1) The document discusses a case study of "Joe", a patient with a history of domestic violence, drug abuse, and murdering his girlfriend, who displays controlling and possessive behavior towards his art therapist in group sessions.
2) Drawing on attachment theory and concepts of transference and countertransference, the therapist explores how Joe's early experiences shape his relationships and how feelings of fear, containment, and captivity emerge in the therapeutic dynamic.
3) Through analyzing Joe's first image in therapy and the therapist's countertransference responses, insights are gained into Joe's internal working models and unresolved attachment issues that both challenge and help the therapeutic process.
The document discusses various therapeutic techniques used in psychiatry including play therapy, music therapy, dance therapy, recreational therapy, light therapy, and repetitive transcranial magnetic stimulation. It provides definitions of each technique, their indications, principles, functions, advantages and the nurse's role in administering them to help treat various psychiatric disorders.
Utilizing clips from the feature films "Ali" and "Magnolia," Dr. Tobin emphasizes the importance of regret in adult development. When pursued in psychotherapy, regrets a patient experiences serve as a bridge into vital aspects of emotional development, mourning, and self-integration. Further, Dr. Tobin introduces the notions of "otherness" and "non-meaning" and characterizes their relevance for personal and existential experience.
1. The document discusses the concept of countertransference in clinical practice. Countertransference refers to the strong emotional reactions or distorted perceptions that mental health professionals may have towards their clients due to their own personal experiences and unresolved issues.
2. It explores how a practitioner's own personality traits, including unacknowledged qualities that reside in their "shadow self," can influence their interactions with and perceptions of clients if not properly managed.
3. Managing countertransference is important to maintain an "adult" position in interactions and prevent one's own needs and issues from interfering with the client's treatment. Self-reflection techniques can help practitioners recognize and address countertransference.
Transference and countertransference refer to unconscious processes in spiritual direction relationships. Transference occurs when a directee unconsciously redirects feelings from past relationships onto the director. Countertransference is when a director unconsciously reacts to feelings aroused by the directee. Unrecognized transference and countertransference can harm the relationship, but addressing them can provide opportunities for growth. Examples include feelings of attraction, treating the director as a parental figure, or running over time. Directors should notice their own feelings and discuss them in supervision to use transference and countertransference constructively.
A free educational training event was being held for community leaders and members to learn about understanding trauma, its effects, and effective trauma treatment. The all-day event included keynote sessions in the morning and afternoon led by experts on topics like the Adverse Childhood Experience Study, neurobiological changes from toxic stress, and inter-partner violence. Several panel discussions were also scheduled featuring local agencies, survivors of trauma, and professionals discussing trauma in the community and approaches to building a more trauma-informed community.
Rhetorical application for mental health MariaPerez964
This document summarizes Maria Perez-Saavedra's rhetorical analysis of the film Joker. It discusses the importance of treating those with mental health conditions with unconditional positive regard, hermeneutics, and heuristics. Unconditional positive regard means accepting people regardless of differences. Hermeneutics is revisiting information to gain a deeper understanding. Heuristics creates new ways to interact respectfully. The document applies these concepts to analyze Arthur's condition in Joker of pseudobulbar affect, which causes uncontrollable laughing. It advocates interacting with compassion by listening, showing acceptance, and distracting in a caring manner.
The document discusses various therapeutic techniques used in psychiatry including play therapy, music therapy, dance therapy, recreational therapy, light therapy, and repetitive transcranial magnetic stimulation. It provides definitions of each technique, their indications, principles, functions, advantages and the nurse's role in administering them to help treat various psychiatric disorders.
Utilizing clips from the feature films "Ali" and "Magnolia," Dr. Tobin emphasizes the importance of regret in adult development. When pursued in psychotherapy, regrets a patient experiences serve as a bridge into vital aspects of emotional development, mourning, and self-integration. Further, Dr. Tobin introduces the notions of "otherness" and "non-meaning" and characterizes their relevance for personal and existential experience.
1. The document discusses the concept of countertransference in clinical practice. Countertransference refers to the strong emotional reactions or distorted perceptions that mental health professionals may have towards their clients due to their own personal experiences and unresolved issues.
2. It explores how a practitioner's own personality traits, including unacknowledged qualities that reside in their "shadow self," can influence their interactions with and perceptions of clients if not properly managed.
3. Managing countertransference is important to maintain an "adult" position in interactions and prevent one's own needs and issues from interfering with the client's treatment. Self-reflection techniques can help practitioners recognize and address countertransference.
Transference and countertransference refer to unconscious processes in spiritual direction relationships. Transference occurs when a directee unconsciously redirects feelings from past relationships onto the director. Countertransference is when a director unconsciously reacts to feelings aroused by the directee. Unrecognized transference and countertransference can harm the relationship, but addressing them can provide opportunities for growth. Examples include feelings of attraction, treating the director as a parental figure, or running over time. Directors should notice their own feelings and discuss them in supervision to use transference and countertransference constructively.
A free educational training event was being held for community leaders and members to learn about understanding trauma, its effects, and effective trauma treatment. The all-day event included keynote sessions in the morning and afternoon led by experts on topics like the Adverse Childhood Experience Study, neurobiological changes from toxic stress, and inter-partner violence. Several panel discussions were also scheduled featuring local agencies, survivors of trauma, and professionals discussing trauma in the community and approaches to building a more trauma-informed community.
Rhetorical application for mental health MariaPerez964
This document summarizes Maria Perez-Saavedra's rhetorical analysis of the film Joker. It discusses the importance of treating those with mental health conditions with unconditional positive regard, hermeneutics, and heuristics. Unconditional positive regard means accepting people regardless of differences. Hermeneutics is revisiting information to gain a deeper understanding. Heuristics creates new ways to interact respectfully. The document applies these concepts to analyze Arthur's condition in Joker of pseudobulbar affect, which causes uncontrollable laughing. It advocates interacting with compassion by listening, showing acceptance, and distracting in a caring manner.
This document discusses transference and countertransference in therapy. It defines transference as clients redirecting feelings from past relationships onto their therapist. Countertransference is the therapist's emotional response to the client. Both phenomena occur unconsciously and can help or hinder treatment, so therapists must understand and manage their own countertransference through self-reflection and supervision. The document provides examples of how transference and countertransference manifest and strategies therapists can use to address them, such as exploring the relationship dynamics in session and maintaining appropriate boundaries.
Here, the client substitutes the psychotherapist for the original parent. She now sees the psychotherapist as fulfilling a role in her script. But she experiences him as doing so in a more benign way than the actual parent did.
The client may experience considerable relief from child fears and anxieties now that she has this more benevolent parent to relate to.
This document summarizes an article about the importance of the therapeutic relationship in psychotherapy. It discusses two key relationships:
1. The client-therapist relationship (Relationship A), which involves transference and countertransference. This relationship is important for establishing trust and intimacy between the client's natural child and therapist's natural child.
2. The client's relationship to the therapeutic technique (Relationship B) used by the therapist. The way a client engages with a technique depends on Relationship A. Relationship B can also impact Relationship A by communicating what behaviors are acceptable.
The document suggests therapeutic change may stem more from a client's suggestibility in relationship to the therapist, rather than from directly experiencing techniques. An ideal
The document provides an overview of Accelerated Experiential Dynamic Psychotherapy (AEDP) for treating complex trauma. It discusses the rationale for using an experiential approach, which involves assisting clients in enhancing their ability to access and process emotions. AEDP directly addresses emotional dysregulation and social isolation through dyadic affect regulation within a secure therapeutic relationship. The core model involves establishing a secure relational base and then using experiential interventions to help clients process trauma-related emotions to completion and achieve transformation.
This document provides an overview of Carl Rogers and his approach to psychotherapy known as person-centered or client-centered therapy. It discusses that Rogers believed the client could solve their own problems with the therapist taking a nondirective role and providing unconditional positive regard, empathy, and congruence. The core concepts of Rogers' approach are that people have the capacity for constructive change and making their own choices with the right environment of understanding and acceptance.
Transference and countertransferenc example pokhrel,bharatBharat Pokhrel
Transference develops in therapy situations where the client feels inferior to the superior therapist, leading to dependence and regression. Transference can occur to some extent in client-centered therapy depending on how ambiguous the situation is and the client's readiness. Transference and countertransference can be positive or negative, stemming from similarities between the therapist and important people in the client's past that evoke old feelings and patterns. For example, a therapist may shy away from a distant client due to reminders of her father. A child psychologist found her past issues with her stepmother were interfering with her work until she resolved them through her own therapy.
Treatment Issues and Relational Strategies for Working with Complex PTSD and ...Daryush Parvinbenam
By: Daryush Parvinbenam M.A., M.Ed., LPCC-S, LICDC
Prevalence of Childhood Trauma: "50-60% of women seeking health services have experienced childhood sexual abuse. Up to 75% of women seeking mental health services has experienced childhood sexual abuse. Children of mothers who were sexually abused are twice as likely to experience childhood sexual abuse."
Overcoming Shame in Borderline Personality Disorder (BPD) Using Compassion Fo...Kenneth Smith, M.S.
This document summarizes a capstone project on using Compassion Focused Therapy (CFT) to treat shame in Borderline Personality Disorder (BPD). It provides an overview of BPD, defining its diagnostic criteria and features. It also discusses theories on the development of BPD and how shame and self-criticism relate to its symptoms. The document introduces CFT as a potential treatment approach and poses questions on the relationship between shame and BPD, how shame affects BPD treatment, and if CFT is an effective tool for treating shame and self-criticism in BPD.
Counseling Strategies Action & Maintenance
By: Linda L. Barclay PH.D. LPCC/S LICDC
CHD 635
Chemical Dependency
"Recovery from addictions requires lifestyle changes"
"Recovery from addictions requires developing and working with relapse prevention or maintenance plans."
The document discusses countertransference in spiritual direction relationships. It defines two main types of countertransference: helper activated, which stems from the helper's own past; and helper reactivated, which is the helper's response to the directee's transference. Helper reactivated countertransference can take the form of objective, concordant, or complementary countertransference. The document provides examples of each and emphasizes that recognizing and addressing countertransference is important for the relationship and can provide insights if explored properly. It concludes that countertransference is inevitable in close relationships and helpers must develop self-awareness and use supervision to best help directees.
Person-centered therapy is a humanistic approach developed by Carl Rogers in the 1940s. It is based on concepts from humanistic psychology and the idea that individuals have the capacity for self-understanding and growth. The core principles of person-centered therapy are congruence, unconditional positive regard, and empathic understanding on the part of the therapist. The therapist aims to understand the client's internal frame of reference without judgment. Over time, person-centered therapy has evolved from a nondirective approach focused on reflection of feelings to emphasizing the therapist's understanding of the client's worldview. Contemporary person-centered therapy remains open to change and refinement while focusing on the therapeutic relationship as the key agent of growth.
This document provides an overview of the existential and psychoanalytical models of conceptualizing human behavior in psychiatric nursing. It defines key terms like theory, concepts, assumptions and phenomena. For the existential model, it describes the philosophical origins, views on behavioral deviations, therapeutic process and roles of therapist and client. For the psychoanalytical model, it outlines Freud's structural theory of mind, psychosexual stages of development, basic concepts like psychic energy and instincts, and roles of patient and psychoanalyst in therapy.
Mode Deactivation Therapy (MDT) was developed as an alternative to standard Cognitive Behavioral Therapy for treating adolescents with behavioral and complex comorbid problems. MDT incorporates principles from CBT, DBT, ACT, and FAP. It is based on Beck's theory of modes and aims to overcome limitations of CBT by assessing and reconstructing adolescents' core beliefs using modes. MDT uses mindfulness, acceptance, and validation techniques to help adolescents manage fears, triggers and core beliefs that lead to maladaptive behaviors. A key part of MDT is developing therapeutic relationships and family support systems to encourage new coping skills and reduce anxiety.
Trauma And Post Traumatic Stress For 2009 National ConferenceMedicalWhistleblower
1) Trauma can cause post-traumatic stress disorder (PTSD) which is a normal reaction to an abnormal situation and is characterized by re-experiencing the trauma through intrusive memories and nightmares, avoidance of trauma-related stimuli, and increased arousal and anxiety.
2) PTSD impacts individuals by causing difficulty trusting others, fear, anger, guilt, and problems with relationships, concentration, and sleep. It can also increase risk of medical illness due to effects on the immune system and stress response.
3) Treatment and support of trauma survivors should focus on fostering safety, trust, choice, strength, healing, and empowerment to overcome feelings of vulnerability and promote
1. The document discusses phase 2 and 3 of complex trauma casework, focusing on trauma memory, emotion processing, and avoidance.
2. Key elements of phase 2 include addressing post-traumatic emotional dysregulation through interventions targeting avoidance and extreme arousal states. Techniques for processing trauma emotions like prolonged exposure and cognitive processing therapy are examined.
3. SAFER strategies are outlined to help with self-care, acknowledgement versus avoidance, functioning, expression of emotions, and relationships during trauma processing. Evidence-based treatments like prolonged exposure and cognitive processing therapy aim to safely expose clients to traumatic memories and rework emotional responses.
This document provides an overview of Gestalt therapy. It discusses the origins and founders of Gestalt therapy, Fritz and Laura Perls. Some key concepts of Gestalt therapy are described, including the holistic view of individuals, the figure-ground process, contact and resistance to contact. Gestalt therapy focuses on awareness in the present moment and experiencing feelings fully rather than interpreting them. The document also discusses techniques used in Gestalt therapy such as exaggeration to increase awareness of tension or blocked energy.
Is IPT time limited psychodynamic psychotherapy? (Markovitz et al, 1998)Sharon
Interpersonal psychotherapy (IPT) and short-term psychodynamic psychotherapy (STPP) are compared across eight aspects: time limit, medical model, goals, interpersonal focus, techniques, termination, therapeutic stance, and empirical support. While IPT and STPP share some similarities, such as a focus on interpersonal relationships and support from the therapist, they differ in key ways. IPT has a strict time limit of 12-16 weeks, uses a medical model framework with a focus on diagnosing and treating the patient's psychiatric illness. In contrast, STPP does not have a fixed time limit and focuses more on underlying unconscious conflicts from early childhood and character defenses rather than diagnoses. The authors conclude that despite some overlaps,
This document provides an overview of existential therapy. It discusses key figures in existential therapy like Viktor Frankl who developed logotherapy. It also discusses Rollo May and his contributions. The document outlines some core concepts of existential therapy including its focus on finding meaning and purpose in life. It describes the goals and processes of existential therapy including techniques like the empty chair. It also notes some advantages and disadvantages of the approach.
Existential psychotherapy focuses on core human experiences like death, freedom, isolation, and meaninglessness. It views humans as always changing and creating themselves rather than having a fixed personality. The therapist aims to facilitate authenticity using techniques like phenomenological analysis to understand the client's present experience. Existential psychotherapy explores how clients navigate relationships with themselves and the world, seeking to help them find meaning and terms with the challenges of existence.
Negotiating the Enduring Trauma Imprint in Critical IncidentsPaulaFenn
I presented this slide deck at the BACP conference on critical Incidents held in Edinburgh in April 2018. Those that are interested in this field of work may find it useful.
The document discusses several major models of psychotherapy:
1) Psychodynamic model (Sigmund Freud), Cognitive-Behavioral model (Albert Ellis, Aaron Beck), Existential-Humanistic model (Carl Rogers, Rollo May), and Multicultural model.
2) Key techniques discussed include free association, dream analysis, cognitive restructuring, Socratic questioning, reflection, and confrontation used in therapies like psychoanalysis, CBT, person-centered therapy and rational emotive behavior therapy.
3) The cognitive-behavioral and rational emotive behavior therapy models make use of techniques like systematic desensitization, modeling, and disputing irrational beliefs through logical arguments.
This document discusses transference and countertransference in therapy. It defines transference as clients redirecting feelings from past relationships onto their therapist. Countertransference is the therapist's emotional response to the client. Both phenomena occur unconsciously and can help or hinder treatment, so therapists must understand and manage their own countertransference through self-reflection and supervision. The document provides examples of how transference and countertransference manifest and strategies therapists can use to address them, such as exploring the relationship dynamics in session and maintaining appropriate boundaries.
Here, the client substitutes the psychotherapist for the original parent. She now sees the psychotherapist as fulfilling a role in her script. But she experiences him as doing so in a more benign way than the actual parent did.
The client may experience considerable relief from child fears and anxieties now that she has this more benevolent parent to relate to.
This document summarizes an article about the importance of the therapeutic relationship in psychotherapy. It discusses two key relationships:
1. The client-therapist relationship (Relationship A), which involves transference and countertransference. This relationship is important for establishing trust and intimacy between the client's natural child and therapist's natural child.
2. The client's relationship to the therapeutic technique (Relationship B) used by the therapist. The way a client engages with a technique depends on Relationship A. Relationship B can also impact Relationship A by communicating what behaviors are acceptable.
The document suggests therapeutic change may stem more from a client's suggestibility in relationship to the therapist, rather than from directly experiencing techniques. An ideal
The document provides an overview of Accelerated Experiential Dynamic Psychotherapy (AEDP) for treating complex trauma. It discusses the rationale for using an experiential approach, which involves assisting clients in enhancing their ability to access and process emotions. AEDP directly addresses emotional dysregulation and social isolation through dyadic affect regulation within a secure therapeutic relationship. The core model involves establishing a secure relational base and then using experiential interventions to help clients process trauma-related emotions to completion and achieve transformation.
This document provides an overview of Carl Rogers and his approach to psychotherapy known as person-centered or client-centered therapy. It discusses that Rogers believed the client could solve their own problems with the therapist taking a nondirective role and providing unconditional positive regard, empathy, and congruence. The core concepts of Rogers' approach are that people have the capacity for constructive change and making their own choices with the right environment of understanding and acceptance.
Transference and countertransferenc example pokhrel,bharatBharat Pokhrel
Transference develops in therapy situations where the client feels inferior to the superior therapist, leading to dependence and regression. Transference can occur to some extent in client-centered therapy depending on how ambiguous the situation is and the client's readiness. Transference and countertransference can be positive or negative, stemming from similarities between the therapist and important people in the client's past that evoke old feelings and patterns. For example, a therapist may shy away from a distant client due to reminders of her father. A child psychologist found her past issues with her stepmother were interfering with her work until she resolved them through her own therapy.
Treatment Issues and Relational Strategies for Working with Complex PTSD and ...Daryush Parvinbenam
By: Daryush Parvinbenam M.A., M.Ed., LPCC-S, LICDC
Prevalence of Childhood Trauma: "50-60% of women seeking health services have experienced childhood sexual abuse. Up to 75% of women seeking mental health services has experienced childhood sexual abuse. Children of mothers who were sexually abused are twice as likely to experience childhood sexual abuse."
Overcoming Shame in Borderline Personality Disorder (BPD) Using Compassion Fo...Kenneth Smith, M.S.
This document summarizes a capstone project on using Compassion Focused Therapy (CFT) to treat shame in Borderline Personality Disorder (BPD). It provides an overview of BPD, defining its diagnostic criteria and features. It also discusses theories on the development of BPD and how shame and self-criticism relate to its symptoms. The document introduces CFT as a potential treatment approach and poses questions on the relationship between shame and BPD, how shame affects BPD treatment, and if CFT is an effective tool for treating shame and self-criticism in BPD.
Counseling Strategies Action & Maintenance
By: Linda L. Barclay PH.D. LPCC/S LICDC
CHD 635
Chemical Dependency
"Recovery from addictions requires lifestyle changes"
"Recovery from addictions requires developing and working with relapse prevention or maintenance plans."
The document discusses countertransference in spiritual direction relationships. It defines two main types of countertransference: helper activated, which stems from the helper's own past; and helper reactivated, which is the helper's response to the directee's transference. Helper reactivated countertransference can take the form of objective, concordant, or complementary countertransference. The document provides examples of each and emphasizes that recognizing and addressing countertransference is important for the relationship and can provide insights if explored properly. It concludes that countertransference is inevitable in close relationships and helpers must develop self-awareness and use supervision to best help directees.
Person-centered therapy is a humanistic approach developed by Carl Rogers in the 1940s. It is based on concepts from humanistic psychology and the idea that individuals have the capacity for self-understanding and growth. The core principles of person-centered therapy are congruence, unconditional positive regard, and empathic understanding on the part of the therapist. The therapist aims to understand the client's internal frame of reference without judgment. Over time, person-centered therapy has evolved from a nondirective approach focused on reflection of feelings to emphasizing the therapist's understanding of the client's worldview. Contemporary person-centered therapy remains open to change and refinement while focusing on the therapeutic relationship as the key agent of growth.
This document provides an overview of the existential and psychoanalytical models of conceptualizing human behavior in psychiatric nursing. It defines key terms like theory, concepts, assumptions and phenomena. For the existential model, it describes the philosophical origins, views on behavioral deviations, therapeutic process and roles of therapist and client. For the psychoanalytical model, it outlines Freud's structural theory of mind, psychosexual stages of development, basic concepts like psychic energy and instincts, and roles of patient and psychoanalyst in therapy.
Mode Deactivation Therapy (MDT) was developed as an alternative to standard Cognitive Behavioral Therapy for treating adolescents with behavioral and complex comorbid problems. MDT incorporates principles from CBT, DBT, ACT, and FAP. It is based on Beck's theory of modes and aims to overcome limitations of CBT by assessing and reconstructing adolescents' core beliefs using modes. MDT uses mindfulness, acceptance, and validation techniques to help adolescents manage fears, triggers and core beliefs that lead to maladaptive behaviors. A key part of MDT is developing therapeutic relationships and family support systems to encourage new coping skills and reduce anxiety.
Trauma And Post Traumatic Stress For 2009 National ConferenceMedicalWhistleblower
1) Trauma can cause post-traumatic stress disorder (PTSD) which is a normal reaction to an abnormal situation and is characterized by re-experiencing the trauma through intrusive memories and nightmares, avoidance of trauma-related stimuli, and increased arousal and anxiety.
2) PTSD impacts individuals by causing difficulty trusting others, fear, anger, guilt, and problems with relationships, concentration, and sleep. It can also increase risk of medical illness due to effects on the immune system and stress response.
3) Treatment and support of trauma survivors should focus on fostering safety, trust, choice, strength, healing, and empowerment to overcome feelings of vulnerability and promote
1. The document discusses phase 2 and 3 of complex trauma casework, focusing on trauma memory, emotion processing, and avoidance.
2. Key elements of phase 2 include addressing post-traumatic emotional dysregulation through interventions targeting avoidance and extreme arousal states. Techniques for processing trauma emotions like prolonged exposure and cognitive processing therapy are examined.
3. SAFER strategies are outlined to help with self-care, acknowledgement versus avoidance, functioning, expression of emotions, and relationships during trauma processing. Evidence-based treatments like prolonged exposure and cognitive processing therapy aim to safely expose clients to traumatic memories and rework emotional responses.
This document provides an overview of Gestalt therapy. It discusses the origins and founders of Gestalt therapy, Fritz and Laura Perls. Some key concepts of Gestalt therapy are described, including the holistic view of individuals, the figure-ground process, contact and resistance to contact. Gestalt therapy focuses on awareness in the present moment and experiencing feelings fully rather than interpreting them. The document also discusses techniques used in Gestalt therapy such as exaggeration to increase awareness of tension or blocked energy.
Is IPT time limited psychodynamic psychotherapy? (Markovitz et al, 1998)Sharon
Interpersonal psychotherapy (IPT) and short-term psychodynamic psychotherapy (STPP) are compared across eight aspects: time limit, medical model, goals, interpersonal focus, techniques, termination, therapeutic stance, and empirical support. While IPT and STPP share some similarities, such as a focus on interpersonal relationships and support from the therapist, they differ in key ways. IPT has a strict time limit of 12-16 weeks, uses a medical model framework with a focus on diagnosing and treating the patient's psychiatric illness. In contrast, STPP does not have a fixed time limit and focuses more on underlying unconscious conflicts from early childhood and character defenses rather than diagnoses. The authors conclude that despite some overlaps,
This document provides an overview of existential therapy. It discusses key figures in existential therapy like Viktor Frankl who developed logotherapy. It also discusses Rollo May and his contributions. The document outlines some core concepts of existential therapy including its focus on finding meaning and purpose in life. It describes the goals and processes of existential therapy including techniques like the empty chair. It also notes some advantages and disadvantages of the approach.
Existential psychotherapy focuses on core human experiences like death, freedom, isolation, and meaninglessness. It views humans as always changing and creating themselves rather than having a fixed personality. The therapist aims to facilitate authenticity using techniques like phenomenological analysis to understand the client's present experience. Existential psychotherapy explores how clients navigate relationships with themselves and the world, seeking to help them find meaning and terms with the challenges of existence.
Negotiating the Enduring Trauma Imprint in Critical IncidentsPaulaFenn
I presented this slide deck at the BACP conference on critical Incidents held in Edinburgh in April 2018. Those that are interested in this field of work may find it useful.
The document discusses several major models of psychotherapy:
1) Psychodynamic model (Sigmund Freud), Cognitive-Behavioral model (Albert Ellis, Aaron Beck), Existential-Humanistic model (Carl Rogers, Rollo May), and Multicultural model.
2) Key techniques discussed include free association, dream analysis, cognitive restructuring, Socratic questioning, reflection, and confrontation used in therapies like psychoanalysis, CBT, person-centered therapy and rational emotive behavior therapy.
3) The cognitive-behavioral and rational emotive behavior therapy models make use of techniques like systematic desensitization, modeling, and disputing irrational beliefs through logical arguments.
Humanistic approach talks about human potential which can only be harnessed by an individual by focussing on internalization and subjective knowledge for this world for the attainment of self-actualization or true potential by fulfilling the needs as per the hierarchy of importance.
The document discusses the use of vocal holding techniques in music therapy to help adults who were traumatized as children recover parts of themselves and reconnect to their authentic selves. Vocal holding involves the client and therapist singing together using a simple repeated chord structure to create a safe and predictable environment. This allows unconscious feelings and memories to emerge through improvised singing. Singing aids embodiment by facilitating deep breathing and releasing trauma stored in the body. It also allows clients to express themselves creatively and take ownership of their voices.
The document provides information on the interpersonal model and behavioral model of mental health. It discusses the key assumptions, principles, techniques, and application of each model. The interpersonal model focuses on how social interactions and relationships influence personality development. It emphasizes anxiety, trust, and security. The behavioral model is based on learning theory and focuses on observable behaviors. It uses techniques like positive reinforcement, systematic desensitization, and assertiveness training to modify behaviors. Both models influence psychiatric nursing practice.
This document discusses moving the NSW homelessness sector towards trauma-informed care. It notes that homeless populations experience high rates of trauma, especially women. Trauma-informed care focuses on safety, control, strengths and compassionate engagement through listening. Training teaches the impacts of trauma, complex trauma, and uses a neuroscience lens. It emphasizes relationship-building, predictability, stability and right-brain interactions over explicit trauma memory work. The goal is cultural change to better support consumers in a trauma-informed manner.
Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience. It is a normalreaction to an abnormalsituation.
•Any human being has the potential to develop PTSD
•Cause external –Psychiatric Injury not Mental Illness
•Not resulting from the individual’s personality –Victim is not inherently weak or inferior
Trauma And Post Traumatic Stress For 2009 National Conferenceguest8ff06f
Persons who have experience mind altering trauma have long term emotional and psychological effects of their experience. Learn how there is hope when a compassionate approach to the traumatized individual is used rather than the traditional approach of viewing the person as irreparably damaged. The human person has unlimited potential for healing if proper emotional support is provided and security and safety issues addressed. We discuss the symptoms of Post Traumatic Stress Disorder and a pathway to recovery.
The document discusses the use of music therapy with a 10-year-old boy ("D") who had been sexually abused for the first five years of his life. Through weekly 30-minute sessions, the boy was able to powerfully express his experience of abuse through developing a repertoire of games and interactions. The therapeutic relationship aimed to provide a secure base and emotional containment for the boy to explore painful feelings and experiences from his past in a supported way. The effects of lack of a secure attachment and base during childhood due to abuse, including disorganized attachment patterns and neurological implications, are also examined.
Viktor Frankl developed logotherapy, which focuses on helping clients find meaning in their lives. Logotherapy holds that finding meaning is an inherent human motivation and the primary driver of human behavior. The therapist helps clients identify experiences they find meaningful and set goals oriented around pursuing more meaningful activities and relationships. The overall aim is for clients to develop a sense of purpose that enhances well-being and motivates constructive behavior.
Existential therapy focuses on helping clients find meaning and purpose in life. It explores themes like morality, freedom, responsibility and the meaning of life. Key figures who influenced existential therapy include Kierkegaard, Nietzsche, Frankl, May and Yalom. Existential therapists believe humans are free and responsible for their choices. The therapist-client relationship is important, with the therapist assisting the client in broadening their self-awareness and considering new options. The goal is for clients to accept responsibility for their lives rather than blaming external forces.
Pre-Therapy (Contact) orientated, nature based. June 2022.pptxRabErskine1
This PowerPoint presentation was developed by Rab Erskine and was offered to the tPCA's Practitioner Conference, Alfreton in June 2022. The slides highlight aspects of offering a Contact-Orientated counselling/therapy model in nature and are based on Rab's learning over the years..
Rab has lived and worked as a therapist, in the Tweed Valley (Scottish Borders Region) for over thirty five years. His initial experience of working therapeutically started in 1985, while employed at a pioneering therapeutic-community project. After qualifying in 1993 as a counsellor and psychotherapist, and alongside working as a counsellor in primary care, he set up a small company offering nature-based short term residential experiences to individuals and groups. From 2004 to 2016, he was commissioned to run the nature-based project for the Adult Mental Health Psychiatric Rehabilitation service. For a number of years he also worked as a trainer and supervisor. He presently runs a nature based private practice alongside mentoring and working with charities that support adults with complex trauma.
Rab describes his work in the following way:
"Although most counselling and psychotherapy takes place indoors, there are times when there is a need for a more natural working environment than the often, somewhat ‘clinical’ indoor therapeutic space.
This much larger working environment sometimes known as Eco-Therapy, Nature Therapy, Eco-Psychology, can assist in the creation of a gentle yet powerful therapeutic encounter, often useful when there is trauma or deep seated emotional experiences to be worked with.
A way of engaging therapeutically which (Rab believes) understands the individuals’ need for a supportive, non judgemental, less intrusive, compassionate environment within which to explore and better understand him/her self.
This very humanistic way of engaging therapeutically, works well with the nature based working context of ecotherapy.
This document summarizes Terry L. Ledford's presentation on using therapeutic stories and metaphors to convey cognitive behavioral therapy principles for overcoming negative self-esteem. The presentation reviews principles of cognitive therapy and schema therapy, provides examples of helpful stories, and allows participants to practice developing therapeutic stories and metaphors in small groups. Ledford has developed various programs and publications that incorporate storytelling to address dysfunctional schema and improve self-esteem.
Why We Love Who We Love: A Psychodynamic Perspective on the Loss of Free Will James Tobin, Ph.D.
In this presentation, Dr. Tobin presents a model of romantic love that synthesizes concepts from evolutionary psychology, Freudian thought, interpersonal neurobiology, and intersubjectivity. Notions of free will and conscious decision-making regarding the choice of romantic partners are refuted. Instead, Dr. Tobin presents an unconsciously motivated perspective on romantic love that emphasizes our uncanny tendency to select and induce others to hurt us emotionally iin ways that are familiar and to which we are highly adapted.
Complex PTSD and Moral Injury - Lane Cook and Herb Piercy.pptxLaneCook2
Presented at the 25th annual Fall Psychiatric Symposium, Knoxville, TN - review of C-PTSD and Moral Injury, overlap. Reviews history, references, psychotherapy, medications. For therapists, psychiatrists and people working with veterans.
The document discusses intergenerational trauma and its impacts. It notes that trauma can be passed down from generation to generation if not resolved. Cultural trauma impacts entire societies by attacking the fabric of the community. The concept of an "invisible backpack" is introduced, which refers to how our culture, experiences and beliefs unconsciously influence our interactions. The cycle of pain, trauma and harm can be addressed through restoring balance, though harm reduction and focusing on wellness and resilience rather than disease models of health. The theory of the "wounded healer" is presented, where those who have experienced and processed trauma can develop greater empathy and understanding to help others.
Experiential family therapy emerged from humanistic movements of the 1960s. It focuses on bringing suppressed emotions to the surface to help family members connect more genuinely. Key innovators like Carl Whitaker and Virginia Satir developed techniques like family sculpting and role playing to facilitate emotional expression. The goal is for each family member to honestly report their feelings and be addressed uniquely, rather than through power dynamics. Breakthroughs often involve members becoming angrier or closer. While it helps discovery and reconnection, experiential family therapy is less focused on problem solving or family structure roles.
This document defines and discusses the concepts of transference and countertransference in mental healthcare. Transference refers to a client unconsciously transferring feelings and attitudes from past relationships onto their healthcare provider. Countertransference occurs when a provider transfers their own feelings onto a client. Recognizing transference and countertransference is important for providers to understand what is happening in the client relationship and avoid acting out. Managing these phenomena involves maintaining appropriate boundaries, being reliable, and using reflection and supervision to avoid reactive responses.
This document discusses the philosophy and practice of clinical outpatient therapy. It begins with a disclaimer stating the purpose is to improve therapy practice through a deeper understanding of methods, not replace expectations of one's agency. It then provides background on the author's training and apprenticeships with notable clinicians over 12 years, and a subsequent innovative practicum with live supervision employing solution-focused, team therapy. The document goes on to discuss perspectives on the origin of psychological symptoms, including from biomedical conditions, trauma/injury, and power struggles in relationships. It emphasizes symptoms acquire purpose, meaning and power in organizing social interaction and communication within relationships.
Similar to A Rock and A Hard Place Presentation Emma Allen (20)
Fold TO A5 Nottinghamshire Eating Disorder Art Therapy Service LeafletEmma Allen
This document provides information about art therapy services available through the Nottinghamshire Eating Disorder Service. It explains that art therapy uses visual art materials and processes to help clients gain insight into personal issues and difficulties, especially for those struggling with eating disorders. A typical art therapy session involves using art materials like painting or clay in a safe space with a trained therapist present to discuss any feelings or thoughts that emerge through creating visual images. The goal is for clients to express themselves freely and find new understanding through this creative therapeutic process.
Fold TO A5 NEDS and FREED Art Therapy Groups LeafletEmma Allen
This document provides information about art therapy groups for people with eating disorders through the Nottinghamshire Eating Disorder Service (NEDS). It explains that individuals can be referred to the groups by their therapist or care coordinator. New referrals will have two assessment sessions to determine if art therapy would be helpful. Groups meet once enough people are referred and last for 12 weekly sessions. The document describes different types of art therapy groups and what to expect in the sessions.
Richard SOG Case Study HCPC Campaign Emma AllenEmma Allen
Richard was a 50-year-old man sentenced to life in prison for rape, burglary, and indecent assault who had a history of abuse and violent offenses. He withdrew from his sex offender treatment program but self-referred to art therapy to explore his feelings and rebuild trust. Through creating non-threatening images in therapy, Richard was able to disclose how witnessing his mother's rape and his own sexual abuse influenced his crimes and issues with anger. At the end of therapy, Richard commented that the art materials allowed him to freely express hidden emotions and explore his mental health and how his past impacted his present and future. He successfully completed both art therapy and sex offender treatment.
When: Saturday 8th November 2014 from 10:45-12.30pm at the Philadelphia Association in London. Registration and refreshments begin at 10.30am. The event costs £10.
The Saturday Forensic Forum presentation will discuss forensic art therapy approaches. Emma Allen, an art therapist from Rampton High Secure Hospital, will present on her use of sandplay in an arson treatment program and how it can help assess and explore the deeper meanings of fire-setting for patients.
The document announces a conference for arts therapists on June 12, 2015 in London titled "Opening Up to Emotionality". The conference will feature a presentation by Emma Allen and Jo Sellam on their use of Jungian sandplay therapy in secure settings. They will present case studies exploring symbolic concepts of "judgment" and "justice" through symbols like the "Judge" and "Statue of Liberty". The presentation aims to highlight differences between art therapy and sandplay therapy and how to use symbolic approaches in forensic psychotherapy. Registration costs £50 with discounts for students, and inquiries can be directed to the Forensic Arts Therapies Advisory Group.
2. “A Rock & A Hard Place:
Counter-transference Captivity ”
A Discussion Of A Piece Of Recent Therapeutic Practice,
Showing How My Art Therapy Experience
Helps Us Learn About An Aspect Of The Theory & Practice
Of Psychodynamic Psychotherapy
Presentation
Emma Allen
HCPC Registered Art Psychotherapist
Rampton Hospital, High Secure Hospital
3. “A Rock & A Hard Place:
Counter-transference Captivity ”
Aims & Objectives
•Providing case study material from forensic mental health setting.
•Drawing upon clinical applications of attachment theory, pathological, violent attachments.
•Looking at the potency of the first image made in a group setting.
•Considering counter-transference expression & “captivity” counter-transference.
•The importance of holding & containing & the centrality of the therapeutic relationship
(patient- image-therapist).
4. Joe
•Joe witnessed domestic violence from an early age – violent & abusive father.
•Left school at 15 to live in a hostel / Illicit drugs & alcohol misuse.
•Challenging & threatening behaviour at school / hospital admissions / bipolar affective
disorder.
•Barricaded himself in an attic – admitted to psychiatric hospital, drug induced psychosis.
•IO: Murdered girlfriend after days of torture – keeping her hostage for a number of days,
causing significant injuries.
•Violent in prison, deteriorating mental state/ months in his cell at a time. Delusions, acute
paranoia – believes he is a prophet.
•Threatening & abusive behaviour at Rampton.
•Hostile when challenged / defensive. Relationship difficulties – Controlling, domineering &
possessive of Art Therapist in a group setting.
•Therapist relates to victim.
5.
6.
7.
8.
9. •Drawing on attachment theory when thinking about the offence, presentation,
transference & counter-transference.
•Experiences from first relationships continue to influence throughout the life span -
experiences include pre & non-verbal interactions (Sobey and Woodcock).
•Patterns of relating that took root in early relationships (& make up the pt’s internal
world) are likely to surface quickly & strongly within the pt-therapist dyad in pt-led
psychotherapeutic work.
•Mary Ainsworth (1976): Securely attached, Insecure-avoidant, Insecure ambivalent.
•In cases where experiences have been destructive, the Art Therapist provides a
different experience of relating – working to create an environment that will promote a
less polarised & more secure attachment – consistency & reliability.
•It is thought that insecure attachment patterns play a significant role within many
emotional, behavioural & psychiatric disorders.
•Chronic emotional detachment in psychopaths (Bowlby, 1944) (Reid, Door, Walker &
Banner, 1986).
10. Violent Attachments
•John Bowlby (1907-1990) ‘father’ of attachment theory identified that abuse & neglect as factors in adult
psychological problems.
•‘A Secure Base’ (1988) Violence of parents a major contributory cause of a number of ‘distressing & puzzling
psychiatric syndromes’.
• ‘Violence breeds violence’; perpetuating itself from one generation to the next. Violent fathers – what has
Joe learnt from how others attach/relate to each other? Fears of being abandoned?
•Anger is often functional. Sado-masochistic projections/ relating reflect the way the offenders internal
model for relationships is organised & may be a way to master trauma.
•Many violent offenders have rarely had any experience of containment or boundaries.
•Maternal deprivation prevents containment.
•“This lack of emotional containment along with enduring trauma that later in life the forensic patient adopts
very complex, often dangerous defence mechanisms simply to survive their unbearable emotional
states”(p.109, Aiyegbusi, 2009).
11.
12. “Many inmates have experienced & perpetrated damage & abuse with
recurring detrimental effect.
A poor sense of belonging, an inability to trust, fears of invasion or rejection,
theft or assault can all overrule the inmate’s capacity to engage in meaningful relationships.”
(Guidelines for Arts Therapists Working in Prisons, 2002).
13. Attachment & Psychotherapy
• Bowlby believed that attachment theory was central to both normative &
psychopathological development – relevance for psychotherapy.
•The therapist functions to “provide the patient with a secure base from which to
explore both himself & also his relations with all those with whom he has made or
might make, an affectional bond” (Bowlby, 1977 p.421).
•Providing a ‘temporary attachment figure’.
•Helping the pt examine the relationship with the therapist, & how this relates to
(past) relationships or experiences outside of therapy (Adshead,1998).
•Transference & counter-transference dynamics provide the opportunity to
negotiate multiple contradictory internal working models, helping pts to feel,
think, & act in new ways.
•The internalization of the bond with the therapist becomes a representational
safe haven the pt can turn internally in times of distress (Levy, K.N et al, 2012).
14. Possessive Containment
•The therapist is ‘held’ & contained in therapy: Feeling stuck, trapped, ‘possessed’ by the pt.
•Art expression can reveal aspects of unconscious communication & offence-paralleling
behaviour.
•“Art is recognised as a process of spontaneous imagery, released from the unconscious, using the
mechanisms of repression, projection, identification, sublimation, & condensation” (Daley, p.xvi).
•For avoidant individuals holding is perhaps the key ingredient in therapy. Only when they feel
securely held can these pts begin to confront their inner world & put emotions into words.
•Domineering / Ownership “Since when have you become Emma? since when do you now speak
for Emma? Since when do you now start acting as if 'she's all mine not yours’?”
•Therapists need to contain not only the pt’s affects but also their countertransference responses
(Therapists can be possessive too).
•Therapist acts as a containing function if can tolerate the clients feelings & emotions through
transference & CT. Melanie Klein ( 1943, 1952).
•Central dilemma in the image: to hold or to let go?
15. Counter-transference Captivity
•“Moments of fear & suspense in the therapeutic relationship where the therapist may
feel pinned to the spot & alert to some unknown danger” (p.57 Greenwood, Wood,
2010).
•Like in the image, I identified with the victim.
•Therapist expected to hear about the offence – sometimes this can be frightening.
•“The attempted integration of subjective & objective ways of thinking in the pt or
the bringing together of empathic understanding & intellectual comprehension by the
analyst that is believed to cause a catastrophe” (R.Britton, 1998:43).
•Attempts to distance – intimacy threat to autonomy (Schaverien, 2006)
•Containment parallels with the experience of a developing therapeutic relationship
with a pt. Detoxifying (Bion, 1962). CT as key to the pt’s unconscious (Heimann, 1950,
Aiyegbusi & Clarke-Moore, 2009).
•Help as weakening / Envy / Growth of therapeutic relationship is defended against;
feelings of need, want & vulnerability are all intolerable (Greenwood, Rosenfeld,
1987).
•Fear is often a projection in the transference & counter-transference.
16. Fear in the countertransference (CT)
•The psychotic aspect of a pt cannot tolerate awareness of their vulnerabilities or
dependency, & wish to attack & kill off awareness of this reality by attacking the
perception, or the source of awareness of reality (Bion, 1957).
• Fear of an eruption of violence.
•This fear is justified: pt’s wish to kill off reality is real - have actually killed or
attacked the source of awareness of reality – their victims. (Aiyegbusi & Clarke-
Moore, 2009).
•Did he feel fear from violent father? Frozen with fear?
•Re-enactments: Victim, persecutor, rescuer (Karpman‘s Drama Triangle, 1968)
psychological roles playing out in the therapeutic alliance.
•The therapeutic alliance in forensic mental health is often complicated by
potential & actual risks the pt presents to others.
•Container paralysis. Feel hostage to pt (Greenwood, 2000).
•Managing CT in supervision & multidisciplinary working.
17. Klein (1975) described how the infant will want to get rid of unwanted parts of himself and will not want to
experience his mother in a way that leaves him with negative feelings about her, as this will cause him
anxiety & distress.
The infant gets rid of intolerable feelings by projecting them into his mother. The infant does this in order
to dominate & control her, take over her capacities & make them his own, & invade & destroy her.
The powerful defence mechanisms of projection & projective identification afford the infant the ability of
avoiding any awareness of his own feelings of separateness, dependence, admiration, feelings of envy,
loss or anger & acute anxieties of fearing death through annihilation. In ‘normal’ development, these
projections lessen as the infant learns to tolerate the ambivalent feelings of love, hate & dependence for
his mother.
18. •Forensic Art Therapy, as part of a
multi-disciplinary approach, can
contribute towards the assessment
of risk of further offending or the
understanding & treatment of an
individual’s offending behaviour.
•Behaviour observance – symbolic
offence paralleling behaviour
•The unspeakable can be
externalised, visualised, expressed,
communicated, shared &
symbolised.
•Vehicle for catharsis.
•Containment is fundamental:
offender patients can develop a
symbolic container inside
themselves through the medium of
art-making.
19. •The combination of ‘The Scream’ &
‘The Kiss’ makes for a very powerful,
first image.
•The potential significance of the
transference is embodied / held &
contained in the artwork.
•The image reveals his attachment
difficulties; suffocating, intoxicating.
•Conflict & resolution: Holding &
Letting go.
•Bridging affective states & memories.
•“Pictures offer a medium for relating,
first to the self and then to another
person” (p.140, Schaverien, 1995).
•Self-awareness & insight into their
impact on others, ways of relating &
attachment patterns.
•The image & Therapist as container.
•Wanting to capture you!
20. “A Rock & A Hard Place:
Counter-transference Captivity ”
Conclusion
•“Working with the Counter-transference” (Captivity), projections. ‘Pinned to the spot’ in fear,
may be the pt’s fear.
•Attachment Theory, Violent Attachments; Early attachment experiences help explain
emotional distress, personality disturbances, anxiety & anger (Bowlby) & helps us understand
the pt.
•Attachment needs exist throughout the lifecycle putting separation & loss central to
psychiatric disturbance/Relationships & Survival/ appropriate dependency.
•Impact /potency of the first image -“charged material” holding significant information.
Conflict & Resolution / Early (pre-verbal) experiences made visible & relevant to present day.
•Importance of holding & containing, safe therapeutic relationship – trusting & collaborative.
Supervision.
Editor's Notes
a situation offering at least two possibilities, neither of which is acceptable
STUCK WITH THE INDEX OFFENCEfeeling in such a bad situation there is no escape
If you are caught between a rock and a hard place, you are in a position where you have to choose between unpleasant alternatives, and your choice might cause you problems; you will not be able to satisfy everyone.
The Secure Base. Art Therapy can assist in alleviating negative reactions to isolation & incarceration; assisting with patients’ self-esteem.
The Secure Base. Art Therapy can assist in alleviating negative reactions to isolation & incarceration; assisting with patients’ self-esteem.
What I am going to do….I will demonstrate how I use attachment / psychodynamic theory for my therapeutic practice
How CT is expressed and can affect thinking.
Joe’s early attachment
a situation offering at least two possibilities, neither of which is acceptable
STUCK WITH THE INDEX OFFENCEfeeling in such a bad situation there is no escape
If you are caught between a rock and a hard place, you are in a position where you have to choose between unpleasant alternatives, and your choice might cause you problems; you will not be able to satisfy everyone.
The index offence strikes me as being in the image – central focus – also of him and his mum?
One interpretation is that the man is forcing a kiss on the woman who is turning away, but unable to escape.
The Kiss, Gustav Klimt, (yr) Klimt reputation as possessive man? Image about relationships and attachment. Joe related to the art in a personal way – it resonated with him personally – even if a copy of postcards. Resonated with him on a symbolic level.
Fraley & Shaver (2000)
3 main attachment patterns secure, avoidant, or ambivalent & these behav’s continue into adulthood.
Violence in the family
The institutional space is designed to contain violent projections (split off anxieties) (Aiyegbusi, Clarke-Moore, 2009)
GROUP DISCUSSION
Possibility of psychological release?
Art Therapy contributes to the development of: Interpersonal relating, Developing insight & self-reflection, Self-esteem / Empathy.
Reminds us of the borderline ‘love me don’t leave me’ ‘I hate you don’t leave me’ Therapists can be possessive of their clients too.
How is the patient making me feel? CT powerful feelings were brought up in me.
Being and feeling captured by the offender patient a difficult and complex dynamic.
Don’t be surprised if you are the subject matter! But what does this mean?
The bridge reminds me of how anger is sublimated, associations to
artwork may be actuated to bridge affective states and memories
Separation and loss central to psychiatric disturbance
Therapy involves attention to the container-contained relationship.
NOT DOMINEERING OR FEARFUL
The artwork can become charged material
a situation offering at least two possibilities, neither of which is acceptable In difficulty, faced with a choice between two unsatisfactory options – relationships – TODAY I WANTED TO THINK ABOUT A ROCK AND A HARD PLACE – not better to be one or the other – to have or to let go. Catch 22 with relationships but the therapeutic one can example a healthier attachment for future distress. TO HAVE IS DANGEROUS AND TO LET GO IS DANGEROUS TOO. Exampled one aspect of attachment and counter-transference.
THE WORK IS ONGOING
STUCK WITH THE INDEX OFFENCEfeeling in such a bad situation there is no escape
If you are caught between a rock and a hard place, you are in a position where you have to choose between unpleasant alternatives, and your choice might cause you problems; you will not be able to satisfy everyone.