New Jersey History (NJH - E-Journal)
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AEDP and Cultural Competence in Developmental Trauma Treatment
No full textThis commentary discusses the therapy of a complex trauma survivor combining Accelerated Experiential Dynamic Psychotherapy (AEDP) with culturally competent strategies, particularly the use of a shared second language of origin. This combination potentiated the transformation of early affectively and bodily held memories and facilitated a successful outcome. Implications for short-term models and the training of therapists are discussed
What Are Case Studies Good For? A Response to Commentaries by McMullen and Karlin
No full textI am grateful to Linda McMullen (2018) and Robert Karlin (2018), for their commentaries on my case studies of Margie and Amie (Hamburg, 2018). Although case studies do not permit strong claims regarding treatment efficacy, they allow strong claims for the plausibility that treatments are efficacious. From a pragmatic standpoint, that is sufficient to justify proposing the treatments to other practitioners to be tried and tested by them, thereby ultimately contributing to the sum total of psychotherapy craft knowledge. On the topic of the placebo effect, the perspectives of researchers and clinicians, based as they are on different kinds of knowledge, can differ to the point of irreconcilability. What have hitherto been characterized as non-specific contributors to treatment outcome might better be classified as specific factors yet to be identified
Introduction to Commentaries on Sociocultural Identity, Trauma Treatment, and AEDP Through the Lens of Bilingualism in the Case of “Rosa”
No full textThe papers in this collaborative commentary explore the importance of engaging issues of sociocultural identity in trauma treatment in general, and specifically in the AEDP treatment of Nicole Vigoda Gonzalez's (2018) case of Rosa. Issues addressed include the role of language, bilingualism and language switching in therapy in general, and a fortiori when trauma or relational trauma is involved. After brief autobiographical sketches of the contributors, organized around each author's personal bilingualism story, there are three separate commentaries: Raymond Rodriguez (2018) begins by elaborating on the construct of sociocultural identity, exploring clients' identification around their native language, and emphasizes how crucial it is to address those concerns in therapy. Next, Yamilka Urquiza Mendoza (2018) introduces the importance of specificity in addressing multicultural issues, proposing that overly broad categories risk cluelessness, just at a higher level of magnification. Taking off from Rosa's being born on a Spanish Caribbean Island, Urquiza Mendoza illustrates how applying the term Hispanic to all Spanish speakers misses the huge ethnic and cultural diversity contained within that overly broad term. In the third commentary, referencing some neurobiological findings on how the traumatized brain processes language, Huan Jacquie Ye-Perman (2018) discusses how choosing to speak in one's non-native language in treatment is not always about distancing and can often be a vehicle for differentiation and exploring new aspects of self-identity. My concluding reflections are on the specific aspects of stance and intervention that allow AEDP to embody fundamental elements, as described by Owen (2013), of the multicultural therapist’s paradigm—i.e., cultural humility, benefitting opportunities, and developing cultural comfort—and to seamlessly manifest them in the nitty gritty of day-to-day, moment-to-moment clinical work. I end with some reflections on what AEDP, with its motto of "make the implicit explicit, and the explicit experiential," needs to do to actively keep optimizing its interventions to meet the challenges of the multicultural orientation framework and to do justice to these vital considerations
The Case of "Rosa": Reflections on the Treatment of a Survivor of Relational Trauma
No full textIn this article, I respond to commentaries by Karen Riggs Skean (2018) and Shigeru Iwakabe (2018) on my presentation of the case of "Rosa," (Vigoda Gonzalez, 2018), a survivor of chronic relational trauma. In her insightful response, Riggs Skean (2018) elaborates on the interplay between language switching and the therapeutic frame, the suitability of Accelerated Experiential Dynamic Psychotherapy (AEDP; Fosha, 2000) for the treatment of trauma, and the short-term nature of the work with this particular client. Iwakabe (2018), an AEDP clinician and researcher, offers insights and reflections on the areas of language switching, emotional change process, and corrective emotional experiences, and poses evocative questions regarding the development of clinical skills relevant to affect-focused therapies. In the following response I consider these thoughtful commentaries and provide feedback with the hope to spur the dialogue regarding the flexible adaptation of treatment approaches to our clients’ psychological needs
The Case of “Rosa”: AEDP in the Realm of Cultural Diversity—One's New Language as a Vehicle for Exploring New Aspects of Identity
No full textVigoda Gonzalez’s (2018) case study provides an excellent illustration of how AEDP leads to deep and effective treatment for a client with attachment trauma, leading not only to significant symptom reduction but also to profound change for the better. In this review, I provide additional observations and analysis of AEDP as reflected in this case, both in terms of specific interventions and the phenomenology of transformation. From the practice of multiculturalism in psychotherapy, I also highlight Vigoda Gonzalez’s bi-linguistic ability and bi-cultural background as facilitative for the therapy process. I examine the various factors that play into the impact of ethnicity/language-matching, and suggest that the lack of such matching is by no means an automatic hindrance for the therapy process. Similarly a client's choosing to speak in a language not native to them in therapy can be a vehicle for the exploration of new experiences, and new aspects of self. It is my belief that what is most important is for the culturally sensitive therapist to actively explore different means of communication within and beyond the boundaries of language, thus staying closely attuned to the client’s emotional experiences
Metaphor, Verstehen or Neither: A Reflection on Hypnotic Analgesia and Active Ingredients in Psychotherapy
No full textHamburg, an experienced and expert therapist, presents two successful psychotherapy cases. In both cases he viewed success as being the product of his use of metaphor, the patients' successful surmounting of a high difficulty task, hypnosis, and nonspecific factors. One of the cases involves a medically unexplained chronic and disabling pain. With a couple of brief vignettes of my own, I suggest careful screening, as using hypnosis to control medically unexplained, chronic pain may cause problems for some patients with major psychopathology (e.g., paranoid schizophrenia). Next, I note that clinical data will reflect back to us the a priori assumptions and interests we bring to it. As an example of how often and misleadingly this can happen, I discuss the autobiographical nature of clinical personality theories. Finally, I agree with Hamburg about the importance of ubiquitous nonspecific effects and note my difficulty accepting that they may be more important than the specific things we do deliberately in psychotherapy
Case Studies in Accelerated Experiential Dynamic Psychotherapy (AEDP):Reflections on the Case of "Rosa"
No full textSystematic case studies can benefit understanding of the process and outcome of Accelerated Experiential Dynamic Psychotherapy (AEDP; Fosha, 2000) and other affect-focused and experiential therapies by expanding the scope of investigation from the moment-to-moment emotional change on which these therapies are particularly strong to changes that occur over and across sessions. Systematic case studies are also important because the link between in-session changes and changes in the client behavior and interpersonal relationships in daily life can be explored. In the engaging AEDP case study of "Rosa" (Vigoda Gonzales, 2018), the language switching that allowed Rosa to access painful emotions had an additional relational implication in that the therapist was able to directly connect to Rosa’s child self, which was encoded in a different language than her adult self. I suspect that this prevented Rosa and the therapist from running into difficulties due to the potential mismatch in their backgrounds. Corrective emotional experience seen in this therapy confirmed the finding by my own case study research team (Nakamura & Iwakabe, 2018b) that client therapeutic gains are most clearly reflected in new relationships rather than existing attachment relationships. My commentary concludes with some questions posed to the author relating to the issue of effective training in empathic attunement and working with strong emotions in therapy
When Skill and Wisdom Merge
No full textSam Hamburg's (2018) case studies of the use of metaphoric tasks in psychotherapy take us into the storied course of therapy with "Margie" and with "Amy." In the nuances of Hamburg's accounts of these two sometimes similar, often different case studies, we see how metaphoric tasks can be conceived, implemented, and understood, and how the sensory-evoking, relationship-enhancing potential of metaphor can be enacted. We also see at work a deeply committed, thoughtful, and skilled practitioner-researcher who is, at once, cautious in his claims about the relation between metaphor use and therapy outcome, confident in what he knows about the practice of psychotherapy, and wise in his integration of the two
A Didactic Teaching and Learning Project in Art Market Research. Researching and Publishing the History of Commercial Art Dealing
No full textIn addition to research, one of the main tasks of art historians is the authoring of academically and stylistically sound texts in differing genres. This case study of the research and publishing project Zur Geschichte des Dsseldorfer Kunsthandels (A History of Commercial Art Dealing in Dsseldorf) will demonstrate how research and writing can be integrated into teaching. The project involved supervised work with source materials, data visualization, semi-structured interviews (oral history), a supplementary writing workshop, as well as detailed feedback from a writing instructor, the teacher, and fellow participants in the seminar. In addition, the high practical relevance of the project (collaborations with galleries and art dealers) increased the participants' later employability. This paper presents both the project's general and specific study objectives (acquisition of methodologies, social and subject-specific skills), its structure and development, discusses its challenges, and critically reappraises the process. It concludes by considering the ways in which writing could be better incorporated into the teaching of Art History at university
Moment-to-Moment Guidance of Clinical Interventions by AEDP’s Healing-Oriented Transformational Phenomenology: Commentary on Vigoda Gonzalez’s (2018) Case of "Rosa"
No full textThis paper, using the methodology of moment-to-moment microanalysis of videotape-based clinical transcripts, explores how Nicole Vigoda Gonzalez’s (2018) case study manifests AEDP’s fundamental transformational phenomenology in clinical action. Vigoda Gonzalez’s highly effective AEDP therapy of Rosa is informed by AEDP’s first "avatar" or iteration (prior to 2008), at the time, a three-state phenomenology. Yet, a close reading of the case reveals the very transformational phenomena, systematically and abundantly reflected in the author’s clinical data, that necessitated the theoretical and clinical developments of AEDP’s second avatar (post-2008) and the current four-state model of transformational change. It is a validation both of the soundness of this student therapist's clinical work and of the accuracy and power of AEDP’s healing-oriented transformational theory that constructs not in the author’s repertoire are nevertheless reflected and illustrated in the unfolding of Rosa’s treatment. This most interesting and unusual experience further illustrates how a descriptive phenomenology, guided by AEDP’s North Star, i.e., its orientation toward the wired-in healing within, can constitute an empirically sound alternative to the manualization of psychotherapeutic treatments. Also uncannily, this parallels the emphasis in Owen's (2013) multicultural orientation (MCO) framework on the need for "values" or "virtues," such as cultural humility, to "inform therapeutic activities as an alternative to the focus on multicultural competencies.