Thoughts
What am I telling myself?
Behaviour
What am I doing or avoiding?
Feelings
Emotion?
Body
Sensations?
each
shapes
Self
calm - curious
Exile
grief/terror
Exile
shame/rage
Exile
despair
Perfectionist
Manager
Pleaser
Manager
Controller
Manager
Angry
Firefighter
Reassurance
Seeker
Numbing
Firefighter
Firefighters (outer)
Managers
Exiles hold pain + emotion
+ self
- self
+ other
- other
Secure
Comfortable with
closeness and space
I am worthy of love
Others are reliable
Anxious
Craves closeness,
fears abandonment
I am not enough
Others may leave
Avoidant
Values independence,
discomfort with closeness
I am self-sufficient
Others are intrusive
Disorganised
Wants and fears
closeness at once
I am unworthy
Others are unsafe
DISCONNECTION AND REJECTION
Abandonment
/ Instability
Emotional
Deprivation
Mistrust /
Abuse
Defectiveness
/ Shame
I am not safe, loved, or belonging
IMPAIRED AUTONOMY
Dependence /
Incompetence
Vulnerability
to Harm
Enmeshment /
Undeveloped Self
I cannot function independently
OTHER-DIRECTEDNESS
Subjugation
suppress self
Self-Sacrifice
give without limits
Pleaser / Fawner
seek approval
Others matter more than me
OVERVIGILANCE AND INHIBITION
Emotional Inhibition
suppress expression
Unrelenting Standards
never enough
I must be vigilant, controlled, perfect
Young, J.E. - Schema Therapy
Thoughts
beliefs - interpretations
Feelings
emotions - body
Behaviour
do - avoid
change one
change all three
Threat
Fight / Flight / Freeze
Protect - Danger-focused
Drive
Achieve - Seek - Acquire
Goal-focused
Soothing
Contentment - Safe
Affiliation - Rest
balance
is the goal
In trauma: threat overactive - soothing underdeveloped
Psychological
Flexibility
ACT goal
Defusion
thoughts as thoughts
Acceptance
open to experience
Values
what matters most
Committed Action
behaviour change
Present Moment
here and now
Observing Self
witness perspective
Pursuer
criticises - demands
Fear: I am alone
Withdrawer
goes quiet - shuts down
Fear: I am failing
The goal: primary emotions
I am terrified you will leave
not: you never listen
vulnerability changes the dance
Ventral Vagal - Safe and Social
Calm - Connected - Curious - Present
Immobilisation WITH safety: rest - play - intimacy
Window of tolerance - healing happens here
Sympathetic - Fight or Flight
Activated - Anxious - Angry - Hypervigilant
Mobilisation - movement toward or away from threat
Heart rate up - muscles primed - scanning
Dorsal Vagal - Shutdown
Collapsed - Numb - Dissociated - Flat
Immobilisation WITHOUT safety - last resort
Heart rate drops - freeze - playing dead
Stillness can mean safety OR shutdown
ventral vagal = safe stillness
dorsal vagal = collapsed stillness
Hyperarousal - Stuck On
Fight - Flight - Panic - Rage - Overwhelm
Sympathetic dominance
Window of Tolerance
Regulated - Present - Able to think and feel
Learning, relating, and healing happen here
widen through therapy
Hypoarousal - Stuck Off
Freeze - Shutdown - Numb - Dissociated - Flat
Dorsal vagal dominance
Stress
Manageable demand
NS activates
then returns
to baseline
Window intact
builds resilience
if supported
Single-event
trauma
Overwhelms
capacity
NS gets stuck
in activation
PTSD
flashbacks
Complex
trauma
Repeated
chronic - early
Reorganises
personality
and attachment
C-PTSD
schemas
The Fantasy Bond - Firestone
Real relationship
inadequate - frightening
or absent
Fantasy bond
imaginary fusion with
idealised caregiver
replaces
The cost: self becomes the problem
own perceptions suppressed - parent idealised
I must be bad - they are good
In adult life
bond with form of
relationship, not person
Healing
grieve real relationship
release the fantasy
The Trauma Bond Cycle
Tension builds
walking on eggshells
Incident
harm occurs
Reconciliation
apology - warmth
Honeymoon
hope returns
Calm
brief relief
dopamine spike
at reconciliation
Carnes - Dutton and Painter
The Trauma Pot - when it overflows
ACEs - complex trauma - loss
relational ruptures
stress - overload - burnout
unprocessed grief
daily stressors - relationship friction
sleep deprivation
resilience - regulation capacity
safe relationships - rest
overflow
symptoms - crisis
shutdown
therapy enlarges the pot\u00a0[15] - processing empties it
Traumatic Memory
isolated - unprocessed
frozen in time - raw
Adaptive Network
context - meaning
I survived - I am safe now
Bilateral Stimulation
eye movements - taps - tones
memory becomes labile - LeDoux / Ecker
Reconsolidated Memory
connected to adaptive network
past in the past - distress reduced
EMDR - The 4 Negative Cognition Domains
Safety
I am in danger
I cannot protect myself
NC: I am going to die
PC: I am safe now
Responsibility
I am to blame
I should have done more
NC: It was my fault
PC: I did the best I could
Control / Power
I am powerless
I have no choices
NC: I am helpless
PC: I have choices now
Lovability / Worth
I am defective
I am unlovable
NC: I am worthless
PC: I am worthy of love
NC = Negative Cognition - PC = Positive Cognition target
ACE score 6+ = life expectancy ~20 years shorter
Brown, Anda et al. 2009 - dose-response relationship, no safe threshold
Common Cognitive Distortions
All-or-nothing
perfect or failure
Catastrophising
worst will happen
Mind reading
I know what they think
Emotional reasoning
feel it = it is true
Personalisation
my fault, always
Should statements
rules that punish
Overgeneralisation
always - never - everyone
Magical thinking
thoughts cause events
Mental filter
one negative cancels all positives
Beck - Ellis
The Repair Sequence
1. Pause
notice activation - stop
2. Regulate
breathe - ground - slow
3. Own your part
I statements - no blame
4. Listen
reflect - validate - stay
5. Re-connect
acknowledge - repair bid
all repairs are valid - timing matters
Self
regulation
Body
sleep - movement - food
Connection
safe people
Reflection
journal - therapy
Nature
outside - light - quiet
Meaning
values - purpose
Rest
stillness - play
The Discharge Cycle - TRE
Threat detected
psoas contracts - adrenalin
muscles prime for action
Threat passes
activation remains
without discharge
Tremoring
psoas releases - shaking
involuntary - complete
Discharge complete
cortisol drops - tension releases
window widens
suppressed
Berceli - animals complete this naturally
Fight - Flight - Freeze - Fix
Fight
Mobilise toward threat
anger - control - attack
I must win this
Flight
Mobilise away from threat
anxiety - perfectionism - busy
I must escape this
Freeze
Immobilise - shut down
numb - dissociate - collapse
I must disappear
Fix
Manage and prevent threat
caretake - anticipate - control
I must solve this
Fawn: appease to survive
agree - submit - become who they need
The Hyperarousal Cycle
Poor sleep
less restorative
more fragmented
More hyperarousal
amygdala more reactive
cortex less active
Harder to sleep
racing thoughts
performance anxiety
Effort to sleep
increases arousal
trying makes it worse
self-sustaining
cycle
Replace: I must sleep. With: I am practising rest.
Emergency
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SHOUT text
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How to use relate - 10 steps
1
Context and pattern
romantic - work - family - friendship
2
Body
what is your body doing right now?
3
Feelings
what do you feel?
4
Story
what is your mind creating?
5
Belief
what do you believe about yourself?
6
Schema
the belief structure underneath
7
Active part
which part is most active?
8
Attachment
which pattern feels most familiar?
9
Early environment
what shaped this?
10
The Map
The Clearing
brainspot
eye position
held gaze
subcortical
brainstem
limbic system
stored activation
Outside
window
therapist-led
Inside
window
client-led
+ bilateral sound (BioLateral) deepens processing
Trauma
vortex
activation
fear · freeze
incomplete
survival response
Healing
vortex
resource
safety · ease
regulated
nervous system
pendulation
titration
small doses only
discharge + completion
shaking · sighing · warmth · tears
the interrupted survival response completes
Levine - Waking the Tiger (1997)
Emotion
Mind
feels true
raw experience
intense · reactive
Reasonable
Mind
logical
analytical
cool · detached
Wise
Mind
felt and known
acceptance ←→ change
Mindfulness
foundation skill - Wise Mind · observe · describe · participate
Distress Tolerance
survive the crisis
TIPP · ACCEPTS
Emotion Regulation
change the feeling
opposite action · ABC
Interpersonal Effectiveness
DEAR MAN · GIVE · FAST
Congruence
genuine presence
no therapeutic mask
Unconditional
Positive Regard
warmth without
conditions
Empathic
Understanding
entering the other's
perceptual world
actualising
tendency
the drive toward
growth
conditions of worth
introjected judgements that censor authentic experience
dissolve with UPR
fully functioning person
open to experience · organismic trust · present moment
Rogers (1957) - necessary and sufficient conditions
the person is not the problem
the problem is the problem
self
The Problem
named · externalised
has a
relationship
Dominant story
selective · authored by others · obscures alternative accounts
I am broken · I have always been this way · I cannot change
unique outcomes - moments that do not fit the dominant story
✦
✦
✦
✦
re-authoring
Alternative story
richer · thicker · historically grounded
includes what the dominant story filtered out
outsider witnesses · definitional ceremonies · thick description
White & Epston (1990)
Fused mind
thoughts = reality
I am worthless
feels like fact
reactive · automatic
past / future
default mode running
practice
Decentred mind
thoughts = events
I notice the thought
observed, not fused
responsive · intentional
present moment
DMN quieted
the observing awareness
stable · non-reactive · always present
Intention
why you
are practising
orients the practice
Attention
present moment
noticing
the technical core
Attitude
non-judging
curious · warm
changes everything
Shapiro et al. (2006) - intention · attention · attitude
MBSR
Kabat-Zinn (1979)
MBCT
50% relapse reduction
underlies ACT · DBT · IFS Self · Person-Centred presence
HPA axis - hypothalamus → pituitary → adrenal
Adrenalin
seconds
heart rate ↑
muscles prime
fast alarm
Cortisol
minutes–hours
sustained threat
toxic if chronic
HPA axis
Norepinephrine
alertness
attention
with adrenalin
in fight/flight
Oxytocin
bonding
lowers cortisol
touch · contact
the antidote
Dopamine
seeking
reward anticipation
intermittent
reward = stronger
Serotonin
mood regulation
90% in gut
sleep · appetite
social status
Chronic cortisol elevation
damages hippocampus · suppresses immunity · disrupts sleep
impairs reproductive hormones · promotes inflammation
repair: safe connection · sleep · movement · rest · oxytocin
Explicit memory
conscious · narrative
hippocampus
episodic
autobiographical events
when · where · who
semantic - facts
Implicit memory
unconscious · automatic
amygdala + body
procedural · somatic
emotional patterns
no timestamp
activates as present
Under trauma: cortisol impairs hippocampus
explicit encoding fragments - implicit encoding intensifies
Flashback - implicit memory activated by cue
body · emotion · image · relational pattern · all without narrative
Reconsolidation - the window for change
retrieve → destabilise → mismatch → reconsolidate updated
the body keeps the score because implicit memory has no past tense
van der Kolk · Nader & LeDoux · Levine
Guilt
I did something bad
behaviour · specific
self intact → repair
Shame
I am bad
self · global
self collapses → hide
four shame responses
Withdrawal
disappear · collapse · freeze
Avoidance
perfectionism · never seen
Attack self
self-criticism · self-harm
Attack others
contempt · rage · blame
all four maintain the shame · none resolve it
shame cannot survive empathy
Name it
bring into
language
Empathy
me too
that makes sense
Self-compassion
warmth not
judgement
Brown · Tangney · Gilbert · Neff · Bradshaw
Self-kindness
warmth toward yourself in difficulty
not self-indulgence · not self-pity
Common humanity
suffering is shared
you are not alone in this
Mindfulness
hold pain in awareness
neither suppress nor amplify
self
compassion
Self-esteem
positive self-evaluation
collapses when needed most
contingent · fragile
Self-compassion
warmth without evaluation
available in failure
unconditional · stable
what would I say to a close friend in this situation?
say that to yourself instead
activates soothing system · oxytocin · lowers cortisol · parasympathetic
neurons that fire together wire together
Hebb (1949) - the foundational principle
Established pathway
repeated early experience
connection = threat
fast · automatic · default
New pathway
repeated new experience
connection = safe
fragile → strengthens with use
therapy
what promotes neuroplasticity
Exercise
increases BDNF
neurogenesis
20 min aerobic
Sleep
consolidation
slow-wave
neurogenesis
Safe connection
co-regulation
oxytocin
earned security
what suppresses it
Chronic stress
cortisol neurotoxic
Sleep deprivation
suppresses BDNF
Isolation
no co-regulation
earned security - Main (1996)
insecure attachment + new relational experience + reflection = secure adult
old patterns don't disappear - new ones become more available
Kübler-Ross (1969) - five stages
not linear · not universal · not a prescription
Denial
protective
buffer
Anger
at the loss
real · valid
Bargaining
what if
if only
Depression
full weight
of the loss
Acceptance
integrating
not forgetting
Dual Process Model - Stroebe & Schut (1999)
Loss orientation
grief work · yearning
processing the loss
necessary - not indulgent
Restoration orientation
daily life · new roles
building forward
necessary - not avoidance
oscillation = health
Accept
the reality
Feel the pain
do not avoid
Adjust
to life without
Continue bond
live forward
Worden:
grief that is never named
disenfranchised grief | developmental grief | the love that was not there
unmourned loss stays present tense
grief allowed to complete makes the past past
Kübler-Ross · Bowlby · Worden · Stroebe & Schut · Doka
Ego states
Parent
what was taught · recorded
nurturing or critical
Adult
here and now · reality-based
responds, not reacts
Child
what was felt · early decisions
free or adapted
Life positions
I am OK · You are OK
secure · connection possible
earned security target
I am OK · You are Not OK
contempt · blame · superiority
Persecutor position
I am Not OK · You are OK
self-devaluing · deference
most common in patterns
Transactions
complementary
Adult
Adult
flows · understood
crossed
Adult
Child
Adult
Parent
breaks down · conflict
Drama Triangle - Karpman
Persecutor
Rescuer
Victim
blames
over-helps
helpless
Berne (1961) · Karpman (1968)
Generation 1
unprocessed trauma or loss
Relational
dysregulated NS
narrow window
caregiving shaped by trauma
Psychological
silences · narratives
what is unspeakable
family emotional atmosphere
Epigenetic
gene expression
HPA axis changes
Yehuda (2016)
Generation 2
carries what was not theirs to carry
ghosts in the nursery - Fraiberg (1975)
75% transmission rate of attachment organisation - Main
breaking the cycle
process
your own history
therapy changes
what you transmit
repair
not perfection
attunement + repair
is enough - Tronick
name it
the named thing
can be located
in the past
Yehuda · Main · Fraiberg · Brave Heart · Tronick
regulated
nervous
system
activated
nervous
system
co-regulation
face · voice · rhythm · presence
social engagement system - Porges
face · expression
voice · prosody
heart · ventral vagal
Social baseline
brain assumes togetherness
isolation = expensive
holding a hand lowers
threat activation - Coan
Loneliness
activates threat system
+50% mortality risk
= smoking - Holt-Lunstad
rewires perception - Cacioppo
Mirror neurons
fire when we act
and when we observe
we simulate each other - Rizzolatti
Right brain to right brain
early trauma stored
in right hemisphere
reached through presence - Schore
connection is not a preference
it is a biological necessity of the same order as food and sleep
Coan · Porges · Cacioppo · Rizzolatti · Schore
four dimensions of mentalization
Implicit
automatic · fast · below awareness
Explicit
deliberate · slow · reflective
Self focus
my own inner world
Other focus
their inner world · curiosity
prementalizing modes - failure under stress
Psychic equiv.
inner = outer
what I feel is real
no as-if
certainty
Pretend mode
inner not outer
talking without feeling
insight without
contact
Teleological
only actions count
words not trusted
show me you care
do something
arousal up - mentalizing down
the more activated the attachment system, the less reflective functioning is available
the not-knowing stance - MBT
I do not know what you are feeling right now - help me understand
parental RF predicts infant attachment security
being thought about is the origin of the capacity to think - Fonagy
the spectrum of human experience
Personal - the individual self
biography · patterns · schemas · attachment · trauma history
Existential - meaning and limits
mortality · freedom · isolation · meaning - Frankl · Yalom
Transpersonal - beyond the self
peak experiences · mystical states · unity · the sacred - Maslow · Grof
Jung
collective
unconscious
archetypes
Grof
holotropic
breathwork
non-ordinary
Assagioli
super-
conscious
psychosynthesis
Frankl
will to meaning
logotherapy
attitudinal values
spiritual bypassing - Welwood (1984)
using spiritual practice to avoid psychological work
acceptance used to not feel grief · non-attachment used to avoid care
integration: psychological depth + transpersonal openness
not bypassing the personal - transforming it
Yalom - four ultimate concerns
Death
we will die
facing it clarifies what matters
awakening experience
Freedom
we are responsible
for our choices
no escape from choosing
Isolation
irreducible aloneness
of consciousness
connection across the gap
Meaninglessness
no inherent meaning
meaning is created
not discovered - Frankl
Sartre - bad faith vs authenticity
Bad faith
I had no choice
that is just who I am
Authenticity
I am choosing this
consciously, freely
Rollo May - existential vs neurotic anxiety
existential: unavoidable
neurotic: displaced avoidance of it
Heidegger - thrownness
given that this is my starting point - what will I make of it from here?
Top-down
thought to feeling to body
insight · language · narrative
CBT · psychodynamic · schema
Bottom-up
body to feeling to meaning
sensation · movement · breath
SE · TRE · BSP · Focusing
trauma is stored in implicit memory - in the body
Broca area goes offline under activation - language unavailable - van der Kolk
three somatic approaches
SE - Levine
complete the
thwarted survival
response
titrate · pendulate
TRE - Berceli
invoke the body
own trembling
discharge
self-directed
BSP - Grand
eye position
subcortical access
relational
attunement
the felt sense - Gendlin
pre-verbal bodily sense · the felt shift signals something has moved
interoception - Damasio · somatic markers guide decision-making before thought
the body is not the background to experience - it is the primary site of it
the dissociation spectrum
normative
depersonalisation
structural
highway hypnosis
derealisation
amnesia
Depersonalisation
detached from self
observer of own life
I know it is me but it does not feel like me
Derealisation
world feels unreal
dreamlike · distant
I know it is real but it does not feel real
structural dissociation - Van der Hart
ANP
apparently normal part
manages daily life · avoids trauma
EP
emotional part(s)
holds trauma · survival responses
severe dissociation = dorsal vagal shutdown - the nervous system has left the building
grounding - returning to the present
5 senses
see · hear · feel
orienting
scan · feet on floor
dual awareness
feel it + now is safe
dissociation is not a malfunction - it was the only available option at the time
internalised critical voice
the evaluating environment brought inside
what it is trying to do
Motivate
prevent failure
Pre-empt shame
attack self first
Keep safe
maintain standard
self-maintaining loops
Perfectionism
impossible standard
fail → critic intensifies
→ try harder → fail
Shame spiral
critic → shame
→ withdraw
→ no correction
Avoidance
critic predicts failure
→ do not try
→ critic confirmed
across the models
IFS
curious about
what it protects
CFT
soothing system
vs threat system
Schema
Healthy Adult
vs Punitive Parent
Self-compassion
friend question
Neff
the critic is protecting something
understanding its intention is more effective than fighting it
Gilbert · Neff · Schwartz · Young
positive self-model →
positive other-model →
Secure
I am OK · You are OK
asks for needs · repairs
tolerates conflict
earned security possible
Avoidant
I am OK · You are not OK
self-sufficient · withdraws
deactivates need
exits conflict · needs space
Anxious
I am not OK · You are OK
monitors · pursues
hyperactivates need
floods in conflict
Disorganised
no coherent strategy
approach then freeze
want + fear closeness
caregiver = threat + safe
anxious + avoidant - the common pairing
pursuit → withdrawal
↔
withdrawal → pursuit
each perfectly activates the other's core fear
earned security - Main
processing + safe relational experience moves any pattern toward secure
Ainsworth · Main · Levine & Heller · Johnson · Wallin
The fear response
Threat signal
(real or relational)
Amygdala fires
before cortex
Body responds
heart, breath, muscle
Fight / Flight
mobilise - move - act
Freeze / Collapse
shut down - go still
In relational fear
the threat is connection itself
Where anger goes
Something is violated
boundary - need - self
Expressed outward
anger as signal
can repair
Turned inward
inner critic
depression
Anger as protest
this matters - I matter
The signal of loss
Something mattered
and now it is gone
Sadness
the natural response - it is healthy
When allowed
grief moves - integrates
When suppressed
sticks - numbs - flattens
The relational foundation
Psychodynamic
the root
Attachment
IFS / Parts
Schemas
Somatic
CBT / ACT
EFT / CFT