Thursday, December 07, 2017

The Adaptive Functions of Nonadaptive Emotion Responses


Entry for 7 Dec 2017: FEAR Conference on Brain, Behaviour and Society in Aarhus

Sandwiched between my November Scottish work period and my December California work-and-holiday-period, I’ve just been to a fascinating and challenging two-day conference hosted by the University of Aarhus Institute for Advanced Studies (AIAS).  I found this conference fascinating because it was by the far the most multidisciplinary scientific meeting I’ve ever been to.  I also found it challenging, for exactly the same reason:  The scientific disciplines featured ranged from cellular biology and neurophysiology on one end of the spectrum, to political science and even history and theology at the other extreme, with many gradations in between.  Along this spectrum, I would have to put myself somewhere in the middle.  What all these folks had in common was an interest in understanding fear and anxiety at multiple levels and from different angles.

I’m pretty sure that the work that I’m going to find most useful going forward is that of the largest group of folks in the middle of that continuum: A collection of experimental field biologists/ethologists/neuroscientists, who are essentially doing animal psychology on animals ranging from racoons to South African birds to snails.  These folks, most notably Liana Zanette, Mike Clinchy, Dan Blumstein, and Tom Flower, do naturalistic field research on predator-prey interactions in wild animals, which is a natural place to study fear.  They use a range of relatively new methods such as camera traps (think motion-sensitive or sound-activated CCTV for spying on animals), battery-powered portable speakers (for scaring animals with the vocalisations of predators), and robotic pseudo-predators.  Related to them are more lab-based neuroscientists like Ken Lukowiak and Cornelius Gross, who use new, elegant technologies such as optogenetics to turn particular sets of brain neurons on and off at will, in order to study their behavioural effects and to trace neural pathways.

I found this work, in itself, to be fascinating, and because I read Science News regularly, I felt I was able to follow it pretty well. It also helped in conversations over meals to be able occasionally to ask for translation of the more obscure jargon terms.  So on first approach I loved being drawn into the world of field biology/ethology, which deeply resonated with the young boy I had once been, fascinated by strange animals and the adventure of field work.

However, this work is actually important for Emotion Focused Therapy and our understanding of how human emotion processes function and can go awry, even when they are doing exactly what they are evolved to do. Over the two days, I was able to see many useful connections. This group has identified persuasive analogues for several important clinical/EFT phenomena: 

First, Liana Zanette & Mike Clinchy, from the University of Western Ontario (now rebranded as Western University), have developed an analog for PTSD by subjecting prey animals (eg, chickadees, racoons) to predator stress, created by intermittently playing predator sounds in the immediate vicinity of birds or smaller mammal further down the food chain.  Played repeatedly and predictably over time, this creates chronic stress in the animals, including behaviours that resemble many specific symptoms of PTSD, such as hypervigilance, exaggerated startle response and loss of appetite. Most strikingly, they have shown that these stressed animals have higher mortality rates and fewer offspring; even more strikingly, this increased mortality and lowered reproductive success is passed on their offspring, and also affects species below them in the food chain. 

Yesterday before I left to catch my bus back to Billund Airport, I had one more relatively brief visit with Liana and Mike at breakfast.  They wanted to make sure I got their main message: Trauma-induced chronic fear/anxiety -- which EFT refers to as Primary Maladaptive Fear/Anxiety – is from an evolutionary point of view, not maladaptive but fundamentally adaptive:  By motivating constant vigilance, this reaction to stressful or even traumatic predator exposure increases the probability of not being killed by those predators.  They argued that falling victim to a predator instantly reduces the individual’s chances of survival to zero.  Our emotion system evolved the ability to overgeneralise from single traumatic events because this has survival value, especially in predator-rich environments, which until recently were quite common. As Mike said this morning, this tendency purchases maintenance of life at the cost of quality of life.  Mike and Liana wanted to know if I had heard anything in these two days that was going to affect how I work with clients.  Of course, it’s hard to know exactly with new ideas, but I told them I thought it might.

One thing for sure, however, is that it’s going change how I talk and write about emotion response types: From an EFT point of view, we assume that by and large Primary Adaptive ERs are more adaptive than the others, and that the broad goal of therapy, both within and across sessions, is to help clients reduce Primary Maladaptive, Secondary Reactive, and Instrumental ERs while at the same time increasing Primary Adaptive ERS.  However, it’s now clear to me that all four types of emotion response distinguished in EFT theory evolved because they had useful functions and survival value, especially in social units or groups:
Primary Adaptive Emotion Response (ER): This is what the emotion evolved for in the first place, eg, danger => fear => flee/freeze.  This is our first, natural and specific emotional response to a particular situation.  Note that in a given situation, our first, most natural response to a situation does not always provide the best way to get our needs met; eg, violation in the form of abuse by a powerful/unsympathetic other => anger => increased danger of further/worse harm.
Primary Maladaptive ER: Predisposes us to develop quite general, long-lasting learning from single traumatic episodes, “because I can’t afford to wait for a second chance”; increases sensitivity/strength of response to danger, but also anticipation of possible danger => anxiety => pause/orient/prepare.  In fact, “generalised primary emotion response” might be a more accurate term for this kind of emotion response.
Secondary Reactive ER: Gives us the ability to respond in complex ways (such as inhibition/interruption) to our emotion responses; eg, violation => anger => fear of possible damage to relationships => partial inhibition of anger allowing time to develop more nuanced useful responses
Instrumental Emotion Display: Gives us the ability to influence others, behave appropriately, or preserve relationships even when we are not feeling the relevant emotion; eg, danger from manageable adversary (eg, mountain lion or bully) => instrumental anger display to intimidate.  Drongo bird (South Africa) example (from Tom Flower): Opportunity to steal food => give danger alarm cry to scare or distract the other.  This works bests where the instrumental emotion display is the expected response or, failing that, where the other lacks the ability to detect the true emotion, or can’t afford to get it wrong.

The implication of this analysis is that the judgement of adaptiveness requires more than just identifying the type of emotion response; some further consideration of two kinds of context is required:  First, the emotional context of our key needs in the situation; second, the interpersonal context of others’ likely responses to our emotion responses.  Taking these further factors into consideration requires a fairly high level of emotional intelligence, both awareness of the range of our important emotions in the situation and reasonably accurate simulation of others’ likely reactions to our emotion responses.

This is why in EFT we don’t talk about maladaptive emotions (except when we are speaking carelessly), but only about maladaptive emotion responses:  This emotion response was useful originally, in the presence of danger, but isn’t here and now, in this particular situation.  Liana and Mike’s research suggests that the tendency to form overgeneralised, automatic fear responses is deeply embedded in us in an evolutionary sense, and research by others (such as Cornelius Gross) indicates that it is very likely to be mediated by the limbic system (especially the amygdala and the hippocampus).

To conclude, when a client with PTSD presents with a stuck feeling of constant fear of being revictimised that is causing them a lot of emotional pain and ruining their ability to get on with important life projects (as in the video I showed at the conference), it is clearly not true that their fear has always been maladaptive. It’s also the case that their continuing hypervigilance and strong response might very well be adaptive in some situations in their current life, more adaptive than a more relaxed view. Thus, it is only in particular situations, in which the person finds themselves unreasonably afraid when they and others’ carefully assess that this is not the case, that we would be justified in concluding that the person’s emotion response of fear is maladaptive, because it doesn’t fit the current situation. However, the fact that they have this response is completely natural, understandable and in the broad evolutionary sense adaptive. 

Friday, November 03, 2017

Ten Petitions: A Prayer

1. Dear Lady of the Universe,
You hold all things in your hands,
All peoples, times and places;
Help me recognise you 
In all your many names and many faces.

2. Help me to know that this is what you want for us:
To meet you in each other,
Here and now, and in the future,
With wisdom, courage and love.

3. And help me find each day
Just what it is that will sustain me;
And enlarge my spirit
And the spirits of those around me.

4. Please understand and contain my limitations,
Just as you help me to understand 
And contain the limitations of others.

5. Help me to listen to and accept all the parts of myself,
However wounded, lost or scared,
Seeking to heal my own and others’ injuries,
Transcending my limitations and theirs.

6. In the end, help me to know 
And truly love myself and those I meet,
Knowing us all to be little bits of consciousness 
Floating on the sea of time.

7. Because I am such a little bit of consciousness,
It’s all too easy for me to feel 
That I’ve come from from nothing 
And will soon disappear;
Therefore help me to accept 
That I can’t really know 
Where I came from or where I go.

8. Also, therefore, help me always know
Each moment, day and year as a gift to me,
And to appreciate how everything I have and am
Comes from you and those who came before me.

9. And help me also see how everything I have and am
I am already passing on to those around me
And those who will come after me.

10. Finally, help me know all this as so,
Each day, and ever here thereafter.
 
 
Notes: This poem is a very loose and highly personal paraphrase of the Lord's Prayer, drawing on previous pieces I've written.  I wrote it in the middle of two sleepless nights in Singapore while I was suffering from the cumulative effects of 15 hours of jet lag over 10 days. The views expressed here are not necessarily those of any particular religious denomination or system of theology. The stanza numbers enumerating the petitions are not to be read aloud but are meant to echo verse numbers in spiritual texts.

Friday, October 06, 2017

A (Hopefully) Wise Old Therapist on On Beginning Professional Practice

Our new MSc in Counselling began a couple of weeks ago, the culmination of a couple years of planning.  So far the course is going really well, with an enthusiastic group of students and energetic, talented new tutor team. However, I've only had bits and pieces of time with them because of travel and being ill last week.  This was their third week, and I'm away in California again, but they are on my mind.

A couple of days ago I got a draft of the input for the session on first sessions, which are first sessions both for their clients and also for them as counsellors.  Here is what I wrote back to my colleague:
Thanks for this. I'm just thinking about what we want to say to them about their psychological contact with the client in all of this and their own anxiety with all the details.  Can we help them balance the need to cover the details with the importance of establishing psychological contact with the client.  As Gendlin used to say: "No contract without contact".  But that's basically impossible for them at this stage, because they haven't mastered the details yet and they are understandably highly anxious. 

As a wise old therapist, I am wanting two things for them somewhere in this process of beginning:  First, that they take a moment right before the session to make some space for themselves to say hello to their anxious parts; second, that they somehow write into their schedule of all the first session things to cover a couple of moments for making genuine contact with their client: Maybe once near the beginning of the session: a short state check and a bit of empathy for the client (and themselves); then maybe later on in the session or at the end, another similar moment. It's like remembering to stop and appreciate the flowers alongside a busy road. Sometimes, it's important to add these little moments of meeting to the big long to-do list that is our only hope of not forgetting something important. 

Thursday, October 05, 2017

Cancelled: Emotion-Focused Therapy: Masterclasses

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CANCELLED: Mondays, 9:30-17.00, 13 Nov 2017 – 14 May 2018
University of Strathclyde, Glasgow
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Facilitated by Professor Robert Elliott & Lorna Carrick

The Emotion-Focused Therapy Masterclass Series is open to counsellors and psychotherapists (Diploma level or above) who have completed Level Two or Level Three training in EFT.  If it’s been a while since you did EFT training, it can serve as a refresher course and enable you to catch up on more recent developments in EFT theory, practice and training.

Each day will feature a mix of EFT Practice Check-in (mini supervisions), brief presentations of specialist material on EFT; video or live demonstrations; in-depth supervision of client work; small group skill practice; and group processing. Emphasis will be on putting EFT into practice and examining blocks to effective practice.  Participants are expected to bring client case material to each session, in the form of either session recordings or process notes.  Robert and/or Lorna will facilitate each session.

Sessions can be signed up for either individually or as a four-day package.  All four masterclasses will be day-long Monday sessions, from November 2017 to May 2018, and held in the main city centre campus of the University of Strathclyde. This course allows participants the opportunity to work toward the expert-supervision-of-own-work criterion for EFT-Individual Certification Level A (Completion of Training, 5 hrs) or Level B (Completion of Supervision, 15 hrs) and can also be taken in place of EFT Level 3.


Topics
13 Nov 2017
EFT Case formulation:  Case formulation is a rapidly developing topic within EFT. This session will focus on  formulation of key emotion processes and tasks for your clients featuring both Five-Dimensional and 14-Step models.  Participants are required to bring client material for case formulation work.
29 Jan 2018
EFT for Trauma:  Research indicates that EFT is a highly effective treatment for post-trauma difficulties, including both single episode traumas and complex trauma.  In this session, an overview of EFT trauma theory and the application of EFT to trauma is provided, emphasising Narrative Retelling, emotional regulation work and Meaning Protest.  The session will feature video or live demonstration, supervision of client work, and small group skill practice.  Bring in material from your trauma clients.
12 March 2018
EFT for Psychological Contact Difficulties:  A recent development for EFT is the incorporation of psychological contact work into EFT, opening up the possibility of using EFT for clients with psychotic, dissociative or autistic processes.  We will focus on the psychological contact task, including videos or live demonstration, supervision of client and small group skill practice.  Bring material from your clients who may dip in and out of psychological contact during sessions; if you don’t work with such clients, bring in material on clients who may be hard to reach in other ways, such as externalising process, silence or emotion dysregulation.
14 May 2018
EFT for Anxiety: There is now an integrated EFT for working with social anxiety and other forms of anxiety difficulty.  In this session I will provide an overview of anxiety difficulties, a review of different person-centred-experiential theories of anxiety difficulties, and the EFT approach to working with anxiety, featuring videos or live demonstration, supervision of client work, and small group skill practice, emphasising anxiety split work and self-soothing.  Bring in material from your anxious clients.

·      Enrolment is set for a minimum of 10 and a maximum of 15.  The balance between supervision and skill practice will depend of number of participants.
·      Course fee: Regular price: Three weeks before each session: Sign up for individual sessions at £95 each or get a discount by registering for the whole series at £350 by 15 Oct 2017.  Late registration (less than 3 weeks before each session): £120.
·      The course could be taken for continuing professional education credit.

Contact: claire.mcconnell@strath.ac.uk or 0141 444 8417 for further information on this training, the facilitators, ways of applying for this course or other APT events

Monday, July 03, 2017

Emotion-Focused Therapy: Level 2 [New 9-Day model] 2017-18 Training Series

Three Modules, 9.30-17.00:
16-18 Nov 2017; 19-21 March 2018; 17-19 May 2018 [Revised dates]
Venue:  University of Strathclyde, Glasgow

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Facilitated by Professor Robert Elliott and Lorna Carrick

University of Strathclyde

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The Counselling Unit at the University of Strathclyde is excited to offer an innovative, restructured and enhanced Level 2 training in Emotion-Focused Therapy (EFT) for counsellors and psychotherapists (Diploma level or above) who have completed Level One training in EFT.  This nine–day series consists of three separate three-day modules, spread over the 2017-2018 academic year to allow participants to begin to implement EFT in their client work. This intensive training is broader and more in-depth than EFT level 1 or the previous EFT level 2, in particular adding training in the specialised empathy skills required to carry out EFT.  The format will be a mixture of brief lectures, videos or demonstrations, experiential practice exercises in small groups, and discussion.

Module A: Advanced Empathic Attunement & EFT (Thurs – Sat, 16-19 Nov 2017)
Day 1: Accessing Empathic Resonance; Evocative Empathy and Empathic Affirmation
Day 2: Exploratory Empathy and Empathic Conjecture
Day 3: Rapidly engaging clients & establishing presence; Empathy & Chairwork

Module B: EFT Fundamentals (Mon – Weds, 19-21 March 2018)
Day 4: EFT Therapist Response Modes; Focusing & EFT
Day 5: The Five Dimensions of EFT Client Case formulation; Alliance Ruptures
Day 6: Two-Chair work & self-critical splits in Depression

Module C: Advanced Methods in EFT (Thurs –Sat, 17-19 May 2018) [Revised dates]
Day 7: Narrative Work in EFT:
Systematic Evocative Unfolding, Creation of Meaning, & Narrative Retelling
Day 8: Advanced Two Chair Work: Self-Interruption & Motivational conflicts
Day 9: Empty Chair work; Compassionate Self-soothing

Enrolment is set for a minimum of 15, with variable staffing to accommodate up to 30.  The course could be taken for continuing professional education credit.  This course is part of Level A Completion of Basic EFT Training, recognised by the International Society for Emotion-Focused Therapy (ISEFT)
Whole Series Package Cost: Regular: £845; Early bird: £795 (by 15 Oct 2017);
Per Module Cost: Regular: £345; Early bird: £295 (prior to 30 days before each module)
In order to keep costs to a minimum, catering is not included in these costs
Please send a non-returnable deposit of £50.00 to secure a place if not paying the whole fee at time of booking. Online booking and payments can be made at the following link:  http://onlineshop.strath.ac.uk/browse/product.asp?catid=45&modid=2&compid=1
Contact: jan.bissett@strath.ac.uk or 0141-444 8415 for further information on this training, the facilitators, ways of applying for this course or other APT events

Tuesday, June 27, 2017

SPR Moments: A Suite of Small Scientific Poems

(On the occasion of the 48th Annual International Conference of the Society for Psychotherapy Research)

1. Random Intercept and Slope

Each of us came here by a different route
And each of us has a different conference,
Paths winding through the program,
Highs and lows, fast and slow,
Pauses and pulses: Who can bear it all?


 2. On the SPR Presidential Address

There is the moment of meeting, the coming together
Of the different tribes, nations and languages.
Friends and competitors reconnect as we gather
For the rituals of welcome, reflection and celebration.

Some we recognize for their accomplishments or promise,
But one of us is made to put down their mark
In an unrecognized act of sacrifice:
Perhaps a tale full of twists and turns,
A labyrinthine journey, made more coherent
Than the bits of which it’s made.   Or perhaps
A bold proposal for future research,
Charting a course to tempt or inspire the rest of us,
But running the risk of crashing on the rocks. 
 
 









The truth is, all SPR presidential addresses
Are dangerous Cretan bull-jumping rituals.
We ask those we chose to grasp the branching horns
Of our most difficult research dilemmas,
And to somersault right over them, lifting us with them,
Making them bear the peril of fatal impalement.



3. Return to the Beginning

Logo for SPR 2000 Chicago
As in nature so at SPR conferences:
Researchers of like feather like to flock together,
Congregating like cranes with others of shared plumage,
Divided by the colours of our diverse theoretical orientations
Or the Darwinian beaks of our methodological bent:
Qualitative or psychodynamic; EFT or outcome monitoring.

But something in me sometimes wants to see
What I’ve been missing, what the other birds are up to,
And I pick a panel more or less at random.
The result is also random: maybe the same old story,
Or something that I find obscure or wrong-headed.
But sometimes I hit the jackpot: A useful,
Lovely new research tool or approach,
A brilliant presenter, an old friend in the audience.

This time it was an old, lost research love:
Significant events, those rare moments
Of transformational magic when something shifts.
In a panel on Saturday morning. this transported me
Forty years to the 1977 Wisconsin meeting
And a long talk with Les that changed my direction.
Now, in 2017, I realized I’d arrived
At the perfect convergence, the auspicious moment
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I’d been waiting for without knowing it,
My beginning looping around
Like the snake that eats its tail.


4. Last Day in Toronto

Every year we come to the same, recognizable
Reaction point at the last session of the conference:
Exhausted, elated, we try to soak up
One last inspiration to take home.

As the conference ends, two dear friends
Each part of my SPR experience from the start,
Tell me, “This is my last SPR.”
With regret they say, “It’s just too much:
Too many papers, the topics too obscure,
The young ones who talk too fast,
The banquet noisy, the travel difficult.

Wistfully shaking their heads, they say
But gently, to soften the blow:
“I don’t think I’ll be coming back again.”

I find myself fighting this, in my own way:
One, I follow after, eking out one last
SPR walk, not to dissuade, but to delay
The moment of a parting that I can hardly bear.
With the other, I arrange an oral history project,
And another friend conveys them away.

While one part of me understands and blesses them on their way,
Another part selfishly protests this parting:
“I’m not ready for you to leave”,
Like a child demanding one more story,
Or the dancers at the very end of this year’s banquet,
Chanting, “One more, one more, one more dance.”

                                            -Robert Elliott, 27 June 2017 

https://www.healthyplace.com/blogs/bingeeatingrecovery/2017/03/the-healing-power-of-movement-during-binge-eating-disorder-recovery/









Tuesday, May 23, 2017

Emotion-Focused Psychotherapy 2017 Level 1 Training in Glasgow Scotland


Tuesday 29thAugust– Friday 1st September 2017, 09.30 – 17.00
Venue:  University of Strathclyde, Glasgow
Facilitated by Robert Elliott and Lorna Carrick
 
Emotion-Focused Therapy (EFT) is a humanistic, evidence-based form of psychotherapy/counselling that integrates person-centred and gestalt therapies, with particular relevance to working with depression, trauma, and anxiety difficulties. It has gained international recognition through the work of Les Greenberg, Laura Rice, Robert Elliott, Jeanne Watson, Rhonda Goldman, Sandra Paivio, Antonio Pascual-Leone and others. The Counselling Unit at the University of Strathclyde is the leading centre of EFT training in the UK, and is again pleased to offer Level One professional training in this approach to qualified counsellors and psychotherapists (Postgraduate Diploma/MSc Level or above).

Offered at the University of Strathclyde since 2006, this successful, four-day Level One EFT training programme will provide participants with a grounding in the theory and skills required to work more effectively with emotion in psychotherapy. Participants will receive in-depth skills training through a combination of brief lectures, video demonstrations, live modelling, case discussions, and supervised role-playing practice.

We begin with an overview of EFT Emotion Theory, including basic principles and the role of emotion and emotional awareness in function and dysfunction; this will be illustrated by Focusing-oriented exercises. Differential intervention based on specific process markers will be demonstrated. Videos of evidence based methods for evoking and exploring emotion schemes, and for dealing with overwhelming emotions, puzzling emotional reactions, painful self-criticism, and emotional injuries from past relationships will be presented.

Participants will be trained in moment-by-moment attunement to emotion, and the use of methods for dialoguing with aspects or configurations of self and imagined significant others in an empty chair. This training will provide therapists from person-centred, psychodynamic, cognitive-behavioural and related backgrounds an opportunity to develop their therapeutic skills and interests, and provides the first step toward certification as an EFT therapist.

  • The course could be taken for continuing professional education credit.

Cost: Before Monday 17 July 2017: £445 or After Monday 17 July 2017: £495
In order to keep costs to a minimum, catering is not included in these costs
                               Register via our online shop at: http://onlineshop.strath.ac.uk/
Contact: jan.bissett@strath.ac.uk or 0141-444 8415 for further information on this training, the facilitators, ways of applying for this course or other APT events