NP008, Attachment, Session 3, Dan Siegel

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Meds: Myths and Realities: NP0035 – Session 4

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Meds: Myths and Realities: NP0035 – Session 3

Do you feel like you could be a more effective therapist with your younger clients? Do you find it hard to determine when interventions--psychological and pharmacological--might be needed? Join Ron Taffel and learn to identify key diagnostic signs that indicate medications could be helpful when dealing with depression, anxiety, AD/HD, and affective disorders. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

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NP0008 The Great Attachment Debate

This blog focuses on discussion regarding the course NP0008 The Great Attachment Debate.

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How can attunement enhance brain integration and self-regulation? In this third session of the Great Attachment Debate, Dan Siegel, one of the leading proponents of integrating brain science and psychotherapy, will explore the practical applications of Attachment Theory in clinical practice, and explain the role of attunement in integration. Siegel, a prominent researcher, will shed light on interpersonal neurobiology.

After participating in this session, please take a few minutes to review and engage in the Comment Board. What did you learn in this session that was new or surprising? What was most interesting or felt most relevant to you? What questions do you have now for the presenter or other participants? Please feel free to share what you thought, and we invite you to include your name and hometown along with your comment. If you ever have any technical questions or concerns, contact support@psychotherapynetworker.org, and someone from our Support Team will respond as soon as possible.

08.22.2011 Posted In: NP0008 The Great Attachment Debate By Psychotherapy Networker
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Not available Dalia Shiber Schlegel 08.24.2011 13:20

Excellent lecture. Thank you very much. Please, I just have a couple of quick questions:

1. Can a person have more than one adult attachment style? For example, be dismissive in certain relationships, but more secure in others?

2. If a child experiences a secure relationship with one parent, but an insecure relationship with the second parent, how is the outcome determined?

Reply
- Not available Dan Siegel 09.04.2011 13:12
  
  Hi Dalia: Great questions! In research, an adult is given one AAI "state of mind with respect to attachment" (this is the adult attachment interview finding); and in the romantic adult attachment research while one category is given, the leaders in that field (Shaver and Mikulincer) acknowledge that any individual is really a composite of a range of variables. From the clinical perspective, yes, we can act differently in differing contexts. This is akin to the child attachment findings, where a "child cateory" is REALLY a relationship category, not a feature of the child. Which reveals how a childhood variable like temperament is not found to predict in any statistically significant way the attachment groupings of the child. Your second question reveals a research approach to the "Primary Attachment Figure" and the relationship the child has with that adult. That's how the research is done to find statistical correlations with future outcomes--but your implication is right on the money, that we have many layers of attachment experiences that persist in our lives. These findings are all reviewed in Mindsight, The Mindful Therapist, and The Developing Mind and Parenting from the Inside Out if you want further elaborations. Thanks
  
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Not available Eva Berlander 08.24.2011 13:20

Thank you both of you for a great time today.
Warmly, Eva Berlander in Sweden

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- Not available Dan Siegel 09.04.2011 13:13
  
  You are quite welcome, Eva! "See you" online soon! Dan
  
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↑ 0 ↓ Denny McGihon 08.24.2011 13:36

What arich and informative session. It integrated theoretical frameworks and gave useful clinical examples. Denny in Denver

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↑ 0 ↓ dennis ruane 08.25.2011 12:23

what is neat is what starts out in the brain appears in the body. abody focus can then invite a feeling experience pleasant or verry unpleasant. i work with women who have been abandoned emotional as children and then abuse as wives.getting them to the place of the inslult eventually leads them to another place inside themselves as very functional survivers whose early experiences can be accepted and used to forge a new relationship with self and others.a painful but rewarding journey dennis in slc,

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- Not available Dan Siegel 09.04.2011 13:15
  
  Thanks, Dennis! Yes, the body is essential for understanding the mind. Within the interpersonal neurobiology view, we see the mind as BOTH embodied and relational, and this perspective helps understand your clinical experiences. Thanks, Dan
  
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Not available naomi 08.27.2011 13:43

Fascinating revisit of attachment theory in terms of including new understanding of brain and how that can now be included in treatment. I was wondering how Dr. Siegel views EMDR which also focusses on right.left brain functioning, especially in terms of early trauma.

Reply
- Not available Dan Siegel 09.04.2011 13:17
  
  Thanks for your question, Naomi. I just did closing keynote for the EMDRIA conference, and I think they recorded the talk (EMDRIA.org). I also wrote up a chapter for Francince Shapiro's EMDR as an integrative therapy book, I think from 2002. That chapter explores what your question implies, that facets of EMDR are likely integrative, not only left-right, but up-down, memory, and even relationally. It's all in these resources. Thanks, Dan
  
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↑ -0.1 ↓ samuel gloyd 08.27.2011 18:32

Thank you Dan and Rich. I'm grateful for a framework to assess and create a treatment plan with clients. I've been doing psychotherapy for over 25 years...some if it with pretty good results. I realize that much of my work has been like intuiting my way through a maze. And my intuition skills have been adequate for the most part and improving. What you are offering is like turning on the lights...or perhaps in keeping with the metaphor of the maze, a hot air balloon lifting me up to see more easily the way through the maze in treating a client. Again, thanks. sAm in Boston

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- Not available Dan Siegel 09.04.2011 13:20
  
  Hi Sam: Your intuitive poetry reminds me of how 'amazing' the mind is, and how much we can support each other in the journey toward cutivating healthier minds! I just completed a non-linear book, The Pocket Guide to Interpersonal Neurobiology, that you might like as it dives into many dimensions of these issues in a way that you yourself, as the reader, can create as you go. That work is also explored in our mindisght community--online courses, web community conversations, annual meeting, discussion sessions, that I invite you to join! As a group, we can weave the tapestry of more deeply understanding the fabric of our human lives. See you soon, Dan
  
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Not available Celia 08.28.2011 07:52

Enjoyed conversation. As a psychotherapist, I"ve been reading Dan's books and others in the field for the last few years. If I had not had some background already in brain structure and in the IP research, I think that I might not have found the conversation to be as useful to me. Dan's clear descriptions and slides helped and I appreciated Rich's contributions via questions re: practical clinical examples. This webinar is very exciting and provocative. I especially appreciate the divergent views around the research. Thank you. BTW, two other psychotherapists and I have been studying together via DVDs, books, and CDs the research around the brain and how therapy changes the brain: we call ourselves the Brain Studies Buddies. :-) One question: Will these webinars be available to view again later? I missed parts of the first two and would like to watch them again.

Reply
- ↑ 0 ↓ Psychotherapy Networker 08.31.2011 09:22
  
  Hi Celia,
  Thanks for your great comment. If you're a paid participant in this course, all of the sessions are available anytime when you log into the website and hover your mouse over the Your Purchased Items menu option. If you didn't pay for the course or if you have questions about how to access the course online, please contact support@psychotherapynetworker.org and our Support Team will help you.
  
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- Not available Dan Siegel 09.04.2011 13:22
  
  Thanks, Celia: It means a lot to hear that the books are useful! I think Rich can let you know about how to listen in again. See you in March at the Networker! Dan
  
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Not available R. Gross, LCSW 08.28.2011 09:43

Really enjoyed this discussion, thank you so much Dan. I have been hearing more and more about Interpersonal Neurobiology and have felt intuitively connected to the ideas and research from the beginning. It makes so much sense to me on a gut level (and have been unknowingly practicing as a therapist from many of these principles for years) as well as in understanding the research. I did wonder if, while the explanation and treatment program offered to this particular client might have appealed to his intellect and difficulty in acessing emotion, the other styles of impaired attachement ie; entangled or unresolved might find this too technical and might feel uncomfortable with the message of "something's underdeveloped in your brain and we are going to develop it". I would love some more clinical examples of working with the different types and will definitely be checking out the website!

Reply
- Not available dan siegel 09.04.2011 13:24
  
  Hi "R": Thanks for your note. Yes, someone's attachment experience, including unresolved states, can influence what is a good "fit" for their needs and what we offer as a therapist. The book Mindsight offers extensive case histories; The Mindful Therapist offers ways of developing these integrative states in ourselves. Enjoy! Dan
  
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Not available Julie Bellamy 08.28.2011 13:42

Agree with the conceptualization of the DSM being descriptions of lack of integration, leaning either to the the chaotic or to the rigid scale. Very encouraging to know that the research continues to reinforce the brain's ability to impove on integration across the lifespan. And so glad to hear Dr. Siegel's focus not only on the child's behavior, but focusing on the child's mental experiences. Teaching this strategy is not only helpful in parenting, but I use it daily in work with couple's.

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- Not available dan siegel 09.04.2011 13:27
  
  Hi Julie: Thanks for your reflections! What is so wonderful about your experiences is that we can open our minds to discover new ways of helping people heal and improve their lives. Hopefully as we work togeterh we can construct a new framework for our field that is truly about mental HEALTH as a baseline, with challenges to health (challenges to integration) see as deviations that can be transofrmed toward integration across the lifespan. Also, the mind is not the same as brain activity. Embracing this somewhat controversial reality enables us to see, just as you are pointing out, that relationships that honor the subjective mental experience of someone else are relationships that thrive. Thanks! Dan
  
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Not available Susan Rosenthal 08.28.2011 15:22

I would like to see discussion on how our relationships, minds and brains are shaped by society, in particular by our society.

All the research shows that class inequality has more impact on health and illness than any other single factor.

Leaving society out of the discussion makes no scientific sense.

Reply
- Not available Richard Hill 08.28.2011 17:49
  
  This is a good issue to raise. I can imagine that a reasonable response is that this was only a 1 hour discussion and limitations will occur. Having said that, I agree that the social impact is a fundamental aspect of the relationship aspect of the 'triangle'. Class inequality is, however, not the issue in itself. The effects of the experience of class inequality on neural integration and neural development is more the central issue. Thanks for reminding us that the discussion can and must expand from the overview we heard today.
  
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  - Not available Susan Rosenthal 08.29.2011 07:53
    
    A study of 282 metropolitan areas in the United States found that the greater the difference in income, the more the death rate rose for all income levels, not just for the poor.
    
    Researchers calculated that reducing income inequality to the lowest level found in the United States would save as many lives as would be saved by eradicating heart disease or by preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined.
    
    Clearly, even greater health benefits would flow from eliminating class inequality entirely.
    
    Lynch, J.W. et. al. Income inequality and mortality in metropolitan areas of the United States. Am J Public Health. Vol. 88, pp.1074-1080, 1998.
    
    http://susanrosenthal.com/articles/america-in-crisis/inequality-the-root-source-of-sickness
    
    Reply
    - Not available Richard Hill 08.29.2011 17:26
      
      Very interesting Susan. The health impact of a socially supportive environment is very important, indeed. Sir Michael Marmot's work with the Whitehall Experiments looking at the negative health issues when you have less control in your job is supportive of the loss of control we might well feel in a widely unequal culture. Isaac Prilletensky also presents a clear picture of the disbenefits of wide gaps in income and class systems. He interestingly points out that in the World Value Survey of 1995 of national well being in the 1990's, Columbia fared the highest, despite having the highest level of murder, random violence and kidnappings because the country had strong interpersonal social support systems in families and communities. The neuro-psycho-biological response to the population, cultural and economic systems of the past 200 years or so are just beginning to be understood. It isn't surprising that we first have to make a mess before we figure out that we would do well to find a better path. Thanks for your interesting references.
      
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      - Not available Dan Siegel 09.04.2011 13:59
        
        Hi Richard! How you going? Great to see this discussion, and thanks for putting in your wise responses. We all need to put our heads and hearts into the important work ahead of us as a human community. All the best, Dan
        
        Reply
- Not available dan siegel 09.04.2011 13:33
  
  Hi Susan: Yes, I totally agree. For ten years now I have been a co-founder and co-investigator at an interdispciplinary program that explores just what you are discussing in the perspective of how cultural experience shapes synaptic connections. Please check out our website for this UCLA-Foundation for Psychocultural Research (FPR) program at CBD.ucla.edu for more details. Also, the second edition of The Developing Mind has new sections devoted to cultural issues. Alan Sroufe's important attachment study reveals also that the micro-culture of the family with secure attachments can confer resilience even in the face of socioeconomic adversity. So the developmental picture is complex and quite context dependent. Please also see the important edited volume regarding this finding in The Mind in Context as well as Sroufe and colleagues' The Development of the Person (both Guilford Press, 2010 and 2005, respectively). Thanks! Dan
  
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Not available leticia tayabas 08.28.2011 22:28

Great, I was moved, excited and very interested in Dan Siegel´s ideas and research, Thank you so much for making this available to me in Mexico. I have one question regarding what happens when there is a problem such as addiction in the care taker or in a patient that impairs integration.

Reply
- Not available dan siegel 09.04.2011 14:03
  
  Hola Leticia: Cuando una persona tiene un problema de addiccion, es importante que el or ella tiene una communidad de salud, como AA, que puede assistirle con la calle a salud. Y tambien, mindulness (como Alan Marlatt he demonstranos) es una parte de la "approach" que puede ayudar. Gracias por su pregunta, y tal vez usted debe estar con nostotros en las classes online donde tenemos personas de Mexico quien esta un parte de la communidad de mindsight! Hasta luego, Dan
  
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Not available Lynn 08.29.2011 17:26

Thank you for the wonderful overview of how attachment steers your therapy. Could you please say more about Synaptic Shadows of Early Experience. This is a very interesting phenomenon and I am wondering how can a person erase/heal these shadows so that they do pull similar(similar to caretaker responses) responses from current people in their lives. Thanks --- Lynn

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- Not available Lynn 08.29.2011 19:25
  
  Please insert "do not pull" instead of "do pull" --- oops, I was typing too fast the first time. Lynn
  
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- Not available dan siegel 09.04.2011 14:07
  
  Hi Lynn: Thanks for your note. The idea of "synaptic shadows" is explored in detail in Mindsight, The Mindful Therapist, The Developing Mind (2nd ed), and the Pocket Guide to Intereprsonal Neuroibology (the latter two out in early 2012). Spo that's the background where you can learn more. Mindsight offers many stories addressing how to unlearn old ways and learn new ways, so that might be a good place to begin. Thanks! dan
  
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↑ 0 ↓ Clyde Tigner 08.29.2011 19:11

I so appreciate the wealth of information I was able to obtain form this presentation. This has left me with a new view of attachment issues and how to help clients overcome them.

Reply
- Not available dan siegel 09.04.2011 14:08
  
  Thanks for your comment, Clyde! I hope these explorations offer help for your work with others! All the best, Dan
  
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Not available David Flohr 08.29.2011 21:38

Wonderful, powerful and positive energy. A grounded man, mindful and clearly mission based. I resonate deeply with the ideas and constructs and yet believe that the operationalizing of change and growth processes within an individual and in the space between them and others remains both the mystery and the artistry. I think Jerome Kagan may oversimplify the "non-specific" factors which promote change and I wonder if Daniel Siegel may over-complicate them. I am left wondering how one would continue the work of depth integration "after the honeymoon" with the those troubled and complex individuals who truly have deep seeded issues which may be initially resistant to
mindfulness practice and interpersonal neurobiologial methods and approaches. Still...I resonate with this fresh language which tries to speak the old wisdoms. I am hoping this approach will remain open, flexible and receptive to emerging learnings from diverse disciplines. Bravo!

Reply
- Not available dan siegel 09.04.2011 14:14
  
  Hi David: Thanks for your reflections and good wishes! The book, The Mindful Therapist, takes a deep look at John Norcross' meta-analytic research of "non-specific" factors and attempts to explore a possible neurobiological understanding of these. I have never been called as someone who "over-complicates" things from the academic community, so this is quite refreshing! Thanks. In interpersonal neurobiology we continually seek the consilient, overlapping, mult-disciplinary principles that help guide us in what we indeed, as you suggest, hope will be an ongoing, flexible, and receptive approach to understanding our human journey and the reailiy of our lives. Combining a wide array of sciences into one view requires, naturally, that we find common principles that guide our construction of the sphere of knowledge. In the Pocket Guide (out in 2012), you'll find a direct discussion of these issues (I hope you'll find it not "over-complicated"!) and an attempt to see, directly, these overlapping nodal points of intersection that frame our field. Let me know your thoughts! And I'll keep the idea that this synthesis of all science into one persepctive should be even simpler! Very inspiring...Thanks. Dan
  
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Not available Kathy Hardie-Williams 08.30.2011 05:18

I have been taking classes in IPNB for the last couple of years at Portland State University. I have taken three of them with Dr. Bonnie Badenoch. Learning about IPNB has opened a new world for me both personally and professionally. Personally, I finally was able to make sense out of my emotional dysregulation; professionally, using the theory of IPNB has allowed me to provide my clients with information about the connection between early attachment and how it plays out in their current relationships, which is information my clients have found quite useful. While I already have several books by Dr. Siegel, Dr. Badenoch, and Lou Cozolino, I will definitely be purchasing 'Mindsight'. And, I will use the 'attachment assessment' Dr. Siegel referred to with clients. One thing that really stood out for me while listening to this webinar is the connection between disorganized attachment and the level of chaos (often self created) in our lives. I found this webinar extremely valuable professionally. Thank you for the opportunity to access such relevant information that is so vital to our professional practice with clients.

Reply
- Not available dan siegel 09.04.2011 14:21
  
  Thanks, Kathy: I am glad IPNB is of help to you! All the best, Dan
  
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↑ 0 ↓ lou lipsitz 08.31.2011 08:09

Exciting discussion. The concept of "entangled attachment" was new to me and I cannot locate any extensive discussions of it. It seems valuable and distinct from other attachment styles we have become familiar with. Where can I find discussions of this concept?
Thanks, Lou Lipsitz, Chapel Hill, NC

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↑ 0 ↓ Randi McAllister-Black 09.09.2011 15:37

please post the 9 domains of integration

Thank you,
Randi McAllister

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