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The Alphabet Soup: Diana Fosha on the Convergence in Today’s Therapies

By Ryan Howes

DBT, ACT, IFS, EMDR, SE . . . We seem to have entered The Acronymic Era of psychotherapy. In today’s profusion of therapeutic models, with all their own particularities, there also seems to be many common assumptions about change, consciousness, biology, and the therapeutic relationship. These days, the approaches that generate the most discussion, each in their own way, try to incorporate a core group of new ideas that have emerged in the field over the last decade—about mindfulness, the use of somatic resources, Positive Psychology, brain research, and the nonverbal dimension of the therapeutic relationship. As various modalities borrow effective techniques and concepts from one another, we seem to be forming a common therapeutic language, a postmodern dialect of healing.

Nowhere is this more apparent than in AEDP—Accelerated Experiential Dynamic Psychotherapy—a modality developed by Diana Fosha, a Romanian-born psychologist trained at Columbia, Cornell, and The City University of New York. Her most recent book, The Healing Power of Emotion (coedited with Daniel Siegel and Marion Solomon), was praised by Daniel Stern as “A masterful, panoramic view of emotion.” Fosha lectures around the world, writes, supervises, and maintains her private practice in New York City. In the following conversation, she offers her perspective on how Freud’s “talking cure” has both changed and remained the same during this latest stage of psychotherapy’s evolution.

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RH: In AEDP, I notice hints of Positive Psychology, solution-focused therapy, ACT, mindfulness, Gestalt. . . .

FOSHA: Yeah, keep going . . . there are lots of other approaches you could mention.

RH: Why is there so much overlap among different therapy models today?

FOSHA: All of these models of psychotherapy use different lenses to look at the same fundamental neurobiology of human experience. So the convergence of methods that we’re seeing comes from looking at the world using a Gestalt lens, or a solution-focused lens, or an AEDP lens, and isn’t so surprising.

RH: How is the new “convergence of methods” or “procedural convergence” any different than good old-fashioned eclecticism?

FOSHA: Eclecticism is a little bit like stew—you bring a little from here and a little from there. What we’re seeing in psychotherapy today is more like a bunch of different chefs agreeing on the value of certain common natural ingredients and then going off to come up with dishes that are different in many ways, but also have many similarities.

RH: The question for many therapists confronted with all these different-sounding therapy models is distinguishing between what’s really new and what’s simply old wine in new bottles. How is AEDP new wine?

FOSHA: To my mind, one of the most original aspects of AEDP is what I’ve called “meta-therapeutic processing”—closely and explicitly exploring the patient’s actual experience of transformation, especially when some positive change occurs. At these moments in AEDP, the therapist and patient pause to process what’s happening together, rather than taking what just happened for granted and moving on to something else too quickly. We try to make the patient’s new experience the focus of mindful reflection. Metatherapeutic processing supports the integration of the new change experience into the person’s sense of self, and also underlies the development of resilience and flourishing.

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