Wednesday, December 17, 2008

Dr. Adi Loebl, Ackerman's New Medical Director, Receives Carl Kempner Award

Lois Braverman, President of the Ackerman Institute, with Michael Kempner, (center), son of the late Carl Kempner, and Dr. Adi Loebl, recipient of the 2008 Carl Kempner Award

Speaking to a full house in the Ackerman Institute Library, Dr. Adi Loebl, the Institute’s new Medical Director and recipient of this year’s Carl Kempner Award, focused on the care of the elderly as he delivered the annual Carl Kempner Memorial Lecture on December 2nd.

The Kempner Award and Lecture are presented under the auspices of the Center for Families and Health. Dr. Evan Imber-Black, Director of the Center, introduced Dr. Loebl.

In his presentation entitled “An Integrated Psychiatric and Family Systems Approach to Caring for Our Elders,” Dr. Loebl noted the many ways in which medical and psychiatric problems, along with complex family dynamics, are intertwined in the care of older patients. The specific case Dr. Loebl used in his talk was that of a 75-year-old woman, Mrs. Smith, with several serious medical conditions, including hypertension and diabetes, pain and osteoporosis, urinary incontinence and memory loss.

Dr. Loebl said that hypertension and diabetes, both common conditions in the elderly, can have an impact on the delivery of blood throughout the body, including the brain. If a patient is not taking appropriate medication for one or both of these medical conditions, the damage to the blood vessels and consequent lack of adequate blood flow to the brain may cause behavior that appears symptomatic of dementia or even vascular dementia itself. This is best prevented with proper medication.

Just as not taking medication for a physical condition can affect symptoms of mental illness, taking medications also can affect mental health, Dr. Loebl commented. He explained that memory problems can be a side effect of many medications prescribed and commonly in medications used to treat urinary incontinence. Coordination of care is vitally important, especially in the elderly who often present with multiple problems for which they are given many different types of medication by a variety of doctors.

Dr. Loebl’s case study demonstrated clearly the importance of family members in caring for an older person as well as the powerful impact of family interaction. Mrs. Smith is a divorcee with four children, but only one daughter, Jenny, is actively involved in her care. Mrs. Smith also has a home health care worker, Cindy. Although Jenny and Cindy were working to coordinate Mrs. Smith’s care, several critical issues had emerged. Jenny was beginning to feel jealous of her mother’s attachment to Cindy. She also resented the fact that when her less involved brother and sisters came to visit, her mother seemed to appreciate them much more than she appreciated Jenny These family concerns surfaced at a time when Jenny was feeling increased pressure about her work and it became apparent that Jenny was beginning to spiral into depression, herself.

Dr. Loebl used circular questioning to address some of these issues. First, he asked Jenny to think why her mother thought the other children were not as involved as Jenny. Then he asked Mrs. Smith to speak about why she thought Jenny was feeling depressed and overburdened. This type of questioning calls up substantial amounts of relational information that may not be made available otherwise, Dr. Loebl said. It also opens the door to exploring intergenerational transmission of beliefs. In the case of the Smith family, Dr. Loebl explained, Jenny may have been repeating a pattern set by her mother, who lost her own mother as a young woman and stepped in to care for her father and siblings.

Dr.Loebl also said he worked with Cindy and Jenny to ease any tensions between them. Dr. Loebl’s approach was unusual in that he involved the caretaker as fully as the family members. As a result, the caretaker, Cindy, played an instrumental role in helping to mobilize the non-involved family members, which Jenny felt unable to do. This helped ease Jenny’s jealousy and sense of burden. Dr. Loebl’s attention to the home health aide’s position as an important member of the system is an innovation in family therapy with geriatric patients and their families.

Dr. Loebl said that recognizing the complex interactions between an illness and a family helps to clarify treatment planning because goal-setting then can be guided by an awareness of the components of family functioning, the phases of the illness and the family’s beliefs in ways that optimize care. Psychosocial factors, as well as biomedical interventions, become important influences in the healing process. Dr. Loebl said that by integrating psychiatric and family systems approaches we can better help families understand the nature of the illness and understand more fully the role of the family at different stages of illness.

The Carl Kempner Award is named in honor of the late Carl Loeb Kempner, husband of Doris Kempner, an active member of the Ackerman Board for many years. The Kempner family’s commitment to education and social services has been life long and, with the support of the Armand G. Erpf Fund, the Carl Kempner Award continues to enhance knowledge in the development of clinical intervention and in training therapists working with families coping with major health issues. Each year the Center for Families and Health at Ackerman selects an awardee from among our Ackerman trainees, alumni or young faculty members engaged in the most innovative research in the area of families and health. The award recipient delivers the Carl Kempner Memorial Lecture.

Friday, November 14, 2008

Dr. Pedro Noguera Discusses Why People Really Do Need People

Dr. Pedro Noguera inaugurated the 2008-2009 Ackerman Institute Alumnae/i Workshop series on Thursday, October 23rd with a stimulating and timely talk on “Understanding the Nature of Risk: Building Support for Children and Families in Distress.” Dr. Noguera is a professor in the Steinhardt School of Education at New York University and the Director of the Metropolitan Center for Urban Education. An urban sociologist, Dr. Noguera’s scholarship and research focuses on the ways in which schools are influenced by social and economic conditions in the urban environment. Dr. Noguera has published more than 150 research articles, monographs and research reports on such topics as urban school reform, conditions that promote student achievement, youth violence, the potential impact of school choice and vouchers on urban public schools, and race and ethnic relations in American society.

Dr. Noguera began by pointing out that unlike many speakers at the workshop series and many people in the audience, he is a sociologist and not a therapist. “We occupy the same kind of social world,” he observed, “but we approach it in different ways.”

Dr. Noguera said he did a lot of his work with schools and to understand schools, it was critically important to see them in a social context. He noted that although the United States has vast resources, it does not do the basics very well. By basics, Dr. Noguera said he meant such endeavors as teaching children from poor communities to read. He said that the schools often are the only safety net available to children.

“We have so many kids suffering from so many ailments,” Dr. Noguera said. “And it’s not just poor kids. In other communities, we have children suffering from substance abuse and eating disorders. It’s a mistake to see risk as only connected to poverty.”

Dr. Noguera noted that the U.S. has the highest teen pregnancy rate of all industrial nations, that the U.S. homicide rate is higher than the death rate of many countries at war, and that more people per capita are incarcerated in the U.S. than in any other country at any time in history.

Dr. Noguera said that the famous sociologist Emile Durkheim – the father of modern sociology – conducted a study of suicide years ago and found that suicide was closely tied to people’s sense of connection to their society. The more connected a person felt, the less likely he or she was to commit suicide. Dr. Noguera said that Emile Durkheim came to see suicide as a symptom of what he called anomie, a term that signifies an erosion, diminution or absence of personal norms, standards or values in an individual. The effect of this normlessness at both the personal or societal level is to introduce alienation, isolation, and desocialization because as norms become less binding for individuals, those individuals lose their sense of right and wrong.

According to Dr. Noguera, anomie grew in the U.S. as society changed from rural to urban and people became less attached to one another. “In other words,” Dr. Noguera said, “people need people.”

Dr. Noguera also cited the observations of Margaret Mead who, when she worked with groups in the 1960s, commented on the fragmentation of generations as a serious societal issue. In his opinion, both Durkehim and Mead were correct, Dr. Noguera commented, because we see in our society a breakdown of both institutions and families.

Social isolation and alienation can lead to mental illness and, in certain circumstances, even death, Dr. Noguera explained. To illustrate his point, he spoke about a heat wave that occurred in Chicago in which a number of elderly people who lived alone actually died because they were so disconnected from their families and communities that there was no one around to see how the extreme heat was harming them. “There was no one to open the window or get them out of their apartments,” he said. However, older people who lived with others or were still involved in a community did well in spite of the dangerous conditions brought about by the heat because another person looked in on them and helped them.

After September 11th, Dr. Noguera said, people experienced an increased sense of community and appreciated it. “There is real social benefit in social community,” Dr. Noguera said. What is needed, he explained, is to teach people emotional intelligence skills. These skills can be taught in schools, but one of the key questions facing society is how to teach them on an even larger scale.

Tuesday, July 29, 2008

Ackerman Honors 17 Extern Graduates

Family and friends filled the Ackerman library on July 24th when the Institute hosted its 2008 graduation ceremony. Seventeen externs took part in the celebration commemorating each trainee’s completion of the Ackerman Institute Core Curriculum. Trainees who complete the full Core Curriculum enroll in the Foundations in Family Therapy course and then participate in Live Clinical Supervision and the Clinical Externship in Family Therapy. Upon completion of the Clinical Externship, each trainee receives a certificate at graduation and an invitation to join the Ackerman Alumnae/i Association.

This year’s graduating class was divided into three groups: Rachel Berezin, Andrea Blumenthal, Scott Hirose, Anita Mambo and Bonnie Siegel, supervised by Evan Imber-Black, PhD; Dana Greco, Jodi Harrison, Andrew Koncz, Keren Ludwig, Margaret T. Ngunang and Sarah Robinson, supervised by Miguel Hernandez, LCSW; and Wendy Bond, Kimberly Hope Andron, Karen Murphy, Genevieve Shineman, Orly Toren-Gabay and Jan Weiss, supervised by Fiona True, LMSW.

Lois Braverman, President of the Ackerman Institute, welcomed the graduates and their guests.

“Completing the Ackerman training program is not an easy task,” Ms. Braverman said. “It requires hard work, dedication and a major commitment of time over a period of years. I am so proud of all of you and I know your families and friends share that pride.”

Ms. Braverman also congratulated the externs’ families and friends.

“At Ackerman, we believe that families are the greatest resource available to individuals coping with the complexities of modern life. We know that individuals’ problems are best solved within the context of family, and we also know that individuals’ achievements also happen within the contexts of families and communities that support those accomplishments,” she explained.

Marcia Sheinberg, Director of Training, characterized the graduates as “an impressive group.”

“You have opened your hearts and your minds to expand your ability to help people,” she said. “You have done so based on a belief in the principles and practices of a relational perspective. While most of the mental health community continues to conceptualize problems as located in individuals whose context may or may not facilitate their well-being, you believe that the essence of one’s health is in the context of connection.”

“As a profession we are facing challenging times,” Ms. Sheinberg continued. “Never has the fork in the road been clearer and the consequences for our field, not to mention the world been greater. As you continue in your careers you will be both ambassadors of the Ackerman approach to human suffering and an advocate for the principles we ascribe, which values all perspective even those which we choose to challenge.”

Each of the three supervisors also congratulated the students. Evan Imber-Black said her externs had shown her they possessed the “authenticity, warmth and empathy” needed to be successful therapists.” She called on the externs to fulfill an ancient Hebrew imperative to “repair the world.”

Miguel Hernandez told his students that their dedication and hard work filled him with the same kind of pride parents feel in their children’s accomplishments.

“You are no longer my students,” he said as he presented each of his externs with flowers. “You are now my colleagues.”

Fiona True said she often uses the metaphor of a pond in family therapy, but that her extern group had really sailed on an ocean. There were storms, she noted, but the externs made their ship seaworthy and took it to an “incredible place.” She congratulated her students for their shared commitment to learn and grow, their dedication to the families they treated and their great intellectual curiosity.

Many of the students then spoke briefly, thanking the faculty and staff at Ackerman, as well as their own families and friends for their love and support.

Thursday, July 10, 2008

Ackerman Announces New Board Leadership

A new slate of officers was elected at the June 10th annual meeting of the Ackerman Institute Board of Directors. Gregory T. Rogers became the new Chair of the Board, transitioning responsibility from Jane Donaldson. Linda Dishy is the new vice chair, and Blair Brewster will serve as the new Secretary. John O’Neill and Al Feliu will continue as Treasurer and Legal Counsel, respectively.

Greg Rogers joined the Ackerman Institute Board in 2006 after participating in Ackerman’s Family Foundations and Live Clinical courses. He is a graduate of Brown University with a degree in Economics and Organizational Behavior, and earned an MBA in International Finance from New York University’s Stern School of Business. He is the Founder and current President of RayLign Advisory, a Greenwich, CT based family consulting firm with a focus on facilitating effective financial decisions in the context of family relationships. In addition, Greg is Founder and President of the RayLign Foundation, as well as advisory member of the Fairfield County Community Foundation, and board member of the Connecticut Council for Economic Education.

“Jane Donaldson, the current Board of Directors and a tremendous Faculty and Staff have put Ackerman on an extremely positive trajectory,” says Mr. Rogers. “I very much look forward to helping further apply Ackerman’s special capabilities toward strengthening families and communities worldwide.”

The Board also welcomed two new members, Diana Benzaquen and John Tyers. Ms. Benzaquen is the Vice President and Director at Brown Harris Stevens, the real estate brokerage firm. Mr. Tyers recently joined Merrill Lynch as Vice President of Broadcort, a leading provider of financial clearing services to investment advisory firms.

Ackerman One-Day Conference Focuses on New Immigrants

Dr. Evan Imber-Black (left) with Dr. Celia Falicov

Celia Falicov, PhD, an internationally known family therapy author, teacher and clinician presented a comprehensive view of “New Immigrants in Therapy: Transnational Journeys” at the Ackerman Institute’s one-day conference on June 6th. More than 150 professionals and students attended the event, which was held at the Hunter College School of Social Work.

Celia Falicov is Clinical Professor in Psychiatry at the University of California, San Diego. Her book, Latino Families in Therapy: A Guide to Multicultural Practice, provides a new model for both trainees and experienced therapists.

Speaking from her experience and using a series of videotapes of sessions with her own clients, Dr. Falicov explained how today’s new technologies, including cell phones, emails, skype and other devices enable new immigrants to maintain close ties with their countries of origin and families there. Even in poorer, underdeveloped countries, cyber cafes support communication.

“What a difference it makes to have that kind of immediacy,” Dr. Falicov noted.

Today, she said, it is possible for immigrants to live “with two hearts instead of a broken heart.”

In addition to technological changes, immigration, itself, has changed considerably from the past. Dr. Falicov said that today’s economic immigrants are very different from the refugees who came to the U.S. decades ago. One big change is that the ratio of women to men immigrants has doubled. In addition, it is common today for immigrants to come to the US without their children. Leaving children behind in the country of origin with grandparents or other caregivers means that there are many new types of separations and reunions that occur.

Dr. Falicov discussed three contexts for working with new immigrants: relational, community and cultural/sociopolitical.

Relational context is the one most familiar to therapists, Dr. Falicov said. She explained that new immigrants most often have a very large relational system at work. The long distance family can act as a resource, providing a collectivist system of care for children. The children involved often develop multiple attachments. In some families in which the caretakers are supportive of the absent parents, this can work well, but in other families, grandparents and other caregivers may be critical of the parents and add to the estrangement children already feel.

Dr. Falicov said that trauma can be part of separation or reunification: during separations, parents, especially solo mothers, often presented with symptoms of depression; during reunifications, it was often the children who were depressed. Mothers who have been apart from their children often need to be re-established in the family hierarchy. This can be a problem in families in which there is ambiguity between the parent and caretaker. When parents and children reunite, Dr. Falicov said, it is important to make meaning out of the separation to repair the bond between them and restore a shared family story.

“This part is very challenging,” Dr. Falicov noted. She recommended that therapists employ a number of techniques, including creating a catching up life narrative, using genograms or family trees to clarify relationships and roles, celebrating family rituals and creating a special ceremony built around a certificate of legitimization that all the family members sign.

The community context includes one of the greatest losses immigrants suffer - the loss of social capital, Dr. Falicov said. She pointed out that while there are many community-based programs that can help immigrants, these programs tended to be geared more toward refugees than today’s economic immigrants (people who come to the U.S. for jobs rather than to escape persecution). Groups do exist for both, Dr. Falicov noted, and can be especially helpful to people with no access to therapy. She recommended that family therapists learn from community-based initiatives.

The final context, the cultural and sociopolitical, focuses on how the community views the immigrant. Dr. Falicov said it was important to determine if the community acted as a source of stress or support.

Following Dr. Falicov’s morning presentation, she was joined by two guest panelists, Robert C. Smith, PhD, an Associate Professor of Sociology specializing in Immigration Studies and Public Affairs at Baruch College and the Graduate Center, City University of New York, and Carola Suárez-Orozco, Professor of Applied Psychology at the NYU Steinhardt School of Culture, Education and Human Development, where she co-directs Immigration Studies.

Ms. Suárez-Orozco told the audience about a recently completed five-year longitudinal study of 400 children from immigrant families that showed that 85 percent of the children had been separated from their parents from six months to ten years. The percentage varied in different ethnic communities, but “it happens in a lot of kids’ lives,” she said. Ms. Suárez-Orozco said the study did not reveal much anger or anxiety in the children, but did find a significant amount of depression.

“The way the separation was handled made quite a difference,” she observed.

In many cases, she explained, the parents did not talk about why they were leaving to the children. Instead, they simply left. This type of separation most often was traumatic and had a bad effect on the children. In families in which parents created a separation narrative to explain why they were leaving, there was substantially less depression.

One other factor that played a key role was the way in which the caregiver handled the narrative, Ms. Suárez-Orozco continued. Caregivers who supported and reinforced the separation narrative initiated by the parents helped decrease depression in the children. Ms. Suárez-Orozko also said that the issue of immigration and separation was not unique to the United States, but an international issue.

Dr. Smith commented that one of the phenomena he observed in immigrant parents was a kid of suspension of life. Often the separation was so lengthy that the children grew up before reunification of the family took place. As a result, Dr. Smith said, parents and children who reunite often feel that they are strangers to each other. In some families, parents are viewed as “fairy godmother” figures because they only visit once in a while and usually bring gifts. The children may expect this type of relationship even after the family is reunited.

Lengthy separations also alter the roles of the family members. Children who have been raised by grandparents or other caregivers may feel they don’t have to obey parents they hardly know.

“The most difficult reunifications seem to happen among teen immigrants,” Dr. Smith said. He added that the alienation these adolescents feel sometimes leads them to join gangs when they are reunified with parents in this country.

Dr. Smith agreed with Ms. Suárez-Orozco that the way parents handle their leaving has a big impact on the children’s emotional and mental health. He said he saw a difference in gender scripts. Men are more likely to just leave with no explanation, he explained, but the children get much angrier at mothers who leave with or without explanation because there is a greater expectation that mothers will not leave their children.

“The technology is very helpful,” Dr. Smith concluded, “but there is a tremendous amount of missed opportunities.”

The conference included case consultations at lunchtime with Ackerman faculty members Mary Kim Brewster, PhD, Jean Malpas, MSW, and Laurie Kaplan, LCSW.

The conference concluded with a discussion of the advantages and pitfalls of cultural retention and long distance family and community connections in treatment decisions and advice about how to integrate all the parts of the model in treatment planning, goals, and implementation.
The one-day conference was chaired by Evan Imber-Black, PhD. The conference committee included Mary Kim Brewster, Elana Katz, LCSW, Lisa Lavelle, LCSW, Jean Malpas and Fiona True, LCSW. The conference was co-sponsored by the Hunter College School of Social Wo

Ackerman Honors Diversity Program Graduates

The Ackerman Institute recognized six students who completed the Diversity and Social Work Training Program this year at a presentation in the Library held on May 7th.

The six students are Dorimar Morales, Eddie Danner and Erika Sosa, from the Hunter College School of Social Work, and Adrianne Fiala, Jacqueline Juarez and Daniela Nunez from the NYU School of Social Work.

Laurie Kaplan, Co-Director of the Program, noted that 2008 marked the 16th year of the Diversity and Social Work Training Program, which was initiated to bring more students of color into the field. The focus of the Program is on personal as well as professional development, and the group process incorporated into the Program often mirrors what students see when they work with families, she remarked

“This kind of program is very important in terms of what it brings to society,” Sippio Small, Co-Director of the Program, said. Mr. Small added that “the important thing in a democracy is to question” and that the Ackerman Institute had always encouraged its trainees to ask many questions.

The Ackerman Institute initiated the Diversity and Social Work Training Program in 1992 as a result of the vision and generosity of Arthur Maslow, former Chair of the Ackerman Board of directors and current Trustee Emeritus. The Program was the country’s first initiative designed specifically to address the critical need for a significantly increased number of professionals of color in family therapy services in community-based social service agencies. Currently, only four percent of family therapists across the nation are people of color although it is expected that the number of minority families in the U.S. will reach 48 percent of the population by 2050. the Program offers social work students of color the opportunity to intern at Ackerman and enroll in a postgraduate training program with scholarship support.

Each student spoke briefly about his/her experience at Ackerman and presented a case. Eddie Danner’s life story demonstrated that at one time, he might have been a client at Ackerman. He was raised by a single mother, was later separated from her, and as a teenager, was drawn to street life in Harlem. Completing the Ackerman program represents a “personal triumph” he said, and he expressed his gratitude to his colleagues and the staff. “We support one another,” he said.

Jacqueline Juarez commented on how a therapist can relate strongly to a family in treatment because often the family’s issues are similar to those in the therapist’s own life. She said she had a definite connection to the family she saw because fighting was a key issue, and as a child she had refereed family fights.

Dorimar Morales said she thought the term “person of color” was a phrase coined by the dominant culture to lump all kinds of people together. Ms. Morales said she identifies in a variety of ways – as a woman, a Latina, a black and as a person from a Puerto Rican culture that is extremely diverse. In therapy sessions, she added, she identified most strongly as an immigrant although Puerto Ricans in the U.S. are not considered immigrants. As a result of her own anxiety about communicating with clients in English, Ms. Morales helped create a document called Diversity Conversation Guidelines that poses a series of questions for therapists to ask clients. The Guidelines help open communications and decrease anxiety.

Erika Sosa told the audience that her work at Ackerman intersected with her own life as her experience in losing her father was amplified by her work with a family who also experienced a loss. She said she and her co-therapist had not always agreed about how to treat their family, but that their different points of view made them a stronger team and allowed them to grow as individuals.

Adrienne Fiala observed that “beliefs influence behavior” and that she had learned how important it was not to let her beliefs influence the family she treated. She also noted that it was important to remember that different people take different meanings from the same action.

The last student to present, Daniela Nunez, said that the parent/child relationship she saw in her client related to the relationship between her and her co-therapist. The experience helped her learn to open up eventually and has altered hew way of thinking and feeling.

Many audience members expressed great appreciation for the students’ honesty in discussing their lives and their work at Ackerman.

“This is such crucial stuff,” NYU professor Allison Aldridge commented, “and so incredibly moving.”

Wednesday, April 30, 2008

Ackerman Theatre Benefit Sells Out

Ackerman Chair Jane Donaldson (left) with Alice Netter, Chair of the Theatre Benefit

The 2008 Theatre Benefit, a preview performance of The Country Girl, starring Morgan Freeman, Frances McDormand and Peter Gallagher, raised more than $160,000 in support for the Ackerman Institute. The event, held on April 22, also included a pre-theatre dinner, held in the Manhattan Ballroom (designed by Ackerman Board member Arnold Syrop) in the New York Marriott Marquis Hotel.

Three hundred friends and supporters of the Ackerman Institute purchased play tickets; 200 attended the dinner.

“This is a very special evening,“ Alice Netter, Chair of the Theatre Benefit, told the guests at the dinner, “because we are completely sold out.”

One new feature at this year’s dinner was a silent auction offering a unique item – a reservation for six at Rao’s, the famous East Harlem Italian restaurant. Rao’s is renowned for its food, celebrity clientele and exclusiveness. It is not uncommon to wait one year for a reservation at one of the tiny restaurant’s ten tables. Board member Carole Mallement secured the auction prize, which was won by Board member Alan Quasha. Ms. Netter and Lois Braverman both acknowledged Ms. Mallement’s contribution.

In her remarks, Ms. Braverman also cited Ms. Netter for her dedication.

“Putting together an evening like this requires enormous commitment and a lot of hard work, “ Ms. Braverman said. “I want to thank Alice Netter, who once again this year has done an amazing job.” Ms. Braverman went on to thank another Board member, Jeannie Ackerman Curhan, who donated gourmet chocolates for the dinner.

Finally, Ms. Braverman reminded the guests of the real meaning of the evening.

“The Theatre Benefit is not only a wonderful social event and a great evening at the theatre, but also provides important support for the Ackerman Institute,” she commented. “For those of you who don’t know us or are new to Ackerman, the Institute is dedicated to providing innovative clinical family therapy services, state-of-the-art training programs for family therapists and cutting-edge research initiatives around critical family issues. Your generosity helps make all of this possible.”

Wednesday, March 26, 2008

Gil Tunnell Presents Applying AEDP to Couple Treatment

Alumni and guests packed the Ackerman Institute library on Friday, March 7 for a presentation on Applying Accelerated Experiential Dynamic Psychotherapy (AEDP) to Couple Treatment by Gil Tunnell, PhD. Dr. Tunnell is pictured above (bottom left) sitting next to Candice Goldberg, Vice President of the Alumni Association, with Brenda Shrobe, President of the Alumni Association, and David Kezur, Faculty Liaison, standing behind. The lecture was the final event in this year’s Alumni Association Lecture Series.

Dr. Tunnell began his talk by contrasting the differences between Salvador Minuchin’s structural model for couple therapy and AEDP. Dr. Tunnell explained that in the AEDP model, the therapist’s goal is to get the couple in treatment to stop behaving defensively so they can experience core emotions, such as sadness or joy. When people are unable to express their feelings, Dr. Tunnell continued, symptoms appear, but when people stop being defensive and express their emotions, they then enter a core state. In order to get patients to let go of their defenses and anxiety, Dr. Tunnell said, the therapist must have an affirmative relationship with the couple so they feel safe enough to talk about how they really feel.

The more traditional model for couple therapy, the structural model, uses a completely different approach. The structural model includes three steps: (1) joining (of the therapist and couple); (2) enactment (by the couple); and (3) unbalancing (during which the therapist uses confrontation to strip away the couple‘s defenses).

Dr. Tunnell said that after he studied the structural model with Salvador Minuchin, he came to believe that “that kind of confrontation is shaming to couples.” The structural model raises anxiety, he continued but “AEDP does just the opposite. It lowers anxiety.”

Dr. Tunnell used the fable of the wind and the sun to illustrate his point. In that fable, the question is how do you get a man walking down a road to take off his coat. The structural model (the wind) says you try and blow the coat off; the AEDP model (the sun) says you warm the man until he removes the coat himself. By lowering anxiety levels, AEDP helps people connect with their feelings and, in turn, one another.

Dr. Tunnell noted that AEDP, which he studied with Diana Fosha, is grounded in attachment theory. From the first session, the therapist is affirmative, creating a healthy attachment and a safe bond with the couple. In order to achieve this objective, the therapist must pay attention to non-verbal signs and allow emotion to emerge in the room. The therapist can encourage the couple to be more empathetic by asking each partner if he/she noticed the other person’s non-verbal reactions. The goal here is for one person to facilitate and encourage, rather than repress and discourage, the full expression of emotion by the partner, a process AEDP calls “dyadic regulation of affect.”

The final phase of AEDP involves metaprocessing the experience. Metaprocessing is a way for partners in the relationship to think about how they feel when their partners respond to them in a particular way. For example, if one person begins to cry when certain aspects of the relationship are discussed, the therapist, during metaprocessing, asks the other person, “What was it like for you to have your partner respond to you by crying?” Metaprocessing often deepens the experience and helps the partners in the relationship connect more fully.

Dr. Tunnell showed several videotapes of sessions to illustrate his points. The last video he showed was not actually an AEDP model, but incorporated many AEDP concepts. The video focused on a couple coping with the approaching death of one partner. In the course of the couple’s therapy, the dying partner made a number of connections between the current situation and his partner’s past, and this association seemed to release a significant amount of anxiety.

The audience was clearly deeply moved by the tape and the process they witnessed. Several audience members expressed admiration for the dying partner’s ability to put aside his own needs and focus so strongly on his partner’s emotional state. One woman commented that the dialogue between the two men was “like watching a play.”

Another alumnus connected the tape and lecture to his overall feelings about the Ackerman Institute.

“I always come back to Ackerman because I always believe there’s something more,” he said, “and this was something more.”

Ackerman Hosts Third Annual Case Consultations

More than 40 alumni and guests squeezed into a packed library on Friday, January 25 when the Ackerman Institute Alumni Association hosted the Third Annual Case Conference. The case conference panel consisted of Jorge Colapinto, LPsych, Lisa Lavelle, LCSW, and Fiona True, LMSW, (pictured from left to right in the photo above).

The Case Consultation panel is one of the most popular events on the Alumni Association calendar. Each year, alumni are invited to submit cases to be discussed by a panel of faculty members. The purpose of the case consultation is to offer the individual therapist a range of different ideas about how to approach particular situations. Alumni and guests in the audience also contribute ideas and opinions.

"That was really fascinating," one audience member said as the evening came to a close. Another audience member noted, "I'm going to be thinking about these cases all weekend."