There is plenty written on the topic of resilience, but reading Eileen Russell’s new book, Restoring Resilience, is as transformative as it is informative. Russell elevates the concept of resilience to an innate process that drives and orients us toward growth, expands into interpersonal connections, and is based in the affective experience. She also uses the backdrop of accelerated experiential dynamic psychotherapy, or AEDP, to discuss the role of attachment and the therapist-client alliance in exposing the client’s innate orientation toward resilience. And, she begins with a reframing of resilience and how we define it.
Exploring the concept through the lens of a clinician, and pointing to the many clinicians who participated in her survey, Russell arrives at the following definition: Resilience is the self’s differentiation from that which is aversive to it. And, she reminds us, “resilience is in the very least a potential waiting to be discovered and brought out.”
In shifting our focus from pathology to healing, Russell presents a clinical vignette where this potential — evidenced through the client’s affective responses — is missed. It is here that Russell also informs us that even resistance can be a manifestation of resilience. She highlights as a very important point the idea that “the seeds of resilience are often to be found in the pathology itself.”
It is in this paradoxical view — and the triangle of conflict that Russell presents us with — that we can see resilience as a pull between “transformative strivings” and “chronic defenses against certain impulses and feelings that elicit anxiety in the person experiencing them.” For example, Russell uses a clinical vignette to demonstrate how these transformational affects and core states depict what she calls a “self-at-best” or a “self-at-worst.” Russell visually depicts resilience, from resistance to transformance, using a graphic, and underscores the importance of viewing resilience as a characteristic that exists in us all. As she explains, “the tendency to seek transformational self-experiences is a reliable part of the human condition and an expression of the underlying resilience potential.” Here, Russell also broadens our definition of resilience to include intra- and interpersonal, contextual, developmental, and universal contexts that serve to highlight the clinician’s importance in the client’s transformational experience.
She also emphasizes the importance of secure attachments in providing the foundation from which the client can have a transformative experience that engenders resilience. Comparing the clinician-client relationship to the mother-child relationship, Russell discusses how affective experiences can determine safety and allow clients to ultimately arrive at “safe vulnerability” where they can begin to expose more of themselves while releasing the defenses that might’ve inhibited them.
Here again, Russell presents a clinical vignette. She shows that through focusing on the client’s emotion and affective change processes, as well as those of the clinician, the client moves through the fundamental aspects of change. It is this self-in-transition that Russell then focuses on, drawing our attention to the “markers of change” that signal a client’s readiness to move toward resilience.
We also follow a vignette showing how the client’s affective responses and the therapist’s careful processing of the transformative relational experience moves the client from a self-at-worst to a self-at-best. While the self-at-best is “the most resourceful and resilient version of that person,” and one in which the therapeutic experience should hope to draw on, it is the self-in-transition in which “much of the work of therapy gets done.”
This work, demonstrated through metatherapeutic processing, connection and coordination exercises, and empathic responsiveness is what, according to Russell, ultimately will bring about “a more adaptive and healthier expression of resilience.”
Russell also introduces the Polyvagal theory of emotion to describe “what is going on in the brain and the body during resilient responses to stress,” and offers several helpful questions clinicians can use to work through maladaptive core affective experiences. Much of the work, according to Russell, also depends on the clinician’s — and ultimately the client’s — ability to recognize, facilitate, and respond to occasions of change. Russell draws our attention to how state shifts can be markers of transformation, and how metaprocessing — reflecting on the change — can move it from implicit experience to explicit awareness.
Finally, Russell explores how clinicians can use experiences such as play, exposure to open spaces, and witnessing beauty to help the client overcome the fear of freedom and move from transformance to flourishing and, ultimately, to being more fully human. Through several vignettes, she demonstrates how we can amplify and intensify positive emotions — and that, she writes, is “a condition necessary for a more complex self-organization.”
Russell also turns her attention to the therapist’s own experience. She writes that resilience-oriented work transforms the clinician, too, and that resilience is an “interdependent process” in which the clinician also experiences an “increased capacity to bear all things.”
While the concepts Russell presents are at times dense and complex, she cleverly parses them with several vignettes, diagrams, and examples — many of which can be used in the moment with the client. Russell encourages us to deepen our understanding of resilience, as well as our own capacity for experiencing it alongside our clients.
Restoring Resilience: Discovering Your Clients’ Capacity for Healing
W. W. Norton & Company, June 2015
Hardcover, 384 pages
$29.95
from Psych Central http://ift.tt/1JuJKNZ
No comments :
Post a Comment