Amy Wilhelmi, LMFT
If you missed last week’s post, start here: It Doesn’t Have to Be Linear: Building a Flexible, Integrated Healing Plan
Last week, we explored how trauma therapy doesn’t have to follow a straight line. Instead, healing can be flexible, looping, and deeply adaptive. This week, I want to bring that framework to life through a composite case example. “Sarah” represents many of the clients I’ve worked with — survivors of early relational trauma whose attachment wounds show up in both intimacy and self-worth.
When trauma fragments our sense of safety, it doesn’t just live in the nervous system — it reshapes how we attach, how we love, and how we see ourselves in relationships (Bowlby, 1982; Mikulincer & Shaver, 2016
1. Meet “Sarah”
Sarah is a 34-year-old woman with a history of childhood emotional neglect and betrayal in adult relationships. She describes herself as “too much” for people she loves and often shuts down during moments of emotional or physical intimacy. In her words: “It’s safer not to need anyone at all.”
Her attachment style is primarily avoidant, marked by withdrawal when closeness feels overwhelming. She also experiences dissociation during sexual contact — a hallmark of how trauma can sever body, mind, and relationship (Van der Kolk, 2014; Green & Mitchell, 2015)
2. The Integrative Path
Here’s how an integrative model supported Sarah’s healing:
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Ketamine-Assisted Psychotherapy (KAP): In her first session, Sarah accessed a vivid memory of her younger self standing alone on a playground. This imagery opened a door to grief she had never touched in talk therapy (Dore et al., 2019).
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Emotionally Focused Therapy (EFT): Building on that insight, EFT helped Sarah explore how the belief “I’m too much” shaped her fear of abandonment. In session, she practiced voicing softer emotions — longing, sadness — instead of shutting down (Johnson, 2004).
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Eye Movement Desensitization and Reprocessing (EMDR): Together, we targeted a specific memory of invisibility — the times she was ignored as a child. Bilateral stimulation helped her reprocess that pain into a new belief: “I deserve to be seen.” (Shapiro, 2018).
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Trauma-Informed Sex Therapy: With new emotional safety, Sarah began gentle self-touch and body awareness practices, reconnecting with sensations of safety and pleasure. Over time, she no longer dissociated when holding her own hand — a profound marker of healing (Kaplan, 1974; Halstead et al., 2021).
3. Lessons from Sarah’s Journey
Sarah’s case illustrates a few key principles of integrative work:
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Healing is layered. KAP opened the emotional door; EFT gave language; EMDR reprocessed old beliefs; sex therapy grounded it in the body.
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Attachment wounds need relational repair. Trauma doesn’t heal in isolation — it heals in safe, responsive connection (Johnson, 2004; Mikulincer & Shaver, 2016).
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Small steps matter. Holding her hand without dissociation was as significant as any breakthrough memory.
4. Why This Matters for You
Whether you’re a therapist or someone navigating your own healing, Sarah’s story shows that trauma recovery is not about “fixing” but about reclaiming connection — to yourself, your body, and others.
If you’re curious to read more about how these approaches work together, explore my earlier post: It Doesn’t Have to Be Linear: Building a Flexible, Integrated Healing Plan (Week 6).
Next week, we’ll shift to couples work. How does this integrative approach help repair intimacy after betrayal or infidelity? We’ll look at how partners can rebuild trust — not just emotionally, but also physically — when trauma has shaken the foundation.
Selected References
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Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment. Basic Books.
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Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., … & Woolley, J. (2019). Ketamine-assisted psychotherapy for treatment-resistant depression: A clinical review. Journal of Psychoactive Drugs.
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Green, B., & Mitchell, S. (2015). Sexual trauma and dissociation. Journal of Sex & Marital Therapy.
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Halstead, M., et al. (2021). Trauma-focused sex therapy: Integrating safety and embodiment. Sexual and Relationship Therapy.
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Johnson, S. (2004). The Practice of Emotionally Focused Couple Therapy: Creating Connection. Brunner-Routledge.
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Mikulincer, M., & Shaver, P. R. (2016). Attachment in Adulthood: Structure, Dynamics, and Change. Guilford Press.
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Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Third Edition: Basic Principles, Protocols, and Procedures. Guilford Press.
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Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.