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Winner of the International Society for the Study of Trauma and Dissociation's (ISSTD) Pierre Janet Writing Award, 2015. What really happens in dissociation. Dissociative processes have long burdened trauma survivors with the dilemma of longing to feel “real” at the same time as they desperately want to avoid the pain that comes with that healing—a dilemma that often presents particularly acute difficulties for healing professionals. Recent clinical and neurobiological research sheds some light into the dark corners of a mind undergoing persistent dissociation, but its integration into the practice of talking therapy has never, until now, been fully realized. Intensive Psychotherapy for Persistent Dissociative Processes brings readers into the consultation room, and into the minds of both patient and therapist, like no other work on the treatment of trauma and dissociation. Richard A. Chefetz marries neuroscientific sophistication with a wealth of extended case histories, following patients over several years and offering several verbatim session transcripts. His unpacking of the emotionally impactful experience of psychodynamic talking therapy is masterfully written, clearly accessible, and singularly thorough. From neurobiological foundations he builds a working understanding of dissociation and its clinical manifestations. Drawing on theories of self-states and their involvement in dissociative experiences, he demonstrates how to identify persistent dissociation and its related psychodynamic processes, including repetition compulsion and enactment. He then guides readers through the beginning stages of a treatment, with particular attention to the psychodynamics of emotion in both patient and therapist. The second half of the book immerses readers in emotionally challenging clinical processes, offering insight into the neurobiology of fear and depersonalization, as well as case examples detailing struggles with histories of incest, sexual addiction, severe negativity, negative therapeutic reactions, enactment, and object-coercive doubting. The narrative style of Chefetz’s casework is nearly novelistic, bringing to life the clinical setting and the struggles in both patient and therapist. The only mystery in this clinical exposition, as it explores several cases over a number of years, is what will happen next. In the depth of his examples and in continual, self-reflexive analysis of flaws in past treatments, Chefetz is both a generous guide and an expert storyteller. Intensive Psychotherapy for Persistent Dissociative Processes is unique in its ability to place readers in the consultation room of psychodynamic therapy. With an evidence-focused approach based in neurobiology and a bold clinical scope, it will be indispensible to new and experienced therapists alike as they grapple with the most intractable clinical obstacles.
An edited collection from some of the most influential writers in mental health. Books in the Norton Series on Interpersonal Neurobiology have collectively sold close to 1 million copies and contributed to a revolution in cutting-edge mental health care. An interpersonal neurobiology of human development enables us to understand that the structure and function of the mind and brain are shaped by experiences, especially those involving emotional relationships. Here, the three series editors have enlisted some of the most widely read IPNB authors to reflect on the impact of IPNB on their clinical practice and offer words of wisdom to the hundreds of thousands of IPNB-informed clinicians around the world. Topics include: Dan Hill on dysregulation and impaired states of consciousness; Bonnie Badenoch on therapeutic presence; Kathy Steele on motivational systems in complex trauma.
An exploration of how the unconscious is formed and functions by one of our most renowned experts on emotion and the brain. This book traces the evolution of the concept of the unconscious from an intangible, metapsychological abstraction to a psychoneurobiological function of a tangible brain. An integration of current findings in the neurobiological and developmental sciences offers a deeper understanding of the dynamic mechanisms of the unconscious. The relevance of this reformulation to clinical work is a central theme of Schore's other new book, Right Brain Psychotherapy.
The rich, complex theory of affect regulation boiled down into a clinically useful guide. Affect regulation theory—the science of how humans regulate their emotions—is at the root of all psychotherapies. Drawing on attachment, developmental trauma, implicit processes, and neurobiology, major theorists from Allan Schore to Daniel Stern have argued how and why regulated affect is key to our optimal functioning. This book translates the intricacies of the theory into a cogent clinical synthesis. With clarity and practicality, Hill decodes the massive body of contemporary research on affect regulation, offering a comprehensible and ready-to-implement model for conducting affect regulation therapy. The book is organized around the four domains of a clinical model: (1) a theory of bodymind; (2) a theory of optimal development of affect regulation in secure attachment relationships; (3) a theory of pathogenesis, in which disordered affect regulation originates in relational trauma and insecure attachment relationships; and (4) a theory of therapeutic actions targeted to repair the affect regulating systems. The key themes of Hill’s affect-focused approach include: how and why different patterns of affect regulation develop; how regulatory patterns are transmitted from caretakers to the infants; what adaptive and maladaptive regulatory patterns look like neurobiologically, psychologically, and relationally; how deficits in affect regulation manifest as psychiatric symptoms and personality disorders; and ultimately, the means by which regulatory deficits can be repaired. Specific chapters explore such subjects as self states, mentalization, classical and modern attachment theory, relational trauma (and its manifestations in chronic dissociation, personality disorders, and pervasive dissociated shame), supporting self-development in therapy, patient–therapist attunement, implicit and explicit therapeutic actions, and many more.
Key concepts in neuroscience presented for the non-medical reader. A fresh take on contemporary brain science, this book presents neuroscience—the scientific study of brain, mind, and behavior—in easy-to-understand ways with a focus on concepts of interest to all science readers. Rigorous and detailed enough to use as a textbook in a university or community college class, it is at the same time meant for any and all readers, clinicians and non-clinicians alike, interested in learning about the foundations of contemporary brain science. From molecules and cells to mind and consciousness, the known and the mysterious are presented in the context of the history of modern biology and with an eye toward better appreciating the beauty and growing public presence of brain science.
Drawing on cutting-edge neuroscience to understand psychotherapeutic change. Growth and change are at the heart of all successful psychotherapy. Regardless of one's clinical orientation or style, psychotherapy is an emerging process that s created moment by moment, between client and therapist. How People Change explores the complexities of attachment, the brain, mind, and body as they aid change during psychotherapy. Research is presented about the properties of healing relationships and communication strategies that facilitate change in the social brain. Contributions by Philip M. Bromberg, Louis Cozolino and Vanessa Davis, Margaret Wilkinson, Pat Ogden, Peter A. Levine, Russell Meares, Dan Hughes, Martha Stark, Stan Tatkin, Marion Solomon, and Daniel J. Siegel and Bonnie Goldstein.
An update to the classic text that links neuroscience and human behavior in the context of therapy. This groundbreaking book explores the recent revolution in psychotherapy that has brought an understanding of the social nature of people’s brains to a therapeutic context. Louis Cozolino is a master at synthesizing neuroscientific information and demonstrating how it applies to psychotherapy practice. New material on altruism, executive function, trauma, and change round out this essential book.
This book presents a comprehensive neuropsychodynamic strategy for treating psychiatric disorders. Rather than pursuing an exclusively biological, psychological, or psychodynamic approach, it offers a methodology that links all three aspects in a unifying, integrative model. Central to this approach is the view of the brain as a bio-psychosocial organ in a neuro-ecological model, rather than the purely neuronal model often presupposed in current neuroscience and psychiatry. Moreover, the book views psychopathological symptoms as spatiotemporal disorders of the altered spatiotemporal structure spanning the brain and its surrounding world. The relation between one of the core symptoms and altered neuronal activity calls for the development of integrated, circular neuropsychodynamic models of psychopathological symptoms in severe psychiatric disorders and their treatment.
Demystifying neurobiology and presenting it anew for the social-work audience. The art and science of relationship are at the core of clinical social work. Research in neurobiology adds a new layer to our understanding of the protective benefits of relationship and specifically, to our understanding of the neurobiology of attachment and early brain development. This second edition of Neurobiology for Clinical Social Work explores the application of recent research in neuroscience to prevention and intervention in multiple systems, settings, and areas such as the neurobiology of stress and the stress response system, the impact of early adversity and toxic stress on brain development, early childhood and adolescent brain development, and the application of this science to prevention and intervention in areas such as child welfare and juvenile justice. Social workers collaborate with individuals, families, communities, and groups that experience adversity, and at times, traumatic stressors. Research in neuroscience adds to our models of risk and resilience; informing our understanding of the processes by which adversity and trauma impact multiple indicators of wellbeing across time. Social workers can use this knowledge to inform their work and to support the neuroprotective benefit of relationship in the lives of individuals, families, and communities. This text provides essential information for cutting-edge social work practice.
Winner of the 2017 International Society for the Study of Trauma and Dissociation (ISSTD) Pierre Janet Writing Award. Establishing safety and working with dissociative parts in complex trauma therapy. Therapists around the world ask similar questions and struggle with similar challenges treating highly dissociative patients. This book arose not only out of countless hours of treating patients with dissociative disorders, but also out of the crucible of supervision and consultation, where therapists bring their most urgent questions, needs, and vulnerabilities. The book offers an overview of the neuropsychology of dissociation as a disorder of non-realization, as well as chapters on assessment, prognosis, case formulation, treatment planning, and treatment phases and goals, based on best practices. The authors describe what to focus on first in a complex therapy, and how to do it; how to help patients establish both internal and external safety without rescuing; how to work systematically with dissociative parts of a patient in ways that facilitate integration rather than further dissociation; how to set and maintain helpful boundaries; specific ways to stay focused on process instead of content; how to deal compassionately and effectively with disorganized attachment and dependency on the therapist; how to help patients integrate traumatic memories; what to do when the patient is enraged, chronically ashamed, avoidant, or unable to trust the therapist; and how to compassionately understand and work with resistances as a co-creation of both patient and therapist. Relational ways of being with the patient are the backbone of treatment, and are themselves essential therapeutic interventions. As such, the book also focused not only on highly practical and theoretically sound interventions, not only on what to do and say, but places strong emphasis on how to be with patients, describing innovative, compassionately collaborative approaches based on the latest research on attachment and evolutionary psychology. Throughout the book, core concepts—fundamental ideas that are highlighted in the text in bold so they can be seen at a glance—are emphasized. These serve as guiding principles in treatment as well as a summing-up of many of the most important notions in each chapter. Each chapter concludes with a section for further examination. These sections include additional ideas and questions, exercises for practicing skills, and suggestions for peer discussions based on topics in a particular chapter, meant to inspire further curiosity, discovery, and growth.