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Fostering therapeutic change through the Early Memory Procedure-An attachment perspective (1.5 CEs)

Abstract

Attachment theory highlights how early experiences with caregivers contribute to later emotional functioning in life, as the memories of these experiences are organized within Internal Working Models of Attachment, i.e. mental representations comprised of information about the self, others and the way relationships work (Main e al. 1985). Understanding the role of Insecure Models of Attachment is often at the center of the psychological assessment process, as clients seek help to comprehend their problems with their sense of self, with their relationships, and with intimacy. The Early Memory Procedure (EMP, Bruhn, 1992) is an effective and time efficient assessment technique that can be used both during a psychological evaluation or in the course of therapy to explore the significant issues in the psychological landscape of the clients (Bruhn, 1990). As clients’ concerns are often related to their attachment needs, the EMP can offer a powerful window into the clients’ attachment world, because the EMP frequently elicits memories about how and if the clients’ attachment needs were met during childhood. The papers presented in this symposium describe one mid-therapy case and three Collaborative/Therapeutic Assessment cases. The EMP work made it possible for clients to identify the connection between their mental health symptoms (depression and anxiety) and their attachment history. Further, the EMP was instrumental in highlighting how the clients’ attachment history affected the quality of their current relationships, whether intergenerationally or with their partner. The case “Superman will save me”, presented by Dr. Serena Messina, describes the treatment of a client in his 30s who struggled with significant symptoms of anxiety and self-blame, symptoms that psychiatric medication did not seem to alleviate. Examining the client’s EMPs with an attachment lens helped the client become aware of the pain he experienced as a child, as well as develop compassion for the strategies (such as withdrawal and conflict avoidance) he developed over time to cope with the lack of emotional support. Through the exploration of the EMPs in the course of therapy, the client started questioning his Insecure Internal Working Model of Attachment and the beliefs that it implied (i.e. his idea that he could not trust anybody for support, and that the lack of connection with others was due to some personal flaw). The re-imagining technique, through which the client was asked to imagine a different ending for one of the memories, was particularly effective to support the client’s development of an internal secure base and a sense of confidence in his own agency. Moreover, the attachment work promoted by the EMP prompted the client to reach out and create secure base experiences outside the therapy room too, by reconnecting with his sister and being more emotionally vulnerable with his partner. Strategies that clinicians can employ to explore clients’ early memories from an attachment perspective will be described throughout the presentation.

Chair

Serena Messina | Private Practice, Austin, Texas

Discussant

Raja David | Minnesota Center for Therapeutic Assessment

Goals & Objectives
  1. To discuss the Early Memories Procedure as a way to access the clients’ Internal Working Models of Attachment.
  2. To illustrate how the Early Memory Procedure can be a powerful tool to start an attachment focused intervention aimed at helping clients initiate the revision of their Internal Working Models of Attachment.
  3. To describe strategies that clinicians can employ when working with the Early Memory Procedure to facilitate the clients’ insights into their attachment history and promote changes in the clients’ narrative about themselves.
  4. To demonstrate how the Early Memory Procedure is an efficient and versatile instrument, that can be used both in the contest of a psychological assessment and in the context of therapeutic treatment. 
Diane Santas, UC Berkeley, The Wright Institute
Non-Member Price: $109
Member Price: $49