Intervening early, without making people tell everything

This is precisely the central idea developed by Stéphanie Khalfa in this interview. We cannot prevent every traumatic event from happening, but we can intervene very early to limit its effects. And that early intervention does not necessarily consist in having the person recount in detail what happened. On the contrary, reliving the event too soon can sometimes worsen the distress. The stakes lie elsewhere: helping the person to quickly regain a minimum of inner safety, stability and appeasement.

The MOSAIC group emergency protocol was designed along these lines. It is a structured intervention framework, in nine steps, ideally to be used within 24 to 48 hours of a potentially traumatogenic event. Its originality is to go through the body, through sensations, through co-regulation and through connection, rather than through a detailed account of the trauma.

From framing to resources

In practice, the protocol begins with a time of framing and psychoeducation. It is recalled that fear reactions are automatic, extremely fast, and that they are not a matter of voluntary choice. Fleeing, freezing or fighting are not considered decisions: they are survival responses. This clarification is fundamental, because it immediately reduces the shame, the guilt and the bewilderment that many people feel after a shock.

The work then turns towards resources. Participants are invited to call to mind a person, an animal or a supportive figure who matters to them. Next comes a time of co-regulation, notably through paired breathing, in order to help the nervous system return to a more stable state. The protocol also introduces alternating bilateral stimulation, then used to reinforce desired internal sensations such as safety, solidity, release or warmth.

Shifting the question

One of the most interesting points of this approach is that shift of focus: the first question asked is not “What happened?”, but rather:

• What are you feeling right now?
• What would you need to feel in your body in order to be a little better?

This logic profoundly changes the intervention. It makes possible an action that is quick, containing and respectful of each person’s pace, including in a group setting.

The protocol goes further still by helping people to associate these restorative sensations with an image and then with a word. This reinforces what was experienced as a resource during the session, and gives participants a concrete support to use again at home afterwards.

After the session: what to stay attentive to

The closing debrief insists, moreover, on the need to continue these exercises in the following days, while staying attentive to certain signs:

• re-experiencing;
• sleep disturbances;
• hypervigilance;
• irritability;
• avoidance;
• a feeling of strangeness.

If these symptoms persist, a referral to a professional trained in psychological trauma becomes necessary.

What this interview shows well is that after a trauma, the urgent thing is not to say everything. The urgent thing is often to regain a little grounding, safety and connection. And in that process, social support is not a mere “extra”: it is part of the therapeutic response itself.

More information about MOSAIC therapy

The full interview — in French — can be watched below.