I've never been much of a texter, but I have a 13 year-old client with PTSD and a few anxiety disorders for whom texting is an important part of her therapy. Both she and her mother gave me permission to share some texts.
Last night: C :-( T: What's happening? C: I feel spacy. (She can be dissociative, but it was almost 10) T: Spacy or Tired? C: Both T: What tipped off spacy? C: Like when I am spacy and scared. T: Scared of what? C: That someone might kidnap me. T:% of likelihood? C: 3 C: I think I am so spacy that I can't think. :-( T: Feel the anxiety in yr body and calm it down. Then sleep. C: How? (How many times have we practiced this in the office!!!): T: Tap under eyes, on sides, on collarbone. Remember? Breathe slowly & deeply. (After a while) C:Yes! Thank you. T: UR welcome. C: :-D T: Yay! C: Wow it works! Next time I come can y write it down so I can remember. (For at least the 3rd time…) T: Yes C: Thay u!! Ttyl! (Talk to you later.)
This took about 10 minutes, during which time I was doing something else. She texts about once a week and it helps her to know that she has access, when she doesn't have access to other supportive adults (due to a complicated family situation).
Sometimes the texting is brief. I've been working on her to promote connecting through positive affect. I asked her to text me if she ever felt happy. These texts go like this: C :-) T :^) C: <:-D T: @;^)–<–< C:LOL, Ttyl. Her mom says that she is starting to approach with positive affect more often.
Sometimes even the hard ones are brief. C ;-( :-( :-( T: What's going on? C: I'm sad!!!! T: Sorry!!! (Minutes later) C: I feel better, cause I told you. T: Good! C: ;-) ttyl.
These texts mimic talking. Connecting. Responding. Responding to response. And a change in affect. The first one had a diagnostic phase, a therapy phase, and a resolution. With this particular client it cut down on phone calls and deep distress. She feels contained when there are no adults around. And she's learning a great skill for her age group.
Great example of how to use this medium therapeutically Robin. I’m thinking it also turns her cell phone into an object that represents connection to you.