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From Vulnerable Child to Vulnerable Infant: Promoting Corrective experiences in very early maladaptive schema patterns

by Galit Goren Gilad, Diana Berindei, David Edwards & Maria Nulty

General Abstract:

This workshop will engage with the question: Can we connect with very early memories of infancy, birth and even before and can we provide corrective experiences to address situations of unmet needs? There will be three contributions.

Presentation 1

Title: Infant Modes in Practice

Presenter's Name: Galit Gilad

Abstract for Presentation 1:

Schemas are beginning to form from birth and even before. Yet little attention was given so far to portraying, identifying and reparenting vulnerable infant modes. The therapeutic relationship is changed when addressing vulnerable infant modes, since the reparenting required here is very different in reparenting vulnerable child modes: the expressions of vulnerable infant mode being non-verbal, emotionally unregulated, and oftentimes obscured by powerful and rigid infant coping modes. Consider, for example, the difference between an abandonment schema created in childhood (e.g. by a loss of a parent) and the same schema created in infancy and thus described as an anxious attachment style.

Schema therapy in its traditional form, is aimed at reparenting child modes, that is, reparenting using language, symbolic gestures and clear logic. Chair-work is relying on the patient’s conceptual ability – which is dormant while entering a vulnerable infant mode – and imagery relies on episodic memory which is non-existent before the age of three. Still, missing the opportunity to reparent these early modes of our patients may result in the persistence of some severe symptoms even after a significant amount of therapy.

This being argued in this short presentation, I will proceed by showing the main properties of vulnerable infant modes using clinical examples. Finally, two main directions for reparenting will be suggested. The first one, inspired by the work of D.W. Winnicott, is more demanding for the therapist, addressing the infant physical needs (e.g. physical proximity or presence) and may involve frequent contact with the patient between sessions, as well as physical regulation during the sessions (e.g. wrapping patient with a warm blanket). Another direction, inspired by Daniel Siegel's ideas, involves mindfulness techniques, and relies on building and then recruiting the healthy adult mode for reparenting and for emotional and physical regulation.

Presentation 2

Title: “It’s not safe to be touched” Reparenting for a crawling infant with a hostile, neglectful mother – a session report

Presenter's Name: Diana Berindei

Abstract for Presentation 2:

The focus of this presentation is a single session in which the client, whom I call Mihaela, made contact with herself as an infant at the crawling stage, in the presence of an enraged and emotionally dysregulated mother. After providing some background on Mihaela and her therapy process, I will describe how I was able to enter the image, confront the mother, and offer protection to the infant. After taking baby Mihaela in my arms and making sure she felt safe and her immediate needs were satisfied, I confronted the mother, who was quite unresponsive to my confrontation. At first, baby Mihaela wanted to protect her mother, but as she calmed down, still in my arms, she started to understand that her mother was wrong. I was able to tell her that she is a good, beautiful girl and she deserves to be loved, to have a calm environment, to feel safe and that it is the adult’s job to ensure that. At this point, Mihaela as Healthy Adult felt ready to enter the scene and care for the baby too. As she did that, she started to cry and felt really connected to the baby. After a while, she sensed a pair of critical eyes watching these tender moments and she felt ashamed. There was a child watching this who rejected this tenderness and physical affection. As we explored this, we found a 5-year-old shamed Mihaela, who felt threatened by the physical touch and tried to shut it out. The end of the session came was approaching, but I was able to guide some brief work with this experience, which is related to inappropriate sexual touching she had experienced from her grandfather.

Presentation 3

Title: “I don’t want to be born!” Rescripting a birth to heal an early dissociation

Presenter's Name: David Edwards and Maria Nulty

Abstract for Presentation 3:

David Edwards will briefly summarize some observations from Winnicott in 1949 on working with birth memories and the session will then focus on a single session of a client with Maria Nulty as therapist in which the client, who had been making rather slow progress in therapy, made contact with a dissociated part that did not want to be born. In the imagery work, and through guided rescripting, the therapist and client were able to welcome the unborn child into the world and give her the experience of being valued and safely held. The impact of this session on the client will be examined and some links to Winnicott will be briefly made as well as to others who have reported working with these kinds of memories.

About the Presenters:

Galit Gilad

Galit Goren Gilad is a Clinical Psychologist. She is a couple therapist and a certified schema therapist. She works in a private clinic, and had taught schema therapy in psychiatric hospitals, psychotherapy training programs and educational psychology centers. She is a co-founder of the Israeli Schema Therapy Society and a member of its board.

Diana Berindei

Diana Berindei is a Romanian psychotherapist with over 11 years’ experience running her own private practice with a broad spectrum of adult clients from across Europe. Diana works with individuals and groups and for several years has been part of a team of specialists who prepare clients to become personal development councilors. Diana is primarily certified as a cognitive-behavioural psychotherapist and clinical psychologist by the Romanian Psychologist`s College.

She is currently qualifying as a schema therapy practitioner. Her training also encompasses a five-year formation in positive psychotherapy (the Peseschkian method) a humanistic and psychoanalytic approach. This extensive training has offered her a deep insight into the human psychology and psychotherapeutic systems. Throughout her practice she has provided support for chronically ill patients as a clinical psychologist in multiple local medical clinics specialized in heart diseases and diabetes.

Diana believes in the power of healing that comes from within the person and sees psychotherapy as a process that can unveil and leverage this amazing human potential. As a result, psychotherapy plays an important role in developing the person`s capacity to acknowledge and live up to their own values and aspirations.

Diana has brought complex subject matters of human phycology to the public sphere, in an accessible way, aiming to remove some of the stigma of mental illness, writing journalistic pieces and making appearances on Romanian media.

David Edwards

David Edwards lives in Cape Town, South Africa, where he runs a training program in schema therapy through the Schema Therapy Institute of South Africa. He presents basic and advanced training workshops in schema therapy in South Africa and internationally. He also has an active private practice offering psychotherapy and clinical supervision. He is registered as a Clinical Psychologist in South Africa and the United Kingdom. He trained in cognitive-behavioural, humanistic and transpersonal approaches to psychotherapy, and has a longstanding interest in psychotherapy integration. He was fortunate to be introduced to schema therapy by Jeffrey Young, the founder of schema therapy, in the 1980s and has followed its development from its beginnings. He is an Emeritus Professor at Rhodes University, where, for over 25 years, he taught cognitive-behavioural therapy (including schema therapy) to trainee clinical and counselling psychologists, and offered intensive workshops to students using expressive therapies including psychodrama, clay sculpture, drawing and dance. Since his retirement at the end of 2009 he continues to work as a researcher and research supervisor. He has over 100 academic publications in the form of journal articles and book chapters.

The focus of many of these is trauma and complex trauma. Several of them are clinical case studies and he is one of the editors of Case studies within psychotherapy trials: Integrating qualitative and quantitative methods (Oxford University Press, 2017). He has also written articles and book chapters on imagery methods in psychotherapy and is the author, with Michael Jacobs, of Conscious and unconscious in the series Core concepts in psychotherapy (McGraw Hill, 2003). The focus of his current work is on the phenomenology of schema modes and understanding the deep structure of modes. This is reflected in a recent pair of articles on modes in a case of anorexia nervosa (Edwards 2017a and Edwards 2017b).

Maria Nulty

I spent 20 years as a Secondary School teacher, before qualifying as a Clinical Psychologist. During these years I gained much experience in understanding adolescents as well as the tensions which often exist between adolescents and their parents. After leaving the education sector I trained as a clinical psychologist at Rhodes University in South Africa and my Masters Dissertation on the stressors experienced by HIV/AIDS counsellors in hospitals was published with my supervisor, David Edwards, as co-author. I have been in practice for 17 years. For the first 12 of these, I was part of the Trauma Clinic network of psychologists. I received further training in working with trauma, and gained valuable experience in working with traumatized individuals who had been exposed to natural disasters, domestic violence, as well as crimes such as robberies and rape.

I have many years’ experience working in community settings (2004-2010), particularly in poor and under-resourced areas. This exposed me to many psycho-social-cultural issues and proved to be invaluable in teaching me to be resourceful and adaptable in diverse mental health settings.

I was a member of SASHA (South African Sexual Health Association) from 2005-2013 which has informed my work in areas such as sexual intimacy in relationships, feelings of sexual inadequacy, gender/sexual identity, and sex addiction.

I was introduced to schema therapy during my professional training at Rhodes University and subsequently completed the Schema Therapy training course with David Edwards in 2018. I have been part of a regular schema therapy supervision group since then and have also received individual Schema Therapy supervision and personal self-therapy since 2014.

Why Schema Therapy?

Schema therapy has been extensively researched to effectively treat a wide variety of typically treatment resistant conditions, including Borderline Personality Disorder and Narcissistic Personality Disorder. Read our summary of the latest research comparing the dramatic results of schema therapy compared to other standard models of psychotherapy.

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