Transformance Journal: Volume 10

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.

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Cultivating Therapeutic Presence: Strengthening Your Clinical Heart, Mind, and Practice

Shari Geller, Ph.D.

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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.

Introduction

I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.
Maya Angelou (as quoted in Booth & Hachiya 2004, p. 14)

A view to the neurophysiological dimensions of relationship informs how TP can create effective relationships and optimal therapists. One lens from which to view this is polyvagal theory (PVT). While we have an idea of what the benefits are of TP on the therapeutic relationship, PVT explains how TP strengthens the relationship, evokes safety for clients, and allows clients to engage in the deeper work of healing trauma and emotional difficulties.

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The Being is the Doing: The Foundational Place of Therapeutic Presence in AEDP

Benjamin Lipton, LCSW

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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.

Introduction

Throughout my first decade as an AEDP therapist, I had been trying to identify and name exactly what it was that I found to be most transformational for my patients from the toolbox of experientially oriented skills and intervention strategies that I was learning and assembling. While a therapeutic stance of affirmation and delight along with the specific skills of privileging transformance, moment-to-moment tracking, making the implicit explicit, and of course, metatherapeutic processing, are all necessary and powerful tools for processing emotions to completion and potentiating lasting psychological change, somehow none of them entirely captured what seemed to be the foundational therapeutic driver of transformation for my clients.

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The Inner Power Awakens: Contemplative Presence and AEDP as a Way of Life

Danny Yeung M.D., and Lily Zhang

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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.

Introduction

The good rain knows its season,
When spring arrives, it brings life.
It follows the wind secretly into the night,
And moistens all things softly, without sound.
On the country road, the clouds are all black,
On a riverboat, a single fire bright.
At dawn one sees this place now red and wet, T
he flowers are heavy in the brocade city.

Du Fu, Welcome Rain on a Spring Night


Welcome Rain on a Spring Night, written by Du Fu (712 – 770 CE), China’s “poet-saint,” is a powerful metaphor for the essence of Accelerated Experiential Dynamic Psychotherapy

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Therapeutic Presence With Emerging Adults: An AEDP-Informed Approach

Wendy Summer, LPC

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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.

Introduction

Many of our most defining experiences happen after we turn 18: our first grownup job, our first adult relationships, and our first time living independently. Emerging adulthood, defined as 18 to 25 (Arnett, 2014; Tanner & Arnett, 2009), is arguably the most change-intensive, growth-oriented stage of our adult lives. This period can be many things: exciting yet uncertain, liberating yet terrifying, expansive yet sometimes paralyzing. Unfortunately, this current generation of emerging adults (EAs) is experiencing what some are calling a mental health crisis, as reported rates of

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Finding the Elephant in the Room: An AEDP Journey to the Heart of Loss, Presence, and Self

Marc Cecil, Ph.D.

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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.

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See Me, Feel Me: An AEDP Toolbox for Creating Therapeutic Presence Online

Natasha Prenn, LCSW, Kate Halliday, LCSW

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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.

Introduction

Great! I can hear you. Can you hear me? Now, if you click on the little icon of the camera, I’ll be able see you too. Great! Hello? Hello? Oh! how good to see you and hear you!

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