Toxic Shame in Clinical Practice: Help Clients Release Shame, Get Unstuck and Improve Treatment Outcomes

CPD

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Patti Ashley, Ph.D., L.P.C. Related seminars and products: 3

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Patti Ashley, Ph.D., LPC, has integrated 40 years of experience in special education, child development, and psychology into her wholehearted work as a psychotherapist, author, international speaker, and authenticity architect coach. She brings unique insights into the identification and treatment of shame, trauma, grief and dysfunctional family patterns.

Dr. Ashley owns and operates Authenticity Architects in Boulder, Colorado. Her inimitable Authenticity Architecture model facilitates long-term changes in the brain and nervous system, helping clients break through unconscious barriers and rediscover a sense of self-love, belonging, and connection. As a licensed professional counselor since 2000, Dr. Ashley has counseled a myriad of individuals, couples, families and groups in metal health agencies, psychiatric hospitals, and private practice settings. She also has many years of experience developing continuing education courses for physicians, hospital wellness programs, universities and other organizations.

Patti holds a Doctor of Philosophy Degree in psychology from the Union Institute and University, a Master of Education Degree in early childhood from Old Dominion University, and a Bachelor of Science Degree in special education from James Madison University. She is the author of Living in the Shadow of the Too-Good Mother Archetype (2014), Letters to Freedom, and Shame-Informed Therapy: Treatment Strategies to Overcome Core Shame and Reconstruct the Authentic Self (2020). For more information, please visit  www.pattiashley.com.

Speaker Disclosures:
Financial: Patti Ashley maintains a private practice. She receives a speaking honorarium from PESI, Inc.
Non-financial: Patti Ashley has no relevant non-financial relationship to disclose.

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Objectives

1. Summarize the nature of toxic shame as it relates to the therapeutic process.
2. Identify how the different attachment styles play a role in how client’s shame is formed.
3. Discover how toxic shame develops as a core identity and how it can be a roadblock in clinical treatment.
4. Correlate how toxic shame and trauma function similarly to the nervous system and how that relates to clinical treatment.
5. Utilize clinical strategies to help heal shame and get clients unstuck in the therapeutic process.
6. Develop skills to help clients regulate shame triggers both in-session and everyday living.

Outline

• Ruptures in interpersonal relationships create a shame-based identity
• Shame and trauma function similarly in the nervous system
• Subconscious shame effects of poisonous parenting
• Attachment theories as they relate to shame
• D.W. Winnicott’s true self/false self
• Shame in family, culture and other systems
• Limitations of the research

• Individual Therapy – the client who:
  • Talks the whole session
  • Frequently cancels sessions
  • Feels bad when progress seems to have eluded
  • Terminates treatment early
  • Deflects and projects onto others
  • Relapses and does not return
  • Minimizes problems
  • Excessively intellectualizes and analyzes treatment
• Couples/Family Therapy
  • The attack/defend patter
  • Anger, rage and contempt
  • Judgment of self and others
  • Grandiosity, narcissism and self-inflation
  • People pleasing and codependency
  • Avoidance
  • Problems with intimacy
• Group Therapy:
  • Cross-talk
  • Intellectualizing
  • Silence
  • Judgment
  • Conflict

• Shame can be activated when therapist appears to be the “expert”
• Some strategies hinder treatment outcomes
• Strategies that may create barriers to creativity and relational presence
• Impact of mirror neurons and epigenetics
• How naming “shame” can be shaming
• Unconsciously enacting shaming parent
• Treating client as appointment or diagnosis
• What to do when your shame is triggered in-session

• Right and left brain integration
• Bottom-up versus top-down treatment approaches
• Modeling, engaging and sustaining self-compassion
• Repair the interpersonal bridge to self and others
• Courage and vulnerability in right-brain regulation
• Sustaining empathy in parallel process
• Transference and counter-transference in treatment

• Build a Safe Therapeutic Holding Environment
  • Establish safety and trust
  • Set a stage for treatment
  • Strong foundation for therapeutic work
• Build a Solid Relationship
  • Therapeutic empathy as the antidote for shame
  • Connect and establish equal power
  • Mindfulness and compassion
• Bridge the Head and Heart
  • Psycho-education to demystify shame
  • ”I” statements to identify shame-based feelings
  • Going beyond cognitive therapy models
• Witness and guide clients through deeper layers
  • Return shame to its origin
  • Somatic strategies
  • Re-wiring new neural pathways
• Experiential Tools and Techniques
  • Creative arts, writing and movement activities
  • Mindfulness and meditation
  • Archetypes, story-telling and mythology
  • Music and sound healing
  • Journaling and letter-writing
• Working with Secrets
  • Patience and compassion
  • Deeper shame
  • Tolerance and non-judgmental witnessing
• Creativity
  • Every client is unique
  • How therapy is like art
  • Goodness of fit
• Research limitations and potential treatment risks

Target Audience

• Counselors
• Social Workers
• Psychologists
• Case Managers
• Marriage & Family Therapists
• Other Mental Health Professionals
• Chaplains/Clergy

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