The Felt Sense of Existing in the Heart and Mind of the Other:
Experiential Work with Receptive Affective Experience
Diana Fosha, Ph.D.
is the developer of AEDP (Accelerated Experiential-Dynamic Psychotherapy), and founder and current director of the AEDP Institute, an internationally recognized school that specializes in training therapists in a healing-oriented transformational approach to the treatment of attachment trauma. A leader in the field of transformational studies in trauma treatment, Fosha’s work on healing transformational processes focuses on integrating neuroplasticity, recognition science and developmental dyadic research into experiential clinical process work with patients. She is the author of The transforming power of affect: A model for accelerated change*(Basic Books, 2000); with Natasha Prenn, co-author of Supervision essentials for Accelerated Experiential Dynamic Psychotherapy. APA, 2016); and senior editor, with Daniel Siegel and Marion Solomon, of The healing power of emotion: Affective neuroscience, development & clinical practice (Norton, 2009). She is the author of numerous papers and chapters on healing transformational processes in experiential therapy and trauma treatment. Three DVDs of her live AEDP clinical work have been issued by the American Psychological Association (APA). Dr. Fosha practices in New York City and leads workshops and trainings worldwide. She was previously on the faculty of the Departments of Psychiatry and Psychology of NYU and Mt. Sinai Medical Centers in New York. Many of her papers are available through the AEDP website at www.aedpinstitute.org
*N.B. Diana Fosha's book has been translated into italian: "Il potere trasformativo dell'emozione: Un modello di cambiamente accelerato"
A Sheep in Wolf’s Clothing: Rage, Sadism, and Predatory Enactments in the Treatment of Complex Trauma
Severe interpersonal trauma is not an ennobling experience from which resilience and recovery naturally develop. Instead, it involves perpetration of the most base and ignoble behaviors of which humankind is capable, and naturally evokes similar reactions in those who are victimized, creating a cycle of violence that can reverberate down the generations. The inner organization of patients who have experienced profound or sadistic abuse often include unintegrated mental representations, ego states and dissociative parts that contain rage and sadistic tendencies. Enactments of trauma may include a very human reaction to being intentionally hurt and humiliated, based on evolutionary tendencies. In many cases, these inner “perpetrators” can remain hidden in therapy while continuing to imitate the abuser and enact pain, control, and humiliation toward the patient, leading to unremitting chaos and therapeutic impasse. Other times, patients overtly act out cruelly toward others, including the therapist. Therapists understandably feel confused, frustrated, intimidated, disgusted, or even terrified by these behaviors and overwhelming negative emotions. We will explore ways to handle our own intense countertransference reactions, as well as how to understand and work with these challenging issues. Therapists can learn how to accept rage and sadism as inevitable aspects of victimization, to remain compassionately engaged while setting firm limits on destructive behaviors, to moderate their own defensive reactions, and to actively help patients bring these issues to therapy. Goals of treatment include helping patients (1) shift from predatory and defense-oriented neural pathways to ones involving social engagement; (2) contain sadistic or enraged behaviors while accepting related emotions; (3) work directly with dissociative parts to increase inner compassion, communication and cooperation; (4) decrease chronic shame and disempowerment; (5) realize traumatic experiences so enactments cease; and (6) develop a mindful personal ethic of compassion and collaboration toward self and others.
"The Science of Consciousness and the Future of Psychotherapy."
Over the past few years, new insights into trauma’s impact on body, brain and relationship have spawned a range of new approaches to treatment. Many of these modalities can be considered fundamental shifts from earlier therapeutic paradigms.
We will examine how neuroscience research has elucidated how, in the course of development, children learn to regulate their arousal systems and to focus on what is most relevant. We then will examine how trauma, abuse and neglect derail these processes and affect brain development. Since traumatic imprints are stored in subcortical brain areas and are largely divorced from verbal recall, a central focus needs to be to the somatic experiencing of trauma-related sensations and affects. These deep imprints are the engines for continuing maladaptive behaviors.
Fixation on the trauma and learned helplessness require interventions aimed at restoring active mastery and the capacity to attend to the here-and-now.
With the aid of videotaped demonstrations and experiential demonstrations of affect regulation techniques, we will examine the role of body oriented therapies, neurofeedback, yoga, theater, IFS and EMDR in resolving the traumatic past and discuss the integration of these approaches during different stages of treatment.
- This lecture will review recent developments in the treatment of PTSD, and the effects that they have been shown to have on the recovery of traumatized individuals.
This lecture will emphasize techniques of physical mastery, affect regulation and memory processing.
Working with the Fragmented Selves of Trauma Survivors
Janina Fisher, Ph.D.
Istituto di Scienza Cognitive
22-24 September 2017
Alienation from self is a survival strategy that maintains children’s attachment to abusive caregivers by disowning themselves as “bad” or “unlovable.” This painful failure of self-acceptance results in lifelong shame and self-loathing, difficulty self-soothing, and internal struggles between structurally dissociated parts of the personality, each with its own defensive strategy. Without internal compassion and a sense of worth, it becomes impossible to take in the compassion and acceptance of others.
To overcome this alienation from self, the therapy must focus on cultivating the clients’ capacity for mindful self-observation. Most importantly, clients must be taught to recognize signs of their disowned selves as the parts manifest in overwhelming emotions, disturbing body sensations and impulses, or self-punitive cognitions. The therapist’s empathy for young, traumatized parts softens phobic avoidance of them, clients slowly come to “befriend” their trauma-related, structurally dissociated younger selves. As clients bring these wounded children “home,” they begin to feel a bodily sense of warmth and safety that changes their internal experience. Once attached to their young selves, a bond forms spontaneously. Using strategies inspired by Structural Dissociation theory, Sensorimotor Psychotherapy and Internal Family Systems, the therapist will discover the therapeutic power of fostering secure attachment bonds to clients’ most deeply disowned selves.
You will learn to:
- Mindfully observe the signs of disowned parts and their internal conflicts
- Identify parts that sabotage self-compassion or self-acceptance
- Describe interventions that increase a somatic sense of connection or attachment to structurally dissociated parts
- Utilize body-centered Sensorimotor Psychotherapy techniques to increase empathy and felt connection to emotion
- Foster ‘earned secure attachment’ as the outcome of attachment bonding between adult and child selves
Rome, September 22-24: “Attachment and trauma – Human evolution and recovery”
The Essence of Successful Trauma Therapies This workshop examines how present-orientation, dual attention, affect, relationship, and meaning are essential components in all good trauma therapies, and how these work in EMDR, ego state, somatic and neo-dynamic therapies. It includes practical ways to enhance the therapeutic presence in all therapies, especially with highly traumatized or dissociative clients.
Pat Ogden, PhD, is a pioneer in somatic psychology and the Founder and Education Director of the Sensorimotor Psychotherapy Institute, an internationally recognized school specializing in somatic–cognitive approaches for the treatment of posttraumatic stress disorder and attachment disturbances. Her Institute, based in Broomfield Colorado, has 19 certified trainers who conduct Sensorimotor Psychotherapy trainings of over 400 hours for mental health professionals throughout the US, Canada, Europe, and Australia. The Sensorimotor Psychotherapy Institute has certified hundreds of psychotherapists throughout the world in this method. She is co-founder of the Hakomi Institute, past faculty of Naropa University (1985-2005), a clinician, consultant, and sought after international lecturer. Dr. Ogden is the first author of two groundbreaking books in somatic psychology: Trauma and the Body: A Sensorimotor Approach to Psychotherapy and Sensorimotor Psychotherapy: Interventions for Trauma and Attachment (2015) both published in the Interpersonal Neurobiology Series of W. W. Norton, and numerous articles. Her current interests include writing and developing training programs in Sensorimotor Psychotherapy for children adolescents and families with colleagues, Embedded Relational Mindfulness, culture and diversity, couple therapy and working with challenging clients.
Brain to Brain, Body to Body: The Interpersonal Nature of Shame
Exploring and resolving shame, especially pre-verbal, chronic shame that is not connected with autobiographical memory, is challenging for even the most effective therapists and their clients. Shame is a painful interpersonal emotion that first develops in relationship with attachment figures. We see ourselves through their eyes, and if we perceive that they are disapproving, humiliating, ridiculing or hold us in contempt, our sense of self, bodies, emotions, thoughts and self-esteem are deeply affected. “Shame” is thought to be a derivation of an earlier word referring to “cover” as in concealing oneself. Indeed, we typically wish to hide the parts of ourselves we feel are shameful—the perceived badness, the parts that do not feel “good enough” in our own or in another’s estimation. Because shame inherently has to do with parts of the self that clients wish to disguise or conceal, they often do not talk about their shame for fear (implicit or explicit) of further humiliation or rejection. Therapists, sometimes because of their own shame, also might avoid bringing shame to the fore in the therapy hour. The avoidance on the part of both parties obfuscates shame itself and renders its treatment inconceivable.
With an emphasize on the relational nature of shame, special attention will be given to the importance of the therapeutic relationship, including both implicit and explicit communication between therapist and client, to resolve shame. Since the first shameful encounters occur between the infant or young child and attachment figure primarily through non-verbal communication, such as prosody, eye contact, and touch, we will explore the role of non-verbal communication in the therapy hour in terms of healing shame. The use of touch especially will be clarified, including cautions, transference and countertransference, and potential benefits. A prominent feature of this workshop is to explore Sensorimotor Psychotherapy interventions that directly address the manifestations of shame in movement, posture, and gesture of the body, as well as in a dysregulated nervous system. We will look at avoidance, compensations and defenses against shame, including the flat affect and inability to connect that often accompanies chronic shame. We will also explore the physical manifestations of the antidotes to shame, such as healthy pride, self-esteem and competence. Sensorimotor Psychotherapy approaches, including the use of touch, will be illustrated through video tapes excerpts of consultation sessions with clients.
Behavioral, biological, and epigenetic consequences of different early social attachment experiences in primates
Stephen J. Suomi, Ph.D.
Laboratory of Comparative Ethology
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of health
Over the past decade a substantial body of research has demonstrated significant interactions between specific genetic polymorphisms and early social environmental factors that can influence behavioral, biological, and epigenetic development in nonhuman primates. Differences in early rearing social experiences (maternal vs. peer-only rearing during the first 6 months of postnatal life) have been associated with significant differences in behavioral development, in emotional regulation, in hypothalamic-pituitary-adrenal activity, in neurotransmitter metabolism, in both brain structure and function, and even in genome wide patterns of methylation and gene expression. Similar consequences for behavioral, biological, and epigenetic development can be demonstrated for infants whose mothers differ in social dominance status. Given the apparently “protective” power of secure early attachment relationships for young monkeys, recent research has been focused on characterizing specific aspects of social interplay between rhesus monkey infants and their mothers during the first month of life, particularly those involving face-to-face exchanges, that are associated with the development of secure attachment relationships. It now appears that these forms of social interaction are far more frequent, extensive, and intense than was previously reported. Moreover, such early social exchanges may provide the foundation for the acquisition of specific social skills and strategies associated with species-normative patterns of social behavior throughout development, and, additionally, may provide a means for minimizing at least some of the behavioral, biological, and epigenetic consequences of otherwise adverse early social experiences.
Trauma and the Social Brain
Our vulnerability to and ability to heal from trauma are deeply informed by the evolution and development of the human brain. Secure attachment, our experience of self, and our ability to link to the group mind can all be undermined by trauma. In this presentation we will explore the evolution, development, and functional organization of the brain with the goal of gaining a deeper understanding of the impact of trauma and the multiple avenues of healing.
Dan Hughes, Ph.D. is a clinical psychologist with a limited practice in South Portland, Maine. He founded and developed Dyadic Developmental Psychotherapy (DDP), the treatment of children who have experienced abuse and neglect and demonstrate ongoing problems related to attachment and trauma. This treatment occurs in a family setting and the treatment model has expanded to become a general model of family treatment. He has conducted seminars, workshops, and spoken at conferences throughout the US, Europe, Canada, and Australia for the past 19 years. He is also engaged in extensive training and supervision in the certification of therapists in his treatment model, along with ongoing consultation to various agencies and professionals. He is president of DDPI a training Institute which is responsible for the certification of professionals in DDP. Information about DDPI can be found on ddpnetwork.org
Dan is the author of many books and articles. These include Attachment-Focused Parenting (2009), Attachment-Focused Family Therapy Workbook (2011) and, with Jon Baylin, Brain-Based Parenting (2012) and The Neurobiology of Attachment-Focused Therapy (2016).
Dan can be contacted at: Dhughes202@gmail.com
His website is www.danielhughes.org
Attachment, Companionship, and the Path of Recovery from Developmental Trauma.
At birth our brain and body are prepared to trust our caregivers to lead us into a most interesting and rewarding life within the shelter of a supportive and engaging family and community. When we are violated or abandoned by those we trust, the resulting trauma hurts the mind and heart of the child like no other trauma could. Recovery from this early betrayal is a long and challenging journey made possible by new relationships where trust takes root again—within the brain and heart—through safety and comfort and where the awakening spirit is then met with warm welcomes, compassion, and the flowering of delight and reciprocal joy. Being traumatized within relationships, the spirit of the child needs to be both healed and come to thrive within relationships. The role of the therapist and teacher, caregiver and friend is not to fix this fearful and shameful child but rather to enable the child to discover—with comfort and joy—who the child was born to be.
Sapienza Rome University
Proximal and Distant Outcomes of stress and traumas during pregnancy
Traumatic experiences and stress during pregnancy are frequently connected to negative outcomes in the expectant mothers, in the maturation of the foetus and in the physiology of delivery. But further consequences can appear later in the development of the child provoking distortions and psychopathological outcomes.
Home Visiting Programs which support parents in the their interaction with the baby can modulate traumatic effects during pregnancy and can be effective also in subsequent phases of the development.