The TRANSFORMATION of EMOTIONAL SUFFERING. Diana Fosha, Ph.D.

Transcription

1 The TRANSFORMATION of EMOTIONAL SUFFERING Diana Fosha, Ph.D. *

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3 Diana Fosha PhD, 2016 aedp *

4 COME JOIN ME! TO REGISTER: Go to *

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7 reduce stress, co-create safety, promote emotion regulation, & expand the realm of transformational experiences Diana Fosha, 2018 aedp *

8 cultivates interpersonal rhythms to achieve psychobiological attunement to undo aloneness and co-create safety nurtures the capacity for people to use right brain-to-right brain communication, eg.., their voices and faces, to regulate emotional states uses experiential methods to regulate and process intense emotions to completion both the heart-breaking, gut-wrenching emotions of trauma, & the positive emotions of healing transformation uses metatherapeutic processing to achieve integration and new meaning, seamlessly integrating somatically based emotional experiences with relational and reflective capacities. Diana Fosha, 2017 aedp *

9 Neuroplasticity Attachment theory and research Developmental studies of caregiver-child interactions Interpersonal Neurobiology Emotion theory Transformational studies Affective neuroscience Somatically based trauma studies Psychodynamics, Relational Psychoanalysis Diana Fosha, 2017 aedp *

10 Positive embodied attachment informed and intersubjectively engaged therapeutic relationship that seeks to replicate the sociobiology of kin-recognition, secure attachment, limbic resonance, mammalian caregiving and early development Relationally reparative stance aimed at undoing aloneness in the face of embodied experience Diana Fosha, 2017 aedp Attachment-based, affect-facilitating therapeutic relationship Embodied positive emotional engagement, dyadic mindfulness, and affirmative advocacy on behalf of clients and their knowing *

11 aedp Psychobiological state attunement, moment-to-moment Empathy Affective resonance Gaze sharing eye contact Mutually shared pleasure Affective engagement Play Diana Fosha, PhD, 2018 *

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13 NEUROPLASTICITY in CLINICAL ACTION UNDOING ALONENESS Diana Fosha, 2017 aedp DYADIC REGULATION & EXPERIENTIAL PROCESSING of the EMOTIONS of TRAUMA The METAPROCESSING of TRANSFORMATIONAL EXPERIENCE *

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15 We are wired to heal. The potential to heal resides within the individual no matter what. We re not just bundles of pathology. Lodged deeply in our brains and bodies, there for awakening, lie the innate, wired-in dispositions for self healing and self righting. Wired-in dispositions for self-healing and self-righting: Our aim is to entrain them and harness their healing potential

16 aedp The human psyche, like human bones, is strongly inclined to self healing. The psychotherapist s job, like that of the orthopaedic surgeon, is to provide the conditions in which self healing can best take place John Bowlby 31

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18 The brain s capacity to change and adapt throughout an individual s life course The brain s ability to reorganize itself by continually forming new neural connections throughout a person s life. The connections among cells reorganize in response to changing needs [is] an intrinsic property of the human brain and represents evolution s invention to enable the nervous system to escape the restrictions of its own genome and thus adapt to environmental pressures, physiological changes, and experiences. Diana Fosha, 2016 aedp *

19 The power to direct our attention has the power to shape the brain s firing patterns, as well as the power to shape the architecture of the brain itself (Siegel, 2010). "Many tastes we think natural' are acquired through learning and become 'second nature to us. We are unable to distinguish our second nature from our original nature because our neuroplastic brains, once rewired, develop a new nature, every bit as biological as our original" (Doidge, 2007). Diana Fosha, 2016 aedp 6

20 (activates the nucleus basalis, which secretes acetylcholine, which strengthens synaptic connections) too safe : need to work at the edge: safe but not (also stimulates growth of new neurons), of new experiences, skills : when an organism is motivated to learn (drive to explore), the brain responds plastically (dopamine and acetylcholine consolidate the changes just made) manifested in positive affect and positive affective markers Diana Fosha, 2016 aedp 7

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22 From aedp Sustained positive emotion: savoring (AEDP: privileging the positive; stay with it; metaprocessing) Recovery from negative emotion: resilience (AEDP: processing to an affective shift, experientially heightening resilience ) Empathy, altruism and pro-social behavior (AEDP stance, core state) Mindfulness: counter to mind wandering and affective stickiness (AEDP: focus, staying with, metaprocessing) Reference: Davidson & Schuyler (2015), pp Diana Fosha,

23 The circuits we identify as underlying these four constituents of well being all exhibit plasticity and thus can be transformed through experience and training. aedp Diana Fosha, 2016 Reference: Davidson & Schuyler (2015), pp *

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26 At its essence, in its therapeutics, i.e., its theory of therapy We already all believe in quantum change. it is called trauma. In AEDP, healing is not just a desired outcome; it is also a, an experience, and a dispositional tendency always at the ready.. Enter

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31 Psychobiological state attunement, moment-to-moment Empathy Affective resonance Gaze sharing eye contact Mutually shared pleasure Affective engagement Play Diana Fosha aedp Diana Fosha,

32 Positive embodied attachment informed and intersubjectively engaged therapeutic relationship that seeks to replicate the sociobiology of kinrecognition, secure attachment, limbic resonance, mammalian caregiving and early development Relationally reparative stance aimed at undoing aloneness in the face of embodied experience Attachment-based, affect-facilitating therapeutic relationship Embodied positive emotional engagement, dyadic mindfulness, and affirmative advocacy on behalf of clients and their knowing Diana Fosha, 2016 aedp *

33 the Brain: Dyadic Resonance is Transformative Diana Fosha PhD aedp *

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35 Diana Fosha, Image courtesy of Ben Lipton

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45 Ancestral Tools for Living Panksepp (2009)

46 Ancestral Tools for Living Panksepp

47 Ancestral Tools for Living Panksepp

48 Ancestral Tools for Living Panksepp

49 Ancestral Tools for Living Panksepp

50 Ancestral Tools for Living Panksepp

51 Dyadic Affect Regulation = Diana Fosha PhD *

52 Dyadic Affect Regulation = Diana Fosha PhD *

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54 Diana Fosha PhD, 2018 aedp Emotional Suffering Flourishing *

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58 Transformational Experience "When the mind regards itself and its own power of activity, it feels pleasure: and that pleasure is greater in proportion to the distinctness wherewith it conceives itself and its own power of activity Spinoza The experience and process of change is part of the AEDP change process! aedp Diana Diana Fosha Fosha, PhD, aedp 22 67

59 "There is a distinct physical sensation of change, which you recognize once you experienced it. We call it a body shift. When people have this even once, they no longer helplessly wonder for years whether they are changing or not. Now they can be their own judges of that (Gendlin, 1981, p. 7) aedp Diana Fosha PhD The sense of what is wrong carries with it, inseparably, a sense of direction toward what is right (Gendlin, 1996, P. 187) *

60 Transformational Experience Therapeutic change is itself a new experience to attend to, fully explore, and reflect on Positive change feels good and becomes the focus of therapeutic work Which leads to further adaptive change

61 Meta-therapeutic Processing Reflection on experience of change deepens integration (R/L Brain) Explores and enlarges the sphere of transformational experience Consolidates therapeutic gains Promotes flourishing Quintessential contribution of AEDP

62 Transformational Experience The experience and process of change is part of the AEDP change process!

63 "When the mind regards itself and its own power of activity, it feels pleasure: and that pleasure is greater in proportion to the distinctness wherewith it conceives itself and its own power of activity Spinoza Diana Fosha PhD aedp *

64 Diana Fosha PhD, 2016 EMOTIONS: Ancestral Tools for Living Panksepp *

65 EMOTIONS: Ancestral Tools for Living Panksepp

66 This buffeting between the extreme polarities of heaven and hell generates the rhythm essential for the transformation of trauma. With the healing vortex, we begin by riding the warble (wobbly oscillation) created by these two opposing forces, experiencing the turbulence between them (1997, p )

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70 Safety Transformance aedp Undo aloneness & minimize barriers to somatically based experience Process Emotional Experience Process and work thorugh til release of adaptive action tendencies Diana Fosha PhD, 2016 Metatherapeutic Processing Process Transformational Experience Core State: the sense of truth Reflection & Integration, New Meaning 24

71 "There is a distinct physical sensation of change, which you recognize once you experienced it. We call it a body shift. When people have this even once, they no longer helplessly wonder for years whether they are changing or not. Now they can be their own judges of that (Gendlin, 1981, p. 7) aedp Diana Fosha PhD The sense of what is wrong carries with it, inseparably, a sense of direction toward what is right (Gendlin, 1996, P. 187) *

72 Diana Fosha, 2016 aedp We come in after the a couple of rounds of work with the 7 yr. old self who was sexually Comes in In the wake of #MeToo, aware that there is some stuff she hasn t dealt with sexual molestation at 7 sexual molestation as adolescent, young adult History of abandonment, neglect, emotional abuse by mom Symptom picture: Depression, anxiety, hx of panic attacks Low n self compassion self esteem 56

73 Session 4, Vignette 1 We come in after the a couple of rounds of work with the 7 yr. old self who was sexually molested The patient wanted me to hold the 7 yr. old, which I, imaginally and experientially, am In terms of transformational affects, you will see examples of Mourning-the-self Receptive affective experiences (valued, loved on, heard) Tremulous Affects/Realization affects: Odd feeling registering change Positive somatic/affective markers of transformational experience that feels right and true it feels good

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76 Session 4, Vignette 2 Each completed piece of new experiential processing work becomes the platform for launching the next round of work Healing the trauma, meeting the unmet need, re-doing: doing in the present what needed to happen in the past; Wiring in the new experience In terms of transformational affects, you will see examples of Post breakthrough affects: relief, release Receptive affective experiences ( being cared for) Healing Affects, with its marker, gaze up: God s love, tears of being loved Positive somatic/affective markers of transformational experience that feels right and true it feels good From transformation and healing, comes differentiation (Bader; Pearson): Decoupling of God and her (flawed) father Then another round of trauma processing work

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78 Session 4, Vignette 3 Wiring in the new experience: Working to experientially process the new experience so that it can be processed in Witnessing the corrective emotion in action In terms therapeutic interventions, you will see examples of Explicit affirmation courage fortitude love

79 Next session, 2 weeks later: The Transformation of the Identity of the Self Metaprocessing the experience of change, the experience of difference In terms of the phenomenology of transformation, we will witness the change Post breakthrough affects: relief, release from bondage to freedom the undoing of shame and guilt Positive somatic/affective markers of transformational experience that feels right and true: it s good Letting go: beginning of change in feelings toward the perpetrator The transformation of the identity: the letting go of the victim identity, i.e., not wearing the badge of hurt

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81 Safety Transformance aedp Undo aloneness & minimize barriers to somatically based experience Process Emotional Experience Diana Fosha PhD Process and work thorugh til release of adaptive action tendencies Metatherapeutic Processing Process Transformational Experience Core State: the sense of truth Reflection & Integration, New Meaning *

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89 Hendel, H. J. (2015). It s Not Always Depression New York Times, March 10, Hendel, H. J. (2015). The Healing Power of Hugs. New York Times, September 1, Retrieved from Klein, A. (2018). What men say about #MeToo in therapy. your clients capacity for healing. New York: Norton. Diana Fosha, PhD, 2017

90 Fosha, D. (2006). Accelerated Experiential Dynamic Psychotherapy with Diana Fosha Ph.D. Systems of Psychotherapy APA Video Series # Fosha, D. (2013). Accelerated Experiential Dynamic Psychotherapy (AEDP) with a Male Client. with Diana Fosha Ph.D. Series II - Specific Treatments for Specific Populations APA Video Series Fosha, D. (2016). Accelerated Experiential Dynamic Psychotherapy (AEDP) Supervision. Psychotherapy Supervision APA Video Series Lamagna, J. (2015). Making good use of suffering: Intra-relational AEDP work with overwhelming emotional experience. Diana Fosha PhD 90

91 Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York: Basic Books. Fosha, D., Siegel, D. J., & Solomon, M. F. (Eds.), (2009). The healing power of emotion: Affective neuroscience, development & clinical practice. New York: Norton. Frederick, R. (2009). Living like you mean it: Use the wisdom and power of your emotions to get the life you really want. San Francisco, CA: Jossey-Bass. Prenn, N. & Fosha, D. (2016). Supervision essentials for Accelerated Experiential Dynamic Psychotherapy. Washington DC: APA Press. Russell, E. M. (2015). Restoring resilience: Discovering your clients capacity for healing. New York: Norton. Diana Fosha PhD 91

92 Faerstein, I. & Levenson, H (2016). Validation of a fidelity scale for accelerated-experiential dynamic psychotherapy." Journal of Psychotherapy Integration, 26(2), Fosha, D. (2003). Dyadic regulation and experiential work with emotion and relatedness in trauma and disordered attachment. In M. F. Solomon & D. J. Siegel (Eds.). Healing trauma: Attachment, trauma, the brain and the mind, pp New York: Norton. Fosha, D. (2005). Emotion, true self, true other, core state: toward a clinical theory of affective change process. Psychoanalytic Review, 92 (4), Fosha D. (2009). Emotion and recognition at work: Energy, vitality, pleasure, truth, desire & the emergent phenomenology of transformational experience. In D. Fosha, D. J. Siegel & M. F. Solomon (Eds.), The healing power of emotion: Affective neuroscience, development, clinical practice (pp ). New York: Norton. Also reprinted in the Neuropsychotherapist, (2013), 2. Diana Fosha PhD 92

93 Fosha, D. (2009). Healing attachment trauma with attachment ( and then some!). In M. Kerman (Ed.), Clinical pearls of wisdom: 21 leading therapists offer their key insights (pp ). New York: Norton. Fosha, D. (2009). Positive affects and the transformation of suffering into flourishing. W. C. Bushell, E. L. Olivo, & N. D. Theise (Eds.) Longevity, regeneration, and optimal health: Integrating Eastern and Western perspectives (pp ). New York: Annals of the New York Academy of Sciences. Fosha, D. (2013). A heaven in a wild flower: Self, dissociation, and treatment in the context of the neurobiological core self. Psychoanalytic Inquiry, 33, DOI: Fosha, D. (2013). Turbocharging the affects of healing and redressing the evolutionary tilt. In D. J. Siegel & Marion F. Solomon (Eds). Healing moments in psychotherapy. Chapter 8 (pp ). New York: Norton. Diana Fosha PhD 93

94 Fosha, D. (2017). Something more than something more than interpretation: AEDP works the experiential edge of transformational experience to transform the internal working model. In S. Lord (Ed). Moments of meeting in psychoanalysis: Interaction and change in the therapeutic encounter. Chapter 15. New York: Routledge. Fosha, D. (2017). How to be a transformational therapist: AEDP harnesses innate healing affects to re-wire experience and accelerate transformation. In J. Loizzo, M. Neale & E. Wolf (Eds). Advances in contemplative psychotherapy: Accelerating transformation. Chapter 14. New York: Norton. Fosha, D., Paivio, S. C., Gleiser, K. & Ford, J. (2009). Experiential and emotion-focused therapy. In C. Courtois & J. D. Ford (Eds.), Complex Traumatic Stress Disorders: An Evidence-Based Clinician's Guide. Chapter 14, pp New York: Guilford Press. Diana Fosha PhD 94

95 Iwakabe, S., & Conceicao, N. (2016). Metatherapeutic processing as a change-based therapeutic immediacy task: Building an initial process model using a task-analytic research strategy. Journal of psychotherapy integration, 26 (3), Lamagna, J. (2011). Of the self, by the self, and for the self: An intrarelational perspective on intra-psychic attunement and psychological change. Journal of Psychotherapy Integration, 21 (3), Lamagna, J. & Gleiser, K. (2007). Building a secure internal attachment: An intra-relational approach to ego strengthening and emotional processing with chronically traumatized clients. Journal of Trauma and Dissociation 8 (1), Lipton, B. & Fosha, D. (2011). Attachment as a transformative process in AEDP: Operationalizing the intersection of attachment theory and affective neuroscience. Journal of Psychotherapy Integration, 21 (3), Diana Fosha PhD 95

96 Prenn, N. (2011). Mind the gap: AEDP interventions translating attachment theory into clinical practice. Journal of Psychotherapy Integration, 21 (3), Russell, E. & Fosha, D. (2008). Transformational affects and core state in AEDP: The emergence and consolidation of joy, hope, gratitude and confidence in the (solid goodness of the) self. Journal of Psychotherapy Integration. 18 (2), Simpson, M. L. (2016). Feeling seen: A pathway to transformation. International Journal of Transpersonal Studies, 35 (1), Tunnell, G. (2006). An affirmational approach to treating gay male couples. Group, 30 (2), Tunnell, G. (2006). Postscript 10 years after: The Oedipal Son revisited. In S. Minuchin, W-Y. Lee, & G. Simon (Eds.), Mastering family therapy: Journeys of growth and transformation (2 nd Ed). New York: John Wiley. Diana Fosha PhD 96

97 Tunnell, G. (2011). An attachment perspective on the first interview. In C. Silverstein (Ed.), The Initial Psychotherapy Interview: A Gay Man Seeks Treatment. New York: Elsevier Insight Books. Recipient of 2011 Distinguished Book Award from American Psychological Association, Division 44. Tunnell, G. (2012). Gay male couple therapy: An attachment model. In J. J. Bigner & J. L. Wetchler (Eds.), Handbook of LGBT-affirmative couple and family Therapy. London: Routledge. Welling, H. (2012). Transformative emotional sequence: Towards a common principle of change. Journal of Psychotherapy Integration, 22 (2), Yeung, D., & Fosha, D. (2015). Accelerated Experiential Dynamic Psychotherapy. In The Sage Encyclopedia of Theory in Counseling and Psychotherapy. New York: Sage Publications. Diana Fosha PhD 97

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