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MELISSA CALDWELL ENGLE, MS, LPC, ATR

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Title: PowerPoint Presentation Author: Tere Kole Last modified by: Rose, Joanne M. Created Date: 9/30/2003 1:53:22 PM Document presentation format – PowerPoint PPT presentation

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Title: MELISSA CALDWELL ENGLE, MS, LPC, ATR


1
MELISSA CALDWELL ENGLE, MS, LPC, ATR
  • THE ROSS INSTITUTE
  • Executive Clinical Director
  • 1701 Gateway, Suite 349
  • Richardson, Texas 75080
  • Private Practice 214-498-5493
  • www.rossinst.com

2
UNRESOLVED ATTACHMENT ISSUES IDENTIFICATION AND
TREATMENT TECHNIQUES
  • Melissa Caldwell Engle, MS, LPC, ATR
  • Texarkana, Texas
  • April 12, 2013
  • www.rossinst.com

3
  • Trauma is a developmental obstacle in normal
    human development.

4
  • Helping people to overcome childhood trauma
    and/or single event trauma in adulthood is an
    integrative process.

5
CORE CLINICAL ASSUMPTIONS
  • 1. Un-integrated sense of self
  • Dissociation between mind and body
  • Black and white thinking
  • Inability to recognize and or tolerate affect
  • Inability to recognize and or tolerate
    ambivalence
  • Treatment Focus- Integrative techniques
    focusing on mind and body connection, education
    about feelings, affect management, containment
    and pacing, and desensitization.

6
SPECTRUM OF EMOTIONS
Stuck Mind Ungrounded-Past Extreme Fluid Mind/Body Grounded Present Balanced Stuck Body Ungrounded-Past Extreme
Numb Anger Rage
Numb Cautious Paranoia
Numb Hurt Despair/Hopeless
Numb Vulnerable Helpless
Numb Sad Depression
Numb Happy Mania
7
SPECTRUM OF EMOTIONS
Stuck Mind Ungrounded-Past Extreme Fluid Mind/Body Grounded Present Balanced Stuck Body Ungrounded-Past Extreme
Numb Afraid/Fear Terror/Panic
Numb Frustration Overwhelmed
Numb Concern Anxiety
Numb Conflicted Confused
Numb Guilt Shame
Numb Rejected Abandoned
8
CORE CLINICAL ASSUMPTIONS
  • 2. Its all about avoidance
  • Dysfunctional affect management/symptom
  • Push feelings into the body/behaviors
  • What problem does this symptom solve? not to
    feel.
  • Treatment Focus Integrative techniques focusing
    on embracing clients ambivalence, balance
    between anger and grief, desensitization,
    challenging treatment objectives and integrative
    statements.

9
OBJECTIVE TO FEEL MY FEELINGS AND STAY SAFE
WAYS TO AVOID FEELING
  • LOC/egocentric thinking
  • Suicidal Ideations
  • Homicidal Ideations
  • Self-Mutilation
  • Medication
  • Confusion
  • Memories/Content
  • Eating or Not
  • Sex
  • Flashbacks
  • cognitive
  • emotional
  • Alter Egos
  • Staying in the past
  • VRP Triangle
  • Externalizing

10
OBJECTIVE TO FEEL MY FEELINGS AND STAY SAFE
WAYS TO AVOID FEELING
  • Depersonalization
  • Numbness
  • Rage
  • Sadness/Depression
  • Isolation
  • Black White thinking
  • Magical childlike thinking
  • Terminally Unique
  • Fantasy
  • internalizing
  • Dissociation
  • Humor
  • Intellectualizing
  • Somatization
  • Anxiety
  • OCD thinking behaving

11
CORE CLINICAL ASSUMPTIONS
  • 3. Locus of control shift
  • Its function
  • Self blaming/sabotaging/cognitions and or
    behaviors
  • Damaged or destroyed inner self/lost innocence
  • Issues of autonomy/identification with the
    aggressor
  • Treatment Focus Integrative techniques focusing
    on reversing the locus of control shift,
    reframing damaged or destroyed, accepting and
    feeling vulnerability, helplessness,
    powerlessness, and grief and separation and
    individuation.

12
LOCUS OF CONTROL SHIFT - ITS FUNTIONS
  1. Age appropriate
  2. Maintains attachment
  3. Provides power and control
  4. Provides hope
  5. Explains why?
  6. Provides identity
  7. Avoids feelings of helplessness, vulnerability,
    and powerlessness

13
CORE CLINICAL ASSUMPTIONS
  • 4. Ambivalent Attachment/Trust Issues
  • Grief work
  • Autonomy
  • Treatment Focus Integrative techniques focusing
    on education about biology of attachment, locus
    of control shift, balance anger vs grief,
    tolerate feelings of helplessness, vulnerability,
    powerlessness, and grief.

14
  • As people get in touch with their feelings,
    expect an increase in urgency to regress
    cognitively, emotionally, or behaviorally.
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