T wo diffe r e nt inte r ve ntions with two c hildr e n who have - - PowerPoint PPT Presentation

T wo diffe r e nt inte r ve ntions with two c hildr e n who have opposite str ate gie s, but similar tr aumas

Ve r te r Pr e gr e ffi, psyc hothe r apist, R e ggio E milia (Italy)

Cr itic al c ause s of c hange T he r ape utic R elathionship T rauma

• I

wo uld like to ta lk a b o ut two c linic a l situa tio ns, a nd to e xpla in tha t it is po ssib le , PE RHAPS, a ddre ss the q ue stio n o f T ra uma . I sa y “Pe rha ps” b e c a use we c a n de c ide this ste p to wa rd tra uma o nly a fte r re fle c ting o n the c ritic a l c a use s o f c ha ng e , individual a nd fa mily. T his kno wle dg e a llo ws us to think

• n the rig ht timing a nd to pe rfo rm a n o rig inal

mo dulatio n o f so ma tic a ro usa l with o ur pa tie nts

Cr itic al c ause s of c hange T he r ape utic R elathionship T rauma

L uig i's pa re nts a sk fo r a dvic e o n ho w to he lp the ir c hildre n, L uig i, 10, Se re na , 8 T he y divo rc e d 1 ye a r a g o , a fte r 20 ye a rs o f ma rria g e

fo r Mo m:

• L

uig i wo uld b e mo re a fra id a t sc ho o l

• L

uig i te lls he r "it's tiring to mo ve from dad and mo m and sle e p in diffe re nt

be ds";

• he wa nts his mo the r is

tidy a nd le a ve s thing s in the ir pla c e while he is a wa y fro m ho me .

• T

he pro b le m fo r mo the r is the divo rc e

Cr itic al c ause s of c hange T he r ape utic R elathionship T rauma

Mo the r: B2 ing e nuo us stra te g y T he DANGE R fo r Mo the r: no t b e ing a b le to he lp he r c hildre n. I n the pa st she ha s a lwa ys so lve d the pro b le ms a nd no w she do e s no t wa nt to ha ve diffic ulty o n the se issue s

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

fo r Da d:

• He minimize s the c a usa lity o f divo rc e
• T

he pro b le m is re la te d to Luigi’s psyc ho lo g ic a l pro file

• His mo tto is "we must handle

the suffe ring…, but at the same time think that it's o kay".

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

F a the r Stra te g y (Dp) C1-2 (Dp in pa rtic ula r with re g a rd to o wn divo rc e ) T he DANGE R is: With his so n he c o uld c o me b a c k to the q ue stio n

• f divo rc e fo r o urse lve s fro m tha t

he wo uld like to g e t a wa y

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

• Luigi’s Strategy: Utr (p) pa re nts divo rc e C2

He is a c tiva te d in the spe e c h (sho wing a ffe c tive sta te s), invo lving . E mo tio ns ma inly c o nc e rn the de sire o f c o mfo rt. I n the ima g e o f the fa the r who g o e s a wa y (in the SAA) into the inve nte d sto ry o fte n ma ke s re fe re nc e s to his situa tio n

Critic al c ause s of c hange T he r ape utic R elathionship T rauma so me sig ns o f the de pre ssio n mo difie r

Cr itic al c ause of c hange

Wha t a re the e le me nts tha t a llo w a n a uto no mo us re o rg a niza tio n? Who is the re c ipie nt? 1) r

e tur n to par e nts the Luigi’s str ate gy c onfigur ation a nd

re fle c t to g e the r, the y a re b o th rig ht to re a d his so n this re turn a llo ws to b o th pa re nts to b e q uite c lo se to the the ra pist, b e a c use the the ra pist thinks like the m!

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Cr itic al c ause of c hange

2) It is the re fo re sha re d tha t a psyc ho lo g ic al wo rk with L uig i c o uld b e do a nd a fte r,

pe r haps, wo rk o n the divo rc e issue . Ste ps:

Se tting a Me a ning fulT he ra pe utic Re la thio nship with L uig i Only a fte r this L uig i c o uld c o mple te the le a rning o f the pa st, e xplo ring the tra uma .

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

About T he r ape utic R e lationship…

Modulation of somatic ar

• usal as fir

st ste p

T he pro c e dural is spo nta ne o us a nd live ly a nd it a c tiva te s b o th, the ra pist a nd c hild

Modulation of the me s

T he c hild wa nts to spe a k a b o ut frie nds, c la ssma te s.. T he the ra pist is c urio us He re me mb e rs no t we ll o rde re d sc ho la stic

e pisode s… The the ra pist he lps to re me mb e r

PR OXIMAL ZONE

PROCE DURAL SE MANT IC E PISODI C IMAGE S

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

No w is po ssib le to e xplo re the tr

auma o f divo rc e …. (b e c a use we ha ve

c re dit)

…In diffe re nt wa ys a nd with diffe re nt

te c hniq ue s

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Ac tions to e xplor e T r auma

• re me mb e r the diffe re nc e s in ha b its

b e twe e n b e fo re a nd a fte r the divo rc e .

• use e xplo ra to ry o r ima g ina tive

te c hniq ue s (ABC te c hniq ue s, sa fe pla c e te c hniq ue s a nd so o n).

«at first i saw my pare nts angry at e ac h o the rand i fe lt so rry, e spe c ially sinc e my mothe r ne ve rlo o ke d at my Dad whe n he gre ate d he r,… but now i ge t it, the y willne ve rc o me bac k to ge the r»

Davide’s mothe ra sks fo ra dvic e o n ho w to he lp he r so n Da vide ,

12

• Diffic ultie s with c la ssma te s a nd frie nds
• He is upse t
• Pla ying to o muc h vide o g a me s
• F

e a r o f stra ng e rs o r thie ve s c o me into ho use

• He ha s witne sse d ma ny pa re nts c o nflic ts

in the pa st

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Mothe r, Davide 12, Siste r15, Siste r17 (fa the r is a lmo st a b se nt)

Divo rc e : Da vide wa s 3 2 F a mily Co urt e xa mina tio ns: a ) Da vide 6 ye a rs o ld b ) Da vide 9 ye a rs o ld in the la st 2 ye a rs F a the r a nd c hildre n me t o nc e a mo nth, no t e ve r…, In the last 6 mo nths

• nly o ne time

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Mother’s str

ate gie s

Utr (ds, p) fre q ue nt re lo c a tio ns, A5 / C3

Danger for he r…

In the pa st: the fe a r o f b e ing a lo ne , a fte r the pa re nts ha ve ma de ma ny ho use c ha ng e s, with a de pre sse d mo the r In the pre se nt the da ng e r turns into a fe a r o f no t b e ing a b le to a tte nd, a lo ne , he r 3 c hildre n

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Davide’s str

ate gie s

Dp, Utr (dx) pa re nts divo rc e a nd c o nflic ts, A+ (6) T he re a re the me a b o ut frie ndship

Danger for him…

his b ro ke n c o mpulsive stra te g y do e s no t wo rk fo r his e vo lutio na ry skills

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Cr itic al Cause of c hange Mothe r : unde rsta nd a nd unde rline wha t wo rks g o o d fo r suppo rt o f he r

so n. T e ll he r she is rig ht re a ding his so n!

Davide: re a ppro pria tio ns o f

A3-4 stra te g y (ide ntifying its a dva nta g e s, fo r frie ndship fo r e xa mple )

NO WORK S ON T RAUMA NOW!

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

T he r aputic r e lationship

Modulation of somatic Ar

• usal as first ste p…

Da vide ha s ra the r lo ng time s fo r ta king turn spe a king ;

…T

he ra pist can’t b e fa st! initia lly he use s fe w wo rds to te ll his e xpe rie nc e s;

…T

he ra pist he lps to use o the r whe n he spe a ks he is ve ry se ma ntic a nd o fte n ma ke s g e ne ra liza tio ns.

…T

he ra pist is se ma ntic a nd so me time s e piso dic

… and modulations of the mes

He wo uld like to ta lk a b o ut frie nds.

…T

he ra pist is c o urio s a b o ut this

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

4 mo nths o f we e kly se ssio ns Sto p fo r 6 mo nths Afte r6 mo nths fro m inte rruptio n Da vide se nt a me ssa g e :

Critic al c ause s of c hange T he r ape utic R elathionship T rauma He llo . My fa the r wa nts spe a k to me …. I don’t kno w… can i talk to yo u?

No w we a re wo rking a b o ut the se the me s

…Ne xt c o nfe re nc e we will te ll yo u ho w is we nt

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

With this mine inte rve ntio n, I wa nte d to te ll yo u tha t b e fo re ta c kling the T ra uma it is g o o d to unde rsta nd the func tio na lity o f the fa mily, the da ng e rs fo r e a c h o ne , in the pa st a nd in the pre se nt. T he se first ste ps a llo w pe o ple to fe e l c lo se a nd unde rsto o d. Only a fte r the se o pe ra tio ns it is po ssib le , no t a lwa ys, to de a l with tra uma . T he DMM pro vide s us the ke ys to pla n the ste ps a nd the timing .

Critic al c ause s of c hange T he r ape utic R elathionship T rauma

Gr azie DMM!