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PLACE/HOME IN UNIVERSEAmsterdam 2009

PBSP & Attachment TheoryComparative Exercise Study

Petra Vrtbovská Ph.D. Natama – Institute for Family Care Development, Prague

Project is supported by Teresa Maxova Foundation Prague

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WHAT WILL BE COVERED?

Method: Comparison of some phenomenological issues in AT and PBSP

PLACE, our HOME, in our mind and bodyAttachment Theory Basics & PBSPCircle of Trust & Shape – Counter-shapeEarly development (0 – 3 - 5), implicit memory

and its impact on „place – home“Attachment disorders in PBSP structures

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Within two (or more) referential frameworks:

Helps to discover phenomenological equivalents and similarities

Helps to discover fundamental differences

COMPARATIVE APPROACH

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TWO FRAMEWORKS

PBSP focuses on and defines :

Developmental needs and importance of interactive fulfillment of them

Principle of „interactive need satisfaction“

Consequences of deficits, trauma and holes in roles

Special effective therapy, which uses „Ideal Parents“ in order to change the impact of these consequences

ATTACHMENT THEORY and derived therapeutic practice focuses on and defines:

Importance of primary care giver (parental figure) for healthy development of personality (including neurobiology)

Principle of need satisfaction process

Disorders caused by neglect, abuse, trauma in early age

„Healthy Parenting Model“ as a healing tool for children and adults

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MAIN FOCUS TODAY

ATTACHMENT THEORY:AttachmentCircle of Trust, Circle of ShameAttachment disorders & therapy (DDP)

PBSPBasic needs – PlaceShape – counter-shape PBSP therapy and attachment disorders

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PLACE/„home“ in UNIVERSE

„The uterus is a place, which literally sustains and respects the child inside. Defines its location and identity. On a symbolic level, the place is in the heart of parents or care givers. Then in the stage of autonomy and self-reliance, we have place in our mind and body. We are „at home“ in our own mind and body…“

Albert Pesso„ One can sit in a beautiful garden and feel

desperation, fear, sadness, hopelessness…. As well one can feel very content, calm and hopeful in rather deserted places…“

His Holiness Dalajlama

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SUMARY OF ATTACHMENT THEORY

John Bowlby (1907 – 1990)Genetically based importance of a „mother

figure“ and relationship between a child and a „mother“

AttachmentSecure BaseInner Working Model

Mary Ainsworth (1913 – 1999)Strange situation (diagnosis – research)

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„ATTACHMENT“ PHENOMENON I

(c) 2009 Center For Family Development www.Center4FamilyDevelop.com 716-810-0790

How Does Attachment Develop?

1. Need

2. Meet Need

3. Gratificationor Relief

4. Trust

EriksonEriksonTrust vs. Trust vs. MistrustMistrust

Necessary I nput:(a) Eye Contact(b) Touch(c) Movement(d) Smiles“L

OVE”

The First Year of Life CycleThe First Year of Life Cycle

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„ATTACHMENT“ PHENOMENON II

„Attachment“ is an in born system in the brain that evolves in ways that influence and organize motivational, emotional, and memory processes with respect to significant caregivers“

„Repeated experiences become encoded in implicit memory (RH) as expectations and mental models…“ (Daniel J. Siegel)

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ENERGY-ACTION-INTERACTION-MEANING in a circle shape…

ENERGY ACTION

MEANING INTERACTION

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„ATTACHMENT“ PHENOMENON III

(c) 2009 Center For Family Development www.Center4FamilyDevelop.com 716-810-0790

Shame CycleRelationship in Sync

Child Transgresses

Parent repairs relationship

Child feels good

EriksonEriksonAutonomy v Autonomy v

ShameShameParent acts

sets limit

Child feels Shame

Child makes amends

Child feels Overwhelming shame

Abuse/neglect &No Repair

NegativeWorking Model

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TWO FRAMEWORKS

Pesso Developmental needs have to

be fulfilled at the right time, with the right people in a right way…

Memory of good experiences

Memory of deficits, trauma, holes in roles…

Bowlby It is important that (1) the

child's needs are satisfied and (2) the way they are

satisfied. By attuned, sensitive caregiver, the same loving safe person.

It creates a relationship between the carer and the child, this relationship is encoded as healthy „attachment pattern“ - secure base

Bad care is then encoded as a distorted relationship - attachment disorders…

The Developing Brain = Embodied Experience of Care

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Encoding in early age… RH

„Self-awareness, empathy, intersubjective processes are largely dependent upon… right hemisphere resources, which are first to develop.“ (Decenty, Chaminade Consciousness and Cognition, 2003)

„Unconscious right brain implicit self now described as „ a cohesive active mental structure that continuously appraises life's experiences and responds according to its scheme of interpretation.“ (Alan Schore, 2003)

Emotions = Meaning Memory of meaning Implicit memory , implicit „I“ = meaning of self

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THE TREE METAPHORE

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SECURE & INSECURE ATTACHMENT

Ainsworth: Secure attachment Insecure attachment:1. Avoidant, anxious2. AmbivalentMain, Hess: Disorganized- disoriented attachmentDSM – IV (USA)Reactive Attachment Disorder (RAD)Boston Group (Bessel van der Kolk…) Complex Developmental Trauma (CDT)

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ATTACHMENT in ADULTHOODChild attachment pattern

Adult state of mind with respect to attachment

Secure Secure/autonomous

Coherent, collaborative, valuing of attachment, objective

Avoidant DismissingNot coherent, dismissing attachment related experiences, normalizing, generalizing, brief, „emotionless“

Ambivalent Preoccupied

Not coherent, preoccupied, angry, passive, fearful, long tangled speech, irrelevant

Disorganized-disoriented

Unresolved/disorganized

Striking lapse in speech, reasoning, discourse

Base for serious personality disorders

Insecure attachments- what do we see?

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SECURE – INSECURE PLACE in UNIVERSE

„Children grow up with dominant experiences of separation, distress, fear and rage, then they will go down not just bad psychological pathway but a bad neurological pathway.“ (Watt, 2003)

„Sickness, insanity and death were the dark angels standing guard at my cradle and they have followed me throughout my life.“ (Edward Munch)

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BOTANICAL GARDEN

Taking our place with us everywhere…

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REACTIVE ATTACHMENT DISORDER (RAD) & CDT

RAD (is not just a disorder…)

It is a psychiatric diagnosis (USA, DSM – IV- R)Marked disturbed and developmentally

inappropriate social relatedness starting before 5 years

Excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses to people, indiscriminative friendliness

History of pathological care

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CDT - Complex Developmental trauma(Boston Group – Bessel van der Kolk)

Refers to the affects of early, chronic maltreatment in care-giving relationship

7 DOMAINS:1. Attachment (relational boundaries, lack of trust, social

isolation, difficulty to attune with others, lack of secure base)

2. Biology 3. Emotional regulation4. Dissociation5. Behavioral regulation6. Cognition7. Self-Concept

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Attachment based therapy approach

For developmentally traumatized children/ adults:

Dyadic developmental Psychotherapy (Daniel A. Hughes)Therapist – parent relationshipHealthy parent – child relationship

Rehabilitation of attachment relationship with a new safe adult (therapist) via relationship here and now.

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PBSP – comprehensive framework

PBSP describes and shows how parental care works on multidimensional level in all developmental phases

Memories of the process of shape – counter-shape and meaning are being stored through the whole childhood

The patterns „form“ the whole „model of autonomy“ of the person (PV)

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Does PBSP touch on attachment?

PBSP structure is from the AT point of view an unique „tool“, as

Within a structure session, the clients brain opens different phases of development, explicit as well as implicit memories of events, relations to carers and „self“.

The healing is done right „then“ with an „ideal attachment figures“.

It is working with memory layers (tree skins)

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HORIZONS & PRACTICE of PBSP with Attachment issues

Attachment disorder = overwhelming SHAME Clients with attachment disorders in PBSPCan PBSP heal attachment disorders and

complex trauma? PBSP and help for parents – healthy parenting

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PBSP and AT disorders, RAD, CDT

Practical outcomes for future work…

Research to evidence effectiveness of PBSP based on established attachment research

(AAP – Adult Attachment protocol)

PBSP introduced as an effective therapy for AT disorder based psychological problems