"Transformative and/or Destructive: Exceptional Experiences from the Clinical Perspective". Isabel Clarke Consultant Clinical Psychologist Hampshire Partnership

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  • Slide 1
  • "Transformative and/or Destructive: Exceptional Experiences from the Clinical Perspective". Isabel Clarke Consultant Clinical Psychologist Hampshire Partnership NHS Foundation Trust
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  • Slide 3
  • Normalizing Unusual Experience Extraordinary experience has always been part of being human - part that has always been both feared and valued Extraordinary experience has always been part of being human - part that has always been both feared and valued Simply pathologizing is not the answer Simply pathologizing is not the answer Research: new and not so new: can offer a more balanced perspective a perspective that is less crushing than dismissing the experience as illness Research: new and not so new: can offer a more balanced perspective a perspective that is less crushing than dismissing the experience as illness
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  • A Word about Words Exceptional neutral in that it can describe both positive and negative experiences but veers to the positive Exceptional neutral in that it can describe both positive and negative experiences but veers to the positive Psychosis and spirituality obviously loaded! Psychosis and spirituality obviously loaded! Transpersonal better, but often used to exclude the shadow experiences Transpersonal better, but often used to exclude the shadow experiences Spiritual emergence/emergency still a suggestion of dichotomy Spiritual emergence/emergency still a suggestion of dichotomy I adopt Thalbournes transliminal I adopt Thalbournes transliminal
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  • Evidence for a new normalisation Schizotypy a dimension of experience: Gordon Claridge. Schizotypy a dimension of experience: Gordon Claridge. Mike Jacksons research on the overlap between psychotic and spiritual experience. Mike Jacksons research on the overlap between psychotic and spiritual experience. Emmanuelle Peters research on New Religious Movements. Emmanuelle Peters research on New Religious Movements. Caroline Bretts research: having a context for anomalous experiences makes the difference between whether they become diagnosable mental health difficulties Caroline Bretts research: having a context for anomalous experiences makes the difference between whether they become diagnosable mental health difficulties and whether the anomalies/symptoms are short lived or persist. and whether the anomalies/symptoms are short lived or persist. Wider sources of evidence e.g.Cross cultural perspectives; anthropology. Richard Warner: Recovery from Schizophrenia. Wider sources of evidence e.g.Cross cultural perspectives; anthropology. Richard Warner: Recovery from Schizophrenia.
  • Slide 6
  • Third Wave Cognitive Therapies Developments in CBT as it tackles personality disorder, psychosis etc. Developments in CBT as it tackles personality disorder, psychosis etc. Therapeutic relationship important Therapeutic relationship important Past history is significant Past history is significant Change lies not so much in altering thought to alter feeling, but in altering the persons relationship to both thought and feeling Change lies not so much in altering thought to alter feeling, but in altering the persons relationship to both thought and feeling Mindfulness is a key component. Mindfulness is a key component. Recognition of a split or incompleteness in human cognition which mindfulness can bridge. Recognition of a split or incompleteness in human cognition which mindfulness can bridge.
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  • Separate pathways in the brain Separate pathways in the brain Developments in CBT come up with 2 or more separate types of processing the split in human cognition! Developments in CBT come up with 2 or more separate types of processing the split in human cognition! There is one direct, sensory driven, type of processing and a more elaborate and conceptual one. There is one direct, sensory driven, type of processing and a more elaborate and conceptual one. The same distinction can be found in the memory. The same distinction can be found in the memory. Direct processing is emotional and characteristed by high arousal. Direct processing is emotional and characteristed by high arousal. This is the one that causes problems e.g. flashbacks in PTSD. This is the one that causes problems e.g. flashbacks in PTSD. The two central meaning making systems of ICS provides a neat way of making sense of this. The two central meaning making systems of ICS provides a neat way of making sense of this.
  • Slide 8
  • Body State subsystem Auditory ss. Visual ss. Interacting Cognitive Subsystems. Implicational subsystem Implicational Memory Propositional subsystem Propositional Memory Verbal ss.
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  • 2 Ways of experiencing ICS gives us a normalizing way of understanding exceptional experiences/ the transliminal. ICS gives us a normalizing way of understanding exceptional experiences/ the transliminal. When the imp.ss and the prop.ss are working together, that gives us an ordinary, grounded quality of experience. When the imp.ss and the prop.ss are working together, that gives us an ordinary, grounded quality of experience. When they become desynchronized, the imp. temporarily takes over When they become desynchronized, the imp. temporarily takes over This feels different; in extreme forms leads to openness to anomalous experience. This feels different; in extreme forms leads to openness to anomalous experience. This quality of experience is also sought and valued! This quality of experience is also sought and valued!
  • Slide 10
  • Linehans STATES OF MIND (from Dialectical Behaviour Therapy) Maps onto Interacting Cognitive Subsystems EMOTION EMOTION MIND MIND(Implicationalsubsystem) REASONABLE MIND (Propositional Subsystem) WISE MIND IN THE PRESENT IN CONTROL
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  • A challenging model of the mind. There is no boss our unitary sense of self is an illusion! There is no boss our unitary sense of self is an illusion! The mind is simultaneously individual, and reaches beyond the individual, when the implicational ss. is dominant. The mind is simultaneously individual, and reaches beyond the individual, when the implicational ss. is dominant. This happens at high and at low arousal. This happens at high and at low arousal. There is a constant balancing act between logic and emotion human fallibility There is a constant balancing act between logic and emotion human fallibility Dysynchrony between the systems explains anomalous experiences psychosis! Dysynchrony between the systems explains anomalous experiences psychosis! Mindfulness is a useful technique to manage the balance. Mindfulness is a useful technique to manage the balance.
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  • Being Porous: therapeutic approach Some people are more open to this type of experience than others cf. Schizotypy Some people are more open to this type of experience than others cf. Schizotypy People high on the schizotypy spectrum are more sensitive and open. People high on the schizotypy spectrum are more sensitive and open. Leading to the need to regulate stimulation. Leading to the need to regulate stimulation. This can lead into an avoidance cycle; social isolation and withdrawal = the other reality takes over. This can lead into an avoidance cycle; social isolation and withdrawal = the other reality takes over. Sensitivity and openness to anomolous experience continuum with normality Sensitivity and openness to anomolous experience continuum with normality Positive side as well as vulnerability Positive side as well as vulnerability
  • Slide 13
  • Normalising the difference in quality of experience as well as the continuity Normalising the difference in quality of experience as well as the continuity Validating the persons experience Validating the persons experience Helping people to manage the threshold mindfulness is key Helping people to manage the threshold mindfulness is key Understanding the role of emotion and arousal the feeling is real, though the story might be suspect. All this helps with building a therapeutic alliance. All this helps with building a therapeutic alliance. Persuasion to join shared reality motivational work. Realistic about the risks of unshared reality. Persuasion to join shared reality motivational work. Realistic about the risks of unshared reality. Recognizing the attraction of unshared reality for many offering specialness, buzz and a handy escape Recognizing the attraction of unshared reality for many offering specialness, buzz and a handy escape Mobilising and nurturing strengths Mobilising and nurturing strengths Creative expression Creative expression
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  • Shared Reality Unshared Reality Ordinary Ordinary Clear limits Clear limits Access to full memory and learning Access to full memory and learning Precise meanings available Precise meanings available Separation between people Separation between people Clear sense of self Clear sense of self Emotions moderated and grounded Emotions moderated and grounded Logic of Either/Or Logic of Either/Or Supernatural Unbounded Access to propositional knowledge/memory is patchy Suffused with meaning or meaningless Self: lost in the whole or supremely important Emotions: swing between extremes or absent Logic of Both/And
  • Slide 15
  • What is real & what is not?: about the programme. A 4 session group programme for an Acute inpatient setting. A 4 session group programme for an Acute inpatient setting. Run by a clinical psychologist and one or two others trainees, nurses, OT etc. Run by a clinical psychologist and one or two others t

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