Le trouble du déficit de l’attention avec ou sans hyperactivité (TDAH) est un trouble neurobiologique du développement affectant l’autorégulation. Il se manifeste dans différents domaines tels que l’attention, les fonctions exécutives et le contrôle des impulsions, ces dimensions étant plus ou moins marquées selon les individus. Les symptômes apparaissent durant l’enfance et peuvent persister tout au long de la vie, même si leur expression extérieure évolue souvent de manière significative avec l’âge.

Critères diagnostiques

1. Début généralement, mais pas obligatoirement, au cours des cinq premières années de vie. Les symptômes doivent être présents pendant au moins 6 mois.
2. Présence persistante de symptômes d’inattention et/ou d’une combinaison de symptômes d’hyperactivité et d’impulsivité.
3. L’intensité des symptômes est incompatible avec le niveau de développement de la personne.
4. Les symptômes apparaissent dans au moins deux contextes ou environnements (par exemple à la maison, à l’école ou au travail).
5. Les symptômes ont un impact négatif direct sur les activités scolaires, professionnelles, sociales ou sur la vie quotidienne.

Symptomatologie du TDAH

Les symptômes d’inattention se manifestent souvent par une capacité réduite à maintenir l’attention sur une longue durée, en particulier lors de tâches monotones ou peu gratifiantes. Les personnes concernées sont facilement distraites, perdent des objets, ont des difficultés à organiser leurs activités, oublient des rendez-vous ou des actions et ont souvent besoin de plus de temps ou de soutien pour accomplir leurs tâches. La concentration peut toutefois être excessivement focalisée dans des situations très intéressantes (« hyperfocalisation »). Cette caractéristique est fréquemment mal comprise, ce qui peut conduire à des interprétations erronées selon lesquelles les personnes concernées « n’auraient en réalité pas de problème d’attention ».

Les symptômes d’hyperactivité sont souvent clairement visibles durant l’enfance : agitation motrice, mouvements constants, besoin de bouger, courir, grimper, ou difficulté générale à rester assis. À l’âge adulte, cette hyperactivité se transforme souvent en une « agitation interne », un sentiment d’être constamment poussé ou incapable de se détendre. De nombreux adultes rapportent que leurs pensées « s’emballent » ou « sautent », et qu’ils supportent difficilement l’inactivité, même si l’agitation extérieure a fortement diminué.

Les symptômes d’impulsivité se manifestent par des actions précipitées sans prise en compte suffisante des conséquences, des difficultés à attendre une récompense, des interruptions fréquentes, des décisions impulsives ou des réactions émotionnelles rapides. L’impulsivité émotionnelle — c’est-à-dire une frustration rapide, de l’irritabilité et des variations de l’humeur — est aujourd’hui également considérée comme une composante typique du TDAH, même si elle n’est pas explicitement mentionnée dans tous les manuels diagnostiques. Cette dysrégulation émotionnelle peut entraîner un stress social et professionnel important.

Outre les symptômes centraux, le TDAH s’accompagne d’une série d’altérations fonctionnelles caractéristiques, souvent moins visibles mais très éprouvantes pour les personnes concernées. Il s’agit notamment de difficultés liées aux fonctions exécutives, comme la planification, la priorisation, la gestion du temps, la mémoire de travail ou la capacité à initier et maintenir une tâche. Beaucoup de personnes concernées luttent contre la procrastination, des structures chaotiques, le sentiment d’être constamment en retard, ou un perfectionnisme marqué qui, paradoxalement, conduit à des blocages.

Symptomatologie en cas de bonne compensation et de masking

Malgré des atteintes importantes, le TDAH peut paraître discret extérieurement lorsque les personnes ont développés des stratégies de compensation ou masquent consciemment ou inconsciemment leurs symptômes afin de fonctionner à l’école, au travail ou dans leur environnement social. Alors que le masking consiste à dissimuler activement ou à compenser les symptômes, les stratégies de compensation renvoient plutôt à des adaptations fonctionnelles développées par expérience ou nécessité.

Avoir à gérer son image en permanence signifie qu’on doit être vigilant tout le temps par rapport à son comportement, ses paroles etc., ce qui a un coût important: c’est coûteux en ressources cognitives (et donc épuisant) et toxique pour l’estime de soi, car un vie authentique est impossible.

Les personnes présentant un TDAH bien compensé ou masqué apparaissent souvent organisées, performantes et socialement adaptées. En interne, elles déploient toutefois un effort considérable pour maintenir cette image. Les symptômes se déplacent alors souvent vers l’intérieur. À la place de l’hyperactivité, on observe une agitation interne, et à la place d’un chaos visible, une forme extrêmement coûteuse d’autocontrôle. Ces personnes peuvent sembler particulièrement structurées, disciplinées, voire perfectionnistes. Pourtant, cette apparence repose souvent sur un équilibre fragile qui exige une grande dépense d’énergie mentale.

Dans le TDAH compensé, l’inattention peut par exemple être masquée par des routines strictes, une planification excessive ou l’utilisation constante d’outils de rappel et d’organisation. La personne ne paraît pas distraite, mais lutte en permanence en arrière-plan contre l’oubli et la distraction. L’hyperfocalisation peut aider à produire certaines performances professionnelles ou créatives, tandis que d’autres domaines de la vie — tâches ménagères, finances, organisation du quotidien — se détériorent fortement sans que cela soit visible.

L’impulsivité peut être partiellement inhibée grâce à des mécanismes d’autocontrôle appris, mais souvent au prix d’une accumulation de tension interne et d’épuisement. Les réactions émotionnelles peuvent ne pas être exprimées, mais elles sont vécues intensément, ce qui peut conduire à de la fatigue, un sentiment de débordement ou un retrait. De nombreuses personnes rapportent un niveau élevé d’autocritique, de honte ou la peur d’être « démasquées » lorsque la façade se fissure.

On comprend qu’à la longue, cela peut être à l’origine de comorbidités comme l’anxiété ou la dépression ou le burnout.

Pour échanger sur vos objectifs et connaître mon approche thérapeutique:

En résumé, un TDAH compensé et masqué se manifeste souvent par les schémas suivants :

• Surcompensation par le perfectionnisme, l’ordre ou la performance
• Forte adaptation aux attentes externes, souvent au détriment des besoins personnels
• Bons résultats scolaires ou réussite professionnelle malgré une forte charge interne
• Épuisement, burnout ou effondrements émotionnels dans des contextes sécurisés
• « Crashs » après des phases de haute performance fonctionnelle
• Difficultés dans la sphère privée alors que la sphère professionnelle paraît stable
• Discrétion apparente dans le comportement social, malgré une insécurité interne ou une surcharge sensorielle

Thérapie du TDAH féminin à Paris et en ligne

Le décalage entre le fonctionnement extérieur et le vécu interne peut conduire à ce que le TDAH chez l’adulte, en particulier chez les femmes ayant une intelligence élevée ou une grande capacité d’adaptation, soit souvent négligé ou mal interprété. Ces personnes ne sont souvent diagnostiquées que lorsque leurs mécanismes de compensation s’effondrent sous l’effet de contraintes de vie, d’exigences croissantes ou d’un épuisement.

Comorbidités

Chez les personnes atteintes de TDAH, des troubles psychiques ou neurodéveloppementaux associés sont fréquents. Jusqu’à 70% des personnes concernées présentent au moins une comorbidité. Les plus courantes sont les troubles anxieux et les dépressions, qui apparaissent souvent de manière secondaire, par exemple en raison d’une surcharge chronique, de problèmes d’estime de soi ou des conséquences d’efforts de compensation prolongés. Une dysrégulation émotionnelle, une irritabilité et des variations rapides de l’humeur sont également fréquemment observées. Celles-ci peuvent être interprétées à tort comme des symptômes dépressifs ou bipolaires. Les troubles liés à l’usage de substances sont également importants, en particulier en cas de TDAH non traité. Les comportements impulsifs, la sensibilité à la récompense et la recherche d’autorégulation augmentent en effet le risque de dépendance à l’alcool, à la nicotine et à d’autres substances.

Sur le plan neurodéveloppemental, les troubles du spectre de l’autisme, les troubles des apprentissages (tels que les troubles de la lecture et de l’orthographe ou la dyscalculie) ainsi que les troubles de la coordination sont particulièrement fréquents. Les troubles des tics et les troubles oppositionnels avec provocation sont également plus fréquents. Chez l’adulte, les troubles du sommeil, les troubles du comportement alimentaire (notamment l’hyperphagie boulimique) ainsi que des traits de personnalité à composantes émotionnellement instables ou évitantes-anxieuses sont souvent au premier plan. La présence de ces comorbidités influence fortement le diagnostic, la planification du traitement et l’évolution clinique. Une évaluation différentielle rigoureuse est donc essentielle, d’autant plus que certaines comorbidités peuvent renforcer ou masquer la symptomatologie du TDAH.

Thérapie du TDAH à Paris / en ligne

La thérapie ne doit pas être comprise simplement comme un traitement de l’inattention, de l’hyperactivité et de l’impulsivité. L’objectif de la personne concernée — ainsi que de ses proches, enseignants, supérieurs hiérarchiques et amis — est de pouvoir répondre aux exigences de la vie quotidienne, des relations et du travail de manière organisée, calme et détendue. Pour cela, il faut de la rétrospection, de la perspective, de la planification, de l’initiative, une bonne gestion de ses ressources et une vérification des résultats.

La prise en charge du TDAH est aujourd’hui multimodale et adaptée individuellement. Comme le trouble agit à plusieurs niveaux — neurobiologique, émotionnel et comportemental — les personnes concernées bénéficient le plus d’une thérapie combinant différents mécanismes d’action.

On peut distinguer, en principe, les composantes thérapeutiques suivantes : psychoéducation, coaching (auto-observation, auto-gestion, auto-instruction), psychothérapie, neuromodulation non médicamenteuse et médicaments. Les éléments qui occupent le premier plan dépendent de l’âge de la personne concernée, de l’intensité de la souffrance, des éventuelles comorbidités et des préférences personnelles.

Psychothérapie, psychoéducation, coaching du TDAH à Paris

Les approches psychothérapeutiques constituent un élément important du traitement. Elles agissent surtout sur le comportement, l’autorégulation, la motivation et la stabilisation émotionnelle. L’objectif de la thérapie est de réduire les limitations fonctionnelles et de construire des stratégies adaptatives.

Les méthodes psychothérapeutiques et psychosociales importantes sont :

• Thérapie cognitivo-comportementale : entraînement à l’organisation, à la gestion du temps, à la régulation de l’attention, au contrôle des impulsions et à la régulation émotionnelle.
• Thérapie du trauma ou de l’anxiété, en présence de comorbidités.
• Psychoéducation : compréhension du trouble, de ses bases neurobiologiques et de ses répercussions concrètes au quotidien.
• Coaching / structuration du quotidien : mise en place de routines, recours à des aides externes, priorisation, gestion de la procrastination.
• Contexte familial: Entraînement aux compétences sociales, surtout chez les enfants et les adolescents. Conseil familial et parental : amélioration des interactions, gestion de l’irritabilité, mise en place de cadres clairs.

Place des médicaments

Les médicaments font aussi partie d’une prise en charge multimodale lorsque cela est indiqué: Le patient reste libre de sa décision d’en prendre ou pas après avoir recueilli les renseignements nécessaires auprès de son psychiatre. Les médicaments – il y a un grand nombre – sont en général intégrés à un plan de soins personnalisé, surtout lorsque les mesures psychoéducatives et psychologiques ne suffisent pas à elles seules.

La psychothérapie agit surtout au niveau fonctionnel du TDAH : elle ne modifie pas directement les bases neurobiologiques, mais elle aide de manière importante à compenser les symptômes et à prévenir les problèmes secondaires.

Raisons du sous-diagnostic du TDAH

Raisons des nombreux cas sous-diagnostiqués ou diagnostiqués tardivement (à l’âge adulte)

• Symptômes masqués : Chez les adultes/femmes, sur-adaptation et compensation par routines ou internalisation (procrastination vs hyperactivité visible) ; rétrospectif depuis l’enfance souvent inaperçu.
• Chevauchements : Confusion avec dépression, anxiété, troubles borderline, bipolaires ou sommeil ; pas de biomarqueur, diagnostic subjectif.
• Biais historiques : Vu comme trouble enfantin (« disparaît à l’âge adulte« ), sous-reconnu chez filles/non perturbatrices ; accès limité aux spécialistes.

Les personnes concernées se sentent en général soulagées de mieux comprendre leur trajectoire biographique et vivent leur diagnostic tardif comme une perte d’opportunité (par rapport à ce que leur vie aurait pu être s’ils avaient reçu un diagnostic plus tôt dans leur vie).

Sachez qu’il n’est jamais trop tard : les patients TDAH, pris en charge de manière adéquate (multimodale en général), peuvent apprendre à gérer leur trouble et à s’épanouir dans leurs relations. Ils arrivent à s’accomplir professionnellement selon leurs potentialités réelles.

Pour échanger sur vos objectifs et connaître mon approche thérapeutique:

Ressources

Outils de screening

ASRS (fr.); ASRS (english),

TDAH & femmes: tests non-officielles: français: Test TDAH Femme Adulte; english: female ADHD test on ADDitude website

L’article Thérapie du TDAH – Le trouble du déficit de l’attention avec ou sans hyperactivité à Paris et en ligne est apparu en premier sur Regina Koehler.

J’ai découvert les « card decks » lors d’une formation sur l’équithérapie aux USA, où ils étaient présentés dans un chapitre sur les moyens de faire thérapie avec les animaux sans présence d’animaux vivants. J’avais choisi cette formation car réputée la plus scientifique, mon étonnement était donc grand mais les textes des cartes m’avaient convaincus: j’avais envie d’essayer.

J’ai donc acheté le card deck « Touched by a horse » (des exemples ci-dessous) dans la suite, puis rapidement d’autres card decks (il y a de plus en plus de cartes en français: cf. ci-dessous). 

La diversité de ces cartes surprend: alors qu’ils existent depuis longtemps, on a l’impression qu’il s’agit d’un phénomène social qui s’est amplifié dans une période post-covid en quête de spiritualité ou de lien avec la nature et les animaux, pour changer de regard sur une situation et avancer ainsi que pour mettre en sens de ce qui nous arrive ? (cf. l’article sur OprahDaily). Elles peuvent contenir des simple affirmations positives, des « slogans » bouddhistes, ou sont rédigés sous format « d’oracle » moderne.

Elles peuvent s’utiliser seul ou à deux ou plusieurs, comme les card decks « couple » ou conversation, pour approfondir nos relations et nous rapprocher.

La school of life, editeur de livres de philosophie appliquée, en a publié un grand nombre, dont celui sur « Kindness » et « Stoicism« , echantillons ci-dessous.

On peut utiliser les card decks de manière ‘playful’ et non-ésoterique: pour des petits rappels réguliers, peu chronophages, qui nous aident à réfléchir en nous donnant une autre perspective, une autre vision des choses, dans une période en manque de sens et de repères (et de playfulness).

Donc les card decks peuvent nous servir comme outils de réflexion sur soi, de self-care, de régulation émotionnelle, etc. Certains les utilisent pour faire du journaling, etc., à des fins méditatives.

En somme, un outil pour nourrir un espace de dialogue positif avec soi-même, entre les séances et au-delà. Elles se prêtent à un usage régulier, quotidien ou presque et ludique (par ex. 1 carte par jour). L’aspect immersif semble être important: choisissez une « prose » et un design/une esthétique qui vous parlent. 

Diversité thématique

Voici quelques exemples de card decks, si cette pratique peut vous intéresser (j’ai volontairement mis un grand nombre, même si je ne les connais pas tous, pour vous montrer la diversité: à vous de choisir celui qui fera sens pour vous.

– Nature et animaux

Nature Meditations (exemple ci-dessous ou sur internet)

« Touched by a horse » Melisa Pearce : exemple en bas de page

Woodland Wardens (victorian design, jolies cartes) Jessica Roux, exemple ci-après

Sacred Forest par Denise Linn, Spirit Animal (ex. en bas de page, fr), Oracle of the Sacred Horse (Kathy Pike)

Medicine Cards (Jamie Sams), en français

– Philosophie, religions du monde

« Stoicism card deck » (dont un de School of Life), « Greek mythology reading card deck » et The Classical Mythology Oracle (2024), ‘The Yogic Path card deck », Buddhism / meditation : « Everyday Peace Cards: 108 Mindfulness Meditations (Hanh, Thich Nhat), Bhagavad Gita Card deck, etc. 

Pema Chodron’s « Compassion cards« : some cards are not trauma informed, please make your own selection or add your own affirmative phrases on them, maybe based on the book Fierce self-compassion by Dr.Kristin Neff

Card decks axés ‘approches thérapeutiques‘

ACT daily card deck (ACT= Acceptance and commitment therapy), Sorenson & Hill, 2023, exemples en fin de page

The live your values card deck

The CBT deck  (CBT = TCC)

Trauma-Informed Yoga Affirmation Card Deck

Awakening Self-Compassion Cards, extrait ici, exemple en fin de page

Polyvagal Card Deck (Deb Dana)

Thera-Pets

The Set Boundaries Deck: A Tool for Expressing Healthy Limits for Happier Relationships (Nedra Glover Tawwab)

Post-Traumatic Growth Deck (Dr. Arielle Schwartz) description sur le site de l’auteure présentation vidéo

Livre sans cartes: « Tarot for change: self-care, acceptance, growth » review ici. Pour ceux qui ont déjà des cartes de Tarot. Par l’auteur: « The cards can foster self-trust, introspection and an interior grounding that can offset the tendency to look only outwards for answers ».

Card decks en français

Très bons card decks:

Les cartes Médécine (bestseller de Jamie Sams)

La voie du Yoga

L‘Oracle de l’Esprit animal (cf. ex. en anglais ci-dessous)

Bons retours des clients sur amazon pour:

La Citadelle de Fez Inkwright

Lumières de Rebecca Campbell (vendu à la Fnac Ternes)

A la Fnac Ternes (Paris): un rayon entier consacré à la « cartomancie » (coté « psycho / bien-être »), avec les cartes d’Isabelle Cerf, dont Mission de vie, bestseller semble-t-il mais je ne connais pas son travail. Faut pas être rebuté par le language « chakra & cie » par contre. Les card deck à la Fnac sont bien sûr sous cellophane, mais demandez au staff de les ouvrir pour pouvoir feuilleter les cartes.

Pour en trouver d’autres, vous pouvez mettre les noms par exemple des auteurs des cards decks ici dans amazon.fr etc

=> Les traductions sont forcément plus chères, mais beaucoup de ces card decks se trouvent d’occasion sur Rakuten ou Momox, ou d’autres sites de livres d’occasion

A deux | cartes pour approfondir ses relations

Conversation & Date night card decks

Table talk – Let’s get closer Intelligent change (Dinner), exemples ci-dessous

The Meaning of Life Cards: Cards for Profound and Playful Chat

Je connais les deux ci-dessus qui sont très bien, il y a de nombreux autres:

Table Talk Placecards Sociability 40 placecards with 80 questions for sparking meaningful and revealing conversations around the table

Intelligent Change Get Closer Conversation Game: Couples => 3 catégories de cartes, faites le tri des quelques cartes qui ne sont pas intéressantes, globalement c’est un bon card deck

Pour les germanophones: la maison d’édition BELZ a également beaucoup de card decks vendu via son site

Couple | Cartes sur le thème du couple

J’en connais aucun de ceux-ci, faites une recherche:

Connect: Remember Why You Matter to One Another

Esther Perel Card deck

Gottman Card deck

Connect (School of life)

Intimacy deck (Best Self)

Intimacy (2)

Better together

Exemples de cartes

Way of the horse (Linda Kohanov) ci-dessous:

Spirit Animal: Armadillo « Set healthy boundaries »

Nature meditations:

L’article Card decks est apparu en premier sur Regina Koehler.

Le bénévolat est un vaste champ qui permet à chacun d’exprimer ses valeurs et de soutenir une cause d’intérêt général.

Réfléchissez sur ce qui vous anime et que vous souhaitez partager, cela vous aidera à choisir des projets ou associations: développement durable, écologie, animaux, actions sociales, personnes vulnérables …

La recherche le montre: « it is not people who pursue their own happiness who are happy but people who care for others (…) Helping others increases people’s individual well-being. (…) volunteering is rewarding for the volunteers in terms of higher life satisfaction. » Given that, why do not more people volunteer?  » People underestimate the benefits from intrinsic tasks like volunteering while they overestimate the value of e.g. additional income from overtime work » (Is volunteering rewarding in itself? Meier, Stutzer, 2004) . On the link between caregiving, resilience and healing from trauma

Général | environnement | personnes vulnérables

• make.org « passe à l’action sur les grands sujets de société »
• makesense (lien vers le site français, il y a des sites pour d’autres pays aussi)
  •  atelier « la brèche« : projets pour « brecher » sa vie
  •  volunteering /benevolat etc 
  • projets / entrepreneuriat
• PachaGaia « s’est fixé pour objectifs principaux de diffuser les concepts de préjudice écologique et d’injustice environnementale, et d’y sensibiliser le grand public par le biais de la cartographie interactive »
• Work Away : NGO voyager et travailler pour soutenir les associations dans le monde entier
• servethecity.paris « migrants »
• Trouver une mission de bénévolat: Benevolt
• je m’engage paris
• « Pour eux » plats pour SDF
• Benenova bénévolat avec des associations près de chez vous, selon vos disponibilités
• Kelbongoo propose des « produits frais et locaux à des prix accessibles, dans les quartiers mixtes et populaires, tout en soutenant des petits producteurs locaux aux pratiques respectueuses de l’environnement et des bêtes » (économie sociale et solidaire)

Animaux 

• Où? Toutes les SPA , refuges pour animaux etc. locaux près de chez vous
• Annuaire Sociétés de Protection animale
• Pour mes patients, les refuges pour animaux sont souvent associés à la souffrance, l’abandon, la solitude.. qui sont des « triggers » pour eux (schéma « abandon » etc.) – donc on évite! Sachez que la meilleure façon de se débarasser de ses démons, c’est de les affronter et d’agir en fonction de ses valeurs…et souvent ce que l’on imagine est bien pire que la réalité: allez à la rencontre de ces personnes, visitez les lieux, vous verrez…
• Adopter ou acheter?
• De même ceux qui sont prêts à accueillir un animal – mais surtout pas un « batard » d’un refuge! Que vont penser les gens … Si j’ai le schema « recherche d’approbation et de reconnaissance », pas de place pour un batard dans ma vie parfaitement présentable : on prend la dernière race à la mode, actuellement le berger australien, le beagle, pire: les races de chien « flat nose », comme le bulldogue français etc., élevages cruels créant des troubles respiratoires…et d’autres problèmes génétiques
• Réussir une adoption d’un refuge: c’est davantage une question de match de personnalités que d’animal trop « difficile/traumatisé » ou pas, comme le prouve la recherche. La preuve en video: Rescue diaries [Youtube]…Journal d’adoption [livre] | Guide de l’adoption animale initiative d’un site commercial qui m’a contacté pour être inclus, je n’ai pas tout lu, mais j’ai quand même voulu soutenir l’effort. Je vous laisse voir
• This step-by-step guide provide positive, healthy stimulation for dogs in the shelter setting while they learned basic manners and behavior control, such as doorway manners, appropriate food bowl behaviors, meeting and greeting and many other training exercises. Shelter dogs who have received some training are often viewed by the public as ‘special’, rather than victims of abuse and neglect.
• [Livre] Train to Adopt: Humane Guidelines and a Training Program for Dogs in Shelters: « This step-by-step guide provide positive, healthy stimulation for dogs in the shelter setting while they learned basic manners and behavior control, such as doorway manners, appropriate food bowl behaviors, meeting and greeting and many other training exercises. Shelter dogs who have received some training are often viewed by the public as ‘special’, rather than victims of abuse and neglect. »
• [Livre] Vous trouverez un grand nombre de livres sur l’entraînement de chiens et le changement de comportements difficiles en anglais sur dogwise.com, ou en français sur Amazon.fr
• Bénévolat
• A côté du travail en lien avec les animaux, il faut des personnes pour des tâches plus administratives aussi, ou alors en contact avec les personnes adoptant des animaux (à leur domicile).
  • La maison des animaux : Devenir « famille » d’accueil pour un animal, le temps de trouver une famille définitive
  • Devenir bénévole à la SPA bénévolat a Solicanin Argenteuil
  • Améliorer les chances d’adoption des chiens: cf. liste de livres « The 7 best dog training books of 2021 » ou ressources similaires en français (ou la langue de votre préférence) | sur Recyclivres
• One voice. Vision:  » Parce qu’il n’y a pas des combats mais un seul combat contre la violence, One Voice agit pour la faire reculer partout où elle se développe et quelle qu’en soit la victime. Elle défend une éthique animale et planétaire. »
  • Devenir militant pour One Voice
• Pour les oiseaux
  • des mangeoires sur le balcon / devant vos fenêtres pour les oiseaux (« mangeoires à cage de protection » pour éviter que les pigeons monopolisent le mangeoire, sur amazon etc.)
  • Il est désormais prouvé scientifiquement: Watching birds near your home is good for your mental health
  • Pour les nichoirs: Wildcare ou Vivara 
• Garde d’animaux
  • Emprunte mon toutou Garde gratuite de chien
  • Animal futé  1er site d’ECHANGE de garde d’animaux (chien, chat, NAC) entre particuliers
  • Pabete.com  La plateforme solidaire de garde d’animaux Pabete.com a pour objectif de démocratiser les services de garde et les rendre accessibles à toutes les personnes ayant des difficultés financières, tout en offrant un environnement sécurisé et bienveillant aux animaux accueillis.
  • Rover Différents types de services (promenades, garde à domicile, hébérgement, etc. par des particuliers) | payant
• https://www.wildcare.eu/  « Fournisseur Européen pour l’écologie » Gites à insectes, nichoirs pour mammifères et oiseaux, etc.
• Action Protection Animale est née du constat que malgré l’intérêt de l’opinion publique portée à la cause animale, la maltraitance est en constante augmentation à un point tel que les associations peinent à endiguer ce phénomène
• Faunalytics‘ mission is to empower animal advocates with access to research, analysis, strategies, and messages that maximize their effectiveness to reduce animal suffering [volunteering]
• La façon la moins chronophage de faire une contribution: faire un don. Voici les trois associations à qui je donne régulièrement
  • A la SPA faire un don est très simple, secure et rapide et on reçoit une attestation pour pouvoir déduire le montant aux impôts
  • Equiwent Association allemande de plus en plus médiatisée et très active en Roumanie, donne des attestations aussi
  • Prince Fluffy Kareem vous trouverez une page facebook et des infos ailleurs sur le web. Très active en Egypte pour aider les équidés

Autres

• Beautiful Trouble site du livre sur les tactiques d’activisme
• Economie circulaire: La Ressourcerie Batignolles  | Recyclivres collecte / achat / vente de livres d’occasion
• BonPote 10 actions simples pour devenir écolo  avec infographie à la fin à imprimer…
• Ressources climat  
• « Nature, Santé & Engagement Vers une nouvelle approche de la transformation écologique » pdf ici | lien sur Fabrique Spinoza
• Guide pour se former à l’écologie [blog challenge for earth]
• Reporterre sur le «compagnonnage», lieux collectifs / entreprises coopératives
• Wild For All | Wild Actions For All How to act for nature
• Agence Régionale de la Biodiversité Renaturer les Villes

Livres Environnement | Activism | Animaux

• Mathieu Dardaillon « Activez vos talents », et  Tu fais quoi dans la vie – s’engager dans une carrière à impact (2021)
• Bénédicte Manier « 1 million de revolutions tranquilles » Dès sa première édition, en 2012, cet œuvre a été la première à décrire la dimension mondiale des alternatives économiques, démocratiques et écologiques mises en place par la société civile. 
• David Oswald Mitchell « Beautiful Trouble » A toolbox for a revolution: a catalogue of activist tactics, principles, theories, and case-studies, organized into 2-3 page bursts consistent with Christopher Alexander’s notion of a design language
• Todd Kashdan « The Art of Insubordination » is the essential guide for anyone seeking to be heard, make change, and rebel against an unhealthy status quo.  A thoroughly research-based set of practicable, actionable strategies for supporting ourselves and others to dissent without alienating everyone around us.
• Active Hope: website and book « The challenges we face can be difficult even to think about. Climate change, political polarization, economic upheaval, and mass extinction together create a planetary emergency of overwhelming proportions. Active Hope shows us how to strengthen our capacity to face this crisis so that we can respond with unexpected resilience and creative power. Drawing on decades of teaching an empowerment approach known as the Work That Reconnects, the authors guide us through a transformational process informed by mythic journeys, modern psychology, spirituality, and holistic science. This process equips us with tools to face the mess we’re in and play our role in the collective transition, or Great Turning, to a life-sustaining society. »
• Liv Strömquist « Grandeur et Décadence » Graphic novel (BD) « La finance qui règne sans partage, le gouffre qui ne cesse pas de se creuser entre richesse et pauvreté, la mainmise de la classe aisée blanche sur la culture et les médias, la gauche qui a renoncé à faire de la politique et l’a remplacée par un creux moralisme… »
• « The Most Important Comic Book on Earth« : Stories to save the World (2021)
• « Through a vet’s eyes –  How We Can All Choose a Better Life for Animals » (2022)
• Face aux animaux – Nos émotions, nos préjugés, nos ambivalences (2022). Livre qui révèle les profils individuels et les circonstances qui favorisent une diminution de notre empathie envers eux. L’auteur montre que nos relations avec eux, de l’attachement à la maltraitance, éclairent profondément notre identité et notre rapport à autrui.
• Mon année zéro souffrance animale « Avec cet ouvrage coup de poing, Yolaine de La Bigne ne cherche pas simplement à éveiller nos consciences, elle nous donne des clés simples et pratiques pour nous impliquer au quotidien et agir concrètement contre la souffrance animale »
• Defending Animals: Finding Hope on the Front Lines of Animal Protection (2023): Globally recognized expert Kendra Coulter takes readers across the different landscapes of animal protection to meet people and animals of all kinds, from cruelty investigators to forensic veterinarians, wildlife rehabilitators and conservation leaders to animal lawyers and entrepreneurs, each working in their own ways to defend animals. Bringing unparalleled research and a distinct and nuanced analytical viewpoint, Defending Animals shows that animal protection is not only physical, intellectual, and emotional work but also a labor so rooted in empathy and care that it just might bridge the vast divide between polarized people and help create a more humane future for us all.
• L’Eco-Anxiété – Vivre sereinement dans un monde abîmé
• « Apps » pour identifier (1) les oiseaux: birdnet | Merlin (Cornell) et (2) les plantes: seek, plantnet
• Peter Wohlleben, auteur de La vie secrete des arbres entre autres, recommande le moteur de recherche Ecosia. Leurs initiatives et projets ont convaincu Peter Wohlleben. Leur outil IA associé me semble intéressant également

• Isabelle Tree: Le réensauvagement à la ferme de Knepp, l’original en anglais:
  • Projet « Wilding » (UK): « Wilding tells the story of a young couple that bets on nature for the future of their failing, four-hundred-year-old estate. The young couple battles entrenched tradition, and dares to place the fate of their farm in the hands of nature. Ripping down the fences, they set the land back to the wild and entrust its recovery to a motley mix of animals both tame and wild. It is the beginning of a grand experiment that will become one of the most significant rewilding experiments in Europe. » trailer youtube | Book of Wilding Practical Guide | Graphic novel Wilding | essay Wilding: The Return of Nature to a British Farm 
    autre ex.: (Pays bas) Rewilding « Rewilding is the first popular book on the ground-breaking science behind the restoration of wild nature. »

source pour la parabole: jour après jour | En anglais « Starfish Story »:

source https://insight-smart.weebly.com/emotional-agility.html

Sources citations : Susan David Emotional Agility

Acceptance and Commitment Therapy

How to be selfish (School of Life)

A Skeptics way to enlightenment | Notes on the Dalai Lama and Selfishness

L’article Bénévolat | Volunteering est apparu en premier sur Regina Koehler.

Let’s stop the suffering: here are some ressources to consider.

Many of the symptoms are at the intersection of stress, nutritional deficiencies and toxins, and even trauma. Thus, the treatment approach should reflect state of the art medical and nutritional research, versus the « take the (contraceptive) pill » traditional approach, that is too often the go-to solution for many health care providers. How Birth Control Switches Off Hormones and Why That Matters (site web Dr Lara Briden)

Excerpt from Dr Lara Briden’s (a naturopathic doctor with a busy hormone practice) highly recommendable book, Period Repair Manual: Natural Treatment for Better Hormones and Better Periods  (take the updated last edition from 2018! The book can be scolled through on Amazon)

*Vitex works for some and not for others.

« Period Repair Manual is your guide to better periods using natural treatments such as diet, nutritional supplements, herbal medicine, and natural hormones. It contains advice and tips for women of every age and situation. If you have a period (or want a period), then this book is for you.

Topics include:

• How to come off hormonal birth control
• What your period should be like
• What can go wrong
• How to talk to your doctor
• Treatment protocols for all common period problems, including PCOS and endometriosis

The second edition contains insights from Professor Jerilynn Prior, more than 300 new references, and an additional chapter on perimenopause and menopause.

Written by a naturopathic doctor with more than twenty years experience, this book is a compilation of everything that works for hormonal health. » (source: Amazon)

Dr. Lara Briden’s Blog

..and the article « How to Improve Premenstrual Mood Symptoms – A Summary of Natural Treatments« 

Blog excerpt: « As I discuss in my blog posts about magnesium, taurine, and vitamin B6, all three nutrients can improve premenstrual mood symptoms and work by reducing inflammation and boosting levels of the calming neurotransmitter GABA. Vitamin B6 can also reduce histamine. Take care with vitamin B6 because too much can cause nerve damage. »

Period Repair sample chapter

Hormone Repair Manual (2021) is a practical guide to feeling better in your 40s, 50s, and beyond. It explains how to navigate the change of perimenopause and relieve symptoms with natural treatments such as diet, nutritional supplements, and bioidentical hormone therapy.

Hormone Repair sample chapter

Patient recommendation (thanks to S.H.) Period Power: Harness Your Hormones and Get Your Cycle Working For You

Dr Sara Gottfried: The Hormone Cure: Reclaim Balance, Sleep and Sex Drive; Lose Weight; Feel Focused, Vital, and Energized Naturally with the Gottfried Protocol (2014)

Related post: Psychonutrition | Nutritional Psychiatry

L’article PMS | SPM est apparu en premier sur Regina Koehler.

What is ACT?

Medical conditions such as anxiety, depression, obsessive compulsive disorder (OCD), addictions, and substance abuse can all benefit from ACT and Mindfulness-Based Cognitive Therapy (MBCT).

ACT develops psychological flexibility and is a form of behavioral therapy that combines mindfulness skills with the practice of self-acceptance. When aiming to be more accepting of your thoughts and feelings, commitment plays a key role.

In the case of ACT, you commit to facing the problem head-on rather than avoiding your stresses. Imagine committing to actions that help you facilitate your experience and embrace any challenge.

It is also effective as a life-affirming and inspirational perspective of self-determination. (source: How does ACT work, see link below)

This summer I worked through these two ACT Journals and found them exceptionally transformative and helpful.

I started with the very streamlined, « essentials of ACT » version, the white and green one by Dr Nic Hopper et al. (UK) and continued right away with the blue and white, more recent US-version by Dr Hill and Dr Sorensen. The latter gives you a complete overview of what can be called all « ACT processes ». Why not bying a notebook and writing your answers in them, so you can do it again in a year? Reading them alone will not be helpful. There has been a tremendous amount of publications on ACT, but what matters with ACT is what you DO not what you KNOW about ACT. It is about activating in a values oriented direction. Therefore I found these workbooks, with their focus on activation and practicing, tremendously helpful and well thought out. Where to purchase the journals:

Hopper et al « The Acceptance and Commitment (ACT) Therapy Journal« The Acceptance and Commitment Therapy (ACT) Journal is designed to help individuals focus on the things that are most important to them by identifying personal values and putting them centre-stage where they can best guide actions and decisions.

Sorensen, Hill « ACT Daily Journal – Get unstuck and live fully »« When you are faced with life’s challenges, it’s easy to lose track of what’s important, get stuck in your thoughts and emotions, and become bogged down by day-to-day problems. Even if you’ve made a commitment to live according to your core values, the ‘real-world’ has a way of driving a wedge between you and a deeper, more meaningful life. Now there’s a flexible program for learning how to practice a popular, proven-effective therapy protocol on your schedule! With The ACT Daily Journal, you’ll learn all about the six core processes of acceptance and commitment therapy (ACT)―including mindfulness, acceptance, and values-based living―and even learn about a seventh: self-compassion.  » (source: Amazon)

App : ACT COACH

What is Willfulness? How to achieve willingness?

Related: Emotional Agility

Source: https://positivepsychology.com/act-acceptance-and-commitment-therapy/

L’article ACT | Acceptance and Commitment Therapy est apparu en premier sur Regina Koehler.

Highlights from Symposium 2019

By Bessel van der KolkMay/June 2019

All human endeavors are intrinsically political, including the way our mental health system is organized: how mental problems are diagnosed, what kind of research gets funded, and what treatments are approved as “evidence based,” as well as what interventions are reimbursed by insurance companies.

The story of how the diagnosis of PTSD (post traumatic stress disorder) came into being is a good example. Back in the late ’70s, it became increasing difficult to ignore the fact that hundreds of thousands of Vietnam veterans were profoundly disturbed after coming back from the war. They sought treatment because they kept blowing up with rage, were unable to calm themselves down and go to sleep, and because they couldn’t feel fully alive in the present. Given the political and economic consequences of acknowledging the connection between the struggles these vets were having and their combat experience, the Department of Veterans Affairs (VA) tried to define the problem as a matter of individual pathology. In effect, they wanted to blame these guys’ troubles on their genetics and upbringing.

Through a hard-fought political process, involving veterans organizations and mental health professionals, the diagnosis of PTSD eventually was created in 1980. Part of the politics of the process was that we had to make that direct link between vets’ struggles and their combat experiences. Hence, we focused on nightmares and flashbacks—intrusive memories of traumatic combat experiences—while downplaying problems with emotional engagement and emotion regulation, issues that we gradually came to understand as being the result of trauma changing fundamental brain processes. To this day, the PTSD diagnosis focuses on having unpleasant memories of the past, rather than on emotion regulation and having problems fully engaging in the present.

Subsequently, a number of us who’d been involved in that first step progressed to the next issue: PTSD was a pretty good diagnosis for war veterans, but it was clear that there’s a much larger population of traumatized people. For every vet who comes back messed up, there are at least 30 kids who get abused, molested, abandoned, and neglected at home. Even though they’re quite different from combat vets in many ways, they show many of the same symptoms. In response to our lobbying, the American Psychiatric Association funded a field trial for a new diagnosis: complex PTSD or DESNOS (Disorders of Extreme Stress Not Otherwise Specified). After that study was completed, the PTSD committee voted 19 to 2 to create a new diagnosis in the DSM. But to our amazement, that diagnosis was eventually left out of the DSM-IV, despite overwhelming research evidence for a much more complex developmental response to trauma.

As a result of that political decision, we still don’t have an accurate way of diagnosing the majority of patients who were traumatized in the context of their early attachment relationships. The DSM gives us a plethora of options: PTSD, Disruptive Mood Dysregulation Disorder, Reactive Attachment Disorder, Dissociative Identity Disorder, Nonsuicidal Self-injury, Intermittent Explosive Disorder, Disinhibited Social Engagement Disorder, Conduct Disorder, or Borderline Personality Disorder, all depending on the clinician’s whim and what will optimally be reimbursed by insurance companies. However, all these “diagnoses” ignore the most common etiology of these disorders: early trauma and disruptions in the safety of the attachment system. If we were to acknowledge the social realities that give rise to these conditions, we could stop looking for some mysterious biochemical or genetic origin that keeps innumerable research labs in business and start putting our resources into becoming a public health system that focuses on prevention and repair, creating optimal conditions for children and young adults to develop and to thrive.

There’s another side to the story of the PTSD diagnosis. Once it was formally recognized, a substantial amount of research money became available to develop “evidence-based” practices. I’ve always been a great proponent of the need to demonstrate the efficacy of mental health treatments, including how well they work, for whom, and what their limitations are. In fact, my colleagues and I have published numerous peer-reviewed scientific papers on the efficacy of a variety of psychiatric treatments, from Prozac to EMDR, and from yoga to theater programs and neurofeedback. However, the rush to evidence-based treatments, paradoxically, had a devastating effect on our field. In effect, the moment researchers found that their particular treatment approach was better than doing nothing, they declared it evidence based. That made some sense, but then politics took over from honest scientific exploration.

Currently, the science of treatment development is largely stuck, because most research funding is focused on basic mechanisms, correlations, neuroimaging studies, and epigenetics, while there’s virtually no federal research funding available to investigate truly innovative treatments. Only the most easily protocolized treatments, like CBT, prolonged exposure, medications, and EMDR, have been thoroughly researched. Interestingly, though medications have been shown, over and over again, to be only marginally helpful for PTSD, they keep being prescribed to the tune of billions of dollars per year.

In contrast, somatic therapies, such as Sensorimotor psychotherapy and Somatic Experiencing, haven’t been thoroughly researched for their efficacy, nor has hypnosis, which for about a century was widely regarded as the treatment of choice for PTSD. There’s also little “hard” evidence for Internal Family Systems therapy, or neurofeedback, even though many clinicians who specialize in the treatment of traumatized individuals consider these among the most effective treatments currently available.

The result of the politics of diagnosis and “evidence-based” treatments is that in most settings that depend on insurance reimbursement, clinicians are mandated to use treatments of questionable efficacy. The fact that study after study shows that these mandated treatments have at best a 40 percent drop in symptomatology, which is only slightly better than placebo, after a third of the patients drop out, seems not to have raised enough concern about wasted lives and wasted resources to affect their growing influence. Meanwhile, the VA, by its reliance on evidence-based approaches, has been a major factor in discouraging the expanded exploration of effective treatments. So once again, we’re faced with a political reality: many of the treatments sophisticated clinicians would consider most effective are only available to people who can pay out of pocket.

The impact of pervasive trauma in our society continues to be largely ignored. We know today that one out of eight kids in the U.S. has been a victim of maltreatment, and that half of all kids in the world are exposed to extreme violence. The Adverse Childhood Experiences studies have demonstrated that early exposure to family violence and emotional abuse is the largest and costliest public health issue in America. As a society, we mobilize against threats like ISIS, but most American kids are not the victims of foreign terrorists; they’re the victims of the social conditions in which they mature.

So the question is why, as a society, do we continue to avoid recognizing the devastating impact of early abuse and neglect? Here, again, politics is at play. In most of Europe, Singapore, Japan, and Korea, governments have incorporated evidence of the devastating effects of family violence, social deprivation, and poverty into public policy. In effect, they’ve said, “Okay, we’ve got to try to abolish poverty and spend our tax money on making it safe for children to grow up in our society.” In the States, we have yet to do that. Maybe this is one of the factors that accounts for the incarceration rate in the Netherlands being 68 out of 100,000, while in the U.S. it’s 860 out of 100,000. We’re the only country in the Western world that doesn’t have early parental leave; our mental and physical health depends more on our zip code than our DNA code. Acknowledging the reality of early deprivation, abuse, and neglect inevitably would lead to an invitation to change the social system. But the fields of psychiatry and psychology have failed to squarely face that reality.

As long as we live with a diagnostic system without scientific validity, all of us are part of the problem. Too often, we label our patients with the diagnoses that are in line with what the insurance companies will reimburse us for, rather than what’s actually going on. In fact, many clinicians confide to me that they don’t bother making diagnoses at all. But how can you treat anybody and ask to be paid for your services if you don’t have a clear idea of what’s wrong and what you need to do to fix it? How would you feel if you went to a cardiologist who gave you the treatment that the insurance company will pay for without really bothering to find out what’s wrong with you? How can we respect ourselves, and be respected by our non-mental health colleagues, if we continue to rely on the opinions of insurance companies and ignore the basics of good diagnosis and a solid scientific approach to clinical care?

If people distrust mental health professionals, they may have a good reason for it. We’ve become slaves to the insurance companies, and until we start dealing with the politics of mental health care today, we’re stuck. It’s nice and comforting to come to the Networker Symposium and see so many of our colleagues doing such innovative work. But this conference isn’t the world that we live in. We need to recognize the politics that are shaping our field and let our voices be heard outside the walls of this hotel.

***

Bessel van der Kolk, MD, is the author of The Body Keeps the Score: Mind, Brain, and Body in the Healing of Trauma and more than 160 peer-reviewed scientific publications on trauma, mechanisms, and treatment.

source https://www.psychotherapynetworker.org/magazine/article/2368/the-politics-of-mental-health

L’article The Politics of Mental Health est apparu en premier sur Regina Koehler.

Susan David, Ph.D. « is one of the world’s leading management thinkers and an award-winning Harvard Medical School psychologist. Her #1 Wall Street Journal bestselling book, Emotional Agility based on the concept that Harvard Business Review heralded as a Management Idea of the Year and winner of the Thinkers50 Breakthrough Idea Award, describes the psychological skills critical to thriving in times of complexity and change. Susan’s TED Talk on the topic of emotional agility has been seen by more than 8 million people. » (source: author website)

Here are some visual recaps of the main ideas. Follow her on Linkedin if you’d like to have those in your newsfeed. There is a close overlap with the ideas of ACT – Acceptance and Commitment Therapy.

L’article Emotional Agility est apparu en premier sur Regina Koehler.

« …So my understanding of how IFS works in practice is it identifies these almost little personalities in the brain. There are managers, who try to protect you from feeling unsafe (also called protectors), and the firefighters, who respond to moments of crisis, the exiles, who you’re trying to avoid, and that helps people identify these distinct parts of their personalities, and how those parts come out and contribute to different reactions.

And that seems like something that would be helpful even outside the context of therapy. In addition to all the wonderful qualities of mine you listed a minute ago, I do a lot of meditation. And one of the things that years of that is done has make me much more sceptical that there is just one of me in here. When you’re sitting there just watching your mind, the constant question is, well who thought that? Who thought thinking that would be a good idea? I didn’t want to be there.

And the mind has felt to me for a long time like it’s more of a corporation. You know, it has different divisions, and some of them have big budgets, and some small. But family systems seems to get at that too. That one thing that actually causes people frustration and shame is they are told they’re in control or should be in control of their minds.

And then it’s very frustrating, for me as somebody who has struggled a lot with anxiety and obsessive rumination, it’s very frustrating to not be able to control my own mind. Because that feels like I’m failing. And the idea that it’s actually not something I should be able to do, that it’s not just one singular mind, but a lot of different minds or something vying to be heard, there’s some relief in that. And it seems to me some real accuracy in it… »

Dr. Bessel van der Kolk on Internal Family Systems therapy

The Voices in Your Head

On the inside, we are more like a family than an individual.

“Please,” the teenager told me, “I can’t go back to therapy. I’m so tired.” She was intelligent, anxious, and depressed. “I’ve tried it, all the coping stuff. It’s so hard, and it makes me feel worse when I have to watch all my thoughts all the time. I can’t keep it up. I get obsessed with having to watch every thought.”

She was not the first person I had heard this from. Her therapy was not working for her, so I had a reasonable indication for medication. Still, I wondered if this bright, insightful, and artistic person was a candidate for a less commonly used therapy called IFS. When I told her about it, her face opened up, “Yeah, yeah, I’ll try that.”

What Is IFS? Internal Family Systems Therapy in Paris

When Dr. Richard Schwartz was a young psychologist trained in family systems, he found himself hitting the wall with some of his clients. Family systems is a theory which posits that our behaviors are related to our roles in our families and that the system determines a great deal. Change the system, change the person. But it was not working with his bulimic clients.

On the inside, we operate like a family system 
Dr. Schwartz, now Adjunct Faculty, Department of Psychiatry, Harvard Medical School, simply started listening. He began to notice an interesting pattern,

“They started talking about these different parts of themselves, that’s the word they used. And they would talk about this critic who, when something bad happened in the outside world, would start to call them names. Then that would bring up another one who would feel bereft and empty, alone and hurt, and then to the rescue would come the binge. That would just take them out of their body and turn them into an unfeeling eating machine. But that would bring back the critic, who’s now calling them, in addition to all the other names ‘fat pig.’ Which brings back that empty alone one. And it just sounded to me as a family therapist like these sequences of escalating circular interaction that we were studying in families. So I became intrigued, and I began to try to track these sequences… And then I started noticing that I had them too.”

We all do this.

“Part of me wants to eat the cookie, but another part of me really wants to stick to my nutrition goals.”
“I’m sorry, I wasn’t myself when I said those things. That wasn’t me.”
“I’m torn.”
“I’m working on silencing my inner critic.”
While the idea of parts of the personality or sub-personalities have been explored by many others, the unique finding came when Dr. Schwartz noticed that the parts seemed to interact like a family. His training was now paying off, and he used some of the techniques he’d used to get family members talking to each other with his clients. Except this time, he had them talk to themselves on the inside.

Dr. Schwartz’s Internal Family Systems (IFS) model “represents a new synthesis of two paradigms. One of these is called the multiplicity of mind—the idea that we all contain many different beings. The other is known as systems thinking.” (Schwartz, 9) When I talked with Dr. Schwartz, he elaborated, “Falconer and I cover the idea that the mind is naturally multiple as it appears throughout the history of our culture and also the history psychotherapy, but also as it appears in different branches of sciences.” Indeed, a quick survey of recent neuroscience will show that the idea is prevalent.

The Parts

But it’s the systems part that is the most interesting. The idea is that we have three main types of parts, all of whom behave with good intentions: managers, exiles, and firefighters. These exist in relationships with each other that may be healthy or dysfunctional.

Exiles are the parts that hold our pain or shame, and they often originate in childhood. They take on our traumatic experiences to protect the most essential part of us, our true selves, but by doing this they can become stuck. The rest of the system exists to keep them quiet so that we don’t consciously experience our pain.

The managers are the responsible adults, who help us function as we are supposed to. In fact, as adults, most of us live primarily from one of our managers and think that’s who we really are. Managers make sure we interact with the world in a way that protects us from pain; they keep our exiles from showing up to flood us with emotion. But when they fail, the firefighters show up.

The firefighters use more extreme behaviors to distract us from the pain, whether acting out in anger, addictive behaviors, impulsive behaviors like binge eating, or more socially acceptable behaviors like overworking. Even though the firefighters seem to be prompting harmful behaviors, their good intention is to protect the system.

The Self

IFS has something very unique at the center of the model: the « Self » with a capital S (≈ » healthy adult » in schema/mode therapy | « wise mind » in DBT). “This idea that people have a self shows up in religion. We have the contemplative sides of religion, and every major religion talks about it the same way,” Dr. Schwartz explained.

« Facing Herself »
What is the self? It’s the core of us. To children, it’s often explained as “the real me.” When the parts feel safe enough to let it, a profound healing energy emerges in people that seems to know what they need. Far from being deficient and needing the help of the therapist, IFS posits that people are equipped with self already, and the goal is to access that self. 
The self is noted to have a list of remarkable characteristics, including eight Cs and five Ps. The eight Cs are calmness, clarity, compassion, curiosity, confidence, courage, creativity, and connectedness. The five Ps are presence, patience, perspective, persistence, and playfulness.

So Schwartz is claiming that we all have an essentially ideal human inside of us already. While the self is the natural leader of the family, harmful incidents in the past created exiles and protectors who wrested control away. The goal of IFS therapy is to restore the internal family’s trust in the self, even as the pain of the past is healed by allowing the exiles to tell their stories and be freed from the burdens they carry. When the parts trust the self to lead, the internal family reorders itself in a healthy way.

Most of us don’t know we have a self.

“Do you think most people have access to their self?” I asked.

“No,” answered Dr. Schwartz, “that’s part of the problem. So it’s becoming aware that there is a self, but it’s covered over by these parts, and that self wants access. Self is your birthright. We work with kids down to age three, and they also have a self.”

I was curious, so I asked, “How can people start to access their self without a guide? Say they’re not working with a therapist?”

“It helps to know when you’re in self and when you’re not. We have a meditation that helps people get their parts in open space and then feel what it’s like to be in self. And then, the simple practice of just noticing how many of those eight Cs you are finding. And noticing how open your heart is, or noticing if you have a big agenda,” Dr. Schwartz shared. A big agenda would be a sure sign of a manager online.

Does IFS work? Try evidence-based Internal Family Systems Therapy, in Paris

IFS is listed as an evidence-based practice in the National Registry of Evidence-based Programs and Practices. Dr. Schwartz shared that a study on PTSD is to be submitted for publication. It looked at 13 clients with moderate to severe PTSD. After 16 weeks of IFS, only one person still qualified for a diagnosis of post-traumatic stress disorder.

The young lady at the beginning (for privacy, a fictional case that reflects my true clinical experience) found that she thrived with IFS. It was a useful treatment modality for her, and her depression resolved without medication.

In his book « No bad parts » Richard Schwartz mentions the meditations by Loch Kelly

References

Dr. Schwartz, Richard C. (1995). Internal Family Systems Therapy. New York: The Guilford Press.–
https://www.psychologytoday.com/us/blog/shouldstorm/201906/the-voices-in-your-head

L’article IFS | Internal Family Systems Therapy in Paris est apparu en premier sur Regina Koehler.

“Pain is the agent of change: if we build walls around it, it remains untouched and alive inside us, slowly contaminating our other feelings. It is in the movement between the poles of the past and the future that we adapt. Our innate drive to get on is profoundly powerful, yet we need to slow down, to give ourselves space between our old and new selves. In therapy, we call this a ‘fertile void’, a time of not knowing, a neutral zone of uncertainty that is uncomfortable or even crazy-making. When we block it, the same problems may reoccur in every phase of life. If we accept the pain of change, and learn how to adapt, we will have the energy and confidence to take the next step.”

“Even the most robust people can find change difficult. The thread that connects them, whatever their age or circumstance, is that each person had to work on themselves actively to understand their unique response to change, and develop the necessary coping mechanisms. ”

“In the last fifty years there have been seismic shifts in the West in every aspect of life, and now people have to cope with more change than ever before. The past is no longer a reliable predictor of the future, and the twenty-first century is more fluid: all of the old certainties – age, gender, sexuality – are being questioned and boundaries broken. It seems we live in a culture of limitless choice. Most of these changes may be positive, but life is now infinitely more complex. These factors, and the overwhelming number of choices we face, have heightened the possibility of more existential crises.”

“A good life is built with good relationships.’ How we construct them is the foundation of everything else. Again and again, through my research and work with my clients, I see we cannot do it alone, whatever life stage we have reached. People need people, and the quality of those relationships is what matters most to us when we look back at our lives.”

“Life is a set of alternating phases, a period of change followed by a period of stability, then another change. Research shows we tend to take stock and think about change every seven to ten years (yes, the seven-year itch is a thing), and the process of change can take up to a year to be integrated into our life. Sometimes the changes feel like success, at others failure, but the key is to learn from them.”

“It is well researched that the more we allow ourselves to learn and expand in response to life changes the more likely we are to thrive. ”
“Often we adapt to change by making tiny adjustments. As in all psychological theories, nothing is certain, in some cases a sudden shift can liberate and transform someone. ”

“This too shall pass” review by The Guardian

The only constant is change, said Heraclitus in about 500BC, yet we are rarely prepared for the significant transitions in our lives. Julia Samuel, a psychotherapist and grief counsellor, has followed up her acclaimed debut, Grief Works, with these “accounts of change, crisis and hopeful beginnings” organised around the themes of family, love, work, health and identity. She draws on patient case studies as well as the insights of 30 years of clinical practice.

In the space between phases – known as the ‘fertile void’ in therapy parlance – we must sit with discomfort for a while

Relationships of all types must adapt to survive; Samuel quips that she herself has had five different marriages, all with the same husband. We meet a mother learning to loosen the grip on her adult daughter, and a man adjusting to the upheaval of new fatherhood. In her discussion of love, Samuel explores “the friction between the desire for predictability versus freedom – safety versus excitement”. She shares stories about marriage, infidelity, sexual obsession and looking for love at various stages of life. Maria, a married woman with a steady lover, is struggling to overcome an infatuation with a second lover (where does she find the time?) after he breaks off the affair. All those involved, including her husband, are respectful of the relationships.

Becoming a grandmother at 47 led me, as a therapist, to rethink my response to change

Samuel considers first jobs, maternity leave, getting fired and retiring. The theme of health covers expected changes, such as the menopause, as well as illness. A story from Grief Works about a family mourning their four-year-old who died in a swimming pool has continued to haunt me. The most heart-wrenching case here is that of Ben, a widowed father of two who has just started to adjust to his bereavement when he receives a life-threatening cancer diagnosis. Samuel has not cherry-picked cases to portray herself as a saviour. Nor does she consider therapy a cure-all: she concedes what Ben needs is not counselling but a turn of luck.

In the chapter on identity we encounter a Kurdish refugee, a young man coming out, and KT, a patient who identifies as gender non-binary. Samuel calls KT’s ghosting lover “a complete fucker” (and dubs another patient’s bullying investor “the Tosser”).

Sometimes change arrives abruptly, other times it’s part of the natural ebb and flow of life. Research shows that people tend to take stock every seven to 10 years. In the space between phases – known as the “fertile void” in therapy parlance – we must sit with the discomfort for a while. Bypassing it can curb “potential growth” and satisfaction in the new phase.

For Samuel, the key to resilience is the quality of our relationships: family and friends can buoy us in turbulent times. Yet: “In England more than a million older people can go for over a month without speaking to their family, friend or neighbour.” The observations of her patients’ progress speak to the value of prolonged talk therapy, as opposed to the less costly cognitive behavioural approach currently favoured by the NHS. We tend to invoke the phrase “this too shall pass” at moments “when life sucks”, Samuel writes. “But here’s the hitch”: moments when life is good will also inevitably pass. Heraclitus’s theory of flux stated that we never step into the same river twice: the river has changed, or else we have. With Samuel guiding us through the rapids, we can forge ahead “with a little more joy, clarity, confidence and … hope”.

 This Too Shall Pass: Stories of Change, Crisis and Hopeful Beginnings by Julia Samuel is published by Penguin

L’article This too shall pass est apparu en premier sur Regina Koehler.

The development of the National Centre for Trauma-Informed Care (NCTIC, 2019) in 2011 in the USA also marked growing recognition of the impact of psychological trauma and its important role in health care services in general.

Practitioners and agencies providing trauma-informed care help people make the link from their past histories to present health concerns and reframe their reactions and behaviours as attempts to cope with what they have experienced.

In brief, the trauma-informed model of care encourages practitioners to consider how traumatic experiences may impact people throughout their lifespan, how these experiences may contribute to a variety of emotional, physical, and cognitive problems, and if trauma reactions are present, how to reduce those reactions through best current practice. (…)

Are you concerned by trauma and its effects? Scroll down to the end of the page, two questionnaires can help you evaluate if you might be concerned by traumatic experiences.

Major principles of trauma-informed practice

1 Trauma is part of many disorders and challenges for people of all ages.

A trauma informed view recognizes that there is an interrelation between trauma and potential outcomes of trauma, e.g. substance abuse, eating disorders, depression, anxiety etc.

It is important to understand how traumatic events throughout the lifespan impact emotional and physical health and general quality of life.

While there are specific categories of trauma (single incident or acute trauma, post-traumatic stress disorder or PTSD, intergenerational trauma, and historical trauma), results of studies like the Adverse Childhood Experiences (ACE) study (Centers for Disease Control and Prevention 2019, see youtube video below) demonstrate the multiple associations between childhood maltreatment and negative health outcomes later in life, adoption of risky health behaviours, emergence of social, emotional and cognitive impairment and early death.

Other concepts, such as developmental trauma and complex trauma, are key to understanding multidimensional outcomes and individual responses to life events.

2 Trauma is not just a psychological experience, it is a mind-body experience.

Trauma specialists emphasize the role of the body, physiology, neurobiology, and neurodevelopment in identifying and addressing trauma reactions, these areas in particular inform practitioners about how to assist traumatized individuals and are key to trauma informed care.

The mind is defined not only as a function of the brain, but as a system that involves the individual in relation to others.

Interpersonal neurobiology (Siegel, 2012) shows that relationships with people, environment, and other systems, impact how individuals respond to traumatic events and is another key part of the mind-body experience (…)

also see EMDR, Post Traumatic Growth

Trauma and the nervous system: a polyvagal perspective

Êtes-vous concerné par le trauma? Les tests ci-dessous peuvent vous donner une première idée mais ne remplacent pas un diagnostic.

Les expériences traumatiques de l’enfance, en français – Calcul de votre « ACE score » (pdf)

• Contexte sur l’étude de Felitti sur le score « ACE »

En anglais, le Traumatic Antecedents Questionnaire

Ressources

source: Cathy Malchiodi | Trauma and Expressive Arts Therapy | Brain, body and imagination in the Healing Process (2020)

Nutritional approaches to psychotrauma

7 Hidden Effects of Trauma and Complex Trauma (2021)

How Trauma Affects Relationships (NICABM)

L’article Trauma-informed practice in Paris est apparu en premier sur Regina Koehler.