Attachment, Trauma

Attachment and Trauma 2017: The Neurobiology of Healing - New York
withStephen Porges, Daniel J. Siegel, Pat Ogden, Vittorio Gallese, Allan Schore, Robin Shapiro, Diana Fosha, Antonio Damasio, Rachel Yehuda, Peter Levine
Duration: 12h 38m 00s
Recordings of the course available without time limits
Available in Italian (simultaneous translation), English
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150 

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INTRODUCTION
Over the last decades, the studies on the brain and on psychotherapy have underlined that what happens within the therapist-patient dyad has an impact on the microarchitecture of the brain. Furthermore, with the passing of time, the relationship between the development of several areas of the brain during the process of growth and the experiences that each individual makes later on, has been increasingly explored. Consequently, not only researchers have succeeded in understanding the links between the different areas of the human brain, but they have also become aware of the influence that the functioning of some specific areas of the brain has on the mental health (or the psychopathology) of each human being. Besides this, these studies have shown the effects of every individual’s relationships on the development and the functioning of his/her brain all over the course of life.

Modern psychotherapy, based on both neurophysiology and neurobiology, has been increasingly oriented towards the creation of a therapeutic relationship where the therapist has a mindful attitude to his/her own patient, while the latter can make new experiences, which are able to change his/her neural patterns of functioning and to make them healthier.

Some of the most eminent experts in the fields of Cognitive Neurophysiology, Neurobiology and Psychotherapy, will meet in New York to attend the Congress “Attachment and Trauma: The Neurobiology of Healing” – organized, for the very first time, in the “Big Apple”, near the vibrant Times Square – to share and integrate their vast knowledge on this subject. After a 60-minute intervention, each speaker will focus on a 30-minute question-and-answer session with the audience. Finally, at the end of each day, all the speakers that have made a presentation will gather in a 180-minute panel discussion, to further analyze different specific topics.

Stephen Porges

Stephen Porges

The Polyvagal Theory: The Transformative Power of Feeling Safe

Safety is critical in enabling humans to optimize their potential. The neurophysiological processes associated with feeling safe are a prerequisite not only for social behavior but also for accessing both the higher brain structures that enable humans to be creative and generative and the lower brain structures involved in regulating health, growth, and restoration. The Polyvagal Theory explains how social behavior turns off defenses and promotes opportunities to feel safe. It provides an innovative model to understand bodily responses to trauma and stress and the importance of the client’s physiological state in mediating the effectiveness of clinical treatments. From a Polyvagal perspective, interventions that target the capacity to feel safe and use social behavior to regulate physiological state can be effective in treating psychological disorders that are dependent on defense systems.

Stephen W. Porges, PhD, is a Distinguished University Scientist at Indiana University, where he is the founding director of the Traumatic Stress Research Consortium within the Kinsey Institute. He holds the position of Professor of Psychiatry at the University of North Carolina and Professor Emeritus at the University of Illinois at Chicago and the University of Maryland. Dr. Porges served as president of both the Society for Psychophysiological Research and the Federation of Associations in Behavioral & Brain Sciences and is a former recipient of a National Institute of Mental Health Research Scientist Development Award. He has published approximately 300 peer-reviewed scientific papers across several disciplines including anesthesiology, biomedical engineering, critical care medicine, ergonomics, exercise physiology, gerontology, neurology, neuroscience, obstetrics, pediatrics, psychiatry, psychology, psychometrics, space medicine, and substance abuse. His research has been cited in approximately 40,000 peer-review publications. In 1994 Dr. Porges proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological state in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders. He is the author of The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation (Norton, 2011), The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe (Norton, 2017), co-editor of Clinical Applications of the Polyvagal Theory: The Emergence of Polyvagal-Informed Therapies (Norton, 2018), and Polyvagal Safety (Norton, 2021). Dr. Porges is also the creator of a music-based intervention, the Safe and Sound Protocol™, which currently is used by more than 2000 therapists to improve spontaneous social engagement, to reduce hearing sensitivities, and to improve language processing, state regulation, and spontaneous social engagement.
Daniel J. Siegel

Daniel L. Siegel

The Mind in Mental Health: How Defining the Mind Empowers the Healing Process

The field of mental health, along with a range of academic disciplines focusing on the mind, rarely define what “mind” actually is. With a range of descriptions of emotion, consciousness, and thought, we naturally have a sense of what we mean by this commonly used term. But without even a working definition of what the mind is, we are left without a common ground, and without a clear view of what a healthy mind might in fact be. In this presentation, we will offer a definition of one aspect of the mind as an embodied and relational, emergent self-organizing process that regulates the flow of energy and information. Optimal self-organization arises with the differentiation and linkage of elements of a system—a process of “integration.” Without integration, systems move toward chaos, rigidity, or both—as is seen with post traumatic stress conditions. The neurobiology of abuse and neglect, for example, result in impairments to the growth of the integrative fibers of the brain, including the corpus callosum, the hippocampus, and the prefrontal cortex. Healing emerges with identifying chaos and rigidity and offering the experiences that can now promote the growth of integration, in the brain and in the relationships that are the inner and interpersonal sources of the emergent mind. 

Studies show that individuals with a history of disorganized attachment develop adaptive responses to the experience of terror experienced with their caregivers, which translate into significant difficulties in emotional regulation and in the development of mutually satisfying relationships, as well as in the appearance of dissociative phenomena in different clinical grades. Similar scientific results that have emerged in repeated studies show the world of psychotherapy the origins in the developmental age of at least one form of dissociation: the fragmentation of consciousness and a compromised integration of the sense of self, or of the individual's "personality". In this intervention we will deepen our knowledge on these developmental processes, and on how to deal with these forms of disorganized attachment within the psychotherapeutic relationship and move from an unresolved trauma linked to abuse and neglect in the developmental age to its complete resolution during the course of therapeutic healing process.
Rachel Yehuda

Rachel Yehuda

Can information obtained from blood provide meaningful information to clinicians seeking information relevant to detection of risk, prognosis, diagnosis or treatment response related to PTSD? To date, there have been numerous, large efforts underway to detect PTSD biomarkers. This presentation will review the rationale for new integrative biological approaches towards biomarker detection in PTSD as well provide an update on the state of the science and data thus far. Knowledge about molecular networks is critical for informing treatment innovation for PTSD, and blood markers have the greatest potential for widespread application. A scientific risk is that peripheral blood will not reflect the brain regions associated with PTSD, but validation studies with animals comparing blood to brain, and reprogrammed human neuronal cell comparisons. These approaches, and the data that can be obtained from them, will be discussed. The presentation will also comment on what promising future data can be anticipated towards the development of customized precision medicine techniques. Indeed, to the extent that molecular disruptions related to PTSD can be identified, it will be possible to use novel drug repositioning approaches to identify novel treatments for PTSD.

Vittorio Gallese

Vittorio Gallese

Emotions in action. Emotion regulation and recognition in traumatized and neglected young individuals.

According to a widely shared perspective, experiencing and expressing a given emotion are two different and independent processes. I’ll propose an alternative perspective: the behaviour connected to a specific emotion is part of the emotion itself. In my talk I will present and discuss recent neuroscientific studies showing the link between emotion experience and expression. I will also present recent empirical research on the impact of trauma and neglect on emotion regulation and recognition in children and young adolescents.

He is Full Professor of Physiology at the Dept. of Neurosciences of the University of Parma, Adjunct Senior Research Scholar at the Dept. of Art History and Archaeology, Columbia University, New York, USA and Professor in Experimental Aesthetics at the Institute of Philosophy of the University of London, U.K. He is coordinator of the PhD in Neuroscience and Director of the Doctoral School of Medicine and Surgery at the University of Parma. Neuroscientist, among his main scientific contributions is the discovery of mirror neurons together with his colleagues in Parma, and the development of a neuroscientific model of intersubjectivity, the theory of embodied simulation. He has worked and taught at the Universities of Lausanne, Tokyo, Berkeley and Berlin. He is the author of over 230 scientific papers in international journals and books, two books as author and three books as editor. He has received the George Miller Fellowship from the University of California at Berkeley in 2001, the Grawemeyer Prize for Psychology for the year 2007, the Doctor Honoris Causa from the Catholic University of Louvain, Belgium in 2010, the Arnold Pfeffer Prize for Neuropsychoanalysis a New York in 2010, the Musatti Prize of the Italian Society of Psychoanalysis in 2014, the Kosmos Felloship from the Humboldt Universität of Berlin and the Einstein Fellowship at the Berlin School of Mind & Brain of the Humboldt University for the period 2016-2018.
Allan Schore

Allan N. Schore

The growth-promoting role of mutual regression in deep psychotherapy

Dr. Schore will discuss his ongoing theoretical and clinical work on therapeutic expertise in facilitating structural changes in the patient’s early developing right brain attachment and stress regulating systems. He will focus on right brain systems of the deep unconscious, and how they can be directly accessed in treatment. Expanding his neurobiological studies of interpersonal creativity and clinical intuition he will present neuropsychoanalytic models of both structural and topographic regression in the treatment of early attachment trauma, and will differentiate clinical work with spontaneous enactments and controlled mutual regressions at different stages of therapy. He will argue that the concept of regression, banished at the end of the last century, needs to return to the clinical literature.

Author of numerous articles and books on theory of emotional regulation, he works on the faculty of the Department of Psychiatry and Biobehavioral Sciences.
Peter Levine

Peter Levine

Bonding and attachment physiology: renegotiation/restoration of the broken connection

Robin Shapiro

Robin Shapiro

Identifying, Unzipping, and Reassigning "Protector" Parts in Dissociated Clients

This practical talk shows how to use ego state therapy (and EMDR, if you know it) to work with entrenched and often self-destructive parts that may "protect" clients from uncomfortable (negative or positive) affect, intimacy, or new, positive experiences in their healing process.

Robin Shapiro, LICSW, edited and contributed to EMDR Solutions: Pathways to Healing (Norton, 2005) and EMDR Solutions II: Depression, Eating Disorders, Performance & More (2009) and wrote Trauma Treatments Handbook (2010), and Easy Ego State Interventions (2016). Alongside with writing activity, she devotes herself passionately in presenting about ego states, EMDR topics, and suicide prevention. Dr. Shapiro offers clinical consultation for EMDR, ego state work, and complex trauma; and thirty-five years of psychotherapy practice, especially around issues of trauma, anxiety, and attachment.
Diana Fosha

Diana Fosha

A Framework for Undoing Aloneness and Doing Transformational Work in AEDP

Four foundational aspects of AEDP (Accelerated Experiential Dynamic Psychotherapy) allow it to reliably do transformational work and transform suffering into flourishing:

(i) Its healing orientation, and its belief, supported by neurobiology and recent advances in neuroplasticity, that we are all self-righting organisms wired with an innate motivational tendency, towards health, healing and growth, which in the right environments, can be potentiated into clinical action;

(ii) Undoing the aloneness that people feel in the face of overwhelming emotional experiences through an attachment-based stance and dyadic affect regulatory techniques;

(iii) Mobilizing subcortical affective systems specialized to adapt to environmental changes by rapidly transforming behavior through its experiential interventions and transformational work with intense emotions;

(iv) Metatherapeutic processing techniques, where, by experientially working with the experience of transformation, and the positive emotions invariably associated with moments of change for the better, non-finite upward spirals of positive emotions are systematically activated. The positive emotions that fuel the self with energy and vitality, are the vehicles of neuroplasticity that, in effect, re-wire the brain.

AEDP emphasizes the co-creation of safety: with accompaniment, patients can risk revisiting past trauma and suffering. Healing and neuroplasticity are set in motion through fully experiencing previously feared emotions in a secure relationship, and through gentle, yet focused, explicit attention to the experience of healing within the patient-therapist relationship. Processing both traumatic and restorative emotional experiences to completion, the AEDP process culminates in vitality, energy, and the non-finite positive emotion-fueled spirals of resilience, well-being and creativity that are so highly correlated with health. 

Clinical videotapes of AEDP in action will be used to illuminate how, through undoing aloneness and experiential work with transformational experience, emotional suffering can be not only ameliorated, but systematically and reliably transformed into resilience, flourishing, and well being.

Diana Fosha, Ph.D. is the developer of AEDP (Accelerated ExperientialDynamic Psychotherapy), healing-oriented, transformational experiential model of therapy, and Founder and Director of the AEDP Institute. For the last 20 years, Diana has been active in promoting a scientific basis for a healing-oriented, attachment-emotion- and transformationfocused trauma treatment model. Fosha’s work focuses on integrating neuroplasticity, recognition science and developmental dyadic research into experiential and transformational clinical work with patients. Her most recent work focuses on flourishing as a seamless part of the process of transforming emotional suffering. She is the author of The transforming power of affect: A model for accelerated change (Basic Books, 2000); co-author, with Natasha Prenn, of Supervision essentials for Accelerated Experiential Dynamic Psychotherapy (APA, 2016); 1st editor, with Daniel Siegel and Marion Solomon, of The healing power of emotion: Affective neuroscience, development & clinical practice (Norton, 2009), and editor of the soon to be released AEDP 2.0: Undoing aloneness and the transformation of suffering into flourishing (APA, in press). Four DVDs of her live AEDP clinical work, including one documenting a complete 6-session treatment, and one on clinical supervision have been issued by the American Psychological Association (APA). Described by psychoanalyst James Grotstein as a “prizefighter of intimacy,” and by David Malan as “the Winnicott of [accelerated experiential] psychotherapy,” Diana Fosha’s writing style is powerful and precise, yet poetic and evocative. Her phrases, —” undoing aloneness,” “existing in the heart and mind of the other,” “stay with it and stay with me,” “rigor without shame” and “True Other” — capture the ethos of AEDP. Many of her papers are available through the AEDP website at www.aedpinstitute.org.
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