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Anthony Quintiliani, Ph.D, LADC

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May 25, 2017 By Admin

Using Cognitive Defusion in Mindfulness Psychotherapy

Cognitive Defusion in Mindfulness Psychotherapy

A well-meaning therapist might ask: What is cognitive defusion. Well this practice, as used in Acceptance and Commitment Therapy, is beyond cognitive restructuring of cognitive distortions and automatic negative thoughts ( I call “Red Ants”). The practice concretely de-literalizes the personal truth and meaning of unhelpful, repetitive thoughts and words. As The Buddha warned: We probably should NOT believe the distinctions of thoughts in our heads. Our strong thoughts may be our best friends or our worst enemies. In neuroscience the fact that more negative than positive thoughts occur in humans implies we are more attached to limbic reactivity and fear than to positive thoughts and emotions. When we get stuck in negative cycles of thinking, feeling and doing our right brain and limbic area dominate. A very old mindfulness belief is that you are not your thoughts, your emotions, or your behaviors; these parts of you are simply associated with your life experiences. When a client learns to defuse a though it means they have changed its linguistic structure and removed it from being cemented into their CABs, or cognition-affect-behavior cycles. In all good therapies, especially Cognitive-Behavioral Therapy and various mindfulness therapies (MBCR, DBT, MBCT, MBRP, ACT), helpers often work on truth-analysis of unhelpful, repetitive, negative thoughts patterns – especially those embedded into CABs cycles of ineffective experiences. Self-medication, isolation, and avoidance are commonly associated with these realities. Sometimes this work includes meta-cognitive analysis regarding your thoughts about your thoughts or the patterns of your thoughts. The clear logic is that the words we often tell ourselves in times of stress or fear are NOT often true. Of course, if indeed you are seriously endangered best to allow your limbic brain area to save your life. The list below will note various approaches used to defuse thoughts from our experience of being, our CABs cycles.

  1. Stay the thoughts out loud and mindfully notice the sensations, images, emotions, and associated CABs cycles that arise. Now say the words over and over again for at least half a minute. Note any changes that follow.
  2. Use scrambling of the phrase to change it grammatical brain-connections. Your brain should react a different way to the “scrambled” message. It is like changing the code of the phrase. For example: try saying “am person a bad” or “person I a bad am” instead of “I am a bad person.”  Notice what your brain-mind does now.
  3. Speed up and then slow down the rate of inner and outer speech. Try all four options; notice any relief you have obtained.
  4. Reduce then intensify your energy level when saying the phrase. Notice, again.
  5. Elongate the sounds of the key words in your phrase.  Keep elongating and notice what happens. Elongate and slow as far as you can.
  6. I like this approach. Change the most important one or two words in your phrase.  Now say the phrase out loud with one or two slightly less harsh words.  You will need to repeat this technique for effects. For example: “I am so worthless” helps solidify your brain plasticity about personal meanings and images. Try this: “Sometimes I feel worthless” or “When really bad things happen, I can feel worthless”  or “My unpleasant feeling can relate to feeling less worthwhile.”
  7. Change the language code of your key word/s. For example: change “I am a terrible person” to “I am a spanty person.” Spanty being Czech for terrible or bad.  Notice how the brain/mind/body responds to this simple change.
  8. You could also sing your statement, or say it in a foolish voice tone.
  9. I have used defusion and added body movements to the process. Here are four examples.

A) Find a spot on the floor where you try to project all your bad feelings about your repetitive phrase. You are consciously projecting the bad feeling into the spot on the floor. Now stand in it and notice how your mind body reacts. Slowly, but with some bodily energetic force, step out of the spot on the floor.  Notice the effects.

B) Stand in the same spot, and pretend you are taking off a pair of pants – BUT when you are out of the imaginary pants, immediately step aside. Notice.

C) Find a pleasant place to go for a brief walk. Enjoy the environment, but say your statement to yourself. Split your attention in two: attention to the beauty of the walk (and watch your step), and attention to repeating your phrase. Notice any changes and shifts that occur.

D) This one is out-there but fun. Energize yourself (if healthy enough) into a rapid skipping movement. At the same time say your phrase, and pay attention to where you are skipping. Your body will respond by contrasting the negative statement against the body-memory of good-old skipping. For most adults, skipping was a fun thing to do. Notice the effects.

For more information refer to: Blackledge, J. T. (2015). Cognitive Defusion in Practice: A Clinician’s Guide… Oakland, CA: Context Press/New Harbinger, pp. 3-42, 87-109, 159-162.

Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

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New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Clinical Practice, Clinicians, Cognitive Behavioral Therapy, Featured, Ideas & Practices, Meditation, Meditation Activities, Mindful Awareness, MIndfulness, MIndfulness Activities, Mindfulness Training, Psychotherapy, Therapy, Therapy Tagged With: ANTHONY QUINTILIANI, COGNITIVE DEFUSION, MINDFUL HAPPINESS, MINDFULNESS

December 17, 2016 By Admin

Supervision and Self-Care in Trauma Therapy

Supervision and Self-Care in Trauma Therapy

Today there  is an ever-increasing demand for effective trauma therapy.  Our American clinical history on this matter leaves much to be desired. John N. Briere and Cheryl B. Lanktree offer important suggestions on how to use clinical supervision and self-care in your clinical work with clients suffering from serious psychological trauma. Here in a nutshell is what they noted. For a more detailed review, please read the cited  material on your own.

Supervision and self-care include the following:rain-mindfulhappiness

  1. Supervisors work on emotional reactions common in trauma therapy;
  2. Guidance and working through unhelpful thoughts, feelings and behaviors;
  3. Use of clinical documentation as a metaphor for structure and true liability protection;
  4. Problematic boundary issues;
  5. Obtaining social-emotional support from others, especially a clinical team;
  6. Participating in personal psychotherapy as needed;
  7. Using mindfulness skills (especially T. Brach’s 2013 RAIN process) in trauma work – both with clients and as self-care;
  8. As a reminder RAIN includes Recognition, Acceptance, Investigation, and Non-Identification when dealing with highly stressful immediate experiences;
  9. Maintaining a personal practice of effective self-care in your work and in your life outside of work.

In addition, they note specific and repeated clinical interactions that help clients but may also deplete emotional and energetic resilience in therapists.  These include attention to:

mindful-happiness-r-a-i-n

  1. Caretaker issues – supports, emotions, energy;
  2. General environmental and relational safety;
  3. Specific risks regarding dangerous behaviors;
  4. Anxiety, depression, grief, anger and other emotionally dysregulating conditions;
  5. Poor sell-concept, low self-esteem, and various self-identity problems;
  6. Various acting out and acting in situations;
  7. Suicidal and self-harm risks and behaviors;
  8. Consequences of various attachment problems and deficits;
  9. Social, school, and family adjustment conditions;
  10. Various somatization complaints; and,
  11. Psychosexual preoccupation, stress, and behaviors.

It is quite obvious that while working with these serious conditions and symptoms, trauma therapists would remain at considerably high risk for vicarious traumatization.  Thus, the need to maintain regular effective clinical supervision and good self-care practices are of utmost importance to psychological survival of the therapist.

For more information refer to Lanktree, C. B. and Briere, J. N. (2017). Treating Complex Trauma in Children and Their Families: An Integrative Approach. Los Angeles,CA: SAGE Publications, pp. 220-246.

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, VermontChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Benefits of Mindfulness, Clinical Practice, Clinical Supervison, Featured, Leadership, MIndfulness, Mindfulness Training, Self -Kindness, Self Care, Therapy, Therapy, Trauma Tagged With: MINDFUL HAPPINESS, R.A.I.N., SELF CARE, TRAUMA THERAPY

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