The AEDP™ Model of Psychotherapy Glossary of Terms

ATTACHMENT SECURITY

Healthy relational handling of affect based on flexible strategies results in rich affective experience (i.e. “feeling and dealing while relating”). The securely attached child is able to experience their feelings of separation and reunion and is not overwhelmed by them; they enhance the strength of the attachment bond, contributing to their resilience.

Citation
Fosha, D. (2000). The Transforming Power of Affect: A model for accelerated change. New York: Basic Books.

ATTUNEMENT

Attunement is where the self and other resonate.

Citation
Transformance, Recognition of Self by Self, and Effective Action
Diana Fosha, Ph.D. In K. J. Schneider (Ed.) Existential-Integrative Psychotherapy: Guideposts to the Core of Practice, pp. 290-320. New York: Routledge, 2008.

Attunement is an essential mechanism in all healthy forms of human relating. It is a process that involves the cultivation of a receptive stance, a state of openness through which we come to understand the intentions that arise within us and in those around us (Fonagy, Gergely, Jurist, & Target, 2002). Attunement also helps us to respond to these various intentions with understanding, empathy, and care (Cassidy, 2001). Such capacities first form in early life, as a caregiver’s sensitive and contingent responses to the child’s emotional expressions allow for both the intersubjective sharing of feeling, motivation, and interest (Main, Kaplan, & Cassidy, 1985; Stern, 1985; Trevarthen, 1993) and the repair of interactive ruptures (Beebe & Lachmann, 2002; Tronick, 2007). Through this attachment relationship,
dispositional capacities for psycho-biological organization, integration, and regulation (Schore, 1994, 2003; Siegel, 1999) are taken in and interpersonal (Bowlby, 1973, 1980, 1982; Cassidy, 2001; Lyons-Ruth, 2000) and intrapersonal (Fairbairn, 1952; Jacobson, 1964; Lamagna & Gleiser, 2007; Schwartz, 1995) patterns of relating are forged.

Citation
Lamagna, J. (2011). Of the self, by the self, and for the self: An intra-relational perspective on intra-psychic attunement and psychological change. Journal of Psychotherapy Integration, 21(3), 280–307. https://doi.org/10.1037/a0025493

CORE AFFECTIVE EXPERIENCE

Citation
Fosha, D. (2000). The Transforming Power of Affect: A model for accelerated change. New York: Basic Books.

Core affective phenomena, when accessed, activate deep transformational processes. The visceral experience of core affect involves a state transformation (Beebe & Lachmann, 1994) In this altered state, deep therapeutic work can be accomplished as the patient gains access to:

Categorical Emotions: Anger, sadness, fear, joy
Coordinated relational experiences: Attachment, Receptive Experience, Shared pleasure/coordination, recognition
Intra-relational work with ego states: Self to self resonance, compassion, wholeness
Body-based Sensation

Experiencing deep emotion viscerally within the therapeutic relationship helps the patient master a vital psychological process with profound implications for well-being.

Citation
Fosha, D. (2021). How AEDP works. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 1, pp. 27-53) APA Press.

Core affective experiences include but are not limited to: categorical emotions of sadness, anger, fear, joy and disgust; coordinated relational experiences; ego states and their associated emotions; attachment strivings; somatic ‘drop-down’ states; and authentic self states.

CORE EMOTION

The categorical emotions, or core emotions, include sadness, fear, anger, joy, excitement and disgust.

Citation
Fosha, D. (2000). The Transforming Power of Affect: A Model for Accelerated Change. New York: Basic Books

Citation
Medley, B. (2021). Portrayals in work with emotion in AEDP: Processing core affective experience and bringing it to completion. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 8, pp. 217-240). APA Press.

CORE STATE

Core state refers to an altered condition, one marked by openness and contact. With it, the individual is deeply in touch with essential aspects of his own self and relational experience, which themselves are considered varieties of core affective experience and become potentially mutative.

Citation
Fosha, D. (2005). Emotion, true self, true other, core state: toward a clinical theory of affective change process. Psychoanalytic Review, 92 (4), 513-552.

META-THERAPEUTIC PROCESSES

The patient’s experience of therapeutic processes

Citation
Fosha (2000) The Transforming Power of Affect

META-THERAPEUTIC PROCESSING

When successful therapeutic experiences themselves become the focus of therapeutic inquiry and work, it becomes possible to deepen and broaden the treatment’s effectiveness. The systematic exploration of phenomena associated with therapeutic change—through exploring the patient’s experience of having a therapeutic experience—activates meta-therapeutic processes associated with characteristic affects of transformation.

Citation
Fosha, D. (2000). Meta-therapeutic processes and the affects of transformation: Affirmation and the healing affects. Journal of Psychotherapy Integration, 10, 71-97.

Fosha, D. & Thoma, N. (2020). Meta-therapeutic processing supports the emergence of flourishing in psychotherapy. Psychotherapy, 57 (3), 323-339. https://doi.org/10.1037/pst0000289

SAFETY

The feeling of safety, fostered by the bond with a trusted companion, counteracts fear (alarm/anxiety), promotes exploration and risk-taking, and fosters a full affective experience. If there is no feeling of safety, anxiety, the mother of all psychopathology, takes hold. Anxiety is a reaction to the nonavailability or nonresponsiveness of the caregiver and is rooted in the feeling of being alone in the face of psychic danger. Defenses arise to reestablish safety where the attachment relationship has failed to do so.

Citation
Fosha, D. (2000). The transforming power of affect: A model for accelerated change. New York: Basic Books.

STATE 1, 2, 3 & 4

State 1: Transformance
Glimmers of resilience, health, strength; manifestations of the drive to heal

State 1: Stress, Distress, and Symptoms
Defenses; dysregulated affects; inhibiting affects (e. g., anxiety,shame)

State 2: The Processing of Emotional Experience
Categorical emotions; attachment experiences; coordinated relational experiences;
receptive affective experiences; somatic “drop-down” states; intersubjective
experiences of pleasure; authentic self states; embodied ego states and their
associated emotions; core needs; attachment strivings.

State 3: “The meta-therapeutic processing of transformational experience”
State 3 is devoted to the meta-therapeutic processing of what has just occurred in the progression from states 1 to 2 as well as the transitional states. This meta-therapeutic processing evokes its own set of transformational affects and is the focus of State 3.[65] Transformational affects of State 3 include mastery affects (pride, joy), healing affects (gratitude, feeling moved), the mourning of the self, for one’s suffering and for what was lost to oneself in the trauma, and tremulous affects associated with the somatic experience of a change process, especially if it feels sudden.

State 4: Core state: “integration, the truth sense
The AEDP healing sequence is completed with the meta-therapeutic processing of the positive emotions that naturally arise following a completion of emotion processing. The result is often a state of clarity and well-being.[47] Core state is characterized by the client reporting a feeling of calm, vitality, a sense of wellbeing, compassion toward self and others, an expanded perspective, and wisdom.[66] Core state involves a coherent reorganized self-narrative. The ability to construct a “coherent and cohesive” self-narrative is shown to be highly correlated with secure attachment status in adulthood and with emotional resilience.[67] The re-organized self-narrative is evidence to the therapist that a corrective emotional experience has occurred.

Fosha, D. (2006). “Quantum Transformation in Trauma and Treatment: Traversing the crisis of healing change”. Journal of Clinical Psychology: In Session. 62 (5): 569–583. doi:10.1002/jclp.20245. PMID 16523489.

Fosha, D. Meta-Therapeutic Processes and the Affects of Transformation: Affirmation and the Healing Affects. Journal of Psychotherapy Integration 10, 71–97 (2000). https://doi.org/10.1023/A:1009422511959

Yeung, D. (2021). “What Went Right? What Happens in the Brain During AEDP’s Meta-therapeutic Processing” In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 13). APA Press.

Fosha, D. & Thoma, N. (2020). Meta-therapeutic processing supports the emergence of flourishing in psychotherapy. Psychotherapy, 57 (3), 323-339. https://doi.org/10.1037/pst0000289

Iwakabe, S., & Conceicao, N. (2016). Meta-therapeutic 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), 230-247.

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), 167–190. https://doi.org/10.1037/1053-0479.18.2.167

THERAPEUTIC COURAGE

Citation
Goto, A., Iwakabe, S., & Heim, N. (2022). Therapeutic courage in novice therapists in Japan: A qualitative study. Journal of Psychotherapy Integration, 32(3), 243–256. https://doi.org/10.1037/int0000260

The concept of therapeutic courage is considered to be an essential therapist variable and is now at a stage of accumulating empirical support.

Fosha (2000). The emotional atmosphere of psychotherapy is characterized by the fact that the patient feels safe and the therapist is being brave because their risk-taking enhances the patient’s sense of safety. Geller (2014) defines therapeutic courage as the psychological processes that move a person in the direction of voluntary “deciding” to face and confront dangers, risks, and hardships in order to protect someone and to achieve personally valued goals.

TRANSFORMANCE

Transformance, a central construct in Accelerated Experiential Dynamic Psychotherapy (AEDP), is the overarching motivational force driving positive change. Transformance is the clinical parallel of positive neuroplasticity in neuroscience.

Citation
Fosha, D. (2021). “We are organized to be better than fine:” Building the transformational theory of AEDP. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 14, pp. 377-400). APA Press.

TRANSFORMANCE AFFECTS

The focus on the experience of healing transformation evokes one or more of the
six types of phenomenologically distinct transformance affects (see Figure 1) identified
to date:

  1. the post breakthrough affects, i.e., feeling relief, as well as feeling lighter,
    clearer, stronger, after an intense emotional experience processed to completion;
  2. the mastery affects, i.e., pride and joy, that come to the fore when fear and shame
    respectively are transformed;
  3. emotional pain, the transformational affect associated with the process of mourning-the-self;
  4. the healing affects, i.e., gratitude and tenderness toward the other, and feeling moved within oneself in response to affirming recognition of the self and its transformation, as well as of the role of the other in the process;
  5. the tremulous affects, i.e., fear/excitement, startle/surprise, curiosity/interest, and a feeling of positive vulnerability, associated with traversing the crisis of healing change ; and finally,
  6. the healing vortex, i.e., oscillating and vibrating sensations, associated with how the
    body proper processes quantum transformation (Fosha, 2006).

Citation: Transformance, Recognition of Self by Self, and Effective Action
Diana Fosha, Ph.D.
In K. J. Schneider (Ed.) Existential-Integrative Psychotherapy: Guideposts
to the Core of Practice, pp. 290-320. New York: Routledge, 2008.

TRIANGLE OF EXPERIENCE
Citation
Fosha, D. (2021). How AEDP works. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 1, pp. 27-53) APA Press.

The Triangle of Experience schematically represents how emotional experience comes to be structured (see Figure 2, Appendix). At the bottom of the Triangle of Experience, we have two categories of core affective experience: (i) On the right half, we find the intrinsically adaptive core affective experiences, which are inherently transforming: i.e., they have adaptive resources wired within them, waiting for the release in auspicious circumstances. (ii) At the left half of the bottom of the Triangle of Experience, we find the maladaptive core affective experiences, which are not transforming: to the contrary, they need transforming, for otherwise, they will have deleterious consequences for the individual. At the bottom of the triangle are both types of core affective experiences. When the emotion is overwhelming, anxiety and other inhibitory affects increase, which then trigger defenses. Anxiety and other inhibitory affects and the defenses are represented at the top of the triangle.

Citation
Pando-Mars, K. (2021). Using AEDP’s representational schemas to orient the therapist’s attunement and engagement. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 6, pp. 159-186). APA Press.

In order “to facilitate affective experience, the therapist must be quick to recognize defenses, anxiety and repeating patterns. She must also be quick to recognize genuine emotions.” (Fosha, 2000, p. 103). That’s precisely what the Triangle of Experience helps us to do.

Citation
Frederick, R. (2021). Neuroplasticity in action: Rewiring internal working models of attachment. In D. Fosha (Ed.) Undoing aloneness and the transformation of suffering into flourishing: AEDP 2.0. (Chapter 7, pp. 189-216). APA Press.

“We have the Triangle of Experience (Figure 2, Appendix). Derived from a long history of short-term psychodynamic therapy models, it graphically depicts what happens when anxiety-provoking core affective phenomena get activated in the patient. As such, it lays bare the coding of one’s internal working models by illuminating learned patterns of responding that were developed early in life in an environment that was inimical to genuine relating and to the experiencing and/or expression of genuine emotion, and that continue to govern the patient’s nervous system and subsequent behavior.

By identifying and graphically separating out the main aspects of one’s emotional experience (defenses, inhibitory affects, and core affective phenomena) and then illustrating how they relate to one another (how the emergence of core affect gives rise to inhibitory affects that now prompt defensive responding), the triangle enables the therapist to understand what is happening for the patient in any given moment. Once the in session locale on the Triangle of Experience is determined, the therapist can then assess how best to respond. For instance, if we are in the land of relational defenses (the “D” corner of the triangle), we can ask ourselves what needs to happen to render them unnecessary so the patient can safely open up to the new experience with the therapist and the associated affective phenomena? If we’re in the realm of red-signal, inhibitory affects (the “A” corner), what do we need to do to help regulate and calm them so that receptive affective capacity can be increased and emotional experiencing can be allowed to come to the fore? And, if we are in the presence of adaptive attachment strivings and associated core affective experiences (the “E” corner), what do we need to do to foster, regulate, and process them through to completion? “