The Case of Mistaken Identity EMDR, EGo States, Attachment Eating Disorders

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today\'s objectives. Valid character: our definitive clinical goalTrauma-educated point of view in treating dietary issues EMDR inside of a stage modelThe inescapable vicinity of dissociationThe requirement for inner self state workThe requirement for connection repair. From Dr. Seuss. Today you are you,This is more genuine than true.There is nobody aliveWho is you-er than you..

Presentation Transcript

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The Case of Mistaken Identity EMDR, EGo States, Attachment & Eating Disorders with Andrew Seubert, NCC, LPC ClearPath Healing Arts Center Mansfield, PA/Corning, NY email:

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today's goals Authentic personality: our definitive clinical objective Trauma-educated point of view in treating dietary issues EMDR inside a stage model The inescapable nearness of separation The requirement for conscience state work The requirement for connection repair

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From Dr. Seuss Today you will be you, This is more genuine than genuine. There is nobody alive Who is you-er than you.

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T H E W O R L D x False fronts Identitites Frozen pictures Roles

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Identity and Experience The Real Self was lost and false personality shaped through excruciating encounters of exclusion and commission. Re-development, re-revelation, re-picking up, re-asserting, re-membering genuine personality require new experience Tearing down and developing similitude: desensitizing and reprocessing/relearning The neurological focal point: Brain bolt versus the evolving cerebrum. The impact of injury, separation and poor connection.

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dietary problems: Introduction and Overview

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ED Theories Genetic: inclinations, disposition Family and connection designs Reviving Ophelia: the impact of culture and promoting The part of slimming down and prohibitive eating Managing agonizing background - injury

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Two parts of a dietary problem How is began: the first reason and requirement for the turmoil. How it develops into a dependence by means of fortification: an existence of its own William Davis: essential and optional issue

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New meaning of injury DSM constrained definition Anything that adversely hues our view of self and the world reclassifies us Instead of being processed, it is pushed behind a divider Buried, yet covered alive - makes a "sore spot" Broadened definition incorporates assortment of occasions, disposition, misfortune and connection damage. Focal point hypothesis.

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treatment Trauma-educated Phase Approach joining Ego State Therapy, Attachment Repair, and the Search for Authentic Identity

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stage 1 - assessment Client History, case detailing, objectives, tx arrange

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Phase one varieties Medical administration Test for separation Include careful connection history Include history of dietary issue Agree upon objectives that are significant and do-capable

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gathering data Physical wellbeing first - medicinal treatment Histories, including jumble (incorporates utilization of work out, diuretics, weight control pills) and family relationship to sustenance and dinners EDI (Garner ), EDE (Fairburn and Cooper) and SDQ - 5 (Nijenhuis, Van der Hart & Vanderlinden)

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More data History of addictions, ED and disposition issue by means of genogram DES/DDIS - check for levels and styles of separation Trauma history, including occasions associated with ED

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stage 1 - where to start History - pacing and frontloading Primacy of the relationship versus depending on ED: dynamic and advantageous (Wm. Davis, PhD): first objective Beginning of connection repair - helpful relationship Case plan as stage support - conceded?

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all the more Beginning Determining objectives - prompt and here and now versus long haul. Motivational meeting. Conceivable quick objectives: managing feelings, especially tension; here and now life triumphs; "energy interests" (Ira Sacker) Eventual case definition, longer-term objectives (work in advance) Case detailing + objectives = treatment arrange Organizing NC: I'm fat and disturbing

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stage 2 Preparation

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Phase Ii-segments Medical redesigns persistent/eating arranges - steadiness Awareness continuum Emotional fitness Body mindfulness - body hunger/satiety. Assets and formats Dissociation - establishing and inner self state planning Attachment repair Short-term victories

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Awareness as a Way

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Awareness Components Outside (visual, sound-related, material) Inside (breath, body, considerations, body sensations, sentiments, open mindfulness) Who is awaring?

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planning Affect Education: the Courage to Feel The why and how of sentiments The Four Steps Dealing with tension, blame and disgrace

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the four stages - A-b-c-d Be AWARE of the inclination BE with the inclination CHECK the message of the inclination DECIDE to express, act or not from The Courage to Feel, 2008

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the visitor house This being human is a visitor house. Each morning another landing. A delight, a melancholy, an ugliness, some transient mindfulness comes as a surprising guest. Welcome and engage them all! Regardless of the possibility that they're a horde of distresses, who savagely clear your home discharge of its furniture, still, treat every visitor decently. He might get you out for some new enjoyment. The dull thought, the disgrace, the malignance, meet them at the entryway snickering, and welcome them in. Be thankful for whoever comes, on the grounds that each has been sent as a guide from past.

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Body mindfulness Body and breath mindfulness Satiety and craving - Judy Lightstone (EMDR Solutions II) Body-focused Gestalt - Edward Smith (The Body in Psychotherapy) - trials to finish activity Somatic resourcing, Ogden, et al. (Injury and the Body)

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asset advancement Building up and tearing down Sources of assets - 4 "M"s (recollections, models, mirrors, imaginings) Resources in light of RSVP (Earl Gray) - the "circle"

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3-section arrangement "Fitness coach demonstrate" Stabilization, wellbeing, case administration Skills and assets Small and prompt triumphs

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separation and ed

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what lies underneath ed notwithstanding injury, defensive evasion is the need and dissociative systems are the instruments of accomplishing that security ED as a dissociative technique The sense of self state both contains and ensures against the separated agony by relating to ED - "cut" illustration In testing the manifestations (eating intentionally), agonizing and separated material is uncovered (urge intrusion).

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T rauma and Dissociation New meaning of "injury" The "divider", torment can't be processed A "section" is conceived - condition of awareness The part goes up against ED - typically inadvertently. Reason: insurance against torment and survival Looking with part-ial vision - limit center of mindfulness The dissociative continuum

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Dissociative Continuum Ego States Spacing Out DID DDNOS

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Ego States The states in the union - regulating stream The part assumes control over the entire Forgetting who you truly BE - lost personality. Lost Self. ED turns into the new character Avoids torment, makes enduring

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ED Parts Work/Tasks Make contact with wellspring of ED Understand that part Appreciate its motivation Educate - old methodologies does not work anymore; ED instruction; space/time introduction Collaborate in giving another set of working responsibilities Find and bolster more advantageous parts - injury treatment

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What now? Grown-up CSS ED part HP

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planning - Ego states Gestalt Polarity work Ego State Therapy (Watkins and Watkins): talking with the part that clutches ED. Carl Forgash: Healing the Heart of Trauma and Dissociation. Van der Hart, et al: The Haunted Self Richard Schwartz - Internal Family Systems Tsultrim Allione - Feeding your Demons

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Contact You can't change what you don't realize What you overlook, stay away from or buckle under to will in the end control you. The gathering table Spontaneous contact with parts: the "simple stream" approach

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Background - J.B. Mid 40's, two children, basic/eager spouse Mother - productive, not supporting Father - unusually dangerous and tensely defensive Teased by kin about being "fat" @ 7 Fondled by instructor in review school ED since 7 - 5 hospitalizations Began to confine before early immature.

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inner self state rudiments To perceive and discourse with "parts" To find the reason, goals and basic torment of each part - getting to be distinctly known. Understanding prompts to empathy. To make shared objectives: new sets of responsibilities. Abstain from making ED the adversary. Remedial relationship needs to wind up distinctly more essential. To make cooperation that will move customer towards sought objectives, including injury determination.

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Educate Education of the stuck part: injury educated Through the eyes of the viewer: "we see the world (and ourselves)not as it seems to be, however as we may be." All-or-nothing considering. Training happens inside the pertinent inner self state

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reinforcing before injury tx Need to decrease practices before injury tx. Building certainty towards end of planning stage Can't sit tight for flawlessness of diminished practices Importance of enduring tension and disgrace Internal coordinated effort and connection repair

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connection damage and repair

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common war - J.B. J/I'm so nauseated with myself! I'm so embarrassed, 'cause I'm so fat at this point. A/So what brings this on? J/I put on weight. I'm fat, and I'm appalling. What's more, I don't have some other options. It is possible that I get fat or I starve. A/Sounds like two difficult situations. J/Exactly. I'm recently so tired of feeling so crumby about myself. [ Tears, discharge take after ] A/Would you take a stab at something? (she gestures) I'd like you to truly focus on how sickened and embarrassed you feel… . A/What else would you say you are taking note? J/I'm dismal, so miserable. Nobody knows how hard this is or how terrible I feel. A/When you feel this tragic, and disturbing and embarrassed, how old do you feel? J/Anywhere in the vicinity of 10 and 13. An/Is there anything you might want me to think about you? J/Just that nobody knows how hard this is for me. A/Do you have anybody to converse with? J/(shakes her head) [More tears… then influence subsides]

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J.B. proceeded with A/Would you have a go at something else? (gestures) I'd like you to sit somewh