The Two-Part Film Technique:

Empowering Dissociative Clients

to Alter Cognitive Distortions
and Maladaptive Behaviors
Sarah Y. Krakauer, PsyD

ABSTRACT. This paper describes and illustrates the two-part film

(TPF) technique, an intervention characteristic of the Collective Heart
model (Krakauer, 2001), a phase-oriented approach to treating dissocia-
tive disorders. Emphasis is on the technique’s value in interdicting mal-
adaptive interpersonal and intrapersonal patterns which perpetuate
depression, anxiety, dissociation, and self-defeating behaviors. The ap-
proach is compared with similar internal screen techniques appearing in
the hypnotic literature, and distinctive features of the TPF are noted.
These include the minimally directive role of the therapist, reliance on the
inner wisdom of the client, present and future orientation, and amplifica-
tion of desired affective and somatic experiences. A verbatim clinical il-
lustration is presented and discussed, with emphasis on the empowering
impact of the TPF. [Article copies available for a fee from The Haworth Doc-
ument Delivery Service: 1-800-HAWORTH. E-mail address: <docdelivery@
haworthpress.com> Website: <http://www.HaworthPress.com>  2006 by The
Haworth Press, Inc. All rights reserved.]

Sarah Y. Krakauer is affiliated with The College of William and Mary and is in
private practice, Williamsburg, VA.
Address correspondence to: Sarah Y. Krakauer, PsyD, 333 McLaws Circle, Suite 1,
Williamsburg, VA 23185 (E-mail: sarahkrakauer@cox.net).
The author wishes to thank Jack Watkins, Onno van der Hart, and Ellert Nijenhuis
for their valuable suggestions, and the clients who generously consented to publication
of their case material.
Journal of Trauma & Dissociation, Vol. 7(2) 2006
Available online at http://www.haworthpress.com/web/JTD
 2006 by The Haworth Press, Inc. All rights reserved.
doi:10.1300/J229v07n02_04 39
40 JOURNAL OF TRAUMA & DISSOCIATION

KEYWORDS. Two-part film, dissociative identity disorder, trauma,

cognitive distortions, maladaptive patterns, empowerment, inner guid-
ance, inner wisdom, Collective Heart

The trauma treatment field has experienced a significant shift during

the past two decades with regard to emphasis and pacing. Renewed in-
terest in the phase-oriented approach advocated by Janet (Van der Hart,
Brown, & Van der Kolk, 1989; Van der Kolk, Brown, & Van der Hart,
1989) contributed to broad recognition of the value of phase-oriented
treatment (e.g., Brown, Scheflin, & Hammond, 1998). The current stan-
dards of care (International Society for the Study of Dissociation, 2005)
emphasize carefully paced treatment fostering increased stability and
avoidance of excessive or premature focus on traumatic memories. Ac-
cordingly, techniques are introduced early in treatment to foster clients’
competence and confidence as they navigate their post-traumatic world
and prepare to grapple, in due time, with painful memories without
decompensating.
One phase-oriented approach, the Collective Heart model (Krakauer,
2001), offers an array of interventions that utilize the client’s dissociative
ability, desire for safety and self-esteem, and unconscious guidance in
healing the effects of traumatization. This paper elaborates one particular
intervention, the two-part film technique (TPF; Krakauer, 2001), intro-
duced early in the first phase of treatment, the stabilization phase preced-
ing exploration of traumatic memories. The TPF provides a straight-
forward means of empowering the client to identify and satisfy her deeper
needs rather than continuing maladaptive patterns that exacerbate her
distress and dysfunction. While informed by the rich hypnotic literature,
this technique is distinguished by a “hands-off” therapeutic stance and
increased client control and initiative.

THE DEVELOPMENT OF MALADAPTIVE AFFECTIVE,

COGNITIVE, AND BEHAVIORAL PATTERNS

Profound deficiencies in the early family life of survivors of prolonged

child abuse–such as inconsistent parenting, interpersonal conflict, lack of
encouragement and warmth, and gross neglect–have been found to con-
tribute significantly to adult psychopathology, beyond that accounted for
by physical and sexual abuse (Gold, 2000). These environmental defi-
ciencies undermine the development of healthy attachment and secure
 Sarah Y. Krakauer 41

sense of self. Attachment style has a profound impact on future relation-

ships, which, in turn, further affect self-image.
Equally importantly, inadequate early environments significantly
influence internal relatedness. Interpersonal attachment serves as a
model for intrapersonal relatedness, that is, the relationships among
what has been conceptualized as parts, ego-states, sub-selves, and al-
ters. (This paper uses these terms interchangeably in recognition of the
TPF’s applicability to a variety of treatment approaches. Distinctions
between the various conceptualizations are beyond the scope of this
paper.) A child who has negligible assistance in transcending black-
and-white thinking and impulsivity continues to have difficulties in
adulthood with tolerating ambiguity, understanding long-term conse-
quences, entertaining multiple perspectives, delaying gratification, self-
soothing, setting priorities, and solving problems creatively. All of
these deficiencies affect not only interpersonal relationships, but also
those internal relationships in which the individual is constantly en-
gaged. Thomas (2005) described the internal working models of the
adequately protected child as a safe constellation consisting of a safe
child, strong protector, and controlled aggressor, and those of the
abused child as an unsafe constellation consisting of an unsafe child,
inadequate protector, and dangerous aggressor.
Many severely traumatized children grow into adults who live in a
state of moderate, high, and extreme alert. As Kluft (1992) pointed out,
dissociating “the damage that one has endured allows the preexisting
personality to sense that it has been preserved and can carry on. The
price that is paid is that there remains a warded-off view of the self as
helpless and damaged” (p. 34). The existence of this warded-off aspect
of self perpetuates feelings of being unable to manage life events and
the emotions they elicit. Dissociation is maintained after cessation of
external threats to safety not only by classical trauma-related condition-
ing, but also by fear and judgment of parts viewed as inadequate or asso-
ciated with overwhelming affect or destructive behavior (Van der Hart,
Nijenhuis, Steele, & Brown, 2004). Shunning of the latter parts creates
“self-perpetuating feedback loops that promote chronicity” (Van der
Hart et al., 2004, p. 911) by compounding the shame, isolation, help-
lessness, worthlessness, and/or rage these latter parts feel. Addressing
shame is particularly crucial in treating traumatized clients (Kluft,
1993), as shame has been found to mediate the relationship between
childhood sexual abuse and later revictimization (Kessler & Bieschke,
1999). The client cannot exit the self-perpetuating feedback loop while
continuing to view aspects of herself as damaged, disgusting, violent,
42 JOURNAL OF TRAUMA & DISSOCIATION

evil, or otherwise threatening. Lacking insight into these dynamics, cli-

ents don’t recognize their power to alter their internal relationships,
thereby minimizing threat and increasing access to resources necessary
for growth and to feelings of self-esteem, well-being, and belonging.
Their phobic responses to their parts preclude the very experiences of
acceptance that parts need in order to release their burdens and choose
new constructive roles, as they do when acknowledged with compas-
sion (Goulding & Schwartz, 1995; Schwartz, 1995) and when offered
essential psychological resources formerly withheld from them.
Thus the pernicious combination of trauma, inadequate home envi-
ronment, and resulting skill deficits and maladaptive self-perceptions
typically keep the dissociative client stuck in patterns that reinforce her
feelings of inadequacy, vulnerability, helplessness, and failure. In other
words, what was done to the child (in terms of trauma) and not done for
the child (in terms of deficits in parenting), set these problems in mo-
tion. What the client is currently doing to herself (albeit unwittingly)
and not doing for herself account for much of her current distress.
Although she is not to blame for her childhood traumatization, she is
responsible–that is, “response-able”–when it comes to altering the pat-
terns in her current life that maintain and exacerbate her distress and
dysfunction.

THE TPF TECHNIQUE: PURPOSE AND PROCEDURE

The TPF helps clients discover that they can interdict the self-perpet-
uating feedback loops that promote their continued dividedness, dis-
tress, and dysfunctional behavior. The TPF reveals to the client, in
sequence, his habitual behavior and its consequences, and an alternative
behavior (not yet within his repertoire) and its consequences. On the
basis of these two experiences, he can determine the deeper purposes
underlying his customary strategies and compare means of meeting his
needs, thereby making an informed choice to continue his current habits
or explore other options.
This section of the paper describes the procedure and offers several
clinical applications. The following section compares the technique
with similar approaches appearing in the hypnotic and dissociative dis-
orders literatures in terms of both procedural and theoretical consider-
ations, including references to inner guidance. Subsequent sections
provide a detailed clinical illustration and discussion.
 Sarah Y. Krakauer 43

The Collective Heart model (Krakauer, 2001) asserts that the dis-
sociative client is able to obtain assistance from part of the unconscious
mind that is not subject to the cognitive distortions resulting from delete-
rious life experiences. Preliminary clinical support for this assertion is
provided elsewhere (Krakauer, 2001). This invaluable unconscious re-
source, the inner wisdom, was renamed the “collective heart” by a client
who experienced the inner wisdom holding all parts of her personality
system in a compassionate, embracing presence (p. xiii-xiv). This inner
resource is not to be confused with core sense of self, which is assumed
not to have developed in severely traumatized, dissociative individuals.
The procedure is appropriate for dissociative clients with identity al-
teration (it has been used effectively with DID and DDNOS with dis-
tinct alters) who have mastered any autohypnotic technique (e.g., see
Krakauer, 2001, pp. 93-95) and utilize an internal venue such as a visu-
alized theater or conference room with a computer screen. The client
should also be familiar with using a visualized remote control to start,
stop, pause, fast-forward, and rewind the film. In addition, she should
have experience with using a dial found on this visualized remote con-
trol to decrease or increase the emotions and sensations experienced
while viewing the film. Each ego-state is encouraged to find her own re-
mote control, and the client is told that an ego-state who has her dial
turned up will feel emotions and sensations that another ego-state, who
chooses not to share this experience, can avoid by turning her dial
down. Before viewing a TPF, the client should have some experience in
viewing a single internal film clip that can be expected to produce feel-
ings of well-being, such as a film about a happy memory not previously
available to conscious recall (Dolan, 1991), or a vision of hope for the
future (Krakauer, 2001). Viewing such films facilitates familiarity with
the mechanical features while demonstrating that the unconscious mind
offers gifts of reassurance, and the client controls the pace at which she
will accept them.
Once this groundwork has been laid, the procedure for viewing TPFs
is as follows. The therapist offers the client an opportunity to “go in-
side” using her autohypnotic technique, first viewing each part of a TPF
with the dial turned all the way down to see the action of the film with-
out emotional engagement, and then rewinding and reviewing relevant
sections, turning up the dial as desired in order to amplify the experi-
ence that accompanies the film content, thereby comparing the experi-
ences the two options produce internally. The consenting client is told
that any ego-states who choose to participate are welcome to do so,
using their own remote controls. I tell my clients that the inner wisdom
44 JOURNAL OF TRAUMA & DISSOCIATION

(IW) provides information they are ready to consider by projecting the

films onto the screen. Clinicians who don’t share my views regarding
IW might simply explain that this technique permits useful unconscious
material to reach consciousness, so that it might be explored produc-
tively. In any case, neither therapist nor client should anticipate or at-
tempt to influence the film content. The client simply observes what
appears on the screen.
It may be helpful to inform the client that this request for guidance is
metaphorical. The client asks for guidance as if addressing another per-
son in order to suspend conscious problem-solving, thus permitting the
initiation of a creative process transcending conscious resources. Some
of my clients have appreciated the following analogy: When trying to
see a dim star in the night sky, it can be helpful to direct one’s gaze off to
the side. Looking directly at the star directs the light to the center of the
retina, where the color-sensitive cones predominate. However, there is a
higher density of light-sensitive rods in the periphery of the retina.
Therefore, the dim star captured in the rod-rich periphery appears
brighter and more distinct. Asking the IW for guidance can be like gaz-
ing off to one side, getting out of one’s own way, so to speak, in order to
disengage one’s usual conscious problem-solving strategies and am-
plify subtle resources that are generally “out of sight and out of mind.”
The TPF incorporates a principle emphasized by Chu (1992) in his
discussion of empathic confrontation, that “the demonstration of empa-
thy for the patient’s position is absolutely essential” (p. 100) before the
patient is confronted with the rationale for abandonment of maladaptive
behaviors. The first film demonstrates that the IW understands the ha-
bitual pattern with its intended purposes and inevitable unwanted con-
sequences. It also serves as a baseline against which the second scenario
is evaluated.
In the prototypical TPF, the dilemma confronting the client is identi-
cal in both parts, but the second part reveals a novel response. For exam-
ple, if a client complains about a recent distressing but non-traumatic
interaction with her hypercritical mother, the therapist may suggest a
TPF in which the client first sees the interaction with its internal conse-
quences, and then sees herself responding differently to the criticism.
This is powerful because the client witnesses her ability to alter at least
her own experience, if not the whole interpersonal sequence, within the
parameters of her objective situation. The TPF can be also used flexibly
and creatively whenever a client may benefit from glimpsing alterna-
tives, whether or not the initial segments are identical. The central point
is that the client is able to compare discrepant internal experiences by
 Sarah Y. Krakauer 45

seeing two scenarios in succession, and then amplifying their somatic

and affective accompaniments. She then faces the key questions: “Does
my customary behavior serve my deeper purposes? What am I really
going after here? What is it that I choose to experience?”
There are many contexts in which a TPF may be offered. Examples
of TPFs addressing interpersonal and intrasystemic difficulties appear
in Krakauer (2001). All clinical case materials appearing in this paper
are presented with written consent from the clients, who approved this
representation of their case materials as adequately protective of their
anonymity and faithful to their clinical experiences. Where names are
used, they are pseudonyms.
Dissociative clients commonly experience anger management prob-
lems, with some ego-states fearing that assertiveness may invite rejec-
tion or abandonment. One DID client’s angry alter, who had great
difficulty relinquishing his threatening interpersonal style, was helped
by viewing a TPF comparing his habitual intimidating style (modeled
on that of his abusive father) with an alternative that emphasized what
was ultimately best for all concerned. The alter’s goal in watching the
TPF was to determine which approach conferred greater power. He
learned from the TPF that although the former strategy worked in the
short run, eventually it depleted him because successful intimidation in-
volved continually escalating his threatening behavior, and because it
intensified internal conflict, as the other self-states weren’t comfortable
with it. When he amplified the emotions and sensations, he could feel in
his body that the second scenario reduced the internal stress and pro-
duced greater power. (A fuller presentation of this case appears in
Krakauer, 2001, pp. 137-175 and 185-191.)
Another DID client used her own variation of the TPF technique to
compare her angry alter’s violent response to boundary transgression
(by her romantic partner) with an alternative response. After viewing
the films and amplifying the empowering effect of addressing her part-
ner calmly, directly, and firmly, the host was surprised to find the alter
amenable to behavioral change. The host observed that the alter, who
had previously defended her physical violence, “‘feels guilty about it.
That doesn’t make her happy. It keeps her in a miserable rut, where she
doesn’t think there are any other choices’” (Krakauer, 2001, p. 180).
TPFs also help clients address self-image problems. A polyfrag-
mented DID client, who reported severe chronic ritual abuse in child-
hood and adolescence, regarded her body disparagingly. A slightly
overweight woman, she was taught in childhood that her personal value
was based on her attractiveness and ability to please men sexually, and
46 JOURNAL OF TRAUMA & DISSOCIATION

had witnessed less pleasing girls receiving worse treatment. I suggested

a TPF with part one showing her current experience of her body, and
part two indicating how she could perceive her current body differently.
In the first film, she saw herself walking down a hallway.

I said to myself that I felt fat and ugly. I feel [sic] like I’m not going
to get approval and attention from men. That made me feel unloved.
In the new video, it was still me walking down the hallway. I was
thinking something different: “This is my body. It’s not who I am.
It’s okay to try to be healthy and attractive but it’s not essential for
being loved. And the attention and approval I want is not really be-
ing loved.” In the first video I felt worthless. In the second video I
felt that sense of peace. I felt a loving feeling toward myself.

THE TPF IN CONTEXT: SCREEN TECHNIQUES

IN THE PROFESSIONAL LITERATURE

Many stage, screen, and film techniques have been described as

effective tools in the treatment of MPD/DID. Traditionally, most have
been utilized hetero-hypnotically in the recovery and integration of
traumatic memories (Putnam, 1989), or in anticipating and achiev-
ing fusion (Fraser, 1991, 1993, 2003; Kluft, 1982), but some have also
been used to help clients build a new life later in therapy (Phillips &
Frederick, 1995). For example, spilt-screen techniques have been used
to help patients tolerate memory work by projecting onto one screen in-
ner resources that reassure the patient, while the traumatic scene ap-
pears on the other (Spiegel & Spiegel, 1978). The patient switches his
focus as needed to tolerate the memory. Fine (1994) described a
multiscreen approach used to ground scenes in the past, present, and fu-
ture. Kluft (1992) used a non-regressive split-screen intervention with a
patient suffering from psychogenic fugue. The man, who was socially
inexperienced and felt quite inadequate, “was asked to envision himself
as he wanted to be on one screen and as he was on the other, and to allow
the two screens to coalesce” (p. 40).
These screen techniques often involve the use of visualized remote
controls for purposes of titration. Functions include speeding and slow-
ing the action, freezing and reversing the film, zooming in and panning
out, and splitting the screen (Fraser, 1993; Phillips & Frederick, 1995;
Putnam, 1989). Other means of attenuating affect include Kluft’s (1993)
“backward telescope” technique and viewing a traumatic memory from
 Sarah Y. Krakauer 47

a comfortable distance, without sound, with subdued color, and through

special binoculars (Phillips & Frederick, 1995).
Underlying the TPF technique are the assumptions that the client will
benefit from sympathetic portrayals of her ego-states’ efforts and inten-
tions, and that once she understands, for example, that attempts to
intimidate serve the deeper purpose of avoiding vulnerability and vic-
timization, members of the internal system will work collaboratively to
achieve their deeper goals. This approach is grounded in Ego-State
Therapy (Watkins & Watkins, 1976; Watkins, 1976). The Watkinses
were early advocates of the view that “every alter or dissociated state
was created to protect the patient” (Watkins, 1992, p. 174), and that
ego-states should be given the “choice of continuing . . . new behavior
[explored in therapy] or returning to old familiar patterns” (Watkins &
Watkins, 1996, p. 444). Similarly, Schwartz’s Internal Family Systems
Therapy (IFST) model emphasizes the Self’s ability to relieve the parts
of their burdens and associated extreme, polarized roles, and free them
to discover preferred, constructive roles (Schwartz, 1995). Just as the
screen techniques inform the structure of the TPF, Ego-State Therapy,
IFST, and other approaches promoting intrasystemic empathy and
cooperation (e.g., Fine, 1994) inform the content.
Fraser’s Dissociative Table Technique (1991, 1993, 2003) is an ele-
gant array of integrated interventions using a table, screen, and stage.
Fraser uses film clips so that ego-states can share memories with each
other (Fraser, 2003). While none of Fraser’s interventions is analogous
to the TPF, his thoroughness in providing verbatim suggestions demon-
strates some basic similarities between the Collective Heart model and
the Dissociative Table Technique. The internal visualized structures are
quite similar, as is the use of inner guidance in his earlier formulations
of the model (Fraser, 1991, 1993), the use of remote controls by each
ego-state, the avoidance of amnesia post-session, the understanding that
ego-states appear inside as they experience themselves, and the focus
on empowerment and mastery. A major difference between the two
models relates to the role of the therapist. Fraser contrasted his approach
with Caul’s Internal Group Therapy (Caul, 1984), explicitly stating that
he wanted to maintain some control over who spoke during internal
conferences (Fraser, 1993). Similarly, Fraser (1991) takes a more active
role than I do, contacting the Center-Ego State himself, and directing
the client with such statements as “I would like you to now go to the ta-
ble” (Fraser, 2003, p. 18) and “we are now going to watch an event”
(Fraser, 2003, p. 20). He also emphasizes his own relationships with the
ego-states, introducing a Mediator Technique so that the presenting
48 JOURNAL OF TRAUMA & DISSOCIATION

personality can facilitate conversation between a reluctant ego-state and

himself, with the result that soon “the reluctant ego state [generally] be-
gins bypassing the presenting personality and we end up no longer
needing the mediator and suddenly are speaking directly to each other”
(Fraser, 2003, p. 18). In contrast, I regard the client’s internal relation-
ships as primary; my relationships with the ego-states are essentially in
the service of intrasystemic understanding. Fraser (2003) discussed
monitoring what is being shown and the emotional state of the ego-state
sharing the memory to avoid revivification, while I suggest that the IW
present what the client is currently ready to see, and encourage each
ego-state to use the dials as needed, obviating my need for monitoring.
Another difference between these models is that I suggest a dial on the
remote control so that the client has a continuous range for titration/
amplification of affective/somatic experience, whereas Fraser tells his
clients “If the scene becomes too difficult, just press the stop button”
(Fraser, 1991, p. 209). Overall, however, the Collective Heart model
embodies the spirit of Fraser’s valuable, innovative model.
While space doesn’t permit individual comparisons with the work of
each contributor to the literature, general discussion of commonalities
and distinctive features of the TPF technique is appropriate. The TPF
utilizes the basic visualized apparatus described in previous contribu-
tions: a screen on which various scenes are projected and a means of
titration for the client, utilized in a trance state. Common to these ap-
proaches is the assumption that visual and auditory information can be
transmitted from the unconscious mind to the conscious mind, whether
or not this is stated explicitly, and that visualized means of attenuat-
ing affect will enhance tolerance of stimuli and cooperation with the
intervention.
Several features distinguish the TPF from previous contributions.
One is the reliance on the client’s IW. Many formulations of inner guid-
ance have been offered (see review in Comstock, 1991b), including
Winnicott’s (1956) “true self,” Jung’s (1959) “inner wisdom,”
Assagioli’s (1965) “Higher Self,” Allison’s (1974) “Inner Self Helper”
(ISH), Comstock’s (1987) “Center” and “Center Ego State” (Comstock,
1991b), Watkins and Watkins’ (1988) “inner wisdom,” Fraser’s (1991)
“Center-Ego (Inner Self Helper)” and “Center Ego-State” (Fraser,
2003), and Frederick and McNeal’s (1993) “Inner Strength.” While
these concepts have much in common with the concept of IW, a signifi-
cant procedural difference exists. To my knowledge, only in the Collec-
tive Heart model is inner guidance accessed exclusively by the client
himself. Although the TPF is not the only method by which the client
 Sarah Y. Krakauer 49

obtains inner guidance within the Collective Heart model, it is typical in

that the therapist makes a suggestion which the client accepts, declines,
or modifies, and may then proceed with the intervention independently.
In addition, the TPF may be the only screen technique in which the
mechanism is explicitly attributed to a source of inner guidance. How-
ever, it would be difficult to make this determination because insuffi-
cient detail is often provided when screen methods are described.
A second feature distinguishing the TPF is the minimally directive
role of the therapist, which is essentially limited to describing the tech-
nique and recommending appropriate applications. By using auto-hyp-
nosis rather than hetero-hypnosis, the client is in control of her own
trance induction. While the client views the TPF, the therapist waits and
rarely interjects anything, and then only with the client’s consent. This
contrasts with Helen Watkins’ (1993) approach: “Wherever we venture
in hypnosis, I accompany the patient so that he or she does not feel alone
or abandoned” (p. 237). With the TPF, the therapist simply recom-
mends a frame and the experience is directed by the IW with the client’s
conscious participation. Because the client obtains guidance directly
from the IW, valuable visual and somatic information, which would be
lost if the therapist consulted the client’s IW, is retained and utilized. Fi-
nally, because the client independently views and amplifies both the ha-
bitual and the novel response, the therapist avoids “usurping one of the
patient’s positions,” to borrow a phrase used by Comstock in discussing
the risks involved in therapist identification with one pole of the pa-
tient’s internal struggle (Comstock, 1991a, p. 29). Of the models previ-
ously mentioned, Schwartz’s IFST is most similar to this approach in
terms of the minimally directive role of the therapist. Phillips and
Frederick’s (1995) approach is also quite similar in that they empha-
sized the value of client mastery in early experiences with hypnosis and
advocated “a cooperative endeavor [in which] control of the trance is in
the hands of the subject, who may accept, reject, or modify any
suggestions from the therapist” (p. 25).
A third distinctive feature of the TPF is the temporal focus. As men-
tioned previously, screen techniques appearing in the literature have
typically been used in the recovery and integration of traumatic memo-
ries, in anticipating fusion, and in achieving fusion. In these applica-
tions, the temporal focus is remote past, remote future, and immediate
future/present, respectively. By contrast, present and future are empha-
sized in the TPF from the outset. Only the proximate past is represented
in the first of the two films, depicting the client’s habitual response, with
50 JOURNAL OF TRAUMA & DISSOCIATION

proximate future or distal future represented in the second. TPFs do not

address traumatic memories until the second phase of therapy.
Another distinctive feature of the TPF is the use of sequential rather
than simultaneous presentations of the contrasting scenes. To my
knowledge, all published split-screen techniques involve simultaneous
presentation. Although the TPF incorporates the basic notion underly-
ing the split-screen technique, sequential viewing may offer additional
support to clients who would like to temporarily immerse themselves in
each of two options in order to make an informed choice. The opportu-
nity to repeatedly rewind and replay segments of the films introduces
one of the advantages of simultaneous presentation, that is, the ability to
vacillate between the two.
Finally, the TPF approach is distinguished by amplification as the
predominant function of the dial on the visualized remote control. When
the purpose of a screen intervention is recovering and metabolizing
traumatic memories, as is true in much of the hypnotic literature, de-
creasing affective and somatic reactivity is the primary function of the
titration device. With the TPF, however, the purpose is to help the client
discover what she would like to experience and what perceptions and
behaviors maximize the probability that she will succeed. Because the
emphasis is on optimal experience rather than feared experience, the
predominant function of the dial is the amplification of sensations and
emotions, which significantly enhances the potency of the TPF. Consis-
tent with the focus of body-oriented approaches, as well as research
supporting the key role of emotion in reasoning and decision-making
(Damasio, 1999), this approach relies on the embodied sensory experi-
ence of the client as an essential complement to intellectual and verbal
exploration in the resolution of post-traumatic symptomatology.

CLINICAL ILLUSTRATION

Pat (a pseudonym) is a married, middle-aged woman receiving treat-

ment for DDNOS with distinct ego-states. She does not have children
or work outside the home. She reports childhood sexual abuse by a
stranger and chronic emotional abuse by her mother, and experiences
a large system of ego-states. Her husband is quite supportive of her
therapy and healing process.
Pat reported that because her mother squelched her childhood inter-
ests and aspirations, Pat lacks a sense of purpose and capacity for enjoy-
ment, and fears that there is nothing to her. In an effort to distinguish
 Sarah Y. Krakauer 51

herself from her harshly judgmental mother, she became a “good lis-
tener” and developed the pattern of feigning interest in people long after
her genuine interest had waned. This tendency, combined with her
avoidance of self-disclosure, results in unrewarding relationships that
take a tremendous toll on her, causing her to further isolate herself,
thereby compounding her difficulties.
Pat, who has used the TPF technique earlier in her therapy, describes
her interpersonal pattern:

Pat: My attention span is really little. . . . For a little while . . . it’s

real. Then it stops and everything that follows is . . . a lie. . . . And
when it’s over and . . . I’m by myself, it takes me a while to pull
back, to be me, to be in that comfortable place . . . where I feel the
safest.

Therapist: When you’re ready to explore alternatives, I have a

suggestion for you.

Pat: I’m afraid of alternatives, but I’ll listen.

Therapist: What I was going to suggest–and this isn’t necessarily

for today–your inner wisdom could send you a two-part film, and
the first part could be a typical interaction where this kind of thing
takes place and you could see [your typical response], and the af-
termath. . . . The second one could be the exact same situation. . . . ,
but your inner wisdom could show you an alternative, so that you
wouldn’t follow the same pattern that has turned out not to be help-
ful for you in the long run. Then you could go back and watch them
with the dials turned up . . . so you could really feel what that alter-
native experience would be, both when you’re with the other per-
son, and afterwards. You can consider whether you’d like to do
this today or just file it away as a future possibility.

Pat (closing her eyes): I can already see what’s happening. [In the
first film] I see the person and they can’t tell that I’ve crossed into
this other place . . . [where] I’m phony, because the exterior does-
n’t change: It goes from being interested and being there with the
person, to being there externally and partially there internally. And
when I’m in that place, all this energy is being pulled away
through the bottom of my feet, it’s being sucked away, and I’m
using all my energy to stay there, to not let the person know that
52 JOURNAL OF TRAUMA & DISSOCIATION

I’m being drained. And it takes me so long after to recover because

it’s harder for the energy to return than . . . to be taken away. And
the more people that there are, the more energy is being pulled
away, and it can’t be filled because there’s always something
sucking it away. Now I’m watching the other video. . . .The begin-
ning is the same. [Then it’s] divided and I see two different mov-
ies. In the first one, I see that I’m not listening anymore, that I’m
blocking it out . . . by doing that, it’s still pulling the energy out of
me. . . . I see that when I’m at the point where I’m losing my con-
nection with the person, that I’m ending our time together. It’s al-
most like there’s another movie behind that movie [in which] I’m
still with the person and we’re changing what we’re doing [chang-
ing the focus of our conversation]. And it can go on for so long,
and then I can end the contact with the person. . . . So there are two
choices: to spend less time and have it be–the word isn’t “enjoy-
able.” What’s the word? “Comfortable?” “Fulfilling?” And if I re-
ally want to spend more time with the person or if I know I need to
spend more time, I can change what we’re doing. . . . I’m being
told I know there are times when you [don’t have to stay, and at
these times] when the inside of me doesn’t want to be there, what-
ever the reasons are, then all I have to say is “I need to be on my
way,” “I need to go now,” “It was good to see you.” Because for
those moments it was good and that’s not a lie, and I can be on my
way. If I continue past a point, then I start losing myself and I start
drifting on the inside, I’ve been depleted. I need a lot of alone time.
I always have. That’s the one thing I have in common with my
mother. . . . I guess . . . I felt it’s been a negative to say that I need it,
because society wants you to think you’re wrong if you’re not so-
cial and with people and doing things all the time. I think for the
first time, I’m beginning to truly accept that it really is okay, that it
is normal for me. (Tears fill her eyes.) I see myself . . . in my house
doing things that . . . help me feel good . . . , free, that I’m creating
something, that I’m making something and it’s mine. I’m doing it
and I don’t have people telling me that it’s wrong. I’m having fun,
I’m enjoying it. I feel free, and I love it. And I can see [my hus-
band] and he feels lighter . . . because he’s not worried about me as
much. It shows in his body and his face and in how he moves and
how he carries himself. And he’s laughing more. . . . He doesn’t
see the sadness. When he sees me, he sees the love coming from
me that he hasn’t seen for a long time. Oh! The house even looks
lighter. There isn’t all the clutter. . . . It’s been put in its proper
 Sarah Y. Krakauer 53

place or it’s been discarded. And it even smells cleaner. Because

there isn’t so much darkness weighing everything down. It’s freer.
(She takes a deep breath.) I’m moving easier. I’m not bogged
down, I’m not chained down. My arms and hands are free. My legs
and feet are free. I still get a tightness in my chest, and I get scared
because I’m afraid of where I may go [emotionally]. And I’m told
that when I feel that, it’s time for me to back away and say “What
do you need to change? What’s getting in the way?” The answers
are always there. The answers have always been there. And if I can
give myself enough space–I don’t know if that’s the right word. If
I can give myself enough–oh, what’s the word? It’s not “love,” it’s
not “compassion.” “Freedom?”

Therapist: You might try using a sentence or two to express it.

Pat: That if I’m aware that it’s beginning to happen, then I can put
myself in a safe place where I can find out why it’s happening, be-
cause there could be very real reasons why it is. And once I learn
why it’s happening . . . then I can decide what choices I have and
what I need to do. . . . It’s all about listening. . . . to ourselves and
who we are. . . . We’ve always had the answers. . . . We think we
have to search for them, like a treasure hunt. When all we have to
do is say “I’m here, right now, and I am listening. What is it that I
need to hear, . . . to learn?” And we need to breathe and to clear the
mind so that we can hear those quiet words of wisdom that are
there for us to hear, and to not be afraid because we can always say
“no, not today, maybe another day, but not today.”

DISCUSSION

This illustration was selected for several reasons. Pat is somewhat

atypical in that she describes her autohypnotic experiences as they oc-
cur and consents to videotaping her sessions, so it was possible to cap-
ture the rich detail of her experience in a transcription.
This vignette exemplifies the TPF in some ways, and is uncharacter-
istic in others. The very fact that the therapist is minimally directive and
the IW is credited with film content means that most TPF experiences
will have idiosyncratic features and few clinical illustrations will be
prototypical. Characteristic of this approach is the manner in which the
TPF was suggested: In response to the concerns Pat was presenting,
54 JOURNAL OF TRAUMA & DISSOCIATION

without expectation that it would be accepted, and in a way that implied

that an alternative response to the problematic situation would be made
available, but without reference to any specific content. This latter point
is essential if the intervention is to be credible and maximally empower-
ing to the client. Also characteristic is the here-and-now focus: The TPF
addresses a current, non-traumatic situation. It’s typical, as well, in that
the first film, while portraying a familiar experience, provides new sen-
sory information that heightens the client’s awareness of her habitual
pattern. In this case, Pat can feel the energy being sucked out through
her feet, with additional energy loss as she tries to hide her reactions
from the other person, and the restoration process being lengthier than
the depletion. The first film sets the stage for the second because the
problem is identified precisely, and in a way that rings true to the client.
This illustration is also characteristic of the intervention in that the solu-
tions offered in the second film are ones that are within reach of the cli-
ent. For example, the second film doesn’t depict Pat self-disclosing,
presumably because she’s not yet ready to take that step. Characteristic,
too, is the guidance to accept and honor her own needs, with the clear
implication that she needn’t choose between hurting others and ignor-
ing or betraying herself. This guidance supports the claim made earlier
in the paper regarding the value of the TPF in addressing developmental
deficits. In this case, the guidance challenges the client’s black-and-
white thinking about being like/unlike her mother, her ability to sustain
genuine interest in others reflecting failure on her part, etc. Also typical
are Pat’s statements that she’s “being told” something while inside. It’s
not unusual for clients to receive verbal guidance from the IW either
during the film or afterwards, while in a state of enhanced receptivity.
Note, too, that in this receptive state Pat is able to accept her introver-
sion for the first time. Overall, this vignette reflects the “hands-off”
therapeutic style (to quote the IW of another client) characteristic of the
Collective Heart model. However, as Nijenhuis observed, the therapist
still plays a vital role by stating that the patient has the ability to engage
in these “new mental and behavioral actions” (personal communication,
May 14, 2005).
This illustration is also idiosyncratic in several ways. Perhaps the most
obvious is that the last part of the second film has two variations, with one
screen appearing behind the other to reveal a second alternative to the
habitual response. Unexpected elements such as this demonstrate to the
client her IW’s initiative, creativity, and power. The elaboration after the
TPF proper is also somewhat atypical: The IW takes the initiative to show
Pat how changing her interpersonal behavior will, in turn, impact her
 Sarah Y. Krakauer 55

energy level and self-esteem; enhance her capacity to engage in creative

pursuits; further affect her emotional state, her husband’s emotional state,
the home atmosphere; and ultimately, increase her ability to give and re-
ceive love and experience well-being. While this portrayal of long-term
benefits of interdicting the maladaptive pattern is unusually well-articu-
lated, the experiential benefits of the TPF (amplified via the dial) are gen-
erally quite compelling. Discovery of new behavioral options that lead to
greater stability and well-being is at the heart of the first phase of treat-
ment, and becomes a foundation for the entire therapy process.

CONCLUSION

While incorporating many valuable features of screen techniques de-

scribed in the hypnotic literature, there are several distinctive features
of the TPF that may be regarded as unique strengths. These include the
minimally directive role of the therapist, focus on concrete ways in
which behaviors and cognitions can be altered in the here-and-now on
the basis of inner guidance, and amplification of the somatic and affec-
tive consequences of various behavior so that the client can meaning-
fully compare options.
As long as traumatized clients continue to experience post-traumatic
symptoms, they believe they lack the power to achieve mastery and im-
prove their lives. The TPF holds promise for altering this belief by dem-
onstrating in a variety of contexts that clients have the ability to
independently determine the extent to which their current patterns serve
their deeper purposes, and what alternatives are already available within
their own unconscious minds.

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RECEIVED: 07/07/05
REVISED: 10/14/05
ACCEPTED: 10/15/05