• John Omaha posted an update in the group Neuroscience For Therapists 3 months, 3 weeks ago

    Here’s an example of integrating Coherence Therapy (CT) with the first of the seven skills of emotion regulation, a skill called Containment. The client is the husband in a couple that has come for help with conflict in their marriage. In Containment, the client, an Adult Child of Alcoholics (both parents) is asked to give an image of a container that would be sufficient to hold Every Disturbing Thing. He initially suggests a 50 gal drum and then increases it to a 9,000 gallon tanker trailer. He has real difficulty visualizing the filling process. He says he feels “blocked off from creativity.” Following CT protocol, I ask him to complete this sentence stem: If I put away Every Disturbing Thing…. and he adds “I won’t be preoccupied when we go on trips.” He also adds “I would be able to enjoy life.” I ask him to complete this sentence stem: I must not put away every disturbing thing because …. and he adds “I wouldn’t be able to take care of my responsibilities.” I put these together in a card reading, “I am becoming aware that I avoid putting every disturbing thing into containment because I won’t take care of my responsibilities if I do, and then I prevent myself from enjoying life.” As an ACOA, enjoyment of life in childhood was fraught and he apparently developed a rumination defense in which he managed anxiety by perseverating on his chores. Apparently enjoyment was also challenging in an alcoholic household and he used the same rumination defense to avoid the sadness when his parents’ drinking ended fun times.

    • Great example. I like the imagery of the containment - nice way to isolate the pro-symptom position. I assume then you look for a juxtaposition of that schema and something contrasting in his felt experience?

      • My work is also deeply influenced by the neuropsychology of the unconscious (See Efrat Ginot’s book of that name). Ginot calls the schemas like the client’s rumination defense “enactments.” Enactments are the key to the unconscious’s contents. My goal in using the Coherence Therapy tool was simply to raise an unconscious schema to awareness. Once it’s moved to the pre-frontal cortex, it can be evaluated and changed if it’s not working. The example I gave is from very early work with this client. Later we will develop more pro-symptom positions, e.g., his impulse to perceive his wife is attacking him when she’s just offering her opinion. Then we’ll create juxtaposition statements. I’ll follow up with more case material as this client moves along.

        • Thanks for that John. We’ve had Efrat in our magazine before (issue 16) - we must get her back.

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