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NICABM Anxiety M7 Working with conflicting sources of anxiety - Coggle…
NICABM Anxiety M7
Working with conflicting sources of anxiety
Working with multi-layered anxiety. Pat Ogden
Performance anxiety: doing the right thing and not making mistakes otherwise harsh judgement => attachment/ relational piece that needs to be healed within the therapeutic relationship
Anxiety from past trauma: dysregulated nervous system that can’t calm down => anxiété état (identify triggers) ou trait
Some patients can mess up a therapeutic relationship [self-sabotage, self fulfilling prophecies that reinforce negative beliefs...]: not doing homework between sessions, negating skills gained during sessions
Process
Identify and name the core belief(s)
Embodiment: find out where the belief sits and the somatic tensions it creates that increases anxiety
Breathwork to relax into the body, diminish anxious sensations: heart-brain coherence
Normalize the belief: "That’s a natural belief that’s formed from the kind of history you had".
Non verbal relational work to repair the relational element by creating positive attachment experiences: therapist embodies safety and non-judgement and gets the patient to witness it and feel it in the body.
Taking the relational work to younger exiled parts
When parts take over during a session.
These expressions of anxiety hold a critical opportunity (Richard Schwartz)
Exile
: A younger hurt part overwhelms the patient during a session. They can use paralyzing ways such as anxiety to control the patient in session. The anxiety is often either an exile who has broken out at times and taken over => panic attack
Not to do
: grounding techniques because it gives the message to this little exile who just broke out that you need to leave. "You don't belong here".
To do
: welcoming the part, greeting her, asking her to defuse from the patient so that it can be helped => leads to grounding
Wording example
: "It's so great you're here. You're so welcome here. I see you're really terrified and young, and I'm sure you're stuck in a really bad place in there, and we're going to help you. It will be a little easier to help you if you wouldn't mind pulling your energy out of him/her so he/she can be there with you. We're not going to lock you up again. We're just going to have you separate so Ican help you too."
Protectors
get triggered when they sense danger or vulnerability. They can use anxiety to try and keep the patient small and safe and out of harm's way.
Just work with them the way we work with protectors in general
Work with the various parts of the client as allies
Uncover the function that a part is serving = the deeper problem that needs attention and healing