From Distancing Defenses to Emotional Closeness:

                                                      Traversing the Gap

                                                By Susan Warshow, MSW

 

If the patient is to be known, a requisite if therapy is to succeed, the distancing defenses must be bravely relinquished. As therapists, we invite the patient to do the counterintuitive: move towards painful feeling and, in the process, towards us. By doing so, the unrecognized and unfelt parts of the self that have been frozen by trauma can begin to heal and intimacy becomes possible.

 

Central to the dynamic relational process that replaces self-hatred with self-value, shame with openness, and fear with courage is the transmission of compassion from therapist to patient. Compassion for self is the engine that makes deep, transformative work possible. This force is inherent in humans yet often is deactivated and dormant as a result of relational trauma. Therapists who sincerely care about their patients and expend much effort to help them often become frustrated when the patient is not invested in the partnership.

 

Mobilizing the will of the patient to care for the self is one of the great challenges in psychotherapy. Success rests on two sets of shoulders! How can we heighten the possibility that the patient will allow their therapist’s caring to become internalized so that ever-greater levels of vulnerability can be accessed?

 

§  Transmission of Compassion from Therapist to Patient

The punitive parts of the self, i.e. the superego-driven defenses, will attempt to block this process and must be brought to awareness if the patient is to build capacity and have the choice to overcome them. We will consider the therapist’s language, facial expressions, tone of voice, steadfastness in the process and other factors that can increase the likelihood of a successful alliance.

 

“Your face comes to mind often when I am in one of my moods where I’m being unkind to myself and a voice comes up that says, ‘Be gentle with yourself. Be kind to this magnificent woman.’ I see your eyes and I see the compassion that comes from them and I ‘remember’ to be present and real in my gentleness, to stop the self-hatred and stop the sabotaging personality from making me miserable.”

 

 

§  Utilizing the Patient’s Inherent Motivation to Maximum Advantage.

What does the patient want on the deepest level? How does the therapist heighten awareness of this potent, expansive force and help the patient to use it as leverage against the defenses? Remembering to remember the patient’s own words is one clue!

 

 

§  The Warrior Therapist

In reality, therapy requires a warrior team involving two courageous partners. Therapist and patient are both up against a perpetrator that resides to varying degrees in each of them. Avoidance of feeling and diminishment of the self are reinforced by widespread, powerful familial and societal norms. Several issues will be considered:

 

1. Surviving the learning phase while addressing formidable defenses;

    mistakes and misalliances.

 

2. Withstanding the tide of complex feeling and working with therapist

    anxiety.

 

3. Counteracting counter-transference based despair and doubt.

 

4. Sustaining tenacity and focus within the therapeutic alliance.

 

 

 

 

 

 

 

GENERAL INFORMATION ON TRAINING PROGRAMS 

 

EDT is a powerful, emotion and somatic-focused, accelerated, attachment-centered psychodynamic therapy.

 

The ability of the therapist to access buried affect has been shown to have a strong correlation to positive outcome in treatment, leading to trauma resolution, reduction in symptoms, greater productivity and enhanced relationships. While patients both long to be known and understood intimately and wish to relieve their suffering, they also present barriers to such a process in the form of conscious and unconscious anxiety, guilt and shame as well as defense mechanisms.

 

Susan Warren Warshow’s training groups in EDT are interactive forums involving moment to moment microanalysis of material from her extensive videotape library of a broad range of patients, which includes severe ego fragility and high resistance. The comprehensive program consists of didactic discussion, slide presentations, shared readings and role playing.

 

The quality and authenticity of the therapeutic relationship and strength of the therapeutic alliance are pivotal to processing core affect. Effective defense interruption is applied empathically and compassionately so as to deepen the patient’s relationship to self and others. Participants are encouraged to value their own style and creativity and to integrate other treatment modalities, as appropriate, within their own repertoire. A supportive and encouraging environment enhances the learning process. A clinical license is required for participation in the training groups. The Friday afternoon group is advanced and prior exposure to EDT, such as a conference or seminar, is requested.

 

 

Participants can expect extensive instruction in:

  • Compassionate defense interruption

  • Tools to effectively reach core affect

  • Tracking emotions and their somatic manifestations

  • Building ego-adaptive capacity, i.e. tolerance for affect

  • Activating an intrapsychic focus and therapeutic alliance

  • How to tailor interventions for a spectrum of psychopathology

  • Healing through the therapeutic relationship

  • Countertransference and training issues

 

“Susan Warren is a gifted therapist - with superb clinical skills and the warmth and flexibility to tailor them to the needs of any given patient. I am confident that these same abilities would be present in her teaching. In fact, I've heard nothing but raves from her students. I have always been impressed with Susan's profound empathy for both patient and therapist, which surely helps her create an open learning environment.”

Patricia Coughlin (Della Selva), Ph.D., Licensed Clinical Psychologist

Former faculty Northwestern University Medical School and Albany Medical School

Author: Intensive Short term Dynamic Psychotherapy: Theory and Technique

Co-author with Dr. David Malan: Lives Transformed

Susan Warren Warshow is a highly skilled therapist and an excellent teacher. With patient and student alike, she deftly and precisely identifies and targets key factors as the first step in swiftly, adroitly, and compassionately resolving critical issues. If you are interested in improving your personal and professional work, take Susan's seminar.

 

Bruce W. Spring, MD
Assistant Professor of Clinical Psychiatry
University of Southern California School of Medicine
Training Group Participant

“Great course! Her clear demonstration of how to identify, track and turn rigid defenses into enemies of the patient, shown through videotapes of her own sessions is invaluable. I was impressed with her skill both at teaching and applying this technique in such a positive and respectful way.

Jean Ball, Ph.D.
 Assistant Professor, California Graduate Institute
Adjunct Professor, California State University at Northridge
Training Group Participant

It was so, so wonderful. The word that was running through my mind yesterday when I left, it’s just so user-friendly. It was great. I think you are so in your element. I think you’re a natural teacher of this stuff and it is so apparent to me how well you have integrated this style of working. It’s just really inspiring. I don’t have any constructive criticism at all. It’s only positive, Susan, what can I tell you? I’m just loving it and I can’t wait to come next week!

Jill Klepetar, LCSW
Training Group Participant

I thought the training was so clear and so good. You have this very clear way of analyzing and being very humble. I can’t think of anything you could have improved upon. I learned a lot in just one meeting. This is amazing work and I’m so excited about it. You made it so comfortable for me, the least experienced person in the group.

Debra King, M.A.
Training Group Participant

 

 

 

PREVIOUS PRESENTATIONS

 

CALIFORNIA ASSOCIATION OF MARRIAGE AND FAMILY THERAPISTS

 

Woodland Hills Country Club
Sunday, October 14, 2007

 

Experiential Dynamic Therapy:

A Powerful Emotion and Somatic-Focused,
Dynamic, Attachment Centered Therapy

A Videotape Presentation

with Susan Warren Warshow, LCSW, MFT

 

Therapists often question how to achieve lasting change with patients with entrenched character pathology. We will discuss videotaped excerpts from the treatment of a patient who presented with chronic depression, compulsive sexual behavior and workaholism.  She was a victim of fraternal molestation and extreme family trauma. To establish an emotionally intimate relationship with the therapist involved great risk for this patient. It also led and to a transformed way of being with herself and significant others. 

 

“You were absolutely amazing. I love your work, and the video demonstration. I learned so much from it.”
 

Anita Avedian, Vice-President of Programs,

California Association of Marriage and Family Therapists

 

 

“I first saw Susan Warshow's work in Amsterdam in 2002 and was blown away.  Her work isn't just good.  It's beautiful!  She has such a warm, related, and kind way of helping patients turn against their defenses and resistances.  I regard this one as a must see presentation.”
 

Jon Frederickson, MSW, Faculty and Co-Chair, ISTDP Training Program

 

Washington School of Psychiatry

ISTDP Training Program presents:

 

Penetrating Defenses to

Overcome Character Disturbances

 

Saturday, September 29, 2007

Susan Warshow, MSW

 

In this presentation Susan Warshow will show how she helps patients mobilize the will to overcome their defenses, face feelings, and develop compassion for the rejected parts of themselves.  Videotaped vignettes will illustrate the process that helps patients develop affect tolerance, undo irrational shame and guilt, and experience new levels of freedom.  By discouraging the punitive and encouraging the life-enhancing parts of the self, she helps patients experience emotional closeness, the ultimate goal, so the patient need no longer feel alone with forbidden feelings.

 

 

The 4th International IEDTA Conference

 

2007 August 24, 25, 26

Lakeside Lecture Theatres

University of Aarhus , Denmark

 

Learn more

Download Registration Form

 

 

Resolving Trauma through Depth Emotional Processing
An Accelerated Dynamic Approach

 

The National Association of Social Workers
2007 Annual Conference
Saturday, May 5, 2007
1:30 – 4:30 P.M.
San Francisco Airport Marriott, Burlingame
Phone: (916) 442-4565 x17

 

 

Resolving Trauma through Depth Emotional Processing
An Accelerated Dynamic Approach

San Gabriel Valley Psychological Association
Friday, March 2, 2007 12:00 - 1:30 P.M.
University Club
175 N. Oakland, Pasadena, California

Contact: Enrico Gnaulati, Ph.D.(janric@pacbell.net)
Phone: (626) 584-9968

 

 

Saturday, Oct. 28, 2006 | Pasadena, California

Saturday, Nov. 11, 2006 | Westwood, California

Click here for Brochure information

  • Compassionate defense interruption

  • Tools to effectively reach core affect

  • Tracking emotions and their somatic manifestations

  • Building ego-adaptive capacity, i.e. tolerance for affect

  • Activating an intrapsychic focus and therapeutic alliance

  • How to tailor interventions for a spectrum of psychopathology

  • Healing through the therapeutic relationship

  • Countertransference and training issues

 

 

Experiential Dynamic Therapy: Making It User-Friendly

Preserving essential principles with flexibility and

authentic use of self.

at the

Third International Congress  of the

International Experiential Dynamic Therapy Association


Freeing the Self:

Working with Core Emotions

in Dynamic Therapy
UCLA, September 9, 2005, 8:00-9:45p.m.

 

Susan Warren Warshow will explore ways to modify, personalize, and integrate techniques of defense interruption to access deep affect and resolve trauma. To effectively apply EDT, it must be adapted to ones own personal style, personality and orientation.


The presenter will share her own journey in this process.

Videotape presentation.


For more information click here

 

 

Presenter - International Short-Term Dynamic Psychotherapy Conference sponsored by the Dutch Association for Short-Term Dynamic Psychotherapy (VKDP), Amsterdam in September, 2002.

 

Presented lecture series on personality disorders to several medical staffs at hospitals in the Southern California area. She has guest lectured at California State University Northridge, California Graduate Institute and California School of Professional Psychology.