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Monday, August 10, 2020

What is Accelerated Experiential Dynamic Psychotherapy (AEDP) and How Does AEDP Heal Trauma - Part 2

In Part 1 of this topic, I began a preliminary discussion about Accelerated Experiential Dynamic Psychotherapy (AEDP) and how it works.  In the current article, I provide a clinical vignette to illustrate how AEDP works.

AEDP Heals Trauma
As mentioned in Part 1, AEDP was developed by Dr. Diana Fosha, and AEDP is based on many different disciplines, including:
  • attachment theory
  • affective neuroscience
  • trauma research
  • developmental research
  • mind-body/somatic therapy
  • emotion therapy
  • phenomonology (the study of subjective experience)
  • transformational studies
Clinical Vignette: AEDP in a Therapy Session
The following clinical vignette is a composite of many different cases where AEDP is used to heal trauma:

Before Ted sought help from an AEDP therapist, he had been in many different types of therapy over the years.  He explained to his AEDP therapist that, although he developed intellectual insight into his problems in his prior therapies, nothing changed for him on an emotional level (see my article: Healing From the Inside Out: Why Insight Isn't Enough to Heal Trauma).

He said he was still struggling with crippling shame that had a negative impact on his personal life as well as his career (see my article: Healing Shame in Therapy).

Ted explained that he was about to turn 45 and he was worried that he would never overcome the shame he had since childhood.  He said he decided to try AEDP because a friend had a very good experience with it.

His AEDP therapist started the consultation by being empathetic and welcoming, which helped to put Ted at ease.  As part of AEDP, she noticed how Ted's facial expression, gestures and body language conveyed the shame he said he was struggling with for many years.

As Ted got more comfortable in the session, he told his therapist, "I'm surprised that I can feel so comfortable with you so quickly.  Usually it takes me at least a few weeks to feel comfortable enough to open up."

Part of the AEDP therapist's role is noticing and emphasizing the somatic markers for positive feelings.  So, to amplify Ted's feeling of comfort, his therapist asked Ted where he noticed that feeling of comfort in his body (see my article: The Body Offers a Window Into the Unconscious Mind).

Ted took a moment to notice where he felt the sense of comfort in his body and then he put his hand over his stomach, "I feel it in my gut."  In response, his therapist asked Ted if he would be willing to stay with that sensation of comfort, and he nodded.

Ted closed his eyes and allowed himself to relax into that sensation of comfort, and his therapist noticed that his whole body relaxed.  Then, after a minute or so, Ted said that along with that feeling of comfort, he was now beginning to feel sad because he recognized that it was so rare for him to feel this way.

Ted's AEDP therapist knew that this is a typical response during the initial stage of therapy for people who have experienced trauma.  The positive feeling often brings up sadness when people compare the positive feeling with the emotional deprivation they experienced in the past.

After a few moments, the feeling of sadness subsided, and Ted's therapist observed that he had just gone through a wave of emotion.  She explained that emotions usually come in waves, similar to waves in the ocean with a surge, a peak and then an ebbing away of emotion.

Ted was able to return to the feeling of comfort and a sense of openness. He said he was usually anxious and guarded in most situations, but he didn't feel that way in this therapy session (see my article: The Creation of the Holding Environment in Therapy).

By the end of the session, his therapist explored with Ted what it was like to have this experience of comfort, which was so rare for him.  Ted said it helped him to feel safe in the session--a feeling that he rarely had anywhere.

Then, his therapist, who understood that AEDP is a relational experience between the client and the therapist and observed Ted's openness, asked Ted what it was like to have this sense of comfort and to have it with her.  Ted responded that he was surprised and pleased. He said he hadn't expected to feel this way with her, especially during an initial therapy consultation.

This type of exploration is called "metaprocessing" in AEDP.  Part of the value of doing metaprocessing is that it brings it brings together both right brain (emotions) and left brain (putting words to feelings) processing.  Another part is that, as previously mentioned, it emphasizes the importance of the therapeutic relationship between the client and the therapist.

Over time, Ted talked about shame he felt as a child with a highly critical father.  His therapist helped Ted to develop the internal resources to deal with the trauma work they would be doing on his shame.  All the while, she continued to pay attention to Ted's emotions and she titrated the work so that it wouldn't be overwhelming for Ted.

During one AEDP session, Ted talked about feeling angry with his father for shaming him at a big family gathering when he was five years old after Ted spilled juice on his clothes. He remembered that his father got very upset and yelled at him for being "so stupid and clumsy." He said this memory was typical of many memories where his father shamed him.

He also remembered feeling so deeply ashamed that he wanted to run and hide.  In addition, even at that young age, he sensed how intimidated everyone was, including his mother, by the father's temper and bullying behavior.

As part of helping Ted to feel a positive experience he could use as a resource, his therapist asked Ted to remember a time when he was feeling proud of himself.  She told him that it could be from any time in his life.

In response, Ted thought about that for a few moments, and then he said he felt proud on the day he graduated from college.  He told his therapist that he graduated with honors, and one of his professors, who was kind and encouraging, helped him to adjust to being away at college.  He recounted how seeing that professor on graduation day made him feel so cared about and proud.

His therapist recognized that Ted was ready to do a "portrayal" (imaginary work, similar to Gestalt chair work) with regard to his anger towards his father, and the professor as well as his sense of pride on graduation day would be good internal resource for Ted.  So, she asked Ted to stay with those positive feelings.

After a few moments, Ted was able to identify a feeling of calm and confidence in his gut as he thought about these positive memories.  His therapist asked Ted to stay with those positive feelings and, after a few seconds, Ted said he felt these positive emotions getting stronger and he noticed that they were expanding from his gut to his throat.

His therapist asked Ted if he would like hold onto that sense of calm and confidence, the image of that professor, and imagine talking to his father in that earlier memory. Ted said he would be willing to do this, so he went back into that memory where his father was berating him at the family gathering.

His therapist helped him to stay within his calm and comforted adult self to look at his humiliated child self, and Ted responded, "I'm looking at that child and I feel sad for him.  I'm also feeling protective towards him.  He didn't deserve to be treated that way.  He was only a child."

With the image of his professor in his mind and the positive emotions he was feeling as his adult self, Ted imagined himself confronting his father, "Stop yelling at him. He's only a child."  He imagined that his father was so surprised and speechless because no one ever confronted him in this way.

Then, Ted imagined taking his child self in his arms hugging him and rubbing his back.  As he did this, his therapist asked Ted to switch his consciousness to being his child self to feel what it was like to receive this comfort and love, and Ted said that, as his child self, he could relax into that hug and he felt protected (see my article: Having a Dialogue With the Different Parts of Yourself).

Afterwards, his therapist helped Ted to process what this experience was like for him, and Ted said he never felt this way before.  He said that he felt comforted and calm, and he also felt happy and strong to be able to confront his father.  He told his therapist that it wasn't nearly as scary as he thought it would be, especially because he imagined coming from a confident stance with his supportive professor with him.  He also said he felt his therapist's presence, which also helped him during this portrayal where he confronted his father.

His therapist explained that doing parts work, which is working with the various aspects of himself, including the adult self, child self and other parts of himself, is part of AEDP (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are).

Whenever his AEDP therapist did parts work as part of a portrayal, she made sure that Ted was coming from an internally resourced, strong, confident place within himself first.

AEDP therapists know that clients often felt alone when they were going through the original trauma, so, as therapists, they need to be present and resonate with clients as they are processing trauma to undo that feeling of aloneness.  This allows the client to have a new experience with the memory of trauma so that they no longer feel alone with it.  This is part of reworking the trauma.

Gradually, Ted overcame the crippling shame that held him back in his personal life and in his career.  Not only did he have insight into his problems, but he also felt the healing benefits of AEDP as an experiential therapy.

The goal of AEDP is not just to help clients to develop insight--although insight is important.  The goal of AEDP is to help clients to transform and heal.

The vignette above illustrates some ways that AEDP therapists help clients to heal.

As mentioned in my prior prior article, AEDP is an evidence-based, cutting edge, experiential therapy.  It incorporates many different approaches, and AEDP therapists work in an empathetic and dynamic way.

AEDP interventions are designed to help the client to access a feeling of strength and calm by using positive memories and resources (like the positive memories in the vignette above) as a lens through which to approach traumatic memories.

Getting Help in Therapy
If you have been struggling to overcome problems, you're not alone.  Help is available to you (see my article: What is a Trauma Therapist?).

The AEDP Institute has a directory of AEDP therapists in the US and all over the world.

Rather than struggling on your own, seek help from an AEDP therapist so you can live a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, AEDP, EMDR, EFT and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Therapy).

I work with individual adults and couples.

I am currently providing teletherapy sessions, which are also known as online therapy, telemental health and telehealth (see my article: The Advantages of Online Therapy).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.

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