Leone Baruh: “Developing TIF, we’ve learned a lot about our own vulnerability to splitting and projections”

Here’s another interview on the topic of the recent IEDTA-conference. This time we sit down with the IEDTA Vice President and Head of education, Leone Baruh, and talk about the conference as well as the newly developed format of ISTDP for families and couples: TIF.

Leone Baruh

How do you feel about the Boston conference? The conference exceeded my expectations in many ways. I experienced the Boston meeting with pleasure and enthusiasm, enjoying the fruits of the hard work of integration, carried out over the past 5 years, between models and different people. I joined the IEDTA Board during the 2014 Washington conference. Besides me, that Board included five wonderful persons: Michael Alpert, Kees Cornelissen, Allen Kalpin, Nat Kuhn and our inexhaustible president Kristin Osborn. I will be forever grateful to Kristin for having marked the path we are following. The personal goal that I set for myself at the time can be summed up in a word shared by the entire board: inclusivity. I believe that the fifty and more Boston presentations explain and show how much the IEDTA community has matured over the years.

What did you find most surprising or exciting about the conference?
The curiosity and the open-mindedness of the participants. When I heard the questions and answers at the end of the presentations I felt that openness, and not controversy, prevailed. I realized that our community is finally ready to grow up and become an adult.

Was there any specific contribution that stood out to you?
I was impressed by the value of the presentations overall. With so many contributions inspired by all the different souls of IEDTA, there was a real risk that quality would be compromised. Instead I saw young colleagues so eager to share and show their intuitions, so able to amaze us with the quality of their therapies that, at the end of the first day, I decided to leave (with great sorrow, I have to admit) the great hall and focus on lesser-known topics and speakers.

Can you tell us about your contribution at the conference?
The entire board worked hard for about two years to make the Boston conference a success and we’re proud of the result in terms of participation, climate and overall satisfaction. There’s no need to specify everyone’s contribution because we all did our best, but we all owe a debt of gratitude to Nat Kuhn for taken over a double role: President of the IEDTA and organizer of the conference. A personal sacrifice that only a few would have accepted in his place. Thanks Nat.

Moving on to the topic of TIF, how did you end up developing ISTDP for families and couples?
The full story is a long one and I’m afraid it might bore your readers. To summarize, I can say that in the nineties as a young psychologist, during my specialization in ISTDP, I saw for the first time the videos of Davanloo and Sifneos. I also had the good fortune to know privately and collaborate professionally with Gianfranco Cecchin. Boscolo and Cecchin are worldwide known for having founded the Milanese Family Therapy Center, better known as The Milan Approach.

In the nineties in Saronno we experimented with the first form of family therapy centered on the symptoms and problems of children. The team was composed of Cecchin, two extraordinary child neuropsychiatrists and a me as a young psychologist. It was a short and intense period. Unfortunately no clinical evidence was kept – I only have anecdotal memories from that time. After twenty years of working with ISTDP I felt a growing desire to better understand that Saronno period and to check if it was possible to create cross-fertilization spaces between those two worlds: ISTDP and family therapy.

In Italy I’ve been collaborating for years with a fantastic group of experienced ISTDP therapists ready to take up and share the challenges that I launch. Thus came about the core training in Bologna, Castelfranco Veneto, Rimini and Padua. This is also how the exciting challenges related to ISTDP applied to the context of professional sport and to couples, families and children within families were born.

Can you tell us some of the things you’ve learned while developing TIF?
The TIF formula (Intergenerational Family Therapy) prescribes the presence of at least two therapists who take charge of the family in a constant positive reciprocal communicative attitude. If these two therapists are inexperienced in couple dynamics, the therapists become three and the third will have the function of supervisor of the two therapists. Three therapists are provided even if the symptomatic patient is only one – the child. The last frontier of TIF – what we’re in the process of developing now – is an ISTDP-informed therapy for children and adolescents. Up until now, we’ve been using techniques from CBT when dealing with the symptomatic issues of the children.

Working with TIF, we’ve learned a lot about our own vulnerability to splitting and projections, and how easy it is for therapists to fall into the trap of thinking that the problem is not in the couple’s relationship, but in one of the two partners. Being an expert therapist has partially mitigated this attitude, but it’s hard work.

What can you tell us about the outcomes of the 40 families so far treated with TIF?
I could lose myself in the amount of information we are acquiring thanks to the outcomes (and insights) on the families treated. In the coming years we’re planning to present and better teach the model in the centers that will request our help. We have contacts with different contexts in Europe and the USA and we are open to new collaborations.

If I must choose a single aspect that captures my interest in this period, I’d say that it concerns the correlation (not yet statistically evaluated) between pressure to awareness and outcome. As ISTDP clinicians, we are used to thinking of Pressure as pressure to feeling and to believe that without emotional breakthroughs it’s difficult to achieve significant and stable results. If this is true for individual therapies, it may not be so for couples. My hypothesis is that some types of couples that struggle to function correspond to patients that in ISTDP we would evaluate on the fragility spectrum. This seems to be true even when the two persons that form the couple aren’t fragile. According to this hypothesis, the pressure to awareness helps the couple become more capable of intellectualizing about their difficulties and conflicts, and it contributes to shifting the couple from the territory of fragility to the territory of neurosis.

What would you like say to people thinking about going to the next conference in Venice in 2021?We have the serious intention of making Venice 2021 a mythical event! IEDTA congresses are always a great opportunity for professional enrichment and, keeping the value of the presentations at a very high level. This time we wish to favor the relational, human and interpersonal dimension. We want this conference to be an unforgettable experience not only for the therapist, but also for the precious human being who lives it. We want it to be amore.

Leone is coming to Copenhagen in a few months, to do an Immersion on ISTDP for couples and families (TIF). He’s also starting a core group in Copenhagen during 2020.

On the topic of the IEDTA conference in Boston, we’ve previously interviewed Allan Abbass, Jon Frederickson, Vidar Husby and Elisabet Rosén:

Allan Abbass: “It is very important for mainstream medicine to realize the impact of attachment trauma on healthcare use”

Jon Frederickson: “Hearing a paper only helps you get better at hearing papers”

Vidar Husby: “Precis som patienten behöver terapeuten en korrigerande upplevelse”

Elisabet Rosén: “Det var oerhört inspirerande att se och lyssna på allt detta, men också att få bidra till konferensen.”

Jon Frederickson: “Hearing a paper only helps you get better at hearing papers”

Here’s another interview on the topic of the IEDTA conference in Boston in late September. This time, we sit down with Jon Frederickson who chaired the panel on addiction

Jon Frederickson

What do you feel about being at the conference?
I enjoyed it very much. It’s always great to be among friends to and to see lots of videotape of cases. I learned a lot from seeing a wide variety of therapists working with a broad range of patients. It’s so important to have conferences where we see actual videotapes of clinical work. Research shows that the usual conferences we have seen do not improve therapist outcome. After all, hearing a paper only helps you get better at hearing papers. Watching videos of skilled clinicians, however, helps us see what we could do even better.

Was there any contribution that stood out to you?
I was very impressed by Robert Johansson’s presentation where he showed how statistical analysis can enable us to sort out which portions of a treatment model contribute to outcome and by what percentage. I look forward to his help in us analyzing our drug rehabilitation program so we can fine tune our treatment to improve outcome. I was also impressed by Allan Abbass’ work with a psychotic patient. The patient had been very disturbed and homeless. Yet, Allan’s work showed that often psychotic symptoms, though dramatic, may actually be occurring in a patient with a borderline level of character pathology. Thus, they can be treated. I also enjoyed Katie’s presentation where she is researching the effects of EDT training on therapists. She and I will do a research project next year with my next core group in Washington, DC. Steve Shapiro also showed a lovely piece of work with a borderline patient where he helped her see how her hallucination was a projection so she could take it back in. Kristy Lamb also showed some lovely work with a drug addict who projected her superego. She showed how to help the patient deactivate the projection, accept her self-criticism, then look at the anger the self-criticism was covering up. And all of this she did within a structured ISTDP group therapy model.

What was your contribution about?
I chaired the panel on EDT and addictions. So I presented a case of a woman who had worked as a prostitute to support her drug habit. She heard a voice telling her to use drugs. I showed the first twenty minutes of the first session to show the importance of deactivating projections in order to bring anxiety down. Then I showed how, as soon as we invite the patient to bear a projection inside rather than project it outside, we need to brace and support the patient at this highest level of anxiety until she can bear the projection inside without disrupting.

Do you have anything to say to someone thinking about going to the Venice conference in 2021?
I am really looking forward to it. How could we not! Some great presentations. A fantastic city to visit. Going off season when it won’t be crowded. Fantastic food and wine! We would be crazy not to go to that conference. I look forward to seeing everyone there who is reading this.

Allan Abbass: “It is very important for mainstream medicine to realize the impact of attachment trauma on healthcare use”

At the IEDTA conference in Boston a few weeks ago, the board of the IEDTA announced that the president of the association, Nat Kuhn, would be substituted by Allan Abbass. Here’s a short interview with Allan on the topic of his presidency, the conference and the future.

Allan at the Stockholm Immersion, august 2019

How does it feel to be the new president of the IEDTA?
I’m very pleased and honored to be the president of this organization. The IEDTA is now a fairly robust group of trainers, researchers and psychotherapy enthusiasts who have a primary interest in the roles of emotion and attachment in accelerated psychotherapy models.

What are your plans as the new president?
My three main goals for the coming two years include 1) encouraging people to research and publish in the treatment methods, 2) disseminate the information about the range of application and effectiveness of the EDT methods, and 3) wider engagement toward broadening our collaborative community of professionals and its connection to the wider field of psychotherapy. I believe that an academic focus on these treatments is very important in order to reach wider audiences, demonstrate the method, and illustrate its strengths and limitations as a healing method. More broadly it is very important for mainstream medicine to realize the impact of attachment trauma on healthcare use, social burden and general population health: in this way the efforts of Malan, Davanloo and others can inform a reorganization of healthcare where the person and his or her attachment system are place front and center for a more holistic approach.

Do you have any specific ideas as to how you’d like to develop this academic focus or get EDT into the mainstream?
One idea is to develop a research section on the IEDTA webpage. There have been many new articles and psychology journal articles in Scandinavia, Canada and beyond reviewing EDT methods.Another plan in the works is to develop an Academic Email group that would include the 150+ people who do research or teach in EDT methods so they can share ideas.Ultimately it will be people in their local areas who show their videos, teach colleagues and share their ideas that will widen knowledge and access about these powerful methods.

What are some of the challenges facing the association in the coming years?
The association relies on volunteers to conduct its activity. This can make certain activities more of a challenge. However, there are a significant number of energetic and capable volunteers including my fellow board members Chip Cooper, Leon Baruh, Ron Albucher and previous presidents Nat Kuhn, Kristin Osborn, Jessica Bolton, Ferruccio Osimo and Allen Kalpin and the many colleagues who helped make this last IEDTA conference and previous ones great successes.

What did you find the most surprising or exciting at the conference in Boston?
As usual it was a very enjoyable and collegial atmosphere where a broad range of case material and theories were examined. There was a pleasant social environment with openness to presenting and learning from one another. For people who haven’t been at these meetings, it is quite warm and encouraging meeting attended by people from all over the world at various stages of their careers and from various backgrounds: the world was there.

What would you like say to people thinking about going to the next conference in Venice in 2021?
Having presented and collaborated with the Italian ISTDP trainers and researchers over the past 10 years, this Italian conference promises to be an and enjoyable one set in the historical city of Venice. Stay tuned for updates as conference planning proceeds but it will be in October 2021 so mark your calendar!

Do you have anything else you’d like to comment on before we wrap up the interview?
Historically psychoanalysts were expected to weigh in public policies and political issues. The knowledge of human emotions, behaviors and attachment compels us to want to make the world a better place beyond just treating individual patients. So with knowledge comes responsibility and burden to contribute to the world, to try to improve the lives of people and to try to improve self-care and the care of vulnerable others in this world.