Lifespan integration

1. Introduction

Version followed: Peggy Pace's Lifespan Integration (LI). Protocol names follow the current four-level curriculum of Lifespan Integration USA. Step detail comes from Pace (2012) and Thorpe (2012) as summarised by Rensch (2015), from Smith (2017), and from the official LI pages. Pace's book itself (Lifespan Integration: Connecting Ego States Through Time, 1st ed. 2003, last revised 2017) and the level manuals are not drawn on, so wording and fine detail of the scripted protocols are [uncertain].

• What it is. LI is a body-based, imagery-led trauma and attachment therapy. Pace developed it in private practice near Seattle; the key case was in 2002, the first book came out in 2003 and the first training in 2004. Its core tool is the Time Line (TL), a chronological list of memory cues from the client's own life. The therapist reads the cues aloud, repeatedly, from a starting point (a target memory, birth, or earlier) up to the present, while the client stays eyes-closed and aware of their body. [source: LI Origins page; Description for Therapists; Rensch 2015]
• How change is thought to happen (Pace's model, not established fact). Pace held that trauma and early neglect leave the self fragmented into disconnected neural networks, or 'ego states'. She believed that repeated passes through the life narrative, inside an attuned right-brain-to-right-brain relationship, integrate those networks. She also held that they prove to the body-mind that time has passed and that the event is over. LI describes this as relying on "the innate ability of the body-mind to heal itself". Pace avoided extended dialogue between parts, believing it could reinforce separation. Two aims are distinguished: clearing trauma and building self-structure (attachment repair, affect regulation, core self). [source: What is LI; Description for Therapists; Origins page]
• Not a talk therapy and not hypnosis. LI uses eyes-closed imagery and body awareness. The client stays conscious and in control throughout, and no trance induction is described. [source: Rensch 2015; Description for Therapists]

2. Framework

Two treatment tracks [source: Description for Therapists; LI USA Trainings Overview; Rejil et al. 2020; Smith 2017]

• Trauma clearing (repair protocols). Use the PTSD protocol, Timeline from Explicit Memory or the Standard protocol for discrete events, for recent trauma or for an identifiable childhood memory behind a current problem. These suit clients who were securely attached and functioned well before a single traumatic event.
• Self-structure building ('self-consolidation'). Use Baseline (and its variations), Birth, Attunement, Preverbal Attachment Repair and Cell Being. These suit early trauma or neglect, weak affect regulation, low self-esteem, insecure attachment and dissociative presentations. French LI practice runs self-consolidation protocols before repair protocols for these clients, and alternates the two across treatment. LI USA's Level Three teaches attachment theory to inform "Stage II" treatment planning. The formal stage scheme is [uncertain].

Typical course

[source: Smith 2017; Rensch 2015; Roland-Smith; Description for Therapists]

Within-session structure (Standard protocol, Pace 2012 via Rensch 2015)

• Steps 1–2 happen once: find the source memory, then discuss it briefly.
• Steps 3–7 form one repetition: re-enter the scene, take the younger self to a peaceful place, reassure, run the Time Line, then bring the younger self into the present home. After a break and check-in, the protocol loops back to step 3.
• Steps 8–9 close the session: re-check the source memory, then re-check the presenting problem.

Criteria for moving on [source: Rensch 2015; Smith 2017; Rejil et al. 2020; Origins page]

• End repetitions when the body sensation that was active at the memory scene has clearly diminished, and when re-accessing the memory no longer activates the client.
• Signs a target is integrated: less intense sensation across connections; the client 'feels' the event is over rather than only knowing it; the client reacts to current triggers in a more age-appropriate way.
• Signs the overall therapy is integrating: the Time Line grows denser as new memories fill gaps; the emotional tone of memories shifts; there is more calm, self-assertion and decision-making; the life story feels coherent. A felt sense of being 'unified' signals therapy is nearing its end.
• When to change track: if each new event re-destabilises the client, or regulation is poor, return to self-consolidation sessions. Smith did this after a fresh violent event.
• Readiness for memory work (trauma-specific; synthesis where marked). The client can stay within their window of tolerance (WOT) when a body sensation is activated. They can return to the present when cued. They have enough current safety (not living with the perpetrator) and a risk assessment is done. Complex early trauma or dissociative disorders (DID/DDNOS) call for Level 3–4 training before using the protocols. [source: Level One page; Roland-Smith] [synthesis: the explicit checklist]

Training [source: LI USA Trainings Overview; Level One page]

• Entry requires a graduate mental-health degree (psychiatric RNs and psychiatrists may also attend).
• There are four 2-day levels, each with a manual and three supervised practicums in the roles of therapist, client and observer.
• Therapists can be listed in the directory after Level Two. LI USA also runs a separate certification, which is not drawn on [uncertain].
• Taking LI sessions oneself as part of certification is reported only by a secondary source [uncertain].

3. Guiding principles

[source: Origins page; Description for Therapists; What is LI; Smith 2017; Rensch 2015, unless tagged]

• Repetition is the active ingredient. Every LI protocol runs repeated Time Lines. In practice: plan for several passes per session, not one long review.
• Show, don't tell, that time has passed. The goal is that the body 'feels' the event is over. In practice: rely on the sequence of the client's own memories, not on reassurance alone.
• Use memory cues, not numerical ages. Concrete cues keep the client in right-brain, sensory processing. In practice: read "the blue bike at Grandma's", not "age 9".
• Therapist attunement and internal coherence matter. The therapist's own regulation and attunement are said to set how well integration proceeds. In practice: track the client's breathing and face moment to moment, and keep your own state settled. Pace links this to the LI requirement that therapists receive LI themselves [uncertain].
• Stay inside the window of tolerance. Too little activation and nothing integrates; too much (fight, flight or freeze) and "healing stops". In practice: adjust the number of cues, reading speed and eyes-open/closed as you go.
• Work through the present adult self. The therapist "interacts only with the patient in the present, never directly with the Child Self" (Smith 2017). In practice: coach the adult self to speak to and care for the younger self; do not address the child part yourself. The exception is children under 12 (see section 4).
• Bring in whatever is needed to resolve the scene. In practice: after re-entering a memory, use imagery to provide rescue, comfort, protection or expression before moving forward through time.
• Trust self-organisation. Repeated Time Lines "always allow the self-system to sort around" the target (Origins page). In practice: follow the memories, feelings and themes that arise even when they are not on the cue list.
• Body-based, not talk-based. In practice: start from where the client feels the problem in the body, and keep discussion brief.
• Match the protocol to the deficit. Clear trauma with repair protocols; build missing structure with Baseline and attachment protocols. In practice: assess attachment history and regulation before choosing.
• Brief, true statements may be woven in. Short phrases such as "It wasn't your fault" or "It's over now" are given between or during repetitions and become integrated in later ones (Origins page). In practice: keep them short and true to the client's situation.
• Memories are the client's experience. [synthesis, consistent with this guide's trauma rules] Cue lists use memories the client actually recalls (Thorpe, via Rensch). In practice: never suggest content, and never treat imagery from prenatal or birth protocols as evidence of what happened.

4. Intervention inventory

The published names, purposes and outline steps are given below. Full scripts live in the level manuals, which are not drawn on. All example language is illustrative and my own. Some Level 3–4 protocols are only named in public sources; they are flagged as such and need training before use.

4.1 Preparation and consent

• Purpose: Orient the client to an eyes-closed, body-focused method and assess which track fits. Screen for risk and dissociation.
• Steps:
  1. Take a history: attachment and caregiving, losses, discrete traumas, memory gaps, current safety. Note any self-harm or suicidality. A published case opened with a thorough risk assessment, including self-harm marks. [source: Roland-Smith] Then set the target and the first protocol.
  2. Explain the method. You will read short cues from the client's own life while they notice images and body sensations. They stay awake and in charge, can open their eyes or stop at any time, and new memories may surface. [synthesis: wording of consent]
  3. Screen for dissociation, using a validated dissociation measure if you use one [synthesis]. Complex early trauma or DID/DDNOS needs further LI training before you use the protocols. [source: Level One page]
  4. Optionally take a baseline symptom measure to track change. One published case used the Impact of Event Scale (IES). [source: Roland-Smith]
• Example language (illustrative): "I'll read little reminders of your life in order, up to today. You just notice what comes, pictures, feelings, or nothing much. If it gets too much, raise a hand and we'll slow down or open your eyes."
• Watch for: Clients who expect to 'find' hidden memories; correct this at the outset [synthesis]. Also watch for current abuse or a crisis, and treat safety first.

4.2 Building the memory cue list (Time Line)

• Purpose: Create the chronological list of the client's own memories that every protocol reads from. [source: Rensch 2015, citing Thorpe 2012 and Pace 2012; Smith 2017]
• Steps:
  1. Usually as homework, or together in session, the client writes about one memory per year from their earliest memory to the present (adults).
  2. For children, Pace suggests 3–4 cues per year and Thorpe suggests 2 per year, about six months apart. Elsewhere Thorpe gives 2–3 per year.
  3. Memories should be ones the client actually remembers, not ones known only from stories or photos. They need not be important or traumatic; neutral, everyday images work well, like the house they lived in at a certain age.
  4. Each cue is a few words that bring up an image. The client keeps the list (paper or file), and the therapist reads from it in session.
  5. A trauma-focused Time Line has at least 12–15 memories. It can span hours or days for a recent event, or years for older ones. [source: Smith 2017]
  6. If the client has big memory gaps, use what they have. LI states that the method works even with poor memory and that gaps tend to fill over treatment. [source: What is LI]
• Example language (illustrative): "For each year, jot a few words for something you can actually picture. It doesn't need to matter. 'Red kitchen at Elm Street' is perfect."
• Watch for:
  • Lists dominated by trauma. Ask for ordinary or neutral images to balance it [synthesis].
  • Distress while writing the list. Allow joint construction in session [synthesis].
  • Cues that don't evoke the memory in session. Follow what does arise. [source: Roland-Smith]

4.3 The Time Line repetition (core procedure in every protocol)

• Purpose: Lead the client's body-mind, or a younger self-state, from a starting point to the present. Each pass shows that time has passed and lets new connections form. [source: What is LI; Origins page; Rensch 2015]
• Steps:
  1. Client sits with eyes closed, ideally with the activated body sensation or younger self 'held' in awareness.
  2. Read the cues in order at a steady pace, one after another. The client does not report back during the pass; they simply let images come. [source for no reporting: uncertain]
  3. Finish in the present: the current home, their current age, today.
  4. Take a short break: eyes open, a brief check-in on what came up and on body sensation.
  5. Repeat. Each pass is a "slightly different 'moving picture show'".
• Pacing tools [source: LI Origins page; LI USA Level One]:
  • Speed. Read faster to reduce activation or prevent abreaction; Smith calls this "accelerating the timeline". Read slower to allow more contact.
  • Number of cues. Use fewer cues per pass if overwhelmed. Use more for depth, or to fill gaps.
  • Eyes open for clients who drift or dissociate.
  • A strong-smelling object to hold and sniff, to anchor in the present.
  • Brief statements. Short true phrases between or during passes, such as "It's over now".
• Example language (illustrative): "Just let it play. … Blue bike at Grandma's … First day at Hillside School … the dog, Max … [continue] … and now you're here, in this room, today. Open your eyes when you're ready. What did you notice?"
• Watch for:
  • Integration signs: sensations ease across passes, new or forgotten good memories appear, the client says 'it feels like a story now'. Clients may feel tired or relieved after many passes. [source: Rensch 2015; Roland-Smith]
  • Too much activation: fight, flight or freeze; shallow breathing; 'spacing out'. Adjust the pacing tools.
  • Hidden over-activation: a client may leave still activated without the therapist noticing. Always check before ending. [source: Origins page]

4.4 Affect bridge (finding the source memory)

• Purpose: Trace a present problem back through its body feeling to the earlier memory it is rooted in. Use it to choose the target for the Standard protocol, and between sessions to address daily difficulties. [source: Rensch 2015 (Thorpe 2012); Smith 2017; GoodTherapy, secondary]
• Steps:
  1. The client recalls a recent instance of the presenting problem and finds where they feel it in the body. It is often felt in the core of the body.
  2. With eyes closed, they stay with that sensation and let an earlier memory with the same feeling come to mind.
  3. Briefly note the memory and the age it comes from. If the problem is rooted in the past, start the Standard protocol there.
• Example language (illustrative): "Bring up last Tuesday with your boss. Where do you feel that? … Stay with the tightness and let your mind float back. What's the earliest time you felt just like this?"
• Watch for:
  • The client 'thinking' instead of sensing. Return attention to the body.
  • Several memories surfacing. Note them for later sessions.
  • Do not suggest what the memory 'should' be [synthesis].

4.5 Standard protocol (trauma clearing from a source memory)

• Purpose: Resolve a specific past memory that drives a current problem while meeting the younger ego state's unmet needs. It is taught at LI USA Level Two and was earlier part of Level One. [source: Rensch 2015 summarising Pace 2012; LI USA Trainings Overview; Level One page; Smith 2017]
• Steps (nine-step outline):
  1. Focus on the body sensation of the presenting problem and find the source memory (see 4.4).
  2. Briefly discuss the memory.
  3. The client goes back into the scene as the younger self and notices where it is felt in the body. Their current adult self then enters the scene and tells the younger self that they have grown up and have come to help.
  4. The adult self takes the younger self to a peaceful place, real or imagined, such as a beach or forest.
  5. The adult reassures the younger self that the event happened long ago. Your attunement here is described as crucial.
  6. The adult 'shows' the younger self their life since then while you read the Time Line from that age to the present, like watching a slideshow together.
  7. At the present, the adult brings the younger self into their current home, shows them around and invites the younger self's questions.
  8. Take a break and check in, then return to step 3. Repeat until the step-3 body sensation has clearly diminished; adults commonly need up to about 8 passes.
  9. Close by re-checking the source memory, then the presenting problem.
• Variations seen in published cases [source: Roland-Smith; Smith 2017; Origins page]:
  • Imaginal resolution in the scene. Before or between passes, the adult self says what was needed ("you're not to blame"). The client may express anger imaginally toward the people involved. In one case, the client pictured friends holding an attacker while she confronted him, then completed a final Time Line. (Confrontation imagery is the client's own, done safely in imagination; see section 5.)
  • The younger self refuses to leave. Bring in another present-day caregiver figure from the client's life to care for the child in the scene, which frees the adult self to move on.
  • The younger self's questions (for example, whether a dead parent is coming back) are answered by the adult self.
  • Teenage self-states. Coach the adult to do ordinary, age-appropriate activities with the teen self, then run the Time Line again.
• Example language (illustrative):
  • "Let your grown-up self step into that kitchen. What do you want to say to her?"
  • "Take her somewhere she feels safe."
  • "Now let's show her what happened next."
  • After the pass: "Bring her into your living room. What does she want to know?"
  • Your role is to coach the adult. You do not speak to the child yourself.
• Watch for:
  • Sensation fading over passes and new memories appearing; these mean it is working.
  • The client flooding inside the scene. Shorten the time spent in it and move to the peaceful place sooner [synthesis].
  • Overwhelm when re-entering. Re-enter for only a moment and run the Time Line faster [synthesis].
  • Steps 3–7 must be done by the client's adult self. Do not supply the content.

4.6 LI PTSD protocol (single-event trauma)

• Purpose: Clear a recent or past single traumatic event. The LI site states that intrusions, nightmares and flashbacks tied to the event should stop, often within 1–2 sessions. It is taught at Level One. [source: Rensch 2015 (Thorpe 2012); Description for Therapists; LI USA Trainings Overview]
• Readiness:
  • The event is over and the client is currently safe.
  • The client can stay within their window of tolerance (WOT) when the event is recalled briefly.
  • The client was reasonably well-functioning beforehand. If not, consider self-structure work first.
  • [synthesis: list; source for the prior-functioning distinction: Description for Therapists]
• Steps:
  1. Together, build a fine-grained cue list of the event itself. Start just before it began and move moment by moment; ask "and then?" to get each next moment. Continue through the end of the event and its aftermath.
  2. Cue density follows time since the event: about one cue per day in the first days and weeks; later day by day and week by week, then month by month up to the present. Join the client's regular Time Line where it fits.
  3. Read the event cues and then the cues to the present, repeatedly, with breaks and check-ins.
  4. In this protocol there is no internal dialogue and no coaching of a younger self. The repetitions do the work.
  5. Stop when recalling the worst moments produces little or no body activation. In one case, imaginal confrontation was added when strong anger emerged, followed by a final pass. [source: Roland-Smith]
• Example language (illustrative): "You're walking to the car … and then? … You hear the brakes … and then?" Later, when reading: "… the ambulance … the hospital ward … home that Friday … back at work in March … here, today."
• Within-session dosing:
  • The event is visited only as a quick sequence inside each pass, not dwelt on.
  • Repeat 5–12 passes per session. [source: Smith 2017]
  • Lower the dose by reading faster or skipping to fewer cues for the most intense moments. [source: Origins page] [synthesis: skipping]
• Watch for:
  • Persistent avoidance between sessions. One case saw this resolve with repeated safety messages plus more passes.
  • Anger that needs expression.
  • Earlier, similar events surfacing. Note them; they may need the Standard protocol. [synthesis]

4.7 Timeline from Explicit Memory

• Purpose: A simple trauma-clearing protocol taught at Level One. [source: LI USA Trainings Overview]
• Steps: [uncertain]. The name suggests starting a Time Line from a consciously remembered (explicit) memory and running it to the present. Do not use it beyond that inference without the training manual.
• Watch for: As for 4.3.

4.8 LI Relationship protocol

• Purpose: Address repeating relationship patterns. It is taught at Level One. [source: LI USA Trainings Overview]
• Steps: Formal steps were not found [uncertain]. A published case used an LI protocol that tracked a body sensation through the client's relationships over time. The client then recognised the repeating pattern and its earlier root. [source: Roland-Smith]
• Example language (illustrative): "Notice that heaviness when your partner goes quiet. Now let's go through the people you've been close to, one at a time, and just notice where it shows up."
• Watch for: Shame on seeing the pattern; keep the focus on the body rather than self-criticism [synthesis].

4.9 Baseline protocol and its variations

• Purpose: Build a more solid self-structure rather than clear a specific trauma. It also expands WOT capacity and engages the client's self-organising capacities. Taught at Levels One to Four. [source: Origins page; LI USA Trainings Overview]
• Steps (outline):
  1. Run Time Line repetitions from a very early starting point (the Origins page describes repetitions beginning at one day old) up to the present.
  2. There is no target memory scene. The repeated passes through the whole life are the intervention.
  3. Detailed instructions are not drawn on [uncertain].
• Variations named by LI USA (outlines only; steps not found [uncertain]):
  • Baseline with Introject. Cathy Thorpe's 2008 belief-based use of the Time Line starts from a self-referencing belief instead of a memory, for example a core negative belief about oneself. [source: Origins page]
  • Baseline with "Pluses". Used to move clients away from embedded introjects toward healthier behaviours and cognitions. Taught at Level Three.
  • Sorting within Baseline. A Level Four process for integrating dissociated material beyond introjects, survival strategies and protectors.
• Example language (illustrative): "This time there's no particular memory. We'll start right at the beginning and travel all the way to now. Just notice your body as we go."
• Watch for: Increasing ease and a 'denser' life story over sessions. Very early start points can stir non-verbal distress; keep within WOT [synthesis].

4.10 Depression protocol

• Purpose: Named in a published case, where it was combined with the Standard protocol and attachment repair over several months to build self-compassion. [source: Roland-Smith]
• Steps: Not described in the sources [uncertain]. Do not use without the manual.

4.11 LI Birth protocol (formerly 'Birth to Present')

• Purpose: Address attachment ruptures, affect-regulation difficulty, anxiety, low self-esteem and problems linked to early abuse or neglect. LI's term for this is "known and unknown birth trauma"; this is LI's framing, not an established fact. Earlier taught at Level One; now at Level Three. Thorpe calls it "putting good stuff in". [source: Rensch 2015; Level One page; LI USA Trainings Overview; Description for Therapists]
• Steps (outline, Pace 2012 / Thorpe 2012 via Rensch 2015):
  1. The client imagines their own birth. The therapist narrates in general terms from the final contractions; the Origins page describes using general descriptions rather than specifics.
  2. The therapist holds an infant doll, 'receives' the baby and, in the client's imagination, cares for the newborn attentively.
  3. The therapist narrates an ordinary, well-cared-for early development up to the client's earliest Time Line cue, then continues with the Time Line to the present.
  4. Take breaks and check-ins, and repeat several times.
  5. There is no trauma scene.
• Example language (illustrative): "… and now the baby is here. I've got you. Warm, held, safe … days pass, you're fed and held … you start to smile … [earliest cue] …"
• Watch for:
  • Grief or longing, often an expected response.
  • Discomfort with the doll or with the therapist as caregiver. Offer to omit the doll [synthesis].
• Caution [synthesis]:
  • Present this as a corrective imaginal experience, not a retrieval of birth memories.
  • Do not interpret sensations as proof of what happened at birth.
  • Get explicit consent for the re-parenting frame.

4.12 LI Attunement protocol

• Purpose: Give an experience of an attuned caregiving pair that builds the core self and meets attachment needs. It also helps the client 'date' body sensations that come from the preverbal period. Taught at Level Three. [source: LI USA Trainings Overview; Smith 2017]
• Steps (outline from Smith's case vignette):
  1. The client imagines being a very young baby (about two weeks old in the vignette) in the original environment.
  2. The therapist, together with the client's adult self, 'retrieves' the baby from the past and brings them into the present, showing that time has passed.
  3. In imagination, the therapist provides holding, calm and affection.
  4. Narrate developmental milestones (lifting the head, turning, crawling) before running the Time Line.
  5. About three Time Line repetitions per session, repeated across sessions.
• Example language (illustrative): "Your grown-up self and I come and lift the baby out of that room … now she's here, being held, calm … she lifts her head … she rolls …"
• Watch for: The client gradually relaxing into the imagined holding across sessions; in Smith's case, anxiety fell. Initial anxiety or resistance to being held is common; go slowly [synthesis].

4.13 LI Preverbal Attachment Repair

• Purpose: Address unmet attachment needs from ages 0–3. Taught at Level Four. [source: LI USA Trainings Overview] Rejil et al. (2020) report that protocols can begin after birth or at various points before age 3.
• Steps: Not described in the sources [uncertain]. It presumably follows the attuned-caregiving and Time Line structure of 4.12; this is inferred.

4.14 LI Cell Being (and prenatal starts)

• Purpose: Pace extended Time Lines to begin at conception and at gestational stages, using general descriptions to activate implicit body memory. LI USA teaches Cell Being at Level Four for "known and unknown in utero trauma" and a deeper connection to the self. [source: Origins page; LI USA Trainings Overview]
• Steps: Not described in the sources [uncertain].
• Caution [synthesis]: Claims about in-utero memory are LI's own model and are not established. Use only as an imaginal or regulating experience. Never tell a client that sensations reveal prenatal events. This is consistent with not using imagery to 'recover' memories.

4.15 Adaptations for children (Thorpe)

• Purpose: Use LI with children, including after trauma, with birth trauma, in adoption and with attachment disorders. [source: Rensch 2015 summarising Thorpe 2012, 2015; Origins page]
• Steps:
  1. Build cue lists with the parent, at 2–4 cues per year (see 4.2).
  2. The child sits on the caregiver's lap throughout, in all protocols.
  3. For children under about 12, the child's current self does not go into the trauma scene. Instead, an imagined safe adult rescues the younger self and takes them to a peaceful place.
  4. In the PTSD protocol, projective play with figures the child chooses can replace visualisation. A protective figure, such as a police figure, may be added for safety and justice.
  5. Two steps: first clear the trauma memory through repetitions, then address the coping behaviours the child developed.
• Example language (illustrative): "Who's a grown-up who keeps you safe? Let's have them scoop up little you and take you to the park."
• Watch for: The caregiver's own activation, which needs managing; the child's play themes shifting from danger to safety [synthesis].

4.16 Hybrid protocol (Thorpe 2015, children)

• Purpose: For children who cannot find a source memory. [source: Rensch 2015]
• Steps:
  1. The child holds the presenting feeling in mind.
  2. The therapist runs a Birth protocol.
  3. The rationale is that a memory linked to the feeling may surface during the Time Line. [synthesis] Do not prompt or suggest such memories.

4.17 Structural dissociation mapping (Janner Steffan, from 2016)

• Purpose: An LI method for complexly traumatised clients. It defines three levels of structural dissociation and uses a mapping form and subcortical regulation techniques. [source: Origins page]
• Steps: Not described in the sources [uncertain]. It requires advanced training.

5. Handling problems

Items tagged [source] come from LI sources. Items tagged [synthesis] are this guide's own guidance, consistent with general trauma-therapy practice.

Over-activation and overwhelm (fight, flight or freeze) [source: Origins page; Smith 2017]

• Read the Time Line faster and use fewer cues.
• Have the client open their eyes and anchor the body in the present: feet on the floor, a strong-smelling object.
• Shorten the time spent in the memory scene.
• [synthesis] Stop the pass, orient to the room (name objects, check the date), then resume with a quicker, shorter pass ending in the present. Never end a session mid-scene: always finish with a full pass to today and a calm check-in.
• Over-activation can go unnoticed, so check the client's state explicitly before they leave. [source: Origins page]

Dissociation, drifting or going blank [source: Origins page; Rejil et al. 2020; Level One page]

• Use eyes open, strong scents and a faster reading pace.
• High dissociation, especially hypo-arousal, slows integration and needs more time.
• Complex early trauma and DID/DDNOS need further training. Use self-consolidation protocols before memory work.
• [synthesis]
  • Check orientation after each pass.
  • Agree a hand signal.
  • If the client switches or loses time, stop memory work, ground fully and return to stabilisation.
  • Seek LI-specific consultation (Level 3–4 trainers) and dissociation expertise.

'Stuck': sensation not diminishing across passes [synthesis unless tagged]

• Check whether there is an earlier source memory; use an affect bridge from the stuck sensation.
• Check whether something in the scene still needs resolving (protection, a statement of truth, expression of anger) before the next pass. [source: Roland-Smith; Smith 2017]
• Check whether the client is in their window of tolerance; adjust the dose.
• Check whether the problem is a structural deficit rather than one trauma; switch to Baseline or attachment protocols.

The younger self won't leave the scene or won't trust the adult [source: Smith 2017]

• Bring in another trusted present-day figure to stay with the child.
• Or let the adult self comfort the child in the scene first. [synthesis]

Strong anger [source: Roland-Smith; Smith 2017]

• Offer imaginal expression or confrontation, then a Time Line pass.
• [synthesis] Keep it imaginal, then process the urge to act it out in reality; screen for risk to others.

Cue list doesn't 'work' or new memories arise [source: Roland-Smith; Origins page]

• Expected. Follow what surfaces; add new memories to the list.
• [synthesis] Do not treat new images as verified history, and do not probe for detail.

Few or no memories, or large gaps [source: What is LI; Rensch 2015 (Thorpe)]

• LI states that gaps fill over treatment.
• Use Baseline or Birth work. For children, use the Hybrid protocol.
• [synthesis] Never use imagery or suggestion to 'find' missing memories, and do not encourage beliefs about abuse that the client does not remember.

Intellectualising, 'thinking instead of feeling' [source: Rejil et al. 2020]

• This is a named obstacle. Return to body sensation and keep discussion between passes short [synthesis].

Very defended or mistrustful clients; refusing to recall the past or bodily memories [source: Rejil et al. 2020]

• Build the alliance and trust first.
• [synthesis] Start with non-trauma Baseline passes to show that the method is gentle and that the client controls the pace.

Destabilisation between sessions (the 'de-structuring' phase) [source: Rejil et al. 2020]

• Some clients pass through a destabilising phase, and change can feel abrupt.
• [synthesis]
  • Warn clients in advance.
  • Schedule sessions closer together during this phase.
  • Give a between-session grounding plan.
  • Alternate LI with talk sessions, as published cases did.

Fatigue after sessions [source: Rensch 2015]

• Exhaustion and relief are reported after many passes.
• [synthesis] Plan the session end time and avoid scheduling demanding tasks straight after.

Suicidality or self-harm [source: Roland-Smith]

• Risk assessment at the start and ongoing monitoring.
• [synthesis] Use standard practice: structured risk assessment, a safety plan, means-safety counselling (safe storage or removal) and crisis contacts. Pause memory work if risk is acute.

Non-adherence (cue list not done, missed sessions) [synthesis]

• Build the list together in session.
• Explore avoidance as information about the trauma.
• Shorten the list to a first set of 12–15 cues.

Ruptures (client feels pushed, or uneasy about the re-parenting frame or the doll) [synthesis]

• Name it and repair openly. Attunement is LI's central mechanism, so the rupture comes first.
• Offer choice of protocol and props.
• Get explicit consent before Birth or Attunement work.

Personality disorders [source: Rejil et al. 2020]

• Emotional regulation and relationships may improve while a full felt sense of integration develops less.
• [synthesis] Set modest goals and combine with structured skills work where needed.

Ongoing danger [synthesis]

• Do not run trauma-clearing protocols while the client is still being abused or is in contact with the perpetrator. 'Showing that it is over' is untrue then; address safety first.

Medical or physical symptoms

• Some LI sources describe hypochondriac anxiety improving [source: Smith 2017].
• [synthesis] Ensure medical assessment of bodily symptoms first. LI is not a treatment for physical disease.

Sources

Sources:

• Lifespan Integration Therapy with Trauma-Exposed Children: A Hermeneutic Single Case Efficacy Study (Rensch, MA thesis, Trinity Western University, 2015). Summarises Pace (2012) and Thorpe (2012, 2015).
• Description For Therapists – Lifespan Integration
• What is Lifespan Integration? – Lifespan Integration
• Origins and Development of Lifespan Integration
• Trainings Overview – Lifespan Integration USA
• Level One Lifespan Integration Training. Dated, reflecting the older curriculum.
• Lifespan Integration Therapy: Two Cases, by Mandy Roland-Smith
• Smith, J. (2017, English translation 2025). Psychotherapy for Trauma and Dissociative Disorders Using Lifespan Integration
• Rejil, S., Smith, J., Dubourg, M., & Untas, A. (2020). Psychotherapy through lifespan integration: How do therapists describe the feeling of integration? European Journal of Trauma & Dissociation
• Lifespan Integration – GoodTherapy. Secondary, used only for context; its reference list contains unverifiable entries, so it was not relied on.

Books cited as further reading (not drawn on; content via the secondary summaries above):

• Pace, P. (2003; revised editions, last 2017). Lifespan Integration: Connecting Ego States Through Time. Self-published; a 2015 edition by Eirene Imprint (UK).
• Pace, P. (2014). Pratiquer l'ICV. Paris: Dunod (French translation).
• Thorpe, C. (2012). The Success and Strategies of Lifespan Integration.
• Smith, J. (Ed.). Applications cliniques de l'ICV.

Further reading (not drawn on): LI USA glossary and forms pages, and the official neuroscience page. The level manuals are not public.