Rodolfo de Bernart *, *M.D.Psychiatrist, Family ... IFTI 2012.pdf · ISTITUTO DI TERAPIA FAMILIARE...
Transcript of Rodolfo de Bernart *, *M.D.Psychiatrist, Family ... IFTI 2012.pdf · ISTITUTO DI TERAPIA FAMILIARE...
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Rodolfo de Bernart *, *M.D.Psychiatrist, Family Psychotherapist ,
Family Therapy Institute of FlorenceIstituto di Terapia Familiare di Firenze
Istanbul IFTI 26th and 27th May 2012
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1. What does this theory think is the basis of psychopathology or
The basis can be a block of or a distorted communication in the family.
Due to unresolved elaboration of the cultural inputs from the Family of Origin.
The Identified Patient (Scapegoat) has a useful function which can soften the pain of a trigenerational wound and “fix” a problem in the actual family, but stops his/her own developement as a person.
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2. How does this theory conceptualize the role of the context
The Context (not only the familiar one) define any communication.
It Must be carefully observed doing the evaluation or the Hypothesis.
Sometimes it has to be changed in order to have a change in the situation
Example of Flomenhalf
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4. How does this theory address developmental processes? The developmental process of one or more
members of the family and of the family itself is blocked in the passage from the actual stage to the next one of the Family Life Cycle (FLC).
This is due to the importance of the function which is in competition with the personal growth
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May I come in bed with you,Mummy ?
If you like. But do not expect special things
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6. What does this theory attempt to do to bring about change? Change occurs through: Important Therapeutic Relation with the Family
and its Members The family makes an important experience in
the session, then reproduced at home. Through a new understanding of the situation
(hypothesis)the Family moves to the next stage of FLC,using its own resources.
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7. What time period does this theory suggest is needed for change to
Different approaches within FST Depends on the nature of the problem Generally brief: 8 – 12 sessions. (Watzlawick) ‘Avuncular’ therapy. (J. Byng-Hall) therapist as
an interested uncle – meet with decreasing frequency, sometimes over years.
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7. What time period does this theory suggest is needed for change to
The change occurs in seconds In order to stabilize it usually we need one or
two years. But the number of session is low, so that SFT
can be considered a brief therapy. Often a Individual Therapy can be added at the
end (not always for the IP).
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8. What aspect of treatment is expected to bring about change? Varies from family to family. What ‘fits’. A number of dimensions:
Family structure The meaning of symptoms or problematic behaviour Change in the meaning of relationships (reframing) Change in the pattern of interactions
Focus of change is what happens between people.
Aim to increase interactional reflexivity. Paradox is that the therapist does not
attempt to create change but a space for reflection and exploration. The family creates change.
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8. What aspect of treatment is expected to bring about change? Using the Non Verbal Channel in order to get
into the “Implicit Relational Knowledge” (Stern) Building New Strong Experiences Creating new readings if the Hypothesis trough
“Conversation” (Maturana) Always trough an important Therapeutic
Relation (Bowlby, Byng Hall)
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3. How is this theory informed by the cognitive neurosciences?
Can be interesting that Non Verbal communication and Implicit Relational Knowing (Stern) are the most important tools in our work
The “Mirror Neurons” (Rizzolati ,Gallese) explain very much of how NVL and IMPLICIT work.
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When I grow You? Forget it : Family I’ll raise a family. must be protected.
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9. How does one identify positive or negative outcomes of treatment? We need to achieve a 2° Order Change
(Bateson , Watzlawick) Possibly a Metacognition in the Family Normally the level of MC is different in the
various members of the family, going from : Mentalization and emotional change to Cognitive or just Behavioural change
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10. What sort of evidence is used & what is its quality for this treatment?
Follow up to 6 months , 1 year and more With family and individuals Sometimes using tools like AAIF (Adult
Attachment Interview for Families)(de Bernart and others, still in trial)
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11.Is the treatment unsuitable for some problems? Which and why? Familes with adopted children , specially if tha
AC is also the IP Paranoic patients (because of the setting with
one way mirror and cameras)
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The verbal channel is to much saturated,
We should use a non verbal channel,
Which is less controlled by patients and can allow us to enter into the
internal image of the family
Istituto di Terapia Familiare di Firenze
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Implicit Relational KnowingNonverbal , nonsymbolized ,Unnarrated , nonconscious
(Unconscious but not repressed)The vast Majority ( 80% ? ) of all we
know about how to be with others (including the Transference)
Daniel Stern
Istituto di Terapia Familiare di Firenze
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
IntelligenceHolisticGeneric
Not definedGlobal
SimultaneousFirst and third
Phase
SequentialAnalytic
StructuredReferentialSequential
Second Phase
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
H o m oSapiens
Learns by readingDecodificates signs
Auto-drivenMediate Emotions
Sequential intelligence
Videns
Learns by seeingLooks at images
Ethero-drivenImmediate Emotion
Simultaneous intelligence(Holistic)
Rhythm
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The Power of Metaphor stays clearly in her capacity to get to
the affective component of Personality which normally
is too much defended to be got
Littmann
Istituto di Terapia Familiare di Firenze
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
Life, intended as images, doesn’t know what to do with family dynamics and genetic predispositions. Before becoming a story, each life offers itself as a continuum of images: and it asks to be seen, first of all. Even if each image is for sure full of meanings and could be analyzed, when we jump to the meanings without considering the image, we loose a pleasure which cannot be recovered by any interpretation no matters how perfect
(James Hillmann)
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Tools in Family Therapy
Istituto di Terapia Familiare di Firenze
1 - Genogram2 - Photographic Genogram3 - Sculpture4 - Conjoint Family Drawing5 - Collage6 - Use of Films7 - Images of art
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How is this theory informed by the cognitive neurosciences ??
Can be interesting that Non Verbal communication and Implicit Relational Knowing (Stern) are the most important tools in our work
The “Mirror Neurons” (Rizzolati ,Gallese) explain very much of how NVL and IMPLICIT work.
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Implicit Relational KnowingNonverbal , nonsymbolized ,Unnarrated , nonconscious
(Unconscious but not repressed)The vast Majority ( 80% ? ) of all we
know about how to be with others (including the Transference)
Daniel Stern
Istituto di Terapia Familiare di Firenze
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Affect Syntonization
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Affect Syntonization
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Emboded SimulationYou exist in my mind
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Sintonizzazione Affettiva e Dialogo Narrativo
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Sintonizzazione Affettiva e Dialogo Narrativo
Emboded NarrativeYour Story exists in my Mind
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Sintonizzazione Affettiva e Dialogo Narrativo
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Sintonizzazione Affettiva e Dialogo Narrativo
Emboded Simulation“You exist in my Mind”
Emboded Narrative“Your Story Exists in my Mind”
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Two Therapist’s Agenda
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Two Therapist’s Agenda Explicit or Narrative Agenda
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Two Therapist’s Agenda Explicit or Narrative Agenda Implicit or Non Verbal Agenda
From Relational Diagnosis
ToImplicit Relational
Diagnosis
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Sintonizzazione Affettiva e Dialogo Narrativo
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Sintonizzazione Affettiva e Dialogo Narrativo
Core of Therapeutic Change
Tuning In
Neural Integration
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From the …To the Mind…
…to the world
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InterpersonalNeurobiology
Mind
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The adjusting Oscillators
They are a sort of body clocks which explain the mechanisms of coordination and synchronization between two or more persons among themselves.
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The adjusting Oscillators
They are a sort of body clocks which explain the mechanisms of coordination and synchronization between two or more persons among themselves.
(G.Ruggiero)
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The Adjusting Oscillators
When two violinists play the same musical score, the rhythm of the impulses in their right brain emispheres is very similar
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The Adjusting Oscillators
When two violinists play the same musical score, the rhythm of the impulses in their right brain emispheres is very similar
(G.Ruggiero)
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
An image is better than
a thousand words.
Le Doux J. “The Emotional Brain”
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The verbal channel is to much saturated,
We should use a non verbal channel,
Which is less controlled by patients and can allow us to enter into the
internal image of the family
Istituto di Terapia Familiare di Firenze
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Thank youFor your attention!!
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Istituto di Terapia Familiare di Firenze
Collage “Idea of the couple”• Card board cm 50 x 70;• Choose and cut from journals,magazines, news
papers : words, images, photos , which evoke in you the idea of the couple;
• Do this homework separatly and keep the secret;• In session we start with a a reciprocal interpretation of
the two collages trying to express the idea each of them has of the image of the couple of the partner;
• At the end each should choose the preferred , the less loved and the “disturbing” picture and explain why;
• Then each reads his/her own collage;• Each should choose the preferred , the less loved and
the “disturbing” picture and explain why;• Each should express how much the two collages are
similar in %:• Each should express how much he/she felt h/she was
well interpreted by the other in %:
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZE
How to look at a Collage•Synthetic general vision•Organization of images:! A - straight line (lines and columns)! B - cyrcular or spyral (clockwise or! counter-clockwise)•Central picture•Other significant pictures•The “Strange” picture•Reading the meanings•The preferred picture, motivation•The refused picture, motivation
•Final general vision
(Each person looks first at the collage of the other person
and then explains his/her collage)
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Istituto di Terapia Familiare di Firenze
Collage “Idea of the couple” 2
• Ask each :what images he/she would like to “steal” from the collage of the partner
• Ask each :what images he/she would like to “give as a present” from his/her collage to the partner
• What imaged could be erased to make room in his/her collage?.
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Istituto di Terapia Familiare di Firenze
Some Thoughts on Things we look at:
• Similarities and differences• Repetitions• Empty and Full• Real and Ideal• Distance and Proximity• Dipendence and autonomy• Coherence with the phase of the Fam.
Life Cycle• Presence of Projectuality,Sexuality,Love
etc.
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZE
Conjoint family drawing1. Static observation
A. Choosing the spacesB. Dividing and putting the borders
C. Presents and absentsD. Distance and closeness
E. Meanings and interpretations2. Dynamic observation
A. Level of collaboration during the projectB. Levels of participation during the making of
C. Levels of sharingD. Erasing and redrawing)
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @dada.it
web page: www.itff.orgDirector: Prof. Rodolfo de BernartObserving the Conjoint Family Drawing
SYMBOLIC INTERPRETATION:Of the drawing of each person
Of the complete drawing Of the relation between drawing and final comments
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Observation of the Conjoint Family
Emotional contex tLevel of partecipation- abstention- intermittent participation- active
participation Proximity and exclusion among the
individuals- position into the drawing- position during
the drawing- movements of the family members
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The Process Who starts,Who follows, and howtreats or
develops the same theme, take part in some other’s drawing, complete some other’s drawing. Who detaches, Propose a different theme...in opposition...searching a difference ,propose an original theme, Taking the initiative, works alone, ask/offer cooperation, organize his and other’s work, refuses to : isolation of a member , common or couple theme, common theme , different themes
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Osservazione delDisegno Congiunto
Il Disegno
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZE
Via Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280
e-mail : itff @dada.it
web page: www.itff.org
Director: Prof. Rodolfo de Bernart
Memory, hystorical and cultural identity are preserved through images.
Representation is the time-space, through which absent becomes present, not only through a magic evocation, but
also through a real substitution of the object
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
Picture makes us aware for theFirst time of the
OPTIC UNCONSCIOUSJust as psychoanalysis opens theINSTICTIVE UNCONSCIOUS
(W. Benjamin)
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
Photography is a reverse prophecy:Like Cassandra
BUTWhit eyes turned to the
PAST(R. Barthes)
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NONNA MATERNA
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Teresa
NONNA MATERNA
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Pictures in Training
Istituto di Terapia Familiare di Firenze
1. Prescription2. Journey back home (choice)3. Group Presentation4. Questions5. Restitutions6. Special Procedures7. Ritual closing8. Rielaboration (at home)9. Special Prescriptions
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LESORELLE
DAPPORTO
Teresa(Teresina)
Carola(Carolina)
Angela(Angelina)
Paola(Paolina)
Orsola(Orsolina)
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Lina e Mauro
Barlucchi
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Pictures in Clinic1. Prescription2. Journey back home (the
choice)3. Presentation in phases:
FofO and childhood (10+10)Adolescence (10+10)Adults - meeting of the couple
(10+5+5)Marriage and Children (10+5+5)
4. Direct interpretationReciproc and Common
5. Rielaboration (at home)6. Special Prescription
Istituto di Terapia Familiare di Firenze
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How to read picturesParametersInteractiveRelational
Symbolic metaphoricalPoint of viewLongitudinalTransversal
Group PicturesClose / FarAbsence
Redundant PicturesIndividual Pictures
Resemblance , Repetitions , DifferencesPosition in Genogram
B/W - ColourProportions in ages
Proportions between FofO and AF
Istituto di Terapia Familiare di Firenze
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Istituto di Terapia Familiare di Firenze
Andolfi (1977) defines sculpture as: "a non verbal creative and dinamic
modality in which sculptor analogically represents his/her
relations with members of his/her family group and relations among others, in a given moment and in a
given context.
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZE
Group and Family Sculptures 1. Traditional sculptureA. Sculpture of the pastB. Sculpture of the presentC. Sculpture of the futureD. Fenomenological and mythical sculpture2. The new sculpturesA. Instant sculptureB. Dynamic transitional sculpture
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What are the MOVIES we use Becoming a couple: Il padre di Famiglia, I Vitelloni, John and
Mary, La Famiglia, Carnal Knowledge 1st Child an childhood : Baby boom, Three men and a baby,Problem
child, L’argent de poche, Totò l’heros, Mit liv som bund, Otak na sluzbenom putu, Fanny och Alexander, Hook.
Adolescence: Dead pet society, Mignon è partita, Pauline a
la plage, Clockwork orange,Peter Pan, Stand
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ISTITUTO DI TERAPIA FAMILIARE DI FIRENZEVia Masaccio 175, 50132 FIRENZE, Italia
Tel e Fax --39 55 577280e-mail : itff @itff.org
web page: www.itff.orgDirector: Prof. Rodolfo de Bernart
To look at something, is not receiving it in a passive way, but
putting in order what you see and organizing the experience
(Elio Franzini)
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MOVIES IN TRAINING AND IN THERAPY
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How to show MOVIES Different ethnic cultures Phases of the life cicle ONLY fragments NEVER show the end Rebuilding the story And the family script Reading the non verbal language Reading relation, not verbal content Looking for hypothesis
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Movies we use, 2 Empty Nest : E non se ne vogliono andare, E se poi se ne
vanno, Tanguy. Family with old parents On golden pond, Smult robstallet, Umberto
D., Coccoon, Driving Miss Daisy, Tante Danielle, Fried green tomatoes and the Whistle stop Cafè,
Sexual Language: Carnal Knowledge, Le Declin de l’Empire
Americaine,Rich and famous, Tootsie,
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MOVIES we use 3 Separation, Divorce and Step Family: Shoot the Moon, Kramervs.Kramer,Come 2
coccodrilli, When Mummy works, This boy’s life,Radio flyer.
Omosexual couples: Strawberries and Chocolate, In and Out, Other cultures: East is East, Monsoon wedding, Water, Yalla
Yalla, The Weddind Banquet, Dona Flor, AND MANY OTHERS
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THE IMAGE OF THE THERAPIST The importance of the non verbal channel The importance of the optical uncoscious The young age of the therapy students,
without personal and professional experience Conny Leporatti
Psychologist Therapist
Family Therapy Institute of Florence
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INSTRUCTIONS The group establishes a film list on the topic of
the therapist Every student watches a film and selects 2-4
important tracks about the therapist and the therapeutic relation
Conny Leporatti
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Every student introduces to the group the selected tracks
Every student of the group comments the selected tracks
The group reflects on the image of the therapist which is being constructed
Conny Leporatti
Psychologist Therapist
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La Vita di noi due / Our life
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Test “Images of Art” for Individuals,Families, Couples and Groups
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Leon Battista AlbertiHumanist Architect
Florentine 1500
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The Chinese Emperor and his painters
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And to close… So thank you for
your attention and ……
Do not forget to keep watching images !!
I hope you will invent some new way of doing it!!
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THANK YOU FOR LISTENING TO MEAND EVEN MORE FOR
LOOKING AT MY IMAGES
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I apologize. From the Direction they tell me
that all I have said is NONSENSE
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Another husband kills his wife
Provided they do it between themselves