Paola : Hello, I am Paola Tavares Sanchez and I am a student in the second year of my master’s degree in Clinical Psychology and Integrative Psychopathology. I did my license in Poitiers and came to Nantes to do my Master’s degree. What about you Caroline?
Caroline : Hello, my name is Caroline Boyadjian. I am from Toulouse but came to Nantes for my studies too. I am doing the first year of the same master’s degree, which I chose because I am interested in adults with mental disorders. And you, what do you want to do as a psychologist ?
Paola : I would like to work with children and adolescents in the field of youth protection or at least in the field of trauma. I am currently doing my internship in this field and my internship tutor was trained in a type of therapy called Lifespan Integration Therapy which is really interesting, not only for people who have traumas but also for other types of problems. Have you heard about it?
Caroline : That’s very interesting. Yes I heard about it! If I remember correctly, Lifespan Integration is a therapy developed by Peggy Pace in 2002. The idea is to encourage the integration of past experiences by the body-mind system, with repetitions and visualization of a chronological life review, called a TimeLine (visual images of scenes from the patient’s life). Indeed, this will allow him/her to understand that the events that happened are no longer present but are part of the past. Moreover, this therapy links body and mind by activating neuronal integration.
Paola : Yes that’s it! The idea for this therapy came to Peggy Pace after a session in which a 40-year-old patient found herself dissociated from her adult resources, as if she was stuck in a painful event from the past. Asking her age, she said she was 6, the age of the trauma. Peggy Pace has shown her the passage of time by making her remember the events between her 6 years and her current age. The therapist tried this method with other patients, making them visualize a timeline of their life, and the results were surprising: these patients were more confident and less mistrustful, and the quality of their relationships improved.
Caroline : That’s amazing, right? Indeed, this therapy is based on the following observation: a traumatic memory activates sensations in the body as if it was blocked at the time of the traumatic event. When similar situations appear in the present, it reactivates and the patient’s behavior may then become inappropriate (unhealthy, self-destructive). The adult person rationally understands that the event is over, but there are younger self-states that are stuck in the past. Indeed, trauma is a failure to integrate information into memory. Peggy Pace thus proposes to work with the inner child.
Paola : Do you know the theoretical basis of this therapy?
Caroline : This therapy is supported by several theoretical elements, in particular by neurosciences. First, studies in the 90s showed that the brain does not differentiate what it is actually experiencing and what it is imagining: brain activation is the same. Then, the integration of trauma into memory relies on cerebral neuroplasticity, which is the brain’s ability to change its neural networks throughout life. Finally, neuronal integration is possible through the relationship. In fact, from childhood, the nervous system develops through interaction with the parental figure: a secure attachment style allows for better emotional regulation. Through the dyad, the child can discuss the events of his life with an adult who knows his story and thus create an autobiographical account of his own life; it is called an integrated Self. To sum up, in Lifespan Integration therapy, the mental imagery created by visualizing the lifeline with the support of the therapist activates and reorganizes the patient’s neural system, towards an integration of the traumatic memory.
Paola : It’s impressive how much neurological and psychological aspects are linked. In therapy, there are different protocols that have been conceptualized which depends on the person you have in front of you. Indeed, depending on the problems encountered by the person and the different types of trauma he or she presents, the treatment will not be quite the same, despite the fact that the principle remains very similar.
Caroline : Oh yes of course, we must always adapt the tools we use to patients but it’s actually very interesting that they have thought about the different ways of dealing with patients’ traumas and problems. Before presenting the different protocols, could you tell us what is the general functioning of Lifespan Integration Therapy?
Paola : Sure! Lifespan Integration is based on a timeline that corresponds to the memories reported by the patient. The purpose will be to write down these memories, one per year according to Peggy Pace. She explains that the patients will not always have a memory at first sight but as we go along, new memories will appear. They don’t necessarily have to correspond to significant events, it can be for example the entry to school. Remembering all those events from the past will activate the right hemisphere of the brain in a pleasant way.
This TimeLine will be repeated to the patient several times to allow him to integrate these elements in his mind and to make him visualize the events in a chronological way. During this process, new images will appear. Those new images don’t have to be enunciated out loud or even be further developed. Normally, the connection body-mind will take effect 24 or 48 hours after the session.
Caroline : That’s incredible. Now, can we talk about the different kinds of protocols and describe them?
Paola : Yes. As you know, Peggy Pace has established six protocols of Lifespan Integration Therapy : a Baseline protocol, a Standard protocol, a Post-Traumatic Stress Disorder protocol, an Attunement (=accordage) protocol, a Birth-Present protocol and an Attachment Repair protocol. We will describe to you the four more common protocols.
Caroline : The Baseline one can be described as the process we described before : we make a timeline with the patient with memories for every year of his life and after that we repeat it several times. It is important to repeat it at least 8 to 10 times to allow an integration. When the person has experienced traumatic events during childhood and doesn’t remember them because it’s not accessible to the conscience, it is preferable to use this protocol.
Paola : The standard protocol is a little bit different because we will be interested in what she named the affect bridge. In fact, we will start from the patients’ current bodily sensation to determine a particular memory, called “signal memory”, which refers to this bodily sensation. During this therapy, the patient should try to stay focused on his or her physical feelings when talking about the current problem. Moreover, the psychotherapist must then take the patient’s present self to the past self, which means mentally visualizing the past scene while introducing the patient as he is now into that scene, which will help the past self. Then, the Present Self will have to take the Past Self to a peaceful place. The aim is to satisfy the needs of his past self and to make him understand that this event is now over. The Timeline will start from the source memory and will be repeated at least five times. Finally, the patient must bring back the past self to the present one to show him how he is now and to present him to the different members of the actual family.
Caroline : Exactly! Now I will explain the PTSD protocol. As stated in its title, this type of protocol is used in the case of single or multiple traumas. The signal memories here will be the traumatic events.The particularity is that we are going to treat a disorder causing great suffering, which will require precautions. It is therefore necessary to keep the patient within his window of tolerance and not to evoke all the details of these events too quickly. When the patient is calm enough to integrate these elements, then we will include them. Also, in this protocol we will begin with a positive memory. In general, between 10 and 12 repetitions are done, but there can of course be more.
Paola : Finally, the Attunement protocol is more applicable to people who have experienced insecure attachment during their childhood. Indeed, during this period, the parent has not been able to attune to their babies and childs’ needs and therefore to provide efficiently for its various care needs (feeding, carrying, affection etc.). The principle in this type of therapy is to rewrite and relive in a positive way the early conditions experienced in the patient-therapist relationship. The particularity of this protocol is that the therapist must bring the subject into contact with his implicit memory, which begins in the first weeks of life. Sometimes, the psychotherapists can use a baby doll to represent the baby the patient was. In this way, the therapist carries the baby while telling its life story to enable a representation.
Caroline : We can conclude that Lifespan Integration therapies can account for many mechanisms present in any person. It is really impressive how tracing one’s life chronologically can help to place oneself in the present. It seems actually very simple but it isn’t always, especially for our childhood. This therapy is also revolutionary because it takes into account the child we were but do not necessarily remember.
Paola : Yes, that’s right! This period of our lives is all the more important because we are in the process of forming and interacting with our environment, without which we cannot build ourselves.
Caroline : I think it is necessary to have tools like this one being a therapist, which can really be helpful not only for the patient but also for us to understand him or her.
Paola : I completely agree! Actually, the Lifespan Integration Therapy is being reviewed, especially for PTSD but nothing has been published for now.
Caroline : Thanks for the talk, it was really fascinating. Bye !
Paola : Thank you! Goodbye!