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In-Congress Workshop 1: Saturday Early Afternoon and Saturday Late Afternoon (S2W2 & S3W2)

Addiction & Intimacy Disorders:Conceptualization and Connection in the Therapeutic Relationship Part 1&2

by Elizabeth Lacy


Aims:

Addictions and Compulsions can be some of the most difficult behaviors for both the client and therapist to understand, work through and heal. This is particularly true in sexual or intimacy disorders but is relevant to all chemical or process addictions. Addictions are often strong features in Borderline Personality Disorder and Narcissistic Personality Disorder, as well as other personality disorders causing destabilizing, destructive behaviors that impede corrective emotional experiences.

In this workshop we will be clarifying a case conceptualization, identifying core schemas and modes fueling addictive behaviors, learning effective interventions that heal schemas and strengthen the Healthy Adult. A special emphasis will be placed on working through the therapist’s own responses to working with this population who can trigger feelings of anger, outrage, frustration, shame and hopelessness.

Addictions and Compulsions can be some of the most difficult behaviors for both the client and therapist to understand, work through and heal. This is particularly true in sexual or intimacy disorders but is relevant to all chemical or process addictions. Addictions are often strong features in Borderline Personality Disorder and Narcissistic Personality Disorder, as well as other personality disorders causing destabilizing, destructive behaviors that impede corrective emotional experiences.

In this workshop we will be clarifying a case conceptualization, identifying core schemas and modes fueling addictive behaviors, learning effective interventions that heal schemas and strengthen the Healthy Adult. A special emphasis will be placed on working through the therapist’s own responses to working with this population who can trigger feelings of anger, outrage, frustration, shame and hopelessness.

Teaching Methods:

Using power point and video vignettes of client sessions for the didactic portion of the workshop, we will clarify terms, ideas and processes of the learning objectives. Role play demonstrations will be used with participants to illustrate how to implement techniques of assessment, core interventions and therapeutic styles in order to reinforce learning objectives. These will include experiential and other techniques. Participants will be encouraged to discuss their specific cases during the workshop resulting in live illustrations and role plays to further learning.
Self-soothing, thrill-seeking detachment and over-compensation modes present in sex, chemical or other addictions can trigger a variety of schemas and modes within the therapist, particularly when a client’s modes merge and are complex. Often intense ambivalence to change exists within the client, despite the devastation and pain it brings to themselves, partners and family. It’s often difficult for us to remain empathic. Normalizing responses within ourselves, yet recognizing these as schema and mode activations is imperative to successful outcomes in the treatment room.
Self-disclosure through real case examples and participant’s cases will be employed to create a safe environment to explore common reactions within the therapist. Clients with addictive disorders who employ these challenging modes and behaviors often provoke feelings of anger, inadequacy, frustration, shame and hopelessness within therapist, impeding the therapeutic process. Understanding oneself, healing one’s own schemas and empathic attunement through accurate case conceptualization will aide in the implementation of corrective emotional experiences.

Learning Objectives:

• Brief Overview of Schema Therapy
• Identify Core Unmet Needs, Schemas and Modes Common to Addictive Disorders
• Learn to do a detailed assessment and case conceptualization that addresses the unique issues of addictive disorders with a special emphasis on intimacy disorders
• How to identify whether the behavior functions as lifestyle choices or self-destructive behaviors, For example, polyamory vs intimacy disorder
• How gender can influence the appearance and assessment of behaviors
• Use the self-destructive behavior itself during assessment to identify the core unmet needs of the clients, particularly in the case of intimacy disorders
• Develop an understanding of the therapists “stance” within the context of the modes specific to addictive disorders, including empathic confrontation, limit-setting and limited re-parenting. It’s critical to understand the function and origin of the mode in order to make the right intervention in addictive disorders.
• Learn core intervention strategies that will help clients move from self-destructive, detachment and overcompensation modes to a more healthy adult mode while meeting the unmet needs of the vulnerable child
• Identify the merged detached-self soothing mode wit the overcompensation mode in sex addiction and compulsive affairs
• Practice core interventions to meet nascent developmental needs through corrective emotional experiences in the therapy room
• Connection in the therapeutic relationship is a core factor in all of schema therapy. However, tears often occur with this population because of reactions to behaviors that challenge our morals and values. Various methods of on-going assessment, mending and fostering of therapeutic connection will be demonstrated and practiced
• Identify common, understandable reactions in the therapist such as frustration, anger, shame, judgement or hopelessness specific to treating these disorders
• Using supervision, self-therapy and other methods to heal the therapist’s schema or mode activation in order to be more effective in the treatment room
• Case Conceptualization for Intimate Vicarious Trauma for partners and family will be addressed as well.

Workshop Intended For:

Intermediate (Participants have had basic ST training)

Relevant Background Readings on Topic:

In the Realm of Hungry Ghosts, Gabor Mate
Chasing The Scream, Johann Hari
Schema Therapy, A Practitioner's Guide, Young, Klosko et al


About the Presenters:

Elizabeth Lacy:

coming soon



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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