Undoing Unbearable Aloneness in the Healing of Trauma

Accelerated Experiential Dynamic Psychotherapy (AEDP) is a healing-oriented, attachment based model developed by Diana Fosha, Ph.D. In this blog post I will touch on some of its essential features, pulling some details from Dr. Fosha’s vast work and that of other AEDP faculty. AEDP draws from experiential and psychodynamic psychotherapy traditions and integrates neuroscience and developmental research, attachment and emotion theories, and trauma and transformational studies.

In addition, AEDP offers unique contributions to the exploration of positive emotions and the process of transformation itself. This model recognizes that even the most troubling symptoms developed out of a patient’s best efforts (at the time) to adapt to adversity and trauma. Alongside these problematic patterns, there are self-righting forces ready to be tapped in conditions of safety and connection.

With a strong belief in innate capacities for healing, AEDP seeks to harness these positive forces from the very beginning of treatment. Yet to do so, we must establish a sense of safety. Trauma involves experiences of danger and possible life threat, experiences which often elicit feelings of unbearable aloneness. So first and foremost, we need to undo this sense of aloneness.

AEDP is deeply relational in its approach, and we focus on the co-creation of a secure attachment. Diana Fosha speaks of leading with a corrective emotional experience. This focus on the therapeutic relationship remains central throughout treatment. We want the relationship to become a secure base, a lifeline of sorts, that can enable wider and deeper exploration.

In working with previously overwhelming experiences, the AEDP therapist tracks moment-to-moment affective shifts and supports the patient in regulating intense emotions. So there is a great deal of attention paid to subtle changes in facial expression, posture, tone of voice, and other nonverbal cues. Every intervention is guided by what is happening in the moment.

We use our presence to sometimes help contain, sometimes resonate or expand emotional states. We want our patients to feel our presence as they allow themselves to face what they’ve feared, so that they can experience the old trauma in a new way--this time they are not alone, this time they have better access to external and internal resources to move through dark waters.

In AEDP, the central agent of change is a visceral experience of core emotional experience, in the here-and-now of the patient-therapist relationship. And in processing these emotional experiences to completion, patients often discover riches—a sense of release or energy, access to adaptive action tendencies, and a greater awareness of their resilient capacities.

While most therapeutic approaches stop there, in AEDP this is the starting point for further transformation. We explicitly explore the transformative experience itself, bringing left brain processes on board to make sense of right brain mediated bodily experiences. We want to shine a light on the treasures won from these deep emotional explorations.

One of AEDP’s mottos is, “Make the implicit explicit, make the explicit experiential”.

The very process of reflecting on the experience of change itself leads to further transformation. In my own clinical work, I have been repeatedly amazed by the transforming effects of this explicit exploration of the process of healing itself. In exploring experiences of mastery, confidence and hope expand. In exploring gratitude, the capacity to receive deepens. In exploring experiences of feeling moved, self-compassion grows.

As a clinician working from this perspective, I have found AEDP to be a very nourishing and grounding model. I’ve appreciated its permission and encouragement to bring more of my self to this work. Knowing that healing and transformation are present alongside trauma and suffering, I can be more present and realistically hopeful. And as many AEDP clinicians have noted, we ourselves are deeply touched and changed by this work.

If you want to learn more about Accelerated Experiential Dynamic Psychotherapy, the institute’s website, www.aedpinstitute.org is a wonderful resource with links to Diana Fosha’s book, free downloadable articles, and much more information.

If you are interested in participating in a AEDP study group, please contact Mary Androff, MD at mary@drmaryandroff.com