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Clinical
Spotlight
Working
with Clients’ Maladaptive Relational Patterns with God in Psychotherapy
Jacqueline L. Gattis, Psy.D.
Program Director
Center for Discovery - Lakewood
Current research suggests that psychological and spiritual functioning
are highly related in important ways (see Brokaw & Edwards, 1994; Hall,
Halcrow, Hill & Delaney, 2004). Attachment theory research indicates
that patterns of infant-caregiver emotional communication are internalized
by infants and serve as templates for interpreting how future attachments
figures will act and organizing their approaches of relating. The
psychological processes that automatically and nonconsciously shape how
individuals process emotional information with humans also influence their
relationships with God. Therefore, in order to begin to describe
the formation, possible difficulties, and means of transforming believers’ relational
patterns with God, we must examine these processes at a general level. This
article summarizes key concepts in attachment theory, including the development,
imbalances, and methods of changing individuals’ unhealthy relational
patterns. This information is then used to illustrate how these same
processes can be used to transform believers’ negative relational
patterns with God.
According to attachment theory, the goal of infants’ bonds to their
caregivers is to create a sense of “felt security” (Sroufe & Waters,
1977). The attachment bond is established through emotional communication
between infants and caregivers, such as caregivers’ responses to infants’ bids
for comfort and desires to explore (Siegel, 1999). Based on the accuracy
and consistency of caregivers’ emotional responses, infants develop
one of two types of attachment bonds: a secure or an insecure attachment. In
a secure attachment bond, a sense of felt security is built within infants
as a result of repeated experiences of attuned emotional response to their
distress. This provides infants with an internal sense of well-being
that enables them to confidently make new connections to others because they
trust that others will be available and responsive to them. Infants
with insecure attachments do not develop these positive expectations.
Attachment bonds do not only affect the external relationship with caregivers,
however. As a result of repeated patterns of emotional interactions,
infants develop mental organizations of the emotions, sensations,
behaviors, and “cognitions” involved in maintaining felt security
with a particular attachment figure (Bowlby, 1969). In secure attachments,
a caregiver’s consistent, attuned responses to infants’ distress
create an internal model of a caregiver who is a source of comfort, resulting
in an expectation that their distress will be soothed. In time, this
mental model of a comforting caregiver becomes the source of security that
enables infants to soothe themselves.
Insecure attachment models do not provide infants with an internalized sense
of felt security, impairing their capacities for regulating their own emotions. As
a result, insecurely-attached infants develop compensatory strategies that
involve restricting certain emotions or behaviors and emitting only the signals
to which their caregivers are capable of responding in order to achieve a
compromised sense of security (Bowlby, 1969). Some parents provide
minimal affective attunement to their infants or are repeatedly unavailable
or rejecting (Siegel, 1999). Over time, this emotionally-barren pattern
of communication establishes a nonconscious model of the attachment figure
as nonresponsive, rendering emotional closeness uncomfortable. In order
to achieve some sense of felt security, avoidantly-attached infants
adapt to their environments by avoiding their own emotions and closeness
to their caregivers.
Some caregivers are unreliably available and attuned. At times, these
caregivers struggle to soothe their own anxiety and often become flooded. When
overwhelmed with their own anxiety, these caregivers intrude on their infants’ states
with their own needs. Ambivalently-attached infants develop
an anxious uncertainty as to whether their distress will be soothed. In
response, ambivalently-attached infants intensify their expressions of distress
as a means of attempting to ensure comfort (Siegel, 1999).
In short, infants’ internal models of attachment to caregivers become
the pattern of relating in all their relationships, including individuals’ interactions
with God.
Difficulties
Due to Insecure Mental Models of Attachment to God
The mental models of attachment established as a result of internalized
caregiver responses to infants’ emotional cues influence individuals'
perceptions of the availability and responsiveness of future attachment
figures, including God. For example, Byrd and Boe’s (2001)
investigation of prayer as a function of attachment revealed that those
with avoidant/dismissive attachment tend to use forms of prayer
that minimize a sense of closeness with God. In other words, avoidant
believers experience a more distant relationship with God and remain defensively
self-sufficient from Him, replicating their early experiences of feeling
completely responsible for their care and of interacting with a caregiver
who is removed and unmoved by their needs.
Research also indicates that those with ambivalent/preoccupied attachment primarily
engage in help-seeking prayer, revealing their mistrust of God’s reliability
and their attempts to maintain the perceived fragile bond by approaching
Him in a clingy manner (Byrd & Boe, 2001). A number of attachment
studies also indicate that ambivalent/preoccupied attachment is associated
with sudden conversion and increases in religious belief and activity following
attachment disruptions. Such sudden increases in religious involvement
are viewed as intensifications of attachment needs in order to attempt to
obtain an external source of temporary felt security during distress. In
other words, relationship with God is not pursued as an end in itself but
as a means of self-soothing (Noffke, 2006). In the end, the decrease
in anxiety that ambivalent/preoccupied believers experience after seeking
comfort from God in a clingy manner perpetuates their assumption that nurturance
is not readily available, rendering them overly-dependent on emotionally
intense religious experiences to achieve a sense of security with God.
Transforming
Insecure Mental Models of Attachment to God
Insecure patterns of attachment are repeated in new relationships because
mental models of attachment are laid down as automatic, nonconscious processes
in memory. In other words, individuals’ expectations of rejection
or of inconsistent attention function outside of awareness. These nonconscious
expectations that new attachment figures will respond like their caregivers
trigger their coping strategies of emotional detachment or hyperactivation
to automatically come “on-line.” In order for individuals to
develop more positive relational patterns with others, including God, it
is necessary to create new mental models, or literally new neural networks
in the brain, that correspond to experiences of others as available and responsive
and of the self as loved.
In therapy, facilitating adaptive change in a client’s relationship
with God first begins through developing an attachment bond between the therapist
and client. The therapeutic relationship must be ascribed sufficient
significance by the client in order to elicit, initially, the insecure attachment
patterns and to, eventually, be internalized as a new attachment figure. However,
triggering individuals’ insecure attachment patterns automatically
results in individuals interpreting and responding to the therapist in manners
that perpetuate their negative beliefs about others’ availability and
their worth. This automatic functioning of the current attachment model
must be interrupted so that construction of more adaptive self and other
models and patterns of interaction can occur.
Therapeutic interventions can lead to transformation of mental models of
attachment in two manners: indirectly, through affectively-ladened verbal
communication and directly, through novel, nonverbal experience. Therapists
link clients’ previously unarticulated senses of rejection or inconsistency
to the context in which their negative attachment assumptions were established. This
linking process provides clients with the means to make sense of their emotional
reactions toward others, including God, and to differentiate their current
relationships from those with their caregivers.
In addition, clients can also experience transformation of their insecure
attachment patterns directly through novel interpersonal exchanges with the
therapist. In other words, attuned, emotional connection between therapist
and client can create a shift directly within the attachment model. While
insecure attachment models tend to negatively skew how novel emotional experiences
are interpreted, this process is not absolute. It appears that the
level of trust within the therapeutic relationship enables clients to differentiate
their therapists' responses from those of early attachment figures and to
internalize these experiences directly.
In helping clients to experience their nonconscious fears and pain, the therapist
interrupts clients’ detachment from these feelings and provides the
insecurely attached with the novel experience of receiving attuned responses
to their emotions. Such emotional synchrony establishes neural networks
corresponding to an experience of attunement to difficult feelings and, consequently,
the expectation that others, including God, will be available during distress. In
other words, the sense of safety and worth experienced in a secure attachment
relationship with another person is then generalized as a template for what
it must be like to be in relationship with God. The therapist also
works to make this connection between experience of safety in human relationships
and with God explicit. Further, the association of attunement and soothing
with the experience of difficult emotion is also the foundation of clients’ abilities
to soothe their own feelings, decreasing their need for defensive self-sufficiency
from or clingy demands of God to achieve a sense of felt security. With
an internalized sense of themselves as safe and loved in the presence of
God, believers are then able to pursue a relationship with God vulnerably
and for its own sake.
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Announcement
 Carrie
White, Ph.D. is a licensed Clinical Psychologist who specializes in the
treatment of Eating Disorders, Mind-Body Health and Relationship Issues.
Dr. White received her Ph.D. in Clinical Psychology from the California
School of Professional Psychology, an American Psychological Association
accredited program renown for clinical training.
After earning her doctorate, Dr. White received advanced training in psychoanalytic
theories and Psychodynamic Psychotherapy at the Wright Institute Los Angeles (WILA),
where she completed a two-year fellowship. As a fellow at WILA, she gained
specialized training in working with eating disorders as part of the clinical
team at the Susan B. Krevoy Eating Disorders Program. Following
her fellowship, Dr. White went on to become a primary therapist at Laureate
Eating Disorders Program in Tulsa, Oklahoma and returned to California
to serve as the Clinical Director of an exclusive residential treatment facility
for addiction. With her formal training and rich clinical experience,
Dr. White has the depth of understanding and solid ability necessary for
treating eating disorders, substance abuse and the underlying mood disorders.
Dr. White holds privileges at Cedars-Sinai Medical Center where
she has worked with individuals and their family members at Thalians Mental
Health Center. She is faculty at the Los Angeles Institute and Society
for Psychoanalytic Studies (LAISPS) for the year-long certificate in
eating disorders program. Dr. White will be teaching a course that
focuses on blending essential Behavioral Interventions and directives into
the psychoanalytic framework. Dr. White also has a private practice
with offices in Beverly Hills and Manhattan Beach, California.
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Back
to School Tips for Parents
- Help your teen find interests in academics, extracurricular and community
activities and encourage them to get involved. Establish short and long-term
goals and a mutually agreed upon reward system when they reach those goals.
- Get to know their teacher and their teaching style. Is it compatible
to your teen’s learning style? If not, help your teen find alternative
ways to study the subjects at home.
- Don’t compare them to siblings or friends that may have better
grades – encourage their own strengths and achievements.
- Keep open communication issues like peer pressure, drugs and alcohol.
- Praise your adolescent for positive choices they make and recognize them
for their efforts and their strength of character.
- Place limits on the amount of time your teen can socialize during the
school week.
Help your teen with budgeting their time and school load.
www.nea.org
Contact
For more information, please contact our Intake Department at 800.760.3934
or info@centerfordiscovery.com
We have immediate placement availability for eating disorder residential
treatment!
24
hours a day, 7 days a week
Center for Discovery: 800.760.3934.
Oceanaire: 866.406.1066.
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Upcoming
Events
Networking
The SD Network – La Costa, CA co-hosted by Reasons Eating Disorder
Treatment at BHC Alhambra, Discovery Practice Management, Hope by the Sea,
and Miracle Recovery. Next meeting is Thursday, August 20 from 11:30 – 1pm
at Miracle Recovery featuring Mark Houston, Mark Houston Recovery Center “Reasons
for Relapse”, Thursday, September 3 TBD, and Thursday, October 8 featuring
Candy Bartole, La Ventana. For more information, contact Alexia Mowry at
562.881.9886 or alexia.mowry@centerfordiscovery.com
The OC Network – San Juan Capistrano , CA co-hosted by Reasons
Eating Disorder Treatment at BHC Alhambra, Discovery Practice Management,
and Hope by the Sea. Meetings are held on the third Friday of every month
at Hope by the Sea from 11:30 – 1pm. Upcoming events: Friday, August
21 featuring Lori Hanson “It Started with Pop Tarts My Story”;
September 18 featuring Cindy Dupuie, CN, Friday, October 16 TBD. For more
information, contact Alexia Mowry at 562-881-9886 or alexia.mowry@centerfordiscovery.com
The South Bay Network – Torrance, CA co-hosted by Discovery
Practice Management and Thelma McMillen Center. Next meeting is Tuesday,
August 25 from 8:30 – 10:00am at Thelma McMillen Center featuring Shari
Corbitt, PsyD, Touchstone “Beyond Co-Occurring Disorders: An Integrated
Treatment Approach in an Age of Multiple Diagnosis”. For more information,
contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com
Adolescent Resource Network – Sherman Oaks, CA co-hosted by
Center for Discovery, Clearview and Insights. Next meeting is Friday, September
11 from 8:30 – 10am at Insight Treatment Center featuring James Healy,
PhD, “Using Dialectical Behavioral Therapy with Adolescents”.
For more information, contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com
IAEDP Arizona – Scottsdale, AZ. Next meeting is Friday, September
18. For more information, contact Liz Rock at 562-298-2634 or elizabeth.rock@centerfordiscovery.com.
IAEDP San Diego – San Diego, CA co-hosted by Montecatini and
Reasons Eating Disorder Center at BHC Alhambra Hospital. Next meeting is
Friday, September 25 11:30 – 1pm at Aurora Behavioral Hospital featuring
Lisa Kantor, JD, Partner, Kantor & Kantor, LLP, “Working With
Insurance Companies in Providing Care for Eating Disorder Clients”.
For more information, contact IAEDP San Diego at iaedpsd@gmail.com.
IAEDP Los Angeles – Venice Beach, CA co-hosted by Discovery
Practice Management and Bella Vita. Next meeting is Friday, September 25
11:00 – 1pm. Featuring, “Real Bodies, Real Beauty: Body Image,
Hollywood and the Media”. Join Jeff Vespa, photographer for Sundance
and Toronto Film Festival, the Academy Awards and a slew of celebrities,
as he takes us on a visual journey into creating the perfect Hollywood image.
Presentation will also include a talk on media literacy and body image experiential
therapies. For more information, contact Christina Weiss at 562-457-7373
or christina.weiss@centerfordiscovery.com
Adolescent Resource Network – Pasadena, CA co-hosted by Center
for Discovery, Clearview and Insights. Next meeting is on Friday, October
16 from 8:30 – 10am held at Casa de Las Amigas – Presentation
TBA. For more information, contact Christina Weiss at 562-457-7373 or christina.weiss@centerfordiscovery.com
Adolescent Resource Network (New Site!) – Venice Beach,
CA. NETWORK LAUNCH is on Friday, November 6 featuring Mark DeAntonio, MD,
UCLA- NP Fellow, “Current Findings and Treatment Approaches for Adolescent
Bipolar Disorder”. For more information, contact Christina Weiss at
562-457-7373 or christina.weiss@centerfordiscovery.com
IAEDP Inland Empire (New Chapter!)– Redlands, CA co-hosted by
Loma Linda Behavioral Medicine Center and Reasons Eating Disorder Center
at BHC Alhambra Hospital. FIRST MEETING is Friday, November 20 11:30 – 1pm
featuring Buck Runyan, MA, MFT, LPC, CEDS. For more information, contact
IAEDP Inland Empire at iaedpinlandempire@gmail.com.
IAEDP Puget Sound (New Chapter!) – Washington State.
Coming soon! Please contact Jenni Scharf or Lisa Geraud at iaedppugetsound@gmail.com for
more information. First event is scheduled for Fall 2009.
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CEU
Events
Discovery looks forward to offering CEU events for Professionals seeking
more training in the Adolescent and Eating Disorder fields in the coming
year. Following is the schedule for our 2009 series. For more information,
please feel free to contact your Regional Manager of Clinical Outreach for
any questions.
A Father’s Voice: Engaging Dad’s in Adolescent Eating Disorder
Treatment
Featuring: Buck Runyan, MFT, LPC, CEDS
Using Expose-Response and Systematic Desensitization Techniques
for Nutritional Recovery in Eating Disorders
Featuring: Rachel Liger, MS, RD
Understanding Substance Abuse and Eating Disorders: A Psychiatric Perspective
Featuring: Brian Holt, MPH, MD
Monterey, California: November 6, 2009
Santa Barbra, CA: November 13, 2009
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Featuring
Buck Runyan
Come see Buck speak at one of the following events:
Adolescent
Eating Disorders: A Directive Approach to Strategic Family Therapy
Featuring: Buck Runyan, MFT, LPC, CEDS
Fall 2009
Trish Stanley Colloqium
San
Diego
,
CA
Contact: Alexia Mowry @ 562-881-9886 or alexia.mowry@centerfordiscovery.com
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Upcoming
Conferences
Stop by Discovery’s booth!
41st Annual Southwestern School for Behavioral Health Studies
Continuing the Journey: Staying Relevant in the 21st Century
Featuring: Buck Runyan, MFT, LPC, CEDS
A Father’s Voice: Engaging Dad’s in Adolescent Eating Disorder
Treatment
August 23-29, 2009
Loews Ventana Canyon Resort
Tucson, AZ
NEDA
September 10 - 12, 2009
Reshaping our Future: A Vision for Recovery, Research, Attitude and Action
Hilton
Minneapolis, MN
Westwind Roundtable
September 11 – 12, 2009
Manitoba, Canada
Art of Recovery Expo
September 198, 2009
For more information contact Liz Rock: 562-298-2634 or elizabeth.rock@centerfordiscovery.com
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Center
for Discovery
At-A-Glance
Center for Discovery is a residential treatment program dedicated
exclusively to adolescents struggling with eating disorders and dual diagnosis
issues. We believe that just as eating disorders and dual diagnosis disorders
require specialized treatment, so do adolescents. Discovery offers professional,
structured environments with the comfort and nurturing of serene home-like
settings where adolescents can safely address their challenges. Our individualized
treatment approach is provided by a multidisciplinary team and a low staff
to resident ratio. At Center for Discovery , we assist hundreds of adolescents
and their families annually across our six JCAHO accredited and California
licensed campuses. Since 1997 we have been privately owned and operated.
Discovery is contracted with most major healthcare insurance providers and
will assist families in verifying their insurance benefits. Our Intake Department
is available for both professionals and families 24 hours a day, 7 days a
week.
EATING DISORDERS PROGRAM
• Helping males and females 10 to 19 years old
• Disorders treated:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Other related complex disordered eating
• Weekly Family Involvement
• The Discovery Therapeutic Family Meal
• Four private therapy sessions per week
• Over 41 structured groups per week
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DUAL
DIAGNOSIS PROGRAM
• Helping males and females 12 to 17 years old
• Disorders treated:
- Addictive Disorders
- Anxiety Disorders
- Depressive Disorders
- Childhood/Adolescent Disorders
• Weekly Family Involvement
• 12-Step Focus
• Four private therapy sessions per week
• Over 41 structured groups per week
Our mission at Center for Discovery is to combine the finest traditional
inpatient approaches with creative, innovative and individualized interventions
that position our therapeutic experience at the forefront of adolescent treatment.
For more information please call 800.760.3934 or visit us at www.centerfordiscovery.com
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Oceanaire
At-A-Glance
Oceanaire is a spacious residential six-bed setting in a serene and confidential
location on the Palos Verdes Peninsula for young adult women struggling with
anorexia nervosa, bulimia nervosa, binge eating disorder or compulsive exercising.
Nestled above one of the greens of the Los Verdes Country Club Golf Course,
Oceanaire provides ocean vistas and Pacific Coast sunsets, creating a peaceful
and healing environment for the mind and body. The home has a private interior
courtyard swimming pool and lovely patio for outdoor relaxation and events.
The space at Oceanaire provides a peaceful setting for healing where young
adult women can safely and effectively address their issues and begin their
path to recovery. Oceanaire provides an intensive treatment program with
four private weekly therapy sessions, a strong family component including
weekly family conjoint sessions, multi-educational groups including DBT (Dialectical
Behavioral Therapy) groups, hands-on food exposure, restaurant outings, nutritional
education, medical and psychiatric consultations, yoga, relaxation and stress
management techniques and much more. Oceanaire is contracted with most major
healthcare insurance providers and will assist families in verifying their
insurance benefits. Our Intake Department is available for both professionals
and families 24 hours a day, 7 days a week.
EATING DISORDERS
PROGRAM
• Disorders treated:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge Eating
- Other related complex disordered eating
• Weekly Family Involvement
• The Discovery Therapeutic Family Meal
• Four private therapy sessions per week
• Over 41 structured groups per week
For more information please call 866.406.1066 or visit us at www.oceanaireinc.com
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