Remco van der Wijngaart
Remco van der Wijngaart works as a psychotherapist in a private practice in Maastricht, the Netherlands. Initially trained in CBT, he was later trained and supervised in schema therapy by Jeffrey Young, with imagery rescripting as one of the most frequently used techniques in this therapy model. Since 2000 he has been providing accredited courses in schema therapy worldwide. He produced and directed several productions, e.g., Fine Tuning Imagery Rescripting, and is the author of the 2021 book Imagery Rescripting, theory and practice. Julie Krans is an assistant professor in clinical psychology and associate director of the Behavioural Science Institute at the Radboud University, and senior researcher at Pro Persona Overwaal centre for anxiety, OCD, and PTSD. Her research focuses on imagery rescripting and schema therapy for chronic anxiety, OCD and PTSD. She is a trained CBT therapist.
Fine-tuning imagery rescripting: fostering and making use of the healthy adult mode
Co-Presented with Julia Krans
Imagery rescripting is nowadays regarded as an evidence-based technique for treating different disorders, such as PTSD, social anxiety disorder, and personality disorders (Morina et al., 2017, Kippe et al., 2023; Kroener et al., 2023). With imagery rescripting we aim to generate corrective emotional experiences in aversive memories/images in order to change negative encapsulated core beliefs. These corrective emotional experiences foster the Healthy Adult Mode, which is one of the main therapeutic goals in schema therapy. Conversely, the Healthy Adult Mode is also an important element that can be used to empower and fine-tune in imagery rescripting sessions. First, a powerful mental image of the Healthy Adult can be a helpful tool for when the patient is ready to start rescripting themselves. Second, in future oriented imagery, the Healthy Adult mode can be drawn upon to help prepare for schema activating events that may still occur, as future oriented imagery has been shown to motivate behavior as well (Libby et al., 2007). However, there are challenges for each use of the Healthy Adult mode in imagery rescripting and we will tackle them in this workshop. For example, it is not always easy to form a powerful mental representation of the Healthy Adult. Second, there are challenges when the patient starts rescripting themselves in which the Healthy Adult mode can play a role. Third, future oriented imagery at the end of treatment has its own specific challenges, as we assume that the client more and more ‘becomes’ a Healthy Adult overall. Should we ask the patient to keep an observer perspective, or should we ask the patient be the Healthy Adult? Should we focus on emotional experiences or behavioral change? Lastly, sometimes therapists themselves can get triggered during sessions too. Having an own empowering Healthy Adult image may benefit your clinical skills!
Chairwork for patients with Obsessive Compulsive Personality Disorder Generating corrective emotional experiences when dealing with strong coping modes
Co-presenting Remco van der Wijngaart
The essential goal in schema therapy is to validate unmet needs in our patients by creating corrective emotional experiences. Changes in Child modes and the Healthy Adult mode are the best predictors for therapy success (Yakin et al.,2020), and unmet needs are best felt when the client is in the Vulnerable Child mode. Therefore, in schema therapy the aim in every session is to connect with this emotional side of the client. Many clients, however, have developed coping modes that make it difficult for both the client and the therapist to connect to the Vulnerable Child mode or Healthy Adult of the patient. This is also strongly the case for patients with Obsessive Compulsive Personality Disorder (OCPD) who struggle with rigid and persistent Coping modes, especially the rational and intellectual Perfectionistic Overcontroller.
Chairwork is considered an effective technique to help the therapist bypass coping modes and connect to the Vulnerable Child modes (Krans & van der Wijngaart, 2022). Yet, applying this technique effectively can be very challenging in the face of extremely rigid and persistent Coping modes. For example, patients with OCPD may find it extremely difficult not to speak from the Perfectionistic Overcontroller mode even when sitting on the chair of the Vulnerable Child. How can we help these patients to connect to their emotional sides? And even if you are successful, how do you create a corrective emotional experience when your patient sees these emotions as uncomfortable, distracting and unproductive? This workshop offers specific methods and techniques to create corrective emotional experiences with patients who have extreme difficulties in connecting to their emotional sides, which is so crucial for healthy change in schema therapy.