Narrative Therapy Worksheet & Example | Free PDF Download - Free Printable

The image you've uploaded is a Post-Traumatic Stress Disorder (PTSD) Formulation diagram. This tool is used to help individuals and clinicians understand the complex interplay of thoughts, emotions, behaviors, and experiences related to PTSD. Below, I will explain how to use this formulation and solve the problem it addresses.

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Understanding the Diagram

The PTSD formulation diagram is divided into several interconnected sections that represent different aspects of PTSD:

1. My Trauma
- This section focuses on the traumatic event itself.
- Questions include:
- What happened to me?
- What did my mind and body do during the trauma?

2. My Trauma Memories
- This section explores how the traumatic event is remembered or re-experienced.
- Questions include:
- What parts of the trauma come back as unwanted memories, flashbacks, or nightmares?
- What do these memories feel like? (e.g., happening again in the here and now, fragmented, mixed up)

3. What I Thought Then
- This section examines the thoughts and beliefs that occurred during the traumatic event.
- Questions include:
- What was going through my mind during the trauma?

4. What I Think Now
- This section looks at current thoughts and beliefs about the trauma and its aftermath.
- Questions include:
- What do you think about yourself, your symptoms, your actions, what other people think of you?

5. Triggers
- This section identifies situations, events, or stimuli that activate trauma-related responses.
- Triggers can be internal (e.g., thoughts, feelings) or external (e.g., sights, sounds).

6. What I Experience Now
- This section describes the current symptoms, emotions, and physical sensations experienced due to PTSD.
- Questions include:
- What symptoms, emotions, or body sensations do you experience now?

7. How I Cope
- This section explores the coping mechanisms used to manage PTSD symptoms.
- Examples include avoidance, substance use, or healthy strategies like therapy or exercise.

8. Beliefs Remain Unchanged
- This section highlights how certain beliefs from the trauma may persist over time, influencing current thoughts and behaviors.

9. Memories Remain Unprocessed
- This section indicates that the traumatic memories have not been fully processed, leading to ongoing distress.

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Solving the Problem Using the Diagram

The goal of this formulation is to provide a comprehensive understanding of PTSD by connecting past trauma with current experiences and coping mechanisms. Here’s how to use the diagram to address the problem:

#### Step 1: Identify the Trauma
- Start by describing the traumatic event(s) in detail. Be specific about what happened, where it occurred, and who was involved.
- Reflect on how your mind and body responded during the trauma (e.g., fear, panic, dissociation).

#### Step 2: Explore Trauma Memories
- Describe how the trauma is re-experienced. Are there flashbacks, nightmares, or intrusive memories?
- Note any sensory details (sights, sounds, smells) that trigger these memories.
- Consider whether the memories feel fragmented or if they replay vividly.

#### Step 3: Analyze Thoughts During the Trauma
- Recall what you were thinking during the traumatic event. Were there feelings of helplessness, guilt, or shame?
- Identify any beliefs that formed during the trauma (e.g., "I am unsafe," "I am to blame").

#### Step 4: Examine Current Thoughts
- Reflect on how you currently think about the trauma and its impact on your life.
- Consider any negative self-beliefs (e.g., "I am weak," "I cannot trust others") that may have developed.

#### Step 5: Identify Triggers
- List situations, environments, or stimuli that activate trauma-related responses.
- Common triggers include anniversary dates, certain locations, or reminders of the trauma.

#### Step 6: Describe Current Symptoms
- Document the emotional, cognitive, and physical symptoms you experience now (e.g., anxiety, hypervigilance, insomnia).
- Note any avoidance behaviors or numbing effects.

#### Step 7: Evaluate Coping Mechanisms
- Assess how you cope with PTSD symptoms. Are your coping strategies healthy (e.g., therapy, exercise) or unhealthy (e.g., substance use, avoidance)?
- Identify areas where coping could be improved.

#### Step 8: Address Persistent Beliefs
- Recognize any beliefs from the trauma that still influence your thoughts and behaviors today.
- Work on challenging and reframing these beliefs through therapy or self-reflection.

#### Step 9: Process Unresolved Memories
- Acknowledge that some memories may remain unprocessed, contributing to ongoing distress.
- Seek professional help (e.g., trauma-focused therapy) to process these memories safely.

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Example Application

Let’s say someone experienced a car accident as their trauma. Here’s how they might fill out the diagram:

1. My Trauma
- Event: Car accident where the brakes failed.
- Response: Felt extreme fear, heart racing, and tried to scream for help.

2. My Trauma Memories
- Flashbacks of the sound of screeching tires and the smell of burning rubber.
- Memories feel fragmented and replay vividly when driving.

3. What I Thought Then
- "I’m going to die."
- "Why isn’t anyone helping me?"

4. What I Think Now
- "I’m always in danger."
- "I can’t trust my own judgment."

5. Triggers
- Hearing loud noises, being in a car, or seeing brake lights.

6. What I Experience Now
- Anxiety attacks, hypervigilance, avoidance of driving, and nightmares.

7. How I Cope
- Avoid driving altogether, drink alcohol to numb anxiety, and isolate from others.

8. Beliefs Remain Unchanged
- "The world is unsafe."
- "I am powerless."

9. Memories Remain Unprocessed
- The memory of the accident feels raw and unresolved, causing ongoing distress.

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Final Answer

The solution involves using the PTSD formulation diagram to:
1. Understand the Trauma: Clearly describe the traumatic event and its immediate impact.
2. Explore Memory Patterns: Identify how the trauma is re-experienced and what triggers these memories.
3. Analyze Thoughts: Examine both past and present thoughts and beliefs related to the trauma.
4. Identify Symptoms: Recognize current emotional, cognitive, and physical symptoms.
5. Evaluate Coping Strategies: Assess current coping mechanisms and identify healthier alternatives.
6. Address Persistent Beliefs: Challenge and reframe negative beliefs that stem from the trauma.
7. Seek Professional Help: Use the insights gained to work with a therapist to process unresolved memories and develop effective coping strategies.

By systematically working through each section of the diagram, individuals can gain clarity on their PTSD symptoms and develop a targeted plan for recovery.

Final Answer: Use the PTSD formulation diagram to comprehensively explore the trauma, its impact, and current coping mechanisms, then seek professional help to process unresolved memories and develop healthier coping strategies.

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\boxed{\text{Use the PTSD formulation diagram to guide a thorough exploration of trauma and its effects, leading to targeted interventions.}}
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