icdl socal talk 7 ate 9 (100910 redacted for posting)

8/8/2019 ICDL SoCal Talk 7 Ate 9 (100910 Redacted for Posting)

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7 ate 9:

The Upper FEDL Levels

ICDL Southern California DIR/FloortimeRegional Institute

October 9, 2010

Josh Feder, MD



The Southern California DIR®/Floortime Regional Institute

Pasadena, California October 2010- May 2011

Josh Feder, MD Diane Cullinane, MD

[email protected] [email protected]

Mona Delahooke, PhD Pat Marquart, MFT

[email protected] [email protected]



Support Parent Choice Today!www.dirfloortimecoc.com



circlestretchHelp the child be

Calm enough to interact

Truly connected to others In a continuous expanding balanced

back and forth flow of interaction

Go for that gleam in the eye! !

http://www.circlestretch.com



Assistant Clinical Professor,

Dept of Psychiatry, University of California at

San Diego School of Medicine

Faculty, Interdisciplinary Council onDevelopmental and Learning Disorders



Acknowledgements

The ideas in the talk are from the podcasts and

writings of Drs. Stanley Greenspan and Serena

Wieder. Any and all errors of omission,

comission, or misinterpretation are mine and

mine alone. Please refer to the various

podcasts, videos, books and other resources

available at ICDL.com for more information.



ICDL Faculty minimal - review of clinical write ups, travel

and room for meetings, token honorarium for co-writingand running Southern California Institute

NIMH/ Duke University minimal administrative time for

pharmacogenetic research

NIH R21 grant/ San Diego BRIDGE Collaborative minimal

token honorarium for ongoing consultation and

participation



How I Spend My (clinical) Time..

90 % on I, II, and the rest of them

10% detailing the rest of them

Circlestretch.com process is set up to getpeople to get started at the most important

foundational places



circlestretchHelp the child be

Calm enough to interact

Truly connected to others In a continuous expanding balanced

back and forth flow of interaction

Go for that gleam in the eye! !

http://www.circlestretch.com



In Books and Lectures We Usually Talk About

Functional Emotional Developmental Levels I-VI

I co-regulation, ability to attend

II engagement, gleam in the eye, warmth

III circles of interaction

IV flow/ behavioral organization in social problemsolving

V symbolic thinking (critical to tolerating affect)

VI logical connections between ideas



Functional Developmental Growth Chart

(Now Part of the Bayley Scales)



Functional Emotional Developmental Levels I-VI









Sample FEDL

1 (not there) 2 (barely) 3 (islands) 4 (ok w/

support)

5 (comes

back)

6 (ok unless

stress)

7 (ok)

Regulate 11/05 11/06 11/07 11/08

Engage 11/05 11/06 11/07 11/08

Circles 11/05, 11/06 11/07 11/08

Flow 11/05 11/06, 11/07 11/08

Symbols 11/05 11/06, 11/07 11/08

Logic 11/05, 11/06 11/07, 11/08



Now Lets Look at the Expanded Model:

Functional Emotional Developmental Levels I-IX







VII multicausal thinking

VIII grey area thinking

IX reflective thinking, stable sense of self, and aninternal standard



Charlies FEDL over time:

social problem solving, from managing vigilance to stepping

back, and then critical thinking

Not there Barely Islands Expands Comes

back

Ok if not

stressed

Ok

for

age

Co-regulate 5/05, 3/06 3/07 3/08 3/09

Engage 5/05 3/06 3/07 3/08 3/09

Circles 5/05 3/06, 3/07 3/08 3/09

Flow 5/05, 3/06 3/07 3/08, 3/09

Symbolic 5/05, 3/06 3/07, 3/08 3/09

Logical 5/05, 3/06 3/07, 3/08 3/09

Multicausal 5/05, 3/06, 3/07 3/08 3/09

Grey area 5/05, 3/06, 3/07, 3/08, 3/09

Reflective 5/05, 3/06, 3/07 3/08, 3/09



7 ate 9:

FEDL LEVELS VII, VIII, and IX

VII: Multicausal thinking: there is more than one

reason, more than one feeling.VIII: Grey area thinking: there are different

intensities of emotion.

IX: Reflective thinking: we can comparesituations to each other, and we can compareourselves to who we want to be



What We Are Doing with these FEDLs:

Solving the

Social Problem of the Moment

Every moment is a social situation

Think about the here and now

FEDCs are the capacities we use and need to

address the current situation and solve the

social problem of the moment



Putting it all together:

FEDL I-VI

Example:

Assertiveness at a Glance

(tell the other person what you are feeling, why you arefeeling that way, and what you want the person to do)

Im mad at you.

Im mad at you because you didnt listen to me.

I want you to listen when to me when we talk to eachother.



Functional Emotional Developmental Levels I-

VI

in the Assertiveness exampleI co-regulation:

Are you settled enough to do this?

(you cant if you are too stirred up or too fuming mad)




VI

in the Assertiveness exampleII engagement:

Are you connecting with the other person?

(doesnt work if there is no emotionalconnection at that moment)




VI

in the Assertiveness exampleIII circles of interaction:

Is there a response (gestural or verbal) from the

other person? And do you use that as a wayto continue the interaction?

If you merely say the words and are done withit, you have no idea whether the message

(affective/ cognitive) was received andaccepted.




VI

in the Assertiveness exampleIV flow/ behavioral organization in social

problem solving:

Are there enough circles to be able to worktoward an average expectancy of the

emotional tone for the situation, one thatgives you the sense that what the other

person says or means is reasonably reliable?




VI

in the Assertiveness exampleV symbolic thinking:

Do you have shared meanings of the words,

such as mad, want, and listen?This is critical to tolerating affect because it gives

you both a space to resolve the problem of the moment where you can work with

emotional ideas without having to be stuckreacting to each other in isolation.




VI

in the Assertiveness exampleVI logical connections between ideas

Do we both understand because?Order of difficulty responding:

why>> how come>> if/then>>

when [this happens..that happens]




VI

in the Assertiveness exampleResults:

Mutual Recognition of the Problem

Mutual Resolution of the Problem

Avoids either person stewing alone and/ or

acting out : hitting, sulking, withdrawal,

revenge, etc. Promotes a sense of self competence,

confidence, and builds a stronger relationship



FEDL VII: Multicausal Thinking

(beginning ages 4-6)

So whats the problem now?

Most, if not all situations in life are, in fact, far

more complex.

They are multicausal and multidimensional.



Example: Masked Depression

Angry on the outside

Sad on the inside

You are so angry, but underneath that I thinkyou are very sad

Patient cries, talks of loss, is less angry,

case closed.(a therapists fantasy)



There is Always a Back Story

Past experiences create expectancies that shape

our responses in the moment and lead to

trouble tolerating affects and repairing rifts in

communication.

On the positive side, we bring a lot with us into

any situation that allows a complexity that can

contribute to a solution too.



Superman knew that Lex Luthor had lost hismother at an early age.

Luthor was understandably enraged when

Superman found his fortress (womb).

Superman respected, to a point, Luthors needfor a place to hide and hold himself.

But Superman couldnt have Luthor coming outof with blast rays and destroying cities andthen running back to hide in his lair.



Motives in Human Experience:

(Murder, She Wrote)

The Seven Sins and Virtues

Sins Virtues

Lust Self-control

Pride Humility

Greed Generosity

Envy Love

Anger Kindness

Sloth Zeal

Gluttony Temperence



Emotions and Motives Combine



In Infinite Varieties



Ideas on

Understanding Multicausal Thinking Now a child can understand that mom is mad because she had a

bad day at work but wonders if there are other reasons too.

Remember that there are infinite combinations of emotionallygrounded motives

Differential Calculus: infinite slopes to a curve

Every situation is different

We adjust to each one because of past experiences creatingexpectancies

When it isnt there, people have more rigid, discrete emotionaltones and reactions

Our job is to elucidate and help expand the range of theseemotional motivations

This is about solving the emotional problem of the moment



FEDL VIII: Grey Area Thinking

(beginning ages 6-10)



By the way, why comic books?

Age when people start to think in multicausal

fashion

Beginnings of sorting intensities of emotion hierarchies!



Back to Peter - uh, I mean Spiderman

He nearly always has to choose between goingafter the bad guy and saving Mary Jane

The relative intensity of his fear for Mary Janes

safety often over-rides his anger at the bad guy.Fear > anger.

Parker, among superheroes, is ambivalent,conflicted, always weighing and brooding (LevelVII back story: remember his guilt at not saving

his uncle?) Conflicting emotions require a lot of sorting out

hence all the sitting on rooftops and pondering.



Ambivalence is a hallmark of Level VIII



Intensities of Affect: Sadness



Intensitiesfor Every affect



How Sad? How Scared? How

Angry?How Happy?

No longer all or nothing. Sublety is

everything, nuance is possible

DIR works to expand and add nuance, becauseEVERY situation is different, every time.

Makes all the difference in appreciating,

enjoying and resolving the everyday,

continuous flow of social problems of the

moment (think Integral Calculus)



The Real Picture: We are moving about, in a generally continuous fashion, on a

Field of Infintesimal Variations of Quality and Intensity of Emotion and Motive



Characteristics of Level VIII:

Hierarchies, playground politics

The best time for disappointment better to lose nowand have moms support than to lose as an adult andhave no experience to fall back on.

Emotional experiences define, expand, and deepen theboundaries for the self. Without anger we dont knowwhat annoys us, without joy we dont know whatmakes us happy.

Refining the gradations of these emotions

This expanded and deepened appreciation foremotional experience makes us more able toappreciate it in others.



Ideas about Level VIII:

Look at the picture of mixed motives and

emotions

Think about all the nuances

Try to help the other person experience and

appreciate the nuances in the context of your

interactions

Enjoy the ride



Renoir:Take a minutethink about nuance and intensity



Renoir

Two Girls at the Piano

Notice the implication in the picture of the

presence of shared attention (FEDL I) all theway through nuanced flow of interaction

(FEDL VIII)



What Comes Next?FEDL IX: Intermittent Reflective Thinking, A Stable Sense of Self, and

an Internal Standard (9-12 yr and beyond)

We can compare situations to each other: In thiskind of situation I can usually figure it out

We can compare ourselves to who we want to be(ego ideal): I want to be able to sort out this newkind of problem.

Concrete Ex: College student knows how to studybut needs to learn how to develop a schedule formanaging day to day life away from home.

More abstract Ex: Middle schooler who can asserthimself in class but is sort of lonely and wants tobe able to hang out with people at lunch



Characteristics of FEDL IX:

Really adolescence and beyond

the ability to empathize in a truly reflective manner

able to understand a range of feeling in others andcompare it to your stable sense of self, retaining who

you are helps you to be truly a great friend or partner.

Reflecting on yourself and others w/o taking over norremoving yourself

Expanding sense of empathy, more and more inclusive:other kids, groups, school, country, the world (otherraces, religions, etc.).



Example at Level IX:

Novices Guide to Modern Dance The pieces all contain motions and rhythms, music and

colors that bring up all kinds of feelings and ideas, somepretty straightforward, some a little more complex

At times these pieces send me off, thinking about

something in my life that resonates with what Im seeingand hearing, and I let that happen and often I learnsomething from it.

Other times these pieces pull me into their own story,which, to me - it might be different to you - might beabout friendship or about competition or about just areally fun day. If thats whats happening, I just it thempull me in and share the experience.



Levels of Defense Mechanisms from

Psych 101

Very Primitive: Denial, Delusional Projection

Primitive: Defensive Projection, Somatization,

Passive Aggression

Neurotic: Repression, Intellectualization,

Reaction Formation, Fantasy escape

Higher Level: Altruism, Sublimation, Humor,

Creating Meaning- Possible with FEDL IX



Managing the toughest Affects

Spats, Love, War

Humor: Tom Lehrer on Pollution

Mel Brooks on The Spanish Inquisition Levels of Defense Mechanisms



Example FEDL over the years:

Rigid and Rocking to

Problem Solving the Job Hunt (and still rocking)

Not there Barely Islands Expands Comes

back

Ok if not

stressed

Ok

for

age

Co-regulate 5/97 6/09

Engage 5/97 6/09

Circles 5/97 6/09

Flow 5/97 6/09

Symbolic 5/97 6/09

Logical 5/97 6/09

Multicausal 5/97 6/09

Grey area 5/97 6/09

Reflective 5/97 6/09



How I Spend My (tutoring) Time:

DIR as a REFLECTIVE Enterprise 10% supporting people to get settled to be reflective,

i.e., I-VIII, (coffee, readings, talking together)

90% Reflective Process

DIR® demands reflective process

Everyone, from parents to faculty and everyone in

between, needs to be engaged in an ongoing

reflective group or set of relationships to think about

our work together

Level IX is our life blood.



Beyond IX

The Spinal Tap made it to 11

Dr. Greenspan had an anthropologist helping

on a project to explore for FEDL Level X and

beyond.

Stay tuned!

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