Saturday, 30 March 2019
Plenary Address: Gabor Maté, MD
Compassionate Inquiry is a psychotherapeutic method developed by Dr. Gabor Maté that reveals what lies beneath the appearance we present to the world.
Using Compassionate Inquiry, the therapist unveils the level of consciousness, mental climate, hidden assumptions, implicit memories and body states that form the real message that words both express and conceal.
Through Compassionate Inquiry, the client can recognize the unconscious dynamics that run their lives and how to liberate themselves from them.
Dr. Maté will model the process of Compassionate Inquiry with course participants and instruct therapists in the practice of this powerful technique to help clients access deep healing and transformation. This will be both an experiential, participatory workshop where participants will be guided through their own personal process, as well as a training to teach the method of Compassionate Inquiry to health professionals, therapists and social workers.
Sunday, 31 March 2019
The Emergence of Polyvagal-Informed Therapies in the Treatment of Trauma
Plenary Address: Stephen W. Porges, PhD
The Polyvagal Theory provides a new perspective to explore how autonomic nervous system function relates to social behavior, emotional regulation, and health. The Polyvagal Theory links the evolution of the autonomic nervous system to affective experience, emotional expression, facial gestures, vocal communication, and contingent social behavior. The theory, by being informed by the phylogeny of the autonomic nervous system, expands our understanding of normal and atypical behavior, mental health (e.g., coping with stress and novelty), experiences (e.g., dissociative states), and psychiatric disorders (e.g., autism, anxiety disorders, PTSD). The theory emphasizes that the core deficits in behavioral and affective regulation associated with several psychiatric disorders is related to neural regulation of the autonomic nervous system. By incorporating a developmental perspective, the theory explains how traumatic experiences can disrupt and ‘retune’ the neural regulation of autonomic function to form a neural “platform” upon which the trauma survivor will have challenges in establishing safe and trusting relationships. The theory explains how the nervous system evaluates risk in the environment, without awareness and often independent of a cognitive narrative, through a process labeled “neuroception.” Neuroception attempts to support adaptive behaviors by matching autonomic state with the neuroceptive state of risk (i.e., safe social environment, danger, and life threat). Abuse and trauma may reset neuroception to protect the individual from others when there is no “real” danger resulting in defensive and often aggressive responses to friends and caregivers.
This presentation will focus on how Polyvagal Theory provides a plausible model to explain how therapy can support mental and physical health during compromised states frequently associated with the consequences of trauma. The Polyvagal Theory informs therapists by providing a strategy to understand the neural mechanisms and processes that are embedded in therapies to improve social engagement behaviors and to enhance the regulation of bodily and behavioral state. The theory provides insights that bridge therapy to the neural regulation of the autonomic nervous system and health outcomes. Polyvagal-informed therapies have two important components: 1) the context of the therapeutic session including the interpersonal relationship between therapist and client that promote feelings of safety and trust, and 2) the functional ‘neural’ exercises that are involved in the specific therapy. The Safe and Sound Protocol will be described as an example of an intervention that incorporates these two components.
Monday, 1 April 2019
The Growth-Promoting Role of Right Brain Mutual Regressions in Long-term Psychotherapy of Relational Trauma
Plenary Address: Allan N. Schore, PhD
In line with the current two-person relational trend in psychodynamic theory Dr. Schore will discuss the critical role of transient synchronized clinical regressions, defined as the process of returning to an earlier stage of development, in the psychotherapy of early relational trauma. Although the paradoxical process of regression may reflect a clinical deterioration it may also represent a creative return to fundamentals and origins that can facilitate a potential reorganization leading to better integration, healthy individuation, and increases in the adaptive capacity of intimacy. Drawing from his next two Norton volumes, Right Brain Psychotherapy and The Development of the Unconscious Mind, Dr. Schore will present interpersonal neurobiological models and case examples of mutual regressions embedded in clinical re-enactments of attachment trauma.
Current neuroscience now documents the critical role of the early developing right brain in attachment mechanisms, intense traumatic dysregulating emotional states, the dissociative defense, connections into the autonomic nervous system, social-emotional functions, interpersonal trust, and implicit affect regulation. The right brain thus needs to be activated in both the patient and the empathic therapist in working with relational trauma. Synchronized mutual regressions initiate an implicit shift from the left to right brain, allowing the therapist to remain intersubjectively connected to the patient as she experiences the subjective bodily-based aspects of relational trauma. Dr. Schore will describe how in heightened affective moments of the session, especially during ruptures and repairs of the therapeutic alliance, the psychobiologically attuned therapist implicitly instantiates a regression, a “reversible dominance of the left over the right hemisphere.” The creative clinician, sensitive to even low levels of the patient’s shifts into and out of affective states, learns how to fluidly synchronize this shift in hemispheric dominance with the patient shifts, thereby increasing safety and trust in the therapeutic alliance. This right lateralized interbrain synchronization allows for the communication and regulation of not just conscious but unconscious affects.
In this expansion of regulation theory Dr. Schore will explicate the central role of the character defense of dissociation (as opposed to repression) in working with regressions in not only symptom-reducing but growth-promoting psychotherapy, on both sides of the therapeutic dyad. He will offer a model for working with defensive coping strategies embedded in clinical regressions, especially those involving unconscious dissociated affect in spontaneous mutual regressions. In line with contemporary psychodynamic theory and interpersonal neurobiology he will argue that the communication and interactive regulation of affect and not interpretation and cognitive insight are central change mechanisms with early traumatized patients. Utilizing case vignettes, he will also elaborate the unconscious neuropsychoanalytic processes that are expressed in these mutual regressions. In deep psychotherapy these long-term changes in the patient’s right brain may underlie the structural psychotherapeutic transformation of the patient’s unconscious attachment internal working model, allowing for an integration of the personality and more adaptive and complex social-emotional functions.