The development of a psychopathological framework is generally not determined by a single factor, but is the outcome of a chain of events that includes both proximal factors, which act as direct causes (the loss of a job, the end of a relationship etc.), it is remote factors, which are placed in the patient’s past history and “prepare the soil” on which the disturbance will be structured.
Refer to the Historical vulnerability of a patient It means focusing attention on all those remote factors (of the past) who may have favored the development of a certain disorder and treat them in order to enhance the work on current symptoms and prevent the risk of a relapse.
In fact, the early experiences They play a leading role in determining negative images of themselves, which support the development of dysfunctional symptoms or behaviors; Depending on that one or more stressful life events meet this vulnerability, or not you can verify the symptomatic debut.
Collect information on the past
It is thanks to the clinical interview (in particular to the collection of life history), the use of tests and the present-parasotes emotional bridges, which we find information about the atmosphere characterizing the patient’s environment, in which the basic needs of attachment, protection, love, attention, attention, unconditional acceptance, praise and autonomy may have been frustrated.
This collection of information and their connection to current symptoms also allows you to understand why a certain problem emerged (anxiety disorders, relational problems that repeat themselves, deflection of mood, compulsive obsessive disorder etc.), which is finally explained to the light of the patient’s life history, and not as something that has “fallen from above”, of which the patient usually guesals.
Identify the interpersonal and family context, the educational and care styles, any traumatic experiences that the patient has experienced, is a first step in understanding his own disturbance or the problem that leads to therapy.
The use of experiential techniques to work on the past
Third generation approaches such as Therapy scheme (Arnetz, Jacob, 2013), Sensomotor therapy (Ogden, Minton & Pain, 2006), The Compassion Focused Therapy (Gilbert, 2005) and others, integrate a wide range of experiential techniques into their protocols. These tools can also be used outside a specific theoretical approach and favor the achievement of different objectives:
- provide the foundations to facilitate the interruption of the recursive processes that maintain the disorder;
- reduce the sensitivity of the patient to the sense of unworthiness, inadequacy, abandonment and loneliness that come from early experiences;
- overcome the obstacles of therapeutic change;
- prevent relapses.
To achieve these objectives and allow the well -being and improvement of the quality of life, the experiential exercises (in imagination and body) e dramaturgicalare particularly suitable for strengthening cognitive behavioral work centered on symptoms.
To summarize, the operations of the therapeutic intervention with patients who need a work on the “past”, can foresee two indissolubly connected levels together: one current one, which represents the patient’s photography in the here and now and one linked to past sensitized experiences, which led to vulnerability.
Some experiential techniques used in psychotherapy
Imaginative techniques
Imagory Rescripting (IMR) is an emotional-expanding procedure, developed by Smucker (1995) and subsequently re-processed by Arrntz and Weertman (1999) which has as its main objective the reduction of the intensity of dysfunctional nuclear convictions (“”I’m not lovable“”I am unworthy“), Associated with the painful memory and the acquisition of functional tools for the care of one’s needs.
It allows you to transform a negative image into a more positive event, thanks to the excitement of frustrated emotional needs in the past.
Thanks to the experience of revised memory, the patient is given the opportunity to change perspective on the problem, for example by changing the perception of the image of non -Amability.
Body techniques
Body exercises. By now we know that many of our physical habits (visceral sensations, postures, usual spontaneous gestures, facial expressions, muscle tensions) constitute the correlated body of the negative images of oneself (if I feel inadequate I will tend to have a curved posture).
The patient will help to experiment with new physical states and note that when the body responds well, ideas and emotions change, vialing towards the positive. For example, fear out of control of being judged can be reduced to a job on the body in which more toned states are experienced.
In general, the work can be done on:
- For example, take on a “power” posture (power poses) It helps to increase the feeling of greater strength, perceived efficacy, thanks to an intervention on posture and muscle tone.
- Exhaust (Lowen, 1975). Movements are unloading tension as “scrolling” arms and legs, they are useful movements to counteract the mental state of demolition and the hypoarousal, as they allow to revitalize the body, loosen the tensions and dissolve some muscle contractions, thus facilitating the feeling of vitality.
- Experimenting with the possibility of removing the other represented as a critic or, even worse, aggressive, can be very useful with patients with difficulties on these issues and make them experience security.
- When there is a tendency to hyperactivation exercises such as grounding are useful tools to learn to calm down, regulate the emotional states perceived as uncontrollable, feel stable, protected and safe.
- Specific physical activity. It is now known that martial arts, such as Chi Kung, Tai Chi Chuan, Jiu Jitsu are very useful practices to implement the issues of safety, strength, ability, presence to themselves. In the studio it is possible to propose some specific movements/action from here borrowed.
- Also yogto, He promotes awareness in patients and increases acceptance and tolerance of emotions, effectively improving emotional regulation.
The dramaturgical techniques
The Role Play It is a technique that consists in reliving a situation of the past, reminiscently remembered by the patient, starting a comparison with one or other subjects who act other roles. The main purpose consists in facilitating change through the development of new perceptions of self and the other.
The patient simulates in the space of the room interactions with others in the presence of the therapist, who impersonates the roles. Thanks to the involvement in new forms of dialogue they emerge ability to regulate one’s emotions and management of suffering.
For example, for a patient with a deep sense of inadequacy, to respond assertively to the critical and contemptuous boyfriend, leads to perceive the overall relationship as less problematic, at the same time feeling stronger, appreciable and capable of managing it.
The game of the two chairs
This technique that stands out from the previous one as there is a dialogue in which the patient makes both characters. In the dialogue between these parts, the patient leads to symbolically embody the moods or psychological positions present in his subjective experience, such as the alternation of a critical self to a positive nuclear image of himself.
The aim is to bring the patient to the dialogue between parts of himself. It is helped to identify the different characters, voices, positions, we try to give them a name, to outsource the dysfunctional parts and understand that they are innerizations of critical parts learned during its life history.
Conclusions
These techniques therefore have the great power to work on the past to improve the quality of life in the present. This is not just a treatment that analyzes what happened, but uses the rewriting of sensitizing events to work on the present and guarantee an improvement in the future.
Bibliography
- ARNTZ, A., Jacob, G., (2013). Therapy scheme in action. Theory and practice. Ist. Cognitive Sciences.
- ARNTZ, A. & Weertman, A. (1999). Treatment of Childhood Memories: Theory and Practice. Behaviour Research and Therapy.
- Gilbert, P., & Irons, C. (2005). Focused Therapies and Compassionate Mind Training for Shame and Self-Attacking. In P. Gilbert (ed.), Compassion: Conceptualisations, Research and Use in Psychotherapy (pp. 263–325). Routlegge.
- Lowen, A., (1975). Bioenergetics. New York, Coward, McCann & Geoghegan.
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. WW Norton & Company.
- Smucker, Mr, Dancu, C., Foa, Eb, & Niederee, JL (1995). Imagery Rescripting: A New Treatment for Survivors of Childhood sexual abuse suffering from posttraumatic stress. Journal of Cognitive Psychotherapy.
