The Therapeutic Challenge
Feelings of shame and inadequacy are often at the core of most therapeutic encounters. Regardless of the presenting symptom or historical background, the majority of our clients enter treatment because they have experienced some degree of early attachment failure, which often leaves a life-long residue of trauma and internalized feelings of shame in its wake.
At the heart of good psychotherapy lies an understanding of the relationship between early attachment failures and learned defense structures that our clients create in an attempt to prevent feelings of inadequacy from breaking into conscious awareness. Therapeutic change, therefore, relies in large part on repairing injuries of attachment and letting go of shame resistant defenses, in exchange for the discovery of one’s authentic strengths, talents, gifts, and resilience. Thus, confronting the defenses that guard against shame becomes a fundamental focus of treatment. This is often one of the most challenging clinical situations for even the most experienced therapists.
This program is designed to assist licensed mental health practitioners, supervisors, and educators in understanding and treating defensive structures that mask feelings of shame. We offer therapists an integrative theoretical model and method of tracking that deepens skills in therapeutic listening and intervention techniques. At the core of our training is a tracking system that helps therapists to recognize the telltale signs of shame by framing our client’s beliefs and behaviors as strategies of over-compensation. These learned over compensations are often unconscious attempts to keep feelings of shame from coming to the surface. Anticipating and attuning ourselves to “shame sensitivity” is one of the therapist’s greatest safeguards against therapeutic rupture or premature termination.
What makes this course unique is that we provide a deeply attuned, context-driven model that acts as a blueprint of the patient’s psyche. Our Four-Quadrant Model illustrates a three-dimensional grid that allows the therapist a better grasp of the meaning of client’s statements, behaviors, and beliefs, especially as these are driven by underlying shame. Defensive postures ranging from grandiose drives for perfectionism to critical self-effacement, from wishes for salvation or rescue, or devaluation of others will be addressed through our treatment model.
Dismantling defensive postures requires an intensive psychological posture of therapeutic listening that allows us to more effectively intervene in the contextual present. Our program provides techniques to help the clinician develop deeper inquiry skills in treatment. We will visually show subtle processes such as “slowing the dialogic process down” or “working with the therapeutic relationship” to repair early, defensively-based relational patterns.
Through lecture, cogent video-taped case demonstrations and small group discussion, we will examine how therapeutic listening and intervention techniques can be effectively used to penetrate the narcissistic structures underlying dissociative splitting, grandiose expansiveness, cognitive distortions, self-destructive behaviors, and revenge enactments.
The onsite residency portion of the program offers participants the experience of an interactive collegial environment with nationally acclaimed faculty who provide students with “hands-on” experience, through a combination of lecture, practice application, videotaped case illustration, and group discussion, all of which provide a lively and rigorous learning environment. Each onsite residency lasts for three full days and take place on the Bellarmine Campus in May 2018, October 2018, and May 2019. The knowledge level required before beginning the Advanced Certificate Program through the Wayne Institute assumes that participants will enter having acquired a beginning level of knowledge that is typically achieved upon completion of most doctoral training programs. The course material and content of each of the Wayne Institute residencies and webinars is geared toward the advancement of knowledge at an intermediate level of instruction.
After each three-day residency, participants return to their regular clinical settings, where the distance-learning portion of the program will continue throughout the year. The distance learning structure includes:
- Three 90-minute case consultation meetings a month
- Six live, interactive webinars. These three-hour webinars occur every other month the schedule is to be determined
- Each clinician trainee will have the opportunity to present case examples from their practice settings as a way of integrating classroom material with daily clinical challenges, thereby increasing clinical proficiency and confidence.
- Participants who are clinical supervisors will be afforded three 90-minute group consultation meetings per month and will be paired with faculty with the goal of becoming more proficient with the integrative training model used in the certificate program. Further Information:
- Application Fee: $65 (non-refundable)
- Full Tuition for the Program: $6,400
- Tuition and fees must be paid in full by May 1, 2019 or student must be enrolled in payment plan (outlined below).
- $750 down payment and application due by May 1, 2019
- The remaining balance of $5,650 will be divided into eight equal payments due by the 10th of each month beginning in June of 2019 and ending in January of 2020.
- Early Registrant Tuition of $4,995 for students who enroll by November 30, 2018!
- $750 due by November 30, 2018, along with $65 application fee
- $4,245 balance (or enrollment in payment plan) due by May 1, 2019
- 100% refund through May 15, 2019
- 50% refund through May 19, 2019
- No refund after first day of program on May 20, 2019
- Contact Linda Bailey at 502.272.8161 for more information about tuition, fees, and payment plan schedules
Theory-focused Morning ModulesDay One
The Relational Psychodynamic Paradigm: From Psychoanalysis to Contemporary, Integrative Practices
- Present the evolution of psychodynamic theory from its earliest roots to present relational models.
- Describe the paradigm shift from a one-person to two-person model of interacting.
- Increase ability to identify degrees of psychopathology and choose treatment options using a relationally based model.
Evolutionary Advances in Attachment Theory & Its Clinical Implications
- Identify normative attachment processes and identify principles of affect-based self-regulation.
- Describe healthy and pathological attachment styles.
- Assess the neuropsychological foundations of attachment, communication, and self-regulation.
The Neurobiology of Trauma: Scientific Developments Impacting Psychological Treatment
- Define the function of the Polyvagal system as it impacts traumatic arousal.
- Present an overview of the evolution of trauma-treatment, from Bowlby’s Attachment Theory to Schore’s neurobiologically-based Regulation Theory.
- Utilize the ACE Study as an assessment tool in the treatment of trauma.
Practice-focused Afternoon ModulesDay One
The Importance of Character Structure: Applying the Four Quadrant Model to Narcissistic Injury
- Illustrate the relationship between failures of early attachment and the formation of defensive character structures that constitute the continuum of “narcissistic injury”.
- Explain how early injuries in childhood, ranging from trauma to neglect, can result in defensive over-compensations that attempt to mask feelings of shame and inadequacy.
- Presentation of the Four-Quadrant Model, a dynamic assessment tool, that offers a picture of psychological defense structures from a relational, intrapsychic, and systemic view.
Introducing Three Techniques to Improve Listening and Intervention Skill Sets
- Explain the importance of slowing down the therapist/client exchange in an effort to increase “right-brain-to-right-brain” communication.
- Demonstrate how listening for triggers in a patient’s language can be used as an “entry point” to understand what is conscious as well as hidden from view.
- Illustrate the techniques of moment-to-moment tracking and forecasting to help increase the client’s self-reflective capacities and ameliorate defensive over-compensations.
Psychodynamic Formulation: Part One
- Describe the elements of a thorough psychodynamic formulation.
- Apply dynamic formulation concepts to assessment, highlighting the degrees of client fragility as well as innate capacities and strengths.
- Present an overview of the importance of timing of therapeutic interventions by using the dynamic formulation assessment.</l
Theory-focused Morning ModulesDay One
Four Quadrant Model Conceptual Review: Contrasting Healthy Self Model with Four Quadrant Model
- Present the “Healthy Self-Realizing Self Model” and contrast this with the defensively based Four Quadrant Model.
- Illustrate the use of both models as an assessment instrument during initial evaluation and as a system for tracking progress throughout the treatment.
- Present the concept of “consolidation of gains” as a dynamic method of monitory progress throughout the treatment, highlighting how early recognition and mirroring of gains can help the internalization and healing process.
Trauma and Recovery: Theory and Treatment of Traumatic Disorders
- Present a historical overview of trauma, including PTSD and Complex Traumatic Stress Disorders.
- Present a three-phase model of trauma treatment that includes: Safety & stabilization, Memory & emotional process of trauma, and Consolidating therapeutic gains.
- Explanation of changes in the DSM-V relating to PTSD will be outlined and explained.
Understanding Transference from a Relational Perspective
- Review various theoretical definitions and understandings of the scope of positive and negative transference.
- Instruction on how to palpate and access feelings of shame through working through a relational transferential lens using a two-person, intersubjective approach.
- Define scope of understanding counter-transference using the two-person, intersubjective orientation.
Practice-focused Afternoon ModulesDay One
Part Whole Analysis: Part One
- Explain the importance of part-whole analysis in terms of initial assessment and on-going treatment.
- Illustrate how the over-use of one therapeutic technique is only working with a “part” of the picture in terms of the unique needs of clients.
- Demonstrate how parts either connect or do not connect to other parts as a way of understanding vertical splitting.
Understanding Shame, Splitting, & Dissociation
- Explain how shame is a result of early attachment failures and how patterns of defensive over-compensations attempt to mask feelings of shame.
- Define vertical splitting and give illustrations from various case scenarios, demonstrating how to work with integrating split-off material.
- Define the continuum of dissociative process and give examples of how to recognize dissociation within the treatment setting.
Psychodynamic Formulation: Part Two
- Define the components of a relationally based loyalty contract, in terms of learned patterns from early childhood.
- Identify how these learned patterns and assumptions play out in adult relationships, including wishes, expectations, and enactments.
- Illustrate and practice how to write a process recording of therapist/client exchange to improve listening and intervention skills.
Theory-focused Morning ModulesDay One
The Dissociative Spectrum: Understanding Macro & Micro Dissociative Ruptures
- Explain how patients with insecure attachment histories are more vulnerable to affect dysregulation and dissociative ruptures.
- Define the difference between micro & macro dissociative episodes.
- Demonstrate the understanding of dissociative defenses as they connect to working with clients with trauma histories.
Preventing Compassion Fatigue: The Importance of Ongoing Professional Development, Networking, & Peer Support
- This session will cover the topic of professional development and self-care, including research and discussion of how to prevent compassion fatigue and burn-out.
- Risk factors will be identified, including depersonalization of energy and distancing from patients.
- Participants will take a Burn-out Risk Survey, that assesses conditions ranging from physical symptoms, environmental and organization conditions, and quality of support systems.
Part-Whole Analysis: Part Two – Integrating Trauma, Attachment Theory, and Psychodynamic Approaches
- Integrate treatment perspectives and approaches of trauma from neurobiological based evidence into psychodynamic treatment.
- Review Part-Whole Analysis as an assessment and intervention instrument.
- Discuss various methods of strengthening the therapeutic alliance in terms of creating an “earned secure attachment”.
Practice-focused Afternoon ModulesDay One
Epigenetic Theory & the Generational Impact of Trauma
- The basic principles of epigenetics will be explained and applied to principles of attachment theory, polyvagal theory, and the ACE study as it relates to early childhood development.
- Explain how the ACE Study correlates to symptom presentation both physically and psychologically in adulthood.
- Demonstrate the impact of nature and nurture on the neurobiology of the human relational development system.
Death, Dying, & Bereavement
- Define the bio-psycho-social-spiritual dimensions of the death and dying process when treating a terminally ill patient.
- Offer treatment strategies to obviate burnout for family members who are health-care providers for a dying loved one.
- Identify techniques that a therapist can use to help normalize the experience of loss associated with a client’s dying process.
“And in the End”: Class Application and Review
- This will be a review and wrap-up of the entire certificate program learning objectives including a review of the Four Quadrant Model and Healthy Self Model.
- Students will review practices techniques learned throughout the year and share how they apply techniques with their current clients.
- The power of shame as it inhibits authentic adult growth and development throughout the lifespan will be discussed in terms of working with the therapeutic relationship to increase feelings of safety and trust in the service of moving toward authentic self-expression.
- Review the parameters of confidentiality and limits of confidentiality.
- Analyze how effective boundary management promotes effective therapy.
- Present differential considerations involved in therapy with children, couples, family, and group therapy.
- Understand the treatment protocols for how and when medications are introduced and side effect management.
- Present the interface between genetic, biological and psychological vulnerabilities.
- Review the major drug categories and apply them to various diagnoses, current research and new medication development.
- Overview of psychological approaches to the treatment of issues around sexuality: sexual dysfunction, gender identity, and sexual choice.
- Review the nature/nurture question of development, as well as social, and clinical attitudes as they impact treatment.
- Review the importance of maintaining appropriate boundaries, confidentiality, and promotion of client safety around sexual concerns and sexual identity exploration.
- Identify various recovery modalities, including twelve-step programs, harm reduction protocols, and evolving non-twelve-step protocols.
- Explore ways early attachment failures link to the emergence of addiction and drug of choice.
- Present neuroscientific and developmental conceptualizations as they contribute to the process of addiction recovery.
- Explore ways of incorporating spiritual practices as an adjunction to traditional clinical care.
- Review various types of evidence-based spiritual practices that have been shown to be effective in reducing depression and anxiety.
- Discuss ethical considerations around maintaining boundaries, clinical competence, and respect for cultural differences.
- Explain the essential relevance for therapists to understand multiple dimensions of the self.
- Identify multiple contexts and factors that impact the course of therapy.
- Explore cultural biases as they impact theoretical orientations and the treatment process.