Editor’s letter: Gil Tunnell, PhD
Expanding the Ordinary to Extraordinary: A Review of Eileen Russell’s Restoring Resilience
Making Good Use of Suffering: Intra-relational Work with Pathogenic Affects: Jerry Lamagna, LCSW
The Community Healing Workshop: A Final Treatment Phase of AEDP for Couples: David Mars PhD
The Impatient Therapist: Hans Welling
Attachment-in-Action: Movement-Inclusive AEDP as a Healing Catalyst: Judy Silvan, LICSW
The Judicious Use of Touch in an AEDP Treatment: Hilary Jacobs Hendel, LCSW
The Editor’s Letter
By Gil Tunnell, PhD
As exemplified in the previous Transformance issue on applying AEDP to couple therapy, AEDP is continuously expanding, not only with new techniques and paradigms presented in this issue, but rapidly expanding all over the world. An international issue is in the works.
As I read these papers one last time, I realized that four articles focus on techniques to help AEDP therapists when we get “stuck,” i.e., when we reach an impasse where AEDP therapy is not working the way we think it should. In this issue, Jerry Lamagna presents his intra-relational parts model within an AEDP frame (he has a three-DVD set of training tapes available on this website). Hilary Jacobs Hendel writes about the judicious use of touch in AEDP (after she had submitted her article here, The New York Times in March 2015 published her article describing AEDP entitled, “It’s Not Always Depression, Sometimes It’s Shame.” This article generated much interest in AEDP and led to Random House offering her a book contract. This Fall, the Times published another article by Jacobs Hendel, “The Healing Power of Hugs,” which is relevant to her article here). Both Jacobs Hendel and Lamagna utilize portrayals and “parts work” yet offer very different approaches to working with pathologic affects and undoing aloneness. Also in this issue, Judy Silvan discusses the use of body movement in AEDP to unblock energy and core affects. Hans Welling offers a delightful short read on how he addressed an issue most of us have experienced: therapist impatience. Up close and personal, he describes his own impatience as an AEDP therapist and the steps he took to “self-correct.” He offers guidelines to the rest of us impatient folk.
Also in this issue, David Mars continues his expansion from individual AEDP, to AEDP with Couples, to his two-day innovative Community Healing Workshop. On the second day the couple he has treated is live on stage, interacting with an audience of therapists who are empathic and supportive as they bear witness to the couple’s growth. (A three-DVD set of this workshop held at Seton Hall, NJ (Training Set 2) is available on this website.)
Finally in this issue, I review Eileen Russell’s masterful new book, Restoring Resilience, which greatly expands the concept of resilience and teaches us how to capitalize on it at each stage of AEDP treatment. Although neither Mars, Lamagna, Jacobs Hendel, Silvan nor Welling explicitly use the term resilience, there are numerous implicit examples in their case transcripts of unearthing resilience in their work with individuals and couples.
Expanding the Ordinary to Extraordinary: A Review of Eileen Russell’s Restoring Resilience
Gil Tunnell, PhD
Restoring resilience: Discovering your clients’ capacity for healing. By Eileen Russell. New York: W. W. Norton., 2015, 356 pp.
Eileen Russell’s new book Restoring Resilience is a major contribution to the psychotherapy literature. It is the best professional book I have read in a long time. Rich in new, jargon-free theory and filled with clinical vignettes that illustrate working with different forms of resilience, the author begins with a comprehensive review of the literature on how clinicians, philosophers and poets have thought about resilience (later she cites relevant research on resilience, mostly on children). Russell is clear from the start that she is not talking about the everyday, ordinary notion of “resilience,” but rather a multi-faceted concept that manifests itself in different ways at each stage and state of the therapeutic process.
Russell believes resilience potential is hard wired yet needs to be nurtured and practiced. First and foremost, she writes that resilience always operates “on behalf of the Self,” whether it exists in its more restrictive mode that results in defensive functioning (in the service of survival and protection of the nascent Self), or in its fully expansive mode such as in transformance, Fosha’s (2008) seminal concept of the individual’s hard-wired striving for healing, growth and expansion of Self. Early in the book, Russell says that the “essence of resilience is the Self’s differentiation from that which is aversive to it” (p. 5). This seems to be a simple sentence the meaning of which, frankly, I did not grasp immediately. Later I came to understand how and why Russell defines resilience this way: Her definition encompasses the complexity of resilience in all its facets. Indeed, our therapeutic efforts might be described as attempts to help the patient minimize, mitigate and sometimes mute the parts aversive to the Self.
Making Good Use of Suffering: Intra-relational Work with Pathogenic Affects
By Jerry Lamagna, LCSW
Abstract. The unbearable psychic pain of pathogenic affect presents a formidable challenge to AEDP-trained therapists. As an experiential re-iteration of abandonment in the face of overwhelming distress, it sometimes renders patients incapable of engaging interpersonally, thus limiting the effectiveness of dyadic regulation. Because of the overwhelming distress and the dysregulation that results, pathogenic affect is generally seen as a clinically undesirable state that blocks therapeutic change. In this paper, the author suggests an intra-personal approach to working with pathogenic affect that involves helping the patient shift from a threat-based response to their overwhelming inner experience (i.e. fighting, fleeing, freezing or fawning) to an engagement-based response characterized by “tending and befriending”. This is accomplished by helping patients to differentiate their present day state from the archaic pathogenic one and then facilitating moments of open-hearted contact between them. It is proposed that the affects that manifest from such types of self-engagement (i.e. mutual resonance, recognition, compassion, understanding appreciation and tenderness) constitute a distinct affective change process that when experientially tracked, can be used to fuel and reinforce transformational experiences.
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The Community Healing Workshop: A Final Treatment Phase of AEDP for Couples
David Mars, PhD
Abstract. This paper describes the nature and purpose of a unique new approach to both teaching the AEDP for Couples method and to assist the couple present on stage in the second day of the workshop to integrate and metaprocess the arc of their therapeutic experience. This integration of AEDP into a large group format of therapists, using the Seven Channels of Experience in I-statements that reflect their internal experience to the couple, gives the couple the experience of being seen, heard and known by a large group of therapists who come to be felt as True Others. The paper describes the three foundations of the Community Healing Workshop: AEDP, Process Oriented Psychology, and the witnessing discipline derived from Authentic Movement. Process Training Language is introduced with its attention to moment-to-moment tracking and “sliding in time” to cultivate the immediacy of present experience that is very useful in generating safety in group processing, metaprocessing and guiding healing portrayals in trauma treatment.
The Impatient Therapist
Hans Welling
Abstract. The author argues that an eagerness in the therapist to help the patient and go deep into emotion can cause unnecessary resistance and a feeling of invalidation in the patient. Listening for the gifts that client give us may counter this attitude. The author gives examples of where these gifts may be found. In a clinical example an occurrence of impatience and its correction are illustrated.
Attachment-in-Action: Movement-Inclusive AEDP as a Healing Catalyst
Judy Silvan, LICSW
Abstract. AEDP with a body activation component can enhance state completion and regulation. This paper discusses and demonstrates with two case examples how movement of energy is used as an affective change process. Studied body movements are particularly useful and judiciously filtered into AEDP when other avenues of accessing, regulating, invigorating or integrating affect and energy are blocked. The therapist gently guides the patient through grounding or expressive body motions, attuned to the patient’s needs and introduced gradually. They are often done in tandem with the patient, while seated or standing. A solidly attached emotional container neutralizes the risk that movement of energy will incite shame or pathogenic withdrawal. Physical movements can (a) help “ground” the patient to prevent or reverse dysregulation, (b) soften defenses, and (c) deepen emerging affect.
The Judicious Use of Touch in an AEDP Treatment: Responding to Developmental Need and Transformance Drive
Hilary Jacobs Hendel, LCSW
Abstract. The use of touch in talk therapy has long been considered controversial and even taboo. However, touch when used thoughtfully and judiciously has the potential to facilitate healing. When confronted with the developmental and core need for touch, psychotherapists should have the ability to think through when it could be helpful and when it could be harmful. This paper considers the use of touch in a clinical case and the way it is negotiated by the patient-therapist dyad.
This paper discusses an AEDP treatment where touch was incorporated into the work. I discuss viewpoints from the literature; some considerations regarding the use of touch that are born from the sum total of my education and training both as a psychoanalyst and an AEDP psychotherapist; and my specific rationale for incorporating touch into this particular treatment. A verbatim transcript from a mid-treatment session illustrates clinical work with touch. At the end, I present some general guidelines for the judicious use of touch.