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FACULTY IEDTA Career Achievement Award 2005 
David Malan, DM, FRCPsych Outcome: The Cinderella of Psychotherapy Research Plenary Address IEDTA AWARDS BANQUET Saturday, September 10, 2005 8:00pm Dr. Malan, son of an English father in the Indian Civil Service and an American mother, spent the first eight years of his life in India. He and his mother returned to England after his father’s premature death from pneumonia, to the traumatic experience of losing everything he knew by going to boarding school at the age of eight. At first, his main subjects at school were Latin and Greek, but at the age of 15 he fell in love with chemistry and spent most of his spare time in the holidays in his home-made laboratory in the garage. Therefore, at 16 he changed over to science, specialising in chemistry and biology, and at University in Oxford he took his Finals in chemistry. He first worked for a year doing War research for SOE (the British equivalent of the American OSS), and was a member of a team of three who devised a new type of incendiary bomb for use on Japanese cities. It is said that a million of these were ordered, but – he is relieved to say - they were never used because they were rendered unnecessary by the Japanese surrender after Hiroshima. After the War he worked for Courtaulds as a research chemist for a year. During this time, feeling the need for personal psychotherapy, and having a distaste for Freud, he got himself taken on by Hilda Stekel, Wilhelm Stekel’s widow, who carried on her husband’s tradition of intuitive brief psychotherapy based on dreams – the beginning of his long involvement with this particular field. This was a disaster and another traumatic experience, for after a few months with little progress Hilda Stekel terminated. Fortunately this was not a foretaste of his later experiences investigating brief psychotherapy as a therapist rather than a patient! After much heart-searching, in 1947 he began a training analysis and a medical training at the same time. His first analyst was Michael Balint, whom he later left for Winnicott. After medical qualification, he worked first as a Casualty Officer, then at the Maudsley, and finally at the Tavistock Clinic, where he stayed for the rest of his professional career. As a chemist, Dr. Malan had always been interested in identifying unknown substances in a quick and intuitive way, rather than going through the laborious stages of formal qualitative analysis. The parallel with Brief Psychotherapy and Psychoanalysis is exact, and it was thus one of the many fortunate coincidences in his life that Balint invited him to be a founding member of his Workshop on Brief Psychotherapy, in spite of the fact that the two of them continued their analysis. The favourable coincidences continued, because the work on Brief Psychotherapy gave him the opportunity to write it up in the form of a thesis for the Oxford postgraduate degree of DM. In this he was able to use his background in the physical sciences in order to introduce the objective study of subjective variables, which has been one of his theme songs ever since. Then there was an even further favourable coincidence: in 1974, Davanloo (who had never read a word of the literature!) was told of Dr. Malan’s existence and came to visit him at the Tavistock. Thus began a long and close friendship, lasting over twelve years. This friendship served its-quite crucial- purpose, for Dr. Malan was perhaps the first colleague to recognise the true value of Davanloo’s revolutionary work. He therefore put his own work aside entirely, and spent these years getting Davanloo accepted by the psychotherapeutic public, thus making a major contribution to the history of psychotherapy. In the meantime, there was yet another favourable coincidence--the Tavistock Clinic was asked if one of its members would be willing to write a textbook of psychotherapy and when no one else was interested, Dr.Malan volunteered. It so happened that over the course of the years, he had kept a record of important sessions with patients that illustrated the theory and practice of dynamic psychotherapy, and these were made the basis of his 1979 book, Individual Psychotherapy and the Science of Psychodynamics. This book has sold over 30,000 copies, including translations into seven different languages. One of the most influential concepts to be found there consists of the “Two Triangles”, the Triangle of Conflict (Defence, Anxiety, and Hidden feeling) and the Triangle of Person (Current, Transference, and Past), which can be made the basis of almost every intervention that the therapist makes. It has emerged that Davanloo’s rather abrasive technique only suits a minority of therapists, so that in recent years, many of his ex-trainees have introduced modifications that suit their own personalities. It is of immense importance that most of these techniques are effective, so that this form of therapy is beginning to spread throughout the world. Dr. Malan has been involved as a sort of benign guru watching these developments with pleasure and satisfaction. Still another fortunate coincidence occurred in meeting Patricia Coughlin Della Selva, one of Davanloo’s trainees and already the author of an important book, Intensive Short-Term Dynamic Psychotherapy (Wiley, 1996, now published by Karnac.) Together they have written a book entitled Lives Transformed (now in the hands of Karnac) highlighting the lives of seven patients with whom she achieved total resolution, with follow-up of up to ten years, and a discussion of the ways in which her work validates every aspect of dynamic psychotherapy-- without the need for “controls.” This biography would not be complete without mention of his wife Jennie– an Educational Psychologist without formal training in psychotherapy – who understands the issues involved as fully as he does, has been a constant support throughout the many years, and has immensely increased the scientific value of Lives Transformed by making blind judgments and predictions about Patricia’s patients. Thus she has been instrumental in greatly furthering Dr. Malan’s major ambition, to introduce the right amount of science into the study of psychotherapy, neither too much nor too little.
Dr Allan Abbass is currently Associate Professor, Director of Psychiatric Education and Director of the Centre for Emotions and Health at Dalhousie University. He completed medical training at Dalhousie University, Family Medicine at McGill and Psychiatry residency at University of Toronto. He currently practices, teaches and researches in the area of Short-term Dynamic Psychotherapy. He provides brief psychotherapy training programs, courses and workshops to local, Canadian and International audiences. His current local education focus is on implementing education in emotional operations and somatization to all medical students and residents in Dalhousie University. Current research foci include: ISTDP trial therapies versus standard intake assessments, a Cochrane Systematic Review of STDP outcome research, STDP for patients with treatment resistant depression and STDP of patients with somatoform disorders including fibromyalgia. Some of his most recent publications include:
Allan Abbass, M.D., FRCPC Saturday September 10, 2005 10:15am-11:30am Projective identification and symptom formation is the process of the client experiencing the same physical symptoms that a victim of their internal rage would have experienced had they acted out the rage. This is a typical event for the client who has repressed love and guilt-laden rage toward the same person. Common formats seen clinically include choking panic attacks and underlying guilt-laden rage to strangle a loved one in the past. Other examples seen, especially in medical referrals, include head pain symptoms with guilt-laden rage directed at a love one's head and chest pain with guilt-laden rage to damage a loved one's chest. Sometimes these phenomena are much more complex with medical complaints which have no physical findings or anatomical explanation. These seemingly physical complaints often lead to emergency visits, medical tests, surgical procedures and usually unhelpful medication trials. A videotape case vignette will be shown to illustrate this process and how it may be ameliorated through the actual somatic experience of these underlying complex feelings about past attachment trauma.
Dr. Michael Alpert graduated from UCLA (BA, Honors ’65) and University of California Irvine (MD, Honors ’69). He interned at Bellevue Hospital (1970) and did his psychiatric residency at the U. of Colorado (1973). He received his MPH from Harvard University (’74) where he studied with Dr. Alexander Leighton. He completed three years of Short-Term Dynamic Psychotherapy (STDP) training with Dr. Habib Davanloo in 1985. In addition to thirty years of private psychiatric practice in New York City, Dr. Alpert has taught psychiatric residents at NYU, Einstein, Downstate, and the New Jersey College of Medicine and Dentistry. He has served as Consultant to the NYC Mayor’s Office for Aging, Chairman & Director Psychiatry at St. Clare’s Hospital, member of the Medical Executive Committee and Board of Trustees of St. Clare’s Hospital. He is a Fellow of the American Psychiatric Association. Dr. Alpert has studied and taught brief psychotherapy for 25 years. He founded the NY/NJ STDP Institute and developed Accelerated Empathic Therapy. During the past fifteen years his clinical research has focused on “Empathic Interaction” and the therapeutic value of the experience of visceral sensations by patients and therapists. He is a founder of the STDP Discussion List and of the International Experiential Dynamic Therapy Association. THE PHYSICAL EXPERIENCE OF EMOTIONS MICHAEL C. ALPERT, M.D. Saturday, September 10, 2005 8:30am-9:45am A synonym for visceral feelings is “internal emotions.” Examples are the physical experience of internal emotions are the “emptiness” of loss, the “swelling” of pride, and the “tender ache” of caring. These sensations are carried by the sensory fibers of the autonomic nervous system (ANS). This presentation explains and demonstrates how patients are helped when they understand and experience visceral sensations. Both the sensation and expression of emotions are transmitted to and from the limbic system by the ANS. The ANS motor fibers are responsible for the involuntary excitation or inhibition of the smooth muscles surrounding the gastrointestinal tract, the bronchial tree, and glands, as well as the striated-smooth muscles of the heart. The resulting contraction or stretching is sensed by ANS sensory receptors in our body cavities (chest, abdomen and pelvis). It is important to distinguish between sensations and a person’s reactions to them. The same sensation can be experienced as painful or pleasurable, e.g., fullness in the chest or abdomen can be comforting or discomforting. The experience of discomfort is often due to unfamiliarity with a sensation and fear that the sensation is due to physical dysfunction. Fear and anxiety feed back to cause greater and greater anxiety and discomfort, or “fear of fear.” The ANS carries the motor and sensory anxiety signals in this negative feedback loop. It is common for people to develop defenses to avoid the experience of anxiety and the sensations causing the anxiety, or to seek medical care for what they fear is a serious physical illness. Even when their initial dysphoria has no physical basis, anxiety and tension can produce a stress based physical illness. Hypertension can be caused by the ANS mediated constriction of the smooth muscles surrounding small arteries and bronchospasm, impeding the flow of air into the lungs, by the constriction of smooth muscles around bronchioles. The increasing anxiety is also responsible for the defensive behavior and resultant symptoms that bring patients to psychotherapy. Videotaped case vignettes are used in the presentation to demonstrate the development of ANS mediated symptoms in a patient with lifelong anxiety and self-punishing behavior as well as recent hypertension. Education, support, reassurance, empathy, empathic interaction, and self-disclosure enable the patient to recognize and attend to his visceral sensations. Calm replaces tension as he learns to understand, experience, and appreciate himself rather than fear and hurt himself. He becomes more sensitive and responsive with others. His growing warmth causes friends, family and co-workers to see a positive change in him. This positive feedback loop further enhances his sense of well-being. Michael Alpert, M.D. Emanuel Peluso, MFT Saturday, September 10, 2005 4:15pm- 6:00pm Most research indicates that the Therapeutic Alliance is the very foundation of successful therapy. Yet most training and supervision tend to ignore it, focusing instead on theory and technique. This workshop starts with a brief overview of the historical development of the TA and the research that supports its importance. The greater part of the workshop concentrates on how to build the alliance, how to monitor and maintain it and how to recognize and quickly repair alliance disruptions. Excerpts from videotaped sessions will make each of these points clear. In this workshop you will learn:
Specific ways of maintaining attunement with the patient--using the here-and-now, renegotiating therapeutic goals—will be discussed and illustrated.
Dr. Jane Blake Mortimer is a Psychologist registered with the South Australian Psychological Board, and former Chair of the College of Clinical Psychologists (SA Branch). She is a Senior Lecturer (Assistant Professor) and Joint Coordinator of the Masters of Psychology (Clinical) at the University of Adelaide. She holds a Bachelor of Arts in Psychology, a First Class Honours degree, and a Masters Degree in Applied Psychology (University of Adelaide), and a Graduate Diploma in Psychological Practice from the University of South Australia. She received her doctorate in Psychology from the University of Adelaide specialling in stress and immunity studies. She has also completed a postdoctoral fellowship in Clinical Psychology at Stanford University, USA. She completed postdoctoral studies at Stanford University in the area of psychoneuroimmunology, examining the relationship between psychological stress and immunity in patients with cancer and posttraumatic stress disorder. During her fellowship, she was trained by Professor David Spiegel, who is the Professor of Psychiatry and Behavioral Science at Stanford University. She is the author of numerous articles that have been published in professional journals. Her current research examines the relationship between emotions, immunity and disease. She is currently chair of the Australian Society for Traumatic Stress Studies (SA Branch) and a member of the Australian Psychological Society (APS). Post Traumatic Stress Disorder Jane Blake Mortimer, Ph.D. Friday, September 9, 2005 8:00pm-9:45pm Background: This workshop is based on a modified form of self hypnosis that was developed by David Spiegel and his colleagues at Stanford University School of Medicine. In 1989, David Spiegel published a randomized controlled trial in which women with metastatic breast cancer who received Supportive Expressive Group Psychotherapy and self hypnosis were less depressed and anxious and lived twice as long than those who received routine care (1). In this context, self hypnosis was a technique employed to help patients confront very painful emotions with a renewed sense of mastery. Objectives: The primary aim of this workshop is to demonstrate the use of self hypnosis with victims of crime suffering Posttraumatic Stress Disorder using a STDP approach. Hypnosis serves as a tool to assist the patient to sit with painful emotions, to access the hidden feeling and to restructure the traumatic memory. For example, Leigh McCullough suggests that in the case of PTSD, “The patient must acquire the affective capacity to imagine escaping or fighting back with full affective arousal. In that way, a different, mutually exclusive and more adaptive emotional reaction to the memory of a trauma is elicited: anger rather than anxiety, and grief (that relieves and resolves) rather than anguish” (p. 405) (3). On the completion of this workshop participants will acquire a working knowledge of how to treat patients with PTSD using self hypnosis. More specifically this workshop will teach participants to use a modified form of David Spiegel’s split screen self hypnosis technique. This form of hypnosis involves a projective technique in which the patient projects images onto an imaginary screen such as a movie screen or a piece of clear blue sky. It can be used to:
Videotaped examples will be used to demonstrate this technique. References: (1) Spiegel, D., Kraemer, HC, Bloom, JR, & Gottheil, E (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. The Lancet, 888-891. (2) Kirsch, I. (1994). Defining hypnosis for the public. Contemporary Hypnosis, 11, 142-143. (3) McCullough Vaillant, Leigh (1997) Changing Character Short-term Anxiety Regulating Psychotherapy for Restructuring Defenses, Affects, and Attachment. Basic Books, New York.
Thomas M. Brod, M.D., DFAPA is in private practice in West Los Angeles. He is an Assistant Clinical Professor at UCLA Department of Psychiatry and Biobehavioral Sciences and on the faculty of the Los Angeles Psychoanalytic Institute. He has studied IS-TDP with Robert Neborsky and Habib Davanloo. Anticipatory State-Change and IS-TDP Efficacy Thomas M. Brod, M.D., DFAPA Friday September 9, 2005 8:00pm-9:45pm The shock-wave phenomenon is a previously undescribed component of the therapeutic "breakthrough into the Unconscious". The shock-wave is a common, but not invariable, anticipatory signal of emergent complex feelings, a tearful communication (from "the Unconscious") announcing impending passage of "guilt" (which is not necessarily dominated by "grief") into consciousness. This particular form of emotional state-shift is intuitively understood by advanced practitioners as a green light signal, but, if misperceived as "weepiness" or "grief", may stimulate unnecessary counter-transference caution. This will be organized in true workshop format for licensed practitioners of Experiential Dynamic Psychotherapy. Videotape anecdotes will be used to focus group discussion. The workshop will necessarily entail examination of the phenomenology of the complex state commonly called "guilt."
Kees L.M. Cornelissen, Soc. D, is a sociologist and a psychotherapist as well as a trainer with the Dutch Society for Client-Centered and Group-Psychotherapy. He works at the Center for Psychotherapy “De Viersprong” in the Netherlands and has developed the application of residential ISTDP. He is chairman of, and trainer with, the Dutch Association for Short-Term Dynamic Psychotherapy (V.K.D.P.), the professional association for therapists working with the techniques of Prof. Dr. H. Davanloo. Residential Setting Kees L.M. Cornelissen, Soc.D. Part I Friday, September 9, 2005 8:00pm- 9:45pm Part II Saturday, September 10, 2005 4:15pm- 6:00pm Part I The first workshop will highlight the residential program and how it is conducted. Special attention will be given to the general assessment procedure as deplored by the Centre itself and the assessment of the specific treatment program of the residential ISTDP in particular. The first results of an extensive research will be presented as a part of the tenth anniversary we will celebrate this year. All patients that were treated will be revisited and interviewed the coming period of time. The first result of the research of the psychiatric files will be presented in today’s workshop regarding the use of psychiatric and other medication before and after treatment, as well as evaluation of somatic complaints during the same period. Follow-up treatment results will be presented from ten years of treatment and evaluation of treatment results during the first and second years after discharge. Part II In part two of this workshop the treatment of a particular patient will be presented. Different step in treatment will be highlighted and explained. The main focus lies on the defence mechanism of projection and how this can be undone.
Patricia Coughlin Della Selva, Ph.D. is a licensed Clinical Psychologist in private practice in Albany, New York. She obtained her Ph.D. from Syracuse University in l980 and did post-doctoral work at Northwestern University Medical School. She maintained a private practice in Chicago from l981-l987. From l988-l99l she trained with Dr. Habib Davanloo in the theory and practice of Intensive Short-term Dynamic Psychotherapy. In addition to treating patients in her private practice in Albany, New York, Dr. Coughlin has held faculty positions at both Northwestern University Medical School and Albany Medical School teaching and supervising residents in training. Over the past 15 years she has written professionally, given presentations at professional conferences, and conducted workshops for mental health professionals around the world. Currently, she is conducting supervision groups and training workshops in California, Washington, DC, Aarhus and Copenhagen, Denmark. Her first book, Intensive Short-term Dynamic Psychotherapy: Theory and Technique (l996) is considered a classic in the field. Her new book, Lives Transformed, written in collaboration with Dr. David Malan, will be published in the fall of 2005. Patricia Coughlin Della Selva, Ph.D. Saturday, September 10, 2005 1:00pm-2:15pm Theoretical and technical issues arising in the treatment of patients who have conflicts regarding emotional closeness and sexuality will be the focus of this presentation. Using the techniques designed by Davanloo to rapidly identify and dismantle defenses, a case will be presented in which a full blown Oedipal conflict is unearthed. The case involves a 35 year old man with primary impotence who also suffers from anxiety, depression and chronic work/relationship difficulties. Special attention will be paid to the task of dealing directly and explicitly with sexual feelings and impulses, particularly in the transference. In addition, the therapeutic task of disentangling a fusion of sexual and aggressive impulses, often found in patients with sexual dysfunction, will be illustrated. In this presentation you will learn how to:
Avoiding the Pitfalls in Experiential Dynamic Practice Patricia Coughlin, Ph.D. Diana Shulman, J.D., Ph.D. Saturday, September 10, 2005 4:15pm-6:00pm In this workshop you'll learn what can go right (the GOOD) and what can go wrong (the BAD and the UGLY) in the process of short-term dynamic psychotherapy. In particular, errors, omissions and remedies for the following three phases of treatment will be covered, through a mixture of lecture, discussion, role-play and video-tape: 1. Failure to adequately structure the interview and maintain an internal or intrapsychic focus; 2. Failure to monitor unconscious anxiety - a vital diagnostic tool that determines the type and pace of interventions; and 3. Failure to turn patients against defenses, which then dominate the therapy process. Without question, experiential dynamic work is challenging for both patient and therapist. Its aim, encouraging the patient to reclaim disowned aspects of the self by facing warded off feeling and impulse, sounds simple enough. Yet the patient's (and therapist's) willingness to tolerate anxiety, take down defensive scaffolding, and "partner up" on a journey into uncharted and often frightening territory can sputter and stall. From the initial 2-4 hour meeting through termination, sessions are structured by the therapist to focus on the relationship between (a) anxiety, (b) defense, and (c) impulse/feeling so that patients can fully understand their inner workings. Sensitivity and caution are called for as patients are encouraged to work at their highest level without taking refuge in defense. The result is the creation of a highly charged therapeutic encounter. Often, because of this emotional intensity, anxiety and defensiveness rise in both therapist and patient and cause the process to bog down. Participants will learn to adequately structure the interview, monitor the pathway of unconscious anxiety, and do a thorough defense analysis without causing misalliance.
DIANA FOSHA, Ph.D., the developer of AEDP and the Director of the AEDP Institute, is the author of The Transforming Power of Affect: A Model for Accelerated Change (Basic Books, 2000), and of papers on experiential process in dynamic psychotherapy. She also contributed to Healing Trauma: Attachment, Mind, Body and Brain, edited by Marion Solomon and Daniel Siegel (Norton, 2003). Her current work in transformational studies has focused on integrating recent developments in affective neuroscience and developmentally based understandings of the dyadic regulation of affect into clinical work with patients. She is the Director of Training of the International Experiential Dynamic Therapy Association (IEDTA), on the editorial board of several journals, and has done workshops and trainings throughout North America, Europe, and Brazil. Diana Fosha teaches and is in private practice in New York City. True Self, True Others; Transformation at Work Diana Fosha, Ph.D. Sunday, September 11, 2005 8:30am-9:45 am Diana Fosha’s presentation will focus on the healing transformational processes that AEDP aims to facilitate from the get go of the initial contact with the patient, and from there on throughout the treatment. AEDP is a transformation-based, healing-oriented model of treatment. From an attachment-based therapeutic stance, intense affective experiences are facilitated, explored and processed to completion, until adaptive action tendencies, resilience, and feelings of well-being are released and become available for the patient to use. AEDP integrates attachment, affective neuroscience, emotion theory, developmental studies of dyadic interaction, relational psychoanalysis, and somatic-based experiential treatments. A central role is played by dyadic affect regulation, moment-to-moment tracking of somatic experience and the affirmation of the patient’s experience of transformation in bringing about the state transformation where the patient’s own healing strivings come online. The phenomenology of the different phases of the transformational process involved in processing of intense emotional experiences to completion –AEDP’s model of three states and two state transformations--will be described so that therapists can recognize the in-the-moment positive affects that are somatic markers of the change process and use those to guide interventions with their own patients. Tracking the moment-to-moment fluctuations in deep, somatically-based emotional experiencing in the context of a relationship with a “True Other,” and then, explicitly processing such affective and relational experiences in the therapeutic dyad can make quantum transformations reliably occur in psychotherapy. The videotapes will illustrate how experientially focusing on the experience of transformation becomes a transformational process in its own right. By affirming and focusing on the patient’s experience of change, particularly the experience of the healing transformation of the self in relation with a healing other, and through moment-to-moment tracking of both the patient’s and the therapeutic dyad’s experience, another powerful transformational process emerges that culminates in the experience of core state. In core state, patients have experiential access to truth, strength, clarity, and the essential self. The focus on the experience of transformation itself releases further healing transformations, leading to a seemingly never-ending process, which only further consolidates the patient’s emergent positive sense of self.
Dr. Ronald J. Frederick is currently the Clinical Supervisor of Abbott Northwestern Hospital’s Park House Program and maintains a private psychotherapy practice in Minneapolis, MN. He received his doctoral degree in clinical psychology from Fairleigh Dickinson University, NJ, and completed his internship at Beth Israel Medical Center, NYC. In addition, he completed a year-long post-doctoral fellowship in Medical Psychology and HIV/AIDS at St. Luke’s-Roosevelt Hospital Ctr., NYC. While on internship, Dr. Frederick began his training in Experiential Dynamic Therapy (EDT), where he completed a year-long training rotation in Intensive Short-Term Dynamic Psychotherapy (ISTDP). Since then, he has been training in, practicing, and teaching these innovative therapeutic approaches that focus on resolving problems and blocks to growth through deep emotional experiencing. Dr. Frederick has also received extensive training and supervision in Accelerated Experiential Dynamic Psychotherapy (AEDP) from psychologist Diana Fosha, PhD the developer of this cutting-edge, healing-centered model. He is now a senior faculty member of the AEDP Institute and provides training and supervision in AEDP nationally. Dr. Frederick has presented numerous workshops, trainings and papers and has written articles and book chapters on an array of mental health issues and is actively involved in the training and supervision of clinicians from a variety of different disciplines. He is currently at work on his first book titled: The Courage to Feel: Harnessing the Power of Emotions to Transform Your Life. Friday, September 9, 2005 3:45pm-5:00pm Attachment studies, developmental research, and affective neuroscience are reshaping our understanding of how the brain works, how psychopathology develops and, subsequently, how psychotherapy can be more effective. From this wealth of information we now understand that dyadic affective regulation between child and caregiver plays a fundamental role in brain development, attachment, and the development of the child’s ability to tolerate and regulate emotions. Through the lens of attachment, psychopathology is then seen as the result of an over-reliance on defensive strategies that arose in an environment inimical to affect regulation. Given a different environment, that is, one in which a client can feel safe, secure and not alone and in which affect is welcome, might the need for defenses against emotional experiencing be counteracted? And, given our understanding of the role of affect regulation in neurobiological development, shouldn’t the work of therapy be focused on engaging and working with right brain mediated processes? Grounded in the EDTs in general, and AEDP in particular, Dr. Frederick’s clinical work emphasizes the relational experience as the foundation on which healing can occur. A corrective relational experience is fostered in which the client can feel safe, secure and deeply known and in which previously warded off emotions can be experienced, shared and worked through. Going “beyond mirroring” and actively helping the client with difficult emotions is central to the work (Fonagy, et al. 1995, Fosha, 2000, 2003). This presentation will focus on both theory and technique, with extensive videotaped case material illustrating the power of therapist emotional engagement to affect change.
Linda C. Gilbert, Ph.D. is a 1989 graduate of the California School of Professional Psychology, Los Angeles. Dr. Gilbert has trained with Habib Davanloo, M.D. in Montreal, and with Robert J. Neborsky, M.D. in Los Angeles. She has had many years of experience working with highly disturbed children and adolescents in various settings in California including the Switzer Center, Torrance, San Bernardino Community Hospital, and Valley Child Guidance Clinic in Palmdale. In addition, she has special research interests in the use of chess with psychologically disturbed and autistic children. Her article, Applying ISTDP Techniques to Child and Adolescent Psychotherapy is published in the September, 2004 issue of the Ad Hoc Bulletin of Short-Term Dynamic Psychotherapy. Linda C. Gilbert, Ph.D. Friday, September 9, 2005 8:00pm-9:45pm This workshop is intended to share experiences and to encourage participants to incorporate theory and techniques of the STDP’s in their work with children and adolescents. The workshop will focus on how the psychotherapy may be similar or different than with adults, especially in the child/adolescent presentation of symptoms and defenses, and in the establishment of the conscious and unconscious working alliance. The role of attention/hyperactivity behaviors as defense mechanism will be featured, as will difficulties facing the therapist in establishing alliance with younger patients who are not in therapy of their own volition. There is little precedence for the use of the STDP’s with younger populations, yet some of the most frequently asked questions at conferences and seminars pertain to this subject. Bias against the use of our techniques with children will be addressed and the underlying assumptions supporting this bias challenged. Other complications will be discussed such as explaining the nature of the treatment to the parent/caregiver, and obtaining consent to videotape sessions for personal and group supervision and for other training purposes.
Kari Gleiser, Ph.D., is a clinical psychologist in private practice in Hanover, NH. After completing her doctoral work at Boston University and internship through Dartmouth Medical School, she has pursued a specialization in treating trauma, dissociative disorders and personality disorders. Dr. Gleiser is a member at large on the Board of Directors of the New England Society for the Treatment of Trauma and Dissociation (NESTTD), and is currently evolving a theoretical and clinical model that unites experiential and relational interventions with existing ego state models for the treatment of chronically traumatized individuals. Treatment of Borderline Syndromes, Dissociation and Complex Trauma Kari A. Gleiser, Ph.D. Jerry Lamagna, LCSW Friday, September 9, 2005 8:00pm-9:45pm Clients who display signs of ego fragility and fragmentation pose an array of formidable challenges to clinicians working within affect-based, experiential-dynamic treatment approaches. Such individuals are prone to spontaneous "dis-integration" or flooding of inhibitory and/or regressive affects when invited to tune into core affect and overtures toward greater intimacy. Shaped by early experiences of trauma, neglect, and attachment failure, these clients often resort to dissociative detachment from feared-to-be unbearable emotions, as well as disavowed parts of the self, and potentially supportive others. These desperately clung-to defenses against restorative emotional and relational experiences perpetuate cycles of severely compromised functioning, weakened sense of self and impoverished supports. Building on the foundation of AEDP’s dyadic regulation, affective attunement, empathic engagement and experiential attending, we propose an explicit extension of these healing elements into the client's inner world of poorly integrated self states. This new "intra-relational" pathway essentially imports AEDP’s relational interventions from the interpersonal domain into the client’s disjointed and conflictual intrapsychic world. Intra-relational interventions open up avenues of communication between isolated islands of self experience, broker ruptures between hostile, warring self-states organized around conflicting agendas (e.g. attachment vs. safety), and entrain shared moments of deep affective resonance between self states. In doing so, intra-relational interventions bridge dissociated self-states by fostering acknowledgement and self-validation, enhancing self-compassion and self-care and, ultimately, allowing clients to reclaim lost selves. The parallel process unfolding simultaneously between therapist/client and client/dissociated self states facilitates and accelerates the internalization of secure attachment dynamics and good object relating. Strengthening relational and intra-relational connections instills safety and containment and builds more robust self-structure, which, in turn, opens up opportunities for the transformative affect work that lies at the heart of STDP approaches.
Arno Goudsmit, Ph.D. is co-director of “Psychotherapiepraktijk Maastricht”, Maastricht, Netherlands, a new institute that emphasizes and favors the application of experiential-dynamic psychotherapies. He is also working as an assistant professor, School of General Practice, Medical Department, University of Maastricht. He wrote a cum laude PhD thesis on fundamentals of psychotherapeutic theory. His major theoretical interests concern the hermeneutics of lived experience, in its implications both for psychotherapy and for biosemiotics. He has published several books and papers. And an Accurate Use of the Triangle of Dynamic Activities Silvia Landra, M.D. Arno Goudsmit, Ph.D. Friday, September 9, 2005 8:00pm-9:45pm Motivation is a fundamental therapeutic ingredient. It is a phenomenon attributed not only to psychotherapeutic techniques but also to the patient's subjectivity. The aim of this workshop is to discuss in detail the following issues: 1 - The therapist's ability to recognize his/her own limitations (cf. M. Buber, 1952) and the patient's freedom as a basic constituent of his/her motivation. 2 - Motivation as an interpersonal process. 3 - How technique can enhance motivation: using the three dynamical activities, according to Dr Osimo's approach. 4 - A clinical case: "The Hanged Man's Son": The five vignettes belong to the case of a man of 42, traumatized at the age of 17 by discovering the dead body of his father. Soon afterwards, the patient started to present severe Somatization Disorder and various Major Depressive Episodes. At the age of 32 he was diagnosed as Type II Bipolar Disorder. The patient was treated with medication by various psychiatrists for about ten years, with only partial relief of symptoms. When the patient was referred to Dr Landra, he was seemingly rather distrustful as to whether psychotherapy could be useful in any way, and he was poorly motivated even to talk about himself. 30 therapeutic sessions followed, during which an important transformation took place: the patient became highly motivated and an active partner in his change process, culminating in a highly satisfactory result. In this workshop we will answer:
Dr. Allen Kalpin is in private practice in Richmond Hill, Ontario, Canada, just north of Toronto. His practice is devoted to Experiential Dynamic Therapy (EDT), with a particular focus on Intensive Short-Term Dynamic Psychotherapy (ISTDP). He also practices addiction medicine in Toronto. He offers training and supervision in EDT in Richmond Hill. Dr. Kalpin is a founder and board member of the International Experiential Dynamic Therapy Association (IEDTA) and is a founder and moderator of the STDP Email Discussion List. He teaches and supervises EDT internationally and has published numerous articles on EDT. Removing the Rock From on Top of the Seed Allen Kalpin, M.D. Friday, September 9, 2005 2:00pm-3:15pm In Intensive Short-Term Dynamic Psychotherapy (ISTDP) the goal is to bring about deep and lasting change in a relatively short time. The view is that within most people there is a great potential for growth and development that is being suppressed by inhibitory psychological forces. Far-reaching therapeutic change can be achieved by helping a person to remove these inhibitory forces as rapidly as possible. If this can be accomplished, then there can be a real blossoming of one’s true potential. Sigmund Freud, in his classical psychoanalytic theory, called such an inhibitory force the punitive superego. This essentially means an overly harsh conscience that cripples a person’s life by inflicting guilt, shame, and self-punishment. As psychoanalysis changed after the time of Freud, the concept of the importance of the punitive superego was to a great extent left behind and became viewed as outmoded and irrelevant. However, in many forms of psychotherapy, although the term “punitive superego” may not be used, there is an acknowledgment that excessive guilt, shame, and “low self-esteem,” are central aspects of many psychological problems, and that removing them is crucial for therapeutic change. For example, in cognitive therapy, the “core beliefs” that one is unlovable and unworthy are often seen as playing a pivotal role in psychopathology. In this presentation, Dr. Kalpin will discuss some of these theoretical issues and then show videotape vignettes of psychotherapy sessions in which the role of the punitive superego-- in the genesis of psychological dysfunction--can be clearly seen. He will then show the process of removing this inhibitory force and some of the therapeutic changes that result from this.
Robin L. Kay, Ph.D. B.A. University of CA, Berkeley; M.A. University of CA, Los Angeles; Ph.D. University of CA, Los Angeles Robin Kay is a Faculty Member of the Southern California Society for ISTDP, is a Clinical Psychologist in private practice in Beverly Hills, California. Dr. Kay teaches and writes articles for professional journals on the application of ISTDP therapy to a wide-range of psychological problems. Dr. Kay's ongoing course on Attachment-Based ISTDP is offered through UCLA Extension. (Role) Playing with the Triangles of Conflict and Persons Josette ten Have-de-Labije, Psy.D. Robin L. Kay, Ph. D. Saturday, September 10, 2005 4:15pm-6:00pm In Intensive Short-Term Dynamic Psychotherapy, the therapist's aim is to help the patient to gain access to his unconscious complex transference feelings and his core conflicts and to work them through in order for the resolution of the patient's problems. As the therapist takes pain helping the patient to make his complex transference feelings conscious and to bear and contain them, it follows that a successful co-operation with the patient depends heavily on the functioning of the patient's ego-adaptive capacity. It is therefore very important for the therapist to assess this capacity repeatedly, and to restructure it when necessary. Most patients are unable to see the causal link between what happened in a concrete situation (the triangle of persons) and the subsequent aroused feelings/impulses, anxiety and defenses (the triangle of conflict), nor can they distinguish correctly between the different aroused feelings/impulses, anxiety and defenses. When assessing the patient's ego-adaptive capacity and helping his patient to understand his intrapsychic problem, Davanloo uses the concepts of the triangles of conflict and persons as developed by Menninger and Malan. After a short theoretical introduction the presenters of this workshop will engage the participants in role-playing to illustrate how the therapist could work with the triangles of conflict and persons to assess his patient's nature/degree of ego-adaptive capacity and to help his patient's understanding of his intrapsychic problems.
Jerry Lamagna, LCSW, is a psychotherapist in private practice in both Manhattan and Westfield, New Jersey. After completing his graduate studies at Adelphi University in 1993, he worked in addiction and trauma treatment. Throughout, his interest in affect based, experiential treatment approaches led him to pursue training in psychodrama, EMDR, ego state therapy, trauma/ dissociative disorder treatment, and AEDP. The study of these modalities has inspired his ongoing efforts to integrate relational, intra-psychic, and experiential elements into his clinical work. Treatment of Borderline Syndromes, Dissociation and Complex Trauma Kari A. Gleiser, Ph.D. Jerry Lamagna, LCSW Friday, September 9, 2005 8:00pm-9:45pm Clients who display signs of ego fragility and fragmentation pose an array of formidable challenges to clinicians working within affect-based, experiential-dynamic treatment approaches. Such individuals are prone to spontaneous "dis-integration" or flooding of inhibitory and/or regressive affects when invited to tune into core affect and overtures toward greater intimacy. Shaped by early experiences of trauma, neglect, and attachment failure, these clients often resort to dissociative detachment from feared-to-be unbearable emotions, as well as disavowed parts of the self, and potentially supportive others. These desperately clung-to defenses against restorative emotional and relational experiences perpetuate cycles of severely compromised functioning, weakened sense of self and impoverished supports. Building on the foundation of AEDP’s dyadic regulation, affective attunement, empathic engagement and experiential attending, we propose an explicit extension of these healing elements into the client's inner world of poorly integrated self states. This new "intra-relational" pathway essentially imports AEDP’s relational interventions from the interpersonal domain into the client’s disjointed and conflictual intrapsychic world. Intra-relational interventions open up avenues of communication between isolated islands of self experience, broker ruptures between hostile, warring self-states organized around conflicting agendas (e.g. attachment vs. safety), and entrain shared moments of deep affective resonance between self states. In doing so, intra-relational interventions bridge dissociated self-states by fostering acknowledgement and self-validation, enhancing self-compassion and self-care and, ultimately, allowing clients to reclaim lost selves. The parallel process unfolding simultaneously between therapist/client and client/dissociated self states facilitates and accelerates the internalization of secure attachment dynamics and good object relating. Strengthening relational and intra-relational connections instills safety and containment and builds more robust self-structure, which, in turn, opens up opportunities for the transformative affect work that lies at the heart of STDP approaches.
Dr Silvia Landra specialized in psychiatry in 2003 at the University of Milan and works as a psychiatrist and psychotherapist at the Teaching Hospital. Here she has gained experience in Dynamic Experiential Psychotherapy (EDT) as one of Dr Ferruccio Osimo's students and has completed her three year Core Training in 2004. (Teachers: F. Osimo and D. Fosha). Dr Landra maintains a psychotherapeutic practice in Milan, Italy. On behalf of Milan "Caritas", Dr Landra runs experimental rehabilitation projects of social psychiatry for the Milan prison and Lombardy Health Authority Region, under the aegis of W.H.O. And an Accurate Use of the Triangle of Dynamic Activities Silvia Landra, M.D. Arno Goudsmit, Ph.D. Friday, September 9, 2005 8:00pm-9:45pm Motivation is a fundamental therapeutic ingredient. It is a phenomenon attributed not only to psychotherapeutic techniques but also to the patient's subjectivity. The aim of this workshop is to discuss in detail the following issues: 1 - The therapist's ability to recognize his/her own limitations (cf. M. Buber, 1952) and the patient's freedom as a basic constituent of his/her motivation. 2 - Motivation as an interpersonal process. 3 - How technique can enhance motivation: using the three dynamical activities, according to Dr Osimo's approach. 4 - A clinical case: "The Hanged Man's Son": The five vignettes belong to the case of a man of 42, traumatized at the age of 17 by discovering the dead body of his father. Soon afterwards, the patient started to present severe Somatization Disorder and various Major Depressive Episodes. At the age of 32 he was diagnosed as Type II Bipolar Disorder. The patient was treated with medication by various psychiatrists for about ten years, with only partial relief of symptoms. When the patient was referred to Dr. Landra, he was seemingly rather distrustful as to whether psychotherapy could be useful in any way, and he was poorly motivated even to talk about himself. 30 therapeutic sessions followed, during which an important transformation took place: the patient became highly motivated and an active partner in his change process, culminating in a highly satisfactory result. In this workshop we will answer:
Benjamin Lipton has been trained and supervised in Accelerated Experiential Dynamic Psychotherapy (AEDP) by its founder, Diana Fosha, Ph.D. and is currently a faculty member and supervisor for the recently inaugurated AEDP Institute. In addition to being in full-time private practice, Mr. Lipton is an adjunct faculty member of the New York University School of Social Work and an independent consultant to social service organizations throughout New York City on issues related to clinical practice and organizational development. Previously, Mr. Lipton served on the faculty at Columbia Presbyterian Department of Psychiatry and was the Director of Clinical Services at Gay Men’s Health Crisis (GMHC), the world’s first and largest HIV/AIDS service organization. Mr. Lipton is the editor of From Crisis to Crossroads: Gay Men Living with Chronic Illnesses (Haworth Press, 2004), as well as the author of several articles and book chapters in psychology and social service textbooks, journals and popular periodicals. Friday, September 9, 2005 8:00pm-9:45pm The field of psychology historically has focused more on pathology than health, more on negative affects than positive. We are in the business of trying to help people heal from their pain, suffering, and symptoms, and it is not often our custom to spend a great amount of time with patients relishing in their strengths, accomplishments, and joys. However, what we traditionally define as negative or contrary feelings are not the only affects excluded in less than optimal family environments. Joy, pleasure, silliness, ebullience, intimacy, tenderness, pride and their behavioral markers are also often repressed, discouraged, or shamed. Helping patients to feel these feelings deeply and share them with another in a secure attachment environment equips them with greater access to all their emotional states and increases their willingness to expose these states to others with whom they are in relationships. This workshop will offer an AEDP perspective on positive affects, their markers, their potential for healing, and the consequences of working with them, specifically in psychotherapy. Using videotape that demonstrates the methodological cornerstone of AEDP--moment-to-moment tracking of right-brain mediated, somatically-based emotional experiences—this workshop will address AEDP concepts such as core affects, transformational/healing affects, core state, and true self/true other. Fundamental to an AEDP perspective, this workshop will demonstrate that the emergence of non-defensive positive affects is not necessarily a sign that the therapy is complete, and that the exploration of positive affects should not be a matter of style, but rather, a matter of good therapy.
Jeffrey J. Magnavita, Ph.D., ABPP, FAPA, is a licensed psychologist and marriage and family therapist in active clinical practice. A Diplomate of the American Board of Professional Psychology and Fellow of the American Psychological Association, Dr. Magnavita has received awards for his work in the practice and theory of psychotherapy and personality disorders. He is the founder of Glastonbury Psychological Associates, PC, and the Connecticut Center for Short-Term Dynamic Psychotherapy. He is an affiliate professor of clinical psychology at the University of Hartford and a lecturer at Smith College of Social Work. He authored Restructuring Personality Disorders: A Short-Term Dynamic Approach, Relational Therapy for Personality Disorders, and a text, Theories of Personality: Contemporary Approaches to the Science of Personality. He was the volume editor of the Comprehensive Handbook of Psychotherapy: Psychodynamic/Object Relations: Volume 1 and the Handbook of Personality Disorders: Theory and Practice, selected by the Behavioral Science Book Club as a featured volume. He is on the editorial board of the Journal of Clinical Psychology/In Session: Psychotherapy in Practice and has edited two special editions on treating personality disorders and on relational therapy. He is an affiliate medical staff at a number of Hartford, Connecticut area hospitals, and a community mental health agency, where he consults and conducts training. He is an active member of the International Society for the Study of Personality Disorders, Society for Psychotherapy Research, New York Academy of Science, and Society for Exploration and Integration of Psychotherapy and a founding member of the International Association of Dynamic Affective Therapy. Trained in various modalities of psychotherapy, he specializes in working with personality dysfunction as it is expressed in various developmental contexts and within family systems. He has developed a personologic system for classifying dysfunctional families based on their processes, core themes and structures. His professional and research efforts have been focused on maximizing human functioning and also stopping the multigenerational transmission process involved in the individual, familial and cultural transmission of bio-negativity and personality dysfunction. A Unified Approach Jeffrey J. Magnavita, Ph.D., ABPP, FAPA Part I Friday September 9, 2005 8:00pm-9:45pm Part II Saturday, September 10, 2005 4:15pm-6:00pm This workshop will introduce participants to a unified personality-guided relational framework with which to conceptualize, assess, and treat personality systems at their various levels, flexibly navigating the microsystem to the mesosystem. Using this component systems model, we will consider the personality system as it is contextualized and expressed in the overall ecological framework, incorporating all vital components of the biopsychosocial model and their interrelationships. Clinical science is now entering a phase where we are moving beyond psychotherapy integration to a unified paradigm that incorporates components from various new disciplines including relational, affective, cognitive and neurosciences, as well as systems/chaos theory, developmental psychopathology, and psychodynamics. The focus will be on the importance of the affective matrix and the centrality of the relational system in organizing and shaping human adaptive responsiveness at four levels of the overall system, represented in triangular configurations: (1) intrapsychic-biological (2) interpersonal-dyadic (3) relational-triadic (4) sociocultural-familial. Within each of these four nested levels of structure/process we will examine the critical component subsystems identified by over a century of empirical and clinical investigation. These include neurobiological, affect-defense-cognitive system, attachment system, interpersonal processes, relational and family system, and sociocultural and political influences. By annexing general systems, cybernetics, chaos and complexity theories we will explore how human personality systems can be understood as operating holistically by incorporating principles of recursive patterns, part-whole relations, nonlinearity, self-replication and complexity. Participants will explore how a unified model guides the psychotherapeutic process by capitalizing on the various mechanisms of change within the levels of the relational system, locating fulcrum points of change. It is becoming increasingly evident through empirical and clinical evidence that the affective subsystem is a central, organizing subsystem whose forces need to be harnessed in order to accelerate the process of change. Videotapes will be shown to facilitate discussion about the various theoretical constructs and methods of restructuring that can be utilized to increase the level of differentiation and integration among various components of the overall system, thus enhancing growth and adaptive capacity. Participants will be introduced to the notion that within the complexity of the human personality system focal interventions can create “tipping points” at which the entire system can be reorganized at a higher level of functioning. Within the unified framework we will explore the synergy that can result when multiple modalities of therapy are combined or offered sequentially, and the array of restructuring methods offered by contemporary psychotherapies. This workshop will emphasize enhancing the growth process of the participants through active engagement, discussion, and microprocessing of audiovisual tapes, along with an elaboration of the theoretical constructs of a unified paradigm.
LEIGH McCULLOUGH, Ph.D. is an Associate Clinical Professor and Director of the Psychotherapy Research Program at Harvard Medical School (Boston, Massachusetts). Her lifelong professional devotion is to psychotherapy research and training; to discover effective ingredients of psychotherapy and teach therapists how to implement the techniques for problem resolution. Leigh was the 1996 Voorhees Distinguished Professor at the Menninger Clinic and received the 1996 Michael Franz Basch Award from the Silvan Tomkins Institute for her contributions toward the exploration of affect in psychotherapy. In 2001 she received the Longwood Psychiatry Award for Excellence in Teaching at Harvard Medical School. Leigh is the author of two books that teach Short-Term Dynamic Psychotherapy; Changing Character (Basic Books, 1997), and Treating Affect Phobia (Guilford, 2003) with Nat Kuhn, Stuart Andrews, Amelia Kaplan, Jonathon Wolf, and Cara Lanza Hurley. She is a co-author of an edited book on STDP, Short Term Therapy for Long Term Change (Norton, 2004), with Marion Solomon and colleagues. She is on the editorial board of the journal, Psychotherapy Research. Leigh has been involved in two randomized, controlled clinical trials demonstrating the effectiveness of STDP with Axis II disorders. She is currently a Co-Director, with Tore Stiles and Martin Svartberg of an extensive program of psychotherapy process research in Trondheim, Norway to identify the effective ingredients of therapy across different theoretical orientations. This research is discussed in detail on her website www.affectphobia.com. She conducts training seminars in STDP world-wide, and has a private clinical practice in Dedham, MA. Leigh McCullough, Ph.D. Friday, September 09, 2005 9:30am to 10:45am A positive self-image constitutes the foundation on which mental health is built, and most of our patients have some degree of impairment in their self structure. To heal this impairment, the therapist must pay particular attention to the defenses and affects associated with the self and with others. The restructuring of the sense of self is designed to shine a spotlight on an extremely important area for healing and ultimately for character change. In this workshop you will learn:
2. The principle of exposure and desensitization to resolve phobias about feelings – in this case, self-compassion, self-care, healthy pride, etc. 3. How to desensitize your patient’s Affect Phobia (i.e., conflicted feelings) - about positive feelings toward the self by helping the patient:
b. respond to needs for autonomy as well as interdependence c. become their own ‘good parent’ Videotaped segments will be shown with examples of restructuring of self in patients with differing levels of functioning; severe disorders, (GAF 40-50), Axis II disorders with moderate dysfunction (GAF 50-65) and higher-level functioning (GAF above 65). A Tutorial in STDP Using the Achievement of Therapeutic Objectives Scale Leigh McCullough, Ph.D. Saturday, September 10, 2005 4:15pm to 5:45pm This workshop will provide a “short-term,” tried-and-true method for teaching you how to do STDP by using the Achievement of Therapist Objectives (ATOS) scale. The ATOS scale was originally developed as a tool to evaluate patients’ progress in psychotherapy, but as we trained people in the coding procedure, it became evident that the rating process was a rapid and excellent way to learn methods of STDP. The only equipment needed as an adjunct to your private clinical practice is a camcorder, a consent form, and the ATOS Scale and you will have the tools in your hands to develop and continually refine your skills for becoming a master therapist. The ATOS scale has seven STDP objectives that are rated on a 1-100 scale and reflect the degree to which your patient has achieved each of the primary treatment objectives. These objectives also reflect common factors in psychotherapy and include the degree of the patient's; 1) insight, 2) motivation to change, 3) in-session experiencing of affect, 4) ability to express wants and needs interpersonally, 5) degree of inhibition, and 6 & 7) the degree of adaptive inner sense of self and others.
1) Instruction in how to rate your tapes with the ATOS Scale 2) Advice on introducing videotaping of sessions to patients and how to obtain informed consent 3) Guidelines on technological issues; camera equipment, copying tapes, etc. 4) Guidelines for how to make your career as a therapist one of lifelong growth and ongoing gratification Ongoing process research in Norway (to be published, as well as reported on our website www.jakobsladder.com) will allow you to compare your ratings to the average ratings of both good versus poor outcomes in the clinical trials of STDP. These ratings will provide normative standards, or a sort of ‘brass ring’ for us all to reach for in mastering our therapy skills.
Robert J. Neborsky, M.D. , a psychiatrist in private practice in Del Mar, California, is a Clinical Professor of Psychiatry at the UCSD School of Medicine as well as an (Honorary) Clinical Professor at the UCLA School of Medicine. He is the Medical Director for Lifespan Learning Institute, a non-profit organization specializing in continuing education seminars for mental health professionals, and a member of the Board of Directors of the International Experiential Dynamic Psychotherapy Association. He was a founding member on the Editorial Board of the International Journal of Short-Term Dynamic Psychotherapy. He is currently guest editor of the Ad Hoc Bulletin of Short-Term Dynamic Psychotherapy. Dr. Neborsky was honored by the UCLA School of Medicine, Clinical Faculty Association as the Distinguished Psychiatric Lecturer of the Year in 2002. In 2003 he was one of the founders of the Southern California Society for ISTDP and was elected by the membership to a two-year term as president of the Society. Dr. Neborsky attended the University of Maryland School of Medicine, where he won the Jacob Finesinger Award in Psychiatry. He served his residency at Emory University School of Medicine, where he earned the Hope Skobba Memorial Award. He served in the United States Navy as Director of In-Patient Psychiatry at Balboa Naval Hospital. From there he joined the full-time faculty of UCSD School of Medicine as an Assistant Professor of Psychiatry in charge of emergency services and the medical student clerkship. He published significant research on the treatment of acute psychosis with high-dose/low-dose haloperidol, and also wrote articles on the combined use of pharmacotherapy and psychotherapy in the treatment of depression. In 1981, while training with Dr. Habib Davanloo, he co-founded the San Diego Institute for Short-Term Dynamic Psychotherapy. In 2001, he co-authored Short-Term Therapy for Long Term Change (Norton) and is a contributing author in the 2003 book, Healing Trauma (Norton.) An active researcher and lecturer, Dr. Neborsky presents scientific papers to local, national and international groups as well as supervising core training in LA and San Diego. His next book will describe the interface between attachment theory and psychotherapy. Robert J. Neborsky, M.D., FAPA Sunday September 11, 2005 10:15am-11:30am Over the past decade, our understanding of the science of human emotions has expanded exponentially. However, application of that understanding--as applied to psychotherapy--has lagged behind scientific knowledge. The goal of my presentation is to narrow the existing gap between this breadth of knowledge and its clinical application. This, in essence, is the science of psychotherapeutic technique. A patient from my practice dramatically illustrates this point. Because he received 20 years of prior psychoanalysis, he presented a natural experiment of different techniques across time, correlated with outcome. From psychoanalysis he developed some accurate intellectual insight, but his unresolved defenses left a residual faulty developmental narrative, and, by his report, a core neurotic structure that had not been altered at all. He was somewhat demoralized and felt he had to accept a life in which he felt inferior to others, all men were enemies and rivals, and he lived in perpetual fear of their attacks. He said his visit with me was a “long shot” because he heard of a new approach that might help. The edited videotape of that therapy will show a weeklong process in which the patient’s dynamic unconscious was examined and repaired under the lens of Attachment Based -ISTDP. Using this clinical case presentation I will argue for the existence of dual layer processing of affective information on a conscious and unconscious basis. I will demonstrate how accessing the unconscious through the exploration of warded off or “repressed “ impulses in either the transference or primary attachment relationships can rapidly free a patient from a chronic need to cripple the self. I will demonstrate how the patient “resisted” the therapeutic potential of psychoanalysis by an unconscious allegiance to a punitive self –structure. This “superego resistance” enabled the continuance of an unconscious incestuous attachment to his mother despite his twenty-year analysis. Using the highly focused, active technique of AB /ISTDP, the patient was able to examine, understand, and alter his role in supporting and allying with his punitive superego. His sense of cause and effect, as represented by his historical narrative, dramatically changed. My case will specifically address how secrets of the unconscious can be unraveled, through close, moment-to-moment attention to the defenses as they emerge in the telling of the patient’s clinical story. The discussion will revolve around the use of conscious affects and memory to open access to unconscious affect and unconscious memory. This technique creates deep and profound abreactions, that lead to our ultimate goal of…”Freeing the Self.”
Dr. Ferruccio Osimo is the president of IEDTA. He founded the Italian Core Training in Experiential Dynamic Therapy, and is a guest teacher at the NYC Core Training. His experiential-dynamic approach is mostly concerned with the interplay of metapsychology, therapeutic techniques, therapist’s personality, and the real personal encounter of therapist and patient. Dr.Osimo was a full time clinical associate at the Tavistock Clinic, London, where his main source of training and inspiration has been Dr. D.H. Malan. The two therapists co-authored Psychodynamics, Training and Outcome in Brief Psychotherapy (Butterworth-Heinemann, 1992.) Dr.Osimo took part in a three year Core Training with Dr. H. Davanloo, and in the Short-Term Psychotherapy Research Program, run by Dr. L. McCullough at HMS. He has published several research and clinical works on EDT, including Brief Psychodynamic Therapy, a chapter from the Comprehensive Handbook of Psychotherapy (Vol. I, Wiley, 2002) and Experiential Short-Term Dynamic Psychotherapy, a Manual (Authorhouse, 2003.) Dr.Osimo’s work has been presented in the U.S.A., Brazil and Europe. Ferruccio Osimo, M.D. Saturday, September 10, 2005 2:30pm-3:45pm The Triangle of Dynamic Activities represents the main technical options of a therapist, according to his/her moment-to-moment interaction with the patient. Techniques should be always used flexibly, all the more when we are faced with an individual suffering from complex and severe personality disturbance, fulfilling the criteria for borderline, histrionic and passive aggressive personalities, with some mild paranoid traits. The patient’s Axis I symptomatology included dissociation, binge eating and anorgasmia. The audiovisual presentation will show vignettes from the central body of therapy, (sessions 21 to 57) mostly highlighting: (1) Undoing of the mechanism of dissociation and emerging of real closeness (2) Integration of split parts of the Self and (3) Desensitization to the fear of physical touching as necessarily involving a sexual request or an obligation to respond sexually. Working with a deeply disturbed patient, a real, personal relationship between therapist and patient, working with body-and-mind and the experience of a thorough connection with the other person are of the essence in order to promote a better integration of the split parts. THE POWER OF CHALLENGE AND THE APPEAL OF EMPATHY Ferruccio Osimo, M.D. Saturday, September 10, 2005 4:15pm-6:00pm This Workshop deals with the variable atmosphere created within each session by the interplay of the following factors:
In Aesop’s fable, the Sun wins the contest. In psychotherapy, we may need more Sun, more Wind, or even a lot of both. This constant variation, the same as with weather, is the resultant of a number of factors, hence the idea of exploring the potential of this metaphor, applied to psychotherapy. Aesop’s fable was first resorted to by Leigh McCullough, with whom the Author presented the first and second “Sun & Wind” Workshops, on Pantelleria (2003) and in Milan (2004). I will introduce the main concepts, and show the first Video, where the Wind is blowing hard, and the second Video, with a lot of Sunshine. In both cases the patients get in touch with very Deep Conflicting Feeling (X). Why is this? Would it have been possible--and equally effective--to work in a “Sunny” way with the first patient, and use a lot of “Wind” with the second?
Emanuel Peluso is a Marriage, Family Therapist in private practice in Del Mar, California. He is the co-author of Women & Drugs (CompCare 1987) and is the author of many articles on drug abuse, child abuse, domestic violence and ISTDP therapy. More information can be found at his website: www.epeluso.com Michael Alpert, M.D. Emanuel Peluso, MFT Saturday, September 10, 2005 4:15pm- 6:00pm Most research indicates that the Therapeutic Alliance is the very foundation of successful therapy. Yet most training and supervision tend to ignore it, focusing instead on theory and technique. This workshop starts with a brief overview of the historical development of the TA and the research that supports its importance. The greater part of the workshop concentrates on how to build the alliance, how to monitor and maintain it and how to recognize and quickly repair alliance disruptions. Excerpts from videotaped sessions will make each of these points clear. In this workshop you will learn:
Specific ways of maintaining attunement with the patient--using the here-and-now, renegotiating therapeutic goals—will be discussed and illustrated.
Albert Sheldon, M.D. has been an outpatient psychiatrist and psychotherapist for 25 years and is an Associate Clinical Professor at the University of Washington. Training in Experiential Dynamic Therapy, Short-Term Psychotherapy. Dr. Sheldon received a three year Bush Medical Fellowship in 1992 to study Short Term Dynamic Psychotherapy. Dr. Sheldon pursued ‘core group’ training in STDP with Habib Davanloo from 1992 to 2002 in Montreal, Canada. The past three years have given him opportunities to teach both basic and advanced courses in STDP/EDT in the Department of Psychiatry and Behavioral Sciences at the University of Washington. He is a visiting professor/presenter at the Washington School of Psychiatry in Washington DC; Dalhousie University in Halifax, Nova Scotia; Minnesota Psychological Association; and Lion’s Gate Hospital in Vancouver, BC. Previously on the clinical faculty at University of Minnesota teaching psychotherapy, he now supervises one training group in Minnesota, and another in Seattle, Washington. Most of Dr. Sheldon’s clinical research has consisted of studying videotapes of psychotherapy sessions to examine psycho-physiological changes in response to therapeutic interventions. He has also been involved in a multi-center outcome research project with Allan Abbass in Short-Term Psychotherapy. Complex Integration of Multiple Brain Systems Friday September 9, 2005 8:00pm-9:45pm In order to achieve the goals of psychotherapy we need to develop an intimate healing relationship with the patient. At the same time we need to facilitate change mechanisms within the patient utilizing the power and safety of this healing relationship. Using a binocular approach, we can view the elements of the psychotherapeutic process and at the same time view the psycho-physiological activation of different brain systems. When we are able to simultaneously activate and integrate [synoptically connect, ‘wire-together’] multiple brain systems within the patient in the here-and-now, we can achieve effective, rapid, and lasting therapeutic changes. Psychotherapy at its best is the complex integrative brain development of relational, emotional, cognitive and motivational structures in the healing context of the therapeutic relationship. Basic Premise: When we attend to multiple brain systems we can access more energy to do the work of therapy, and we can more clearly see what obstacles or inhibitions are present at this moment. As a result the patient experiences inner parts of themselves that they have hidden, buried, and/or avoided, most if not all of their lives. Patients come to us with symptoms that reflect underlying structural weaknesses. An architect patient said midway through his first session: “I thought we were here to repair the leaky gutters now I realize we are here to redesign the foundation of the house.” I understand those weaknesses as a lack of integration of fundamental parts of the emotional, motivational, and relational dimensions of the patient’s mind. This videotape presentation will elaborate on an approach to EDT, which focuses on preconscious motivational, relational, inhibitory, as well as emotional systems. It is based on years of research studying psychophysiological responses in patients in the therapeutic process of STDP and then experimenting with different interventions to smooth, speed, or maximize healing responses. When the therapist works with a constant focus on the intimacy of the therapeutic relationship in the here-and-now, there is maximal activation of non-conscious and preconscious relational appraisal systems. This opens unconscious procedural and implicit memory files which manifest as preconscious emotions, anxiety, inhibitions and drives. These nonverbal preconscious bodily responses are the transference: “a lived bodily memory of affect regulation.” [Schore]. The process is initiated with a careful mobilization of the patient to collaborate on the task of therapy. The focus of the task is on mindful awareness of psychophysiological processes and preconscious activation of emotional, motivational, and relational systems [brain systems]. Therefore, there is limited focus on affect, per se or on specific incidents in the patient’s life. The therapist attends to and explores which brain systems are active/ and which are not, at this moment in therapy. Therapeutic Process: The combination of focus on therapeutic intimacy, high levels of activation and attention to multiple brain systems is notably effective and rapid. We are changing synaptic pathways from the bottom up, the way they were originally developed. This simultaneous activation will wire together multiple systems giving rise to flexible complexity across the full spectrum of the individual thus “Freeing the Self”. I believe this adaptive integration is the essence of healing in psychotherapy.
Boston University School of Law, 1975 Ph.D., California Graduate Institute, 1989 Diana Shulman, J.D., Ph.D., Faculty Member of the Southern California Society for ISTDP, is a Research Psychoanalyst in private practice in Los Angeles and Encino, California. Dr. Shulman is a member of the California State Bar and the author of Co-Parenting after Divorce (WinnSpeed, 1996). Avoiding the Pitfalls in Experiential Dynamic Practice Patricia Coughlin, Ph.D. Diana Shulman, J.D., Ph.D. Saturday, September 10, 2005 4:15pm-6:00pm In this workshop you'll learn what can go right (the GOOD) and what can go wrong (the BAD and the UGLY) in the process of short-term dynamic psychotherapy. In particular, errors, omissions and remedies for the following three phases of treatment will be covered, through a mixture of lecture, discussion, role-play and video-tape: 1. Failure to adequately structure the interview and maintain an internal or intrapsychic focus 2. Failure to monitor unconscious anxiety - a vital diagnostic tool that determines the type and pace of interventions; and 3. Failure to turn patients against defenses, which then dominate the therapy process. Without question, experiential dynamic work is challenging for both patient and therapist. Its aim, encouraging the patient to reclaim disowned aspects of the self by facing warded off feeling and impulse, sounds simple enough. Yet the patient's (and therapist's) willingness to tolerate anxiety, take down defensive scaffolding, and "partner up" on a journey into uncharted and often frightening territory can sputter and stall. From the initial 2-4 hour meeting through termination, sessions are structured by the therapist to focus on the relationship between (a) anxiety, (b) defense, and (c) impulse/feeling so that patients can fully understand their inner workings. Sensitivity and caution are called for as patients are encouraged to work at their highest level without taking refuge in defense. The result is the creation of a highly charged therapeutic encounter. Often, because of this emotional intensity, anxiety and defensiveness rise in both therapist and patient and cause the process to bog down. Participants will learn to adequately structure the interview, monitor the pathway of unconscious anxiety, and do a thorough defense analysis without causing misalliance.
Isabel Sklar received her MSW from NYU, subsequently trained in psychoanalytic ego psychology and later in short-term dynamic psychotherapy with Habib Davanloo. She worked closely with Michael Alpert, Diana Fosha and others at the New York and New Jersey STDP Institute. Ms. Sklar is in private practice in New York and New Jersey. Isabel Sklar co-authored a chapter in an APA monograph, “Clinical and Research issues in Short-Term Dynamic Psychotherapy,” and has presented at numerous conferences. Friday, September 9, 2005 9:15am This presentation will provide the participants with a historical overview of the short-term dynamic therapy movement. It will trace short-term dynamic psychotherapy’s roots in psychoanalytic theory, beginning with Freud, in order to assist the participants in understanding the context within which STDP developed. Additionally, the presentation will provide an overview of the theoretical positions of the significant pioneers in short-term dynamic psychotherapy, including Davanloo, Malan, Sifneos, Mann, as well as highlighting more recent innovations in short-term therapy models. The purpose of this presentation is to provide the participants a common perspective on the development of short-term dynamic therapy.
Marion F. Solomon, Ph.D. is senior faculty at UCLA, Department of Humanities, Sciences and Social Sciences, Extension Division, and Professor at the American Behavioral Studies Institute. She is Co-Founder of the Lifespan Learning Institute, dedicated to advanced training and application of research in individual, group and family therapy. Dr. Solomon is a member of the California Psychoanalytic Society, a Research analyst, American Academy of Psychoanalysis, a fellow of the American Group Psychotherapy Association and a member of the Division of Psychoanalysis, American Psychological Association. Her books include, “Narcissism and Intimacy: Love and Marriage in an Age of Confusion,” (WW Norton), “Lean on Me: The Power of Positive Dependency in Intimate Relationships,” (Simon and Schuster), Co-Author of “Short Term Therapy For Long Term Change,” (WW Norton), Co-Editor of “The Borderline Patient,” (The Analytic Press); “Countertransference in Couples Therapy,” (WW Norton) and “Healing Trauma,” (WW Norton). The books "Narcissism and Intimacy" and "Lean On Me" predated her immersion into short term dynamic psychotherapy. They were very focused on attachment, attunement, and the trauma of failed relationships. "Narcissism and Intimacy" focuses on early developmental issues, connection to emotions, and narcissistic defenses against closeness. "Lean On Me" was a challenge to the co-dependency movement, and focuses on the importance of interdependence in a culture that values independence. "Short Term Therapy For Long Term Change," was an outgrowth of several conferences with Rob Neborsky, David Malan, Leigh McCullough, etc. Her chapters in that book and the "Healing Trauma" book could be called "Emotionally Centered Couple's Therapy," but she has not formally named her therapeutic approach. Marion Solomon has played a major role in organizing EDT conferences in southern California through the Lifespan Learning Institute. in a Model of Couples Therapy Marion F. Solomon, Ph.D. Saturday, September 10, 2005 4:15pm-6:00pm New developments in attachment and neuroscience research will be presented showing that traumas of early disturbed bonding experiences can be healed through a period of attachment in an adult relationship. Participants in this workshop will explore ways to apply understanding of right and left brain functions in diagnosing and treating partners who are experiencing difficulties in their adult relationships. The presentation examines three important aspects of the couples' system; 1) the narratives of each about specific distressing interactions, 2) Integration of right brain core affective experiences and left brain cognitive explanations of events, 3) defenses against painful or shameful emotion that intensify problems of a relationship. Emotional states often monopolize brain resources. We tend to form strong memories around emotional events. In marriage and other committed relationships interactional patterns recreate internal working models developed in early childhood. Problems in early life of one or both partners are recapitulated in the current relationship. The re-emergence of intense affect may distort the ability to recognize clearly, and respond appropriately to emotionally laden situations. When emotional responses are very intense, reasoning ability is distorted. This model of couples’ therapy presented here is well suited for collaboration with colleagues who are providing individual treatment. It opens new avenues for exploration, and provides a milieu to test out newly learned ways of experiencing emotion in the here-and-now of an ongoing relationship. The treatment is designed to recognize ingrained patterns of defense against attachment trauma. The workshop includes videotapes of sessions to clarify the ways that this treatment is applied in couples’ therapy. We will see how to listening to the partners' process of presenting problems (money, work, sex, etc.) can give insight into how coherent or disorganized the narratives of each may be. The information presented will provide the therapist important information about how to change the working model of attachment in the current relationship. OBJECTIVES- Participants attending this workshop will learn to: 1. Identify the ways traumatic experiences and early attachment traumas are re-experienced in adult attachments. 2. Define underlying affective yearnings that remain below the surface of such identified problems as money, work, sex, in-laws, childrearing differences, etc. 3. Distinguish between right-brain emotional development and left-brain cognitive development in patterns of attachment throughout the lifespan
Josette ten Have-de Labije, a registered psychologist-psychotherapist and clinical psychologist, started her professional career in 1972 at the department for Neuro and Psychophysiology of the Free University of Brussels (Belgium). Thereafter she has worked in the Netherlands at a public mental health center for ambulant (non-residential) patients as coordinator of the Behavior Therapy Department and member of the Diagnostic Staff. She has been in private practice since1990. She is a member of the Dutch Associations for Cognitive and Behavior Therapy, for Group Psychotherapy, for Couples and Family Therapy, and for Intensive Short-Term Dynamic Psychotherapy. From 1989 -1992 she was member of the Dutch ISTDP core-group, which was trained and supervised by Professor Dr Habib Davanloo. As supervisor and trainer of the Dutch Association for Cognitive and Behavior therapy, she has given post-graduate courses in behavior therapy at the Universities of Utrecht and Amsterdam and several post-doctorate courses and workshops. As supervisor and trainer of the Dutch Association for Short-Term Dynamic Psychotherapy, she has given several post-doctorate courses and workshops. She has organized several national and international conferences on Behavior Therapy, on Cancer Treatment and Mental Health, and on ISTDP. As one of the founders of the Dutch Association for Short-Term Dynamic Psychotherapy (VKDP), she has been on the Board through October 2004 and is the coordinator of the VKDP’s educational program. Publications Presentations at the International Congress on Behavior Therapy at Jerusalem 1980 (Fear of flying), the European Congress on Behavior Therapy in Amsterdam 1987 (Group therapy for women with autonomy problems), several publications in Dutch Scientific Journals, and a self-help book (in the Dutch language) on Fear of Flying (ISBN 906009851x). Editor (together with Professor Dr H. Balner) of the Conference. Proceedings “Coping with Cancer and Beyond: Cancer Treatment and Mental Health” (1990, ISBN 9026512236) Presentations: The International Congress on STDP in Milano (2001) in Amsterdam (2002) and in Washington (2003). Editor of the VKDP Summer School Proceedings 2001; The Working Alliance in ISTDP: Whose Intrapsychic Crisis? (ISBN 90-806335-1-8), Editor of the Conference Proceedings; Natura Artis Magistra, (Un)conscious Animals as Teachers of STDP (ISBN 90-806335-2-6) Editor (together with C. Cornelissen, P. van Tricht, R. Neborsky) of the Ad Hoc Bulletin of STDP : Practice and Theory. Several publications for the Ad Hoc Bulletin for STDP Turning Red Traffic Lights into Green on the Road to Mourning Josette ten Have-de Labije, Psy.D. Friday September 9.2005 11:15am-12:30pm The patient is a 44-year old woman, who enters therapy because of her continuous self-punitive talk, which intensified after a serious accident, six years ago, in which her ankle was smashed. During the initial interview it became clear that this accident and the subsequent years of recuperation can be viewed as a sequence of repeated psychotraumas, which are superimposed on an earlier psychotrauma from 24 years before. Video-vignettes from parts of the initial interview and some subsequent sessions will demonstrate the patient's and therapist's common undertaking to conquer the patient's punitive superego and to restructure her ego-adaptive capacity in order to work through the patient's many painful feelings. (Role) Playing with the Triangles of Conflict and Persons Josette ten Have-de-Labije, Psy.D. Robin L. Kay, Ph. D. Saturday, September 10, 2005 4:15pm-6:00pm In Intensive Short-Term Dynamic Psychotherapy, the therapist's aim is to help the patient to gain access to his unconscious complex transference feelings and his core conflicts and to work them through in order for the resolution of the patient's problems. As the therapist takes pain helping the patient to make his complex transference feelings conscious and to bear and contain them, it follows that a successful co-operation with the patient depends heavily on the functioning of the patient's ego-adaptive capacity. It is therefore very important for the therapist to assess this capacity repeatedly, and to restructure it when necessary. Most patients are unable to see the causal link between what happened in a concrete situation (the triangle of persons) and the subsequent aroused feelings/impulses, anxiety and defenses (the triangle of conflict), nor can they distinguish correctly between the different aroused feelings/impulses, anxiety and defenses. When assessing the patient's ego-adaptive capacity and helping his patient to understand his intrapsychic problem, Davanloo uses the concepts of the triangles of conflict and persons as developed by Menninger and Malan. After a short theoretical introduction the presenters of this workshop will engage the participants in role-playing to illustrate how the therapist could work with the triangles of conflict and persons to assess his patient's nature/degree of ego-adaptive capacity and to help his patient's understanding of his intrapsychic problems.
Susan Warren Warshow is a Licensed Clinical Social Worker (Board Certified Diplomate) and Licensed Marriage and Family Therapist in private practice since 1980, with an office in Woodland Hills, California. She offers individual and marital therapy, as well as group and individual supervision to licensed professionals interested in expanding their knowledge of Experiential Dynamic Therapy. She completed a three-year core curriculum in Intensive Short-Term Dynamic Psychotherapy with Robert Neborsky, M.D. and Patricia Coughlin Della Selva, Ph.D., and presented at the International Conference for STDP in Amsterdam in 2002. She has guest lectured at California State University Northridge, California Graduate Institute and California School of Professional Psychology, and has given a series of lectures on personality disorders to several medical staffs at hospitals in the Southern California area. She has published several articles in the Ad Hoc Bulletin, an international journal of the Dutch Association for Short-Term Dynamic Psychotherapy (the VKDP). After receiving her M.S.W. from U.C. Berkeley in 1970, she was a psychotherapist, supervisor and coordinator of continuing education at the Department of Psychiatry at Northridge Hospital. She coordinated over100 public presentations on child abuse and neglect in Los Angeles County and was publicity director for its first child abuse hotline. These were services for the Center for the Improvement of Child Caring. She has led many psychotherapy groups and workshops focusing on a variety of issues. Preserving Essential Principles With Flexibility and Authentic Use of Self Susan Warren-Warshow, LCSW Friday, September 9, 2005 8:00pm-9:45pm The presentation will explore ways to modify, personalize, and integrate techniques of defense interruption to access deep affect and resolve trauma. To effectively apply EDT, it must be adapted to one’s own personal style, personality and orientation. The presenter will share her own journey in this process. Videotape presentation. This is a workshop for therapists who are seeking to develop their own authentic voice, creativity, and intuitive capacity in the application of EDT. When therapists begin to work with an intensely emotion-focused approach, we quickly encounter powerful forces of resistance and defenses against emotional closeness. As core feelings rise, we also see the rise of anxiety, guilt and shame. We learn to welcome resistance as a sign of ego strength. This approach can feel quite daunting in spite of its amazing effectiveness. Direct and focused efforts to penetrate resistance to core affect can bring striking relief to longstanding, seemingly intractable symptomatology. However, as we learn this approach, it is common to become discouraged at times and to begin to doubt our capabilities. Therapists can feel very concerned by negative reactions, usually due to aborted attempts at breakthroughs into the unconscious; accessing intensely disturbing and painful emotions without first reducing excessively high states of anxiety; or insufficiently processing shame and guilt. Adequate supervision and emotional support for the therapist and timely follow-up with the patient can significantly alleviate unsatisfactory results. How do we integrate the powerful principles of EDT in a way that can truly work for us--and our patients? In this workshop, the following will be discussed:
2. How to maximize use of self through suspension of our agendas; spontaneity; laughter; helpful self-disclosure; listening for the sake of being “present” and allowing our intuitive sense of direction to emerge in the session. 3. Learning to avoid the error of mimicry. The training process rather naturally leads to the idealization of our brilliant teachers and the desire to copy them. Yet it is important for therapists to honor their personal gifts and unique interactive styles. 4. Issues of pacing will be explored, related to the therapist’s readiness to incorporate new concepts and the patient’s readiness to relinquish defenses. 5. Suggestions for handling the training process and increasing compassion for the self of the therapist, as well the patient. 6. How to incorporate varying elements of the approach with a “take what works for you” attitude. 7. Identifying unrealistic expectations of oneself and EDT. There is a tendency to assume that every treatment disappointment is “about us” or a misuse of the approach. Home |
