Scroll down to read about the “contagion of shame” (Morrison, Herman). Check out new Gallery photos! Hope to get new training videos posted soon.

WEBINAR on Compassionate Interventions
to Dissolve Defenses

You and your friends are happily invited to attend two of my upcoming events this week and next. It’s my great pleasure to be presenting a Webinar again through the ISTDP Institute with my brilliant colleague, Jon Frederickson, on October 19, 2012,12-3 pm EST. You can register at www.istdpinstitute.com.

I plan to illustrate my own therapeutic style through role plays dealing with specific defenses with Jon Frederickson aimed at dissolving defenses in cooperation with the client. I hope to demonstrate the conveyance of compassion through carefully selected language, vocal tone, facial expression and other aspects of neurobiological attunement. There are other factors too, like how we promote a sense of equality, build upon client strengths and create a felt partnership through healing attachment and authentic, egalitarian relationship between client and therapist.

“Going Slow to Accelerate Later” at LACPA

Also, please join me for my presentation on mindfulness, “Going Slow to Accelerate Later,” as it applies to Dynamic Emotion-Focused Therapy (DEFT) at an LA County Psychological Association event. Follow the link to register.

I’m loving the expansion of the DEFT/EDT community here in L.A., and feel extremely fortunate to have such great therapists participating! May everyone enjoy the fabulous photos added to the Gallery page, contributed by DEFT participants, as thoroughly as I have, as they capture our joy in learning and in supporting each other on this journey. I also thank each participant for your feedback on the program, which just keeps inspiring me to make the DEFT training better and better.

 “CONTAGION OF SHAME” IN THE CONSULTING ROOM AND IN TRAINING 

In our September and October training, we dove into the riveting topic of shame as it affects both clients and their therapists… and also myself (perfectionism perhaps?) as I’ve tackled the daunting task of sharing DEFT/EDT with high-aspiration therapists! Curiously, I’ve had some serious shame attacks myself while taking on this most central subject affecting our work. I endure my own performance anxiety/shame issues for one reason only … this work begs to be shared!

It also strikes me that my own shame experiences may actually be helping me to be even more empathic and attuned to the experience of therapists in training who doubt their competence. Seasoned therapists also have self-doubt and I believe that appropriate humility has advantages for all of us.

One of the topics we covered was “adaptive aspects of shame.”  Epstein & Falconier: “[Shame] can motivate people to make positive change.” There is truth in the statement that the more you know, the more you know what you don’t know… which is an invaluable motivator. Therapists tell me it would be helpful for me to show session material that reveals my own struggles and I plan to do so in future trainings.

That being said, we can all celebrate those times when we really make a difference in people’s lives and we have reason to feel deeply gratified to be informed by such great thinkers and scientists as Sigmund Freud, MD, Habib Davanloo, MD, and many others.

It was my awareness of the shame experience in my clients that drove me over the past 10 years to painstakingly craft defense interventions to reflect the most sensitive language, to communicate equality with the client by sometimes revealing myself and eschewing the role of expert, and to convey the compassion that I truly feel around the pain of shame.

I also feel strongly that we are better when we avoid language that is directive or overbearing, “You need to..,” “You must…” “We will…” and remember to ask permission and to honor client choice. This does not have to be cumbersome to the process, as therapists tend to think, and it goes a long way towards building self regard, sense of self and reducing compliance. I know of clients who gained symptom reduction in treatment but retained the same degree of co-dependency/compliance and I think our therapeutic stance can have an impact on this. Generally speaking, “You Messages” provoke shame… “You’re doing it again…,” “You’ve forgotten…,” even perhaps “You treat yourself like you’re nothing.” As i write, I ask myself, could it be preferable to say, “After all those years of being treated like you don’t count, it’s no wonder you have learned to treat yourself as though this is true. Do you see what I mean?” “How is it for you inside to see this so clearly with me?” and “It’s so great you want to turn this around!” Of course, tone of voice and facial expressions are HUGE in their impact on how our communications are received. Do we lean forward or do we appear disengaged? How about an occasional comforting smile or look of compassion?

It was my pleasure to write an article entitled “Slaying the Serpent of Shame” and it contains transcript material on the treatment of a chronically depressed, anxious patient. It appeared in Volume 11, Number 3  December 2007, Page 6, “Ad Hoc Bulletin,” an international journal of the Dutch Association for Short-Term Dynamic Psychotherapy (the VKDP). It can be accessed through the Southern California Society for ISTDP.

Participants in our DEFT program expressed enthusiasm for this topic and all of us felt that something powerful occurred as we supported each other to deal with our own internal shame experiences. We discovered that as we do this, our own performance anxiety is reduced and we are therefore more able to be mindfully present for our clients.

SENSITIVITY TO SHAME ON LISTSERVE AND TRAINING PROGRAMS

It’s become something of a mission with me to support a therapeutic community that helps each other to refrain from shaming either ourselves or each other. Toxic shame is poisonous to any person or group. Recently, I felt personally challenged to find ways to address communications that I found to be shaming and devaluing on a list serve without engaging in the shaming of others or myself. How do we request that something be changed or corrected without sounding critical? It’s tough. And there’s always the punitive superego, doing its projection thing, that may misinterpret… not to mention the great difficulty communicating feelings electronically. I also want to say here, for the record, that I plead guilty to erring in choice (and quantity) of words at times and that I am by no means above anyone else in needing to work in this area. I didn’t entirely succeed at my endeavors but some very good things did evolve for me personally as a result of taking the risks of exposure, such as some deepening relationships and also learning a lot from the experience.

Brene Brown, Ph.D., had fascinating findings about the links between showing vulnerability and connection to others. Certainly when we communicate in a public forum about a controversial subject, there is indeed vulnerability. And also benefits!

Stadter tells us, “Therapists are vulnerable to shaming and being shamed by clients.”    I would add that we are vulnerable to shaming ourselves and each other professionally as well. I have always encouraged my therapists in training to use the listserve as a resource. I may not always be available to answer their questions and others on the listserve can add valuable perspectives. It also takes considerable repetition of certain principles before they really sink into our minds. But some who posted questions about their cases were told to “speak to their supervisor.” It struck me that these are sophisticated people who don’t need to be told they can call their supervisor and who have made an inquiry on the list serve to explore additional ways of understanding their clients. Practically speaking, many therapists don’t have the funds for both training and a lot of supervision. So, it concerned me that these individuals might interpret that reaching out to the list serve was somehow inappropriate and that such information should only be obtained through supervision. Seems to me that a good use for a list serve is to share our expertise with one another and to also normalize our self doubts by sharing our vulnerabilities with each other. There were other areas that also aroused my concern even more and I hope that the lengthy discussion will bear some fruit along the way.

Gilbert tells us “Shame may be a major reason that important material is not disclosed during supervision.” Indeed, this is a clarion call to all of us who teach and supervise to heighten our sensitivity to shame inducing language and tone and to bring shame into the light of awareness for our therapists in training and for ourselves. Interesting, I’m finding myself using the phrase “therapists in training” rather than “trainees”  as “trainee” creates an impression to me that doesn’t reflect the advanced knowledge and experience that many “trainees” have. Also, I advocate that teachers of the work promote a sense of equality and collegiality with the therapists we teach, showing a willingness to share our own limitations and stumbles, and also appreciating the way that our colleagues in training often teach us too.

And finally, I agree with the following statement:

This entry was posted on Tuesday, October 16th, 2012 at 12:34 pm and is filed under Conference, Other Topics, Shame, Therapist Concerns, Treatment Process. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.