Lvl 2 Mod 1 Flashcards
1
Q
What are the three primary purposes of attachment
A
- Safety/Protection
- Regulation
- Connection
2
Q
3 types of connection provided by attachment
A
- Physical Contact
- Emotional Connection
- Sense of Belonging
3
Q
How do effective attachment relationship modify stress factors affecting childhood development?
A
They serve as a buffer and reduce the negative impacts
4
Q
Is “family comes first, I come second” a pathological response?
A
No, it is a reflection of different cultural norms
5
Q
Do all emotions exist in all cultures?
A
No, for example sadness doesn’t exist in Tahiti – they perceive the somatic sensations as tiredness
6
Q
Do parents have to verbally communicate to children to pass on developmental learnings?
A
No, nonverbal communication is very powerful
7
Q
4 categories of factors that inform a person’s attachment patterns
A
- Attachment Relationships
- Society
- Environment
- Other developmental factors
8
Q
What two things are more important than getting our contact statements correct?
A
- That we show our client we are trying to connect
- That clients check in with themselves
9
Q
3 Actions associated with Proximity Seeking
A
- Reaching Motions
- Eye Contact
- Grasping
10
Q
3 Actions associated with Distancing
A
- Leaning away
- Avoidance movement in hands or arms
- Looking down or away
11
Q
What is the most extreme of childhood abuse and the hardest to treat?
A
Neglect
12
Q
What is the influencer of the number of connections between OPFC and amygdala?
A
The amount of attuned caregiving we got
13
Q
Can a child do their own emotional regulation?
A
No, children depend on an adult’s nervous system
14
Q
What is more important – tolerance for positive states or negative states?
A
Neither – they are equally as important
15
Q
What is the value of disruption in the attachment relationships? (2 things)
A
- It demonstrates how repair happens
- Shows its ok to experience states of distress
16
Q
How does a person learn auto-regulation?
A
From an attachment figure repeating soothing actions over time
17
Q
What conditions created babies at 6 months that had the best auto-regulation capability?
A
The caregivers that would let the child dysregulate a little before coming in to regulate interactively
18
Q
If a person is having trouble dropping into an emotion (not just uncomfortable) or is losing mindfulness/cognitive ability, what could that be an indicator of?
A
Some unresolved trauma
19
Q
Why do we work with trauma first?
A
To make sure that the client has a wider zone of optimal arousal to allow them to be present and metabolize difficult emotions and pain. A client can be expressing deep emotions yet not get benefit due to lack of ability to integrate.
20
Q
4 more specific tasks within the goal of widening a client’s zone of optimal arousal when doing developmental injury work
A
- Expand affect array (eliminate/reduce emotional biases)
- Enhance range of affect intensity, including positive affect
- Increase emotional specificity
- Increase ability to sense a blend of emotions
21
Q
What is “memory glue” and what happens to this glue and the memories during trauma?
A
The ability of the hippocampus to engage in long-term potentiation. Hippocampus is inhibited during events perceived as a life-threat and so the memory glue is missing and that page of the life story book is floating loose in the body
22
Q
In the simplest terms, what is a developmental injury? What may a person with this type of injury think about themselves?
A
A wound to the sense of self or a disowning a part of self, typically caused within an attachment relationship.
A person may think - “I suck as a person”
23
Q
What is relational trauma? Does this result in disorganized attachment?
A
Something that happened within a relationship that elicited animal defenses and dissociation.
Does not necessarily result in disorganized attachment.
24
Q
What is attachment trauma? Does this result in disorganized attachment?
A
The perception that attaching to the caregiver is unsafe due to past trauma experiences.
Results in disorganized attachment.
25
What is developmental trauma? Does this result in disorganized attachment?
A trauma that occurs in childhood (e.g. surgery) that results in a wound to sense of self (a developmental injury).
Does not necessarily result in disorganized attachment.
26
What is implicit relational knowing?
How to do things with others -- how to play, what thoughts/emotions to show vs not, etc.
27
What is the three part feedback loop involving experiences, expectations and action tendencies?
1. Experiences prime expectations
2. Expectations prime action tendencies
3. Action tendencies reveal expectations to careful observers
28
What are the 6 principles
1. Organicity
2. Presence/Mindfulness
3. Relational Alchemy
4. Holism
5. Unity
6. Nonviolence
29
If we notice the client is having difficulty being mindful, what is one thing we can notice within ourselves?
Notice our own level of mindfulness
30
What are four elements within the organicity principle?
1. Each living system is self-organizing, complex, non-linear, and evolving.
2. Our client has their own answers inside and can grow and change.
3. Each culture has its own wisdom.
4. Organicity is filtered through individual experience and shaped by social location and culture
31
What are three elements within the principle of nonviolence?
1. The therapist must cultivate a non-judgmental, compassionate attitude accepting of all parts and responses of client.
2. We can go with the grain rather than use force, trusting in the existence of the client’s natural impulse towards a higher level of organization.
3. Awareness of of the potential impact of implicit biases that exist in the therapeutic relationship.
32
What are two elements within the principle of holism?
1. Body, Mind, Spirit, and Culture are essential aspects of the human organism, each can only be understood in relationship to the whole they comprise.
2. All experience is registered in the body and all significant bodily experience has a corresponding mental, spiritual, and cultural component.
33
What is Relational Alchemy and what are two elements within this principle?
Relational Alchemy is the interaction of implicit selves (both positive and challenging) that emerge from the relationship.
1. The healing and growth-producing power of relationships
2. Acknowledges that therapeutic enactments are an impetus for higher degrees of organization.
34
How can we acknowledge symptoms/behavior in a way that challenges the tendency to pathologize those aspects as shameful or indicative of an innate fault in the person?
We can acknowledge them as "survival resources"
35
Rather than giving advice, trying to change, fix or get rid of the client, what do we do?
Take an experimental attitude
36
What are two characteristics of the experimental attitude? And how are these characteristics reflected?
1. Driven by an inquisitive mindset receptive to and interested in whatever emerges.
2. Without the kind of agenda (change, fix, get rid of) or investment in a specific outcome or attitude that renders a “right” and “wrong” outcome.
Reflected in prosody and body language and phrasing
37
Why is it important to study all of the core organizers during reconstructing the state specific memory?
If core organizers are missing, it can result in the client getting stuck
38
Why do our habits of organizing experience have tremendous power over the quality of our daily life experience?
Because they operate unconsciously
39
What widens the gap between stimulus and response?
Mindfulness
40
What is Body-Experiencing (4 parts)?
1. Taking in the postures and chronic patterns of a client's body
2. Take it on for ourselves and observe our own 3 levels of information processing
3. Use this experience to inform ourselves of what is going on for the client in this moment and to form a hypothesis of the client's history as a child
4. Mirroring - verbally reflecting (with qualifiers) about the client through therapist's experience while also mirroring body language
41
3 Elements of Tracking a clients words
1. Narrative/Content
2. Word choice/developmental age of language
3. Incomplete sentences
42
Present moment indicators of Trauma (2) vs indicators of Developmental Injury (5)
Trauma:
1. Indicators of dysregulation
2. Indicators of dissociation
Developmental Injury:
1. Physical tendencies: chronic and acute (structure, movement, posture, tension) indicating beliefs, predictions.
2. Emotional tendencies: habitual or masked emotions
3. Cognitive tendencies: significant thoughts and beliefs
4. Relational tendencies: relational defenses or patterns of interaction
5. Memories: significant images and memories of attachment relationships
43
An example of what to say if we are getting sleepy when listening to a client and we think we may be picking up on something from them
As you say that, I notice a sense of a collapse or lower energy in myself, are you feeling any of that?
44
How to tell if an emotion is indicative of trauma vs attachment-related
Trauma emotions are the most extreme versions aka vehement emotions (e.g. rage instead of just anger)
45
What creates a vehement emotion (2 parts)?
An emotion plus an animal defense due to unresolved trauma
46
How to work with a vehement emotion (2 steps)?
1. Resolve the traumatic memory which will de-escalate the emotional and return then back into the ZOA.
2. Then use developmental injury tools to work with the leftover emotional material
47
What's the thematic difference (in verbal content) between a belief resulting from trauma vs attachment injury?
Trauma-rooted beliefs are about the theme of dying or killing (life or death). Attachment related injuries are about everything else besides this.
48
Where is the "real story" vs where is it not?
The real story is in the body and not in what the person is saying/thinking
49
What is Implicit Social Cognition?
Thoughts and feelings happen outside of conscious awareness and include attitudes, stereotypes, and other hidden biases
50
How is meaning (including the seeds of implicit social cognition) transmitted to the next generation?
Through culture and attachment relationships.
51
What is stereotyping?
A widely held but fixed and oversimplified image or idea of a particular type of person or thing
52
How does increasing cultural/ethnic/racial disparity between a client and clinician affect somatic implicit bias and why?
It increases somatic implicit bias because we are trying to make sense of something that is unknown and unknown things are perceived with a sense of warning
53
What are 5 somatic themes we look at when body experiencing?
1. Psycho/somatic forces
2. Support/alignment
3. Core & periphery
4. Holding Patterns
5. Easy/difficult actions
54
3 Psycho/somatic forces
1. Pushing up/down
2. Pushing forward/backward
3. Pushing out from inside
55
Two questions that helps us gauge support and alignment?
1. How does the body achieve support? (E.g. rigid core, locked knees)
2. How aligned are parts of the body across front/back and side-to-side?
56
Two questions that helps us understand the core and periphery?
1. Are elements of the core either collapsed or puffed up?
2. Where is the periphery in relation to the core?
57
What are holding patterns?
Patterns in the body such as tension, flaccidity and compression
58
Instead of saying a person got triggered you can say
Something in that person got triggered
59
What 3 somatic aspects are employed by a child to help them maintain or enhance relationships with an individual or group
1. Actions/movements
2. Posture
3. Tensions
60
What is a relational procedural tendency? (7 aspects)
1. A sensorimotor, emotional and cognitive readiness for a particular behavior
2. Always present in latent form
3. Activated in response to specific internal or external stimuli
4. Reveals a preparedness for a specific outcome based on past learning
5. Somewhat flexible in relationship to self, others, the context, task, or goal
6. Mobilized by stress
7. Affected by proximity/distance in relationship
61
According to Allan Schore, how much of the communication is body-to-body?
95%
62
What does body experiencing help the therapist identify and reflect on (2 things)?
1. Procedural tendencies and the purpose they served in the past
2. Hints of unmet needs
63
4 ways to avoid cultural biases
1. Consider how culture/race/ethnicity differences may result in implicit biases that may lead to inaccurate assumptions in body experiencing. For example, a specific alignment may be adaptive in their cultural context.
2. Do your own work to become aware of your biases
3. Aspire not to impose your own meaning or interpretation
4. Cultivate curiosity
64
Should you wait or not when contacting present moment emotions?
No
65
Should you wait or not when contacting present moment body experiences?
You may need to, since it is more intimate and thus important stronger container has been developed
66
What are the two most fundamental understandings we are gaining about the client and then communicating to them?
1. Understanding their pain
2. Understanding what they need
67
What fear does creating a sense of containment allay in the client?
It allays the fear that the client will move into a highly distressing state and then be stuck/abandoned/punished for it
68
How much time to shoot for when assessing and building the container?
7-10 minutes and more if needed (it'll pay off later by making later stages go smoother/faster)
69
Do we rely more on our left brain explicit cognition or right brain implicit processing when contacting or formulating an access route? Why?
Rely on our right brain (implicit communication + bodily experience) and not the left brain. If we contact from the left brain, we'll take them out of the experience.
70
What will cause the access route to jump out?
Taking time to assess and build a strong container
71
When to know that it's time to frame?
When the client is able to drop more into their emotions as opposed to being in the narrative
72
1 unique task of the container stage when doing developmental work as compared to trauma work
To identify implicit needs that aren’t verbally expressed by applying tracking and body experiencing
73
"Steps to Mindfulness" Process
1. Track
2. Contact Statement
3. Mindfulness Directive
4. Mindfulness Question
5. Obtain mindful report (assess)
74
What is a reason why a client may still leave the ZOA even after you've gone thru the trauma narrative multiple times until there was no longer activation?
The dysregulation could be based in procedural memory (esp. if it was developmental trauma)
75
When we're working with developmental injury and making contact statements, are we infusing statements with empathic emotional charge?
Yes
76
What 3 things does successful contact do?
1. Create a sense of connection and social engagement between therapist and client, which enhances trust and safety
2. Helps the client feel comfortable with whatever is contacted
3. Increases the clients mindfulness and curiosity of what is contacted
77
How to sense the intensity and type of contact that the client needs?
Track it and if something happens pull back a little bit
78
Rebecca's example of contact statement when something doesn't land with the client
I'm sensing I didn't quite get that right, huh?
79
If contacting an emotion causes client to move towards the edges of the ZOA, what may this be an indication of?
The emotion could be trauma-related
80
One example each of a reparative attachment experience for :
1. loneliness
2. not accepting their own anger
3. being criticized
1. If the client’s issue is about being alone, the therapist emphasizes being supportive and “there”.
2. If the client’s issue is about not accepting their own anger, the therapist emphasizes acceptance of aggression and anger.
3. If the client’s issue is about being criticized, the therapist emphasizes acceptance.
81
Is shame more related to trauma or developmental and how to tell the difference?
Could go either way. If contacting the shame goes into hypoarousal, it's trauma related.
82
When you're in mindfulness, why contact something just below the client's awareness instead of going as deep as you can?
If you go too deep, it becomes an interpretation and risks them needing to come out of present moment experience to process what you said.
83
Are qualifiers the same as questions?
No, it is an implicit question. It doesn't require the client to answer but just gives them a way to disagree safely.
84
Do we wait for clients to stop talking before making verbal contact?
No, we artfully and empathically interrupt them so we can "plug-in" with our client's nervous system
85
In developmental work, what is the role of exploring meaning and how is it/is it not evoked?
Exploring meaning is central and meaning is evoked through body experience not cognitive analysis
86
According to Rebecca, how much of the work has been done by the time they drop into the very center of their meaning?
Rebecca says 85-90% - this is the hardest part of the process to do
87
How many nerve pathways up are there for every single nerve pathway down and what is the implication of this as far as change?
10 -- so if we work in this way the change will be deeper and more durable
88
7 negative messages from caregivers and a corrective message for each
1. “I don’t really want you” -\> "You are loved and safe"
2. “I don’t have time for you” -\> "You are special to me"
3. “You must do what I say” -\> "You have choices"
4. “Your feelings don’t count” -\> Your feelings are important to me"
5. “Be strong, not needy” -\> "You can depend on me"
6. “It’s your fault I’m unhappy” -\> "You are not responsible for my upset"
7. “You have to perform” -\> "You are loved as you are"
89
3 examples of statements that contact the problem and offer a solution based in somatics
1. "The body is playing a role here. So by working with the body we can get an understand of what that is and resolve it"
2. "Oh you want X. People might be picking up on your body language and that body language may be saying Y. Let's work with your body organically so that it communicates what you want"
3. I hear you are really wanting to change X and I'm happy to continue talking about it. However, I also know that we can probably change it faster if we work through the body. What do you think about that?
90
4 Common Psychoeducation Topics
1. Why SP engages Mindfulness to support change
2. How SP uses the body to support changes in emotional and thinking patterns
3. How our bodies hold learning and information about our habits
4. Role of Touch
91
Where is therapeutic touch especially useful?
When you are working with pre-verbal trauma, touch (such as arm or shoulder) works much better than verbal
92
According to Rebecca, what is a very important part of posture to notice and what does it possibly indicate?
Notice if the tail is tucked because it could indicate shame
93
What is the value of explicit contact statements from the perspective of the client's inner child?
Children cannot really put words to their experience so they need an adult to do it for them
94
How does Rebecca adapt body experiencing to the telehealth format (2 things)?
1. Asking client to adjust camera to get as much of their head and torso as possible
2. Asking client to report on things outside the frame (how are your legs, are they crossed?)
95
Is it possible that a misaligned body part doesn't actually mean anything psychologically?
Yes, sometimes there isn't psychological information stored in misaligned body parts
96
Examples of messages from caregivers and their opposites
"I don't really want you" -> "You are loved and safe"
"I don't have time for you" -> "You are special to me"
"You must do what I say" -> "You have choices"
"Your feelings don't count -> "Your feelings are important to me"
"Be strong not needy" -> "You can depend on me"
"It's your fault I'm unhappy" -> "You are not responsible for my upset"
97
Is the body involved in psychoeducation in SP?
Yes
98
What are the two goals of psychoed in SP?
1. how the body is related to their
psychological distress
2. why working with the body could he
them obtain their goals for therapy
