Visceral Impact Formulation; engaging heart as well as head using ICS. . Isabel Clarke Consultant Clinical Psychologist. Why ICS?. Neat explanation for the head/heart split – normalizing rationale. Takes the horrible feeling;the sense of threat, seriously – helps engagement
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Consultant Clinical Psychologist
LEVELS OF PROCESSING – A THEORETICAL JUNGLE! using ICS.
Interacting Cognitive Subsystems. using ICS.
IN THE PRESENT
Experience stored in
Sense of self as
early info. Needs
Suitable for working with high states of arousal – identifies the individual’s relationship to feeling awful inside as the problem.
Effective over one, two or three sessions (evaluated – see Durrant et al).
Introduces approaches to change that can be supported by staff on the ward, and carried on by CPN etc. in the community after discharge.
FEAR using ICS.
Nightmares: can’t sleep
More difficult to cope
Friends and family alarmed. Could lose custody of children.
Avoid going out and seeing people
More time to brood
Feel worseTypical formulation
Don’t let the feelings be in control: YOU ARE IN CHARGE
Do things despite the feeling
Breathing and mindfulness to get back to the present
Use the energy of the anger positively
Sense of threat
Being in crowds, busy places
This means I’m bad and
others want to hurt me
This also means I’m bad and
others want to hurt me
Escapes from thoughts
By slipping into unshared world
Withdraw, hide away
Or Fight, becomes aggressive
Ordinary using ICS.
Access to full memory and learning
Precise meanings available
Separation between people
Clear sense of self
Emotions moderated and grounded
Logic of Either/Or
Access to propositional knowledge/memory is patchy
Suffused with meaning or meaningless
Self: lost in the whole or supremely important
Emotions: swing between extremes or absent
Logic of Both/AndShared Reality Unshared Reality
High Arousal - stress
Discussion of Ways of coping suggested by this approach –
management of arousal and distraction.