Bottom-Up Gratitude

An AEDP Approach

Judy Silvan

It’s New Year’s weekend, and I’m at Kripalu, the epicenter of yoga and meditation in the northeast. Mid downward-dog, my mind returns to a recent breakthrough session with my client, Alfred. It dawns on me that nearly every good AEDP session, in some way or another, can be termed a breakthrough. It’s a nice parallel to what I’m experiencing during this weekend getaway: even the most subtle moments can feel divine.

I’m an Accelerated Experiential Dynamic Psychotherapy (AEDP) therapist. AEDP is a therapeutic model that weaves mindfulness, contemplation, and gratitude into the fabric of therapy, to the benefit of both the client and the therapist. A core tenet of AEDP teaches us that humans have a built-in, primitive drive to seek out healing attachment, that if something inside us feels wrong, we move toward fixing it.

Somewhere during my second decade as a therapist, I learned about AEDP and was completely taken with it. Under a framework developed over 20 years ago by Diana Fosha, the AEDP therapist creates an explicit, almost intense attunement, leaning in to the client to help them experience the many colors of their emotional palette, especially in cases where there’s been childhood trauma. Using a four-state model, we create enough safety to plumb these depths and explore very strong feelings, whether negative or positive. As we discuss them in treatment, clients often experience spontaneous clicks of recognition, expressed in surprising metaphors, imagery, intuition, and visceral sensations.

By offering clients a gentle, compassionate voice and stepping up emotionally to help them re-regulate and manage chaotic emotions, we're able to bypass defenses, lower anxiety, and engage in deep inner work. This regularly results in clients feeling love toward themselves and others, a love that courses through the body. They often use words and phrases like truth, light, it just feels right, I feel calm and complete, or this is the real me. These moments sometimes feel akin to a sacred experience. A successful session leaves clients with a bottom-up experience of feeling right. They carry it outside the therapy room and tackle previously difficult challenges with relative ease—what Fosha called transformance and adaptive action tendencies.

How exactly does it play out?

Alfred

In the four months Alfred and I had been working together, we’d excavated the depths of his emotional turmoil many times. He was 54 years old, gay, married, and a biracial father to two young adult sons. Initially, he’d sought therapy because of a fraught relationship with his mother, who’d passed away about a year earlier. Lately, he’d been butting heads with his husband, John.

A few months before Alfred was born, his mother had immigrated to the U.S. from Brazil to join Alfred’s dad, who was stationed here as an office in the U.S. Navy. For years, she struggled to transition to American life. Most of Alfred’s early memories of her were of a strict, punitive woman who left little room for her oldest son to experience the world on his own. He’d told me in earlier sessions he’d sometimes felt like her punching bag. Once, after she pushed him to grab a video game from his hands, he ran to the closet to hide, nose bleeding. The memory still stung, even decades later.

As a Black woman who experienced prejudice in her own country and in the United States, Alfred’s mother was highly anxious and hypervigilant, and her worries about racial violence felt oppressive to him, rather than protective. With his dad working long hours away from home quite often, Alfred said his mother became “possessive” of him as a teenager, demanding that he come straight home after school so she wouldn’t be alone. His peers teased him relentlessly for this, which made it hard for him to develop friendships and romantic relationships. As much as Alfred sympathized with his mother’s challenges, he also feared and resented her.

It was clear that these early parental traumas still haunted him and were impacting his life at home. “John and I had a horrible argument this morning,” he announced flatly at the start of our last session, “He said I don’t know how to deal with closeness, just like my mom couldn’t.” In AEDP, we term this State 1—narrative content which may expose vulnerability, yet is articulated in a disconnected, sometimes intellectual tone.

“I know John didn’t mean to be so harsh, but he’s right,” Alfred said matter-of-factly, with a tinge of frustration. “I can’t keep living like this.”

I knew Alfred’s problems were complex, emanating from internalized racism and homophobia he’d faced in high school and college. We’d uncovered some of this in depth in earlier sessions. Rather than risk him getting overwhelmed, I put on my AEDP hat.

“I wonder if we can try something I think may help us unwrap things,” I said gently. “Can we slow the pace of our conversation and really attend to what you’re feeling in this moment? Does that sound okay?”

Alfred nodded. Rarely does a client say no when I ask their permission to come back to the here and now. I looked into his eyes. His expression was pained, and I could tell he was eager to reach a place of safety to work through that pain.

I like to self-disclose a bit to strengthen the therapeutic relationship, sometimes right out of the gate. As hallmarks of the AEDP model, these interventions involve constantly checking back with the client to ascertain how they land. “I’m feeling so much sadness for you as we’re having this conversation, Alfred. How does it feel for you to know I feel connected, touched by what you’re going through right now?”

His face softened and his eyes welled with tears. I handed him a tissue. He blew his nose and cleared his throat. “I like that you get it,” he said softly.

Following the AEDP framework, the next step after slowing down was for us to move even further toward his emotions, helping him have a cathartic release, which we refer to as State 2. I use gentle soothing para-messages in these moments, like an affirmative Mmmm-hmmm intonation, so the client knows I’m right there with them. “Wow, I see a lot of pain and tears coming from you right now, Alfred. What’s happening inside as we share your mom’s confusion adapting to a new culture?”

The choice of the pronoun we was intentional. In AEDP, this allows the therapist to join with the client and, again, stress that they’re not alone in their pain.

Tears were flowing as he choked through his words. “Well, I feel really sad. For her, but also for myself. After our last session, I realized how much of my mom’s experiences I absorbed. That got me thinking about how I never really had anyone to turn to when I felt sad or worried. I mean, growing up, we were the only Latinx family in town. My dad was never around, and my mom was a mess.”

I listened silently. Several seconds of silence followed. The moment was deep and contemplative. I could hear the quiet tick of the clock on my office wall now. Outside the window, a bird chirped a few times. Then, Alfred said something that really struck me. “Even though some people think I’m white, I know on the inside I’m dark brown. That’s who I am. That culture, my heritage, it feels right to me. I think my mom was always trying to keep me hidden, trying to bury it.”

In AEDP, we call this a State 3 “click of recognition”—an important, organically arising truth that springs up from the unconscious. I tried to match his excitement.

“Wow, Albert, that’s profound. What’s happening inside you in this moment as you realize this? Do any images or visceral experiences come up?”

Alfred closed his eyes and breathed slowly, deeply for a few seconds. Then, he opened his eyes. “I see myself,” he said tentatively. “I’m 12 years old. I’m holding this image of myself lying on the floor. I’m crying.”

“Hmmmm… That word holding. I’m curious, what direction does the holding go? Is it the 12-year-old who’s getting this holding? Is it your adult self who’s doing the holding, stooping beside the boy?”

Alfred furrowed his brow. I could tell he was a little confused. “I don’t think it’s either,” he said. “It’s just the phrase holding. Just a sensation I had.”

“Oh, sorry. Did I jump to a conclusion there?”

He held up a hand and closed his eyes once more. “No, no, it’s okay,” he continued. “It’s strange, this is new for me. I think it’s both now—I’m both being held and I feel myself holding myself as a young boy. It’s like I’m soothing him.”

I was excited for him. We’d hit a positive, soothing glimmer within the trauma. “Wow, that’s really beautiful. Tell me more. What’s it like to experience this soothing feeling?”

He took another deep breath, and exhaled. “I feel . . . thankful. It’s like with every breath I’m taking, waves are lapping back and forth on the shore of my insides, and every time they come, they’re touching me with love. The boy—I still see him. He’s curled up, but now he’s happy.”

He opened his eyes and blinked. We’d broken through to the transformative experience. “Wow, I feel…grateful,” he said. “Yeah, gratitude. That’s what I feel right now. It’s amazing”

In sessions incorporating AEDP, expressions of gratitude like this are common at the end of powerful sessions. “Can we reflect on what just happened? I asked. “We’ve only got a few minutes left, so I want to know: What was it like for us to do this work together today?”

“It was pretty incredible,” he said. “I feel a light in my whole body. This feeling of lightness. And now it’s going back and forth between us.”

It’s what AEDP therapists call State 4—the Core State, or a truth experience.

“Alfred, I feel it too. I’m so moved to be doing this work with you.”

As I shared this with him, in our synergy, I began to feel a tingle running all the way down my shoulders and legs.

“I’m really feeling that connection with you, too. Thank you for letting me in. It was so brave of you, and I think we’re doing some really remarkable transformation here.”

“Yeah, I agree. I feel really good. Like, I came in today feeling disgusted with John—and with myself. And now, I feel lightness. I feel love.” Finally, he looked relaxed. “It’s weird,” he said, smiling, “but I feel more love toward my mom, too. And toward John after that awful fight. You know, he complains that I push him away when I’m stressed. He says that’s when I really need his love. Maybe he’s right.”

This was the continuation of the Core State. It doesn’t come from deep intellectual thought or disciplined meditation. Rather, it’s an organic, authentic experience that arises naturally in the AEDP encounter. It’s bottom-up change that encompasses the mind, body, and spirit. And Alfred was experiencing it in the here and now. And I was there with him, in my own Core State.

What Worked

When I check in with clients as much as I did with Alfred, in accordance with AEDP principles, we meta-process each small gain. I didn’t try to force these gains. When I picked up Alfred’s use of the word holding and followed it, only to realize that maybe it wasn’t as important as it seemed, I apologized. That’s when he dove deeper and things really began to take off. Not only was it an opportunity to repair a possible rupture, but it led to an accelerated change process, to momentum. Here, Alfred got the chance to name for himself what worked and what didn’t.

I also often find that clients stumble upon their own revelations in between sessions. The process we’ve created together persists outside the office. Although this case example might make AEDP look easy, it’s worth noting that the AEDP toolkit is large, and learning it takes time and practice. Still, I’ve found that the consistency of clients’ positive responses to AEDP and their ability to move easily through the four states is remarkable. There’s the occasional person who deems this work is too deep for their comfort level or who can’t access their emotions enough for AEDP to work effectively, but Alfred let me know from our very first meeting that he would respond well to it.

Although we had a particularly fruitful session before I left for Kripalu, I know my work with Alfred is far from over. Like two singers in a duet, our work embraces the present moment. Sometimes it feels sacred, even divine. We’re coordinated and harmonious. We both feel confident about where therapy is heading and what will happen next, because we trust that every moment together can teach us what we need to know.

***

Judy Silvan, LICSW, LCSW is an AEDP-certified supervisor and psychotherapist practicing in Cambridge, Massachusetts. She’s also licensed in California. Her passion is to practice and teach experiential methods of psychotherapy. She specializes in AEDP, Bioenergetic Analysis, and mindfulness.

Photo © iStock/Yolya

Topic: Anxiety/Depression | Mindfulness

Tags: Anxiety | depression | experiential psychotherapy | meditation mindfulness | Mindfulness | psychodynamic therapist

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1 Comment

Saturday, December 12, 2020 5:54:37 PM | posted by Jennifer
Thanks for sharing Judy! What a gift you are to your clients.