Guest Contributor: Diana Fosha, PhD

"Good Spiraling:" The Phenomenology of Healing and the Engendering of Secure Attachment in AEDP Reprinted with permission of Connections & Reflections, the GAINS Quarterly, Summer 2007

Introduction phenomena. Vitalizing positive affective In this second part of a two-part article on experiences are fundamentally linked with transformation and AEDP, I want to zoom in on transformance and its moment-to-moment the healing process itself and take a look, up close operation in therapy: they mark it (somatic and personal, at the phenomena that mark its markers), accompany it (vitality affects), and are gorgeous unfolding. I also want to talk about the the result of it (transformational affects). double helix of attachment and transformation: Moreover, these positive vitalizing experiences are how, through tracking the moment-to-moment the affective correlates of a neurochemical unfolding of transformational processes in the environment in the brain that is most conducive to context of a dyadic relationship where the optimal learning, development, and brain growth individual feels safe and known, security of (Schore, 2001), and that are at the core of health, attachment is engendered. So this is all about how, well-being, resilience, and flourishing in adult treatment, transformation and attachment (Frederickson & Losada, 2005; Sander, 2002). go hand in hand. In this piece, I want to share with you something In the last decade, I have been interested in about the trajectory of my own journey, which led exploring the process of change and the motivation to the development of the concept of for change, healing, self-regulation, and self- transformance, and the growing appreciation of the correction, all those forces that are always there for affective experiences that invariably signal its the entraining in adult treatment, even with the operation. I will describe some of the specific most recalcitrant of patients. Another way of processes and affects that made themselves known saying this is that I have been interested in to me, once this interest declared itself. I will then exploring the motivational forces that are the show how these phenomena and processes are part counterparts of the forces that drive resistance, i.e., and parcel of the processing of difficult, painful, in the forces driving/motivating/informing healing and heretofore too frightening emotional tendencies in the patient. I have coined the term experiences to completion in the context of a safe, "transformance" for those forces (Fosha, in press; affect-facilitating dyad. Finally, I also want to see also the Winter 2006 edition of the GAINS show you how AEDP and the dyadic, experiential Quarterly). work with intense emotion and transformation become a very specific methodology for the In the first part of this article, which was titled engendering of security of attachment and its AEDP: Transformance in Action, I defined ultimate internalization in a vital and resilient self. transformance as an overarching motivational force, operating both in development and therapy, Something About How All This Came to Be that strives toward maximally adaptive organization, coherence, vitality, authenticity, and A number of years ago, I became very interested in connection, and that drives processes that, in the a particular clinical phenomenon: whenever I right environment, eventuate in healing and spoke with patients about how they felt about thriving. Transformance is driven by hope, while something positive that had happened in treatment, its motivational counterpart, resistance, is driven or as a result of treatment, they would invariably by dread. A felt sense of vitality and energy start to cry. I became intrigued. I began to pursue characterizes transformance-based emergent this more systematically. Whenever patients had a positive, transforming, therapeutic experience, I started to inquire into, and engage them in an Patients would explicitly say that they were not experiential exploration of their experience of this feeling sad or pained; rather, they would speak of change. I started to ask questions such as: "What is feeling moved, and being filled with feelings of it like for you to feel understood?" "How do you appreciation, love, and gratitude toward me, in my experience this feeling of safety?" What does that role as their dyadic other, witness, and companion feel like in your body as you tell me about it?" on their journey. Subsequent to these tears, which "What is it like for you to be able to share this with my then three year old daughter dubbed "happy me?" "What is it like for you to feel assertive and tears," as we kept processing, there would be all not afraid?" "What does the experience of sorts of deepenings. More often than not, a state I liberation feel like?" “What does the feeling of came to call "core state" came to the fore. In this love feel like in your body?" “How does seeing me state of calm, everything fell into place: patients so moved by your feelings/actions/what have you effortlessly gained access to experiences of make you feel about me? About you? What is it wisdom, generosity, ease, clarity, and, more like for you to have done generally, compassion and this with me?" bigness of heart and mind toward self and other. They As I got emotionally-based also became able to tell their answers, I kept exploring story and make sense of their the experience of those life. experiences. I simply kept asking "And what does that It seemed that we had tapped feel like?" and then once I into a powerful healing got an answer, "And what mechanism. These affects, does that feel like?" And expressed through soft, open there would always be tears, seemed to another round. I felt like affectively/somatically mark we had uncovered this the very process of healing spiral down which we transformation. It also seemed could keep traveling, as if that the process unleashed by ad infinitum (the process exploring the experience of made finite only by the transformation, was itself a pragmatics of finite transformational process, a sessions, and other reality vehicle of therapeutic healing. constraints). Thus the It seemed to be the mirror "good spiraling" of the image of the process of title. I will say more about mourning, another essential it later. process of therapeutic resolution. In mourning, resolution comes about through the psyche's As I did this, and as I kept doing it, I started to coming to terms with not having, i.e., through observe uncanny regularities in the phenomena processing painful experiences of loss and associated with these processes, remarkable deprivation. Instead, in this new process, it seemed invariants amidst the infinite variety of response. like resolution came about through the psyche In response to the exploration of patients' coming to terms with having, i.e., through experience of change for the better (in the context processing positive experiences (which of a safe dyadic connection), a very specific set of disconfirmed negative expectations and answered affective experiences would come to the fore: hopes that people dared not have, but had anyway). patients would report an upward feeling ("a rush," In trying to find a name for the therapeutic process " a surge"), their eyes would go up, and then their that is the opposite of mourning, I came up with eyes would invariably fill with tears. However, "the affirming recognition process" or, "the these were not tears of sadness or grief; rather, they process of the affirming recognition of the were tears of happiness or joy, or poignant tears. transformation of the self" (a mouthful, I admit). I came up with the name "the healing affects" for the tremulous affects. The tremulous affects (see positive affective experiences—tears, gaze Fosha, 2006) include: fear/excitement, up—that marked the process of affirming shock/surprise, curiosity/interest, exploration, and recognition, and the name "metatherapeutic positive vulnerability. Which side of the yoked processing" for the therapeutic activity of pairs comes to the fore depends on the security of exploring the patient's experience of what is the relationship. therapeutic in therapy. This is all described in my book, The Transforming Power of Affect (Fosha, 6. The healing vortex and the sensations of 2000). quantum transformation. The transformational affects that accompany this metatherapeutic I continued to delve into the process of process are bodily sensations of vibrations, experientially exploring the patient's experience of oscillations, reverberations, energy shifts, and transformation as a transformational process (the other bodily-based sensations that accompany the redundancy in the language is intentional). experience of profound, and somewhat sudden However, in continuing to focus on patients' transformation. experience of therapeutic transformation, additional metatherapeutic processes, with their respective affective phenomena that I named "transformational affects"—the invariably positive Recognition Processes, Metatherapeutic affects that mark these transformational processes Processes, and Transformational Affects and are signposts along the road to healing—came The process and experience of recognition within to the fore to make themselves known. To date, the dyad is key in reflecting back to the self other types of transformational affects something about the self, which can then be accompanying other metatherapeutic processes owned. Then, that new "knowledge," so to speak, have been identified. All six are listed below: can be entrained, integrated, and harnessed in the process of development, growth, and healing, 1. The completion of emotional processing and the while also strengthening the attachment bond. post-breakthrough affects. Its transformational When such dyadic experiences occur, not only is affects are the post-breakthrough affects of relief, the experience of each partner of the dyad enriched hope, feeling lighter, cleaner, stronger. and transformed (this is one of the mechanisms by which growth takes place), but there is a very 2. Affective mastery and the mastery affects of joy specific identifying experience of vitalization and and pride ("I did it. We did it"). The undoing of positive energy that is the fuel for glorious fear and its processing to completion leads the developmnental growth. This is key to emergence of joy, curiosity, confidence, and understanding the transformational power of exuberance. The undoing of shame and its metatherapeutic processes. processing to completion unfolds into emergence of pride and pleasure in the expansive, competent Metatherapeutic processes, marked by the self. invariably positive transformational affects, are a particular type of recognition process. They 3: Mourning-the-self and emotional pain. Its involve the recognition of the experience of transformational affect is the affect of emotional transformation of the self in the context of a dyad pain, a grief about the self. where the self feels safe, known, helped, and understood. The focus can be on self experience, 4. Affirming recognition of the transformation of on dyadic experience, on the self's experience of the self and the healing affects. There are two types the other and what that means, or on the very of healing affects: a) feeling moved, touched, and experience of transformation itself. And, of course, emotional within the self; and b) feeling love, the process of recognition is a transformational tenderness, and gratitude toward the other. process in its own right. The transformational affects are emergent phenomena, the positive, 5. Traversing the crisis of healing change and the vitalizing, energizing experiences, which themselves in turn, evoke recognition processes, in much less processed, now in the context of a seemingly never-ending transformational spiral. attachment safety can be, and is, experientially processed to completion (Fosha, 2005). Three Work with Intense Emotions: The Three States states bridged by two state transformations (see Figure 1 on the next page) characterize this process and Two State Transformations of AEDP of working with emotion to heal suffering and The phenomena of transformation, i.e., the release its transformational potential. metatherapeutic processes, and the emergence of transformational affects, are part and parcel of the State 1: The dyadic co-creation of safety. State 1 process by which AEDP works with intense, functioning is how the patient comes in. It is previously feared-to-be-unbearable emotions. The functioning that results from attempts to deal with processing to completion of difficult, painful, and unsafety and aloneness. Defenses and inhibiting heretofore-too-frightening emotional experiences affects, such as shame and fear, which block the in the context of a safe, affect-facilitating dyad is person’s direct contact with his/her own emotional characterized by three states and two state experience are prominent. That is one aspect of transformations. It is within this overall process State 1. The self always being on the lookout for that we locate the emergence of metatherapeutic safe, affect-facilitating environments in which its processes and their respective transformational strivings for self-healing and repair can come to affects. the fore is another. Thus, in the midst of dread, despair, and stuckness, we also invariably see It is the ethos and goal of AEDP to entrain the glimmers, however small, of hope and openness. forces of transformance. AEDP, an attachment and We recognize those glimmers, welcome and emotion and transformation validate them, and seek to model, seeks to do so through enlarge them. Interventions facilitating the co-creation of a here aim at building the dyadic relationship, which experience of safety becomes a safe environment in through establishing which the motivation for relatedness, bypassing transformation can come to the defenses, and alleviating fore. Such an environment is fear and shame. We seek to then buttressed by therapeutic co-create safety, and thus efforts that help the conditions conducive to the aforementioned motivation grow activation of the social stronger than the motivation that engagement system, a fuels resistance. system mediated by the Abraham Maslow wrote: "...Both [creatureliness myelinated ventral vagus and godlikeness] are...defining characteristics of (Porges, 2005) maximally suited for dyadic human nature... And any philosophy which leaves engagement and attuned emotional out either cannot be considered to be communication. Its activation signals a readiness comprehensive" (Maslow, 1968, quoted in for attachment and bonding. This dyadic Schneider & May, 1995, p. 92). safety—co-created through the synergistic combination of the therapist's attachment-informed In AEDP, we do not leave out "creatureliness," i.e., activities, and the patient's transformance-based biologically-based processes, like emotion and strivings—obviates the need for defenses through attachment, rooted in our mammalian brains and undoing the patient’s aloneness. The patient starts bodies; and we do not leave out "godlikeness," i.e., to feel willing to take the risk of opening to the transcendent aspects, equally biologically contacting deep emotion. based, of our selves-at-best. The two are organically and inextricably connected in the The first state transformation. The first state transformational process by which emotion, which transformation reflects the disruption of old and in the past was too overwhelming to be bearable, dysfunctional patterns as a result of the new experiences being generated within the therapeutic emotions. With the social engagement system on dyad. Staying with the patient, so that he/she does line, the experience of safety entrained, and with not feel alone, we seek to amplify the glimmers of defenses and inhibiting affects out of the way, the affect that herald the stirring of previously warded patient becomes in touch with bodily-rooted off intense, painful emotional experiences. We are emotional experience, most notably, the categorical also on the lookout for the glimmers of emotions. The categorical emotions, or to use Jaak transformational affects and positive vitality Panksepp's term (Panksepp, 2005), the primary affects. Here, dyadic affect regulation is achieved core emotional systems—fear, anger, joy, grief, through right-brain-to-right-brain communication: separation distress, disgust–are emotions wired through eye contact, tone of voice, gaze, tone, into our brains and bodies that play a powerful role rhythm etc., and the use of simple, evocative, in survival. The categorical emotions are universal sensory-laden, imagistic language, we seek to (Darwin, 1872): each has a specific identifying entrain (and facilitate non-traumatic access to) brain landscape, bodily signature, and right-brain-mediated, somatically-rooted emotional characteristic arrangement of facial musculature. experience, all the while Their full expression bestows seeking to bypass defenses and access to broadened thought- entrain transformance- action repertoires and activated pathways. The secure adaptive tendencies base is being co-constructed as (Damasio, 2001; Darwin, old patterns are being de- 1872; Fosha, 2000; constructed. Frederickson & Losada, 2005; van der Kolk, in press). The transition to the next state, where the intense emotions However, these categorical that could not previously be emotions are intense and, as processed can now be engaged, Pierre Janet said, is often signaled by the "vehement," and potentially patient's experience of safety. overwhelming. They are Taking a deep breath and desperately in need of dyadic exhaling with some relief, a regulation when they prove patient whose deep relational to be "too much" for the anxieties were honored and individual to deal with alone. addressed (Fosha, in press), The failure of the dyadic volunteered: "This is safe or relationship to provide that something." I took that as a clear, green light that regulatory help and support for these emotions is at we could now move to explore the disturbing the heart of what constitutes attachment trauma: emotional experiences, the avoidance of which the individual is left alone with feared-to-be- played a major role in his sexual addiction and unbearable emotions, which are disengaged—via self-destructive patterns. Safety detectors satisfied, defense mechanisms—as they cannot be borne and the social engagement system (Porges, 2005) is processed alone. Defenses pick up what dyadic now online, mediating experience and interaction. regulatory failure has dropped. The result is safety A now more resourced individual (see Fosha through disconnection from vital affective [2000] for how AEDP seeks to work with the self- experience. at-best from under the aegis of the self-at-best) is now better able to make use of connection and With safety established, and with the patient's accept help. Aloneness undone, the dyadic aloneness counteracted through the therapeutic regulation and processing of primary core relationship, these vehement emotions—be they emotions can now be undertaken in the context of grief, or rage, or fear, or even joy—can now not engagement. only be engaged and accessed, but as a result of the dyadic affect regulation available through the State 2. The dyadic regulation of the "vehement" therapeutic relationship, these emotions can now be processed and worked through to completion. of the beginning of another round of work. In Emotions associated with experiences of rejection, metatherapeutic processing, the focus shifts to the loss, abandonment, abuse, and humiliation, can be patient’s experience of transformation. Using borne, and these experiences, as well as their alternating waves of (right-brain-mediated) implications, processed. Patients' bodies also no experience and (left-brain-mediated) reflection, the longer need to hold the somatic consequences of goal now becomes to integrate the fruits of intense all the interrupted emotion sequences. Again, the emotional experience into the personality key here is AEDP's attachment-informed organization via dyadic processing. The focus on therapeutic stance: once that attachment bond is in the experience of healing transformation evokes place, State 2 somatically-rooted emotional and crystallizes one or more of the six types of processing work can be launched. phenomenologically distinct transformational affects associated with the six metatherapeutic State 2 dyadic affect regulation engages the processes. Through these processes and affective orbitofrontal cortex (Schore, 2001, 2003) and has experiences, patients can open up into areas that patient and therapist working together to help the were previously not accessible to them. Through patient access, deepen, regulate, and work through the processing of this transformational experience, subcortically-initiated and right-brain-mediated we thus help patients process positive affects, and emotional experiences, so that what was previously not only negative affects. Experience with this kind overwhelming can be borne and shared. The goal is of work has taught those of us who do it that the processing of each sometimes, given emotion to completion so people's relational that the seeds of healing, histories, work with transformation, and repair positive affects and contained in such emotional positive affective experiences can be released. experiences can be just With grief processed, clarity as challenging, if not can come; with anger more so, than work processed, the body's tension processing negative can relax and the individual's emotions, and that it strength and power can be presents with its own engaged. The release of troubled waters, which adaptive action tendencies is patients need help and evidence of the completion support traversing of a particular round of (Russell & Fosha, in emotional processing. In press). most therapies, that release marks and is the culmination of the work. In AEDP, it does mark The post breakthrough affects, such as feeling the end of State 2 work; but it also ushers in the relief, lightness, clarity, and strength, emerging next phase of work, i.e. the metatherapeutic work after the breakthrough of an intense emotional with respect to the patient's experience of experience processed to completion, allow the transformation that has just taken place through the exploration of the new self, unburdened and emotional work. We are now in a position to locate unencumbered. It is important for patients to metatherapeutic processing and work with the register how good they feel in the aftermath of transformational affects that I spoke about earlier deep and painful work. Doing so will help next in the article in the context of work with painful time in overcoming resistance to touching and emotions involved in trauma and suffering. working with what has so long been avoided.

The second state transformation: What in most The mastery affects, evident in feelings of joy and therapies is often seen as a natural endpoint of pride, come to the fore when fear and shame experiential work, i.e., the completion of a round respectively are transformed, allowing the of processing of emotion, is for AEDP the herald individual, within the dyad, to access, process, and internalize experiences that are at the heart of quantum transformation (Fosha, 2006), especially efficacy, effectiveness, and agency. The emotional when it happens rapidly. By making these pain, the transformational affect associated with sensations the focus of metatherapeutic processing, the process of mourning-the-self, is a way into we allow a place and space for those somatic empathy and compassion for the self, and for the responses to become regulated as well (Levine, processing of difficult past experiences from a 1997; Ogden et al, 2006), and for them to release place of safety and support of self for self. resources held in the body.

The healing affects, gratitude and tenderness Working with one set of the transformational toward the other, and feeling moved within oneself affects, and processing them through to in response to affirming recognition of the self and completion, can very well lead to another round of its transformation, allow a deeper processing of the processing the affects that emerge in the wake of therapeutic experiences. They are a way of this processing. Thus, when we stay in the changing self and other schemas, as well as self- moment, and keep tracking, and moving back and other schemas, so as to integrate within them the forth between experience and reflection on the new relational/affective experiences of the experience, and the experience of that, we are therapeutic work. Through processing together the involved in a process of cascading transformations. good, transforming dyadic experiences, and the Eventually, the cascade of transformations comparison between then-and-there and here-and- culminates in the calm, clear pool of core state. now from the vantage point of the here-and-now, the patient registers more deeply the State 3: Core State. The sacred and the effective. disconfirmation of old The processing of an pathological beliefs. emotion to completion This leads to the ushers in a third state. In capacity to further core state, the patient has solidify an acceptance a subjective sense of toward the self, which “truth” and a heightened goes hand in hand with sense of authenticity and a willingness to open to vitality; almost always, so relational experiences. does the therapist. As in State 2, defenses and The tremulous affects, anxiety are absent in core fear/excitement, state. But whereas the shock/startle/surprise, turbulence of intense, curiosity/interest, and a vehement emotions feeling of positive defines State 2, calm, vulnerability, register clarity, confidence, the disorganization centeredness, curiosity, associated with traversing the crisis of healing compassion, courage, and creativity, Schwartz’s change, particularly when the change is big and (2003) eight Cs, catchily capture the defining occurred rapidly. Such a disorganization of old qualities of core state. patterns is a profound source of transformation, if and only if, it is held and supported within the Work with core state phenomena culminates in the safety, security, and steadiness of the attachment assertion of personal truth and strengthening of the bond. It is that which allows excitement rather than individual’s core identity. In this "state of fear, and curiosity rather than withdrawal to come assurance" (James, 1902/1985), the patient to the fore in response to the new experience. contacts a confidence that naturally translates into effective action. The patient's true self declares Finally, the healing vortex, somatically- itself (Osiason, 2006). A strong sense of self and experienced oscillating and vibrating sensations, the capacity for effective action on behalf of the are associated with how the body proper processes self are inextricably intertwined. patient's experience of that transformation, and In core state, the patient experiences a sense of then (c) reflection on the process, followed by expansion and liberation of the self, as well as experiential exploration of the experience of the openness to and capacity for deep contact and felt sense of what the reflection yields. And so interrelatedness. Being fully able to move back on…. The process goes something like this: The and forth between compassion and self- patient is invited to first recognize and then focus compassion, between wisdom and generosity, in and attend to the experiential and somatic True-Self and True-Other relating—AEDP’s correlates of what felt good and therapeutic, equivalent of I-Thou relating—is a quintessential whether big or small, and how it felt good. Once core state phenomenon. Thus, the transcendent the patient is able to hone in and expand into the qualities Maslow associates with "godlikeness," experiential, somatic correlates of what felt are front and center in core state. therapeutic about her/his experience, s/he is then asked to find words that Processing intense capture the quality of that emotion to completion experience. This is a describes an arc of bottom-up, from the transformation (Fosha, inside-out, embodied par 2005). It goes from (a) excellence use of building safety and thus language (Lakeoff & no longer needing to rely Johnson, 1999). Finding on defenses against, and the words that "feel right" anxiety and shame about, to describe the both "creatureliness" and experience—this is what "godlikeness," to (b) Gendlin (1988) calls working with finding a handle—leads "creatureliness," i.e., the to yet another felt shift: bodily-rooted, something clicks into subcortically-initiated place, and another new categorical emotions, to (c) entraining experience emerges. This new experience itself "godlikeness," i.e., core state, where through a now becomes the platform for the next round of sense of the sacred and the effective, we become exploring and reflecting. We can most deeply human, and most ourselves. The time- alternate/oscillate between experience and honored dichotomy between creatureliness and reflection, and the experience of reflection and godlikeness is bridged in a continuous, moment-to- reflection on experience. The process assumes the moment, experientially-tracked wave. dynamic trajectory of a spiral, with experience on one side and reflection on the other. Now we are in a place where we can consider how Phenomenologically speaking, if we just focus on the dyadic regulation of transformational the transformational affects that arise with each experience is simultaneously a deep methodology new transformational round, what we see is a series for engendering secure attachment. 1 of cascading transformations. Carried forward by the momentum of transformance, one affect The Double Helix of Attachment cascades into another into another, until they all eventually gather in the still deep calm of core and Transformation state. Metatherapeutic processing involves (a) the recognition and affirmation of transformation, then There are a lot of back and forths involved in (b) the experiential and dyadic processing of the metatherapeutic processing of the patient's experience of transforming therapeutic experience,

which invariably involves contrast and 1 I wish to thank Mark Ludwig for a series of comparisons between what feels good now, which observations and subsequent conversations that led gains meaning from being compared with what to the development of these ideas. didn't feel good before. There is the going back and processing is both a one-brain process and a two- forth between self and other; there is the brain process. While the dyad supports the alternating between experience and reflection on integrative work that takes place within the the experience, and the experience of that, and so individual's neural processing (left to right and on; there is the back and forth between here-and- back, and up and down and up, both ways), it also now and there-and-then; and, while holding an supports a dyadic brain-to-brain communication openness to future possibility, there is the going process involving the integrative brain structures of back and forth, contrasting past and present, and the dyadic partners. The result is the patient's before and after. nascent capacity to generate a coherent autobiographical narrative, the single best predictor While doing a moment-to-moment analysis of the of security of attachment and resilience in the face dynamics of the transformational process involved of trauma, becomes increasingly robust through the in the processing of intense overwhelming alternating rounds of experience and reflection emotions to completion, we have just named all the involved in the metatherapeutic processing (Main, elements that are required to be synergistically 1999; Siegel). Key here is that what is being engaged in the construction of a cohesive and experientially and dyadically processed are the coherent autobiographical narrative, the hallmark positive vitalizing experiences and positive dyadic of secure attachment: self and other, emotion and interactions that are the stuff of secure attachment reflection, past, present, and future, all considered (Schore, 2001), intersubjective flourishing from a perspective infused with compassion and (Trevarthen, 2001), optimal development (Sander, acceptance. And indeed, as a result of the growing 2002), brain states conducive to optimal growth recognition of what is happening and of its import, and learning, and bodily states associated with and as a result of the back- health and longevity and-forths while moving (Fredrickson & Losada, forward yielding this 2005). recognition, once the transformational process Like the security- cascades into the calm of engendering caregiver, the core state, the patient is therapist who is able to now indeed able to tell—to receive and engage with all self and other—her/his emotional communications story in an integrated, (Cassidy, 1994) that the mindful manner. patient brings into the dyad fosters the patient's access The dyadic affect to all those experiences in regulation characteristic of metatherapeutic her/himself. Through thus exploring the experience processing entrains the integrative structures of the and meaning of what the individual has just gone brain, i.e., the corpus callosum, the prefrontal through, and sharing it with an accepting, affirming cortex—especially the right prefrontal cortex other, we not only solidify, deepen and extend the shown to mediate emotionally loaded transformational experience; we also further autobiographical narrative (Siegel, 2003), the strengthen attachment security which is rooted in insula, and the anterior cingulate (Lanius et al., difficult experience, successfully traversed 2004; van der Kolk, in press). These structures, together. We become our selves through being hypothesized to play a central role in attachment, together with, truly together with, another. Deep have been shown to be adversely affected by attachment security is engendered through the trauma (Teicher, 2002), and to play a significant moment-to-moment of going though this together; role in healing from trauma through the feeling safe to be open and transparent, sharing the coordination of left brain and right brain aspects of deepest aspects of oneself with an other; going to emotional experience, as well as of somatic and places that were too frightening to go to before; all perceptual aspects (Lanius et al; van der Kolk). with a sense of being received, accepted, and met. Entraining them through metatherapeutic Aloneness undone, we can be separate and together with. Feeling seen, we can see ourselves. Feeling (re)-owned. However, in so doing, I have also felt (Siegel, 2003), we can feel, and be. documented the unfolding of a process by Experiential work with intense emotion and which—through sharing and bearing deeply and transformation in an attachment context becomes honestly the traversing of intense emotional the methodology for the engendering of secure experiences, both good and bad—security of attachment. I wanted to document the unfolding attachment is engendered. The two go hand in phenomenology of the process of healing, once hand. previously disowned emotion is processed and

Diana Fosha, PhD, is the developer of AEDP (Accelerated Experiential-Dynamic Psychotherapy), and the Director of the AEDP Institute in New York City. She is the author of The Transforming Power of Affect: A Model for Accelerated Change (Basic Books, 2000), and of papers on transformational studies, experiential process and trauma treatment. She also contributed a chapter to Healing Trauma: Attachment, Mind, Body and Brain, edited by Marion Solomon and Daniel Siegel (Norton, 2003). A dvd of her AEDP work with a patient has just been released by APA, as part of their Systems of Psychotherapy Video Series. Many of her papers are available through the AEDP website at www.aedpinstitute.com.

References

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