Individual Psychology, Brainspotting, Trauma and Addiction

Jared Lee

Adler Graduate School

Master’s Thesis Presentation

Individual Psychology

• Safety, significance, and a place to belong• (Ansbacher & Ansbacher 1956)

• Culture of isolation and separation

• Trauma leading to addiction and loneliness

• 1 in 20 people ages 15 to 64 use an illicit drug • (WHO, para. 1, 2017)

• Individual Psychology: Emphasis on courage and community

• Brainspotting connects mind-body to restore the whole person

Trauma and the Body

• Trauma is an unresolved negative experience held in the body

• Nervous System responds with fight, flight, freeze, faint

• Creating “dis-ease” or altered functioning

• Trauma causes physiology to change• (Van der Kolk, 2016)

• (Scaer, 2007)

• (Levine, 2010)

The Brain

• Front brain responsible for decision making

• Midbrain responsible for emotion regulation

• Hindbrain responsible for “instinctual functions” (i.e., breathing and survival responses)

• (Siegel, 2012)

Nervous System

• Sends and receives signals throughout the body

• Sympathetic Nervous System prepares body for activity

• Parasympathetic Nervous System calms and relaxes the body

• Together - create a balanced state of responses

• (Siegel, 2012)

Trauma and Arousal

• Nervous System

• Triggers

• Distress

• Survival Instincts

• Therapist/Client Understanding

Threshold of Arousal

• Unique to the individual

• Trauma to narrow range of arousal, less effective regulation

• Hyper-panic, racing thoughts, or tension

• Hypo-numbness, dissociation, shutting down

• Difficulty managing triggers, emotions, and thoughts

• (Van der kolk, 2016)

• (Porges, 2011)

• (Siegel, 2012)

Psychological Response to Trauma

• Herman stated that trauma overwhelms the human system

• Van der Kolk defined trauma as shock or threat that changes coping ability

• DSM-5 states trauma produces symptoms similar to:• Generalized Anxiety Disorder (GAD)

• Panic Disorder

• Post-traumatic Stress Disorder (PTSD)

• (Herman, 2000)

• (Van der Kolk, 2000)

• (APA, 2013)

PTSD

• Re-experience, avoidance, isolation, and hyperarousal (APA, 2013)

• Dysregulation impairs ability to cope with emotions

• Cope with symptoms through drugs and alcohol

• 14 times more likely to have SUD (McCauley, Killeen, Gros, Brady, & Back, 2012).

• Traumatic event has unprocessed emotions (Dube et. al., 2006).

• 6 x more likely to develop generalized anxiety

• 4 x more likely to experience panic attacks

• 7 x more likely to experience depression (Kessler, Sonnega, Bromet, Hughes, &

Nelson, 1995; Shaley et al. 1998).

GAD

• Worry beyond normal worry

• Ruminating thoughts, restlessness, irritability, muscle tension, poor concentration

• 4% of the population

• Alegria et al. (2010) 43,000 participants, 2% had GAD and met criteria for SUD

• Mental Illness increases vulnerability to substance use

Panic Disorder

• 5% of the population (APA, 2013).

• Symptoms lasting several minutes to days or weeks, marked by avoidance of…

• Heart pounding, hot flashes, pain, trembling, fear of lost control (APA, 2013)

• Kim, Dager, & Lyoo (2012) similarity between panic and PTSD

• Kim et al. (2013) therapy to identify reprocessing area of the brain would help

Depression

• Low mood, fatigue, apathy, decreased interest, guilt, isolate (APA, 2013)

• 337 participants in a level-1 trauma center experienced similar trauma, 3 months later predicted presence of either PTSD or depression (O’Donnell, Creamer, & Pattison, 2004)

• Negatively held experiences affect mood

• Trauma feels present, processing occurred in the past

• Siegel (2012) described 2 chemical reactions from trauma

• Block short to long-term memory passage

• Adrenaline increases coding of unconscious memory

Adverse Childhood Experiences

• Study impact of negative childhood experiences

• Researchers raised awareness for childhood abuse

• 900,000 children physically abused nearly 100,00 sexually abused (U.S.

Department of Veteran Affairs, 2015)

• ACES increase adult illnesses (Swan, 1998)

• ACES correlated trauma and increased drug and alcohol use

• 3 times more likely than general population to use drugs (Dube et al, 2003)

Addiction and Trauma

• 59% of traumatized adolescence are affected by substances (Khoury et al.,

2010)

• Looks like: anger, sleep issues, and change in school performance (Dube

et al., 2003)

• Substance use leads to more traumatic experiences (Brick, 2012)

• Siegel (2012) stated substances compromise nervous system

• Unable to process and integrate experiences

Individual Psychology

Alfred Adler:

• Inspired to become a physician after childhood rickets and pneumonia

• Transitioned to psychology and in 1902 joined Sigmund Freud

• In 1912, founded Society of Individual Psychology

• Child guidance clinics after WWI.

• Theory influenced by Freud, Jung, Frank, Nietzsche, and Kierkegaard

• Individuals strive to perceived plus by encouragement (Oberst & Stewart, 2003)

• Strive for superiority and feelings of safety, significance, and belonging (Ansbacher & Ansbacher, 1956)

Holism

• Sum greater than it’s parts

• Individual’s thoughts, feelings, and actions

• Treat the whole person (Powers & Griffith, 2007).

Lifestyle

• Private logic, and goals of life

• Thoughts, feelings, actions used to make sense of world (Oberst & Stewart,

2003)

• As if, acting by private meaning

• Developed from family of origin (Ansbacher & Ansbacher 1956)

• Adler believed poor mental health = lack of social interest

• Poor mental health marked by feelings of inferiority (Oberst & Stewart,

2003)

Tasks of Life

Tasks: 0-6 years old

• Contribute to decisions how individual will meet tasks of life (Oberst & Stewart,

2003)

• Social

• Ability to get along, intrinsic need to belong

• Work

• Enables survival and thrive, includes obligations and responsibilities

• Love

• Grow and develop ideas of being a man or woman (Ansbacher & Ansbacher, 1964)

Social Interest

• Each individual responsible for a role in community

• Private assessment of the world

• Promotes community - is on the useful side of life

• Superiority is acting on the useless side of life

• Community shapes social interest

• All behavior has a purpose (Ansbacher & Ansbacher, 1956)

• Family forms lifestyle, social interest, and ability to manage tasks (Oberst & Stewart, 2003)

Organ Jargon

• Evaluation of self, others, world, and tasks of life

• Body response reveals attitudes and opinions

• Private reasoning is conclusion to the behavior

• Useful side of life = private logic benefits community (Griffith & Powers,

2007).

• Addiction and trauma affect views and feelings of relationships (Yoshimasu, 2012; Gupta, 2013)

Organ Inferiority

• Adler said, “Trust only movement. Life happens at the level of events, not of words. Trust movement” (Ansbacher & Ansbacher, 1956, p. 195).

• Perceived organ inferiority manifests throughout the body

• Physical symptoms are language of lifestyle

• Brainspotting examines physical and emotional reactions to life events

Early Recollections

• Memory

• Facts are irrelevant

• Presents current convictions, attitudes, and biases of life’s challenges (Griffith, 1984).

• Measure progress of views on life or traumatic situations

• Measure progress in stages of change

• Access activation and serve as pre and post intervention

Brainspotting

• Identifies, processes, and releases negatively-held energy in the mind and body (Grand, 2013; Scaer, 2007)

• Dysregulation of mind-body regulation

• Accesses nervous system through field of vision (Grand, 2013).

The Process and Techniques

• Sympathetic

• Reflexes

• Emotions of arousal

• Parasympathetic

• Reflexes

• Emotions of calming and soothing (Grand, 2013).

Outside and Inside Window

• Brainspot, a reflex indicating point of importance

• Accessed through activation

• Outside, scan field of vision for reflexes

• Inside, locate activation in the body and locate a fixed eye position

• Or, access through calm, neutral spot

Gazespotting and Resource Model

• Unconscious or spontaneous look reflects internal mechanisms

• Hold spot with pointer

• Activating emotions are overwhelming, start with calm

• Locate calmness or “okayness” within body

• Reference or coping location for distress

• “Islands” of calm, grow islands as coping skills (Grand, 2013)

Discussion and Implications

• Adler found in most approaches:

• Social relations

• Self-actualization

• Person centered

• Empathy to build rapport

▪ Lacks long term studies

▪ Trained therapists

▪ Alternative to talk therapy

▪ Intervention for addiction and emotional dysregulation

Recommendations

• More intervention studies

• Dual intervention model for trauma and addiction

• Individual Psychology and brainspotting research

Conclusion

• Adler said, “to see with the eyes of another, listen with the ears of another, and feel with the heart of another,” (p. 164)

• Encouragement

• Treat the whole person, change the community

References

• Alegría, A. A., Hasin, D. S., Nunes, E. V., Liu, S.-M., Davies, C., Grant, B. F., & Blanco, C. (2010). Comorbidity of generalized anxiety disorder and substance use disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry, 71(9), 1187–1195. doi: 10.4088/JCP.09m05328gry

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

• Ansbacher, H. L., & Ansbacher, R. R. (Eds.). (1956). The Individual Psychology of Alfred Adler: A systematic presentation in selections from his writings. New York, NY: Basic Books.

• Ansbacher, H. L., & Ansbacher, R. R. (Eds.). (1964). Alfred Adler, superiority and social interest: A collection of later writing. Evanston, Ill: Northwestern University Press.

• Brick, J. (2012). Handbook of the medical consequences of alcohol and drug abuse (2nd ed.). Binghampton, NY: The Haworth Press, Inc.

• Dube, S. R., Anda, R. F., Felitti, V. J., Edwards, V. J., & Williamson, D. F. (2002). Exposure to abuse, neglect and household dysfunction among adults who witnessed intimate partner violence as children: Implications for health and social services. Violence and Victims, 17(1), 3-18.

• Dube, S. R., Miller, J. W., Brown, D. W., Giles, W. H., Felitti, V. J., Dong, M., & Anda, R. F. (2006). Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. Journal of Adolescent Health, 38(4), 444.e1-444.e10.

• Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: The adverse childhood experience study. Pediatrics, 111, 564-772.

Cont.

• Felitti, V, J. (2002) The relation between adverse childhood experiences and adult health: Turning gold into lead. The Permanente Journal, 6(1), 44-47.

• Grand, D. (2013). Brainspotting: The revolutionary new therapy for rapid and effective change. Boulder, CO: Sounds True, Inc.

• Griffith, J. (1984). Adler's organ jargon. Individual Psychology, 40(4), 437-444.

• Griffith, J., & Powers, R. L. (2007). The lexicon of Adlerian Psychology: 106 terms associated with the Individual Psychology of Alfred Adler (2nd ed.). Port Townsend, WA: Adlerian Psychology Associates.

• Gupta, M. A. (2013). Review of somatic symptoms in post-traumatic stress disorder. International Review of Psychiatry. 25(1).

• Hosseinbor, M., Yassini Ardekani, S. M., Bakhshani, S., & Bakhshani, S. (2014). Emotional and social loneliness in individuals with and without substance dependence disorder. International Journal of High Risk Behaviors & Addiction, 3(3), e22688. Retrieved from https://pdfs.semanticscholar.org/9f2e/3c447024e448c4113514f2419d2767cc8945.pdf

• Kessler, R. C., Sonnega A., Bromet E., Hughes M., & Nelson C. B., (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 2(12), 1048–1060. doi:10.1001/archpsyc.1995.03950240066012

• Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. Depression and Anxiety, 27(12), 1077–1086.

• Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. Berkeley, CA: North Atlantic Books.

• Levine, P. A. (1997). Waking the tiger: Healing trauma: the innate capacity to transform overwhelming experiences. Berkeley, CA: North Atlantic Books.

• Management of substance abuse. (2017). World Health Organization. Retrieved October 5th, 2017, from http://www.who.int/substance_abuse/en/

• McCauley, J. L., Killeen, T., Gros, D. F., Brady, K. T., & Back, S. E. (2012). Posttraumatic stress disorder and co-occurring substance use disorders: Advances inassessment and treatment. Clinical Psychology: A Publication of the Division of Clinical Psychology of the American Psychological Association, 19(3), doi: 10.1111/cpsp.12006

Cont.

• National Child Traumatic Stress Network (2008) Understanding the links between adolescent trauma and substance abuse: A toolkit for providers. (2nd ed.). Retrieved October 5, 2017 from http://www.nctsnet.org/nctsn_assets/pdfs/SAToolkit_ProviderGuide.pdf

• National Institute on Drug Abuse. (2017). America’s addiction to opioids: Heroin and prescription drug abuse. Retrieved June 19, 2017, from www.drugabuse.gov

• Oberst, U., & Stewart, A. (2003). Adlerian Psychotherapy: An advanced approach to Individual Psychology: Advancing theory in therapy. New York, NY: Brunner-Routledge.

• O’Donnell, M. L., Creamer, M., & Pattison, P. (2004). Posttraumatic stress disorder and depression following trauma: Understanding comorbidity. American Journal of Psychiatry, 161(8), 1390-1396.

• Scaer, R. C. (2007). The body bears the burden: Trauma, dissociation, and disease (2nd ed.). New York, NY: Haworth Medical Press.

• Siegel, D. (2012). Pocket guide to interpersonal neurobiology (1st ed.). New York, NY: W.W. Norton & Company, Inc.

• Steffenhagen, R. A. (1974). Drug abuse and related phenomena: an Adlerian approach. Journal of Individual Psychology. 30(2), 238.

• Substance Abuse and Mental Health Services Administration. (2017). Adverse childhood experiences. Retrieved May 2nd, 2017, from https://www.samhsa.gov/capt/practicing-effective-prevention/prevention-behavioral-health/adverse-childhood-experiences

• Swan, N. (1998). Exploring the role of child abuse in later drug abuse. Retrieved from Archives.drugabsue.gov/NIDA_Notes/NNVol13N2/exploring.html

• Trauma. (n.d.). In Merriam-Webster’s online dictionary (11th ed.). Retrieved from https://www.merriam-webster.com/dictionary/trauma?src=search-dict-hed

Cont.

• U.S. Department of Veterans Affairs. (2015, August 13). PTSD in children and teens. Retrieved

• from www.ptsd.va.gov/public/family/ptsd-children-adolscents.asp

• van der Kolk, B. (2000). Posttraumatic stress disorder and the nature of trauma. Dialogues in Clinical Neuroscience, 2(1), 7–22.

• van der Kolk, B. (2016). The body keeps the score: Mind, brain, and body in the transformation of trauma. Journal of Analytical Psychology, 61(2), 239-244. doi:10.1111/146Understanding trauma has taken shape over decades8-5922.12213_1