MELISSA CALDWELL ENGLE, MS, LPC, ATR

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MELISSA CALDWELL ENGLE, MS, LPC, ATR

• THE ROSS INSTITUTE
• Executive Clinical Director
• 1701 Gateway, Suite 349
• Richardson, Texas 75080
• Private Practice 214-498-5493
• www.rossinst.com

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UNRESOLVED ATTACHMENT ISSUESIDENTIFICATION AND
TREATMENT TECHNIQUES

• Melissa Caldwell Engle, MS, LPC, ATR
• Texarkana, Texas
• April 12, 2013
• www.rossinst.com

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• Trauma is a developmental obstacle in normal
  human development.

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• Helping people to overcome childhood trauma
  and/or single event trauma in adulthood is an
  integrative process.

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CORE CLINICAL ASSUMPTIONS

• 1. Un-integrated sense of self
• Dissociation between mind and body
• Black and white thinking
• Inability to recognize and or tolerate affect
• Inability to recognize and or tolerate
  ambivalence
• Treatment Focus- Integrative techniques
  focusing on mind and body connection, education
  about feelings, affect management, containment
  and pacing, and desensitization.

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SPECTRUM OF EMOTIONS
Stuck Mind Ungrounded-Past Extreme Fluid Mind/Body Grounded Present Balanced Stuck Body Ungrounded-Past Extreme
Numb Anger Rage
Numb Cautious Paranoia
Numb Hurt Despair/Hopeless
Numb Vulnerable Helpless
Numb Sad Depression
Numb Happy Mania
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SPECTRUM OF EMOTIONS
Stuck Mind Ungrounded-Past Extreme Fluid Mind/Body Grounded Present Balanced Stuck Body Ungrounded-Past Extreme
Numb Afraid/Fear Terror/Panic
Numb Frustration Overwhelmed
Numb Concern Anxiety
Numb Conflicted Confused
Numb Guilt Shame
Numb Rejected Abandoned
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CORE CLINICAL ASSUMPTIONS

• 2. Its all about avoidance
• Dysfunctional affect management/symptom
• Push feelings into the body/behaviors
• What problem does this symptom solve? not to
  feel.
• Treatment Focus Integrative techniques focusing
  on embracing clients ambivalence, balance
  between anger and grief, desensitization,
  challenging treatment objectives and integrative
  statements.

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OBJECTIVE TO FEEL MY FEELINGSAND STAY SAFE
WAYS TO AVOID FEELING

• LOC/egocentric thinking
• Suicidal Ideations
• Homicidal Ideations
• Self-Mutilation
• Medication
• Confusion
• Memories/Content
• Eating or Not

• Sex
• Flashbacks
• cognitive
• emotional
• Alter Egos
• Staying in the past
• VRP Triangle
• Externalizing

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OBJECTIVE TO FEEL MY FEELINGSAND STAY SAFE
WAYS TO AVOID FEELING

• Depersonalization
• Numbness
• Rage
• Sadness/Depression
• Isolation
• Black White thinking
• Magical childlike thinking
• Terminally Unique

• Fantasy
• internalizing
• Dissociation
• Humor
• Intellectualizing
• Somatization
• Anxiety
• OCD thinking behaving

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CORE CLINICAL ASSUMPTIONS

• 3. Locus of control shift
• Its function
• Self blaming/sabotaging/cognitions and or
  behaviors
• Damaged or destroyed inner self/lost innocence
• Issues of autonomy/identification with the
  aggressor
• Treatment Focus Integrative techniques focusing
  on reversing the locus of control shift,
  reframing damaged or destroyed, accepting and
  feeling vulnerability, helplessness,
  powerlessness, and grief and separation and
  individuation.

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LOCUS OF CONTROL SHIFT - ITS FUNTIONS

1. Age appropriate
2. Maintains attachment
3. Provides power and control
4. Provides hope
5. Explains why?
6. Provides identity
7. Avoids feelings of helplessness, vulnerability,
   and powerlessness

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CORE CLINICAL ASSUMPTIONS

• 4. Ambivalent Attachment/Trust Issues
• Grief work
• Autonomy
• Treatment Focus Integrative techniques focusing
  on education about biology of attachment, locus
  of control shift, balance anger vs grief,
  tolerate feelings of helplessness, vulnerability,
  powerlessness, and grief.

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• As people get in touch with their feelings,
  expect an increase in urgency to regress
  cognitively, emotionally, or behaviorally.