This training manual for pateints who have suffered severe trauma includes a short educational piece, homework sheets, and exercises that promote essential emotional and life skills.
Winner of the 2017 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award. Establishing safety and working with dissociative parts in complex trauma therapy. Therapists around the world ask similar questions and struggle with similar challenges treating highly dissociative patients. This book arose not only out of countless hours of treating patients with dissociative disorders, but also out of the crucible of supervision and consultation, where therapists bring their most urgent questions, needs, and vulnerabilities. The book offers an overview of the neuropsychology of dissociation as a disorder of non-realization, as well as chapters on assessment, prognosis, case formulation, treatment planning, and treatment phases and goals, based on best practices. The authors describe what to focus on first in a complex therapy, and how to do it; how to help patients establish both internal and external safety without rescuing; how to work systematically with dissociative parts of a patient in ways that facilitate integration rather than further dissociation; how to set and maintain helpful boundaries; specific ways to stay focused on process instead of content; how to deal compassionately and effectively with disorganized attachment and dependency on the therapist; how to help patients integrate traumatic memories; what to do when the patient is enraged, chronically ashamed, avoidant, or unable to trust the therapist; and how to compassionately understand and work with resistances as a co-creation of both patient and therapist. Relational ways of being with the patient are the backbone of treatment, and are themselves essential therapeutic interventions. As such, the book also focused not only on highly practical and theoretically sound interventions, not only on what to do and say, but places strong emphasis on how to be with patients, describing innovative, compassionately collaborative approaches based on the latest research on attachment and evolutionary psychology. Throughout the book, core concepts—fundamental ideas that are highlighted in the text in bold so they can be seen at a glance—are emphasized. These serve as guiding principles in treatment as well as a summing-up of many of the most important notions in each chapter. Each chapter concludes with a section for further examination. These sections include additional ideas and questions, exercises for practicing skills, and suggestions for peer discussions based on topics in a particular chapter, meant to inspire further curiosity, discovery, and growth.
This book, part of the acclaimed Norton Series on Interpersonal Neurobiology, brings interpersonal neurobiology into the counseling room, weaving the concepts of neurobiology into the ever-changing flow of therapy. Neuroscientific discoveries have begun to illuminate the workings of the active brain in intricate detail. In fact, sometimes it seems that in order to be a cutting-edge therapist, not only do you need knowledge of traditional psychotherapeutic models, but a solid understanding of the role the brain plays as well. But theory is never enough. You also need to know how to apply the theories to work with actual clients during sessions. In easy-to-understand prose, Being a Brain-Wise Therapist reviews the basic principles about brain structure, function, and development, and explains the neurobiological correlates of some familiar diagnostic categories. You will learn how to make theory come to life in the midst of clinical work, so that the principles of interpersonal neurobiology can be applied to a range of patients and issues, such as couples, teens, and children, and those dealing with depression, anxiety, and other disorders. Liberal use of exercises and case histories enliven the material and make this an essential guide for seamlessly integrating the latest neuroscientific research into your therapeutic practice.
Born out of the excitement of a convergence of ideas and passions, this book provides a synthesis of the work of researchers, clinicians, and theoreticians who are leaders in the field of trauma, attachment, and psychotherapy. As we move into the third millennium, the field of mental health is in an exciting position to bring together diverse ideas from a range of disciplines that illuminate our understanding of human experience: neurobiology, developmental psychology, traumatology, and systems theory. The contributors emphasize the ways in which the social environment, including relationships of childhood, adulthood, and the treatment milieu change aspects of the structure of the brain and ultimately alter the mind.
Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Dissociative processes have long burdened trauma survivors with the dilemma of longing to feel “real” at the same time as they desperately want to avoid the pain that comes with that healing—a dilemma that often presents particularly acute difficulties for healing professionals. Recent clinical and neurobiological research sheds some light into the dark corners of a mind undergoing persistent dissociation, but its integration into the practice of talking therapy has never, until now, been fully realized. Intensive Psychotherapy for Persistent Dissociative Processes brings readers into the consultation room, and into the minds of both patient and therapist, like no other work on the treatment of trauma and dissociation. Richard A. Chefetz marries neuroscientific sophistication with a wealth of extended case histories, following patients over several years and offering several verbatim session transcripts. His unpacking of the emotionally impactful experience of psychodynamic talking therapy is masterfully written, clearly accessible, and singularly thorough. From neurobiological foundations he builds a working understanding of dissociation and its clinical manifestations. Drawing on theories of self-states and their involvement in dissociative experiences, he demonstrates how to identify persistent dissociation and its related psychodynamic processes, including repetition compulsion and enactment. He then guides readers through the beginning stages of a treatment, with particular attention to the psychodynamics of emotion in both patient and therapist. The second half of the book immerses readers in emotionally challenging clinical processes, offering insight into the neurobiology of fear and depersonalization, as well as case examples detailing struggles with histories of incest, sexual addiction, severe negativity, negative therapeutic reactions, enactment, and object-coercive doubting. The narrative style of Chefetz’s casework is nearly novelistic, bringing to life the clinical setting and the struggles in both patient and therapist. The only mystery in this clinical exposition, as it explores several cases over a number of years, is what will happen next. In the depth of his examples and in continual, self-reflexive analysis of flaws in past treatments, Chefetz is both a generous guide and an expert storyteller. Intensive Psychotherapy for Persistent Dissociative Processes is unique in its ability to place readers in the consultation room of psychodynamic therapy. With an evidence-focused approach based in neurobiology and a bold clinical scope, it will be indispensible to new and experienced therapists alike as they grapple with the most intractable clinical obstacles.
Understanding Trauma and Dissociation is a groundbreaking guide to unraveling the mysteries of trauma and dissociation and offering real hope for the chance to heal. Dr. Lynn Karjala, a renowned therapist, provides a comprehensive understanding of the debilitating physical and psychological effects of trauma ... Her innovative approach employing both conventional and mind-body techniques for trauma treatment makes this book a must-read for anyone interested in helping trauma survivors heal and recover.--Publisher.
A practical guide to working with the principles of polyvagal theory beyond the therapy session. Deb Dana is the foremost translator of polyvagal theory into clinical practice. Here, in her third book on this groundbreaking theory, she provides therapists with a grab bag of polyvagal-informed exercises for their clients, to use both within and between sessions. These exercises offer readily understandable explanations of the ways the autonomic nervous system directs daily living. They use the principles of polyvagal theory to guide clients to safely connect to their autonomic responses and navigate daily experiences in new ways. The exercises are designed to be introduced over time in a variety of clinical sessions with accompanying exercises appropriate for use by clients between sessions to enhance the therapeutic change process. Essential reading for any therapist who wants to take their polyvagal knowledge to the next level and is looking for easy ways to deliver polyvagal solutions with their clients.
Presenting a neuroscientifically aware approach to art therapy. Art Therapy and the Neuroscience of Relationships, Creativity, and Resiliency offers a comprehensive integration of art therapy and interpersonal neurobiology. It showcases the Art Therapy Relational Neuroscience (ATR-N) theoretical and clinical approach, and demonstrates how it can be used to help clients with autobiographical memory, reflecting and creating, touch and space, meaning-making, emotions, and dealing with long-term stress and trauma. The ATR-N approach, first developed by Noah Hass-Cohen, is comprised of six principles: Creative Embodiment, Relational Resonating, Expressive Communicating, Adaptive Responding, Transformative Integrating, and Empathizing and Compassion (CREATE). The chapters in this book are organized around these CREATE principles, demonstrating the dynamic interplay of brain and bodily systems during art therapy. Each chapter begins with an overview of one CREATE principle, which is then richly illustrated with therapeutic artwork and intrapersonal reflections. The subsequent discussion of the related relational neuroscience elucidates how the ATR-N work is grounded in research and evidence-based theory. The last section of each chapter, which is devoted to clinical skills and applications, integrates practices and approaches across all six of the CREATE principles, demonstrating how therapeutic art making can help people decipher the functional mystery of their relational nervous system, enhance their emotive and cognitive abilities, and increase the motivation to learn novel concepts and participate in a meaningful social discourse.
A collection of groundbreaking research by a leading figure in neuroscience. This book compiles, for the first time, Stephen W. Porges’s decades of research. A leading expert in developmental psychophysiology and developmental behavioral neuroscience, Porges is the mind behind the groundbreaking Polyvagal Theory, which has startling implications for the treatment of anxiety, depression, trauma, and autism. Adopted by clinicians around the world, the Polyvagal Theory has provided exciting new insights into the way our autonomic nervous system unconsciously mediates social engagement, trust, and intimacy.