The Tranforming Power of Affect (Basic Behavioral Science, 2000) is the best therapy book I’ve read in many years. It is a readable, comprehensive, and creative survey of attachment research and how to apply it to your adult clients. Diana Fosha comes from the Short Term Dynamic Therapy lineage of Davanloo and Malan, and adds to it attachment-informed use of self to help propel clients forward. I have no training in STDP and just a little in AEDP, Fosha’s Accelerated Experiential-Dynamic Psychotherapy. The book gave me tools I can use.
The book group liked it. Most of us found the prose a bit dense, but understandable. All of us said that our work had already changed from the reading. We agreed that her therapeutic lens included attachment awareness, affect awareness, and the therapist’s own relational experience with the client. Her techniques were many, and way cool. We are now all finishing our sessions with, "What was that like to do this piece of work together?" We are either feeling validated for how we already use ourselves in the sessions, or doing more of it. This therapy puts the space between the client and the clinician in the center of awareness and process.
What does Fosha do that I like: She uses her self. She uses the body. She teaches attunement. She teaches several new ways to make sense of the client’s material/behavior. She keeps clients in their experience. She is collaborative with her clients. She’s real. Her therapy is backed-up with research and it is (informed) intuition. Her descriptions of human interactions are exquisite. And her asides in describing interactions with patients can be quite funny.
I do think that Fosha uses process awareness as a kind of dual attention. I like that, it works. AEDP processes relational trauma, pretty well. I think EMDR is more efficient for many kinds of trauma. (I know that Fosha is trained in EMDR and uses it on occasion, though it’s not mentioned in the book.) There is no overt mention of dissociation, though she discusses the phenomenon as defense and "disorganized attachment." Her techniques have caused some of my most dissociative clients to "disappear". I think AEDP can help keep other, less dissociated folks in the room.
I’d like to be able to explain the techniques, but, they are so nuanced, that I fear to put broad, unexplored, descriptions on this blog. Read the book. Six good therapists in Seattle think you should. If you have seen Fosha speak at conferences and were unimpressed, read the book anyway. She’s one of the few people who writes better than she talks. If you are going to take Fosha’s 5-day AEDP immersion class, read the book first, you’ll get more out of the class. The videos in the class are worth the price of admission. I think if you simply watched the videos, you’d become a better therapist, though you might not know why. It’s good stuff.