycle (C) relates to losses resulting from all the traumas pertaining to the entire experience as a single source of trauma: as the experiences have resulted in a single impact upon the individual's life. For example, when a spouse of a chemical dependent person completes all 5 TRT phases, he or she looks at the entire experience for its total effect. In some cases, this total effect may encompass as little as 6 months, or as much as 35 years, of one's life.

The grief cycle (C) relates to this total effect and is manifested as a parallel grief cycle (C) to the first two cycles (A) and (B). In this regard, the client experiences generalized feeling states in addition to the specific feeling states associated with specific losses. In TRT Phase One, the generalized feeling states (stemming from grief cycle C) are shock, disbelief and horror. While completing TRT Phase Two, the generalized states are shame, anger, and hurt. Phases Three and Four are manifested in cycle (C) by, respectively, guilt, sadness (TRT Phase Three) and profound sadness or deep mourning (TRT Phase Four). Grief cycle (C) is a component of all 4 psychological trauma patterns.
Parallel Grief Cycles: Summary
To summarize the three grief cycles (A), (B), and (C), cycle (A) is a consequence of the individual's grieving specific losses directly resulting from the initial trauma-causing event(s). This cycle (A) comprises psychological trauma patterns 1 and 2 and is experienced over TRT Phases One and Two. Grief cycle (B) is also a consequence of the trauma victim's grieving specific losses, but losses that result from the trauma victim's own behaviors -- that is, survival responses to the initial trauma-causing event(s). This cycle (B) comprises psychological trauma patterns 3 and 4 and is experienced (divided) over TRT Phases Three and Four. Grief cycle (C) is manifested as a parallel, overlapping, experience to cycles (A) and (B). Cycle (C) is experienced as a general manifestation of grief comprising all four psychological trauma patterns and is experienced evenly over the entire 5 phase Trauma Resolution Therapy process.
Detailing Etiology Reversal: 
Resolving the Initial Trauma
The application of the Matrix resolves the initial trauma: reverses etiology (one) directly caused by the event, as opposed to reversing etiology (two) indirectly caused by trauma-induced survival responses (described in chapters 3 and 4). To achieve this resolution, the client transacts 2 parallel and existentially oriented processes: 1) the identification and experience of specific emotions comprising grief cycles (A) and (C) and simultaneous with 2) the intellectual assimilation, reassociation and reconstitution of those values, beliefs, images and realities comprising pre trauma existential identity and that were contradicted by the event(s).
Resolving the Initial Trauma: 
First Resolution Component; Emotional 
Processing of Grief Cycles (A) and (C)
In the first process, that is, while negotiating the passage through the emotional component, the trauma victim proceeds through grief cycles (A) and (C). With regards to cycle (A), by the time clients are working in Phase Two, they have already addressed in Phase One the first elements of that cycle; clients have identified, experienced and expressed shock, disbelief, fear and embarrassment.

However, when clients apply the incidents to Phase Two they re-identify and re-experience those emotions again, but without the volatility that accompanied their identification and experience in Phase One. The additional emotions recorded in column 2 of the Matrix are usually feelings that continue the person's progressions through cycle (A); those emotions are often shame, anger, and hurt.

As the person progresses across the form, contradicted values, beliefs, images and realities (column 3) and subsequent losses (column 4) are identified and the rest of grief cycle (A) is negotiated. Guilt and sadness are the predominant emotional experiences reported as that part of the Matrix is completed.

The feedback processes described in Clinical/ TRT Phase One and Two provide for the clients' identifications of the emotions, as well as provide for their experience and expressions. The person identifies the particular emotion and then remains with the experience and without associating it with any particular intellectual thought.

This experiential process continues until the emotion is expressed. The feelings -- experiences eventually dissipate.

Because the client's use of the Phase Two format provides for the inevitable association of these feelings and feeling states to the specific contradictions and losses underpinning their existence, it is not necessary to use analytical cognitive methods during the experiential component of the effort to provide such associations. For example, when someone expresses profound sadness or hurt, it is unnecessary to facilitate the association of those particular feelings to a particular contradicted belief or loss because the structure provides for such association automatically.

A subsequent and central value of the structure is that it allows for the emotions to be experienced to the extent required individually. Phase Two makes guesswork obsolete, which interrogatory activities are shown through facilitation of TRT to divert the person from the full experience. Subsequent stabilization facilitates thorough understanding.

With regards to grief cycle (C), clients notify therapists of this ongoing process when asked to discuss the emotional experiences they are having outside of (following) their TRT sessions. As indicated in the preceding section on grief cycles, the trauma victim usually experiences embarrassment to the extent that it becomes great shame, and anger to the extent that it becomes rage. These 2 feelings characterize the client's general emotional progressions through Phase Two.

To summarize the emotional process, clients, as a rule, readdress (re-experience) the shock, disbelief, fear and embarrassment already addressed in Phase One, but without the volatility and intensity accompanying initial elements of that Phase. As the client proceeds across the Matrix, he or she will continue negotiating cycle (A), all the while identifying, experiencing and expressing those emotions comprising that cycle until those emotions no longer exist. Outside of the group process the predominant emotional experiences are great shame and rage. These latter and sometimes general characterizations of emotional experience indicate that the individual is progressing through grief cycle (C): the emotional processing related to all the episodes taken as a single life experience.
Resolving the Initial Trauma: Second 
Resolution Component; Intellectual/Experiential 
Reconstitution of Existential Identity
The second resolution component provides for the combined intellectual and experientially influenced reconstitution of existential identity. Completion of this component involves completing the last 4 (b, c, d and e) resolution steps described earlier and reviewed here:
Identify the Contradicted Elements of Identity (b) and 
Identify, Experience and Express Loss (c)
Loss is a paradox. That is, the term "loss" is intended to represent something that no longer exists, but in that non existence there is a psychological (and neurological) reality, and although frequently unknown, this new reality is equal to any other element of the psyche. The identification of this loss is always tied to the successful identification of that which existed prior to the occurrence of the loss: the particular element of existential identity contradicted by the intruding episode.

Therefore, when completing the third and fourth columns of the Matrix, clients first identify the contradicted values, beliefs, images and realities that comprised themselves before the intrusion; second, clients identify the loss that had become a replacement for those values, beliefs, images, and realities which used to exist unfettered, uncompromised, and unchallenged in the psyche. Following the identification of the loss, it is also experienced to the extent that it carries with it its own characterization of feeling. In other words, the loss is both an element of existential identity, that is, a replacement for seemingly non existent values, etc., and a feeling experience in its own right.

Trauma victims negotiate this experience by stating that it is occurring, and then as occurs in other experiential processing, the client remains with the experience of the loss until it no longer is manifested: the loss is dissipated. This "remaining with the feeling of loss" is a profoundly sad experience. Moreover, the experience of loss is also antithetical to control, which experience requires its own description.

"Antithesis of control" is manifested by some as "nothingness" and a "dark, deep and bottomless void." The passage through this experience of "nothingness" and "bottomless void" proves to be the ending of it.

Some clients also report that prior to using TRT they had routinely entered (that is, felt as if they were entering some form of passage) these experiences of "nothingness" and "voids without ending" and become frightened by the prospects that they would never exit these passages. However, in TRT, the structure, to include the written component completed prior to its reading and the group's continued and consistent feedback to have been demonstrated (in Clinical/ TRT Phase One) to accompany the person to any level of internal introspection and emotional pain, replaces this fear of not exiting the dark passages.

The structure assures the individual that the venture through such passages are a matter-of-fact therapeutic process. Assisted excursions into previously unknown areas, which, based on the experience of the first TRT phase, undoubtedly result in a positive outcome. Patients and facilitators learn to trust the structure implicitly.

As the passages through "nothingness" and "the void" are negotiated to the extent required individually, the vacuums previously comprising these passages are dissipated. Moreover, the "nothingness" and "void" are replaced with the trauma victim's reconstitution of those values, beliefs, images and realities that had existed prior to the trauma's occurrence, and which had been contradicted to the extent that the "nothingness" and "void" had been created in the first place.

Importantly, when values, etc., are "reconstituted," they are maintained in the existential identity depending on the ontology of the individual; the retention is not a function of the values of those administering the therapeutic process. This ability to select elements of existential identity that are now pertinent to the individual ontology, or to discard other values, beliefs, images and realities no longer pertinent to that ontology, represent a manifestation of the trauma victim's reestablishment of control: the regaining of free will, the ability to choose.

Etiology one is reversed.

After discussing the trauma-induced paradoxical thought system that encumbers control, the next section describes the referenced process through which TRT reestablishes control.

TRT Phase Three

Paradox and Survival Response 
Create Problems for Etiology Reversal
We should remind the reader that at the third phase of TRT, although the etiology (one) caused by the initial traumatic event has been reversed by the application of Phases One and Two (patterns 1 and 2 no longer exist), the etiology caused by the action of survival response, the contradiction of existential identity, has not. Therefore, sufficient etiology remains to continue some paradoxical influence during the application of Phase Three. If this influence is not addressed, it can and will effect the opposite outcome desired: the paradoxical influence can and will prevent the reversal of the etiology (two) attending pattern 3. Where this section overviews this problem, a fuller description of it is provided in About/ Comparison - Contrast/ Neurobiology.

Phase Three identifies survival responses. The identification leads to Phase Four's reversal of the etiology. However, if the paradox is inadvertently strengthened during the Phase Three process of identification of survival responses, then the etiology will not be reversed.

This "strengthening" occurs when, following Phase Three's identification of the responses, the paradoxical control system initiates and manages ongoing and usually repeated attempts to change the behaviors. If these attempts are allowed, they will divert attention from the remaining resolution process. The attempts to change behavior in mid stream (Phase Three is halfway through the entire resolution process) will alter the direction of the therapy such that its goals of identifying and reversing the second etiology no longer exist. The new goals would become identification and reduction of the trauma's symptoms (survival responses).

Symptom-reduction activities engage completely different brain functions from those that provide for the experience of grief (see About/ Theory/ Neurobiology/ Etiology/ Etiology Reversal, and About/ Comparison - Contrast/ Psychology and Biology) and emphasizing symptom-reduction over existentially-based functions at this time can not only end the resolution process altogether, but failure to use the proper amount of existentialism to complete the grief functions can and will strengthen etiology in the long-run, making matters worse (the person can lose trust that the condition can be overcome).

This "paradoxical-strengthening" must and can be avoided. Recommendations are provided in the facilitation section of Clinical/ Long-Term Trauma/ TRT Phase Three (following the descriptions of how to write and read Phase Three).
Phase Three Initiates Etiology Two's 
Reversal (Etiology Two attends Pattern 3)
Clients progress through Phase Three accordingly.

First, Phase three provides cognitive connection between survival responses to etiology resulting from the initial traumatic event. One continuous system of logic tracts the fact of the occurrence of the event (Phase One - Pattern 1), to the event's effects (Phase Two - patterns 1 and 2), to trauma victim thought and behavior (Phase 3 - pattern 3).

Second, Phase Three initiates the passage through grief cycle B. The person identifies, experiences, and expresses the first emotional components of that pattern. Those emotions include shock, disbelief, and fear.

Third, grief cycle C is continued. The client identifies, experiences and expresses profound sadness. This sadness is related to the entirety of the trauma's effects. The person sees survival thought and behavior both as damaging and as a consequence of damage resulting from the original identity.

Fourth, Phase Three recapacitates operational identity: returns control. As indicated at the beginning of this chapter, however, this return of control occurs first during applications of Phases One and Two.

Because the paradox's effects on control were not described in earlier sections addressing etiology reveral in TRT Phases One and Two, the description of the return of control was delayed until the paradox was explained in this section. Consequently, before continuing with the description of the influence of Phase Three on control processes, I'll take time out here to discuss Phase One's and Phase Two's influences on the same.
Regaining Control: Phases One and Two
The first vestages of control begin to occur while the trauma victim is progressing through TRT Phase One. Behavioral manifestations of this appearance include the ability to remain in therapy, recall and relate a story previously not recallable or describable, and not be controlled by wide emotional swings or outburst, including hysteria, hyperarousal and other symptoms of trauma that prevent people from addressing it.

I emphasize "appearance of control" because these controls are in large part provided by the TRT structure. The trauma victim is drawn through the experience by the logic and the dictates of the controlled writing, controlled reading, and controlled feedback.

In Phase Two, this appearance (of returning control) becomes real. It is located in the client's psychological management system as opposed to the therapy.

For additional detail, as the trauma victim progresses through the reading of the Matrix, the person completes grief cycle (A) for a portion (usually half) of the total number of trauma-causing incidents applied as rows to the Matrix, the person identifies contradictions to existential identity and then identifies, experiences and expresses loss directly resulting from those contradictions, the person begins to effect his or her choice over the reconstitution of the reestablishment/ reconstitution of existential identity. Simultaneous with the initiation of this newly reconstituting management (control) process, the person also begins, outside of the TRT process (usually in parallel "here and now," couples, or family groups) to demonstrate the ability to interact between experiential and rational/ cognitive oriented attributes to the extent that the person can modulate feelings with intellectual processes.

These feelings can be 1) related to the traumatic event(s), 2) emerging in response to interaction with other trauma victims who are addressing their traumatic episodes, or 3) occurring as a response to discussions about issues separate from the trauma resolution process (or as indicated in parallel clinical processes). Moreover, projections onto perpetrators, that is, upside-down perceptions of the locus of responsibility for the trauma-causing events (where the client assumes responsibility for the perpetrator's acts) are also ended. And, trauma victims assert, where applicable (prospective exposure to additional trauma-causing events: the TRT participant is a spouse of an actively-using chemically dependent person), that the trauma-causing events will be concluded They are concluded. Behaviors described in codependency treatment literature as enabling behaviors cease.

Further indications of control being regained include perpetrator confrontation where appropriate (safe). Such confrontations usually occur when spouses intervene on chemically dependent people who are still using.

In such cases, the spouse (TRT participant) usually demands both an end to the use and participation in an abstinent oriented helping process as a condition for further interaction (a continuing relationship). If these two conditions are not met, and with conviction of commitment, the trauma victim likely sets out on a new life path that does not include the perpetrator (still actively using chemically dependent person). (If you believe this to be harsh, please read the "Codependency" examples in Clinical/ Long - Term Trauma/ TRT Phases One - Five.
Regaining Control: Phase Three
Phase Three continues the return of control. This return is demonstrated by increased interaction between rational-cognitive and experiential oriented attributes and between all attributes and the existential identity.

Examples include the growing capacity to modulate between intellectual and emotional experience and to choose the most beneficial life direction. This choice is based on individual needs and interests forming out of the newly reconstituting existential identity. "Growing" means that these changes occur on a continuum in concert with the progress initiated in Phase One, strengthened in Two, and continued in Phase Three.

Responsibility

In TRT sessions, and in contrast to other forms of therapy, trauma's resolution is primarily a management (therapist) as opposed to individual (patient) responsibility. In TRT, responsibility is not conveyed by projecting it didactically; for example, the slogan "People" or "You," meaning the patient, "ought to be accountable and responsible," is replaced with an alternative slogans: "I am responsible to this patient," and "I am responsible for the success of the therapy that I deliver." TRT does meet this responsibility; it is accountable to the patient. It does reverse psychological trauma's etiology.

In addition, on observing the facilitation of the patient's identification of survival responses that function contrary to the individual's (and the culture's) best interests, some clinicians may ask why the therapy does not shift its focus to one that attempts to change that apparently (from some views) irresponsible behavior, in the process incorporating the standard psychotherapy application where the teaching that assumption of personal responsibility for individual behavior is the mainstay, or primary goal, of the clinical process.

The complete answer to this important question is long and complex, and considered again in other parts of the book including the neurobiology chapters in About/ Theory and Comparison - Contrast, and in the Clinical and Strategic segments of the book. I can say here, however, that where I assume that many people no doubt would benefit from such teachings, trying to enforce controls over trauma-induced behavior can strengthen the paradox described in this chapter and in the process produce the opposite outcome desired.

A strengthened paradoxical system of control will almost always, or eventually, produce apparent aberant or irresponsible behaviors: ones that function not only countervailant to the individual's interest, but also as antithetical to universal cultural standards.

Given that this hypothesis may be correct, responsibility-teaching methods would be destined, when applied to trauma victims, to become part-in-parcel the new problem. They could lock the etiology into place by strengthening the paradox against the trauma's resolution, cyclically and continuously producing apparent irresponsible behaviors and regardless of the assiduity with which the behavioral control methods were applied.

Moreover, because TRT does not engage in judging behavior, it functions apolitically. And because this functioning stands in contrast to the responsibility-teaching paradigm (the nosotropic approach) where helping is occurring politically, that is, the culture is attempting to conform individual behavior to cultural standards, conflict between the models can arise. Strategic sheds some light on how this conflict is reconciled through application of ETM.

Biology of Resolution and Control

The reader will remember that these chapters are presented from the psychological paradigm. About/ Theory/ Neurobiology/ Etiology and Reversal, supported by About/ Comparison - Contrast/ Biology, present the biological perspective of resolution and control, a perspective that is grounded in molecular terms as opposed to behavioral. Those chapters explain, among other things, the great value of emotional pain to neuronal molecular change, the structural and functional substrate of resolution and control.

The next section describes the rest of the trauma resolution process. It regards reconstitution of existential identity contradicted by survival responses.

TRT Phase Four: 
Reversing the Last of the Etiology 
(Etiology Two, Attending Pattern 3)

Phase Four reverses the etiology attending pattern 3, but does so by first completing the address of pattern 4. Phase Four's etiology-reversal process is identical to the one facilitated by Phase Two (reversal of etiology attending pattern 1), except that the Phase Four effort connects the identification, experience and expression of the loss in pattern 4 and the reversal of the etiology in pattern 3 to the initial trauma. The negotiation of the different grief cycles addressed by Phase Four constitute the additional principal exception, that is, primary difference between Phases Two and Four. This section explains Phase Four's address of patterns 3 and 4, the etiology-reversal process, and the demise of the paradoxical system of control.
Phase Four Facilitates the Emotional Reconciliation 
Component of the Etiology Reversal Process
Phase Four assists the client to negotiate and complete grief cycle B, the emotional responses to the contradictions resulting from the survival thoughts and behaviors, and grief cycle C, the emotional response to the sum of the impact of the episodes taken as a whole. Excepting the experience in the summary, completion of these grief cycles produces the culmination of the emotional experience; it is hallmarked by sadness and mourning.
Phase Four Facilitates the Contradiction - Reconciliation 
Component of the Etiology Reversal Process
The client identifies survival response-induced contradictions to values, beliefs, images and realities. To make this identification, pretrauma existential identity must also be identified in order to show the contradictions.

Identification of the contradictions leads to identification of loss resulting from the contradictions. Like the loss addressed in pattern 2, this loss in pattern 4 is, once identified, also experienced and expressed as an emotion.
Phase Four Facilitates the Restoration -of- Control 
Component of the Etiology Reversal Process
The operational identity formerly divided by the repressed emotion (grief cycles B and C) and the unreconciled loss is reintegrated with the emotion/loss reconciliation; the rational-cognitive and experiential processing attributes now can and do work together to effect control over the psychological management system. The paradoxical system of control has lost its influence and the system no longer exists. The same examples of regained control provided in chapter 3 are applicable in Phase Four, but they are now experienced and demonstrated with a consistency, congruity and certitude not prevalent in the earlier components of the therapy. Moreover, regained control produces the ability to, and does, restore values, beliefs, images and realties previously contradicted, damaged, by the traumatic event. The person says, "These values and beliefs were me." "They were taken from me -- I was taken from me." "Now, they are mine again. I've got them back. And I've got me back!"

Existential identity affected by the event has now been reconstituted -- etiology two has been reversed. The 4 psychological trauma patterns have been expunged.
Phase Four Facilitates Reconstitution of 
Existential Identity Within the Current Reality
Etiology reversal provides additional control capacities that include the ability to reconstitute existential identity within the context of the current reality; the person automatically evaluates whether the pretrauma values, beliefs, images and realities that have been restored by the etiology reversal process fit today's person. For example, the trauma may have occurred during childhood: the values, beliefs, images and realities contradicted were those of a child.

Once the etiology resulting from those contradictions (trauma) has been reversed, as it has by the application of the 4 TRT phases, the childhood beliefs, etc., may no longer be applicable to the adult. In contrast, some values do not change with adulthood. Through the restoration of an integrated, or reintegrating, operational identity, the person then automatically chooses those elements of identity most important to today's individual: values that fit the ontology of the individual. "Automatically" infers that no additional therapeutic assistance is required to make these evaluations and choices.

The Trauma is Resolved

Completion of Phase Four completes the trauma resolution process. Both etiologies, one attending pattern 1 and the other attending pattern 3, have been reversed. Existential and operational identities are restored.

Phase Five: 
Concluding and Reviewing TRT

In TRT Phase Five, the last TRT Phase (for this source of trauma), the client looks back on the resolution process, summarizing the process. This summary is a sad, joyous, and concluding experience. During the review, the client reports learning, that is, clients will report that they know and understand:
  1. Who they were before the traumas occurred
  2. Exactly what happened to them because of the events
  3. The difference between what they had to do to survive and who they were/are (as people)
  4. Who they are now that the traumas have been resolved
These learning experiences then provide the basic criteria for determining if resolution has occurred. "Measuring Trauma Resolution" presents specific guidelines for making this determination.

The person exits TRT for this source of trauma. If another source of trauma exists, the patient will likely discontinue therapy for a while, months or even a year or two. The client will, as a rule, then elect to apply TRT to the other source of trauma (see About/ Theory/ Addrssing Multiple Sources of Trauma).

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