Case Study

Rediscovering Happiness

The Use of Positive Childhood Triggers in Psychotherapy

Magazine Issue
May/June 2015
Rediscovering Happiness

I’ll give you three months,” Rosemary announced, shaking my hand and plunking herself down on the couch. “I’ve done therapy before, and I don’t want to go digging around into childhood stuff or anything like that.”

Ugh, I cringed inwardly. It wasn’t exactly what I wanted to hear at the onset of my first session with a new client. She’d set the timer for tangible, lasting results, and the clock was ticking. I knew I wouldn’t have the luxury of gradually letting therapy unfold, and I’d already seen the shortcomings of many of the techniques out there for effecting the quick change she demanded. I’d regularly used gratitude journals, appreciation letters, yoga, and meditation to jump-start therapy, but I knew that these techniques, in themselves, often had limited effects.

My experience as a therapist had shown me many times over that if you really want to help people open a doorway to a different way in life, therapy needs to give them powerful experiences—positive ones. Low-energy encounters with a therapist just don’t make enough of an impact to create real change. So I’d even gone so far as to create retreats where people could swim with wild dolphins, pet whales, and firewalk. These were certainly powerful experiences, but they didn’t have the staying power I was looking for.

Then I saw a picture that captured the experiential intensity that can make a real difference in people’s lives. It showed a group of boys playing soccer on a pile of rubble in the wake of the 2004 tsunami. The joy on their faces was undeniable. It felt like their beaming expressions were screaming at me, “We all know how to be happy, no matter what. It’s encoded in our very being.” Of course, it didn’t mean these boys wouldn’t cry themselves to sleep that night, and it certainly didn’t minimize their trauma in any way, but it underscored the power of the hope and openheartedness that’s embedded in childhood. As a result, I developed ways of helping clients access intense memories of positive childhood experiences that could jump-start the therapy process. And I decided that the most powerful and effective way to get therapy with Rosemary off on the right note was to help her access her version of that beaming-boy-playing-soccer energy.

Gone Too Fast

Rosemary had made the call to my office for a session at her husband’s prodding because she’d lost interest in sex, but she confided that a lot more than just sex didn’t interest her anymore. She felt increasingly that her life had no meaning.

“All I do is take care of other people, and I’m tired and worn down,” she told me. “I used to be passionate about so many things, but now I feel as if I’m just going through the motions.”

In our initial phone conversation, Rosemary had casually mentioned that she’d been beaten by her mother, adding, “But that was just how you did it in those days.” She’d also said that two of her older cousins had sexually abused her for years. But Rosemary insisted she didn’t want to talk about “that.” In the past, she’d “fallen apart” when her therapist had encouraged her to work on her childhood abuse. “I can’t go there again,” she said.

She was clearly ambivalent about being in therapy and was sitting in my office only to appease her husband. I knew that if I didn’t find a way to get her solidly hooked, I could easily lose her.

vRosemary began by talking about her weight and her inability to control her bingeing. She knew she was using food to calm her anxiety and mask her depression, and she hated herself for it. I offered guided meditation as a way to help with her anxiety, but she was worried that she wouldn’t be able to do it right. When I assured her there was no right or wrong way to meditate, she reluctantly agreed to try it.

Great, I thought, and asked her to close her eyes. “Let yourself take a deep breath into your whole body,” I instructed. “Imagine that every single one of your trillions of cells is breathing in relaxation and then breathing out any tension—just letting it go. And again, breathing in relaxation and breathing out any tension. Relax your face, all the muscles you use to express your personality. Your mind is relaxing.” Rosemary’s body began to loosen visibly.

“Imagine you’re drifting on a cloud, weightless, not a care in the world,” I continued. “Now take a journey back in time, back to a time in childhood when you felt happy and alive in your body.” That’s when Rosemary’s body visibly tensed. Her breathing quickened. Her fists clenched. Her eyes flew open. Disaster!

“I’m sorry, I went too fast with that,” I said, backpedaling as fast as I could. “I wanted to help you access a really strong positive childhood memory, one that would give you a real taste of happiness. It’s a lot easier to work toward something than it is to work just from the negative side of something. But I should’ve been more careful.”

She was understandably angry with me, as she’d immediately seen a flash of an abuse memory with one of her cousins. “I trusted you,” she admonished in an accusatory tone.

Afterward, we had a fruitful conversation about the fact that I’d left her out of the therapeutic process. We talked about the need for her to be able to control the pacing of the work she did, especially around any childhood trauma issues. Still, I worried that she wouldn’t return for her next session.

To my surprise, Rosemary walked into my office the following week armed with research on the benefits of meditation. She wanted to try it again, “without any of that childhood-memory stuff.” Increasingly, we wove guided meditation into her sessions, and she began to reap benefits from it. But even though she reported feeling calmer and more clearheaded, I sensed we were just scratching the surface. I knew that to help her expand her sense of possibility and capacity for pleasure, I needed to help her deepen her sense of fully felt happiness. The breadth and depth of our work would be exponentially increased if I could help her raise her expectations for what was possible in therapy.

Many therapists often overlook this piece, but I’ve found it to be a powerful motivational component. Once clients have had a taste of the level of happiness that’s still possible for them, they begin to work toward something (happiness), as opposed to just trying to get rid of negative feelings.

With this in mind, I broached the subject of tapping into a positive childhood memory again, reminding her of the healing potential these happy snapshots could have for her and what a dramatic effect they could have on her life. I explained that I suspected it’d been too long since she’d felt the kind of fun and freedom she must’ve felt as a child, at least at times. Even in the midst of a childhood of abuse, I told her, there are nevertheless powerful moments of joy. When I described the picture of the boys playing soccer the day after the tsunami, she agreed to try accessing them again.

Given her earlier experience of triggering an abuse memory, I was careful to move more cautiously into Rosemary’s internal landscape. “You’re the driver of this experience, Rosemary. I’m just making suggestions,” I said, “so if there’s someplace that doesn’t feel right to you, just let me know and we’ll redirect.”

While she was in a state of deep relaxation, I suggested that Rosemary could contain any negative memories that came up by visualizing putting them in a trunk with a strong lock and key, with the understanding that we’d come back to them in time, when she felt ready to deal with them. We agreed that even though she was in a trancelike state, she could continue to talk to me, letting me know what she was experiencing as we went.

I could see that Rosemary was relaxed. She was breathing deeply. “I see some trees,” she said softly.

“Great. How does that feel?” I asked her.

“Good. Kind of calm.”

“Great. So just move into that experience,” I instructed.

“It’s kind of foggy.”

“That’s fine. Just allow yourself to be with those trees and see what happens.”

“I think I’m with some friends,” she whispered.

“Just see yourself there with your friends.”

“It’s my two best friends, Liz and Jason.”

“About how old are you?”

“Maybe 10 or 11. We’re playing by the creek. This is where we used to cannonball into the water.”

“Great,” I said. “Just allow your experience to flow.”

“We’re swinging on a rope.”

“Let yourself be with that. Really dive into it,” I suggested, asking her to step back into that 10- or 11-year-old body, to smell the air around her and feel it on her skin. I asked her to feel the rope in her hands, to feel the water when she hit it.

Once she was fully engaged in the memory, I asked her how strongly she was experiencing the memory on a scale of 1 to 10. She said she was at a 3. I asked her to see if she could turn up the volume. As she did, I watched her face become increasingly animated even though her eyes were still closed. The corners of her mouth slowly broke into a smile, and a light filled her face. It was like watching the sun rise across her features. Gradually she reached an 8.

“I feel it! I feel it like it’s happening now,” Rosemary beamed. “I mean, I really feel it!”

She stayed with the memory, fully relishing it. When it was time to finish, I asked her to notice her body, to feel the energy in every cell of her being, and to let the memory fade while still maintaining the feeling state. Rosemary’s face was radiant as she opened her eyes, returning fully to the room. “I haven’t felt that alive in years!” she exclaimed.

This session was the turning point of Rosemary’s treatment. She’d tasted something she didn’t know she wanted, something she thought she was beyond feeling. She was now a woman on a mission to infuse that aliveness and vibrancy into as much of her present life as she could. I asked Rosemary to include this memory of childhood joy in her daily meditation and to come back to it as often as possible, even if only for several moments, throughout her day. We talked about her using this memory as a way of peppering little doses of happiness into her life. In time, this peppering would add up and begin to put her progress on a fast track.

In the following weeks, we found other positive childhood memories Rosemary could use. We found that she could anchor some of these memories by replicating the physical motions of some of her childhood activities, creating shortcuts—or portals—to certain felt states. Her portals included sitting on a high stool and swinging her legs back and forth (this became a particularly powerful portal when it was coupled with a Beatles song she’d played over and over with her friends), the smell of crayons, and hopscotching. She intentionally incorporated these sensations into her repertoire.

Rosemary’s regular use of these kinds of childhood triggers created an immediate increase in her positive feelings, even if only for a few minutes. As these few minutes began to add up, she became more active in seeking them out and less willing to stay bogged down in negative emotional states. She experienced increasing facility in accessing positive feeling states and working through psychological issues she’d previously avoided, including the effects of her early trauma.

In my work with Rosemary, I used many modalities and techniques: Gestalt therapy, EMDR, trance work, inner-child work, yoga, and journaling. However, the use of positive childhood memories became the cornerstone of our work and formed the container for her trauma work. These positive visceral childhood memories raised the bar for Rosemary’s treatment outcome as the strong pleasurable emotion they evoked increasingly became the goal of her therapy.

She began clearing out anything that stood in her way of feeling that kind of aliveness and vitality as often as she could. In that way, helping clients directly taste the kind of spontaneity, freedom, and untethered happiness that’s often left behind in early childhood, while not in itself offering an instant cure, can become a powerful beacon illuminating the path toward healing.

Case Commentary

By Janina Fisher

Rosemary’s initial caveat with her new therapist—“I don’t want to go digging around into childhood stuff”—speaks to what many clients have come to expect: therapy is a place for digging up the painful past and reexperiencing childhood wounds. In fact, most of us were trained as young therapists to believe that in the consulting room, displays of joy and pleasure are often an emotional defense and an expression of “inappropriate affect,” while immersion in painful negative emotions is a prerequisite for lasting therapeutic change. So it’s no wonder Rosemary set her timer for three months! If she was going to endure reliving her traumatic childhood, she’d at least keep it brief.

Sinozich’s problem with Rosemary’s deadline comes from a different perspective: she wanted time to “let therapy unfold,” but not to focus on the dark places in her client’s past. As she puts it, “If you really want to help people open a doorway to a different way in life, therapy needs to give [them] powerful experiences—positive ones.”

This viewpoint reflects the growing sea change in the field that began with the positive psychology movement and has gained momentum with the growing influence of brain science and mindfulness practices in clinical thinking. Dan Siegel’s interpersonal neurobiology has introduced a new model of integrated psychological functioning focused not on childhood pain, but on increasing well-being and self-compassion. In mindfulness, nonjudgmental interest is cultivated in all emotional and physical states, pleasurable and distressing. Rick Hanson, in his work on the negativity bias, has emphasized the importance of paying special attention to positive feelings, body sensations, images, and memories in helping clients learn to experience well-being.

This is a perspective that Sinozich clearly shares. But for clients with histories of trauma and attachment failure, experiencing positive feelings often triggers intense fear. For them, it’s dangerous let go of their vigilance to feel happy, or even to relax. Thus, with Rosemary, Sinozich takes a risk by asking her to recall a positive moment from early childhood. Given that the negativity bias increases the odds that strong feelings of fear or shame will also emerge, trying to help clients connect to a place that felt safe or good in childhood is often a risky therapeutic tactic. In my own practice, I’ve found that the same therapeutic goal can be achieved with less risk by helping clients access more recent positive memories:

“Just allow your mind to float back to one moment in your adult life when you’ve felt good or maybe even safe,” I often suggest. With clients whose negativity bias interferes with retrieval of positive memories, I might have to be more concrete by saying, “Remember back to when your daughter was born, or to the day you brought your dog home as a little puppy. Let’s go back to that moment—that second—that you first felt the warmth of that tiny body. Can you feel it now?”

Even the connection to a single recent experience or an imagined moment can be enough to activate neural networks holding feelings of warmth, calm, pleasure, even excitement, without delving deeply into a client’s history. Once clients like Rosemary feel the nourishing impact of feeling good, rather than being subject to old conditioned fear responses, they can learn to stay more fully focused on positive states, rather than to obey the brain’s primitive command to move into fight, flight, or freeze.

The emphasis on positive experiences as an antidote to trauma and emotional pain is a new one in the psychotherapy world, and we’re still learning how best to increase our clients’ capacity for positive emotion. Although I might have moved more cautiously and chosen a somewhat different approach, I share Sinozich’s strong belief in the power of helping clients enhance their capacity to feel good, no matter how much they’ve suffered.


Illustration © Sally Wern Comport

Rhegina Sinozich

Rhegina Sinozich, LCSW-C, is a psychotherapist in private practice. She’s the founder and director of and the author of Balloon to the Moon: A Guide to Vibrant Living, Plug Yourself into the Frequency of Happiness, and a series of guided meditation CDs. She’s a continuing education trainer, an international speaker, and a workshop facilitator.

Janina Fisher

Janina Fisher, PhD, is a licensed clinical psychologist and former instructor at The Trauma Center, a research and treatment center founded by Bessel van der Kolk.  Known as an expert on the treatment of trauma, Dr. Fisher has also been treating individuals, couples and families since 1980.

She is past president of the New England Society for the Treatment of Trauma and Dissociation, an EMDR International Association Credit Provider, Assistant Educational Director of the Sensorimotor Psychotherapy Institute, and a former Instructor, Harvard Medical School.  Dr. Fisher lectures and teaches nationally and internationally on topics related to the integration of the neurobiological research and newer trauma treatment paradigms into traditional therapeutic modalities.

She is author of the bestselling Transforming the Living Legacy of Trauma: A Workbook for Survivors and Therapists (2021), Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation (2017), and co-author with Pat Ogden of Sensorimotor Psychotherapy: Interventions for Attachment and Trauma.(2015).