Cultivating Therapeutic Presence: Strengthening Your Clinical Heart, Mind, and Practice: Shari Geller, Ph.D.
The Being is the Doing: The Foundational Place of Therapeutic Presence in AEDP: Benjamin Lipton, LCSW
The Inner Power Awakens: Contemplative Presence: Danny Yeung M.D., and Lily Zhang
Therapeutic Presence With Emerging Adults: An AEDP-Informed Approach: Wendy Summer, LPC
Finding the Elephant in the Room: An AEDP Journey to the Heart of Loss, Presence, and Self: Marc Cecil, Ph.D.
See Me, Feel Me: An AEDP Toolbox for Creating Therapeutic Presence Online: Natasha Prenn, LCSW, Kate Halliday, LCSW
Editor’s Letter: Special Issue on Therapeutic Presence
Gil Tunnell, Ph.D
This issue of Transformance: The AEDP Journal has been over a year in the making, and I thank the eight authors for their patience! Carrie Ruggieri, the new associate editor, and I believe it has been well worth the wait and the effort, as the six articles bring together the writings of senior therapists who are well versed in Therapeutic Presence (TP).
We are honored to have among our authors for this issue, Shari Geller, who coined the term Therapeutic Presence. Other articles in this issue expand upon Geller’s concept from the AEDP perspective. Each author provides us with ways to create and maintain TP in a blend of unique styles, in the form of four scholarly articles, a very personal essay, and a highly useful toolkit for creating TP online.
All authors make the point that while we can be well trained in clinical skills and have a complete intellectual understanding of the AEDP model, these skills and knowledge should become background when we are with our patients. Therapeutic Presence demands that we be in the moment, and in the precise way of being that each patient requires, trusting that when we have settled our own nervous systems, we will intuitively know what to do and how to do it. To guide our intuition, each author offers specific ways of creating and maintaining TP.
AEDP faculty member Ben Lipton complements Geller’s TP with his own model of TP called Active Empathy: Presence, Attunement, Intention, Resonance, Reflection (PAIRR). Lipton’s PAIRR emphasizes the therapist’s act of being within the relationship. An intriguing backdrop to this article is Lipton’s reflection upon his 20 years practicing and teaching AEDP. PAIRR represents his synthesis of insights and observations that lead to his thesis that the doing of therapy is, in fact, in the act of being as therapist. Lipton’s gorgeous session transcript is ripe with the rewards of achieving Active Empathy, resonance, attunement, and flow and the promise of “surrender to the improvisational emergent truth of the moment.” You will want to read this article more than once. First for the pleasure of it, and then to uncover the layers of depth and insight.
AEDP faculty member Danny Yeung and co-author Lily Zhang describe a result similar to Lipton’s when a therapist is able to cultivate a version of Therapeutic Presence they call contemplative presence. Among the benefits of contemplative presence is the expansion of intuition, and the authors explain the neuroscience underlying intuition. The article provides therapists with specific actions to take to cultivate contemplative presence. And, as if that is not enough, a session transcript demonstrates an abundance of intuitive therapeutic moments, which the authors earmark with a “BLINK,” that move with the AEDP transformational process. The transcript illustrates what this expansion of intuition looks like in action. Personally, Yeung and Zhang have inspired me to practice contemplative presence almost daily during the COVID crisis. Yeung did a webinar on May 8, 2020, entitled “Awakening the Healing Power Within: Insula, Neuroception, Dyadic Contemplative Presence and Zhaungzi in AEDP,” which will soon be available on the AEDP website.
Wendy Summers, a certified AEDP therapist, describes how she creates Therapeutic Presence in her work with Emerging Adults (EAs). She argues that therapists must calibrate their TP to the EAs’ unique developmental challenge as they strive toward autonomy, individuation and identity. She writes tenderly of this poignant developmental challenge and proposes that EAs need their therapists to be attuned and connected while also conveying a differentiated “we- ness.” Her session transcript demonstrates her embodiment of one of AEDP’s core principles: Transformational strivings are there to be harvested as EAs discover their core self, agency and identity. One challenge for the therapist is working with the tension in EAs between dependency needs and autonomous strivings. Summers skillfully describes how to use intuition to navigate the slippery slope when being can so easily be experienced as doing by EAs.
In a lyrical and heart-opening personal essay, Marc Cecil, a certified AEDP supervisor, describes his journey into immersive TP as he accompanies his patients into their journeys through painful grieving. Using the metaphor of the “elephant” (an inspirational symbol of quiet strength despite difficult hardships) as a way into TP, he discovers that his own healing processes get underway as he sits with being with his client’s suffering. Cecil’s essay is an experienced-near account of AEDP principles and methodologies. It is a right-brain didactive for those new to AEDP and a sophisticated demonstration of what Lipton and Yeung and Zhang describe as the hallmark of TP, when we “surrender to the improvisational emergent moment,” trusting that our left-brain knowing will chime in when we need it.
Lastly, this issue could not have been complete without an article on creating and maintaining Therapeutic Presence online in this new era of telehealth. For that, Carrie and I asked AEDP faculty members Natasha Prenn and Kate Halliday to summarize how they do what they do. Many of you have seen their YouTube videos. Here is a written account, with Prenn, in her brilliant and invaluable way of providing for AEDP therapists phrases to suit almost every clinical moment. In her delightful languaging of AEDP, she and Halliday suggest we practice these phrases so that they will come to us at the right time. Their article is truly a toolbox for creating Therapeutic Presence online.
As we go to press, I want to mention an article that appeared in the June 1, 2020 issue of The New Yorker: “The New Theatrics of Remote Therapy.” The journalist interviewed several psychoanalysts about their experiences in the “new normal” of seeing their patients online. It complements the article by Prenn and Halliday, as well as offering a perspective from the psychoanalytic community.
https://www.newyorker.com/magazine/2020/06/01/the-new-theatrics-of-remote-therapy
Finally, I want to acknowledge the enormous contribution of Carrie Ruggieri to this issue. She is associate editor of our AEDP Journal, and this is the first time we have worked together. She has made editing much easier, as we put our heads together to re-write sentences that we think better convey what these authors are trying to say (and take on the burden of cross checking their references). You can look forward to Carrie leading a listserv discussion of each article. In the last month, Carrie has been instrumental in reformatting the downloadable PDF version of each article. We think it gives our Journal a new layout that is more professional.
We hope the new look is also more readable. Please give us your feedback. We trust that everyone is staying safe, and somehow maintaining hope, in these extraordinary, surreal times.
Gil and Carrie
Cultivating Therapeutic Presence: Strengthening Your Clinical Heart, Mind, and Practice
Shari Geller, Ph.D.
Abstract. Working effectively in psychotherapy is only possible when clients feel safe and secure. To promote safety and optimal therapy, therapists need to focus more on how they are with clients than what techniques they do in the therapy session. Decades of research demonstrate that the therapeutic relationship is the most consistent predictor of change. Yet what contributes to a positive therapy relationship has been less clear. Emerging research suggests that therapeutic presence (TP) is a necessary and preliminary step to facilitating positive therapeutic relationships and more effective therapy. The therapeutic relationship is core to both Emotion Focused Therapy (EFT) and Accelerated Experiential Dynamic Therapy (AEDP). Intentional cultivation of TP is essential in both models and is trans-theoretical across various therapy approaches. TP facilitates an experience of safety for clients and therapists, which promotes effective therapeutic relationships and treatment.
The Being is the Doing: The Foundational Place of Therapeutic Presence in AEDP
Benjamin Lipton, LCSW
Abstract: The primary didactic objective that bridges all my teaching is to convey that in AEDP, the “doing” of therapy is, first and foremost, the therapist’s way of being as a therapist, and that this being transcends the concept of therapeutic stance. Everything we “do” in AEDP begins with the therapist’s ability to be present in body and mind, while being oriented to what is happening in the client, and staying open to being explicitly impacted by what is happening in the intersubjective space of the moment between therapist and client. This is what Diana Fosha has named “feeling and dealing while relating,” what is now known more broadly recognized in the work of Shari Geller as Therapeutic Presence (TP). In this article I propose my model of therapeutic presence, Active Empathy: Presence, Attunement, Intention, Resonance, and Reflection (PAIRR), built upon my synthesis of embodied presence phenomena, and emphasizing the active, relational thrust of the processes. Active Empathy is engaged when we surrender to the improvisational emergent truth of the moment while trusting that our left-brain knowing will come to our aid when necessary. A session transcript demonstrates the application of Active Empathy and highlights the act of being in embodied therapeutic presence.
The Inner Power Awakens: Contemplative Presence and AEDP as a Way of Life
Danny Yeung M.D., and Lily Zhang
Abstract. Presence has been underscored as a foundational therapeutic stance for AEDP. We propose that contemplative presence is deeply intrinsic to the AEDP therapeutic stance. Enabled by von Economo neurons, the AEDP therapist, by embodying contemplative presence, can enhance intuitive ability and accuracy to land the right intervention with a client, in just the right time, and in just the right way. A session transcript highlights practical elements and applications of contemplative presence. The stances of ‘being’ proposed by Rogers, Buber, and Schweitzer are explored for their resonance with the AEDP therapeutic stance, and also for the example that a root idea, such as contemplative presence, can be adopted as a way of life. Finally, we offer our reverie that the therapist’s well-being would be enriched by practicing, beyond the therapy room, the embrace of existence in the here and now with appreciation, admiration and reverence, as exemplified by contemplative presence.
Therapeutic Presence With Emerging Adults: An AEDP-Informed Approach
Wendy Summer, LPC
Abstract. As the developmental period of emerging adulthood (ages 18 to 25) is now recognized more broadly, so are the mental health challenges facing this particular generation of emerging adults (EAs). Anxiety and depression rates for EAs have increased by more than 60% in a recent 10-year period, as college counseling centers struggle to keep up with their needs. This article explores how to use therapeutic presence within Accelerated Experiential Dynamic Psychotherapy (AEDP) to treat EAs. With the overall goal of helping EAs successfully emerge into adulthood, treatment with these clients has the potential to use their innate, developmental desire for growth, and their heightened transformance drive, to fuel the change process. As AEDP therapists meet EAs with delight and adult-to-adult respect within an explicitly differentiated dyad, EAs can safely explore and step into their wise, capable adult-selves-at-best.
Finding the Elephant in the Room: An AEDP Journey to the Heart of Loss, Presence, and Self
Marc Cecil, Ph.D.
Abstract. Starting with the discovery of an elephant figurine left behind by a dear patient, this paper shares the personal journey of transformation and healing of an AEDP therapist and his patients. While facing a painful loss, the author finds the light of the elephant in the room and discovers the essence of AEDP. Following the quiet strength of the elephant, a metaphorical guide to therapeutic presence and healing, the therapist connects to the map of AEDP and makes room for the pain and joy in his patients as well as in himself. By highlighting the glimmers of transformation, he enables a natural healing and growth process to unfold. Bearing witness to the reality of death and dying, the therapist helps others see the obvious but painful truth in their lives, and also finds his own. With the author’s growing sense of presence and connection to himself and others, his patients find their self-compassion, courage, and wisdom, along with a new sense of wholeness in being alive. Parallel to a new balance developing inside his patients, the therapist finds some of the missing pieces of his own story and the treasures inside himself and others in his life. This discovery reinforces an appreciation of our humanness and unique gifts, many of which are accessible, but others harder to find. Although one journey may end, a new one begins, with a deeper connection to our presence as therapists and people, along with our capacity for transformation and healing. The author holds the hope for other therapists to find the timeless light of loving-kindness and presence within and between our hearts, emboldening new hope of healing loss and aloneness in our lives and around the world.
See Me, Feel Me: An AEDP Toolbox for Creating Therapeutic Presence Online
Natasha Prenn, LCSW, Kate Halliday, LCSW
Abstract. When teletherapy became the medium of therapeutic delivery following the arrival of the Covid-19 pandemic in North America in early 2020, the authors spontaneously launched an experimental project of recording brief YouTube videos for their AEDP colleagues. Each video offered viewers the experience of an AEDP- inspired conversation between the authors (and occasional guests). Episodes
anchored each discussion with didactic presentation of specific interventions easily translatable to therapy online. Here we present some reflections on this experience, and offer a summary of specific skills and interventions especially applicable to promoting Therapeutic Presence when “meeting” with the internet as the medium. It is our assertion that the “doing” of psychotherapy supports the “being” of the psychotherapist, and that the being of the psychotherapist in turn promotes client presence. Having an array of AEDP skills and interventions promotes Therapist Presence, never more so than when we see and are seen on a video screen.