Dr Melissa Harte Counselling Psychologist Developing an attuned - PowerPoint PPT Presentation

Dr Melissa Harte Counselling Psychologist Developing an attuned therapeutic relationship to enhance healing and transformation for those with complex trauma from an Emotion- Focused Therapy (EFT) perspective The Harte Felt Centre

Aims • Brief introduction to EFT • Therapist Factors • Importance of Attunement • Felt Sense and Felt Shift • Highly Sensitive Person Phenomenon • Grounding and Safe Place • Focusing for processing Traumatic and Painful Events – case study

Emotion-Focused Therapy (EFT) • Developed by Greenberg, Rice and Elliott in 1980’s • Research – Task analyses of effective therapy • Identified “Change Events” – Problematic reaction points (Rice, 1974) – Conflict splits (Greenberg, 1975) • Is a marker driven and task/intervention orientated psychotherapy The Harte Felt Centre

EFT • Evidenced-based, integrative, manualised and emotion-focused psychotherapy • Transforming and restructuring therapy • Person-centred framework of Rogers • Empathy, Congruence and Respect • Self-determination (Self-actualisation) • Humanistic assumptions and values underpinnings The Harte Felt Centre

Humanistic Assumptions and Values Presence / Authenticity. People function best and are best • helped through authentic, person-to-person relationships. • Experiencing. Immediate experiencing is the basis of human thought, feeling and action. Agency / Self-determination. Human beings are • fundamentally free to choose what to do and how to construct their worlds. • Holism. People are greater than the sum of their parts, and cannot be understood by focusing on single aspects. • Pluralism / Equality. At the same time, differences within and between people should be recognized, tolerated and even prized. • Growth. People have a natural tendency toward psychological growth and development that continues throughout the life The Harte Felt Centre

EFT integrates • Experiential Perspectives – Eugene Gendlin – Focusing – Fritz Perls – Gestalt therapy • Cognitive Science • Contemporary Emotion Theory • Existential thought • Attachment Theory The Harte Felt Centre

EFT • Develops emotional intelligence • By systematically and flexibly helping clients become aware of and make productive use of their emotions • Facilitating clients to experience and clarify their emotions • Make meaning of their emotions • Strengthen expression of healthy emotions The Harte Felt Centre

Working Alliance (WA) • Positive WA = best predicator of outcome – Experiencing the therapist as empathetic and genuinely respectful is viewed as helping clients to free themselves from their constraining internal conditions of worth - Rogers • Person-centred approach client-therapist relationship is curative – effective but not efficient • EFT therapist facilitation is directive of process and in tune with client – effective and efficient The Harte Felt Centre

Therapist Factors • Previously overlooked • According to Hubble, Duncan, Miller and Wampold (2010) most robust predictor of outcome • Some therapists are more effective than others – Better therapist form better alliances • Assisting therapists to form better alliances has a direct impact on outcome The Harte Felt Centre

Qualities of Therapist • Presence – Fully aware of the moment – Directly encountering the client's experience • Physically, emotionally, mentally and viscerally – Being ‘with’ and ‘for’ the other – Intimately engaged whilst maintaining a sense of centre and grounding within self in that shared space • Genuineness – Have integrity, wholeness and congruence – Authentic, self-disclosing, up-front, real, unpretentious – Open and transparent The Harte Felt Centre

Qualities of Therapist • Acceptance, prizing and trust – Non-judgemental, unconditional – set aside own values, expectations – Value, affirm and honour client as a fellow human being – Unconditional confidence in client’s resources • Collaborative – Tasks negotiated with client • Create safety The Harte Felt Centre

Empathetic Attunement from Therapist – felt-sense • Tuning into – Enter the client's internal frame of reference – Client feels therapist is “empathically present” to them whilst they process their pain and/or trauma • Resonating – Conveys to client a sense of being really “heard” and being non-judgmentally valued • Tracking – Complex internal process – Enables therapist to more accurately determine the intervention required The Harte Felt Centre

The Importance of Attunement • Blank face experiment http://www.youtube.com/watch?v=apzXGEbZht0 The Harte Felt Centre

Being Attuned and Empathic • Letting go – Tolerating ambiguity – Open to experience of the other – Suspend judgement – Flexible – Curious • Entering – Enter client’s inner world naturally and easily – Tracking – Understanding cognitively and emotionally The Harte Felt Centre

Therapist-Client Connection Proximal Zone - Provides safety Space of Client Therapist empathic attunement Provides safety Therapist boundaries intact Client boundaries porous The Harte Felt Centre

Therapist-Client Connection Proximal Zone Space of Client Therapist empathic attunement Advanced empathy and attunement in session The Harte Felt Centre

Therapist-Client Connection Proximal Zone Client Therapist Therapist boundaries intact Client boundaries become more intact and separate - Individuation process The Harte Felt Centre

Felt-sense (Eugene Gendlin, 1978) • An internal bodily sensed feeling • Pre-verbal, complex, holistic • Experienced but often unable to capture into words • Symbolic expression of internal world • An implicit higher-level meaning via symbolic expression • Includes thoughts, feelings, perceptions, internal actions and context • Accessed by internal attending and experiential processing The Harte Felt Centre

Attunement through felt-sense • A skill that can be learnt • A process of self- and other-awareness • A kind of “inner listening” For the client • Creating an energetic space of “holding” • To feel “truly known” and “heard” • Allows opportunity to get to their “inner truth” The Harte Felt Centre

Felt Shift • Useful indicator that a full resolution had been achieved • This may take the form of a bodily felt shift or Ah-Ha experience, or a change in the symbolic representation. • Such shifts not only indicate that a shift in awareness has occurred but are quite possibly mechanisms for change.

Felt Shift • A peak moment when change and growth were possible. • The client often seemed to get a direct sense of authenticity, autonomy, or rightness that could be used to validate choice and responsibility. • If achieved in the majority of sessions help strengthen the clients’ sense of self and contribute to a feeling of wellbeing and an unfolding self understanding and meaning.

Processing Experience • Change happens in the present • Cognitive processing of emotion helps – Make meaning – Aids regulation • In therapy, facilitate emotional expression in conjunction with reflective processing The Harte Felt Centre

Why focus on Emotion? • Emotion influences – biological and neurochemical levels of system functioning – the psychological, cognitive and behavioural levels • Interface between body and mind The Harte Felt Centre

Link Between Emotion and Body • Limbic system is responsible for basic emotional processes – e.g. fear • Two paths for producing emotion – Fast “low” road - amygdala senses danger – survival – Slower “high” road – information carried through the thalamus to neocortex • Emotions create physiological reactions that can be interpreted • Emotion has been clearly identified as being connected to the immune system and physiology (Pennebaker, 1995) The Harte Felt Centre

Emotions are adaptive • Efficient automatic signalling system necessary for survival • Have neurological primacy • Are outside of awareness (e.g. snake) • Prepare us for action • Involve wishes/needs that lead to action The Harte Felt Centre

Emotion • Precedes language-based knowing • With development is fused with cognition • Has a relational action tendency – Tell us what is important and whether things are going our way • An important part of meaning construction – Integrate experience by giving meaning, value and direction The Harte Felt Centre

Seven discrete primary emotions • happiness • anger • sadness • fear • disgust • interest • shame The Harte Felt Centre

Action tendency • Anger - puff up and thrust forward + empowerment and assertiveness • Sadness - cry out for lost other - withdrawal + adaptive grieving • Fear • reaction to danger - withdraw, freeze, vigilance • Shame - hide and shrink, deferring to others + compassion for self • Disgust – expulsion of something repulsive • Happiness – feels good • Surprise – interest and engagement The Harte Felt Centre