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Exploring the experience of adult participants in therapeutic enactment, a group-based trauma intervention Frender, Jesse 2014

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      EXPLORING THE EXPERIENCE OF ADULT PARTICIPANTS IN THERAPEUTIC ENACTMENT, A GROUP-BASED TRAUMA INTERVENTION   by JESSE FRENDER    A THESIS SUMBITTED IN PARTIAL FULFILLMENT OF  THE REQUIREMENTS FOR THE DEGREE OF  MASTER OF ARTS  in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES  (Counselling Psychology)  THE UNIVERSITY OF BRITISH COLUMBIA  (Vancouver)  June, 2014  © Jesse Frender, 2014     ? ∢ ?Abstract   Counselling and psychotherapy literature frequently reports that group-based interventions are effective and appropriate for addressing psychological trauma. Predominantly, this literature is grounded in theoretical assumptions about the process of healing trauma, or the clinical experiences and observations of clinicians. Although a small and growing body of empirical outcome studies exists, virtually non-existent are investigations into clients' own experiences of the process of group trauma therapy. On the premise that understanding client perspectives is integral to refining intervention techniques and shaping future empirical research, the present study is an inquiry into participants' experiences of therapeutic enactment (TE), a multimodal group-based trauma intervention. Following their participation in the intervention, participants were interviewed using a video-assisted method known as interpersonal process recall (IPR), with the aim of accessing their experience in a more immediate, less retrospective way than more frequently used interview methods. The interview transcripts were analyzed thematically and are re-presented herein as three distinct accounts of experiencing therapeutic enactment. Insights for both clinical and research development are discussed.   ? ∢? ? Preface   This thesis is an original, unpublished, independent work of the author, Jesse Frender. This research was approved by the University of British Columbia’s Behavioural Research Ethics Board. The Certificate Number of the Ethics Certificate obtained was H14-00565.    ? ∣ ?Table of contents  Abstract.…………………………………………………………………………………...ii Preface …………………………………………………………………………………...iii Table of contents………………………………………………………………………....iv Acknowledgments……………………………………………………………………….vii  Chapter I: Introduction…………………………….………………….…………………...1  Background………………………………………………………………………………..1 Identifying the research problem….…….……………………………………………...…3 Rationale..………………………………………………………………………………....4 Purpose and research question.……..………………………………………………..……5 Researcher reflexivity ……………….……………………………………………………6 Reflexivity on therapeutic enactment………………………………………………6 Reflexivity on the research process……………………………………………...…7  Chapter II: Review of the literature………………………….…………………………...9  Introduction to the literature review……………………..………………………………..9 Search methods……………………………………………………………………………9 Theoretical discussions of group-based trauma interventions………………………...…10  Establishing safety…………………………………………………………………11  Opportunities to experience trust ………………………………………………….12  Addressing isolation and developing relationships………………………………..12  Commonality, universality, normalization………………………………………...13 Therapeutic enactment in the literature……..……………………………………………13 Overview of therapeutic enactment…..………………………………………………….14 Theoretical foundations of therapeutic enactment………...……………………………..16 Group counselling theory…………………...……………………………………17 Self-psychology and object relations theory...…………………………...………18 Schema and script theory………………..…………………………………….…19 Gestalt therapy theory…………………………...………………………….……20 Distinguishing therapeutic enactment theory from psychodrama …...………………….20  Chapter III: Method…………………...…………………………………………………23  Introduction to methods………………………………………………………………….23 Research paradigm: a theoretical framework …………………………………...............24 Interpersonal process recall: overview and rationale ……....……………………………25 Thematic analysis: overview and rationale …..….………………………………………27 Participants ………………………………………………………………………………27 Inclusion and exclusion criteria …………………………………………………………28 Recruitment procedures …………………………………………………………………29 Data collection: the interpersonal process recall interview …...…….…………………..29 Data analysis: identifying themes ……………………………………………….………30 ? ??Re-presentation of findings ………….……………………………………………..……31 Chosen criteria for evaluation……..……………………………………………..………31 Verisimilitude……………..………………..……………………………………32 Commitment and rigour ………………………………………………..…….…32 Theoretical and practical impact…………………………………………...….…33  Chapter IV: Findings ……………………...…………………………………………..…34  Overview of findings …………………………….………………………………...……34  Participant one: Pete’s experience…….………………….………...……………………35  Introduction to Pete's themes………..……………………………..………………35  Pete's theme one: recognizing pivotal and symbolic moments ……………...……36   Moment one: "the radish moment" …..……………………………..………36   Moment two: the moment with the nuns…..……………………………..…37   Moment three: the moment he loses his boyhood and his manhood…….…39   Moment four: confronting his parents ………………………………..……39  Pete's theme two: insights into the origins of his present identity…………………41   Pete's emotional self…………………………………………………………41   Pete's self-perceived behavioural patterns………………………………..…42   Pete's personal values and spirituality……….……………………...………43  Pete's theme three: accessing and expressing emotions………………...…………44  Pete's theme four: remaining in process……………………………………...……46   Participant two: Larry’s experience…..….………………………………………………47  Introduction to Larry’s themes…………………………………………….………47  Larry's theme one: congruence with memories……………………………………48   Vivid recreation of life moments ……………………………………...……48   Group members' effective portrayals ...…………………………………..…51   Bringing his father into the room……………………………………………53  Larry's theme two: the experience of contact……………………………………...56   Positive power of eye contact with other members…………………………56   Positive power of physical touch with other members……………………...57   Negative power of eye contact with other members………………………...59   Negative power of physical touch with other members…………………..…60  Larry's theme three: Lack of resonance with facilitators' decisions…..……….…..62   Over-directive leadership ………………………………………………...…63   Misunderstanding his family relationships…………………………….……67   Masculinity, initiation, humiliation, "mental suffocation"……………….…71  Larry's theme four: the enhancement of insight………………………………….76   Importance of feeling understood ……..……………………………………77   Relationship with his parents ……………………………………….………78   His own definition of masculinity…….……………………………..………81   Participant three: Ken’s experience…………..……………………………………….…83  Introduction to Ken's themes………………………………………………………83 ? ⌢ ? Ken’s theme one: emotional intensity…………………………………………..…85   Felt sense of reality / vividness …………………………………………..…85   Evocative of emotional memories .…………………………………………86   Engagement by the facilitators ..……………………………………………87  Ken’s theme two: physical activation…………………………………………….89   Feeling grandma's hands……….……………………………………………89   Recalling the urge to fight……………………………………………….…..90  Ken’s theme three: transformative nature of the experience ……..……………….91   Gained cognitive insights  ………………………………………………..…92   Reintegration of old self into his identity ………………………………...…93   Growth of hope, optimism, belief in himself……………………………..…94  Summary of findings …………………………………………………………...……… 95  Chapter V: Discussion ………………………..…………………………………………98  Overview ………………………………………………………………...………………98 Limitations  …………………………………………………………………………...…98 Contributions to the literature …………………………………………………………101   Establishing safety and the experience of trusting relationships………..…101   Emotional processing………………………………………………..…..…102   Self-Psychology and object relations theory……..…………………….....103   Schema and script theory…………………………………………………105 Implications for future research……………………………………………………...…106 Clinical implications.…………………………………………………………………...107    Conclusion…………………………………………………………………………...…111  References………………………..……….…………………………………………….114   ? ⌢? ?Acknowledgments   The Participants: Larry, Pete and Ken  Dr. Norm Amundson Dr. Tim Black Dr. Marla Buchanan Dr. Michael Dadson Julia Gerlitz Dr. Matt Graham Carson Kivari Dr. David Kuhl Tim Laidler James Nickason Duncan Shields Becky Stewart Dr. Marvin Westwood Dr. Richard Young  ? ??Chapter I: Introduction Background Over the past four decades, psychological trauma and its repair have become widely theorized about, and vastly researched within the field of counselling and psychotherapy (eg. Bradley et al., 2005; Herman, 1997, Van der Kolk, 1993). Working with trauma survivors is likely one of the most challenging and complex endeavours clinicians undertake, as the precipitating events and the array of resulting symptoms are often so unique to those who experience them. And although its highly subjective nature may tempt us to conceive of trauma as a predominantly within an individual, it is in fact a deeply social phenomenon. Traumatic events have the capacity to destroy the sustaining bonds between individuals and their communities (Herman, 1997). Van der Kolk (1993) informs us that at the core of traumatic distress, there is a destruction of basic beliefs in safety of the world and a loss of trust that can have terrible consequences for interpersonal relationships. This can be accompanied by symptoms such as chronic shame or self-blame; sensation seeking such as excessive aggression or sexuality, or alternatively, inhibition of these; self-destructive behaviours such as substance abuse, eating dysfunction, or self-harm; a loss of belief in the possibility of conflict resolution; loss of ability to commit to long term relationships; and difficulty in affect regulation - including extreme reactivity, emotional constriction, or dissociation. In addition, survivors may develop symptoms such as intrusive recollections of the event; avoidance of the traumatic situation, a numbing of general responsiveness; and increased physiological arousal, persistent re-experiencing of the event in images, thoughts, recollections, daydreams, and nightmares, and may even feel as if they are reliving these events or experience great distress in the face of events that remind the survivor of their ? ??trauma (Mejia, 2005). It has been noted that due to the pervasive nature of violence and neglect in our culture, and the “dramatic and pervasive” effects, that most clients in the mental health system are likely survivors of trauma (ibid, p. 31).   With these compelling observations in mind, the field of counselling and psychotherapy has turned increasingly towards group therapy to help survivors of trauma (Foy et al. 2000, Foy et al. 2001). “Trauma isolates; the group recreates a sense of belonging. Trauma shames and stigmatizes; the group bears witness and affirms. Trauma degrades the victim; the group exalts her. Trauma dehumanizes the victim; the group restores her humanity” (Herman, 1997, p. 214). It is thus suggested that the experience of commonality is a central healing feature of group therapy for trauma survivors. This is akin to what Yalom (2005), in his seminal introduction to group psychotherapy, refers to as “homogeneity”. Although Yalom originally observed a paucity of rigourous study on the relationship between group composition and long-term therapeutic outcomes, he observed what he called a “general clinical sentiment” (ibid, p. 261) that homogenous groups tend to form bonds more quickly, experience less conflict, and reach symptom reduction more swiftly. Herein lies the premise for group-based trauma therapy, that joining with others who have also experienced traumatic events can create a sense of belonging, reduce feelings of isolation and alienation, and provide support that may not be found elsewhere. Both Herman (1997), and Van der Kolk (1993) highlight the fact that traumatic events are often accompanied by deep feelings of shame, secrecy, stigma, and self-blame – in particular for those who experienced child abuse, sexual assault, or military deployment. Groups are considered especially helpful in neutralizing these features of trauma; being able to tell a whole story in a safe, supportive, accepting ? ??environment is seen as an essential feature of mitigating and healing traumatic stress. Van der Kolk (1993, p. 551) adds, “the creation of a context in which that can safely occur becomes more and more difficult as the psychological toll exacted by coping with the trauma starts to complicate the patient’s capacity to function comfortably in the usual social matrix”. Thus, the power of groups, to both help rebuild social connectivity and reduce isolation, is often considered essential for trauma healing at each phase of the process (Herman, 1997).  Identifying the research problem Significantly, and problematically, the myriad of psychotherapeutic theoretical frameworks developed for traditional, dyadic “talk therapy”, also propose differing approaches to group-based trauma therapy (Foy et al., 2000; Foy et al., 2001; Shea et al., 2008). As well as the more established paradigms, such as psychodynamic and CBT-based group protocols (Foa et al., 2000; Fritch & Lynch, 2008; Sloan et al. 2013), pilot studies have begun to emerge over the past decade, exploring group interventions for trauma grounded in modalities from across the bio-psycho-social spectrum (eg. King et al., 2013; Langmuir et al., 2012; Levine, 1997; Payne et al., 2007, Ray & Webster, 2010; Ready et al., 2008; Ready et al., 2012). There is an emerging body of literature exploring the outcomes of the various group-based trauma interventions, with mixed, although frequently encouraging results (eg. Sloan et al., 2013). However, a significant problem is a lack of consensus on the precise mechanisms of change; the processes by which group-based counseling and psychotherapy contribute to emotional and psychological healing from trauma. Furthermore, within the accounts that do exist of group trauma-healing processes in the literature, the vast majority explores mechanisms of change from ? ??clinician and researcher perspectives, fusing clinical or academic observations with theoretical exposition. With very few exceptions, the exploration of client perspectives on the process of group-based trauma interventions is non-existent within the counseling and psychotherapy literature. Rationale    The present study is intended to begin addressing that absence in the literature, on the premise that understanding client perspectives is integral to the understanding, and on-going development, of how group work facilitates trauma repair. This is not intended to supplant the importance of quantitative outcome research, nor clinical theory development, but to complement both. It has been observed of process research into individual counselling that client and professional caregiver experiences over the same session often differ (Larsen, Flesaker, Stege, 2008). These authors suggest that “rather than becoming distressed by these differences, we must establish an in-depth knowledge of these important differences in perspective as they are likely to offer insights regarding improved client care” (ibid. p. 29). The present study takes a unique place within the research of group-based trauma interventions, as an in-depth, qualitative exploration of clients’ subjective experiences of a specific intervention known as Therapeutic Enactment (TE) - a multi-modal, experiential, action-based intervention developed for use in group-based trauma repair (Westwood & Wilensky, 2005; Westwood, Keats & Wilensky, 2003). It is the author’s belief that as such group-based trauma interventions continue to develop and proliferate, similar studies should be undertaken to explore client experiences of each, in turn. The value of an exploratory study such as this one, is grounded in its ability to humanize the ? ??experience, to provide entry points for further outcome research questions, and to inform the continuing refinement of intervention techniques and theories.  In this way clinicians, researchers, theorists, and above all - survivors of trauma, may benefit. According to Larsen and colleagues (2008),  “Investigating client experiences as they occur in professional caregiving interactions adds richness and depth to the work that professional caregivers, such as counseling psychologists, offer in their helping relationships.” Purpose and research question  The purpose of this study is to explore the subjective experience of participants who underwent therapeutic enactment interventions, through the thematic analysis of transcripts of post-intervention interviews conducted by interpersonal process recall (IPR), an established methodology for capturing client experiences of therapeutic processes. These video-assisted interviews were conducted within forty-eight hours of the intervention, in an attempt to capture each participants’ experience as it happened, rather than in a delayed, self-analytical approach (Larsen et al., 2008). The intention is to conduct this research from a relativist ontological position, and a social constructionist framework, so that each participants’ own subjective truth, as well as the author’s own reflexivity and interpretive process, may be taken into account within the findings. The specific research question guiding the present study is, “What is the experience of participating in therapeutic enactment as a group-based trauma intervention?” Researcher reflexivity   When undertaking qualitative research projects, in particular from a social constructionist framework, it is essential to recognize that the role of the researcher is ? ??active, collaborative, and necessarily creative. The process of generating the final representation of the research findings is not, as is often the case within other research paradigms, conceived of as simply apprehending what is true or not true in the world.   On this premise, it is considered essential, at the outset of such research, to examine and consider the influence of my own values and experiences, and to continue to reflect on these as the necessarily shift and change through the process of conducting the research. I neither believe in nor aspire towards the idea of objective “silent authorship” (Arvay, 2003; Charmaz & Mitchell, 1996). The following is an account of my own experience of therapeutic enactment; presented with the hope is that by addressing this explicitly, the reader is afforded the opportunity to interpret the results through the contextual lens I unavoidably apply as I conduct the analysis.  Reflexivity on therapeutic enactment. I was invited to participate in a TE in the first month of my graduate studies in counselling psychology at UBC, in September 2011. My interest was piqued and I began to actively seek out further exposure to the intervention. This took two parallel paths; on an academic, theoretical level, I began to read the literature on TE, sought out graduate level training in group counselling, and made myself available to participate in TE workshops and training over the next three years. On a personal level, I recognized traumatic events from my own past that I was willing to explore in my own TE if the opportunity arose. At the time of completion of this research study, I have participated in approximately forty-five enactments. I have been the "lead" client, I have been a witnessing group member, I have taken on numerous roles in the TE's of others, and have co-facilitated as a group leader. In this way, both my personal development and professional clinical training have paralleled the completion of ? ??this research project. My interest in this research question was precipitated by my own diverse array of experiences with TE.  Reflexivity on the research process. In the course of my training, I have conducted each step of the research process involved in the present study. I have participated fully as a trainee facilitator with the Veterans' Transition Program. I have been responsible for audio/video recording the enactments, and have conducted the Interpersonal Process Recall (IPR) interviews used to collect the data, including recording those. An important point to acknowledge is that the data used for the present study was not generated by interviews I conducted.   Instead, I chose to review, transcribe, and analyze interviews with three clients from a VTP in which I was not involved. Although a sense of objectivity is not a goal of the present study, I feel that this "arm's length" allowed me to take a more open-minded approach to the analysis process, without the filter of my own memories of the enactments being examined. Another point to acknowledge is that I have professional relationships with both of the facilitators who conducted the enactments explored in the present study.   I entered this project with a great deal of respect for the originators and practitioners who have developed and refined therapeutic enactment. I believe there is much value in the intervention. However, I feel that this respect I have for the approach also allowed me to remain willing to acknowledge and consider its imperfections and the ways it may be continually refined and advanced. In the process of reviewing many hours of recorded enactments and follow-up interviews, one thing I can state I have learned is that to truly understand an intervention that is by its very nature experiential, is not to ? ??watch videos, nor read exposition. To truly understand experiential interventions is to experience them oneself, firsthand. Finally I wish to acknowledge the courage of all those whose enactments I have had the privilege to witness, participate in, or conduct research on. I believe it takes great courage to explore one's most traumatic memories in a group setting, and even more courage to volunteer to the scrutiny of academic research that includes having these enactments recorded and reviewed. I would like to express my deep and profound gratitude to the participants who, through their trust and courage, made this study possible.       ? ??Chapter II: Review of the literature  Introduction to the literature review   The purpose of the present study is to explore the research question: “What is the experience of participating in therapeutic enactment as a group-based trauma intervention?” Before undertaking such an inquiry, the question must first be contextualized within the existing relevant literature.  Reviewing the vast body of literature on counseling and psychotherapy interventions for trauma is far beyond the scope of this review - as is an exhaustive review of the theory and practice of group psychotherapy. Instead, the present review has two objectives. The first is to situate research on therapeutic enactment within the research on other group-based approaches. I thus present a focused, in depth exploration of the theoretical and empirical research on all group-based counselling and psychotherapy interventions applied to assisting clients with traumatic experiences. The second objective is to present an exhaustive, in-depth discussion of the literature specifically examining therapeutic enactment (TE). As TE is a relatively recently developed modality, it will benefit the reader to have a detailed theoretical understanding of the intervention, as well as the context within which it was delivered to the participants, in order to better understand their experiences. Search methods The following is a step-by-step outline of the methods used for searching the literature. First, I searched Academic Databases (in particular, psychARTICLES and PubMed) for peer-reviewed articles with abstracts that included terms that matched various combinations of the following search terms: "psychological trauma" or ? ∣ ?"posttraumatic stress" and "group therapy", “group psychotherapy”, “group counselling, “Group-based trauma therapy/interventions”, “therapeutic enactment”. Second, I conducted in-depth searches of numerous prominent journals in the field of counseling and psychotherapy, as well as those specific to psychological trauma and specific to group process. Third, I scanned the abstracts of all the identified articles, to identify the most apparently relevant to the present study. Of that list of most relevant articles, I reviewed the reference lists for any articles that may not have appeared in the initial stages of my search.  Next, I eliminated any articles that referred to group debriefing models for the immediate aftermath of disaster survivors. As Weinberg and colleagues (2005) observe, these models are more prevention-based, time-limited, and have recently been called into question as potentially harmful. I also eliminated articles on interventions for children and adolescents, as the present study is focused on an intervention designed for adult survivors of trauma. I saved and read the remaining articles. Upon this more thorough reading, I divided the articles into four categories, which were not considered mutually exclusive: 1. Theoretical discussions and program descriptions for group-based trauma interventions (including case studies and clinical vignettes) 2. Outcome measurement for group-based trauma interventions  3. Client-voiced process analysis for group-based trauma interventions 4. Research specifically describing/assessing therapeutic enactment Theoretical discussions of group-based trauma interventions  Although research on group-based trauma interventions is relatively sparse within the broader scope of individual counselling and psychotherapy, the statement that "group ? ∢ ?therapy is widely used in treating victims of trauma" (Weinberg et al., 2005, p. 190) appears to be universally accepted within the literature, and is subsequently followed with a description of the various theoretical rationale for the employment for group-based interventions for psychological trauma. Some authors acknowledge that the mechanisms of change that support the use of group over individual therapy are "assumed" (eg: Sloan, D. M., Bovin, M. J., & Schnurr, P. P. 2012), or predominantly based on clinical experience and theory (Stige et al. 2013). Despite the array of theoretical models of the origins and nature of trauma, as well as large variations in group structure, format, and focus (ie. trauma-focused or present-focused)(Fritch & Lynch, 2008), there is a set of common, inter-related theoretical rationale that are presented as unique to, or enhanced by, group-based interventions, which can be clustered together as follows:  Establishing safety. Above all is else, establishing safety is considered of primary importance to any trauma healing framework (Herman, 1997). All survivors of trauma need to be provided with a warm, supportive environment within which they can recover, and restore a "belief in humanity" and safety within their outer world (Weinberg, Nuttman-Schwartz & Gilmore, 2005). As many of the most disabling effects of trauma are interpersonal in nature, including feelings of alienation, isolation, mistrust (Foy et al., 2000), therapy groups are variously described as ideal environments such as "healing matrices" (Klein and Schermer, 2000; Robertson et al. 2004), or "mother-groups" (Weinberg et al., 2005) in which clients can feel safe enough to begin to address these. Mendelsohn and colleagues (2007) refer to groups as "transitional spaces", a "microcosm" within which clients can begin to restore their foundations of safety, and rework problems that have arisen as a result of traumatizing experiences. In particular, ? ∣ ?for those traumas that were interpersonal in nature themselves, such as abusive relationships, the norms and boundaries of healthy therapy groups exist in sharp contrast to the original environment of trauma.  Opportunities to experience trust. Directly linked with the establishment of an overall sense of safety, is the opportunity within groups to begin rebuilding feelings of trust. Disruption of interpersonal trust manifests in survivors of trauma as feelings of withdrawal, avoidance, profound detachment or estrangement from others (Foy, Eriksson & Trice, 2001). Groups provide opportunities to bond with others, to focus on here and now experiences of interpersonal safety, and also to experience feeling trusted, of value, and liked by others (Foy et al., 2001; Herman, 1997; Weinberg et al. 2005).  Addressing isolation and developing relationships. Along with the degradation of safety and trust that can follow trauma, the subsequent avoidance and self-preservation can generate a profound sense of isolation - clients frequently report feeling completely alone with their post-traumatic symptoms. This may be particularly true for survivors of combat or sexual assault, who can often feel ostracized from the larger society, judged and blamed for their predicament. (Foy et al., 2001; Robertson et al., 2004). Groups are seen to counteract this isolating process, by providing alternative relational experiences., in which the client and his or her safety is valued (Mendelsohn et al., 2007). As members allow themselves to feel as members who belong to the group, allow others to hear, understand, and empathize with them, feelings of isolation and alienation are allowed to diminish significantly. In their place, experiences of reciprocity, empowerment, and genuine care can emerge. Furthermore, this experience can extend outward into the client's relational world to expand their network of support. Clients can begin to ? ∣ ?reintegrate into their family and social lives, and are empowered to both rebuild their past community, and seek out new relationships built on intimacy, affirmation, and compassion. In this way, therapy groups have been referred to as an "ecological bridge to new community" (Mendelsohn et al., 2007; Weinberg et al., 2005).  Commonality, universality, normalization. As group treatment provides opportunities for trauma survivors to share experiences and form new relationships (Fritch & Lynch, 2008), so it allows for group members to begin to perceive themselves, and their unique stories as similar to others' (Foy et al., 2000; Van der Kolk, 1987). Often, trauma survivors, feel their symptoms are unique, and that others will not understand them - in many ways this can be an accurate appraisal of their world, but in other ways it may not (Sloan et al., 2012). As survivors begin to feel safety, trust, diminished isolation, and develop relationships with others in a group setting, so too can they begin to feel more "normal". Yalom (2005) refers to this process as universality, and views it as an essential component of group development. This is particularly true of groups whose membership is determined by common trauma experiences (Foy et al., 2001). Therapeutic enactment in the literature  With a clear understanding of the existing literature on group-based trauma interventions, we may now turn our attention towards a detailed understanding of the specific process under investigation in the present study. The following summary is based on an exhaustive examination of the literature on Therapeutic Enactment to date. The first purpose of this section is to provide as detailed an understanding of the intervention as possible, for those readers who have not experienced or witnessed therapeutic enactment ? ∣ ?for themselves. Second, as above, the review of the literature is structured in three parts: theoretical description, outcome research, and process research.  Overview of therapeutic enactment. For the most comprehensive description of Therapeutic Enactment published to date, readers may wish to consult Westwood and Wilensky (2005), as well as Westwood, Keats and Wilensky (2003). Below is a detailed synthesis of the descriptions of TE within the key published literature to date. A typical TE experience often occurs within the context of a workshop or retreat-based group counselling experience, offered over an intensive weekend, or an evening following several weeks of group-building and narrative life reviews. A group ranging from 8-10 or as many as 15-25 participants may come together to participate, and several enactments are often completed in sequence over a full day or evening. An individual enactment, including group debriefing, will typically take from two to four hours.  Within each enactment, participants may take on the lead role, or may participate as other roles in the lead's life (for example, friends, relatives, perpetrators of traumatic experiences, other victims of traumatic experiences, younger or alternative versions of the lead's "self"). These roles are taken in in direct consultation with the group facilitator. Typically two, sometimes three, co-facilitators "direct" the enactment process. The primary facilitator focuses his or her attention on the lead, and the secondary facilitators share their attention between the other role-takers and the witnesses, constantly vigilant to the group as a whole; as noted above, TE is at all times a group therapy process.  The therapeutic enactment model is divided into five distinct phases: (a) assessment and preparation, (b) group building, (c) enactment, (d) group processing, and (e) integration and transfer.  ? ∣ ? Phase 1: Assessment and preparation. After clients have identified critical or traumatic life events within the context of individual therapy, they are interviewed to assess current psychological and emotional functioning and suitability for the TE process. The facilitators, trained in trauma therapy, group work, and therapeutic enactment facilitation, conduct a pre-enactment meeting with the client, to assess client needs, and begin to form a detailed script, or series of scenes, for the enactment to take shape. This includes the people, the places, the material things, and the events. Ideally, the chosen event is "normally one that cannot be fully accessed through a verbal therapy approach; rather, it requires a reliving of the event in which all parts (i.e., feelings, actions, thoughts, spirituality) of the person are involved" (Westwood et al. 2003).  The facilitators also ascertain various personal and social resources that the lead could use during the enactment to facilitate a sense of strength and safety (Hirakata & Arvay, 2005).   Phase 2: Group building. The group-building phase is rooted in the predominant theories of group counselling (Yalom, 2005) and revolves around, "Creation of an atmosphere of safety, affection, and cohesion among the group members. Feelings of inclusion, belonging, spontaneity, and support for one another are essential ingredients that encourage member risk taking and participation within the enactment" (Westwood et al., 2003).  Phase 3: Enactment. The enactment phase is the point at which leads enact their chosen scenes, with the aid of the group facilitator as "director", and involving some or all of the other group members assuming various significant roles in the lead client's life. Within the safety of a well-established witnessing group - as a "safe & supportive ? ∣ ?container" (Hirakata & Arvay, 2005) the therapeutic enactment unfolds as the directors guide the lead in a careful reconstruction of his or her story. The lead physically, as well as psychologically and emotionally, moves through the enactment and in doing so, co-creates a shared story of their past traumatic experience. The lead is given opportunities to "re-story", that is, change the scenes from how they exist in their memory, to newer, less painful, or corrective experiences, which they have an embodied memory of, within a safe, supportive context.  Phase 4: Group processing. In the fourth phase of the model is group processing. Members are given the opportunity to "de-role" from any part they may have taken, and then are, in turn, given space within the group circle to share his or her own unique, personal reactions to the enactment they witnessed or co-created. The process of group sharing is designed to consolidate the lead’s experience and further connect the members through increased inclusion in the group process. As TE is a group-based intervention, it is at this point we may acknowledge the potential for a corrective, therapeutic experience, for any and all members of the group, not merely the "lead" role.   Phase 5: Integration and transfer. The first stage of integration involves the lead reflecting in on the enactment experience and the feedback from group members and facilitators, within the group context. The second stage involves the lead's commitment to transferring, applying the changes experienced within the group context, into their daily life. This involves encouragement, and potentially referral, by the facilitators, towards ongoing counselling or therapy, to continue and solidify the trauma repair process. Theoretical foundations of therapeutic enactment. Developed through the collaborative work and research of Dr. Marvin Westwood and Dr. Patricia Wilensky, ? ∣ ?therapeutic enactment, has been described in the literature varyingly as a complex, multi-modal, integrative, and multi-faceted approach to trauma repair (Hirakata & Arvay, 2005; Keats and Arvay, 2004; Westwood et al., 2003). Its originators suggest that it is a "holistic solution to the complex concerns that single system therapies cannot address" (Westwood et al., 2003, p. 123). The authors then delineate four distinct theoretical foundations: Group Theory, Self Psychology and Object Relations, Schema and Script Theory, and Gestalt theory, each of which will be addressed briefly below.   TE is further described as a fusion of narrative, story-based therapy, and action-based interventions, that extends "the traditional interventions of talking and thinking by placing an emphasis on experiencing and doing" in order to re-create and work through significant and traumatic life events within the safety and security of a strongly developed group of witnesses (Hirakata & Arvay, 2005, p. 446). By extension, it is contended that the very experiential nature of TE places it in the domain of somatic processing interventions, which aligns with the developing research into trauma as an essentially embodied phenomenon. Although TE shares common foundation to the field of psychodrama, the TE literature distinguishes the two in fundamental ways, which will be addressed below.  Group counselling theory. Group counselling theory is the framework within which TE is made possible. The individual acting as the "lead" role receives the benefits of the intervention within a group context where all participants feel included, involved, and committed to the process, thereby creating the safety necessary for intensive trauma processing. The group container is seen as symbolic of the client's larger community, so the trauma can be addressed in a "public space". As Westwood et al. (2003, p. 124) state: ? ∣ ?"The reparative nature of a participatory, nonjudgmental work group is a central assumption of the model". In building groups for TE, the authors note an emphasis on the key therapeutic factors identified by Yalom (2005) to promote client change in a group context. Yalom’s factors include group cohesiveness, corrective emotional experience, interpersonal learning, imitative behavior, universality, and installation of hope. Furthermore, the authors attend to the phase-oriented model of group development elucidated by Schutz (1958), that states groups form along three common member concerns: inclusion, control, and affection. Inclusion refers to an individual’s need to belong, to know what expectations of their participation exist, how their relationship with the leader will develop, and what status each group member displays. Control involves establishing how much influence they have over what will happen to them as group members, and includes issues of interpersonal dominance, leadership, competition, and perceived group structure. Westwood et al. (2003, p. 125) state that: "In therapeutic enactment groups, members witness a leader who is clearly in charge, yet are also consulted when it becomes relevant for them to contribute to decisions about group participation related to the enactment". Affection - the third phase of group development - is characterized by the expressions of positive feelings, member sharing, emotional support, and enhanced member-to-member attachment. As group affection develops, so too does the perception of trust, self-disclosure and risk taking.   Self-psychology and object relations theory. Interpersonal relationships are fundamental to the therapeutic enactment process: those between the clients and the facilitators, those that form amongst group members, and frequently, clients' internalized representations of relationships with significant people in their lives. It is thus a ? ∣ ?framework that relies on the interpersonal theories of self-psychology and object-relations, which are, according to Ford and Urban (1998), as cited by Westwood et al., 2003) "concerned with how the relations with others (whether real, imagined, past, or present) determine psychological functioning (i.e., affect and cognition) and behaviour".  Westwood et al. (2003) observe that traumas often occur with a primary wounding, break, or insult to the person, which most often prevents the normal or healthy development of the individual within relationships. This is taken as evidence of a need to return to that previous interactional event that is interfering with how the client interacts within the relational world of their life today. The enactment process is theorized, and clinically observed, by the authors as "most often to repair these wounds by returning to action—to re-experience the event as a means to alter and reshift the original self-schema and, in doing so, endeavor to resolve shame, abandonment, abuse, or neglect". In other words, TE is suggested to work through externalization of internal representations of self-important others in client's lives.  Schema and script theory. According to Bruning, Schraw, and Ronning (1999), as cited by Westwood et al. (2003), schema theory holds that people organize what we learn about the world into complex cognitive structures called schemata, which "control the encoding, storage, organization, and retrieval of information about objects, events, sequences of events, and actions - our declarative knowledge about what is currently happening in the environment." These schemata are essential to how we recall our past, and create meaning of the world. Relatedly, scripts provide the underlying mental framework for procedural knowledge: as we take actions, the knowledge of those actions becomes encoded in a script-like mental structure (Bruning et al., 1999). Therapeutic ? ∣ ?enactment takes these cognitive processes into account as fundamental to how we interact with our environment, particularly our social environment. These schemas and scripts are considered highly objective and personal. Therapeutic enactment is grounded in the possibility of restructuring obstructive schema and rewriting problematic scripts that may have been formed as the result of traumatic experiences, by creating alternative lived experiences (Westwood et al., 2003).  Gestalt therapy theory. Gestalt therapy theory (Perls, 1969, cited by Westwood et al., 2003) is referenced as a component of Therapeutic Enactment, for its array of techniques used to encourage clients beyond thinking and talking, into doing and acting. Westwood et al. (2003) state: "When clients experience present-centered awareness of bodily sensations, energy levels…personal integration is facilitated by linking what they are thinking to what they are doing and feeling. Focus on the here-and-now experience in the enactment permits the most pressing needs to surface, opening an opportunity to address these needs as the enactment proceeds…Meaningful experiences cannot be separated from the environment or context in which they occur; therefore, the author’s goal in therapeutic enactment is to reenact the original event in a new context where a high level of acceptance, trust, and support exists for the client in a present-centered experience. Thus, new gestalts, different from the original ones, are formed as a result of this process." Distinguishing therapeutic enactment theory from psychodrama. TE has its roots in classical psychodrama (Blatner, 2000; Moreno & Moreno, 1969). Although a detailed comparison of TE and psychodrama is beyond the scope of the present study, it is important to recognize that the literature on TE (eg. Black, 2009; Westwood et al., ? ∣ ?2003) acknowledges similarities in technique, but expressly distinguishes the two in fundamental ways. It is not the purpose of this study to critique psychodrama in any way, however, it is of value to delineate the four fundamental differences as described by the originators of TE:  Psychological safety of the individual. In TE, the psychological safety of clients is considered as paramount, and all other aspects of the group process are considered secondary to this principle during enactment (Black, 2009, Westwood et al., 2003).   The role of spontaneity. Westwood et al. (2003) state that spontaneity is viewed as the end result of a successfully planned enactment process, which is designed to resolve issues that may be blocking it; rather than something that can be trained, for the purpose of successful therapeutic process. Black (2009) observes that although practitioners of psychodrama may share this belief, the literature on psychodrama doesn't make specific mention of this concept.   The purpose of catharsis. Within TE, catharsis is not considered the end point, instead it is viewed as the beginning of reparation and healing (Westwood et al., 2003). For example, according to Black (2009): "In TE, resolution begins when… disowned suffering and grief are accepted, expressed, and integrated by both the individual and the group" (p. 94).   Attention to group process. Whereas psychodrama is essentially "protagonist centered" (Westwood et al., 2003), TE is fundamentally a group-based intervention. Practitioners make a priority of attending to group processes throughout, "in order to prevent negative group dynamics from impeding the enactment and to use the positive aspects of group dynamics to enhance the enactment." (Black, 2009, p. 94). Again, Black ? ∢ ?(2009) states, "while it may be the case that individual psychodrama practitioners follow the same principles as outlined by Westwood et al., Westwood et al. is the only available reference that explicates these issues."    ? ∣ ?Chapter III: Methods Introduction to methods  In asking the question, “what is the experience of participating in a specific group-based trauma intervention?” I am undertaking a necessarily qualitative inquiry. My purpose is to explore with each participant, their own subjective recall of an event in their life, through the use of language, to construct a sense of that experience’s meaning for each participant. I believe both meaning and experience are not quantifiable constructs, which exist only insomuch as they exist within individuals. A meaningful or important experience is thus an entirely subjective, personal phenomenon, and the degree to which that experience resonates with others has no bearing on its "truth" in a permanent sense. I intend to conduct research that allows each participant to share his or her own unique experience.   I selected to collect data using a qualitative interview method known as Interpersonal Process Recall (IPR) (Elliot, 1986; Kagan, 1984; Larsen et al., 2008) that allows for entirely open-ended inquiry. The method was initially developed to focus on clients’ perspectives of therapy based on observations that counselor perspectives on process dominated the literature (Larsen et al., 2008, p. 21). This observation is confirmed in the literature review of the present study.   I chosen to conduct a thematic analysis of the interview responses, as elucidated by Braun and Clark (2006), that involved systematically transcribing and then analyzing those transcripts for emergent themes, re-presenting these themes in my own way, and acknowledging my influence on the research process and stories that emerge. From within the broad range of established qualitative methods, I believe this combination is ? ∣ ?the most suitable for exploring the question I have raised.  Research paradigm: a theoretical framework  This work was undertaken from a social constructionist theoretical framework, and a firmly relativist ontological position. Although formalizing a static definition of social constructionism would be a paradoxical endeavour in itself, the following are some key elements of adopting such a worldview that I feel are most relevant to this research project. These elements are drawn from Vivian Burr’s work on social constructionism (1995), as well as the work of Arvay (2003), Polkinghorne (1992/2005) and Reissman (2008).  Knowledge is constructed. Knowledge, including that of meaning and experience, is co-constructed through relational dialogue (socially constructed), as opposed to "discovered" in the external world of "truth" or "reality” or inherent within individuals.   Language is limited. Language is not transparent, in other words, there is no linear correspondence between what something "is" and what it "means".  Context matters. Stories are always reconstructions and are thus context-dependent. Each co-researcher’s recollections, interpretations and representations of their own stories will invariably change over time, as their own context changes.  Multiple selves. Rather than accepting that there is one true core self at the heart of each being, a social constructionist epistemology acknowledges that we can have multiple selves that exist inasmuch as we interact with others. Thus, as a function of context, each participant, or co-researcher, will choose to or be compelled to present one version of self to the interviewer, in the process of this inquiry; we can only know the story they share.   ? ∣ ? Research is an inherently creative process. Constructionist methods emphasize individual stories, including that of the researcher. The principle researchers’ own subjective beliefs are deemed essential to the process, as any knowledge generated is, by definition, a temporary co-construction between the interviewer and the interviewee (Riessman, 2008). Again, the emphasis is that any meanings revealed in the research process are fluid, dynamic products of dialogue and language. Thus, although the original data set was the interview responses of the participants, this final re-presentation is necessarily a co-constructed, created endeavor, made up of the participants recall of experience, in one context, at one time, and the analysis and re-presentation conducted by myself as the researcher. This creation reflects the subjective reality of each participant as effectively as my own limitations allow, and is ultimately a product of my own creation. In summary, social constructionist views suggest that meaning and experience are socially produced, multiple, and "always disputable depending on who is speaking to whom" (Arvay, 2003, p. 164). Furthermore, from a constructionist perspective, we can acknowledge that decisions are made at each stage of the research process. We choose our methods, from the inclusion criteria for our participants, to the interview questions we ask, to how we transcribe, analyze, and represent the answers, and how we evaluate the outcome of the process.  Interpersonal process recall: overview and rationale  Interpersonal process recall (IPR) interviewing has origins with educators in a program of health related skill-training (Kagan, 1984, Larsen et al. 2008). The fundamental premise is using video-playback to facilitate recollection of specific events in the training process. For the purpose of qualitative research in counseling and ? ∣ ?psychotherapy, this basic technique is modified into a specialized interview procedure wherein a recorded session is played back while the client is interviewed, with a focus on their internal experiences during the session. (Larsen et al., 2008, p. 21).  IPR is intended as a process-focused interview method, which is what makes it so ideal for inquiry into therapeutic interventions (Levitt, 2001; Lokken & Twohey, 2004; Martin & Stelmaczonek, 1988; Timulak & Lietaer, 2001). According to Larsen et al. (2008), an essential component of the method is to focus primarily on the thoughts, feelings, felt sensations and physical experiences, rather than on self-reflection, confrontation, or critique in a retrospective way. These authors suggest that these "unspoken, in-session experiences" may be inaccessible by many other research methods, both qualitative and quantitative (Larsen et al., 2008, p. 20). This enhanced recall associated with the method may be a result of a number of associated components. First, by accessing client experiences as close to the moment as possible - typically within 48 hours of the recorded intervention - IPR is designed to access individuals’ "conscious yet unspoken experiences as they occurred at the time of the interpersonal interaction under investigation", which may have remained un-verbalized until the time of the research interview (Larsen et al., 2008, p. 19/25). In essence, vivid and easy activation of memory can occur in the quick follow up time span. Second, the IPR process also slows the pace of conversation, allowing space for participants to reflect on and then verbalize complex experiences. Furthermore, during IPR the interviewer has the option of asking the interviewee to focus on a specific observable interaction as it is viewed during playback. In essence, the moment may be slowed to the point of being "frozen" onscreen in front of them, and time can be taken to explore the myriad of simultaneous experiences the ? ∣ ?participant may have been going through in a very brief time frame. This capability gives the promise of much more specific reporting, and avoids broader generalizations. Thematic analysis: overview and rationale  Thematic analysis is a method for identifying, analyzing, and reporting patterns or themes within a set of data. It minimally organizes and describes a data set in (rich) detail. However, in its simplicity, it has the capacity, if warranted, to go further than this, and interprets various aspects of the research topic. Thematic Analysis is not bound to any epistemology, which allows for a flexibility, to either create themes within a data item, such as an interview, in the way a case study may function. Or it can be used for analysis across themes, in a similar way to discourse analysis or grounded theory, without the requisite theoretical and technological expertise required. For this reason, it is suggested as a more "accessible" analysis method, one suitable for novice qualitative researchers (Braun & Clarke, 2006). For this research, as stated, I conducted a thematic analysis within a constructionist framework, "seek(ing) to theorise the socio-cultural contexts, and structural conditions, that enable the individual accounts that are provided” (Braun & Clarke, 2006, p. 14). In other words, a further strength of thematic analysis is that it allowed for social as well as psychological interpretations of the data. Participants   Three participants were recruited for this study. Each participant was asked to engage in one IPR interview. The duration of this interview was understood as contingent on the length of time the therapeutic enactment took – typically from one to two hours, and the degree of depth engaged in the interview processes. These three interviews each took between 1.5 and 2.5 hours, with breaks built in when necessary. Each of the ? ∣ ?participants in the present study were males participating in The Veterans’ Transition Program, as detailed in the section II of this study. The employment of Therapeutic Enactment as a group-based intervention for trauma is increasing outside of this format, expanding into the broader counseling and psychotherapy community (Westwood & Ewasiw, 2011). However, the clients of the VTP remain the most accessible population being exposed to TE on an ongoing basis. Furthermore, this program has an established connection with The University of British Columbia, from which it originated, and researchers from that institution are conducting ongoing outcome research of the program (Westwood et al., in press).   Inclusion and exclusion criteria  The Veterans’ Transition Program is offered to former and current members of the Canadian Armed Forces, who are referred to the program by other veteran’s who have completed the program, or through contacts in the Royal Canadian Legion, Veterans Affairs Canada, and the Operational Stress Injury Social Support Program. To qualify for the VTP, and subsequently for this research study, all participants were pre-screened and assessed by a registered psychologist, to determine suitability for participation in group process work. Participants who would not qualify for participation were those with psychotic symptoms, current severe dependence on alcohol or other substances, an unwillingness to refrain from substance use during the course of the program, significant cognitive impairment, current suicidal ideation or intent, and/or any severe cardiovascular impairment. The same exclusion criteria applied for the current study, because anyone unable to attend the VTP was not eligible for participation in the study. These criteria overlapped directly with recommendations by Larsen et al. (2008) on suitability for ? ∣ ?participation in the IPR interview process.  As taking part in an IPR interview can be an emotional experience, requiring interviewees to “delve into, re-experience, and describe their inner cognitive, affective, and somatic experiences and processes” (Larsen et al. 2008), consent was viewed as an ongoing process. Participants were able to withdraw, in the unlikely event that within the context of the intervention itself, the group facilitators or the researchers deemed them no longer suitable for the IPR process due to risk of psychological distress. This did not occur. Recruitment procedures  Once a veteran had met inclusion criteria for the program and agreed to participate, they were approached to participate in the research study by the primary investigator. All phases of the research process were explained, and it was made clear that participation in the present study was not obligatory in any way, and would not impact their access to interventions in any way.  Data collection: the interpersonal process recall interview Once participants were identified, collection of the data for the present study occurred in three stages. First, participants were given the option of having their therapeutic enactment audio and video recorded. It should be noted that even undergoing the intervention is also an optional experience for each group member. Second, the participants were invited to participate in the follow-up interview in which they watched the video playback of their own intervention, alongside a research interviewer, while simultaneously being interviewed about the processes they were aware of undergoing ? ∣ ?during the intervention. Third, these IPR interviews were also recorded - the video footage of the IPR interviews constitutes the data that was then analyzed. Data analysis: identifying themes The analysis was conducted in multiple stages, beginning with transcription, which I conducted myself. I acknowledge that transcription is an inherently interpretive, analytical process in itself; how one chooses to punctuate, spell, emphasize, highlight, encode non-verbal information, are all decisions to be made by the transcriber, and have the potential to influence subsequent readings of the text (Braun & Clarke, 2006; Lapadat & Lindsay, 1999, Reissman, 2008). Following transcription, the next stages of thematic analysis were multiple readings; first, for familiarization and immersion with what is spoken; a second reading to generate codes which organize (cluster) the data; a third reading to form these codes into themes (repeated patterns of meaning), and a final reading to review, define and name themes (Braun & Clarke, 2006). The flexibility of this method extends to the choice of themes. The number or nature of themes generated was both context and participant dependent.  I felt three or four strong themes emerged for each participant, so I chose to "provide a more detailed and nuanced account of one particular theme, or group of themes, within the data" (Braun & Clarke, 2006, p. 11). Generally, my inclination was to take a more holistic approach, rather than a categorical one. This meant striving to keep the narratives as intact as possible, using the narrator's natural breaks in the storytelling process to dictate the beginnings and endings of excerpts, rather than breaking them down into smaller units of measurement (Lieblich et al., 1998). At times I wove thematically similar segments together to produce lengthier, more coherent excerpts. ? ∣ ?Re-presentation of findings  As with each stage in the research process, re-presentation of any data is an innately creative (constructive) process, as a product of decisions made by the investigators. And, as stated previously, the exploratory nature of true open-ended inquiry leaves the final form of the data somewhat undetermined. For the present study, I chose to create a written exposition, interspersed with selected direct quotes from the transcribed interview data, in order to illustrate the themes that I believe emerged. My hope was to accomplish what Braun & Clarke (2006, p. 23) put most succinctly: “your write-up needs to do more than just provide data. Extracts need to be embedded within an analytic narrative that compellingly illustrates the story that you are telling about your data, and your analytic narrative needs to go beyond description of the data, and make an argument in relation to your research question”. Again, it is worth reiterating that the final product of this research process was an act of creation, capturing a singular instance of exploration in a singular context. Chosen criteria for evaluation Assessing the value of a study conducted using these methods is not a simple task; indeed it is one that may be approached from a multitude of angles. As the data in any study undertaken from a social constructionist framework originates with participants' own subjective experiences, we must be compelled to accept these accounts as they are (Reissman, 2008). Thus, the measure of value for the present study is focused instead on the process of analysis; my own interpretive re-organization and re-presentation of those accounts. I have selected several criteria I feel are meaningful for this study. Each is described below, including the steps taken to uphold them. ? ∣ ?Verisimilitude. This criterion refers to the appearance or approximation of truth, and refers to the goal of creating an overlay between a researcher’s interpretation of participants’ experience and what they really did experience. The concept of verisimilitude is anchored within the limitations of language; the very fact that there is no linear correspondence between what something "is" to one person and what they are able to communicate about that to another person, means that at best we can hope for a closeness or likeness to the truth; the “true” truth of one can never truly be known to another (Reissman, 2008). Since the data are personal accounts, only the narrators of those accounts themselves are the "experts". Verisimilitude was pursued in two ways in this study. First, I tracked my own reflexive stance (see Researcher Reflexivity section, pg. 6) as I conducted the thematic analysis of the data, in an effort to remain aware of my own inevitable influence on the process. Second, I engaged in ongoing consultation with an acknowledged expert in conducting process research on counselling interventions. Commitment and rigour. These associated criteria refer to the degree of in-depth engagement with the topic of study, as well as demonstrated competence in the application of the methodologies employed (Yardley, 2000). I believe I achieved a degree of commitment through my immersion in studying therapeutic enactment on both a theoretical, academic level, and a personal, experiential level. As detailed in the section on reflexivity (p. 6), during the course of conducting this study, I have participating in therapeutic enactments in all the possible roles, including undergoing my own as a client, taking on roles in others', and leading as a co-facilitator. The rigour of this study is demonstrated in the complete and thorough manner in which the video data were ? ∢ ?reviewed multiple times, transcribed, and interpreted, to a point that can be referred to as saturation (ibid, 2000). Theoretical and practical impact. Yardley (2000, p. 223) writes:  "The decisive criterion by which any piece of research must be judged is, arguably, its impact and utility. It is not sufficient to develop a sensitive,  thorough and plausible analysis, if the ideas propounded by the researcher have no influence on the beliefs or actions of anyone else.  However, there are many varieties of usefulness, and the ultimate value of a piece of research can only be assessed in relation to the objectives of the analysis, the applications it was intended for, and the community for whom the findings were deemed relevant."   This criterion is akin to what Reissman (2003) refers to as Compellingness, the degree to which a study may compel readers into further thought or action. Compelling counselling psychologists and researchers to further pursue questions raised by this research is an explicit goal. I have striven to achieve a degree of theoretical worth with the present study, by anchoring my analysis in detailed understanding of the theoretical foundations of group-based trauma interventions and therapeutic enactment specifically. I have striven for practical value by creating an analysis that is accessible and of value to both aspiring and experienced practitioners in the field of group therapy for trauma, as well as future researchers. Whether or not this was achieved is not for me to judge, but rather must be left in the hands of subsequent readers of the work.    ? ∣ ?Chapter IV: Findings  Overview of findings  Lieblich (1998) posited that one of the greatest challenges in thematic analysis is to strike a balance between two opposing tendencies. The first is the tendency towards creating numerous categories that retain all the richness, nuance and variation of the original data, at the risk of a level of complexity that renders conclusions less accessible. The other tendency is to delineate a few broader, simpler themes, which are more easily comprehensible, but may lose intricacy in the process. This dialectic was taken into consideration in the course of the present analysis. Each account was examined holistically, and the themes presented herein are an attempt to capture the three individual experiences in a broad, easily comprehensible way. This is balanced out by a detailed parsing of the dialogue between interviewer and interviewee, into small exchanges, sentence length statements, simple exclamations uttered by each participant, at times facial expressions and gestures. At times these units of measurement have been folded into one another, rearranged and woven together, in an attempt to express the more subtle nuances of the themes that became evident upon multiple, in depth readings, informed by the pre-existing literature on therapeutic enactment, and group therapy for trauma in general.  This chapter is broken into four sections, with the themes from each participant explored in turn, for a total of eleven themes. Each participant’s themes will be illustrated with excerpts drawn directly from the text, accompanied by my own exposition designed to facilitate continuity amongst the themes. These themes are not mutually exclusive; indeed they will readily be seen to overlap in many ways.  ? ∣ ? It is important to emphasize that the nature of this thematic analysis is exploratory, rather than explanatory. I present no hypotheses, nor suggest any objective truth by which these findings will be measured for their value. Each account will stand alone as its own truth, in one context: the relationship developed between the interviewee and the interviewer. The final outcome of the research will also be one account, as generated in one context, the process of textual analysis. Participant one: Pete's experience  Introduction to Pete's themes. In the process of analysis, I constructed four themes that I believe illustrate Pete's experience of this particular therapeutic enactment. Each theme is represented below, with accompanying excerpts from the transcripts. The first theme is his recognition of pivotal and/or symbolic moments in his life. Four examples of such moments are discussed. The second theme is Pete's generation of insight into his identity, at the time of the interview. These insights span across his emotional self, his observations of his own behavioural patterns, his personal values, his spirituality, and his own innate goodness as a man. Each of these is discussed in detail below. Theme three is Pete's access to and expression of his own core emotions. Illustrated examples reveal his connection to the emotions of sadness, anger, pain, loneliness, helplessness, and betrayal. Finally, the fourth theme is that Pete remained "in process" for the IPR interview; this theme is somewhat unique in its representation. Whereas the first three themes are illustrated with excerpts of content, this theme is constructed based on observations of Pete's own behavioural and speech patterns within the interview itself. The function of IPR interviewing is to take a reflexive position and explore the interpersonal experience, in this case, that of TE. Despite this, Pete spends ? ∣ ?much of his interview still actively processing, still apparently engaged in his own therapeutic work, and attempting to engage the interviewer in a more "therapeutic dialogue". The observations that illustrate this theme are presented at the conclusion of this section.   Pete's theme one: recognizing pivotal and symbolic moments. Pete speaks of "moments" frequently throughout his interview. Pete appears to think in moments, to remember in moments. His tone of voice, and thoughtful language, as well as his body language and facial expressions, appear to indicate that, during the course of the interview, he continued to remain in a processing state, rather than entering a reflexive state. Throughout the interview he experiences further insights, which he reports to the interviewer as "having a moment". This "in-process" state constitutes a theme in its own right, which will be returned to in more depth below, but it is noteworthy to observe that the term "moment" is a meaningful one for him. Thus, throughout the interview process, Pete appears to be scanning the video for moments that he can capture, mark in some way, to extract meaning or value from. Below are four distinct moments that Pete identifies during the course of his interview, that he acknowledges as either symbolic of something greater in his lived experience, or else as pivotal turning points in his life. It is worth noting that the four moments map directly onto the four scenes that were played out during the course of Pete's enactment. Either intuitively or deliberately, he extracts a single moment within each scene he views, and identifies it as meaningful to him.  Moment one: "the radish moment". The first moment Pete identifies occurs in the first scene of his TE. He watches his younger, innocent child self, who grew up on the family farm, enjoying "doing his own thing" growing vegetables, tending to animals; and ? ∣ ?enjoying spending time with his dad while he worked. The scene depicts a memory he had of approaching his father with radishes that he has grown, and naively attempts to sell them to his father. His father takes the opportunity to teach his son a lesson, about conducting good business: Interviewer: What’s going on for you right there? Pete: It’s sad, because it was a really good moment, that was then lost…  Here Pete can acknowledge that this moment captures something he did not experience enough as a child. It is a loving moment. His Dad was proud of him, and both wanted and enjoyed having him around on the farm during this time. Because of his innocence, it is also a moment of humour. But it is fleeting, and this chapter of Pete's life ends too soon, as we learn. Then Pete says: Pete: Yeah, that’s it…because that moment, of the radish, and that connection, and being with Dad…that radish thing really symbolized Dad, what we were doing…  Here we see evidence of Pete's ability to view a brief scene, designed within the enactment to activate his memory of his childhood, as a symbolic moment that captures, in essence, his entire childhood. He says: Pete: that was quite complete on a lot of levels  This can be seen to refer to how this single moment captures, for Pete, multiple themes being played out within the scene: the loving connection, the mentorship from, and pride of his father, his own innocence and naivety that were cut short far too early for Pete.  Moment two: the moment with the nuns. The second moment Pete identifies can be viewed as an actual turning point in his life, for multiple dimensions of himself: ? ∣ ?spiritual, political, and emotional. It occurs within the second scene of his TE, which depicts young Pete being sent away to a boarding school, a school for "children with special needs", operated by a group of catholic nuns. Pete describes how much he missed his family, his siblings and friends, and felt like he was missing out on so much of his life back home on the farm. Pete describes the eighty-year old nun who ran the boarding house, who he felt "had no clue about how to care for kids". He reports feeling like he got a glimpse of what life is like for an orphan: he was treated terribly, like he was "just a number", with no love or compassion. Upon viewing, Pete exclaims: Pete: Right there, when I said I hated the nuns…that’s why, unfortunately, I was never a religious person, I’m a spiritual person, but there and then I thought: ‘is this how the church operates? Is this how a nun treats children? Well fuck you God’.  This moment is a powerful instant for him - an actual turning point and also a symbolic moment of how his own spirituality would begin to develop - with an unwillingness or inability to embrace organized religion. Peter then goes on to say: Pete: “yeah, big change…sorry, I’m just having a moment here…because that big change…really, sort of, made me anti-establishment…and any institution…its only now I’ve just remembered that moment…”  Here he reveals that not only did this moment with the nuns shift his spirituality, but it shifted his relationship with authority as well - influencing his ability to respect "any institution". Finally, regarding this moment Pete reports: Pete: “it was, like… almost…the beginning of a lonely time…  He reveals insight into this moment as an actual pivot point for him emotionally. In the scene itself, he relates that this is the time he "lost love" that he'd had growing up on ? ∣ ?the farm. In one sense, Pete was exiled - by his own parents - from the place of his innocence and youth. This marked the beginning of a lonely phase in his life. As we will see later, this also shaped how he saw himself as a lonely, withdrawn person.  Moment three: the moment he loses his boyhood and his manhood. This moment occurs within the context of dialogue with his father in the enactment. The scene portrays Pete's young self, lost on the boarding school playground, alone, lonely, and afraid, while his family remains tightly united back on the family farm. Although there is no scene that depicts any actual assault occurring, this scene is symbolic of the events that transpired while he was away at boarding school, when Pete was raped by adult male religious authority figures. Pete begins to confront his father in this scene, to explain to them that he felt abandoned, neglected, and "served up" by his parents. He expresses his shame - that he had never felt there was something wrong with him, but after being raped, he began to believe there was. He began to doubt his masculinity. As he re-views this scene, Pete exclaims: Pete: Yeah, that was it! (then, repeating his own words from the original scene) “You took my boyhood and my manhood”. Both those guys did that, and after that I just…reflecting back on having said that now…things changed…I changed after that.  Moment four: confronting his parents. As the third scene culminates with Pete continuing to confront his parents, the interviewer asks: Interviewer: So did you actually tell (that your manhood and boyhood were taken) to your real father, or is this the first time you’ve said that? Pete: No I’ve never said that…  Thus we see an example of the capacity of TE as an intervention, to allow ? ∣ ?participants to say or do things they've never had a chance to before. Within the enactment, the fourth scene emerges organically from the third, as Pete begins to open up and express himself to his father, it shifts into a dialogue with both his parents. He tells them both "they don't understand", that he holds so much anger towards them for sending him away, and abandoning him. He tells them he's going to hand back his anger, because it belongs with them, not him. He reveals he felt unloved, because they hardly ever came to visit him, justifying that with financial costs. In the review, the dialogue unfolds: Interviewer: So you were abandoned and scared…what was it like to tell (your parents) that? Pete: well, actually I did get around to doing that (prior to the TE) because I’d done a lot of this work in 2005, beginning of 2006…I was in a very fortunate position that I could tell them…before they died.  Pete reveals that he was able to express his anger towards them as a result of previous therapeutic work. As the IPR interview continues, he watches himself extend from handing back to his parents his anger, abandonment, and shame, to another feeling: betrayal. He tells them, "there was nothing wrong with me, but something was taken from me, because you weren't there to protect me". In the review process, Pete remarks: Pete: Yeah that was a nice, clean moment there…and that’s how I felt… I may not have articulated the betrayal to Mum and Dad, but the hurt…It did feel cleaner, and a weight was lifted…It was good doing it a second time.  This moment for Pete had value, not because he has never said these things to his parents, but because he is provided an opportunity to re-do something, to improve the experience for himself. We learn that through the experience of the TE, he is able to go ? ∣ ?deeper, from articulating the feelings of pain and anger he had towards his parents, which he had done before, to identifying the betrayal he felt. We can note here that Pete has revealed his parents are now both deceased, but in the course of TE, he is able to dialogue with them, or more precisely, with his internalized memories of them.  Pete's theme two: insights into the origins of his present identity. As discussed above, Pete appears to be searching, seeking, as he views his enactment experience. He is looking to extract meaning, and in a sense, one can perceive him as looking for his self within the video. The second theme identified in the process of this analysis, was Pete's experience of insight into the origins of himself in the here and now. For example, at one point Pete remarks: Pete: it’s uncanny how my Dad and I are similar   Unfortunately, an opportunity was missed to explore this comment with Pete more fully, a new topic arose and this observation was not returned to. But it is significant to observe that Pete is not making this comment based on seeing actual footage of his own father - he is watching another group member portray his own internalized experience of his father. And yet he is still able to draw this comparison, still able to get a glimpse into how his father's personality shaped his own. Throughout the interview, however, Pete makes numerous other observations that illustrate this theme - that his experience generated or expanded his self-awareness regarding his emotional self, his own self-perceived behavioural patterns, and his personal values.  Pete's emotional self. Within the enactment experience, as well as the interview process, Pete describes himself as a solitary, withdrawn person. For example: Pete: what I go through in life…is, I often don’t tell people things…at work, even tell my ? ∣ ?wife, where I should…sometimes I just don’t bother…I just don’t feel like answering questions…so I can just do it on my own.”  In the course of analysis, he makes the observation that when his parents send him away to boarding school:  Pete: it was, like… almost…the beginning of a lonely time…  One can get the sense that, in a way, that lonely time never ended for him. He recalls his youth prior to boarding school as one of connection to family, of closeness, of love, but once he is sent away from them, he withdraws: Pete: And reflecting back on having said that now, and what my mom said, that things changed…I changed after that. Interviewer: how did your mother know you’d changed? Pete: she just said I’ve changed. But I think now, when I look back…I withdrew.  Further, Pete acknowledges the role of his own anger in his withdrawal. And even more significantly, he gets a glimpse into a deeper level of emotion than his anger: his feelings of betrayal. Pete indicates in the excerpt below, that in the process of exploring the TE, he sees the betrayal he experienced when his parents abandoned him at boarding school as the "fuel" for his own anger, that he has carried with him into his adult life. Pete: I didn’t realize how much I was hanging on to…and the anger that was there...I just went silent, I was numb… Pete: I hadn’t really defined the betrayal…there was anger, but I hadn’t defined where it was fueled from…it was the betrayal.  Pete's self-perceived behavioural patterns. As stated earlier, Pete acknowledged how, in the course of his adult life, he can often isolate himself, not communicate with ? ∣ ?others at work, even his wife. As well as providing an insight into his emotional self, we also learn about his own behaviours, and things he may wish to change: Pete: what I go through in life…is, I often don’t tell people things…at work, even tell my wife, where I should…sometimes I just don’t bother…I just don’t feel like answering questions…so I can just do it on my own.” Pete: For me, that’s something I do to my children…so there’s a pattern that I follow…  And then later, Pete makes another clear observation of his present day behaviour patterns, and perhaps more significantly, he identifies something that he believes he must now do to aid his own healing process: Pete: I’ve been too much of a…people pleaser…always helped, always others before myself…and its time for some self-nurturing. Looking back…since this whole exercise…what I’ve established from this session right here…is that I’ve inadvertently, or subconsciously, self-nurtured…and now I have to take time out (to deliberately take better care of myself).  Pete's personal values and spirituality. Pete's work in the enactment process, around the experience of being sent away to boarding school, appeared to illuminate fundamental values that he has held to this day - here he acknowledges resistance to both organized religion, as well as authority, established institutions in general: Pete: “yeah, big change…that big change…really, sort of, made me antiestablishment…and any institution…” Pete: “Right there, when I said I hated the nuns…that’s why, unfortunately, I was never a religious person, I’m a spiritual person, but there and then I thought ‘is this how the church operates? Is this how a nun treats children? Well fuck you God’”. ? ∢ ? Finally, Pete has an opportunity to acknowledge himself as someone who has overcome adversity, and that ultimately, he is aware of his own strengths, and his own innate goodness as a person: Pete: you see, a lot of this…I was a survivor…no matter where I’ve been I’ve had to start from scratch….and I’ve pulled myself up, so it doesn’t worry me now… Interviewer: how did it feel to say ‘I’m a strong, kind, caring, real man’? (to your father. Pete: It reaffirmed what I know, I’ve said that before…and I’ve actually said it to Dad. I said ‘I’m a good man’…so that’s a knowledge I know…  Pete's theme three: accessing and expressing emotions. The third theme I constructed from the analysis of Pete's interview was his recognition of the opportunities he had to access his own emotions, and to express them, both during the enactment itself, and again in the follow up process. Some of the key emotions he recognized himself expressing are sadness, anger, pain, loneliness, helplessness, and betrayal. Below are a series of brief excerpts that illustrate each.  Sadness.  Interviewer: What’s going on for you right there? Pete: It’s sad, because it was a really good moment, that was then lost.  Anger. Interviewer: so how’s he feeling in that moment ? Pete: “Angry…FUCKING PISSED OFF actually…!” Pete: I didn’t realize how much I was hanging on to…and the anger that was there...I just went silent, I was numb… Pete: "Is this how a nun treats children? Well fuck you God"… ? ∣ ? Pain Pete: “That hurt, that moment….” Interviewer: where (another group member) put his hand on your shoulder, what did you notice, when he touched you like that?  Pete: Pain Interviewer: Pain…you noticed the pain when (the other group member) put his hand on your shoulder because it felt like…? Pete: someone was there for me…(during the enactment - contrary to his actual lived experience)  Loneliness  Pete: it was, like… almost…the beginning of a lonely time… Pete: that’s interesting because (another member) mentioned the word homesick…There was pain right there…and then I somehow remembered at the time…its something I’ve been meaning to mention… when he said the word ‘homesick’, I said ‘that’s it.”  Helplessness Pete: there…that’s that moment…feeling a little… uncomfortable… and,,, helpless. Yeah, there, see?  Pete: I think…that’s one of the things the rape – I couldn’t – even afterwards I couldn’t stand up and bring them to justice…  Betrayal  Pete: I hadn’t really defined the betrayal…there was anger, but I hadn’t defined where it was fueled from…it was the betrayal.  Pete's theme four: remaining in process. The fourth theme I constructed out of ? ∣ ?Pete's interview is less represented in the content, the words he spoke, and is revealed more in the process of the interview itself. It takes shape in the way he spoke, in the tone of the interview. Some behavioural observations that illustrate this theme are as follows: Often, when asked direct questions regarding the material he was viewing, Pete answered the questions very succinctly, and then resumed the video playback, appearing to be more interested in analyzing the video and reflecting on it for his own purpose of continuing analysis. He seemed to be experiencing the enactment for the first time, as though he had no recollection of it. On other occasions, Pete stopped the video playback, but instead of commenting on the scene being watched, he engaged the interviewer in lengthy discussions, more resembling a therapy session than a reflective interview. He shared new memories arising for him in the moment. His responses would begin as: Pete: “I’m just trying to reflect back on… (long pause – deep in thought) on how I changed… Pete: But I think now, when I look back… Pete: I’m just working out now...  Other times, Pete stopped speaking mid-sentence, and took long pauses mid-response. Occasionally he appeared to be looking away from the screen, to experience new memories. On several occasions, he sat back in his chair, placed his hands on the back of his head, and looked away, appearing to "stare into space". He then "came back", by indicating that a new insight had occurred to him, using phrases such as: Pete: “um…yeah…sorry I’ve just had a moment…” Pete: “yeah, big change…sorry, I’m just having a moment here… Pete: its only now I’ve just remembered that moment…” ? ∣ ?Pete: I’ve only now just made that connection” Pete: “Yeah…I’ve just had another moment…that’s interesting…I’ll reflect back on that…that’s quite important… Pete: "I just had a flashing moment there…"  Participant two: Larry's experience  Introduction to Larry's themes. In the process of analysis, I constructed four themes that I believe illustrate Larry's experience of this particular therapeutic enactment. Each theme is represented below, with accompanying excerpts from the transcripts of his interview. The first theme is the congruence of the enactment with is own life memories. This is presented in three ways; the first is Larry's reports of the vivid and accurate recreation of moments in his life; the second is through other group members' effective portrayal of key figures in his life; and the third builds on this, as his now deceased father is "brought back" into the room. Each of these features of the experience facilitated Larry, in his own words, "going from re-enactment, to being in it". The second theme of Larry's experience is the power of contact with the other group members. This nuclides both direct eye contact and physical touch, which he experienced powerfully in both negative and positive ways. The third theme was Larry's feelings that the group facilitators made interpretations, and gave directions, that didn't resonate with him. He felt at times that "words were put in his mouth", that his relationships with family were misjudged, and that his sense of masculinity was threatened, to the point of times experiencing humiliation, and what he refers to as "mental suffocation". The final theme of Larry's experience was an overall enhancement of insight; Larry reported increased self-awareness around his own need to feel understood, the nature of his relationships ? ∣ ?with his parents, and his own definition of masculinity.   Larry's theme one: congruence with memories. At numerous points throughout the interview process, Larry indicated that the scenes portrayed during his therapeutic enactment felt real, and "right" to him. He reports feeling "taken back" to memories from long ago in his past. He reports feeling his memories, and the emotions that accompany them, being evoked. He reports similarities between group members and important people from his life, along with accuracy in their portrayals. Perhaps most significantly, this contributed to Larry feeling that his own father was indeed "back in the room" with him, during moments of the enactment process.  Vivid recreation of life moments. The following three excerpts serve to illustrate how Larry experienced moments within his enactment, which vividly and accurately re-created or symbolized "real memories" he brought forth. The scenes captured not only memories, but his relationships with significant people in his life, and his own emotions, needs and wants. The first occurs during the video playback of introducing Larry as a child, and his father, and recollecting enjoyable memories he had of them together: Interviewer: So when you look at you here - remembering - looking down - retrieving these wonderful memories - what was going on inside of you, in your body? Larry: Visualization (makes gesture with his hand from face to the screen) - so many different - I was right there - standing in the bush with Dad, taking photos - standing on the hill, looking down on the family farm, taking photos - and all the bush trips that we did...every Sunday we'd go out in the was great. Interviewer: and in this moment (gesturing at screen) that felt...? Larry: Peaceful. Again. That was my childhood. ? ∣ ? We can draw our attention to several features of this excerpt. First, the gesture he makes, in which he appears to cup his own face and then fop his hand to cup the screen, in a motion that might be perceived as saying: his own mind is being mirrored by what he is seeing. Second, the phrase, "I was right there", a powerful indicator of the Larry being "transported" back to another time in his life. Third, "it was great", suggesting a positive emotion is captured here for me. Finally, "that was my childhood"; here Larry communicates powerfully and succinctly that one scene within his enactment served to capture an entire chapter in his life history - one that took place over forty years ago.  The next excerpt is drawn from viewing a young adult Larry and his father together, in the time just before his father died when Larry was seventeen: Interviewer: Do you remember what you said there?  Larry: Yeah, he was asking me what I saw in THAT setting - and its me, constantly looking at my father, looking for answers, looking for conversation, looking for love...and he (points at screen, referring to another group member) played my father SO WELL. He was there (gestures next to him, referring to the other members physical position in the enactment on the video playback) but THERE (makes gesture of flat palms on either side of his own face - suggesting "in focus, in my direct line of vision"). Interviewer: So what is it like now, to see this? Larry: Its still that separation, its still there between the two. Interviewer: How did that feel to recognize that, look at that boy...(points at screen) Larry: Its gonna sound silly, but it looks normal. Thats what my normal life was like.  Here Larry acknowledges the symbolic nature of the way the scene is re-enacted. On the screen before him, he is seeing his teenage self and his father, sitting in chairs side ? ∣ ?by side, but separated. The group member portraying his father is looking straight ahead, not making eye contact, and the member playing younger Larry is turned toward his father, looking at him. In the interview, Larry recognizes that this physical embodies their actual relationship - his own yearning for his father's attention, love, guidance, as well as the gap that existed between them. With the statement, "that's what my normal life was like", Larry once again reveals that a brief moment within his TE served to capture how he believed his life really was, in this case around thirty years ago.  The third excerpt is distinct from the first two, in that now Larry has seen himself step into the scenes of the enactment. We can recall that at first, other members took on the role of playing younger versions of the client, but then the client is encouraged to "step into" the role of “younger self” at another point in time. Here Larry has been given the opportunity to walk in the shoes of his childhood self: Interviewer: Look at how happy you are - the peace - look at how different you look… Larry: I had the VIVID image of that - again, I was three or four - and I remember, it was mom saying ' just go down there and pick a flower and show it to us' - so I walked down and picked the flower and starting coming up to her, and Mom's going: 'no no no, stay there stay there'... Interviewer: because it was so beautiful... Larry: And I remember (my Uncle) going, "Oh (his mother's name), let him be...' Interviewer: Just let him be natural? Yeah, he really got you, he really saw you. And look at you - you look so much younger, you look almost four years old in the garden. Larry: YES (emphatically) Interviewer: you did go there, you went back there? ? ∣ ?Larry: (nods affirmative)   We can note here: Larry's use of the word "vivid" to describe how the memory returned to him, of being three or four years old. He could hear his memory of his own mother and Uncle's dialogue. The interviewer asked him, "you did go there, you went back there?" and he agreed, he felt he did "go back there".  Group members' effective portrayals. The following three excerpts serve to illustrate how the enactment's congruence with Larry's memories, the "realness" was derived from other members of the therapy group effective, accurate portrayals of the key figures they were asked to represent; including Larry himself. First, upon viewing the introduction of a former commanding officer from Larry's time serving in the military in Vietnam, Larry acknowledges that a facial expression matched a memory he had of this important role model, a person he trusted during a stressful, dangerous period of his life, and that in the enactment process, he could access how he felt towards that man again: Larry: I was feeling all the admiration that I had for him (his former commanding officer) in that moment...its interesting, the look on (the acting group member's) face, IS...similar.  Next, during a discussion of the facilitators moving the other group members into "sculpted" positions in order to symbolize a memory, Larry remarks: Larry: I said 'yeah thats right, thats fitting more'...his (the member portraying his brother) head, its perfect....I made up my mind early...that he would play my brother.  In this remark, Larry again acknowledges the symbolic capacity of TE: "(his) head, its perfect" - is in reference to the positioning the other group member was guided into by the facilitators, to portray a scene for Larry to witness. He reveals that it is working for ? ∣ ?him; it felt congruent. This excerpt also reveals the opportunity provided to TE participants, to pre-select members that remind them of key figures from their past. In another passage, Larry more expressively reveals the power of the similarity between another group member and his own brother: Larry: Whaaghh! (exclaiming, loudly, tilting head back and then laughs, with an incredulous tone) Interviewer: What was that like? (laughing too) he just went in there and... (makes pressing motion on her shoulders - indicating that during the playback they are viewing the member portraying Larry's brother squeezing Larry's shoulders) Larry: Apart from a being a very masculine (mimics her motion), just to feel those (wrings his shoulders like he's having them gripped, then makes tight gripping hands gesture) - he got a grip - and it was great. Interviewer: And you liked it? Larry: Yeah Interviewer: so the feeling there is good? Larry: that to me WAS my brother's hands  The power of the physical contact that Larry expresses here constitutes a theme in itself, to be discussed next. In the present context, Larry's exuberance gives us a glimpse into the effect of the opportunity to feel close and connected, to an important figure in one's life: "that to me WAS my brother's hands". Again Larry communicates the congruence with his memories, and that it feels "great" for him.  Finally, Larry makes an observation of the group member portraying himself. He acknowledges the similarities between a younger group member and his young self, and ? ∣ ?observes that he was able to form a unique connection with that member as a result.  Larry: I was having a lot of eye contact with (the group member portraying my younger self) - and again, that's very unusual (for me) for that long. I think I do have good eye contact with people in usual conversation, but that - that was intense...(Exclaims) there's so much of me in him!  Bringing his father into the room. Perhaps more significant to Larry than even seeing his own self captured effectively, was the congruence of the representation, and symbolization of his father throughout the course of the enactment. Building on the excerpts above, the following sequences of dialogue form to portray a compelling example of what we might call the suspension of disbelief, in which Larry experiences the presence of his father so fully and truthfully, that he is taken back into the memories of his life. As detailed above, Larry remarks: Interviewer: Do you remember what you said there?  Larry: Yeah, (facilitator #1) was asking me what I saw in THAT setting - and its me, constantly looking at my father, looking for answers, looking for conversation, looking for love...and he (pointing at screen) played my father SO well.  Interviewer: what was it about (that group member) that reminded you of your father? I'm just wondering about him as your selection to represent... Larry: The serenity. Serenity, and probably compassion.  And then, shortly after: Larry: It was about there, that I saw, in (the group member portraying his father)'s eyes, my father. That's where the change happened. Interviewer: the change - can you explain that? ? ∣ ?Larry: Going from re-enactment, to BEING IN IT. Just (his) eyes.  Larry reveals to us that a change took place within the TE process - that he became "in it" and he was at that moment present with his own, now deceased father. And the following excerpts demonstrate multiple moments in which Larry was aware that during the TE, he felt his father present in the room with him: Interviewer: What's it like to realize that, at this moment, your father's actually, in reality, there with you?  Larry: my hand’s up (pointing at screen - indicating that the gesture he sees himself making on screen indicates something meaningful about his relationship with his father) Interviewer: Did you know then, or are you knowing it now? Larry: No, I knew then...  And then, he reveals the emotional impact of this experience: his father's presence seems to facilitate Larry's connection to his grief; to the sadness of losing his father, to the awareness of all he missed out on: Interviewer: ...What was happening for you in that moment? Larry: I was feeling Dad. He was present. He was here. (touches his chest). Interviewer: How did it feel to have Dad back (touching chest too) Larry: Great. Great. Even now I know, I often think, I wish he was here, cause I want to talk to him about that. He has missed A LOT of things. When something new comes out, and how he would have reacted. (For example) He would have been blown away by the technology as far as cameras are concerned... Interviewer: He missed out on a lot that you could have shared with him and had good conversations with him about... ? ∢ ?Larry: (nodding) He didn't see the man on the moon. Interviewer: ...look at your face, what do you see there, in that your face there. Larry: Just the feeling of having him back, but also having the resignation that...he's not...takes me to the place that 'he died'. Interviewer: So is that loss? (pointing at screen) Larry: Its a sadness.  Finally, this opportunity for "contact" culminates with actual physical contact: the group member portraying his father is guided to place his hand on Larry chest. Here Larry observes this scene: Interviewer: So remember you were able to connect to this man's eyes as your Dad... Larry: and now I felt Dad's hand on my chest – Interviewer: Do you feel Dad's hand on your chest here? Larry: you betcha - I can still see his hand (holds his own hand up to look at it, as if it's his father's hand) Interviewer: You can still see your father's hand, yeah - so when he touched your chest, your heart –  Larry: ...probably the only time I REALLY felt my father's hand was on my backside Interviewer: and now its on your heart - and did it FEEL Like your Dad was touching your heart? Larry: Yes, yeah. Interviewer: And so what did that mean to you? Larry: I think it reinforced the fact that he was back with me at that time - and again, I ? ∣ ?wished he'd done that when he was alive.  The first observation I wish to make about this poignant passage, is that Larry refers to the other member as "Dad", rather than by his own name. It appears that the congruence, the vivid recreation endures into the follow up interview. The physical contact "reinforced" the sensation of his father being "back with him". Second, herein we get a glimpse of what TE is purported to provide: a "corrective emotional experience", that clients may have never or rarely received in their own life: "I wished he'd done that when he was alive".   Larry's theme two: the experience of contact. The second theme that I constructed from Larry's interview, was the powerful impact on him of experiencing contact with the other group members. This sense of contact was experienced by Larry as both eye contact, and actual physical touch, and each of these forms of contact manifested in both positive and negative experiences for Larry.  Positive power of eye contact with other members.  Larry: I was having a lot of eye contact with (the group member portraying my younger self) - and again, that's very unusual (for me) for that long. I think I do have good eye contact with people in usual conversation, but that - that was intense... Interviewer: Yeah, you can SEE yourself in him...And so the interaction with your eyes - look at him. REALLY looking at each other. You said it felt great to be back at seventeen, to see yourself as that seventeen year old? Larry: well up to seventeen, life was great, everything was going well...  As illustrated above, the eye contact with another group member constitutes a unique experience for Larry; in saying "that's unusual (for me) for that long", he seems to ? ∣ ?suggest that he wishes he could get that more, but perhaps doesn't feel safe or comfortable with eye contact of that intensity level. With the knowledge that Larry was really accessing his younger self through the enactment process, here we might infer that it was a positive experience to be afforded the chance to look his seventeen year old self in the eyes. This is echoed once again in his observations of himself interacting with his father: Larry: Again, (I'm noticing) the length of time that I looked, even at (the member playing my father)'s eyes... Interviewer: Yeah, look at you, look at your face there, you're just drawn into him Larry: (nods)   Positive power of physical touch with other members. Building on this experience of eye contact, Larry's enactment progressed to opportunities to experience physical contact with his father: Interviewer: So remember you were able to connect to this man's eyes as your Dad... Larry: and now I felt Dad's hand on my chest – Interviewer: Do you feel Dad's hand on your chest here? Larry: you betcha - I can still see his hand (holds his own hand up to look at it, as if it's his father's hand) Interviewer: You can still see your father's hand, yeah - so when he touched your chest, your heart –  Larry: ...probably the only time I REALLY felt my father's hand was on my backside Interviewer: and now its on your heart - and did it FEEL Like your Dad was touching your heart? ? ∣ ?Larry: Yes, yeah. Interviewer: And so what did that mean to you? Larry: I think it reinforced the fact that he was back with me at that time - and again, I wished he'd done that when I was alive...  And once more, later in the dialogue: Interviewer: So now we have (the member playing your father) back with you, putting his hand on your chest... Larry: (nods) I feel like he's got something special in his hands (chuckles) Interviewer: what was that like - the touch there? Larry: Amazing. He has such powerful hands.  And finally, Larry emphatically acknowledges the positive experience of feeling physical contact with the group member portraying his brother. Larry: Whaaghh! (exclaiming, loudly, tilting head back and then laughs, with an incredulous tone) Interviewer: What was that like? (laughing too) he just went in there and... (makes pressing motion on her shoulders - indicating that during the playback they are viewing the member portraying Larry's brother squeezing Larry's shoulders) Larry: Apart from a being a very masculine (mimics her motion), just to feel those (wrings his shoulders like he's having them gripped, then makes tight gripping hands gesture) - he got a grip - and it was great. Interviewer: And you liked it? Larry: Yeah Interviewer: so the feeling there is good? ? ∣ ?Larry: that to me WAS my brother's hands   Negative power of eye contact with other members. At this point in the analysis, it is important to acknowledge that a shift in the tone will occur. Larry reported discomfort and dissatisfaction with many components of his enactment. The following two illustrations of this theme - the power of contact, as well as the entire third theme, address Larry's negative experiences of TE, which primarily focus on one particular scene. The facilitators have asked the female group members (both assistant facilitators in training) to leave the room, in order to create a "circle of men" to confront Larry with his strengths as man, on the presumption that he doubts his own manhood. The men encircle him, place their hands on his shoulders, and are asked to report to him what they consider "manly" in him. Here, he reports his discomfort with one particular group member - one he doesn't trust - as he has been guided into Larry's personal space.  Larry: (softly) Can I say something about one of the other guys (group members)? About how he makes me feel? Interviewer: Yeah. Larry: (this specific group member) intimidates me. (referring to a group member who is - on the video playback- being directed by the facilitators to put his hand on Larry's shoulder, and look him in the eye) I think just cause of his looks - his constant so DARK look on his face. Interviewer: Its a scary look Larry: Yeah, I can't believe the things he says - I think he's got some...(shakes head) I don't want to be judgmental, and I don't think I'm being judgmental - I think he has some very deep issues that have not come out here.  ? ∣ ?Interviewer: No, he hasn't even touched on them... Larry: He's got so much rage...and he imposes that on others...he's the antichrist.  Interviewer: Yeah, he's the male that you just don't wanna EVER be, right? that male anger... Larry: (nods affirmative) Interviewer: ...he has treated you differently (than the other group members), hasn't he? Larry: yeah, very little eye contact - but he has made it with (the other group members).  Negative power of physical touch with other members. The above passage may be seen as a shift for Larry within the IPR process itself. It is worth noting that before saying anything disparaging about another group member, he first asks permission. His voice softens to almost a whisper, as if he may be overheard, and asks: "can I say something about one of the other guys?". The interviewer's handling of this question and the subsequent revelation, seem to put Larry at ease about continuing. Here, in two consecutive passages, he reports his discomfort with the physical contact during this final scene of his enactment: Larry: This…is VERY uncomfortable Interviewer: All their hands on you is very uncomfortable Larry: (nods)  Interviewer: why is that? Larry: They're all males - and I'm in the middle Interviewer: So it would have been better if the females had come back into the room (smiling) (in reference to facilitator #1 asking the two female group members to step out of the room for the segment currently being reviewed) ? ∣ ?Larry: I'd like to have that there - the softer touch, within that (referring to all the male touch). Interviewer: So you're feeling really crowded maybe, and uncomfortable? Larry: Yeah, I'm surrounded - its a real uncomfortable feeling  Then moments later: Larry: I'm glad I can't see me there (on the video playback, Larry's face is obscured by the bodies of all the other men encircling him) Interviewer: You're glad that you can't see yourself, it was that uncomfortable... Larry: Yeah. Interviewer: You don't wanna be reminded of this? Larry: Not really. Interviewer: this is the part you were regretting - and so what IS it about this that's really uncomfortable? what's happening for you? Larry: So many males - concentrating on me. (makes shivering motion, like it makes his skin crawl) Interviewer: Because you don't trust that maleness thing Larry: (shakes his head, no.)  Larry then reports his experience of being placed in this position, of having the conflicting feelings of discomfort with the encircling, and contact imposed on him by the full group of males, but also the positive experience of contact with two group members he did trust, those portraying his father and his younger self. Interviewer: So (the member portraying your father) is talking to you here...  Larry: Yeah, basically his was the only hand I could feel. ? ∣ ?Interviewer: Oh isn't that interesting. So the father's hand you could feel –  Larry: His hand on my leg - and I put my hand on his hand. And (the group member portraying my younger self) was the other one that I could feel  Interviewer: Because those are the ones YOU PICKED. That you trusted. Larry: Yeah.  Herein lies the dialectic of Larry's experience of contact within his therapeutic enactment. He describes both the eye contact and physical touch he experienced - always with other males in the group, as extremely powerful for him, apparently as a result of his own acknowledged difficulties with interacting with other males - in groups in particular. This power created extremely positive experiences for him - in the cases of one-to-one connection with those members in whom he entrusted important roles. However, powerfully negative experiences were generated in the case of one-to-one contact with a member in who he didn't feel safety or trust, as well as in the context of contact with the entire group of males all at once. Larry's reported experience of this particular scene, encircled by the other men, will be revisited within the context of the next theme, as it is this writer's belief that the circle was created in an attempt by the facilitators to create a circle of strength, support and validation for him. However, as Larry reveals to us, a dominant theme of this particular enactment experience was that he didn't feel the facilitator's interpretations of his story, or directions within the enactment, resonated with him.  Larry's theme three: lack of resonance with facilitator's decisions. Larry indicates a dissatisfaction with the decisions of the group leaders in three distinct ways. First, he articulates feeling too directed by the facilitators. Second, he suggests that they ? ∣ ?misunderstand, and perhaps also, inaccurately prioritize his relationships with his father, mother, and brother. Third, in discussion specifically regarding the final scene of his enactment, he suggests they may have inadvertently activated feelings of embarrassment and shame in him. Within the context of this theme, many of the excerpts from the interview reveal Larry at his most eloquent, and his most passionate. It is noteworthy to point out that this theme reveals important features of the IPR process: first, that the context felt safe and comfortable enough for him to discuss what may be considered critiques or misgivings about the process; and second, that the interviewer conducting the IPR maintained an open, non-judgemental presence, to allow Larry to freely express himself. Indeed, within many of the passages that follow, Larry talks with a sense of exuberance, that this writer interpreted as thrill of feeling able to speak up, to have his voice of discontent be heard.    Over-directive leadership. This aspect of the theme is conveyed in two ways. The first is in regards to the sentence stems used by the facilitators to prompt clients into addressing their feelings during TE. Larry's feeling on this point come through clearly at several times throughout the dialogue. In a sense, his exasperation can be perceived as rising, or else he is becoming increasingly comfortable expressing himself, and correspondingly less "diplomatic". Early in the interview the discussion is as follows: Interviewer: You said you felt it mostly in your head, and then (facilitator #1) said, I think he hit your chest, and he said 'what about in here' or something - and you said yes, was it that true for you? Or was it more just 'in your head'? Larry: It was just in my head.  Interviewer: Yeah, it didn't seem true for you (at the time) ? ∣ ?Larry: That's something that has bothered me through all of… these 10 days (the course of the VTP) - is, I sometimes feel (facilitator #1) and (facilitator #2) sometimes put words in your mouth. And, I think you'll find that I do hesitate after some of the things that he wanted me to say - especially when I'm talking to Mom and Dad. Interviewer: So... in this instance, did you have to take a moment to check to see if the words were right, or did you just say them? Larry: No, I was checking... … Larry: and this is where I started to have a conflict with myself, in defending Dad...This is where they were starting to try and put words in my mouth about what wasn't good... Interviewer: yes, about Dad… Larry: Yeah, and this is where I really started to think about what to say after they told me what to say. And I did change. I changed language, changed sentences... Interviewer: Because cause it didn't fit Larry: No it didn't...  Then later he suggests: Larry: It becomes - it doesn't become your own - it becomes (facilitator #1)'s idea of what the situation is, of what you might be thinking. And one of my biggest (peeves) is somebody telling me what I'm thinking, or assuming I'm thinking something.  He has moved from "something that bothered me", to "one of my biggest peeves", and then finally, near to the end of the interview, Larry became more candid: Larry: Let me talk! (facilitator #1) shut up! (yelling at screen, then gently chuckling)  And finally, Larry is able to articulate what it is that bothers him so much about this ? ∣ ?"putting words in his mouth": it activates a schema from his own family dynamics:  Larry: It takes me now to thinking about the rest of my family, and that's how they - they try to put words in my mouth, they try to tell me how I was thinking or feeling... Interviewer: this is the 2nd time you've mentioned this about people putting words in your mouth - you have a real trigger around that? Larry: Absolutely.  The second way in which Larry expresses feeling over-directed by the facilitators was in regards to their interpretation of his feelings on masculinity: Interviewer: There's a lot of bravado happening at this point, where (facilitator #1)'s getting assertive, and being loud, and (facilitator #2) goes in and sort of puts his hand (makes fast, aggressive motion) - it's like their definition of masculinity is assertiveness and strength, you you think they were trying to embrace that in you, or...its not your natural way to be in the world? Larry: Yeah, it ISN'T my natural way to be in the world, but they were trying to bring that in... Interviewer: So this isn't quite going right (pointing at screen) - parts of it's right, parts of it true - but part's of it doesn't fit - them (the group) trying to form you into this 'manly man'... Larry: Yeah, I felt like Gumby (both laughing aloud together).  And below, Larry elaborates, indicating that at one point he "almost laughed off" a suggestion by one of the facilitators. It is important to acknowledge at this point, that in the video playback, Larry has just revealed to the facilitators for the first time something that his mother once told him, to the effect of "your father once said he thought you'd ? ∢ ?have been better off if you'd been born a girl". The facilitators react with anger and dismay towards Larry's parents, and perceive him to be telling them this because it was a source of distress to him. This marked a turning point in the TE, after which the facilitators focused primarily on working to instil a sense of "proud manliness" in Larry. Interviewer: Did you? (referring to the video playback in which facilitator #2 guides Larry to say: 'Mom, the day you told me that Dad had said I should have probably been born a girl, I felt castrated') Larry: No, I actually almost laughed it off –  Interviewer: You didn't feel that Larry: No. Interviewer: What DID you feel the day she told you that, do you remember? Larry: It was almost as if I believed that Dad had said that - I could almost understand possibly why. Um, I do believe I have, um...more of the female chromosome than the male. I've always related to females better, and all of that. Interviewer: And that feels FINE with you –  Larry: Well it does I guess, because its my nature...but then, to have that disconnect from males, though - to always have that in the back of your mind, back of MY mind. 'Why don't I fit in'? Interviewer: Yeah...that was maybe part of the bullying (you experienced as a child) do you think? Larry: probably - because I lost trust in males, at 5 years of age - and not just because of my brother, but because of kids at school... Interviewer: And it wasn't your PARENTS fault - you didn't ever believe it was. ? ∣ ?Larry: No...  In this final excerpt to illustrate this point, we may draw our attention to Larry's laughter. In the interview, he is visibly at ease with the (female) interviewer, and they appear to be bonding over their shared awareness of the group facilitators' "missing the mark" in their overemphasis on masculinity. It is important to acknowledge that, even as he critiques their work, he is smiling and laughing with the interviewer, indicating that this is not a source of distress for him. Indeed, it could even be perceived as empowering him. Interviewer: but the thing: 'I'm did that feel? Larry: Well it didn't - they weren't right. because I haven't... Interviewer: Its not how you see yourself? Larry: No (shaking head for emphasis) Interviewer: Its probably not even that important to you? Larry: No, not anymore... Interviewer: But, they're working it - they're really working it  Larry: they certainly are (chuckling together) Interviewer: They wanted that for you  Misunderstanding his family relationships. Here Larry brings us to the second of his three misgivings with the decisions of the facilitators: their misjudgment of his relationships with his family, in two ways: first was an an overemphasis on his relationship with his mother, at the expense of addressing his relationship with his brother, which was part of the intended enactment script: Larry: Can I make an observation there too? During this part of it - I was surprised at ? ∣ ?how quickly we moved away from (work around) my brother - we totally shut him down (pointing at the participant playing his brother on screen) Interviewer: ...when (facilitator #1) moved in, yeah. Oh, yeah, we didn't do ANYTHING with him... Larry: No, and part of what we (he and the facilitators) had decided to do (during pre-enactment phase) WAS to confront him... Interviewer: We were gonna work on (your brother) and all of a sudden we're working on Mom... Larry: Yeah Interviewer:...and just went sideways.You never completed that piece (pointing at screen) Larry: ...a quantum leap Interviewer: And I don't think we came back to him...? Larry: No, we didn't Interviewer: ...were you aware of it at the time? Larry: I was aware of it afterwards. I said to (another member) "we never came back". I didn't know my mother was coming into it at all.  Second, Larry indicates that the facilitators misread his feelings towards his father, and to his parents together as a unit. Whereas the facilitators interpret Larry as having unexpressed, unprocessed anger towards his parents, he says emphatically that he did not, that in fact what he felt was a sense of loss:  Interviewer: - I think they were trying to get you to have some insight around the loss - that he died when you were so young, too soon, and you didn't get everything you ? ∣ ?need...but you didn't feel that way... Larry: No...and everybody has asked me 'you must have had a lot of anger' and I DIDN'T (bangs on table) - it was loss. It was NOT anger, it was loss. Which made me LOST - I didn't know who to turn to next.  Where the facilitators suggest he needed to assertively, perhaps even aggressively, confront his parents as a corrective experience, Larry suggests that what he wanted most was to ask them to understand him, rather than blame them for anything in his life: Interviewer: That didn't fit, did it? So (facilitator #1) said 'Dad I'm pissed off' and you made a (gulping sound)...  Larry: Yeah I wouldn't say that –  Interviewer: ...cause it didn't fit. Dad didn't piss you off... Larry: (chuckles) Interviewer: you changed what you said. Larry: I changed the words... ... Larry: (points at screen) my facial expression was "I want you to stop this". Interviewer: Yeah, 'I don't wanna be doing this - I don't want to be confronting my father'... Larry: Yes. That (pointing at screen) was probably one of the most difficult times... Interviewer: So what was it about it that wasn't right? Larry: Just that I would never confront my father like that. Interviewer: So they're making you do something that didn't feel like it could be YOU, or even possible to do. ? ∣ ?Larry: probably more so because - I didn't NEED to confront my father - it was not 'I'm afraid to confront you' I just wouldn't want to hurt his feelings...  ... Larry: yeah this was difficult. (facilitator #1)'s getting aggressive and that would never have come into my psyche at all. Interviewer: its not who you are in the world, to think - to be that way...that’s not how you approach someone... Larry: No... I'm so sympathetic towards other people's feelings, and I'm so in tune with other people's feelings, that that has controlled a lot of the way I've spoken to people my whole life... Interviewer: So that didn't ring true there, although the message was good, but its how it was delivered? Larry: It's good, but I was sort of cringing, saying - I couldn't be that aggressive with my parents... … Interviewer: so what (facilitator #1) is saying here is there's a disconnect between the blaming of the parents and it was their fault - there's something not quite RIGHT in it (for you)... Larry: yeah, its difficult to think that they were at fault.  … Interviewer: That doesn't quite fit, does it? Larry: No. 'Its not what you took from me, its what you prevented'...  Interviewer: So - yeah. so what you're doing here is having a 'corrective moment'. ? ∣ ?(facilitator #1) is feeding you these lines about what your parents took from you – Larry: Yeah Interviewer: - you're SAYING them, but I can see a disconnect - it wouldn't have been that way? Larry: Yeah. Interviewer: - you didn't really blame them for taking those things (away from you) Larry: No. Interviewer: - but what you did want was for them to see you? Larry: I wanted them to see and understand who I was - and I knew I was different. Interviewer: Yeah, that part really rang true –  Larry: Yeah.  Masculinity, initiation, humiliation, "mental suffocation". As discussed previously, during a scene in which Larry is in dialogue with his parents, Larry revealed to the group - and the facilitators - that his mother once remarked that his father felt he should have been "born a girl". The facilitators respond by suggesting that his "manhood was taken from him" in that moment, that because he was in touch with his feminine self, he'd been "betrayed" by his parents, even "kicked in the nuts", and "castrated". The facilitators then create a scene that appears designed to affirm Larry's masculinity. The female members are asked to leave the room, and Larry is then encircled by the other men. Below is Larry's commentary as he watches this scene unfold: Larry:...if there's anything that’s gonna take me a long time to process, its the (scene in which he was directed to join) the men's group. That "now I'm 'a MAN". That will take a lot of processing... ? ∣ ?Interviewer: So you've never felt that you were part of a men's society, a mens' group? Larry: No, I never went to the pubs...I've been rejected by men's groups.  Interviewer: Was it because of the message your mother gave you? (referring to earlier in the enactment) Larry: I don't know - possibly...I didn't like drinking. I had my mother’s alcohol intolerance. Interviewer: So that's a real male thing - thing that men do, right? Larry: Yeah.  I mean, I drank a bit in Vietnam, but there was nothing else to do... Interviewer: So your description of your young self, the things you said you were: adventurous, rebellious, all that stuff, didn't necessarily MEAN that you were the kind of man THEY were thinking of (pointing to screen, referring to the facilitators and other group members)  Larry: No. Interviewer: and they kinda missed that part... Larry: Still gentle. Interviewer: There was that gentle person who was adventurous, curious, musical, rebellious,  Larry: Yeah, yup. Interviewer: But not in an aggressive male way - they (the facilitators) never asked you that –  Larry: Nope...   Next in the scene, the other group members, still encircling him, are encouraged to place their hands on Larry's shoulders. The facilitators remind him that he was a ? ∣ ?helicopter gunner in the Vietnam war, and invite each of the other males to share with Larry something they respect about him, as a man.  Larry: This- is very uncomfortable Interviewer: All their hands on you is very uncomfortable - (he nods) - why is that? Larry: They're all males - and I'm in the middle Interviewer: So it would have been better if the females had come back into the room? Larry: I'd like to have that there - the softer touch, within (all the male touch) Interviewer: So you're feeling really crowded maybe, and uncomfortable? Larry: Yeah, I'm surrounded - its a real uncomfortable feeling.  As the scene progresses on the video playback, the facilitators ask Larry if he can "take in" the support and the strength of the other men. Facilitator #2 asks if he can see his seventeen year old self again, "with balls". He tells Larry how angry he is on his behalf, and instructs the group of men to repeat, in unison, "you are a MAN". Larry: I'm glad I can't see me there (on the video playback, Larry's face is obscured by the bodies of all the other men encircling him) Interviewer: You're glad that you can't see yourself, it was that uncomfortable... Larry: Yeah. Interviewer: You don't wanna be reminded of this? Larry: Not really. Interviewer: this is the part you were regretting - and so what IS it about this that's really uncomfortable? what's happening for you? Larry: So many males - concentrating on me. (makes shivering motion, like it makes his skin crawl) ? ∣ ?Interviewer: Because you don't trust that maleness thing Larry: (shakes his head, no.)   In the video playback, the facilitators create a new circle. The men link arms, and create a space for Larry to enter. Facilitator #2 invites Larry to "join the company of men". It is created to appear ceremonial, inclusive, welcoming. Larry's commentary below reveals that it had a very different impact on him: Larry: And this part, actually borders on humiliation.  Interviewer: Oh? Larry: And the word 'initiation'.  Interviewer: Aaahh, so the male initiation –  Larry: Yeah, its something - that I was fearful of what I had to do, what I had to say... Interviewer: Yeah, yeah (nodding) well it was scary, a little scary right here – Larry: Yeah Interviewer: - because of the fear of this male initiation - 'what's he gonna do?' ... Larry: I suffered from some humiliation - from that (gestures at the screen) um...I found it difficult to have eye contact with...some of them - when they were saying things to me, about being 'a man'... Interviewer: did you feel like they were giving you instructions, or - what was it like to hear? what kind of things were they saying to you? Larry: ALMOST condescending...and almost scripted... That goes back to (facilitator #1) and (facilitator #2) putting words in their mouths. Is it really what they feel, what they want to say? Do they really see me like that? ? ∣ ? Larry and the interviewer stop the video playback and begin to explore the possible origins of this reaction arising in him. The interviewer inquires if he can recall a bullying experience, or a military experience, that may have given him a fear of male groups. Larry reveals that the sensation he had was less a physical experience and more what he refers to "a mental suffocation", as a result of feeling like he's being over directed, and is unable to speak up and correct how his own enactment is unfolding before him. Larry: I'm trying to come up with where the claustrophobia came from - words I'm coming up with when I'm looking at this is 'I'm suffocating, you're too close, you're suffocating me' Interviewer: Did boys ever encircle you in school? Pin you up against a wall…? Larry: There was the pushing and shoving (makes two arm "shoving" motion), back and forth from one to the other... Interviewer: Did it look anything like that? (pointing at screen) Larry: No (furrows brow, appears frustrated, struggling for words) Interviewer: You're close - but you can't quite retrieve it? Larry: Yeah, I can't get that... Interviewer: So do you think it was a war experience? Larry: No, I don't think it was a physical thing, I think it was a mental suffocation... Interviewer: yeah, perfect (points at screen) because you were being suffocated physically, but also mentally because 'this is NOT true to me...yet again, YOU don't see me. I'm not being seen, in my OWN enactment'? Larry: Yes! (eyes widening). Yeah, yeah (nodding) Interviewer: They're doing what THEY think is corrective, in terms of getting you in ? ∣ ?touch with this 'male' culture - this maleness, but that's not what you needed... Larry: No.   Larry's theme four: the enhancement of insight. Larry's critiques of the experience constitute one dominant theme within the data of his IPR interview. In contrast to this, or perhaps, in conjunction with this, I present as the fourth theme, Larry's opportunity to gain and enhance his self-awareness. Larry indicates throughout the process, gaining insights into his past, the origins of some of his own schemas; insights into himself now, his values, needs, emotions, behaviours; and into key relationships. At the conclusion of his interview, Larry is asked: Interviewer: If you could just think overall, is there anything you could take away from this experience? Any new knowledge, or anything? Larry: Heaps. I believe the whole process has worked well, in that its given me a lot more knowledge about myself - the fact that I was able to get that out…(referring to the comment that his mother reported his father saying "he should have been a girl")  This theme of enhanced insights, will be broken down into three distinct sub-themes; these are the domains in which Larry reported the most significant changes in his self-awareness: First, his own definition of masculinity, and what he is proud of in himself, as a man. Second, the importance he places on feeling understood by others. Third, his relationships with his parents. Before unpacking each of these sub-themes in more detail, it is worth observing that each of these can be seen a parallel to the three aspects of Larry's critiques of the process: Larry reported feeling misunderstood, or misheard, by the facilitators, and herein reports learning more about his need to be understood. Larry reported the facilitators as misinterpreting his relationships with his ? ∢ ?parents, and herein reports gaining insight into those relationships from the TE process. Larry reported negative experiences of imposed masculinity within the group context, and herein reports gaining new awareness around his own definition of manhood. These parallels will be addressed in further detail in the discussion chapter of this study.  Importance of feeling understood. Early in his enactment, Larry introduced a former commanding officer from his time serving in the Vietnam war. In the pre-enactment phase, Larry had identified this person as an important figure in is life, that he wanted to have alongside him for support. Here he identifies what it was that was important for him about that: Interviewer: So what was it like to know that your leader was there? You said that you had anxiety coming into this and now you have your leader here... Larry: that was a lot of reassurance. Interviewer: so that was a support person for you - that you brought in like a resource... Larry:...he was a father figure. And he woulda been about Dad's age ... Larry: When (facilitator #2) asked me about what was important about him being here - and I said 'understanding' - and again, I can fit that into a whole lot of stops along the way (gesturing with his hand along a time line - indicating his life narrative), where if a person understood me, I was much better in, just, social relationships and things like that. Interviewer: did it make you feel safer when you were understood like that - in a war situation? Larry: I felt…real. ? ∣ ? In contrast to feeling "real" as a result of feeling understood by an authority figure, a role model, here Larry explains how it felt for him to not be understood - it brings him to an awareness of his family dynamics, his role in the family, and how he had previously understood his feeling like an outsider, misunderstood: Interviewer: So what is it like to have someone (the facilitators) coaching you to be (a way you don't want to be?) Larry: Its sort of ok, but it's NOT how I would do it. ... Interviewer: Isn't that interesting that what they (the facilitators) were trying to get you to see - didn't fit... Larry: It takes me now to thinking about the rest of my family, and that's how they - they try to put words in my mouth, they try to tell me how I was thinking or feeling... Interviewer: this is the second time you've mentioned this about people putting words in your mouth - you have a real trigger around that... Larry: Absolutely. … Larry: my family referred to me as the Black Sheep of the family - I was the middle child - I was led to believe there was something significant to being the middle child...I put it down to growing up in the sixties, a societal shift, I was embraced by that...  Relationship with his parents. The following series of exceprts illustrate Larry's growth of insight into the nature of his relationships with his parents, and the emotional consequences thereof. He explains what he did and didn't learn from them, what he is grateful for, and what he wishes they'd taught him. ? ∣ ?Larry: in reflection, from this (experience), I've realized that (my parents) didn't stop me from doing things - they allowed me to make mistakes... but never pulled me up - didn't give me that sense of responsibility, for what I was doing. That I was responsible for my own actions - and I wish they'd taught me that. I probably wouldn't have done some of these things (he's done in his life) Interviewer: but you know, he didn't have enough time with you - even though it was seventeen years? Larry: No… … Interviewer: So he taught you a lot of things. What was it like to remember all those qualities of your father? Larry:...Its was actually good - because I've only, in recent years, started to realize how much he taught me.   Larry also has the opportunity to clarify for the interviewer, and also for himself, that he does not carry any anger towards his parents, or blame them for anything that has happened in his life, in particular towards his father, despite what others have suggested to him. Instead, Larry here articulates that his feelings towards his father is one of loss - perhaps we can infer grief, at the tragedy of losing his father while only seventeen; and the subsequent feeling of being lost in the world, not knowing who to turn to for guidance: Larry: Yeah, that's significant. I KNEW that he loved me, but he never said it – Interviewer: - I think they were trying to get you to have some insight around the loss - that he died when you were so young, too soon, and you didn't get everything you ? ∣ ?need...but you didn't feel that way... Larry: No...and everybody has asked me 'you must have had a lot of anger' and I DIDN'T (bangs on table) - it was loss. It was NOT anger, it was loss. Which made me LOST - I didn't know who to turn to next. … Interviewer: so what (Facilitator #1) is saying here - there's a disconnect between the blaming of the parents and it was their fault - there's something not quite RIGHT in it (for you)... Larry: yeah, its difficult to think that they were at fault.  Interviewer: Yeah. Larry: And to articulate it - well - that would be very difficult for me to do...   Finally, in the following poignant excerpt, Larry illustrates a series of events that began with the sense of abandonment he felt at death of his father, which culminated in his inability to trust in any significant relationship, because if he dared get too close to someone, he could lose them to death too. Larry: It started when I joined the air force, which is less than 12 months after Dad died, it seemed that every friend that I made was either posted out somewhere, just when the trust and the relationship was developing - or they were killed...I had lost a couple of friends in car accidents by this time - by just several accidents, were rather horrific, so death had become almost a normality in my life…So I got to the point where I said 'I can't make friends. I can't put myself into a good close friendship, for the fear that if I do, they'll get killed... Interviewer: So you started to believe that, that was a belief you laid down? ? ∣ ?Larry: Yeah. Interviewer: After your father died, that if you get close…? Larry: It'll be taken away from me. Interviewer: So what you lost in men? Larry: Actually it was trust in anybody…Abandonment. Yeah. at that point, is when I started looking for another father - and looking for that kind of relationship - but the lack of trust, um, followed me through. When I joined the air force, I found that if I made friends with somebody...(holds hand to head) I'm just thinking about what (another group member, who lost friends in combat) said yesterday about being jinxed...  His own definition of masculinity. As detailed previously, much of Larry's enactment focused around his sense of masculinity. The facilitators appeared to work from a hypothesis that he had been denied the opportunity to "be a man" in what me might refer to as the gender norms of his culture. Larry was resistant to this, and instead felt pressure to conform, felt he was being forced, 'initiated', in some sense. Larry:...if there's anything thats gonna take me a long time to process, its the joining the men's group (scene). Interviewer: Yeah Larry: That now I'm 'a MAN". That will take a lot of processing... Interviewer: So you've never felt that you were part of a men's society, a mens' group? Larry: No, I never went to the pubs. I never got drunk. I've been rejected by men's groups.   However, within this context, this emphasis on "manly" masculinity, Larry is afforded the opportunity to articulate clearly HIS OWN values around being a man. He ? ∣ ?can acknowledge what qualities he sees in himself that are important to him, and those that aren't. He articulates what is and isn't his own "natural way", in his words.  Interviewer: There's a lot of bravado happening at this point…it's like their definition of masculinity is assertiveness and strength, you you think they were trying to embrace that in you, or…? Larry: Yeah, it ISN'T my natural way to be in the world, but they were trying to bring that in... … Interviewer: ...the thing: 'I'm did that feel? Larry: Well it didn't - they weren't right. because I haven't... Interviewer: Its not how you see yourself? Larry: No (shaking head for emphasis) Interviewer: Its probably not even that important to you? Larry: No, not anymore...  Further, he appears to have appreciated the opportunity to connect to the qualities in him that he was proud of at age seventeen, prior to his father's death and his entrance into the military. In explaining which qualities he could recall wanting "just a little recognition" for, he illustrates which qualities he is most proud of in himself, as a man: gentleness, adventurousness, curiosity, athleticism, his sense of humour, rebelliousness are some examples: Interviewer: So your description of your young self, the things you said you were: adventurous, rebellious, all that stuff, didn't necessarily MEAN that you were the kind of man THEY were thinking of (pointing to screen)  ? ∣ ?Larry: No. Interviewer: and they kinda missed that part... Larry: Still gentle. Interviewer: There was that gentle person who was adventurous, curious, musical, rebellious… Larry: Yeah, yup. … Interviewer: what was that like recalling all those qualities of yourself as a young...seventeen year old? Larry: I found it interesting to articulate  - I don't know if I've ever said - had to describe myself that way before, and...I feel pretty good about it (touches his heart, smiles) Interviewer: (lists them off), athletic, good looking, sense of humour, there was many things in there... Larry: It was probably all the things that I - would have liked the recognition for - just a little recognition.  Participant three: Ken's experience  Introduction to Ken's themes. In the process of analysis, I constructed three themes that illustrate Ken's experience of this therapeutic enactment. Each of these three themes is represented below, with accompanying excerpts from the transcript of his interview. The first theme is the emotional intensity which Ken reported experiencing during his enactment. Ken appeared to be surprised or taken aback by the power of his emotional reactions; perhaps as a function of a degree of skepticism he entered the TE with, or perhaps because he may be someone unaccustomed to being so connected to his ? ∣ ?emotional self, these are speculative suggestions based on my own holistic impression of the footage of his enactment and the subsequent IPR interview. This first theme is presented as three distinct sub-themes: the first is Ken's sense of reality of the scenes as they unfolded - in particular, his encounter with his now deceased grandmother, as portrayed by another group member. The second sub-theme was that the experience was highly evocative of emotional memories for Ken. The third sub-theme was the engagement Ken felt with the facilitators and the group as a whole, which he reported as preventing him from "zoning out" as he might usually when presented with difficult emotional experiences. Theme two of Ken's experience was the physical activation he experienced. This manifested in two very distinct ways: the enjoyable and memorable imprint of re-experiencing the feeling of his Grandma's hands, and the highly charged "urge to fight" he experienced when his anger was activated. The third and final theme of Ken's interview was the highly transformative nature of his experience. This is represented as a set of three sub-themes also: Ken reported gaining cognitive insights, Ken reported reintegrating "lost" parts of his old identity, and Ken reported experiencing a growth in his confidence, optimism and belief in himself for the future.  Before illustrating Ken's themes, I wish to draw the reader's attention to a distinguishing feature of the excerpts provide from Ken's interview, in contrast to the excerpts drawn from both Larry and Dave's interviews. Whereas Larry and Dave's reported experiences were captured within sequences of dialogue with the interviewer, excerpts from Ken are much shorter, drawn from single or few sentences he gave. This distinction was both a function of the nature of the interview itself, as well as a deliberate analysis decision. This will be taken up in further detail in the discussion section, but I ? ∣ ?believe it is worth noting at the commencement of the analysis.  Ken's theme one: emotional intensity Ken: Yeah it was intense…because I was trying to dig myself out of the hole…I mean I was talking about some of the physical and external problems, like the gambling, drinking, loss of marriage…but internally, the depression…um, demotivation, anger – all these things that ever used to be part of what I was, are internally goin' on behind the scenes…all those were brought to the surface on that day”  The excerpt above provides a succinct summary of Ken's emotional experience of therapeutic enactment. Ken acknowledges that while the focus of the dialogue is on what he refers to as the "external problems" of his life, he could connect to his feelings of depression, demotivation, and anger", that they were happening for him underneath, alongside of the behavioural experience. Here, in more detail, are the three sub-themes of the emotional intensity Ken reports.  Felt sense of reality / vividness. One of the more poignant scenes of Ken's enactment occurs very early, in which he introduces the group to his Grandmother, who died when he was very young, who he never had an opportunity to say important things to; that he'd always wanted to say. Although Ken may have had some reservations going into the enactment experience, here is his commentary upon viewing the scene: Ken: You’re caught up in the moment…and then to actually hold her hand again, (makes an expressive sound), nothing else mattered…to be holding her hand while she was passing away, it overshadows everything…because its like I actually was holding her hand…”  Ken describes feeling "caught up in the moment", in a way that suggests he wasn't ? ∣ ?able to deny the felt sense of reality. "Its like I actually was holding her hand" informs us of the vivid recreation of that memory, although in reality he was holding the hand of another man, another member of the TE group. He tells us "nothing else mattered", and that that memory "overshadows everything", it was so powerful for him. Further, he informs us that the experience was not simply physical, although that is a central theme in its own right - here he illustrates that the he was brought back to his memories of her love, nurturing and care, and indeed, of his childhood itself - something was captured for him in this moment, that was still enduring at the time of the follow-up interview: Ken: …feeling the warmth of her hand…her smell…its like whenever I was in her presence, I could feel – not her aura, but her love, her nurturing, her care, I could feel everything about who she was…and my childhood…I remember when I was holding her hand, yeah, it just felt like all those things again, and its still with me…so the feeling is still there…”  Evocative of emotional memories. Beyond generally reporting that emotions were all "brought to the surface" during the enactment, herein are a few specific references he makes, to a range of emotional moments he was able to access. First, Ken's report of experiencing grief, which he reveals surprised him at the intensity of his own emotional response. Ken: I already started to feel the sense of loss…when (facilitator #1) asked me about (my Grandma's funeral), my heart started to sink… I didn’t know that I was gonna say goodbye until I saw the actual thing, the bed…and I was like ‘we’re not seriously gonna bury her’…that’s when I was like ‘oh my God...yeah that fucking threw me off big time, yeah… ? ∣ ? Next, Ken reports his experience of the facilitators' inquiry into his sporting career, which came to an abrupt end due to serious injury. He is able to connect to the joy of his first memory of scoring in a big game, as well as alluding to his grief and shock he tried to "hold back" when the pain of his career being cut short was addressed: Ken: Just hearing that again, brought back the memory of that first try that I did score, (when I was) on my (older) brother’s team. It was a pretty cool moment.”...I think I was trying to hold back emotions there…because all that’s true…(what the facilitator said to him about his sporting career)  Finally, Ken reports poignantly, albeit briefly, what it was like for him to access his memories of parenting his young son, with who he had been only in brief contact with in the few years prior to the enactment experience. Ken: Reminiscing about (my son)…I’m smiling…(my son) the memories of him…The enjoyment of fatherhood… Pure bliss. Pure enjoyment.”  Engagement by the facilitators. Ken gives us a clue into a self-awareness he has: that, when faced with emotionally intense material, a common response for him is to disengage, or retreat: Ken: I was hyperactive, I just wanted to get it all out so I could go back into my cave, you know?  My isolation, to just sit there and be anonymous… usually I’d just zone out and try to think about other shit.   We may note here his use of the word "hyperactive", which in this context we may infer simply means, that he wasn't able to shut down - he was activated by the experience. At other times, Ken reports feeling both like "fighting" and "fleeing": Ken: I felt like fighting. You know how you go into fight/flight mode? I was wanting to fly, ? ∢ ?but then I was like ‘fucking hell’, and usually I need to keep my hands busy…usually I mighta gone for a cigarette or a beer, or (slot machines)…  However, instead of shutting down, or fighting, or flying in this experience, Ken reports doing something different, he reports staying in the experience, and talking, engaging. He alludes both to a trust in the group, as a unique context for him, and qualities in the facilitators, that created the space for him to stay engaged and present. Ken: You know, I trust the group. I trust (the facilitators).  I mean, this is what, day five? …you know, after the previous five days, the fact (is) that we all trust and believe in each other to get through whatever we’re going through. ... Ken: … if I was out (in my daily life) and somebody started askin’ me those questions (the facilitator is asking me)... I’d get angry, and, whoosh, backhand or something like that…but here we are, talking about it. ... Ken: It was honesty…what (the facilitator) was saying, you know, I was agreeing with him, totally agreeing with him...I was thinking, like: ‘I’ve tried so hard to get enjoyment back – I mean, I don’t find enjoyment in anything, anymore. You know, when (the facilitator) was talking about stability, I’ve tried to find it…and he reminded me of that time when I was trying”  Here we may note Ken is reminded by the facilitator of "that time when I was trying". We are brought back to the notion of disengaging and may think of it as akin to "giving up", in contrast to trying. Ken seems to suggest here that something in the perceptivity of the facilitator kept him from giving up, kept him engaged with the process ? ∣ ?and the emotions he was experiencing.  Ken's theme two: physical activation  Feeling grandma's hands. The power of the physicality of Ken's experience is revealed in two distinct examples. First, the imprint of feeling his Grandma's hand again, which Ken reports is the most memorable feature of his enactment, two days later: Ken: The biggest thing I remember, probably the only thing I remember, was Bubu’s hand…when she was lying in that bed and I was holding on to her and I didn’t want to let go.  And then again he reports: Ken: actually hold her hand again, (makes an expressive sound), nothing else mattered…to be holding her hand while she was passing away, it overshadows everything…because its like I actually was holding her hand…” ... Ken: …feeling the warmth of her hand…her smell…its like whenever I was in her presence, I could feel – not her aura, but her love, her nurturing, her care, I could feel everything about who she was…and my childhood…I remember when I was holding her hand, yeah, it just felt like all those things again, and its still with me…so the feeling is still there…”  As discussed previously, this physical contact had the impact of evoking strong emotional memories in Ken; we must bear in mind that the scene he is watching at this moment is of him holding the hand of another male group member, another combat veteran. And yet, in that moment, he can connect to memories of his Grandmother's warmth, her scent, even her very love and care for him. And it is also significant to ? ∣ ?observe that the feeling has endured for him at the time if the follow up interview.  Recalling the urge to fight. The second way in which Ken reports the physical activation during his enactment, is in multiple instances that he reports feeling "like fighting", or "ready to fight". Herein we get a glimpse of the arousal level that he felt, primarily in his body, that engaged him in the process, as described in the aforementioned theme of emotional engagement. First, here are two examples of Ken referencing his "fight" response in a general way, followed by more specific, detailed examples of him describing the sensations. Ken: I’ve been in that situation…I’ve been out (in my daily life), and I’ve felt like THAT (referring to his memory of his physical sensations in the scene on the video playback). People say ‘you look mean, you look angry”…do I look angry? That (pointing at screen) reminds me of when I’m fucking ready to kill someone. … Ken: I felt like fighting. You know how you go into fight (or) flight mode? I was wanting to fly, but then I was like ‘fucking hell’, and usually I need to keep my hands busy…usually I mighta gone for a cigarette or a beer, or (slot machines)… if I was out (in my daily life) and somebody started askin’ me those questions... I’d get angry, and, whoosh, backhand or something like that…but here we are talking about it, and, I dunno, I just had to move my hands…  In addition to his awareness of the energy in his hands, "I need to my hands busy…I just had to move my hands", Ken reports awareness of other physical symptoms: Ken: I’m sitting here thinking, ‘Oh I remember that…my heart’s racing...My jaw’s sore now like it was then as well. ? ∣ ? As well, an overall arousal level: Ken: I was hyperactive, I was sorta just spitting out everything...  Finally, Ken reports an awareness of himself going beyond emotion and beyond cognition, in this moment he observes himself completely ready to "launch" into fight mode: Ken: You know sometimes when you’ve just gone past that point of assessment and you just wanna like…where emotion sort of just goes to the side? That’s what I feel like (pointing at monitor) All I want to do is launch myself and put all my body weight behind me and ‘crack’…. I wasn’t even thinking – I was ready to fight, I was ready to launch.  What was not captured in the interview process was Ken's thoughts on why he did not launch into fighting mode - although he doesn't say so explicitly, we may infer possible clues to this from the discussion of previous themes: namely, his trust of the group and the facilitators, his emotional engagement with the process, as well as his emerging desire for the process to work, as discussed below within the context of his growth of optimism.  Ken's theme three: transformative nature of the experience. The final theme I constructed from Ken's review of his enactment was how highly transformative the experience felt for him. This transformative quality can be divided into three distinct sub-themes. First, Ken reported gaining numerous cognitive insights. Second, Ken reported feeling able to reintegrate "old" parts of himself, or qualities of a self he'd forgotten about. Third, Ken reported growth in a number of interconnected domains; self-confidence, trust, hope and optimism.  Gained Cognitive Insights. One example of self-awareness Ken reveals relates to a ? ∣ ?pivotal time in his life, in which he began to feel like a failure:  Ken: (gesturing at himself on screen) I Look like a defeated man!  …addressing loss or failure. Addressing the failure of what could have been…yeah. …I guess I went from being someone to no-one…(representative level) rugby player, Navy chef, to just another guy in (my hometown), didn’t even have any friends or family…  And then further, he reveals insight into what occurred for him in the subsequent period of his life, which brought him to the Veterans' Transition Program. Although he doesn't quite say it explicitly, we can infer his anger at himself when he reports "I'm angry at four years…I just wanna strangle that four year gap"; in a sense we are witnessing Ken awaken to only to the changes that sent him into this phase, but to his responsibility for his subsequent choices as well. Ken: That’s yesteryear, and this is today…Fast forward four years and that’s where I am now…And so I’m frustrated at the period in between – four years. I’m angry at four years, not at the old me, not at the me sitting there (in the enactment on the screen), it’s the four years of fucking bullshit, of being on welfare, of gambling, drinking, divorce, fucking cheating on my wife, not seeing my son – it’s all that….I just wanna strangle that four year gap…  Furthermore, Ken acknowledges that he is "still dealing with it" during his enactment. Here we see Ken's awareness that he's been "carrying baggage" for four years, and that may be a causal factor in how his life has gone, in the decisions he's found himself making. We can, perhaps, see in this excerpt the beginning of Ken acknowledging what he wants to do, in order to live a better life. ? ∣ ?Ken: That shit’s all still raw, its been the last three or four years I’ve been carrying it, not like something I have to recall from ten years ago…that I’m still dealing with it (here in the enactment we're watching)...I guess the reason I was gambling and drinking, excessively is because I was carrying that baggage, so when I let go of the baggage, (I hope) there goes the bad habits as well.   Reintegration of old self into his identity. A second sub-theme of transformation for Ken was his awareness that he had lost or forgotten  something of himself, and needed to remember it, reconnect with something of himself from his younger years, before he went "from being someone to no-one" in his own eyes. Early in the enactment process, one of the facilitator's asked him to think about what that change cost him. Ken: I paused and asked myself ‘What DID it cost me?’ and I was thinking, ‘where do I start?’…and I was like, my self-identity…  As well as identity, Ken recognizes that he lost the important lessons his Grandmother had imparted to him, and reveals the influence of recreating that scene on re-connecting him to that memory, those lessons: Ken: ...I’ve got a better perspective now…it came about remembering who I was – say, with my grandma, remembering the grace and everything that she said to me on her deathbed…those little things do put things in perspective…yeah they got lost man, they fuckin did.”  Further, Ken articulates a loss of the ability to enjoy life: Ken: I was thinking, like: ‘I’ve tried so hard to get enjoyment back – I mean, I don’t find enjoyment in anything, anymore. You know, when (the facilitator) was talking about stability, I’ve tried to find it…and he reminded me of that time when I was trying. ? ∣ ? Finally, near the culmination of his interview, Ken suggests that he feels re-connected to his older self, before he lost connection with his Grandma's message, before he began to feel like a failure, like a “no-one”: Ken: I’m sorta going …back to the old me…I feel like I’m gonna go back, and (my ex-wife)’s gonna see me as that guy… The old (me), that’s how I am now, how see myself now…  Growth of optimism, confidence, belief in himself. The third sub-theme within the transformative nature of Ken's experience with TE, is his self-reported growth. This growth appears to begin with his willingness to believe in the experience. Upon observing his dialogue with his younger self, Ken recalls: Ken: I started to look up at him (the group member playing his younger self) because I wanted to believe anything he was gonna say.  At first glimpse, this may appear like Ken is wanting to believe in somebody else, but we must recall that this other group member is portraying Ken's younger self, based entirely on Ken's direction and information, as relayed through the facilitators. Ken later elaborates on the experience of beginning to trust in the group, and consequently himself: Ken: The fact that we all trust and believe in each other to get through whatever we’re going through, maybe on a subconscious level is there with me, so when I’m talking to the old me I’m looking at (the other participant)…maybe inside there’s a gelling of that whole belief system…ok, yeah, I believe in myself, I’ll try this new way of thinking…I’ll trust (the other participants).   Finally, Ken reports an increase in his optimism for his own healing process: Ken: I mean, this is the process, we’re right in the middle of it here, but even looking ? ∣ ?back on this…even after two days…I feel I’ve, um, maybe, not come through it, but I’m more optimistic about the challenges…  And in a compelling final word, he helps us to understand how truly important this idea of belief is for him; that without it, no professional is going to be able to help him. n Ken's estimation, the experience of therapeutic enactment appears to have given him a belief in himself that he feels he needs to regain the self he lost: Ken: You can have a thousand and one fuckin' psychologists tell ya its not your fault, but until you believe it, then it doesn’t mean shit. And (in the enactment), I wanted to believe it, and I did start to believe it…and still continuing two days later, building the belief, the confidence – (my) self identity is still taking steps forward in a positive way. Summary of findings  In summary, the research findings from this study were articulated independently, with each participants' account of their experience depicted as unique to them; just as each participant is a unique individual, as were their enactments and the contexts within their lives that the TE took place. In the course of analysis, eleven themes were derived from these three accounts, each of which provides an illustrative example of how therapeutic enactment, applied as a group-based trauma intervention, was experienced by these particular clients.   Pete's experience was illustrated in four themes; the first two were cognitive, insight-based in nature, in which he was able to recognize pivotal, symbolic moments in his life, as well as origins of his present identity, emotionality, behaviours, and values. Pete also appeared to still be in a cognitive processing frame of mind, during the course of the interview, which constituted a theme unto itself. Finally, a fourth theme generated ? ∣ ?from Pete's experience was an awareness of his ability to both access and express his emotions within the context of therapeutic enactment.  Larry's experience was also illustrated in four themes. Larry described that for him, there was a congruence with his actual memories of important events in his life - the scenes enacted, the way in which other members portrayed important people, in particular his father, created a vivid suspension of disbelief; "that was my childhood", he reports. Larry was also struck by the power of contact with other group members, both in terms of eye contact, and physical touch, which he experienced in both positive and negative ways. As with Pete, Larry reported experiencing an enhancement of insight into important values he has, as well as into his relationships with his parents. A unique experience Larry was able to articulate, was a fourth theme: that he felt the group facilitators' decisions didn't resonate with him, he disagreed with interpretations they made about his relationships with parents, and about his definition of masculinity. At times he reported feeling over-directed, and at times experienced feelings of humiliation in the course of the enactment, which he appeared to attribute to the scenes generated by the facilitators.   Ken's experience of TE was presented in three themes. The first was the emotional intensity he felt, which appeared to surprise him, engage him, and like Ken, he felt it created an opportunity for him to feel and express his own emotions. Second, Ken experienced awareness of the physical activation he felt in the course of his enactment, both with the imprinted memory of feeling his Grandma's hands again, and the urge he felt to fight or flee, as he said in his own words. Finally, Ken felt the TE was a transformative experience, in which he also gained insights, reconnected with an old part ? ∣ ?of his identity which he felt he'd lost, and generated a new sense of hopefulness, and belief in his own ability to make positive changes in his life.   These findings are presented as a modest, preliminary exploration into the experience of TE from three distinct participants' perspectives, and it is this researcher's belief that we must resist the temptation to draw grand conclusions; it is not the objective of the present study to attempt a comparison or contrast across the individual accounts. It is important to bear in mind that each set of themes was created by the researcher, and the very process of analyzing each participants story influenced the analysis of the other two; thus any commonalities amongst themes may be seen as both useful, or convenient. In the following chapter, the findings will be addressed more generally, as we explore the present study within the context of the existing literature, discuss the implications of this study for both future research and clinical application.   ? ∣ ?Chapter V: Discussion Overview     This exploratory study sought to address the overarching question: “What is the experience of participating in therapeutic enactment as a group-based trauma intervention?” To date, very few studies have examined the client's perspective of any group-based trauma interventions, despite a wealth of theoretical and clinical observations made in the literature, from the perspective of researchers and clinicians. It is this author's belief that these three distinct sets of themes provide an insightful representation of three unique individual experiences of therapeutic enactment. The following discussion addresses how these findings are of value for continuing research into therapeutic enactment as well as group-based trauma therapy, more generally. Further, this chapter explores how the research method may be applied more effectively towards group therapy research. Finally, this chapter highlights the significance of this study for practitioners in the field of group counselling and psychotherapy for trauma. Limitations  Before engaging in a discussion of the value of the present study, it is pertinent to acknowledge and address the key limitations it faces. Herein I will address what I perceive as three shortcomings of this research. The first pertains to the specific nature of the clients that were available for participation. The second is grounded in the immediacy of the IPR interview method, and the absence of outcome data. Third, is the fact that we are only examining one perspective of an experience had by multiple group members, as well as facilitators, at the same time.  The primary limitation of this study pertains to the sample of participants ? ∢ ?themselves. At present, the Veterans' Transition program is the only formal setting in which therapeutic enactment is being both delivered and researched on a regular basis. In essence, this makes clients of that program an ideal convenience sample from which we can access members of the community who are being exposed to TE. This also means that, with very few exceptions, the potential participants for the present study are exclusively males, and all have served in the military service. This is a very specific subgroup within our culture. It is significant to observe that frequently within the VTP program, the traumatic experiences clients are choosing to address are NOT combat related, are in fact, experiences they faced while civilians. Nonetheless, we must acknowledge that as TE begins to be delivered to a more diverse array of clients, ongoing research will be essential to create a broader knowledge base about the array of client experiences.    The second limitation that must be acknowledged is that, by its very nature, IPR is conducted in a very immediate timeframe following the intervention experience. What is not present in this data is any form of longitudinal component; we don't know how each participant's recall of their experience may change over time. Of course, this is inherently true of any research conducted without follow up; it is necessarily a snapshot of a given context. Further to this, it is important to recognize that the reported experiences herein do not correspond to any outcome data - we don't know how therapeutically beneficial each of these experiences of TE were for the clients, in terms of trauma symptom reduction, or any other measurements of change.   Third, it is important to acknowledge that, until now, IPR has only been used as a method to explore dyadic therapeutic interactions. The present study is one of the first ? ∣? ?applications of IPR to the experience of group therapy, and yet we have only captured reports from one member of the group at any given time - the primary client. For instance, in Larry's experience, he was powerfully moved by contact with other group members. In the present study we have no way of knowing what those other members experienced in those moments of contact - but as TE is a group-based intervention, we can reasonably suggest that there is value in finding that out. Furthermore, each of the three participants made mention of the vivid portrayal of key people in their lives by other members - we don't have reported experiences of what its like for group members to do this portrayal.   In a related vein, what is also missing from this data set, are the perspectives of the facilitators. As there is a wealth of clinician-reported data within the literature, this was not the purpose of the present study. However, Larry's reported experience of a distinct lack of resonance with the facilitators of his enactment raises a valuable question: what premises were the facilitators working from at those moments? IPR has been used to study both sides of dyadic therapy (Larsen et al., 2008) and it has been observed that client and clinician experiences frequently differ. It bears repeating the view of these authors that, “rather than becoming distressed by these differences, we must establish an in-depth knowledge of these important differences in perspective as they are likely to offer insights regarding improved client care” (ibid. p. 29). It is this authors belief that Larry's willingness to express his dissatisfaction with his TE experience (along with much of it that he found very helpful and rewarding) provides invaluable insights that can be explored in future research. How much more valuable would it be, if we were able to cross-reference his experience with that of the clinicians. As it stands, we can only make ? ∣? ?conjectures based on the clinical foundations of TE, as to the facilitators' perspectives. Contributions to the literature   The following section will first endeavour to contextualize the findings of the present study within the existing theoretical rationale for processing trauma through group-based interventions. Specifically, this discussion will focus on the themes and sub-themes that reflect the establishment of safety and opportunities to experience trusting relationships, as well as the opportunities for clients to process and express emotions in a social context. Next, the findings will be discussed more specifically in terms of their relevance to the existing literature on therapeutic enactment. In particular, those themes and sub-themes that reflect the origins of TE in object-relations theory and schema and script theory. It is this author's belief that the current study represents a novel contribution to the published literature on TE as a therapeutic intervention for trauma, as well as to the literature on group-based trauma interventions in general.  Establishing safety and the experience of trusting relationships. The literature on group therapy for trauma highlights the risk of loss of trust and sense of safety in the world, as well as experiences of social isolation (Herman, 1997, Van der Kolk, 1993). The experiences reported by these three particular participants indicate that for each of them, a degree of safety was established through the formation of bonds with the others members, and through the opportunities provided for social contact and engagement. Perhaps the most telling example of this is in the example of Larry's experience of contact. Larry reported a power in the opportunities to make eye contact with other group members, as well as the instances of physical touch that occur in the natural course of enacting scenes. He described feeling that one other member had something "special" in ? ∣? ?his hands, as a result of that member portraying his father then and placing his hands on Larry's shoulders. Larry also provided insight into the experience of contact with a member who he did not feel comfortable with, revealing it to be a limiting factor in his sense of safety. Further, each of the participants expressed a degree of surprise at the effectiveness of other members' abilities in portraying or capturing the essence of family members, or other key figures in their lives, such as Larry's father, or Ken's grandmother, who Ken was able to reconnect with by holding the hands of another (male) member of the process group. We may surmise that in order for this experience to occur, the group members must have established a considerable degree of trust and comfort with one another. In Ken's words: "You know, I trust the group. I trust (the facilitators).  I mean, this is what, day five? …you know, after the previous five days, the fact (is) that we all trust and believe in each other to get through whatever we’re going through".   Emotional processing. Directly associated with this establishment of safety, is the creation of a space in which each participant felt an ability to access their own emotions, and to express those emotions within the social context of the group. As one reads the excerpts from each of the participants' experiences, it becomes apparent that each was surprised at this, as though it is a novel or  rare occurrence for them. We may consider this as potentially a direct result of their trauma experiences, which can lead to emotional constriction, disengagement, and dissociation. Ken specifically addresses his own tendency to "zone out and try to think about other shit", and suggested that something about the group experience, and the engagement with the facilitators and other members, prevented him from doing so in this experience. And in this exchange between the interviewer and Pete, we can see how the contact made with another member facilitates ? ∣? ?his access to pain from his past, and then creates a sense that he is supported, in the here and now of the enactment: Pete: That hurt, that moment…. Interviewer: where (another group member) put his hand on your shoulder, what did you notice, when he touched you like that?  Pete: Pain Interviewer: Pain…you noticed the pain when (the other group member) put his hand on your shoulder because it felt like…? Pete: someone was there for me…  And again, Pete illustrates how another member sparks his awareness of an emotion that had been eluding him, in his quest to understand his past: Pete: that’s interesting because (another member) mentioned the word homesick…There was pain right there…and then I somehow remembered at the time…its something I’ve been meaning to mention… when he said the word ‘homesick’, I said ‘that’s it.”  Here we have a poignant example of two group members, in an apparently trusting relationship, able to connect with each other around a painful emotion, and express that openly within the group context.   Self-Psychology and object relations theory. We will recall that TE is described as grounded in the interpersonal theories of self-psychology and object-relations, as trauma is frequently associated with how relationships, past or present, from the perspective of individuals, affects their functioning. Interpersonal relationships are thus considered fundamental to the process of TE, which works, in part, through externalization of internal representations of self-important others in client's lives ? ∣? ?(Westwood et al., 2003). In order to do this, the process of TE includes attempting to return to previous interactional events that may be interfering with the clients' present day relational world. Within the present findings, we can see numerous indications that, from the client's own perspectives, this is indeed occurring. Larry's first theme was of the congruence of his experience with his own memories - in particular of his childhood, and of numerous key relationships. Larry described witnessing and participating in scenes that suspended his disbelief, even in the face of his self-described doubts about the process and the decisions of the clinicians. Larry experienced other members portray his brother, his mother, a former commanding officer from the war in Vietnam, and in particular his father. Each of these experiences was so vivid that Larry describes feeling they were in the room with him. And embedded within Larry's theme of enhanced insights, he particularly referred to an increased awareness into the nature of his relationships with his parents. It is once again worth noting that he experienced this despite also reporting feeling that the facilitators themselves were missing the mark about those relationships. Pete also describes the transformative moments he experienced, in which he was able to witness and participate in key experiences of his childhood. He revisits his family farm and gets to be his young, innocent self, and then later, he is afforded an opportunity to confront his parents about the betrayal he experienced when they sent him away from that place of innocence, to the boarding school at which he would be traumatized in a profound way. Finally, once again, the poignancy of Ken's description of holding his Grandmother's hands, illustrates first hand the capacity of TE to transport clients back to relational experiences that are important for self-growth. Ken describes experiencing TE as helping him reintegrate "old" parts of himself he felt he ? ∣? ?lost, back into his identity. And he ascribes this to the opportunity to touch his Grandma's hands again, and to hear her words of wisdom.  Schema and script theory. The cognitive component of TE is grounded in the assertion that through action, and experiential emotional processing, there lies a possibility to re-structure problematic mental structures, referred to as schemata and scripts, that have formed as a result of traumatic events in a client's life (Bruning et al., 1999, Westwood et al., 2003).  Each of the three participants in the present study reveal numerous cognitive insights gained in the process of their enactments, that we can overlay with the notion of personal schemata and scripts. A predominant theme within Pete's experience, was the generation of insights into self as he understands it now: as a withdrawn, angry, solitary person; as a "people-pleaser" with a tendency to put others' needs before his own; and as someone with a distrust of both organized religion and authority. His reported experience of TE included seeing glimpses into the origins of these beliefs. This parallels closely Larry's experience of enhanced insight around the importance for him of feeling understood by people in order to trust; and regarding his own personally generated definition of masculinity, which didn't fit with many of the other group members' apparent norms around what constitutes a "real man". Indeed, it is possible to interpret this new awareness he describes as occurring directly as a result of this discrepancy. Finally, Ken reports seeing, and understanding more clearly, the origins of his own behavioural patterns, in particular the self-destructive patterns of gambling and alcohol use. The reintegration of old "parts" of himself he describes can be seen as a restructuring of schemata, and on a very optimistic note, Ken is able to articulate that the experience ? ∣? ?generated in him a renewed sense of hope, and belief in himself and his ability to make positive changes. Implications for future research  This research study represents a very preliminary foray into the use of IPR as a means of understanding clients' subjective experiences of group trauma therapy; a line of inquiry heretofore rarely found in the literature. For this reason, we must resist drawing sweeping conclusions, and instead view the present findings as roots for many branches of potential future study.   As discussed in the preceding section on the limitations of this study, the population from which participants were drawn represents a very narrow subgroup within our culture: male combat veterans. It is the belief of this author that as practitioners of TE continue to expand their work into a more diverse array of clients, research such as this should be conducted on an ongoing basis. Although no one experience can be referred to as representative of any particular group, just as these findings do not represent TE "for veterans", or "for males", there is much to be gained from understanding the experience of TE from a multitude of voices.  Also discussed in the limitations section, the data used in this study constitute the experiences of only one member of each group intervention – the primary client. However, the originators of therapeutic enactment stress that it is, by design, an intervention grounded in group counselling theory (Westwood et al., 2003). All activities must be conducted in consideration of benefiting all group members. In order to more fully understand the processes involved in TE, it would behoove researchers to conduct IPR interviews with multiple members of the same enactment. The predominance of ? ∣? ?references to contact with other members in the present findings suggests rich possibilities in cross-referencing each members experience of the same moments. There is an entirely unique line of inquiry into the experience of taking on roles for others' enactments. There is also potential for conducting IPR interviews with the group facilitators. Perhaps the most valuable insight found in Larry's themes, is a reminder of the potential for disparity between client and professional caregiver accounts, and that, in the words of Larsen and colleagues (2008, p. 29), “rather than becoming distressed by these differences, we must establish an in-depth knowledge of these important differences in perspective as they are likely to offer insights regarding improved client care”.  Finally, as the present study applied the IPR method of inquiry in isolation, the findings represent a snap-shot of the participants' experiences in the near-immediate window of time following the intervention. On the premise that these findings are of merit in their own right, we may suggest in future, applying mixed methods approach, that would fuse this form of inquiry with longer-term follow ups, as well as outcome measures of the effectiveness of the intervention in addressing trauma symptoms. This was beyond the scope of this modest study. Clinical implications   In previous research on therapeutic enactment, Black (2009) reminds us that no mode of therapy should be considered as a "magic bullet", as research consistently demonstrates that no intervention provides superior treatment for all clients in all scenarios. Therapeutic enactment is a one-time, brief intervention, best employed when built on and followed up with effective individual therapy. In a sense, TE may be conceived of as a catalyst for therapeutic change. The present study does not address ? ∣? ?outcomes or measures of effectiveness. However, the knowledge derived from this exploratory study does provide some valuable insights for practitioners wishing to develop the skills to deliver therapeutic enactment as an intervention for trauma, and for those clinicians continuing to develop and refine TE as a modality.  Therapeutic enactment as an integrative approach to group-based trauma processing. The findings presented herein demonstrate that TE is indeed a complex, multimodal, integrative approach. For these three participants, participation in their own enactments has created an experience that impacted them on multiple levels. The eleven themes generated from the participants' own accounts span across the cognitive (schematic & narrative), behavioural, emotional, relational and social, and somatic domains. The developers of the intervention theorized that TE is a "holistic solution to the complex concerns that single system therapies cannot address" (Westwood et al., 2003, p. 123).  It has also been suggested that TE extends "the traditional interventions of talking and thinking by placing an emphasis on experiencing and doing" in order to re-create and work through significant and traumatic life events within the safety of a group of trusted others (Hirakata & Arvay, 2005, p. 446).  Although the present study offers no contrast to other systems of therapy, it does provide much that supports TE as a holistic and complex intervention, and further that the provision of a safe group environment facilitated emotional access and expression, social connection (including physical contact), cognitive insights, and embodied experiences. All of these were reported predominantly as positive, healing experiences for each of the participants.   The one exception to the positive accounts was captured in Larry's theme, referred to as his lack of resonance with the facilitators' decisions. Larry's courage to express his ? ∣? ?dissatisfaction with important elements of the process, affords a valuable learning opportunity for the clinical application of therapeutic enactment. Each of Larry's critique will be discussed in turn. Significantly, it will be noted that each critique can be seen to overlap with a new sense of self-awareness Larry reported experiencing. One might hypothesize that, even in his dissatisfaction with the process as it occurred, changes began for Larry by the time of the IPR interview.   Directive leadership. Larry's experience of feeling over-directed by the group facilitators of his enactment, appear to occur as a result of the use of what are referred to as "sentence stems" within the TE literature (Westwood et al., 2003). In essence, these are prompts that clinicians use to move the client through the process, to verbalize their feelings and thoughts in the moment. Although we only have Larry's account of his enactment, surely we may, with confidence, assume that the leaders did not intend for Larry to feel "like Gumby", that words were being put in is mouth. And we might also be wise to consider what is unique to Larry that prevented him from correcting the facilitators when the prompts they provided did not resonate with him - perhaps it had much to do with his own comfort level in the moment. We know he did have the comfort in the follow up interview to make this grievance known. From this author's perspective, this highlights the importance of assessing clients' for their confidence and ability to clarify their own thoughts; for thoroughly briefing clients prior to their enactment, about how the prompting "sentence stems" are employed. For Larry, although he remained silent in the moment of his TE, only days later, in the IPR process, he felt comfortable with openly expressing his opinions.  Understanding family relationships. Larry spontaneously revealed a significant ? ∢? ?relational event, in the midst of his enactment: that his mother had once told him that his father had once said to her that perhaps Larry should have been born female. At that moment, the facilitators appear to have made a clinical judgment call to focus much of the rest of his enactment on dialogue with his mother and father about that fact. In the IPR, Larry expresses his surprise at that shift - the plan had been to focus on his relationship with is older brother. Larry felt the facilitators misunderstood the nature of his family dynamics. However, he also stated that the experience allowed him to gain greater understanding of those very relationships himself. I suggest that this can be of value to clinicians in two ways. The first is a caution against "changing the script" too significantly in the course of a TE, or perhaps, collaborating more fully with the client about the new direction one might wish to take. The second, somewhat paradoxically, is to note the low level of risk that occurred when the group leaders "got it wrong". They followed a hunch that Larry's masculinity suffered a great deal as a result of this comment from his mother - perhaps a very reasonable clinical judgment given the typically hyper-masculine dynamics found in the context of the Veterans' Transition Program. Although Larry felt misunderstood in that moment, Larry reported later that feeling misunderstood was a significant schema he has struggled with throughout his life; and he appeared to benefit from this new awareness.   Initiation and humiliation. A final caution raised by Larry's account of his experience, relates to the scene in which Larry was invited into the "circle of men". Once again, we do not truly know the intentions of the facilitators, but we can confidently assume there was no intention to create a sense of humiliation for Larry. Instead, we might posit that the intent was to create a for of strength confrontation - to acknowledge ? ∢? ?Larry as a "real man" despite the potentially wounding words of his mother; to invite Larry to feel included in a group. Larry reveals to the interviewer that he has at times been shamed amongst groups of men, and it appears that this sense of shame was activated in this enactment. Once again, Larry reveals that he gained a greater clarity and confidence in his own definition of masculinity as a direct result of the experience; the sense of humiliation was not what carried through. However, Larry highlights here a prudent caution for the employment of group-based trauma interventions in general: if the very nature of a client's traumatic history is grounded in group experiences, extra caution might be considered.  IPR as a therapeutic intervention. Larry's willingness to reveal what he found unsatisfactory about his experience reveals much that clinicians and researchers can learn from. Bearing in mind, once again, the likelihood of disparity between client and professional accounts of therapeutic encounters, it is this author’s suggestion that we may consider building video-assisted follow-up interviews into the process of TE as a form of feedback loop that can be generated for the refinement of the intervention technique. The ancillary benefit of this would align with what Larsen and colleagues (2008) report: that clients who participate in the IPR process often report experiencing significant additional therapeutic benefits stemming from the opportunity to watch their experience on video and further integrate the experience. Conclusion  Group-based interventions are frequently referred to as effective and appropriate for addressing psychological trauma, most frequently for the opportunity to experience feelings of safety, trust and social connectivity that are often damaged as a result of ? ∢? ?traumatic experiences. There is much in the way of theoretical exposition to support this, and a limited amount of outcome data with mixed results. There is but very rare literature that has been conducted from client perspectives of group trauma therapy.   There are a multitude of group-based modalities that have been developed to address trauma, based in the various theoretical foundations of counselling. The most common of which are based in psychodynamic and cognitive-behavioural principles. This study sought to explore client perspectives of the experience of participating in therapeutic enactment (TE), a complex, integrative, experiential approach to addressing trauma in a group setting. The findings of this study expand the still minimal knowledge base on client experiences of both TE specifically, and group interventions for trauma more generally. In doing so, this study takes a unique place in the literature.  The study was not intended to assess outcomes, instead focused entirely on the process of enactment for three particular participants. The study employed a video-assisted research interview method known as interpersonal process recall (IPR) in an attempt to capture participants' experiences as immediately as was feasible, rather than in a more reflexive state than other modes of qualitative inquiry. IPR is a less frequently used method, but its application in this study suggests it to be very valuable tool for assessing therapeutic encounters, and indeed it may be viewed as a therapeutic endeavour in its own right.  The findings of this study were re-presented through the process of a thematic analysis, which was conducted on three distinct participant accounts of their experience of TE. These themes spanned across a diverse range of domains that clinical interventions may focus on - cognitive, emotional, behavioural, relational, and somatic. As the ? ∢? ?developers of TE have suggested, these findings indicate that, for these three particular clients, in these particular contexts, TE was indeed a complex, integrative experience.  The findings of this study suggest several ideas for developing further research into TE and group trauma-processing, including exploration of other group members' and facilitators accounts of the same events, conducting longer-term follow up interviews, and combining experiential process research with outcome studies. The author suggests that as TE continues to proliferate as an intervention of choice for group trauma therapists, continuing IPR interviews would be of use both to clinicians, as a means of generating a feedback loop from clients to professionals, and for the potential therapeutic benefits of further integration and processing of such a complex experience, for clients.  Finally, the value of exploring clients' experiences of counselling interventions is the humanization of the process. Applying video-assisted recall in order to understanding how clients felt in the moment of therapeutic engagements, in their own words, is seen in this study to provide a depth and a nuance that future researchers and clinicians can apply to their continual advancement of the field of trauma therapy. 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