Creating a Safe Place or a Control Place

One of the important aspects of Phase 2 is to determine with the client whether he or she has sufficient affect tolerance to handle the distressing feelings that may come up during processing. (This procedure was origi- nally developed by EMDR clinician Neal Daniels.) The Safe Place exercise helps the clinician to diagnose whether the client can develop his or her own sense of safety. It also enables the clinician to determine whether a client can engage in dual attention, because it asks the client to recreate the feeling of safety when experiencing a low level of distress. This part of Phase 2 must be handled with delicacy and care on the part of the clinician so as not to stir up what Aaron Beck has termed “evaluation anxieties” (Beck, 1985, pp. 146–164).

There is a cluster of clients for whom the Safe Place exercise will not be useful because they lack the ability to bring up the imagery necessary for the process. For this group, affect control techniques are helpful, and the clinician should evaluate their ability to shut down intense affect when they need to (such as at the end of an incomplete active trauma-processing session). Techniques such as controlled breathing and Jacobsonian muscle relaxation exercises are a good substitute. For those clients who can access imagery, I prefer to use the entire Safe Place exercise.

By using this exercise, clinicians are training their clients in the skills necessary to process their trauma. It is crucial that no client should begin active trauma work until he or she can successfully complete the Safe Place (or control place) exercise. There are eight steps in the Safe Place exercise. It is not my intention here to teach you this exercise. It is documented in Shapiro’s first and second textbooks. I will, however, com- ment on the ways in which various parts of the exercise affect the client–clinician relationship.

The clinician starts the Safe Place exercise by asking the client, “Do you have a place where you can feel perfectly safe?” This could be a place the client has been, a place he or she could go, or a place in his or her imagina- tion. If the client does not have a safe place or the clinician and client cannot develop one within a few minutes, the client is expressing how unsafe he or she feels inside. Relationally, the client is telling the clinician how vulnerable he or she is.

Sometimes the client is not certain what is being asked. It is fine to give some examples of a safe place, such as sitting on the beach or being with one’s best friend. But do not choose the safe place for the client. That would defeat one of the diagnostic purposes. Also, you might choose a place that seems safe to you, but it might not feel safe to the client for per- sonal reasons. For example, not everyone will choose a safe place that has a loving person in it. Remember, the aftereffects of trauma include isolation and shame. Some clients will feel safety only with a pet or in solitude. For example, Madeline’s safe place was the womb. To her, it was a place that was pressure-free, stress-free, totally soothing, pleasant, warm, relaxing, and dreamy.

It is not uncommon for a client to choose the clinician’s office as the safe place. This could be dicey (it is where the client will relive the trauma, which may be quite frightening at first), but it speaks to the importance of the therapeutic relationship. As long as attunement is not breached trans- ferentially or countertransferentially, the client will feel a safe connection to the clinician. In some cases, this alone may be sufficient to create enough affect tolerance for processing to begin. By the way, try asking your clients about their safe place after treatment has been successfully concluded. It may surprise you to hear how fully they have reentered the community.

It is easy to work with a high-functioning person who has lots of access to safe places. Conversely, when the client is multiply traumatized and cannot find a safe place at all, the clinician must help stabilize him or her, possibly by using the strategy of resource development and installation, which I will discuss shortly. Most clients fall between these poles.

The second step in the Safe Place exercise is to have the client focus on and describe the feelings and emotions that the image evokes, and then to notice where he or she feels them in his or her body. This step helps the client ground the experience inside. Again, the astute clinician will be able to assess whether the client is capable of having a positive somatic experience or if the client is experiencing psychic numbing. I see this next step in the exercise as highly Rogerian. It is called enhancement, and it entails the clinician’s use of his empathic attunement abilities to

Phase 2 • 73

strengthen the client’s safe place by speaking in a soothing tone and repeating the feelings and emotions that the client has described.

The clinician’s repetition and the client’s reception enhance not only the safe place but also the dyadic state of mind between the two, thus link- ing the client’s positive feeling of the safe place to positive feelings toward the clinician.

The Safe Place exercise also gives the client a sample of dual attention. When the client first brings up the positive image, feelings, and sensations, he or she is moving into a different state of mind (albeit a positive one). That state of mind is usually about something outside the consulting room. Therefore, the client is learning to be in two places at once. The brilliance of the Safe Place exercise is that the client and clinician start with a positive dual experience; then the client shifts back and forth from a positive state of mind to a mildly disturbing state of mind, doing so with the empathic attunement of the clinician. Dual attention is what creates the balancing of two worlds that otherwise may have remained separated by blocks, or may even have collided. During this stage, the clinician ori- ents the client to active trauma work and explains the role that he or she will play in keeping the client safely in both worlds.

Step 4 of the Safe Place exercise involves the client’s first actual experi- ence with bilateral stimulation. The clinician instructs the client to bring up the image of his safe place and to concentrate on the positive feelings and sensations it evokes, noting where he or she feels them bodily. Then the clinician applies a short set of 6 to 12 eye movements, auditory tones, or tactile stimuli. The client is then instructed to notice whether the feel- ings of safety improved. The clinician and client repeat this procedure a few times, continuing to notice whether the safe place remains safe or strengthens. This is a very strong interpersonal moment. The clinician is now actively applying a procedure to the client. How does the client perceive this process? Does the client actually feel safer? Is he or she telling the truth about how he or she feels? Does the client seem to relax or instead tense up? Is what the client reports congruent with what the clini- cian notices? How does the clinician deal with any perceived dissonance? These are just some of the interactions that make the Safe Place exercise one of the best ways I have found of forming a deeper bond with the cli- ent.