Psychodynamic Imaginative Trauma Therapy, PITT

Domain I · Psychodynamic & depth psychology · Luise Reddemann · 1985 · Bielefeld

What it is

PITT was developed by the psychoanalyst Luise Reddemann and her team at the Bielefeld clinic for psychotherapeutic and psychosomatic medicine (1985–2003). It is a psychodynamic, resource- and resilience-oriented treatment for complex trauma sequelae, mainly after severe early attachment and…

Format

• Format: individual sessions, face to face, therapist active and transparent.
• Format: individual sessions, groups, or inpatient programmes (ch. 4.10, ch. 10). Exercises are practised in session and then daily at home.

Who practises it, and how they are trained or regulated

• Goals: psychoeducation; affect differentiation, regulation and tolerance; distancing from intrusions; self-soothing; external safety; boundaries; everyday functioning; caring for injured child parts; reducing the power of perpetrator introjects.
• PITT was developed by the psychoanalyst Luise Reddemann and her team at the Bielefeld clinic for psychotherapeutic and psychosomatic medicine (1985–2003). It is a psychodynamic, resource- and resilience-oriented treatment for complex trauma sequelae, mainly after severe early attachment and relational trauma. Its core idea of change: the patient first learns to regulate, soothe and distance herself using her own…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Imposing the therapist's worldview.
• Impulsive sending; flooding. Contain with the Tresor.
• Complexity that confuses. Keep it as simple as possible.
• Rituals imposed by the therapist. The patient owns them.
• Premature reassurance that dismisses the guilt feelings.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.