Developmental Attunement, Relational-Needs and Therapeutic Presence
A 2-day training workshop at London on Relational Psychotherapy with
Dr Richard G. Erskine
London, 24 & 25 June 2016, Friday & Saturday
9:30am - 5:00pm on both days
“The healing of cumulative neglects, traumas, and attachment disruptions occurs through a contactful therapeutic relationship”
A contact-oriented and Relational psychotherapy through inquiry, attunement and involvement responds to the client’s current needs for an emotionally nurturing relationship that is reparative and sustaining. The aim of such therapy is the integration of the affect-laden experiences and an intrapsychic reorganization of the client’s beliefs about self and others while acknowledging, validating and normalizing the client’s essential relational needs. As therapists, how do we allow affective, behavioural, cognitive and physiological dimensions to inform our therapeutic direction while effectively interpreting whether ego state regression, activation of the intrapsychic influence of introjection and presence of defence mechanisms are indications of contact deficits that seek fulfilment?
At this unique and practical training workshop, Dr Richard Erskine draws on an integrative therapeutic approach and explains Relational Psychotherapy as a process of making whole: taking disowned, unaware, unresolved aspects of the ego and making them part of the cohesive self. He especially highlights how ‘developmental attunement’ is key to this reparative process – through which, we as therapists can sensitise our therapeutic responses to a client’s regression, while remaining aware that such regression allows clients to access defended memories and experience otherwise forbidden affect.
Through lecture, case vignettes, videos & therapy demonstrations and clinical discussions, the workshop helps us comprehend a series of psychotherapeutic methods that include:
• the creation of interpersonal contact;
• the formation of a healing relationship;
• the therapeutic use of phenomenological inquiry;
• the relational centrality of attunement to the client’s affects and rhythm;
• the timing of relational-inquiry;
• the significance of resonating with the client’s level of emotional development;
• the affirming use of acknowledgement, validation, and normalization;
• the distinction between a reactive and responsive countertransference;
• the centrality of therapeutic presence
Keeping in mind the therapeutic challenges we face as psychotherapists, psychologists, counsellors and psychiatrists, Richard describes the Eight Relational-Needs essential for human development and wellbeing. He focusses on the centrality of an involved therapeutic relationship while emphasizing the in-depth methods of a psychotherapy that integrates the client's affect, cognition, physiology and behaviour. Emphasis will be placed on:
• the clinical application of therapeutic methods that reverse the effects of neglect and trauma;
• the use of a co-constructive involvement in forming therapeutic methods;
• the importance of working intersubjectively; and
• the effective utilization of relational methods
At this workshop, participants will:
• assimilate and comprehend a series of therapeutic interventions that reflect relational, co-constructive and intersubjective sensitivity
• differentiate between various forms of therapeutic inquiry and apply the skills of acknowledgement, validation and normalization
• formulate a therapeutic perspective that will include the significance of attunement to the client’s affects and rhythm while resonating with the client’s level of emotional development
• critique a psychotherapy demonstration and describe what they think is therapeutically effective
EMDR & Trauma: an orientation
An evening seminar with Dr Jamie Marich
author of ‘EMDR made simple: Four approaches to using EMDR with every client’
London, 27 May 2016, Friday
6:00pm - 9:00pm
While EMDR (Eye Movement Desensitization and Reprocessing) has been recommended as an effective psychotherapy for PTSD and other trauma and stressor-related disorders by organisations worldwide including US, Britain, France, the Netherlands and Israel; scepticism is also widespread about its efficacy as a viable alternative to psychoanalytical and cognitive approaches. At this evening seminar, which would be especially useful for therapists who are not currently trained in EMDR, Dr Jamie Marich – who is an EMDRIA-Approved Consultant and Training Provider demystifies the process of EMDR and outlines the EMDR-related techniques that can be clinically applied for manifestations of multiple variations of Trauma including PTSD. Through process descriptions, case vignettes and discussions, the seminar:
• describes the biopsychosocial nature of trauma and its various manifestations in the human experience, as defined by the EMDR approach
• explains what EMDR stands for and what it offers as an approach to psychotherapy in the treatment of trauma and stressor-related disorders
• explains the fundamentals of how bilateral stimulation works to aid in client stabilization and to enhance trauma reprocessing
• allows us to comprehend how we can assess the most appropriate approach/modality for reprocessing trauma in a client, including the assessment of appropriateness for EMDR or related interventions
• allows us to determine if further training in EMDR will enhance our own clinical practice
Trauma and Mindfulness: Effective Interventions
A one-day training workshop with Dr Jamie Marich
London, 28 May 2016, Saturday
9:30am - 5:00pm
Mindfulness practice has formed the basis of a wide range of psychotherapeutic and psychiatric techniques that have found application in alleviating the manifestations of depression, stress, anxiety and addictions. At this practical and clinical application oriented training workshop, Dr Jamie Marich explains how we can build a mindfulness-informed therapeutic practice specifically when working with Trauma and its myriad variations. Drawing on evidence from across modern psychotherapies including EMDR, MBCT (Mindfulness Based Cognitive Therapy) and MBRP (Mindfulness Based Relapse Prevention), Dr Marich helps us conceptualize Trauma from a person-centered, psychological, diagnostic and neurological perspective while demonstrating how these are presented within a mindfulness-informed framework.
The workshop focusses on specific skills that are required in a clinical setting including: grounding, stabilization, body awareness, breath work, self-soothing, and crisis management. Dr Marich especially demonstrates how these skills can be adapted for clients who traditionally ‘resist’ affect regulation and stabilization strategies. Uniquely, she doesn’t present these skills as alternatives to our existing modalities but instead highlights how we can incorporate simple, effective mindfulness-informed approaches into our existing clinical models.
Working with Survivors of Childhood Sexual Abuse
A One-Day Seminar with Christiane Sanderson
Dublin, 28 May 2016, Saturday
10:00am - 4:00pm
Current research indicates that only 1 in 8 survivors of childhood sexual abuse (CSA) report their abusive experiences, often years later. For practitioners, providing effective therapy becomes challenging when both survivors and therapists are not able to recognise the linkages between a range of mental and physical health issues and a history of CSA. Such linkages may be manifest in emotional dysregulation, addictions, self-harm and suicidal ideation, anxiety disorders, sexual health and relational difficulties, personality disorders as well as persistent somatic complaints, chronic pain, autoimmune disorders and chronic fatigue syndrome.
The danger of not being able to identity the relationship between CSA and presenting symptoms is that CSA remains undetected which can lead to misinterpretation and pervasive mental and physical health problems. It is critical that practitioners in a wide range of mental and physical health settings have a good understanding of the impact and long term effects of CSA and how this manifests in a range of clinical settings so that they are able to respond appropriately.
This seminar, which would be especially relevant for psychotherapists, counsellors, psychologists and psychiatrists, aims to enhance our comprehension of CSA, its impact and long term effects on survivors, while explaining how, as practitioners, we can work effectively using the principles of safe trauma therapy, psychoeducation and stabilisation to restore control and to allow for the processing of the CSA narrative.
Using illustrative case examples, the seminar will present a range of skills that facilitate right brain engagement, while emphasising the importance of the therapeutic relationship to build shame resilience and facilitate post traumatic growth. The seminar will also examine the impact of working with survivors on practitioners and explain how we can minimise vicarious traumatisation and secondary traumatic stress through counsellor self-care. In identifying a range of therapeutic skills and the challenges of working with survivors of CSA, practitioners will feel more equipped when working with survivors and appreciate the transformative effects of post traumatic growth for both client and practitioner. Specifically, we will consider:
• The nature and dynamics of CSA such as: the grooming process, secrecy and the distortion of reality
• CSA as Trauma and its neurobiological impact
• The psychological impact and long term effects of CSA
• The intergenerational transmission of CSA
• The role of shame and self-blame
• The principles of safe trauma therapy, psychoeducation and stabilisation
• The importance of the therapeutic relationship and right brain based therapeutic skills
• Challenges and impact of working with CSA on practitioners
• Post traumatic growth
Always Hurting the Ones We Love:
Understanding Intimate Violence from an Attachment and Trauma Perspective
An online webinar with Paul Renn
2 June 2016, Thursday
6:00pm - 9:00pm, London, UK Time
The social and political implications of aggression and destructiveness cannot be overstated. Interpersonal violence, in particular, is seen by many as having reached epidemic proportions in modern society. In this webinar, which would be of value to psychiatrists, psychotherapists, psychologists and couples therapists, Paul Renn draws on attachment and trauma theory and research, as well as his own clinical experience with violent individuals and couples to explicate why so many of us end up hurting the ones we profess to love.
From an attachment perspective, an important motivational factor in the perpetuation of archaic attachment bonds is the implicit desire to recreate in the present a familiar relationship pattern from the past, regardless of how violent and self-destructive this might have been, precisely because it is familiar and, therefore, provides a modicum of felt security. Indeed, attachment theory holds that the person’s implicitly encoded cognitive-affective representational models of early self-other relationships mediate all subsequent relationships, particularly those developed with intimate partners in adulthood. As Paul illustrates, the seemingly addictive propensity to repeatedly forge adult romantic relationships that are redolent of ties to early attachment figures, even when these were characterized by violence, abuse and trauma, suggests that such behavior reflects neurobiological, as well as psychological, derivatives. Paul concludes sessions 1 and 2 by presenting a case vignette to illustrate theoretical and clinical issues.
Interpretation & Therapeutic Change
A workshop in three half-day modules with
Dr Anne Alvarez, Dr Christopher Clulow and Jan McGregor Hepburn
London, 10 & 11 June 2016, Friday & Saturday
Friday, 10 June: 6:00pm – 9:00pm, Module 1
Saturday, 11 June: 10:00am – 5:00pm, Modules 2 & 3
Effective interpretation is fundamental to the delivery of therapeutic action across psychodynamic, insight-oriented and cognitive psychotherapies and yet it continues to present a number of challenges to us as practitioners. Drawing on Attachment tenets, psychopathological and developmental priorities and practical learnings from James Strachey’s ideas of mutative interpretation, this unique and practical workshop explains:
• how various levels of interpretation may need to be applied when working with borderline personality disordered, autistic or schizoid clients
• the importance of describing the client’s phantasy without the need for unmasking
• the legacy of Strachey’s mutative interpretation in providing a context for therapeutic action
• the potential for applying Winnicott’s ideas about mirroring to therapeutic practice
• when interpretation might be counter-therapeutic
• the relational aspects of mutative interpretation and how these can influence therapeutic technique
Dr Anne Alvarez, PhD, M.A.C.P is a Consultant Child and Adolescent Psychotherapist (and retired Co-Convener of the Autism Service, Child and Family Department, Tavistock Clinic, London). She is author of: The Thinking Heart: Three Levels of Psychotherapy with Disturbed Children, Live Company: Psychotherapy with Autistic, Borderline, Deprived and Abused Children and has edited with Susan Reid, Autism and Personality: Findings from the Tavistock Autism Workshop.
Dr Christopher Clulow is a Senior Fellow of the Tavistock Centre for Couple Relationships, London. He has published extensively on marriage, partnerships, parenthood and couple psychotherapy, most recently from an attachment perspective. His two edited books in this area are Adult attachment and couple psychotherapy: The ‘secure base’ in practice and research (2001, Brunner-Routledge) and Attachment, sex and couple psychotherapy: Psychoanalytic perspectives (2009, Karnac).
Jan McGregor Hepburn has been the Registrar of the British Psychoanalytic Council (BPC) since 2005 and has a background in social work management and Psychoanalytic Psychotherapy. She is a trainer for the North of England Association for Training in Psychoanalytic Psychotherapy. She is on the Reading Panel of the British Journal of Psychotherapy and is currently conducting doctoral research in Infant Observation at the University of Northumbria.
Personality Disorders & Affect Regulation
A one-day seminar with Dr Gwen Adshead
London, 17 June 2016, Friday
10:00am - 4:00pm
Early childhood adversity, neglect and childhood sexual abuse are just some of the risk factors that can directly impact behaviours we associate with Personality Disorders. An explanation for such linkage is that clients with personality disorders experience great difficulty in establishing and sustaining interpersonal relationships that require good affect regulation. Their inability to regulate negative affects increases the likelihood of unregulated hostility and angry responses. This actually puts such clients at an enhanced disadvantage – not only do they tend to alienate caregivers, but they are likely to do so at times of greatest need.
At this practical seminar which would be especially relevant for psychotherapists, psychologists, counsellors and psychiatrists, Dr Adshead suggests that it is impractical to provide therapy for behavioural manifestations without a proper understanding of underlying cognitive schema and neurobiological basis. She presents evidence on the development of affect regulation within attachment relationships that explains both the symptoms of and effective therapeutic strategies for personality disorders. By viewing personality disorders through the lenses of attachment and affect regulation, she equips us to recognise the multiple challenges faced by clients: heightened perception of threats, inability to repair emotional states stimulated by threat or fear and the shift in locus from external to internal affect regulation.
We comprehend the specific nature of affect dysregulation for personality disorders according to clusters:
• Cluster A: paranoid personality disorders
• Cluster B: borderline personality disorders
• Cluster C: anxious / avoidant personality disorders
By drawing our attention to Affect Regulation as only one, but arguably the most critical aspect of personality disorders, Dr Adshead helps us inform our therapeutic approaches when working with mild to moderate disorders across the spectrum.
Working with Adolescents:
Depression, Self-harm and Suicidality
A one-day training workshop with Professor Stephen Briggs
London, 18 June 2016, Saturday
10:00am - 5:00pm
Depression, anxiety, self-harm and suicidal thoughts are interconnected and also distinct phenomena, with a myriad of meaning and a plethora of different clinical presentations. These manifestations can be understood by practitioners in different ways; in psychiatric, behavioural, cognitive, developmental, emotional, systemic and psychosocial terms, amongst others. At this practical and therapeutically oriented workshop which would be especially relevant for psychotherapists, psychologists, student counsellors and psychiatrists, Professor Briggs draws on his long-standing psychodynamic and clinical experience to explore:
• How adolescent therapy is different and our therapeutic stance needs to adapt accordingly
• How the adolescent developmental process generates energy, vulnerability, opportunity and risk
• Why therapeutic work with adolescents is emotionally charged and what this implies for containment and counter-transference
We will apply these considerations to understand and work with different manifestations of depression, anxiety, self-harm and suicidal ideation in young people. We will explore how to resolve the therapeutic dilemmas that arise, and the workshop will use clinical examples to help us comprehend:
• As practitioners, how can we be ‘adolescent centred’ – so as to facilitate engagement
• How we can work with our own emotional responses as therapists when presented with depression, self-harm and suicidality
• How a developmental approach can allow us to draw on the adolescent capacities for growth and change
• How attention to contemporary social contexts and challenges, including the impacts of online and social media, can inform our therapeutic practice.
Deepen Your Clinical Practice on the Back of a Napkin: Writing Your Way to New Depths
A clinical writing webinar with Suzi Naiburg, PhD. LICSW
Author of Structure and Spontaneity in Clinical Prose: A Writer’s Guide for Psychoanalysts and Psychotherapists (Routledge 2015)
30 June 2016, Thursday
6:00pm - 9:00pm, London, UK Time
As therapists, we realise that writing about our clients, ourselves and our clinical practice can help us gain valuable insights, share experiences and provide important opportunities for reflection and internalization. At this unique and experiential online workshop, experienced writing coach and psychoanalyst/psychotherapist Suzi Naiburg follows a step-by-step guidance process that resonates with clinicians regardless of their modalities and writing anxiety levels. This is how Suzi describes it:
‘This webinar is for all health care professionals who see clients in their practice, whatever their practice or discipline, however experienced they are, and whatever anxiety they may have about writing. The writing we do together will all be “low stakes” writing, as Peter Elbow calls ungraded writing, but high value writing as we “court surprise” (Stern) and make the implicit explicit, extending the reach of what we know by letting the momentum of the writing process lead us.
You’ll leave this workshop with new ways to write and a handful of short writing exercises to use, which allow you to explore, for example, what was so emotionally challenging about that last clinical hour, what went unsaid, what color the silence was, or what might be shifting in the intersubjective field.’
Working with Multilingual Clients:
with and without an interpreter
A one-day workshop with Beverley Costa
London, 2 July 2016, Saturday
10:00am - 4:00pm
At this practical workshop that would be especially useful for psychotherapists, psychologists and counsellors across modalities, Beverley draws on her extensive experience to elucidate how we can work most effectively with multilingual clients – with or without the benefit of an interpreter. Through case studies and practical examples, she acknowledges that while multilingual work can be demanding; the language gap can, in fact, sometimes be a source of creativity and therapeutic potential.
For example, the workshop will refer to research which demonstrates that people are able to access emotions in a second language that have been repressed in the client’s native culture and language and that traumatic scenes experienced in one’s native language may be explored more readily by switching to a second language in order to gain sufficient emotional distance.
The workshop also explores the challenges involved in working with interpreters. Traditionally, clinical work and psychotherapy is conducted between two people and the idea of incorporating a third person into the therapeutic relationship can be unsettling. The workshop will provide ideas and a reflective space to think about the best way in which a collaborative relationship can be formed between the Interpreter and the Practitioner for the best possible outcome for clients. Specifically, the workshop explores the following topics:
• The relationship between the practitioner and interpreter and the implications this has for the therapeutic alliance
• The ways of working therapeutically as a triad rather than as a dyad
• The extent, limitations and professional boundaries of roles in such a triad
• Communicating effectively with interpreters about the nature of therapeutic change
Using case examples that highlight the topics above and drawing from contemporary research, Beverley also presents a series of guidelines and suggested code of practice for working in multilingual settings.
nscience UK is an independent organisation that seeks to explore the interdisciplinary richness of mental health disciplines. Through a series of seminars, workshops and conferences that are conducted throughout the year, we aim to present the latest advances in theory and research to practitioners; with a view to furthering their continuing professional development.
Disclaimer: Individuals pictured are either conference speakers or models. All images are used for illustrative purposes only.
Continuing professional development through seminars, workshops and conferences for psychotherapists, counsellors and psychologists.