Working From the Adult Self

The way severely traumatized people take care of themselves, both internally and in relationships, is deeply disturbed. The dysfunctional patterns of taking care of themselves that they learned as dependents persist beyond the situations that generated them. Dysfunctional self-care may influence the patient’s attitude towards getting help and change in therapy. To change in therapy, the person must work patiently on modifying these patterns. They need to actively participate in the transformation process. This article reflects on the complex topic of patients’ responsibility and motivation for change in trauma-oriented psychotherapies. It presents a working model based on empowering the patient’s adult self and proposes some practical interventions to work on promoting it.