To Be Met As A Person

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ISBN: 9781855753266 | 185575326X
Cover: Paperback
Copyright: 3/30/2005

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"The aim of this book is to help us make sense of the feelings we have when we are successful and not successful in providing help for other people when they are in what one would describe as a "state". It also addresses our own or others' experiences of feeling frustrated and defeated by attempts to achieve a compassionate and intelligent response when we are frightened and anxious." -- From the Introduction This volume looks closely at attachment theory and how it relates to adults when they engage in careseeking-caregiving relationships. The key concept in the book is goal-corrected empathic attunement (GCEA) that has been developed within the context of psychotherapy. A series of empirical studies, designed to identify the elements and processes involved in GCEA that explore the role of empathic attunement in effective care-giving , are detailed. This is a thought-provoking read that sets out a framework for thinking about the way we interact with one another, and understanding and responding positively to these interactions.

Acknowledgments

Foreword by Peter D. Campion

xiii

Preface

1 The dynamics of careseeking and caregiving

Introduction

(8)

Origins of interest in attunement in therapy

(4)

Structure of the book

(2)

2 Research on the process of interaction in adult psychotherapy

Introduction

(3)

The work of the Chicago Group: 1940-1960

(5)

From a focus on the individual to a focus on interaction: 1960-1980

(2)

Psychotherapy research: 1980-2000's

(3)

Conclusion

(2)

3 Infant/caregiver interactions: the process of affect identification, communication, and regulation

Introduction

(2)

From deduction to construction: from Melanie Klein to Gyorgy Gergely

(3)

Affect regulation is linked with caregiving from the start of life

(2)

Correct identification of affect by the caregiver affects the infant's developing sense of self

(3)

How caregivers communicate to infants that they understand their affective state: the process of affect attunement

(3)

Infants' responsiveness to affective interaction with caregivers and their response to loss of contact with caregivers

(3)

Caregiver/infant interactions: the patterning of relationship

(1)

Patterns of affect attunement associated with effective caregiving

(2)

Affect attunement and empathy

(2)

Summary

(3)

4 Patterns of careseeking/caregiving relationships: research into attachment behaviour in infants and young children

Introduction

(2)

Attachment theory

(1)

Internal working models of the experience of relationship

(1)

Attachment classification: stable and persistent over time

(1)

The adult attachment interview

(1)

Careseeker/caregiver dyads: communication patterns in relation to affect

(1)

Careseeker/caregiver dyads: interaction patterns in relation to play

(1)

Careseeker/caregiver dyads: interaction strategies based on secure or insecure relationships

(3)

Effective caregiving: attunement to a range of affect

(2)

Summary

(4)

5 Presenting the concept of goal-corrected empathic attunement: effective caregiving within psychotherapy

Introduction

(1)

The attachment dynamic

(2)

The system for exploration

(1)

Goal-corrected empathic attunement: a process involved in effective caregiving

(1)

The psychotherapeutic relationship: an account of interactional sequences using the concept of goal-corrected empathic attunement

(8)

Where have we come so far?

(6)

6 First experiment: the identification of affect attunement in adult psychotherapy

Introduction

(1)

The reasearch design

(1)

First experiment

(1)

Materials and procedure

(1)

Subjects

(1)

Results

(5)

Table 1: Ratings of excerpts given by the experts

(1)

Table 2: Rating of the excerpts by experts and students

(9)

Characteristics of an 'attuned' therapist

(1)

Characteristics of a 'non-attuned' therapist

(1)

Discussion

(3)

Summary

101

(1)

7 Second experiment: is empathic attunement interactive?

Introduction

102

(1)

Hypothesis

102

(1)

Overview of the experiment

102

(1)

Methodology: subjects

103

(1)

Method of allocation to groups

103

(1)

Table 3: The experimental group and the control group

103

(1)

Confidentiality

104

(1)

Materials and practical arrangements

104

(1)

Procedure

104

(1)

Rating instruments

105

(1)

The mechanics of the debriefing

105

(1)

My experience of the debriefing sessions

106

(1)

Manging and collating the qualitative material

106

(1)

Statistical analysis

107

(1)

Correct identification of attuned and non-attuned excerpts by the experimental group and the control group

107

(1)

Qualitative analysis

108

(10)

Chart 1: Correct and incorrect identification of verbal and non-verbal behaviour

110

(5)

Chart 2: Interpretation of non-attuned extract

115

(3)

Discussion

118

(2)

Summary

120

(2)

8 Third experiment: an experiment designed to test whether secure attachment style correlates with empathic attunement and whether empathic attunement can be improved with training

Introduction

122

(1)

Overview

123

(1)

Table 4: The design and rationale for the study

124

(1)

Reasons for employing professional actors

124

(1)

Hiring the actors

125

(1)

Reasons for deciding the number of actors and students to be involved

125

(1)

Constructing the scenarios

126

(1)

Creating a control group and an experimental group for the purposes of training

127

(1)

The process of creating matched pairs

127

(1)

Creating a measure of caregiving: the careseeker's and caregiver's perspectives

127

(1)

Briefing for the students

128

(1)

Briefing for the actors

129

(1)

Briefing for the cameramen

129

(1)

Observations of the day

130

(2)

Training

132

(1)

Discussion

132

(1)

Experiment time two

133

(1)

Attachment questionnaires

133

(2)

Summary

135

(1)

9 The process of obtaining a reliable measure for goal-corrected empathic attunement

Introduction

136

(1)

Phase one: method

137

(1)

Creating a measuring instrument

137

(2)

Obtaining the clinical material

139

(4)

Modifying the rating instrument

143

(1)

Creating a second measuring instrument

143

(2)

Rating procedure

145

(2)

Issues arising from the first attempt at getting a reliable rating

147

(1)

Involving a second independent rater

147

(1)

Table 5: Empathic attunement score correlation between two independent raters and self

148

(1)

Phase two: method

148

(3)

Table 6: Empathic attunement between independent rater and self

150

(1)

Table 7: Scores of all three raters for each of the 12 students

150

(1)

Learning from our mistakes or repeating our mistakes

151

(1)

Analysis of our attempts so far

152

(5)

Example 1: Goal-corrected empathic attunement within the context of psychotherapy

155

(1)

Example 2: Poor goal-correctedempathic attunement

156

(1)

Phase three: method

157

(1)

Technique for managing defensive processes

158

(3)

Table 8: Correlation between the two independent raters on21 segments of tape taken from four interviews

159

(1)

Table 9: Correlation between the two independent raters on the average of 1.5-minute segments of tape from twelve interviews

160

(1)

Table 10: Correlation between the two independent raters on twelve tapes

160

(1)

Summary

161

(1)

10 Results of the Third Experiment

Introduction

162

(1)

Measures

163

(1)

Table 11: Internal consistency of the scales involved in caregivers' measure of caregiving

164

(1)

Table 12: Frequency of distribution: caregivers' (students') score

164

(1)

Subjective measures of empathic attunement: careseekers' (actors') score

164

(4)

Chart 3: Students' score/frequency of distribution

165

(1)

Table 13: Internal consistency of the scales involved in careseekers' measure of caregiving

166

(1)

Table 14: Frequency of distribution: careseekers' (actors') score

166

(1)

Chart 4: Actors' score/frequency of distribution

167

(1)

Chart 5: Independent measure of GCEA/frequency of distribution

167

(1)

Correlations between the measurers

168

(2)

Table 15: Correlation between measures of careseeker/caregiver interaction

168

(1)

Chart 6: Student score by actor score

169

(1)

Analysis of variance

170

(1)

Table 16: Analysis of variance student score

170

(1)

Table 17: Analysis of variance actor score (total score)

170

(1)

Table 18: Analysis of variance: independent measure

171

(1)

Summary

171

(1)

Goal-corrected empathic attunement and attachment style

172

(4)

Table 19: Correlation between measures of compulsive caregiving and insecure attachment with the careseekers', caregivers' and the independent scores for empathic attunement

173

(1)

Chart 7: Goal-corrected attunement score by attachment score

174

(1)

Chart 8: Mean goal-corrected attunement score by predicted GCEA score

175

(1)

Results of training: Experimental group

176

(3)

Table 20: Trained students' average scores: day one and day two

177

(1)

Table 21: Student, time and student score: an analysis of variance

177

(1)

Table 22: Student, time and actor score: an analysis of variance

178

(1)

Table 23: Student, time and independent score: an analysis of variance

178

(1)

Results of training: Control group

179

(2)

Table 24: Average scores for untrained students on day one and day two: self-assessment. Actors' scores and empathic attunement scores

179

(1)

Table 25: Student, time and score: an analysis of variance

180

(1)

Table 26: Student, time and actor score: an analysis of variance

180

(1)

Improvement score

181

(3)

Table 27: Students' average score at time 1: independent rater

181

(1)

Table 28: Caregivers' (students') average score at time 2: independent rater

181

(1)

Table 29: Improvement score for experimental and control groups

182

(1)

Table 30: Improvement score for careseeker (actor) and caregiver (student)

182

(1)

Table 31: Student, time and independent score: an analysis of variance

183

(1)

Measures

184

(1)

Attachment style and independent measure of goal-corrected empathic attunement

185

(1)

Training

186

(2)

Conclusion

188

(1)

11 Patterns of functional and dysfunctional careseeking-caregiving partnerships

Introduction

189

(2)

Extended attachment theory and goal-corrected instinctive systems

191

(2)

Data

193

(3)

Interactions patterns and the emotive messages that accompany them

196

(1)

The regulation or lack of regulation of careseeker vitality states through effective or ineffective misattunement or non-attunement by the caregiver

196

(5)

Sequences of interaction depicting affect regulation through purposeful misattunement to affect

201

(5)

Affect identification, regulation and containment

206

(2)

Non-attunement to affect giving rise to self-defence in the careseeking-caregiving partnership

208

(2)

Instinctive fear system overriding the arousal of exploratory caregiving

210

(4)

Goal-corrected empathic attunement: amplification of affect and affect regulation

214

(4)

Comment

218

(1)

Careseeking: typical styles of communication

219

(1)

Caregivers: typical responses to careseeking

220

(1)

Patterns of interaction associated with effective and ineffective caregiving

221

(6)

Example of a successful consultation

227

(11)

Summary

238

(1)

12 Interactions between therapists and patients and their roots in infancy

Introduction

239

(1)

Theoretical development

239

(5)

Empirical research

244

(3)

Subsequent work

247

(1)

Five styles of careseeking behaviour

247

(1)

Caregiver responses

248

(1)

The power of vitality affects to convey emotional states

248

(1)

Conclusion

249

(1)

Appendix 1 Role play scenarios for day one

250

(2)

Appendix 2 Measure of student attunement to be completed by the student after each interview

252

(2)

Appendix 3 Measure of student attunement to be completed by the actor after each interview

254

(2)

Appendix 4 Role play scenarios for day two

256

(3)

References

259

(6)

Index

265

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