How-to AEDP Experiential language, essential AEDP interventions, self-disclosure, and metaprocessing, of course! Natasha Prenn, LCSW AEDP Institute, Senior Faculty AEDP Immersion Course, NYC May, 2013 1
Can we have a relationship? How would we all go about that here now? Can we track it together? Why? 2
Experience ... deeper experience ... can we have an experience? Can we deepen the experience? how would we go about that? why? 3
“The patient needs to have an experience, a new experience. And that experience should be good. ” (Fosha, 2002) The patient needs a new, good relationship aka CEE (Alexander and French and Fosha) 4
stay with it and stay with me oh won’ t you stay just a little bit longer ... 5
how to say it? slow down and low down 6
how to say it? say half with conviction seriously like you mean it (Frederick) 7
slowing down let’ s slow this down... let’ s take a breath here mmm...a lot here can we make some space for this? would it be all right with you if we slowed this down right now? 8
TURNING Going too fast for myself I missed more than I think I can remember almost everything it seems sometimes and yet there are chances that come back that I did not notice when they stood where I could have reached out and touched them this morning the black shepherd dog still young looking up and saying Are you ready this time W. S. Merwin 9
What to say? some interventions do work better than others: hand-out/cheat sheet 10
orient patient to their internal experience/ relationship and relatedness 11
if we move away from events and you check in with yourself inside...what are you aware of? 12
That is from your head! What is in your heart? 13
what is it like sharing this with me? 14
and what is that like ...? 15
A. reflect, platform/organize Ping Pong experience, mirror, reframe 16
B. go down, go into it, explore, deepen, experiential 17
four states correspond to four steps state one - anxiety and defense - track for glimmers of emotion state two - core emotion, core affect - stay with it state three - metaprocess the experience of the affect - what’ s it like state four - core state - LET IT BE! the truth: coherent narrative 18
"In order to arrive at a personal style, you have to have a technique to begin with. In other words, when I say that style is a special case of technique, you have to have the technique — you have to have a place to make the choices from. If you don't have a basis on which to make the choice, then you don't have a style at all. You have a series of accidents.” Philip Glass talking to his cousin Ira Glass 19
Moment-to-moment tracking 20
moment-to-moment tracking is the interpersonal version of mindfulness - just notice (tip: you don’ t have to know what patient is feeling) 21
ENTRY POINTS when and how do we intervene? pick a target and stay with it probe/ experiment/gather data metaprocess 22
therapist vagueness and curiosity/patient specificity patient specificity/details: can you give me an example? therapist vagueness: a lot of feeling ... here/ mmm ... wow ... that is really something 23
choose entry point notice and seize moment explore and expand: what’ s it like? circle back to target if and when he moves away work actively at the beginning to help him access core emotion make our relationship explicit i am direct and specific when he is vague ask him to look at me to regulate him anchor it in his body affirm and metaprocess 24
“The patient needs an experience, not an explanation. ” Frieda Fromm-Reichmann 25
I second that emotion! On Self-disclosing and its metaprocessing 26
“...attempting to do effective psychotherapy without the benefit of the resource that is self- disclosure makes no more sense than attempting to play the piano with one hand. ” Wallin, 2007, 185 27
AEDP intervention par excellence 28
“What is usually the endpoint of the therapeutic road is [a] starting point” in AEDP. Fosha, 2000, p. 72 29
“...these are high-risk and intense interventions...if the patient feels burdened, intruded upon, or is disgusted by the therapist’ s disclosure, or if the patient reacts with numbing, blocking, or anxiety, those reactions become the focus of the therapeutic work. ” Fosha (2000) 30
“Only new emotional exchanges [can] facilitate the altering of old affective patterns. ” Maroda, 1998, p. 85 31
What’ s it like to know this about me? 32
unit of intervention = disclosure and its metaprocessing 33
if i do x (self-disclose or remain silent), something will happen 34
there are no wrong notes, only what you do next! 35
2 kinds of self- disclosure self-involving: the process, what is happening in the here-and-now, how I feel, etc. self-revealing self-disclosure: the disclosure of actual shared experience, life experience, successes, vulnerabilities, etc. 36
37
In thwarting our patients in their quest for an emotional response from us, have we unknowingly been withholding that which could be most therapeutic?” Maroda, Show Some Emotion (1998). 38
“I want to end by advocating that self- disclosure take its place as an essential, integral, teachable part of the fabric of every treatment... 39
and that we question why we didn’ t disclose as much as we have traditionally examined why we did!” Prenn, 2009 40
stay with it and stay with me 41
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