Final Exam Flashcards
What is trauma?
Trauma is any negative unexpected event that overwhelms, confuses, or makes you feel powerless.
Often some of life’s typical assumptions can be shattered when a trauma is experienced.
What are the 4 most common assumptions that get shattered?
- I can trust God or any higher power that aligns with your beliefs (bad things do not happen to good people, God will protect)
- I can trust others (family, spouse, friends, authorities, leaders)
- I can trust my own judgement (choices, decisions, direction)
- The world is a safe and predictable place (especially for those that pray)
What happens when life’s typical assumptions are shattered?
When these assumptions are broken it can result in grief and disorientation within oneself and in relationships. These traumas are stored in our senses and bodies not in our cognitive awareness which means they come out in our reactions or responses to events that remind us of the original experience.
These responses can sometimes be overlooked because they mimic a typical stress response that is prevalent today. Understanding how to differentiate between current life stress and embedded trauma can be difficult. For some, getting help to trace the sensation or feeling to earlier life experiences through counselling is beneficial.
It is also important to note that these responses are automatic and outside of conscious control. They are our nervous systems way of protecting us and coping with the lasting effects of the trauma.
What are common signs and symptoms of trauma?
- Exhaustion and fatigue
- Trouble sleeping or sleeping too much
- Digestive problems
- Skin problems (acne)
- Headaches, dizziness
- Heart racing, chest pain
- Lower immune system and more frequent illness
- Anxiety
- Irritability and negativity
- Changes in libido
- Loss of focus and concentration
- Depression
- Clenched jaw
- Racing heart, sweating
- Panic attacks
- High blood pressure
- Muscle tension or aching muscles
- Increased tendency to soothe using substances (alcohol, drugs, smoking, overeating, screen time, etc.)
- Disengaging from loved ones
- Loss of interest in favorite activities
- Increased emotional reactivity
- Reduced or absent emotional response
- Feel detached from their bodies
- Experience the world as unreal or dreamlike
- Have difficulty recalling specific details of the traumatic event (dissociative amnesia)
- Experience numbing
- Have a reduced awareness of one’s surroundings
What do you do after you identify a trauma?
Use the relational trauma matrix
What are 5 types of trauma?
- rejection and critcism
- humiliation and embarrassment
- deception and betrayal
- abandonment and neglect
- intentional harm and torture
What is the psychodynamic iceberg?
top of iceberg == conscious awareness (present thoughts and percpetions, current struggles
middle of iceberg == memories and stored knowledge (relational patterns)
bottom of iceberg = unconscious awareness (traumas, body memory, gut reactions/instincts – somatic)
What can you do to take clients to deeper levels of awareness in iceberg?
- querying I/C markers
- stay aware of transference and countertransference
- metacommunication can interrupt transference, flooding or cycling
What do you do in a therapy session if you are feeling stuck?
- “I’m noticing some distance”
- I wonder if you feel that too
- “I’m feeling a bit stuck right now”
- I wonder what that’s about
- work in the here and now – pull back into immediacy
What is embodied trauma?
- trauma is stored in our bodies, not in our language processing
- it is stored in unconscious processing
- it is preverbal
- it happens before we are conscious of it
- if you feel stuck, pay attention to the body
- “the body keeps the score”
How do you point out I/C markers?
- Query the actual marker
- “I notice your hand movements”
- this can make them self-conscious about their bodily movements
- “I notice your hand movements”
- query the emotion
- “I notice you are very excited when talking about this”
- “I wonder….”
- “I’m curious…”
- Get feedback, invite feedback, ask how it was
What are some basic concepts of psychoanalytic theories?
- the unconscious
- fantasy
- primary and secondary processes
- defenses
- transference
What does secure attachment look like in adults?
- positive thoughts of self
- positive thoughts of others
- high self esteem
- appropiate boundaries
- able to be vulnerable
- meaningful relationship
- comfortable with intimacy
What does ambivalent (preoccupied/anxious) attachment look like in adults?
-negative thoughts of self
- positive thoughts of others
- low self esteem
- overly concerned about tohers
- clingly
- seeks validation and approval
- wants excess intimacy
- high anxiety, low avoidance
- grasping
What does avoidant attachment (dismissive) look like for adults?
- positive thoughts of self
- negative thoughts of others
- high self esteem
- independent
- doesn’t show emotions easily
- uncomfortable with intimacy
- blaming
- avoiding closeness
-distant. critical, rigid, intolerant, frustrated - high avoidance, low anxiety
What does disorganized attachment (fearful) look like in adults?
-negative thoughts of self
negative thoughts of others
- low self esteem
- dependent
- see self as helpless
- fearful of intimacy
- expects to be hurt
- ruminating
- chaotic, explosive, abusive, untrusting
- high anxiety, high avoidance
How does a parent treat a child in secure attachment?
aligned and attuned
How does the parent treat the child in ambivalent/preoccupied/anxious attachment?
- inconsistent
How does the parent treat the child in avoidant attachment?
- unavailable or rejecting
How does parent treat the child in disorganized attachment?
- ignored
What does an existential approach to therapy look like?
An existential approach to therapy involves someone, a therapist, who is willing to walk unflinchingly with patients through life’s
deepest and most vexing problems.
Existential psychotherapy is an attitude toward human
suffering and has no manual.
It asks deep questions about the nature of the human
being and the nature of anxiety, despair, grief, loneliness, isolation, and anomie.
What are the 4 ultimate concerns according to existential therapy?
Yalom defines four categories of “ultimate concerns” that encompass these fundamental challenges of the human condition:
1. freedom,
2. isolation,
3. meaning,
4. and death.
What is freedom in existential therapy?
The term freedom in the existential sense refers to the idea that we all live in a universe without inherent design in which we are the authors of our own lives.
- Life is groundless, and we alone are responsible for our choices.
- This existential freedom carries with it terrifying responsibility
and is always connected to dread. - It is the kind of freedom people fear so much that they enlist dictators, masters, and gods to remove the burden from them.
What is isolation in existential therapy?
Individuals may be isolated from others (interpersonal isolation) or from parts of themselves (intrapersonal isolation).
- But there is a more basic form of isolation, existential
isolation, that pertains to our aloneness in the universe that remains even if assuaged
by connections to other human beings.- We enter and leave the world alone.
- While we are alive, we must always manage the tension between our wish for contact with others and our knowledge of our aloneness.
- Erich Fromm believed that isolation is the primary
source of anxiety
What is meaning in existential therapy?
- All humans must find some meaning in life, although none is absolute and none is given to us.
- We create our own world and have to answer for ourselves why we live and how we shall live.
- One of our major life tasks is to invent a purpose sturdy enough to support a life; often we have a sense of discovering meaning and then it may seem to us that it was “out there” waiting for us
What is death in existential therapy?
- Overshadowing all these ultimate concerns, the awareness of our inevitable demise is the most painful and difficult.
- We strive to find meaning in the context of our existential aloneness and take responsibility for the choices that we make within our freedom to choose, yet one day we will cease to be.
- And we live our lives with that awareness in the shadow.
- Death is always the distant thunder at our picnic, however much we may wish to deny it.
-
Existential psychotherapy emphasizes the importance of
living mindfully and purposefully, aware of one’s possibilities and limits in a context of absolute freedom and choice. Death, in this view, enriches life.
What is the untangling the knots exercise?
This is an exercise to connect with the various inner voices of the self, the various archetypal energies we all carry. Usually we ‘edit’ what we say and don’t allow for the complexities of opposing opinions or emotions to be present regarding a situation or relationship. This exercise can help ‘untangle’ the intensity of emotional or psychological energy that can feel like a knot inside of our bodies.
- Draw a small circle at the center of a piece of paper and write inside that circle the ‘knot’ you are currently experiencing. It could be a situation, a decision you need to make, a relationship or anything else you are feeling tangled up about.
- Draw 7 ‘spokes’ coming out of the circle.
- Write ‘child self’ on the first spoke of your wheel. Allow the child self so say
whatever she needs to say about the tangle and write that in the space under the first spoke. - The second spoke is the teen self / young adult self. Again, allow this energy of you as a teen or young adult to fully express what she needs to say. Here is the list of 7:
a. Child Self
b. Teen / Young Adult self
c. Anxious / Fearful self
d. Angry self
e. Over - Responsible / Religious Do – good self
f. Wild / Out of control / Gypsy – break the rules self
g. Elder / Crone self - Allow yourself to feel all these energies within you. What was an ‘aha’ moment for you? What did you become aware of? Write this down.
- Finally, draw a big circle around the whole thing and write the word Love. What if you knew that all of the aspects of yourself was held in love? Are you able to turn to all the parts of yourself with compassion and kindness? Are you able to listen and notice what needs to be heard?
- What did you learn? What did you become aware of?
How do you figure out your core values? (exercise from class)
Gillian led us in an activity that helps clients discover their core values which in turn, can help them make consequent decisions with “inner consent”. The activity was as follows:
- Ask the client to describe what a perfect day in their life looks like.
- Out of the activities that the client described, extrapolate their core values. For instance, if they mentioned family time multiple times, then you can assume that “family & interpersonal relationships” is a core value for them.
- If the client needs to make a decision, create a table listing their core values at each column heading and potential answers to the decision for each row heading.
- Evaluate each possible answer according to each core value out of 5.
- Add up the sums for each potential answer.
- The potential answer with the highest score reflects a solution that aligns the most with the client’s core values.
What does dream work look like? (Jungian)
I am ___(object in dream)___
My purpose is ______________
I like being __________ whose purpose is ___________ because _____________
I don’t like __________
___(my name)____ my message to you today is ___________
What does chair work look like in Gestalt therapy?
- chair exercise — your depression, anxiety, and grief is in that chair, what would you say to it
- reverse roles
client-centered therapy beleives that
- human beings possess vast resources for self-understanding and self-direction.
- individuals are most able to access their own creative resources when provided a relationship offered by a genuine, congruent therapist who is experiencing unconditional positive regard and warm acceptance and is empathically receptive to the client’s own perceived realities.
Name the first 3 propositions of REBT
- People are born with the potential to be rational (self-constructive) as well as irrational (self-defeating).
- People’s tendency to irrational thinking, self-damaging habituations, wishful thinking, and intolerance is frequently exacerbated by their culture and their family group.
- Humans perceive, think, emote, and behave simultaneously.
What did Rogers believe about people?
- Rogers’s ethical vision of the person is expressed in scientific language by his axiomatic concept of the actualizing tendency
- Rogers’s theory posits that organisms are motivated to maintain and enhance themselves. This tendency is inherent in the design of all living organisms.
- The significance of this view is that people do the best they can under the circumstances they perceive and that are acting on them
According to REBT, psychopathology occurs when….
individuals demand that their wishes be satisfied, that they succeed and be approved, that others treat them fairly, etc.
What did Rogers believe about the human person?
- In psychotherapy, Rogers was attuned to the fact that each person has a unique temperament, a unique history of experiences and learnings, and a way of using the therapeutic situation. His approach is oriented to the phenomenology of the unique person.
Rogers posits that every organism possesses an inherent organismic valuing process, and only to the extent that the emerging self of the person can assimilate their lived experiencing can congruence or wholeness be achieved.
What is congruence for Rogers?
- For Rogers, congruence, the state of wholeness and integration within the experience of the person, is the hallmark of psychological adjustment.
Rogers regarded congruence as the most basic of the attitudinal conditions that foster therapeutic growth.
On one hand, Rogers depicted congruence as transparent communication
- the therapist does not deny the feelings being experienced, even when the feelings may be antitherapeutic, and that the therapist is willing to express and be open about any persistent feelings that exist in the relationship.
What is the most “elegant” solution to irrational demandingness?
To help individuals become less demanding through minimization of demandingness.
What are the 3 core conditions of client-centered therapy?
Congruence, unconditional positive regard, and empathic understanding of the client’s internal frame of reference are the three therapist-provided conditions in client-centered therapy
According to REBT, what are inelegant solutions to emotional trouble?
- Distraction - a therapist can try to divert a patient into activities such as sports, a political cause, yoga, etc.
- Satisfaction of demands: satisfy clients needs so they feel better (i.e., therapist gives their love or approval to the client).
- Magic and mysticism: therapist is some kind of magician who will take their problem away.
(True or False) REBT therapists make sure to get an accurate depiction of the client’s history and be reflective while the client story tells.
False.
Describe the ABC’s of REBT
A - adverse event
B- beliefs about adverse event
C- emotional consequences
D - dispute the irrational beliefs
E - effective new philosophy
Describe the paradoxical theory of change
The more one tries to become who one is not, the more one stays the same. Knowing and accepting the truth of one’s feelings, beliefs, situation, and behavior builds wholeness and supports growth.
What is unconditional positive regard in client-centered therapy?
Other terms for this condition are warm acceptance, nonpossessive caring, and a nonjudgmental openness to the client as a person and his or her behaviors, beliefs, and values.
Biases and prejudices go with us into the therapy room, but within that relationship, the therapist makes every effort to be aware of evaluative or judgmental responses and to set them aside.
If the reactions are troublesome and threaten unconditional positive regard, then the responsible therapist takes up the basis of the judgments with a trusted consultant.
Describe the three main concepts emphasized in gestalt therapy
- Contact - being in touch with what is emerging here and now, moment to moment.
- Conscious awareness - primary therapeutic tool along with dialogue. Being in touch with what is.
- Experimentation - the act of trying something new to increase understanding. (i.e., role-playing, two-chair work)
According to gestalt therapy, what is the second order of awareness?
The awareness of one’s awareness process
Name 2 similarities and 2 differences between Gestalt therapy and client-centered therapy
- Both believe in the potential for human growth.
- Both believe that growth results from a relationship in which the therapist is experienced as warm and authentic (congruent).
- Gestalt therapy has a more active and experimental phenomenological approach (similar to behavior techniques, but designed to clarify the patient’s awareness rather than control her or his behavior)
- Gestalt therapist is more inclined to self-disclose about his or her own feelings or experience.
What 3 things does gestalt therapy focus on?
1) helping patients become aware of how they avoid learning from experience
2) how their self-regulatory processes may be close-ended rather than open-ended
3) how problems in current awareness limit one’s ability to experiment to broaden awareness.
Goal of Gestalt therapy
Awareness
What is lifespan integration?
Lifespan Integration is a gentle, body-based therapeutic method which heals without re-traumatizing. In 2003, Peggy Pace published the first edition of her book, Lifespan Integration: Connecting Ego States through Time. In her book Pace describes the new therapeutic method which she originally developed to heal adult survivors of childhood abuse or neglect. Pace soon found that LI therapy facilitates rapid healing in people of all ages, and is effective with a wide range of therapeutic issues.
Lifespan Integration relies on the innate ability of the body-mind to heal itself. LI is body-based, and utilizes repetitions of a visual timeline of memories to facilitate neural integration and rapid healing.
During the integrating phase of each LI protocol, the therapist leads the client through a series of chronological timelines of memories of their life.
The Lifespan Integration technique causes memories to surface spontaneously, and because of how memories are held neurologically, each memory which surfaces is related to the emotional theme or issue being targeted. The resulting panoramic view of the client’s life gives the client new insights about lifelong patterns resultant from the past trauma or neglect.
Discuss how gestalt therapy is done
Gestalt therapy is an exploration rather than a direct attempt to change behavior. Gestalt therapy prioritizes an active relationship and active methods to help patients gain the self-support necessary to solve problems.
What is the primary tool in Gestalt therapy?
Direct experience. Focus is always on the here and now. Therapist focuses on what the patient does and how the patient does it.
Nonverbal subtext is the most important form of contact in the gestalt therapy session (true or false).
True
