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Anthony Quintiliani, Ph.D, LADC

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March 22, 2020 By Admin

ACT – The Absolute Basics; Acceptance & Commitment Therapy

ACT – The Absolute Basics; Acceptance & Commitment Therapy

In this post I begin a series of writing dealing with ACT, Acceptance and Commitment Therapy. The details below are basic, but perhaps just enough to develop more interest in learning about ACT. Here we go!

1) Act, developed mainly by Steven Hayes Ph.D.and based on a foundation of Relational Frame Theory, uses both language and cognition as key components of therapy. However, ACT goes much further than RFT.

2) Act utilizes the Hexaflex Model to ground the therapy process. Within this model ACT focuses on flexible contact with the present moment, no matter what that contact is. It suggests that acceptance of difficulties works better than avoidance of them, in fact showing how avoidance of personal problems often makes condition worse emotionally. Self-as-context is emphasized. The focus is on cognition, emotion, and behavior of the person seeking help. Values are used in congruence with motivation, and cognitive diffusion is taught to free the person from deep “stuckness” in unhelpful thoughts. Finally, once a behavioral action plan is agreed upon, ACT works to obtain clear commitment to action by the person who is suffering. In summary, ACT does its best to reduce/eliminate cognitive and behavioral inflexibility. Ultimately, ACT strives to enhance and expand psychological flexibility on the part of the person seeking help.

3) ACT emphasizes the utter importance of a strong clinical relationship, alliance and trust in therapy. Without such a therapeutic relationship, it is unlikely there will be constructive, positive change.

4) Act utilizes helpful metaphors and reinforcing clinical interventions to support positive change. Act intends to reduce the power on unhelpful verbal rules used by the person hoping to change. For example, ACT notes the hopeless futility of avoiding personal problems and works to get the person unstuck from unhelpful thoughts, emotions, and behaviors. With both personal acceptance of your own cognition, emotion, and behavior (they are important but they are NOT you) – and commitment to valued actions – ACT hopes to improve what needs to be changed in a collaborative relationship.

5) ACT skill building occurs in interactive experiential actions and experiments; ACT pays close attention to positive changes that may occur. In the process ACT is both interpersonal and intrapersonal in nature. With costs-benefits analysis and various forms of behavioral functional analysis, ACT supports personal goals and improved stimulus control via contingencies of reinforcement (very behavioral here).

6) ACT has shown effectiveness in dealing with depression, anxiety, and addictions. More recently, ACT has modified its approach to improve outcomes in trauma treatment. In this process ACT recognizes self-medication contingencies, the role of avoidance in making things worse, as well as intrusive cognitions, emotions, and behaviors. Act hopes to use skillful means (mindfulness in acceptance and defusion) to reduce rigid reactions and fears. Act is flexible enough to complement other forms of evidence-based therapies.

For more information refer to Harris, R. (2019). ACT Made Simple. Oakland, CA: New Harbinger Publications or the various articles and book written by Steven Hayes on this topic.

Anthony R. Quintiliani, PhD., LADC  

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: ACT - Acceptance & Commitment Therapy, Featured, Therapy Tagged With: ACCEPTANCE AND COMMITMENT THERAPY, ACT, ANTHONY QUINTILIANI, MINDFUL HAPPINESS, MINFUL HAPPINESS, THERAPY.

May 31, 2019 By Admin

More on Yoga Nidra

More on Yoga Nidra

Yoga nidra is sometimes called yoga sleep or yoga relaxation. It is a very powerful mindfulness technique that allows one to relax the body and limbic brain area, while holding mental control for deeper relaxation and projective practices without falling asleep. For some it may be like lucid dreaming, but a state that remains focused on the physical, energetic, and psychic body. In mindfulness terms, this is a state of deep relaxed awareness. Advanced practices use projective techniques outside the body. One asset of this practice is that it allows us to retain cognitive awareness as the body and brain waves shift into more subtle states. Once we are in the subtle energy field, the body-mind may be altered with relative ease. The ancient practice helps practitioners to improve physical conditions, injuries, energy homeostasis, and to awaken dormant energies.

Ideally this practice is done in a laying down position, so the body can conserve energy. Laying on your back is called savasana, the course pose – being very still like a corpse. The use of blankets and cushions may improve comfort. It may also be done in a comfortable sitting position. During practice it is important not to move the body in any way; this is a goal even if uncomfortable sensations arise. Our job is to observe the movement of inner energies without physical or mental reactions, thus allowing a more expansive meditation experience.

Stages of Yoga Nidra

In the first stage of practice, we engage in a progressive body scan to relax and harmonize the physical body. This allows gross or non-subtle energy to move out of the body so the physical body is completely relaxed. We may feel the tension leaving our mind and body. This alone may enable one to experience waves of deep relaxation and peace of mind. However, this first stage is simply preparation for other yoga nidra techniques. If practice time is extended, sometimes people experience a drop in body temperature.

In the second stage, the practitioner will be guided into other subtle energy experiences. These may include sensory awareness and manipulation, chakra awareness, visualizations, awakening energy techniques, and projective experiences. In the more advanced yoga nidra techniques, it is important that the teacher possesses ample experience in doing these practices. A good reason for this is that while being in deeper energetic systems of the body, a person’s stored tensions, memories, and perhaps karma may be released. Participant safety is a priority, so the teacher must observe closely to notice signs the practice is going beyond the practitioner’s capacity.

Yoga nidra is a powerful body-based technique that may improve access to subtle energy as well as cognitive and physical functioning. It can be a very powerful, healing meditation.

Anthony R. Quintiliani, PhD., LADC  & Brian Tobin 

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont and the Home of The Monkton SanghaChiYinYang_EleanorRLiebmanCenter

Author of Mindful Happiness  

Mindful Happiness cover designs.indd

New Edition of Mindful Happiness in Production…Coming soon!

Filed Under: Activities, Featured, Meditation, MIndfulness, Mindfulness Training, Sleep, Yoga, Yoga Nidra Tagged With: ACT, ANTHONY QUINTILIANI, BRIAN TOBIN, MINDFULNESS, SLEEP, YOGA NIDRA

March 11, 2017 By Admin

Object Relations Therapy for Trauma

Trauma: Object Relations Therapy

Object relations therapists, D. W. Winnicott especially, have presented a logical analysis on how to provide object-relations-oriented therapy to people suffering from the effects of psychological trauma. Such attachment-based trauma therapy provides support and healing from trauma, loss and long-term trauma-effects.  The interventions below combine the best of object relations therapy, mindfulness therapy (MBSR, ACT), and cognitive-behavioral therapy. Here is the listing of therapeutic functions and interventions.

  1. Provide support for “going-on-being” in the therapeutic alliance and the therapy itself. (Winnicott)
  2. Unconditional positive regard is a must. (Rogers)
  3. Recognize, work with and work through the splitting process as it activates in therapy. (Lineman)
  4. Safely and with effective skill help to re-connect the person with safe transitional space. (Winnicott)
  5. Carefully build and monitor the emotional “holding environment” in both alliance and therapy. (Rogers, Winnicott)
  6. Include contextual stimuli and symbols of the traumatic experience, from very general to specific and shift slowly over time. (Briere)
  7. Once there is a firm alliance and safety in the therapy, be more specific in exposure to traumatic experiences – monitor carefully. (Briere)
  8. In all exposure work, best to utilize SUDs scores from 0 to 100 – larger range between numbers allows deeper investigation and specificity.
  9. Work hard to understand and utilize body-based communications. (Ogden, Fisher, van der Kolk)
  10. Use mindfulness attention and skills (MBSR, ACT) to remain in The Middle Way between traumatic re-exposure and the safety of “going-on-being.” (Briere, van der Kolk)
  11. Check in with the experiences of transference and countertransference as you use images and defenses to support progress. (A. Freud)
  12. Use multi-sensory interventions in gentle, safe, re-exposure to traumatic materials – using one step removed and cognitive processes first. (Quintiliani)
  13. If skilled in its use, utilize the Attachment-CABs-VAKGO-IS-Rels formula for interventions. (Quintiliani – see mindfulhappiness.org for more details)
  14. Using items #s 8-13 above, aim for development of a safe cognitive schema and narrative clarification about the traumatic event/s.
  15. Work closely with the person to help them internalize the growth-benefits of all of the above. Take time with this process.
  16. Be a “good object” and always return to safety over and over again – check-in and stabilizes often.
  17. Slowly and with safety move up the hierarchy of trauma exposure process, possibly experiencing the full array of sensory experience. (Briere, Foa)
  18. Listen, support emotionally, radically accept, validate and understand the process and the person. This is your best way to develop a “good enough” self-object via “transmuting internalization.” (Kohut)  Various mindfulness and CBT skills will be used here.
  19. Use mindfulness and good CBT to make space for acceptance and validation for post-traumatic growth. (Lineman)
  20. Help to impact these positive changes into a “different” memory system as you expand and deepen the narrative.
  21. Support and directly reinforce (behaviorally) the improved self – a “felt sense” of a healthier self psychologically and physically.
  22. Place more and more safety into the transitional space, and generalize this process into therapy and life practices.
  23. Finally, expand the person’s capacity for pleasure, joy, self-esteem, success and HAPPINESS before therapy ends.

For more information refer to Savage Scharff, J. and Scharff, D. E. (1994).  Object Relations Therapy of Physical and Sexual Trauma. Northvale, NJ: J. Aronson.

Note: The ideas have been presented in this text, but I have added more current interventions and details based on new research and treatments.

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: Activities, Featured, MIndfulness, MIndfulness Activities, Mindfulness Training, Object Relations Therapy, Therapy, Trauma Tagged With: ACT, COGNITIVE BEHAVIORAL THERAPY, D.W.WINNICOTT, MBSR, MINDFULNESS, OBJECT RELATIONS THERAPY, THERAPY., TRAUMA

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