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					Facilitating the Capacity for Intimacy and
  Connection from the IFS Perspective

                 IFS Conference
              Friday, October 22nd

                  Mark Schwartz, Sc.D.
     Castlewood Treatment Center for Eating Disorders
                   800 Holland Road
                     636-386-6611
                 www.castlewoodtc.com
                    mfs96@aol.com

                                            1
2
3
Inter-Psychic Intimacy (between the couple)

                     vs.

Intra-Psychic Intimacy (within the individual)




                                   4
Intra-Psychic Conflict

  Extension of intra-psychic conflict onto the stage of the outer
  world often manifests itself in interactions with others that
  cannot strictly be called interpersonal, because they are
  essentially extensions of the individual’s problems from the
  past. These problems are played out using another, not for his
  or her real self, but as an involuntary actor cast in a role from a
  scenario the patient repeats in the present in order to avoid past
  memories and feelings.
  From Masterson, J & Orcutt, C. (1989). Marital Co-Therapy of a Narcissistic
  Couple. In J. Masterson & R. Klein (Eds.), Psychotherapy of the Disorders of the
  Self. New York: Brunner/Mazel


                                                             5
The fantasy bond is formed originally in early childhood as a substitute for
love and care that may be missing in the infant’s environment. It is highly
effective as a defense because a human being’s capacity for imagination
provides partial gratification of needs and reduces tension. The illusion of
being connected to the mother (or primary caregiver), together with self-
gratifiying, self-soothing patterns such as thumb-sucking, nail-biting, and
excessive masturbation are an attempt to heal the fracture in separation
experiences and compensate for emotional deprivation. Such behaviors
lead to a posture of pseudoindependence in the developing child, an
attitude that “I don’t need anyone, I can take care of myself.” The irony is
that the more an individual relies on the fantasy process, the more helpless
or ineffective he or she becomes in the real world. The more seriously
children are deprived, the more they depend on the fantasy bond as a
compensation and reject genuine closeness and affection from others.

              Fireston, Robert W., Creating a Life of Meaning and Compassion

                                                          6
People go to great lengths to maintain the illusion of connection.
Many select mates who remind them of their parents to try to
recreate their past. They ignore their children’s individuality and try
to mold them into an image of themselves in an attempt to achieve a
kind of immortality. Others work compulsively, take refuge in
routines, or choose addictions to avoid real experiences that threaten
their illusions. In contrast, individuals living a self-actualized
existence discover what lies beyond defenses and illusions of
connection. They make real contact and establish genuinely loving
relationships with actual people in real life in spite of the awesome
specter of existential aloneness and interpersonal pain.

         Fireston, Robert W., Creating a Life of Meaning and Compassion



                                                    7
Attachment Trauma

 The psychologic distress underlying the craving is the result of
 an inability to metabolize negative emotions utilizing the
 attachment system (Fosha, 2003; Neborsky, 2003). Successful
 therapy restores secure attachment which allows for intimate
 relationships to utilize for self-soothing. Injury to the
 attachment system is the result of difficulties between the
 caregiver and child that results in segregated systems of
 attachment and dissociated self-systems. The result is a variant
 of narcissism or a false-self personality organization as a means
 of avoiding the need for attachment.


                                                8
Assumptions Regarding Relationships
Freeman, 1992

 Unfinished business - is a present emotional reaction shaped by a
 past experience. It is a reactive response guided by strong emotional
 feelings based on past experience of anxiety. Unfinished business
 does not allow for a thoughtful, creative response to a here and now
 situation; rather, it triggers an emotional, reactive response. Who we
 bring into our life, our major life decisions, how we embrace
 important people and the amount of closeness and distance we need
 emotionally are all shaped by unfinished business carried into adult
 life. Relationship problems are more a reflection of unfinished
 business than expressions of lack of commitment, caring and love.



                                                    9
 The child’s first relationship acts as a template, and it molds
the individual’s capacities to enter into all emotional
relationships. Development essentially represents a number of
sequential, mutually driven, infant-caregiver processes which
occur in a continuing dialectic between the maturing organism
and the changing environment. It now appears that affect is
what is actually transacted within the mother-infant dyad, and
this highly efficient system of emotional communication is
essentially non-verbal.
                                      (Alan Schore)



                                               10
Secure Attachment I
L.Alan Stroufe, 2000

  • Because their caretakers have been routinely available to them,
  sensitive to their signals, and response with some degree of reliability
  (though by no means is perfect care required), these infants develop a
  confidence that supportive care is available to them.
  •They expect that when a need arises, help will be available. If they do
  become threatened or distressed, the caregiver will help them regain
  equilibrium.
  •Such confident expectations are precisely what is meant by attachment
  security.
  •Secure Attachment (earned) with self.




                                                         11
Secure Attachment results from a “critical mass” of
Self-led Parenting.

The “Template” is less constrained because there is greater:
Attentiveness
Attunement
Accurate Responsiveness
Access to a range of affect
Acceptance for that which is normative and healthy in children
and humans in general



                                                12
Secure Attachment thereby requires:

Less “Exiling” in order to obtain the available
resources of the Attachment Environment.




                                  13
14
In Secure Attachment

Burdening is lessened. When loss or trauma or life’s harshness
occur, mitigation and assimilation are more possible.

Experiences can be absorbed due to the availability of the attachment
figure to:
1.   Patiently connect with the child
2.   Compassionately witness
3.   Register the impact of events upon the child at the time
4.   Affectively abide with the child without merging or abandoning
5.   Allowing the totality of child’s feelings: including fear, sadness, grief, fury,
     powerlessness, etc.
6.   Assist the child in arriving at accurate attributions
7.   Reinstate safety
8.   Remain in ongoing relationship


                                                                        15
Attachment Process in Eating Disorder and Depression
Main, 1990

 Deactivation (avoidant) can be maintained through actively
 diverting attention from attachment issues and distressing
 childhood memories. A second major type of defensive
 strategy develops when an individual perceives attachment
 figures as inconsistently responsive. To maintain the
 relationship with this type of caregiver, an individual
 hyperactivates (pre-occupied) the attachment system to
 constantly monitor the attachment figure and maximize the
 output of the attachment system.


                                              16
In Avoidant Attachment, Protectors Dominate, to
      - Minimize needs
      - Dismiss necessity for intimacy
      - Create pseudo-independent or pseudo-mature stance
      - Keep vulnerability and longing at bay
      - Restriction
In Pre-occupied Attachment, Exiles are allowed expression,
however, satiation is not possible due to unavailability of Self,
first in caregiver, later internally. So, while there seems a heavy
emphasis on relationship, there is a going through-the-motions
quality an orchestrated pseudo-self as-if quality: food without
nourishment, relationships between objects.
        - Get all you can, but it’s never “enough.”

                                                  17
Disorganized Attachment

  Drawing close to the other is thus accompanied by the
  expectation of re-experiencing the anxiety of unpredictable
  availability, the fear that allowing oneself to ask for and
  obtain care may mean giving up one’s identity and
  independence.




                                               18
Ogawa Research

• 126 children with disorganized attachment followed until age
  19. Prediction of Dissociative Disorder from maternal
  unavailability and disorganized attachment in the first 24
  months of life was more predictive than trauma. Trauma
  history did not add to the prediction, of dissociation after
  disorganized attachment.
• Specifically maternal Dissociative symptoms, disrupted
  maternal affective communication, maternal lack of
  involvement at 12 months, significantly contributed 5 other
  measures non > 19.


                                                19
Disorganized Attachment

  The difficulties encountered during the complex process of
  social adjustment, poor flexibility and resilience in facing
  life’s painful events, the possibility of building a sense of
  self that is coherent and integrated, of producing a fluid and
  coherent narration, ultimately psychopathological suffering
  itself, seem to point to the attachment pattern as an
  important aetiopathogenic factor.




                                                 20
Dissociation
( Liotta, 2000)


• Early dyadic processes lead to a “primary breakdown” or lack
  of integration of a coherent sense of self, i.e. Unintegrated
  internal working models.
• Disorganized attachment is the initial step in the development
  trajectory that leaves an individual vulnerable to developing
  dissociation in response to trauma.




                                                 21
Disorganized Attachment in the Internal System
•   Chaotic Internal System
•   Extremists
•   Inconsistency
•   Who am “I”?
•   Rigidity (in lieu of consistency)
•   Air-Tight Compartmentalization
•   Warring Factions
•   Repetition
•   New Learning Difficult to Integrate
•   One Miserable Thing Leads to Another


                                           22
“Trauma related to structural dissociation then, is a
deficiency in the cohesiveness and flexibility o the
personality structure. The lack of cohesion and integration
of the personality manifests itself most clearly in the
alteration between the vivid re-experiencing of the
traumatic event and avoidance of reminders of the
traumatic experience.”

                              (van der Hart et al., 2006)



                                             23
Repetition
Alice Miller

   Nevertheless, the need to repeat also has a positive side.
   Repetition is the language used by a child who has remained
   dumb, his only means of expressing himself. A dumb child
   needs a particularly empathic partner if he is to be understood at
   all. Speech, on the other hand, is often used less to express
   genuine feelings and thoughts than to hide, veil or deny them
   and, thus, to express the false self. And so, there are often long
   periods in our work with our patients during which we are
   dependent on their compulsion to repeat - for this repetition is
   then the only manifestation of their true self.


                                                   24
Every deep desire, every powerful emotion, gives a trail
into the unconscious. Usually there is only one-way
traffic: outbound, toward the world of sensation and action.
But we can follow the trail to its source by going against
the current. With this desire to go against desire, to buck
the demands of biological conditioning, the journey of self-
realization begins in earnest.

                                   Meditation in Action
                                   Eknath Easwaran


                                           25
“…it is normal and healthy for the individual to be able to
defend the self against specific environmental failure by a
freezing of the failure situation. Along with this goes an
unconscious assumption (which can become a conscious
hope) that opportunity will occur at a later date for
renewed experience in which the failure situation will be
able to be unfrozen and re-experienced, with the individual
in a regressed state, in an environment that is making
adequate adaptation.”

                      (Winnicott Collected Papers, p. 281)

                                         26
“SELF-EMPATHY” - The internalizing
  (evoking) of the attentive, validating, caring
  relationship to oneself. This involves
  helping the client articulate her experience
  and bring it into her own internal relational
  context.



                                  27
Parts of Self


      Therapy involves helping the client reclaim parts
      of self that were sacrificed to gain safety.

      In therapy, we create a context and relationship
      where pain, anger and difficulty can be safely
      acknowledged while maintaining a connection.




                                            28
Target Symptoms For “Earned Secure Attachment”

   1.   Turning towards other people for self-soothing and
        intimacy.
   2.   Establishing a coherent narrative regarding one’s
        life.
   3.   Establishing metacognitional thinking in relation to
        family of origin.
   4.   Minimize idealization and family loyalties.
   5.   Establishing clarity with regards to self and self in
        relation to significant others
   6.   Resolution of significant losses in one’s life.


                                                29
Adult Attachment

1. Describe your relationship with your parents as a young child (i.e., derogation,
   relevance violation, loving).
2. 5 adjectives to describe your relationship with mother/father as young child (i.e.,
   idealization, dysfunctional).
3. Your first remembered separation from parent.
4. Ever frightened or worried as a child?
5. Did you tell your parents?
6. Any close relatives or loved one die?
7. How did you respond?
8. Do you think loss has had an affect on your personality?
9. What is your relationship like with your parents now?


                                                                  30
Refer to Handout on
 Adult Attachment
       Protocol

                31
Affect and Cognition I
Van der Kolk, Brown & van der Hart, 1989



      Janet believed that traumatized individuals became
      phobic about memory because they have failed to
      develop narratives about their traumata, instead
      experiencing posttraumatic amnesias and hyperamnesias




                                              32
State of Mind Regarding Attachment

COHERENCE: (truthful, succinct, relevant, clean)
  Steady flow of ideas, intent thoughts, feelings, clear truthful, consistent,
  plausible responses, completed, but not long.

COLLABORATIVE:
  Speaker appears to value attachment relationships and experiences

CONSISTENCY:
  Descriptions of relationships with parents are supported by specific
  memories.



                                                             33
Metacognitional

    Metacognition means treatment of one’s mental contents
    as “objects” on which to reflect, or in other words
    “thinking about one’s thinking.” Distinct skills
    contribute to its characterization, such as the ability to
    reflect on one’s mental states, elaborating a theory of the
    other’s mind, decentralizing, and the sense of mastery
    and personal efficacy.




                                                34
Intra-Relational

• Relatedness
1.   Fostering empathy for dissociated parts of self.
2.   Tracking of intra-relational patterns – internal abandonment, ridicule.
3.   Understanding survival function of parts of self.
4.   Resolution of internal conflicts.
5.   Internal witnessing, reduces shame and aloneness.
6.   Affect regulation between internal dyads.


• Emotional Processing
7.   Recognition that different parts of self encompasses different defense strategies, divergent
     emotions and divergent attachment schemes.

• Meta Therapies
8.   Recognition that different parts of self encompasses different defense strategies, divergent
     emotions and divergent attachment schemes.


                                                                         35
Attachment Therapy for Groups: Concepts and Methods
 Week 1: Idealization and Family Loyalty
 Definition: Idealization – the discrepancy between the overall picture or presentation of the parent and the readers
    inferences regarding actual behavior of the parent.
 Week 2: Rejection and Neglect
 Definition: Define rejection and neglect by AAI standards
 •   Reject – child goes to attachment figure with tender feelings and emotions and parents turns away the child’s
     expression of the emotions “I’ll give you something to cry about…”
 •   Neglect – parent is physically available but inaccessible emotionally/psychologically unavailable
 Week 3: Loving Behaviors
 Definition: The attachment figure is dedicated to the development of the child as a person and is emotionally supportive
    and available. Loving behavior vs. instrumental love vs. non-loving behaviors.
 Week 4: Involving and role reversal
 Definition: Define involving and role reversal by AAI standards
 •   Involving – parent uses child attachment system to become the object of the child’s attention
 •   Role reversal – more severe form of involving behavior; the parent uses the child in the role of a spouse or parent, for
     their own emotional needs



                                                                                             36
Attachment Therapy for Groups: Concepts and Methods
 Week 5: Caretaking behaviors
     Involving behavior on the part of our “caretakers” (parents, other attachment figures) can lead us into unhealthy caretaking behaviors in our
     relationships. Ex. From Alcoholics Anonymous language – Alcoholic as dependent, partner as codependent
 Definition: Caretaking behaviors deceptively (to self and others):
 • Keep people in a dependency relationship with you
 • Keeps you from dealing with your own issues
 • Require that everyone you care for must conform to your set of rules and norms about their life
 • Look good and proper on the surface but in reality are a subtle way of manipulating others to keep them under your control
 • Make you valuable to others who need your assistance, rescuing and help.
 Week 6: Caretaking vs. Supporting behavior
 Definition: Review from Week 5
 Week 7: Involving Anger
 Definition: Involving anger is the reason that when a thing happens in relationship, all the past hurt comes in and it feels as if it is a
    continuation or what always happens.
     Involving anger sounds like this… “ she was always trying to make me into a little doll that was always doing what she wanted, and she
     dressed me that way, and for awhile I acted that way, but I’m onto her now and I know what she’s up to and I’m sorry but I am not your
     little baby doll anymore.”
     Often longer, but even though it’s a short passage it would score a 6/9 for involving anger on the AAI
 Week 8: Passivity
 Partial Definition: The speaker appears unable to prevent sounds or phrases from arising while unable to specify it’s presumed intent or
    content



                                                                                                                 37
Therapist >         SELF

     Parts > Protectors > Exiles
              First Level   Second Level



          Intra-Psychic Intimacy
        Secure Attachment with Self


                                           38
Attachment Therapy for Groups: Concepts and Methods
 Week 1: Idealization and Family Loyalty
 Definition: Idealization – the discrepancy between the overall picture or presentation of the parent
   and the readers inferences regarding actual behavior of the parent.
 Purpose: How dismissive clients idealize their family-harmful effects for treatment
 Intervention: Role played a mini-AAI:
   Can you give me three adjectives regarding relationship with a parent and then specific
   supporting memories? (3 glowing adjectives with very little specific memories)
   When you were upset as a child what would you do? (Not go to parents due to their unloving
   behaviors)
   How do you think your overall experiences with your parents have affected your adult
   personality? (either is hasn’t or they made me stronger)
 Expressive: 3 chair expressive Narrative concerning struggle with family or parental loyalty; 1st
   chair-the loving nurturing parent, 2nd chair-the polar opposite behavior of the parent, 3rd client.
   Client sits any or all chairs and acts out all three parts.


                                                                            39
Attachment Therapy for Groups: Concepts and Methods

 Week 2: Rejection and Neglect
 Definition: Define rejection and neglect by AAI standards
 • Reject – child goes to attachment figure with tender feelings and emotions and
   parents turns away the child’s expression of the emotions “I’ll give you something to
   cry about…”
 • Neglect – parent is physically available but inaccessible emotionally/psychologically
   unavailable
 Intervention: Clients discuss these experiences in their childhood
 Expressive: Expressive around scene where child was rejected or neglected. Work
   with parts around this. Have self validate feelings.




                                                                 40
Attachment Therapy for Groups: Concepts and Methods

 Week 3: Loving Behaviors
 Definition: The attachment figure is dedicated to the development of the child as a
   person and is emotionally supportive and available. Loving behavior vs.
   instrumental love vs. non-loving behaviors.
 Intervention: Hakomi exercise: Bring to mind a loving individual in your life that you
   are willing to share with peers. Get in groups of 3-4. Each person gets 7 minutes to
   speak about this person with no interruption or feedback. When everyone shares, the
   last 7 minutes is for the small group to give feedback concerning how each person’s
   story had an impact on them.


   Group reconvenes and shares their experience of focusing on loving people and
   behaviors in their lives. If time permits, write down as many loving behaviors as
   possible and place them in the rating categories of the AAI loving scale.



                                                                  41
Attachment Therapy for Groups: Concepts and Methods
 Week 4: Involving and role reversal
 Definition: Define involving and role reversal by AAI standards
 • Involving – parent uses child attachment system to become the object of the child’s attention
 • Role reversal – more severe form of involving behavior; the parent uses the child in the role of
   a spouse or parent, for their own emotional needs
 Intervention: Pre-determined client shares a narrative regarding parental involving behavior.
    Questions for discussion:
 • What function do they serve?
 • Where do these behaviors lead to (present strategies)?
 • What can you do now (to step away from caretaking behavior)?
 Expressive: Laura




                                                                          42
Attachment Therapy for Groups: Concepts and Methods
 Week 5: Caretaking behaviors
    Involving behavior on the part of our “caretakers” (parents, other attachment figures) can lead us into
    unhealthy caretaking behaviors in our relationships. Ex. From Alcoholics Anonymous language – Alcoholic
    as dependent, partner as codependent
 Definition: Caretaking behaviors deceptively (to self and others):
 • Keep people in a dependency relationship with you
 • Keeps you from dealing with your own issues
 • Require that everyone you care for must conform to your set of rules and norms about their life
 • Look good and proper on the surface but in reality are a subtle way of manipulating others to keep them
   under your control
 • Make you valuable to others who need your assistance, rescuing and help.
 Intervention: Make a list of caretaking behaviors from the group and allow discussion as needed. Have clients
    answer the following (in writing):
 1.) What caretaking behaviors do I engage in? 2.) What purpose does this role serve for me personally and/or
     emotionally? 3.) How does this practice look like healthy behavior? 4.) How is it not healthy behavior for me
     and what are the consequences? 5.) Where/how did this behavior originate in my life?
 Expressive: Laura




                                                                                     43
Attachment Therapy for Groups: Concepts and Methods

 Week 6: Caretaking vs. Supporting behavior
 Definition: Review from Week 5
 Intervention: Caretaking demonstration acted out by staff – three scenarios, and
   discussion of each.
 1. Typical caretaking by clients in group
 2. Consequences of using your voice with a caretaker (shows what “strings” are
    attached)
 3. Appropriate resolution of issue between caretaker and the usually dependent person
    who decided to use their voice.
 Expressive: Laura




                                                                 44
Attachment Therapy for Groups: Concepts and Methods
 Week 7: Involving Anger
 Definition: Involving anger is the reason that when a thing happens in relationship, all the past
   hurt comes in and it feels as if it is a continuation or what always happens.
   Involving anger sounds like this… “ she was always trying to make me into a little doll that
   was always doing what she wanted, and she dressed me that way, and for awhile I acted that
   way, but I’m onto her now and I know what she’s up to and I’m sorry but I am not your little
   baby doll anymore.”
   Often longer, but even though it’s a short passage it would score a 6/9 for involving anger on
   the AAI
 Intervention and Expressive:
 1. Revisit – a scene from more recent adult life with an attachment figure (someone you care
    about, have emotions that could become vulnerable around) where a disproportionate amount
    of anger arose within you, seen in what you said or what you thought in the moment.
 2. Reinterpret (the anger) – break the scene down, view it in slow motion and see what parts are
    activated and find the origin of the involving anger. Attend to the angry parts as well as the
    injured parts that the angry one(s) protect.

                                                                           45
Attachment Therapy for Groups: Concepts and Methods
 Week 7: cont.
 Intervention and Expressive:
 3. Reevaluate the actions and intentions of the parties in the present scene from this new
    metacognitive perspective.
 4. Release – the anger towards the appropriate targets (e.g. two chair work)
 5. Revise – imagine a scene in the near future where involving anger could rear it’s ugly head…
 6. Rewrite – the script in coherent and collaborative form and read it aloud.
 7. Reintegrate




                                                                          46
Attachment Therapy for Groups: Concepts and Methods
 Week 8: Passivity
 Partial Definition: The speaker appears unable to prevent sounds or phrases from arising while unable to
   specify it’s presumed intent or content.
    One of the most surprising finds in early AAI’s was an implied passivity of though processes manifested by:
 • Overtly vague expressions suggesting an inability to find words or focus on a topic
 • Failure to complete sentences and lapse into silence or start a new one
 • Odd words or phrases added to the end of sentences
 • Wandering to irrelevant topics with no apparent reason
 • Indeliberate use of child speech or parental style of speech
 • Pronoun confusion between self and parent in recounting past episodes
 • These are not dysfluencies and common space fillers like “you know” or “like”…
 A hand reaches for a book, hesitates, then grabs it is a restart. A hand that reaches for a book and changes
    direction and grabs a glass is a redirection. These are also common in conversation. But a hand that reaches
    for a book, stops, then drops limp on the table is analogous to a sentence which is passive.




                                                                                   47
 In I.F.S., the more unburdening of these
“legacy” and personal burdens, the more
space for Self to re-enter. Decreasing
compartmentalization leads to an increase
in metacognitive capacities and
establishment of a coherent, cohesive
narrative.


                               48
Stuckpoints

   1.    How am I avoiding remembering?
   2.    How am I avoiding feelings?
   3.    How am I avoiding talking about it?
   4.    How am I minimizing?
   5.    How am I avoiding focusing on enjoying parts of life?
   6.    How am I avoiding noticing triggers that cause me to hurt
         self?
   7.    How am I avoiding dealing with current life stresses?
   8.    How am I still protecting those who hurt me?
   9.    How am I avoiding being close to others?
   10.   What secrets have I not yet discussed?
   11.   How am I fighting my therapist and working my program?

                                                      49
                Schema-Focused DX of Personality Disorders
                               Hyper-Criticism &             Subjugation &              Over-Protection &
 Other Directedness
                               High Expectations               Inhibition               Over-Involvement
Emphasis on self-denial      In areas of performances    Over controlled by others    Parents over involved in
people pleasing, over        & achievement,              restrained emotionally       life situations, fostering
emphasis on needs and        hypercritical, high         inhibited, rule-bound        dependence, discouraging
opinions of others           expectations for            given little freedom of      autonomy, enmeshing,
                             achievement, shames or      expression                   worried, over concerned
SCHEMAS: self sacrifice      unloved for inadequate                                   with danger
approval and recognition     performance.                SCHEMAS: Subjugation,
seeking                                                  over control, punitiveness   SCHEMAS:
                             SCHEMAS: unrelenting                                     Dependence/incompetence
                             standards, failure, error                                , vulnerability to harm and
                                                                                      illness enmeshment.
  Disconnection &              Over-Indulgence                     Lack of Safety & Stability
     Rejection
In area of intimacy &        Spoiled, undisciplined      Mistreated, abused, lied to, betrayed, manipulated,
closeness, child is                                      humiliated, abandoned, environment characterized by
emotionally deprived,                                    instability, unpredictability, danger.
socially isolated, made to
feel bad, unlovable                                      SCHEMAS: mistrust and abuse

SCHEMAS: emotional
deprivation, social
isolation
                                                                                 50

				
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