Over the years there has been an accumulation of misunderstandings regarding the new treatment modality that I have developed dubbed "cold therapy".
Cold as in brrrr, opposite of hot.
So there has been a lot of misunderstandings and of course malicious smearing and innocent comments and so on and so forth.
Then I thought it's high time to create a short video to disambiguate and to clarify a few points regarding cold therapy.
Now this short video is followed by a longer video attached to it which is more academic and delves much deeper into the tenets, the philosophy and the practice of cold therapy.
So to all of you out there who are wondering what to make of cold therapy, this by far is the video for you.
Many of the rumors and the misunderstandings are positive, for example the claim that cold therapy cures narcissism, it doesn't.
Or the claim that cold therapy somehow involves physical abuse or even violence, it doesn't.
My name is Sam Bachnin, I'm the author of Malignant Self-Love, Narcissism Revisited, a former visiting professor of psychology and currently on the faculty of CEAPs.
I have developed cold therapy over the past 10 years.
Now cold therapy is talk therapy, as the name implies, it's 100% verbal.
There's no physical component to cold therapy, there's no element of treating the body, there's no physical contact.
Cold therapy does create a hostile environment and this on rare occasions could lead to real world outcomes such as aggression.
This is common in other treatment modalities, there's nothing new about this.
But cold therapy is not a body-mind or a mind-body therapy, it's strictly a mind-related therapy which is based on words and silences.
Now nothingness is an extension of cold therapy, in the wake of cold therapy nothingness is the kind of philosophy that can restructure and reorder the narcissist mind so as to yield positive outcomes in the future.
Cold therapy does not cure narcissism, it tackles only specific elements in narcissistic pathologies, elements such as grandiosity, the false self and the need or addiction to narcissistic supply.
All the rest remains untouched, the narcissist's inability to empathize, the narcissist's abrasive or antisocial behaviors and so on and so forth have nothing to do with cold therapy.
Cold therapy doesn't deal with these issues.
Now cold therapy is strictly for people diagnosed with narcissistic personality disorder.
People who have been diagnosed with borderline personality disorder suffer from complex trauma, CPTSD.
People who have developed PTSD, post-traumatic stress disorder, owing to events which are highly traumatic such as rape, natural disasters, man-made disasters, war etc etc.
These kind of people should not be treated with cold therapy.
This is counter indicated in the strongest possible terms because cold therapy strips all the defenses and when these people remain defenseless they become highly suicidal and it's very dangerous.
So cold therapy is geared to deal 100% with people who have been diagnosed with narcissistic personality disorder and major depression.
This is the narrowest possible application of the therapy.
Only a licensed clinician, only a therapist with a license can administer cold therapy after appropriate training.
Now we have conducted several seminars around the world from Sao Paulo to Budapest and so on and so forth.
These are training seminars and you can purchase the recordings of the first training seminar online.
So everything is in the open.
There's nothing hidden or mysterious or ulterior in cold therapy.
It's a totally open platform and anyone with the right qualifications can tap in.
But I have to emphasize and repeat, don't try it at home by yourself and only people with the appropriate education, credentials and licenses can apply cold therapy to their patients or their clients.
The patient also must be fully informed about the risks associated with cold therapy and sign a detailed legally binding release form.
How did I come across cold therapy?
And again, when it comes to the details of cold therapy, listen to the second half of this video which is essentially presentation in an international conference.
And how did I come across cold therapy?
I observed that in environments such as the military and prison, narcissists absolutely lose their narcissistic behaviors and many of their traits. They become different people. They're no longer grandiose. They're no longer in your face, defined. They are no longer challenging. They are no longer abrasive or antisocial. They're no longer contemptuous.
In short, narcissists in prison, in the military, in hospital settings, what we call total environments, change. They lose at least the outward appearance of their narcissism.
Why is that?
Because these are potentially traumatic or traumatizing environments. Dangerous, risky, including risk to life.
It then occurred to me that one way to get rid of narcissism or at least the socially unacceptable manifestations and expressions of narcissism is to place the narcissist in a total artificially manufactured, highly structured, total environment, the equivalent of a prison, to recreate conditions which are hostile and thereby re-traumatize, recreate trauma.
The narcissist is likely to react, I thought at the time, to such an environment and to such a recreated trauma by losing narcissistic features of narcissism.
Retraumatization is nothing new. It has not been invented by me, I regret to say.
Retraumatization is very common in a multiplicity of treatment modalities.
Actually one could easily argue that psychoanalysis, the mother of all treatment modalities, all therapies, psychoanalysis is based on retraumatization, dredging up old traumas, eliminating or suspending defenses so that the patient can re-experience the trauma, process it, reframe it and survive with it.
That's psychoanalysis.
Similarly, most exposure therapies are based on retraumatization.
I refer you to work by Foer, by Cossack, by Rothbaum and there are many more.
Even early work by Breuer and later work by Freud explicitly talk about retraumatizing the patient.
Retraumatization therefore is not a crazy idea of Samvaknim, it's actually the core, the pillar, the pivot and the axis around which most treatment modalities revolve.
Because after all, if you can't process your trauma, you're unlikely to heal.
Now the difference between cold therapy and other techniques, other treatment modalities, the difference is that in cold therapy we are faced with a patient, the narcissist, whose defenses are such that he needs to be modified, he needs to really experience the therapy, not only discuss it, not only dissect it, not only analyze it, not only recall it or remember it, not only, you know, but experience it.
He needs to go through the equivalent of an artificially induced or engineered flashback.
Cold therapy seeks to simulate what is known as narcissistic modification with the therapist in the role of the public or the audience.
To remind you, narcissistic modification is humiliation in public in front of meaningful others. Motification is a good description of what cold therapy does to the narcissist.
And then in the wake of modification, the narcissist's defenses collapse, a process known as decompensation, and there's a window of opportunity to work with the narcissist.
Now he's vulnerable, now he's open to change, now he's contemplative and introspective, now he's a transformed person in the wake of the new experience of the trauma, verbal trauma might do.
I repeat, there's no physical element, no physical contact is allowed in any way, shape or form, no violence, of course, it's total nonsense, total malicious nonsense spread online by smear campaigners.
So the verbal trauma, which is by the way, highly structured, highly ritualized, a derivative of techniques, it's not just crazy making trauma, this trauma leads the narcissist to open up to treatment, to be for the first time maybe available for personal soul searching and the consequent insight and transformation.
This is the main accomplishment of cold therapy, forcing the narcissist to face himself in the mirror or herself in the mirror, the shame, the fact that compensatory strategies and mechanisms such as narcissism no longer work and therefore not needed.
The narcissist through cold therapy learns that it's possible to survive trauma without becoming a narcissist, without deploying or using or leveraging pathological narcissism.
The narcissist discovers new options and new possibilities, cold therapy is a very optimistic treatment modality in this sense, following a very brief phase of trauma at the very beginning of the treatment process.
The narcissist then begins to become extremely optimistic and begins to change shedding layers of defenses, cognitive distortions such as grandiosity and so on and so forth.
The reason cold therapy is way more successful or should be way more successful than other treatment modalities is because it's eclectic.
It makes use of techniques borrowed from 40, 40 other types of therapies plus 25 proprietary techniques that are developed.
Cold therapy is founded on child psychology, trauma therapies, addiction therapies, attachment therapies, depression and anxiety therapies and therefore mentioned proprietary techniques.
Cold therapy is not a child.
The common mistake of all other treatment modalities is to treat the narcissist as if the narcissist were an adult, to try to strike a therapeutic alliance with the narcissist, negotiate a treatment plan with the narcissist and other such narcissists.
Narcissists are children and should be treated as such.
Intimidation is also a post-traumatic reaction, it's also an addiction, it's also insecure attachment, it's also closely intertwined with depression and anxiety and so on and so forth.
So cold therapy borrows techniques and tools from multiple other treatment modalities.
It is a compendium or encyclopedia of everything we have ever learned about treating the human mind plus my not so modest contributions in the form as I said of 25 proprietary techniques.
So this is a general introduction to cold therapy.
I hope I've dispelled some of the myths, rumors, misunderstandings and smears online, innocent or malicious or malevolent.
And now here's a more academic, more in-depth presentation of cold therapy that I delivered a few years ago in an international conference.
In the description you will find links to literature and other resources.
And of course you are welcome to purchase the 11 recordings, 11 training videos and recordings of cold therapy.
They're available for purchase and they describe cold therapy in minute detail.
And having listened to these videos, these training videos, you will realize immediately how wrong the information about cold therapy online is.
And again, unfortunately some of it or a lot of it is motivated by malice and envy and worse commercial competition.
Thank you for listening and enjoy the rest of the show.
Good day to all of you.
My name is Sam Vachnin and I'm the author of Malignant Self-Love, Narcissism Revisited, as well as a professor of psychology in Southern Federal University in Rostov-on-Don, the Russian Federation and in the Center for Advanced Studies, CEOPS.
I have spent the past seven years developing a new treatment modality for narcissistic personality disorder.
I dubbed it cold therapy.
The past 22 years I dedicated to the study of pathological secondary narcissism, narcissistic defenses and in the most extreme cases malignant narcissism and narcissistic personality disorder, the full-fledged disorder of the spectrum.
In Irish conclusion that there are several misconceptions about pathological narcissism.
It is presented as a regression to an earlier childhood developmental phase or a psychological defense or an organizing principle or a schema or in the more comprehensive form is a personality disorder and it may well be all these four but not only these four.
I think a much better way of looking and considering pathological narcissism is as a post-traumatic condition.
Pathological narcissism is elicited and provoked in a child. It starts at the age of three or four, during the four motif years, in an abusive household where the child's boundaries are not recognized and individuation and separation are prevented by a capricious narcissistic or even malicious parent.
So this traumatic experience gives rise to a whole array, a whole amalgam of defenses which we call pathological narcissism.
It therefore behooves us to regard pathological narcissism as a post-traumatic condition.
The second thing that I notice is that when narcissistic patients, when narcissists finally attend therapy having hit rock bottom, they are treated as adults. Techniques borrowed from adult psychotherapies are applied to the treatment of the narcissism.
But narcissism is not an adult disorder. It is an attachment dysfunction and it is coupled with arrested development. It therefore should be amenable to techniques borrowed from child psychology and from trauma therapy.
In other words, I regard pathological narcissism as less of a disorder of the self and more of an interpersonal disorder.
Indeed as Hazel McFarland wrote in 2010, when alarmed, the child seeks proximity to a caregiver, a safe base, but proximity to frightening caregivers increases the alarm.
And I think the child attaches to an imaginary caregiver in this case and this is the false self. The false self is a god-like concoction. The false self is everything the child is not. The child is helpless. The false self is unlimited. The child doesn't know what's going to happen next. The false self is omniscient. The child is perceived as a bad, worthless object by the parent and introjects this perception. The false self is perfect and brilliant.
In a way, narcissism is a private religion with the false self as the deity worshipped by the narcissist.
And so the child remains fixated and when a narcissist comes to therapy, he is nine years old, sometimes young. There's no point in applying adult techniques.
And this child is heavily traumatized. It's a child with no boundaries, a child with no organization or personality. It's a severe post-traumatic condition, complex PTSD. And so co-therapy adopted a completely different approach to pathologic narcissism, as I said, not regarding it as a personality problem or a character problem, but as an interpersonal issue.
And so what co-therapy seeks to do, following in the footsteps of Tfor and Cossack in 1985, what it seeks to do is to re-traumatize the patient.
The idea is that if the patient goes through the same trauma again, if he's re-traumatized, then this should be helpful in resolving the conflicts, in achieving closure, encountering avoidance, helplessness and depression.
Of course, the re-traumatization is both controlled and tiered. There is a process of triggering trauma, stimulation, stressing, but the environment is a non-holding environment. It's absolutely hostile. We are trying in co-therapy to generate a facsimile of the environment of the primary or originating trauma.
And there's no way to generate such a facsimile in a holding setting. If the therapist is empathic, compassionate, genuinely emotional, concerned with patient, there is not a replica of the abusive parent and the re-traumatization process would fade.
The therapist needs to emulate the abusive parent, and that is why we encourage actually transference in co-therapy.
The idea is that as the adult patient emerges from the re-traumatization process alive, as he survives the re-traumatization, as he successfully copes with it, the patient's non-adductive narcissism, his cognitions, his beliefs, his emotions, his shamans, if you wish, all these will be rendered redundant.
The patient will no longer need his pathological narcissism to cope. The narcissism starts as an adaptation.
But the adult patient needs to learn that even if he finds himself in an identical state of trauma, there are other mechanisms to cope. He does not need his narcissism anymore.
It's unnecessary.
It's obsolete.
And as we know from the principle of economy of mental energy, if something is unnecessary and obsolete, it vanishes and fades away.
So this is the core person, the core tenets of co-therapy.
Co-therapy re-interprets the narcissist's behaviors and actions in socially acceptable ways.
What are the goals of co-therapy?
The goals of co-therapy is to process trauma via skilled, reliving, foster more adaptive functioning, replace negative with positive coping strategies, integrate distressing materials, thoughts, feelings and memories in a way which would render them, neutralize them, lead to internal resolution and homeostasis, and aid the growth of skills such as resilience, ego regulation, internal ego regulation and empathy.
Narcissistic responding is thereby rendered unnecessary because the main role of narcissistic responding is the regulation of the sense of self-worth, its stabilization, and the fulfillment of certain ego functions which the narcissist is unable to provide from the inside.
At the conclusion of co-therapy, the narcissist's ego construct, so to speak, is perfectly functional.
We all know that narcissists are difficult patients.
We know that there's a variety of types of narcissists, overt, classic or grandiose, there's covert, shy, fragile, invulnerable, inverted narcissist, somatic, cerebral, etc.
We know that narcissism is co-warming very often with other personality disorders and they're duly diagnosed with eating mood disorders, substance disorders, and even autism.
And there are various treatment modalities that have tried to cope with narcissism, with a core, with a nucleus.
Enough to mention, there is cognitive behavior, emotive behavior, therapy, Shema therapy, CMDR, dynamic therapy, psychoanalysis, Gestalt, you name it.
They have not been successful.
There has been some success modifying behavior, abrasive behaviors, antisocial behaviors, particularly unacceptable behaviors, all these have been modified to allow the narcissist to coexist with other people and to somehow function in various settings such as the workplace.
But this is far from healing.
This is far from tackling the core and the nucleus of narcissism.
This deals with these techniques, these treatment modalities deal with some presenting symptoms or signs.
Indeed, even the process of clinical interview and a basis, a diagnosis, they are all heavily dependent on self-reporting.
Current existing psychological tests such as the narcissistic personality inventory are ridiculously premised on the assumption that narcissists will truthfully self-report.
And we all know that narcissists are pathological liars, confabernators.
So the patient's narcissistic defenses and resistances prevent proper therapeutic liars.
They even prevent the proper diagnosis.
Psychological tests are useless.
And the realistic therapy goes with current, with existing treatment modalities is some form of behavioral defecation.
As I mentioned, reconciling lifestyle and choices with pathological secondary narcissism and setting an extended timeframe of measurement of outcomes that somehow will create a positive feedback loop.
These are very restricted, but realistic goals, but they are very restricted.
That's a problem.
They don't touch the core, as I said, and they are not long lost.
The rate of remission or relapse is almost, almost I would say, universal.
And the therapist in this treatment modality suffers.
The therapist suffers idealization and devaluation cycles.
There's transference and counter transference, which is very pernicious.
There's vicarious traumatization of the therapist.
The therapist's own narcissistic defenses are heavily provoked.
Resentment, alienation, burnout, emotional exhaustion, trauma, very common.
And finally, there's a lot of co-opation and collusion.
The narcissist tries to buy or bribe the therapist, to victimize the therapist.
And so very often we have situations where there is a shared psychotic disorder somehow emerging fully adieu.
There's paranoia as a form of narcissism, placing the narcissist at the center of some persecular evolution in which the therapist plays the role of the persecutor.
And settings are not uncommon, where the therapist actually admires the narcissist.
So it's all very problematic.
And I would say with a sweeping generalization for which I hope to be excused, that all current existing treatment modalities have a visual effect to deal with pathological narcissism.
It's not that all therapies devoid of its own problems.
For example, it needs to leverage the false self-grandiosity.
And that's not always easy.
And if the line is crossed, actually it could enhance the narcissist's grandiosity.
Grandiosity and fantasy are defense mechanisms.
And unhealthy ones, dysfunctional ones, maladaptive ones.
So we seek to minimize them or to maximize them.
But co-therapy walks a very fine and thin line and sometimes actually ends up enhancing fantasy and grandiosity.
There's an issue of overcoming psychological defense mechanisms like splitting, projected by notification, projection, magical thinking.
There's an issue of tackling cognitive deficits, cognitive distortions, thinking errors, fallacies, and failed reality tests.
Example is the Dunning-Kruger grandiosity fallacy.
And then there's the issue in co-therapy of dealing with the narcissist's victim's stance, an internal working model.
They are challenged heavily in co-therapy on the one hand, but on the other hand they are somehow supported and enhanced because the narcissist is really victimized in co-therapy, is really traumatized.
It's not his imagination.
His paranoia in this case is justified and so is his victim's stance.
So how to modify his internal working model when we're actually ending up supporting it.
There's also a risk of suicide at the very beginning.
Retraumatization phase can be very dangerous and requires close monitoring.
All kinds of grandiose, paranoid, and schizoate automatic thoughts are provoked.
And contracting and aliasing are absent, so there's no common goal, no kind of mutual horizon.
It's all conflictive.
Co-therapy is very adversary and we need to manage and contain transference and countertransference very carefully or it gets out of hand.
And of course the patients who are also on medication, medication's effects and side effects need to be taken into account.
Most importantly I would say that because co-therapy is confrontational, because it fosters knowingly a hostile environment, because it imposes trauma on the narcissist, it fosters persecutory delusions.
It creates intentionally paranoia, narcissistic rage, narcissistic shame.
And so the aim of co-therapy is to distinguish primary originating traumas from secondary ones and from complex species.
So we have tools, proprietary tools, developed in co-therapy aimed at doing exactly this.
Ultimately we need to merge the patient's comfort zone with the hostile, non-holding, unsafe environment.
And this merger, this fusion, leads at the beginning to some kind of repetition compulsion.
On the face of it, this sounds bad.
Repetition compulsion is not a healthy thing.
But it's far preferable to decompensation and acting out.
So here you are, I'll be honest with you, about the disadvantages, shortcomings, shortfalls and dangers.
So co-therapy currently comes with 25 proprietary techniques.
And these techniques are highly unusual in various ways.
And even I would say counterintuitive.
They are divided to 11.1, 2 and 3.
On 11.1 we have some basic, more basic techniques.
One of them is called erasure.
Erasure again builds on the work of Foe and Kozak in the 80s.
They said that fear memory, the memory of fear, is combined with absent information.
So what we're doing in erasure is suppress expression.
We suppress the speech of the patient.
Now this runs completely against anything done in any other kind of therapy.
In all other kinds of therapy we try to encourage the patient to share, to cogitate, to associate, to talk, etc., to communicate.
But in co-therapy we actually encourage the patient to shut up.
And we do it pretty aggressively.
We select a series of keywords and we then filter for keywords which are heavily associated or described, a primary and original trauma.
And the speech suppression techniques are both active.
We hush the patient when he tries to use the keywords.
Or they are also passive.
When the patient uses a certain keyword we ignore it or we treat it as irrelevant.
We underestimate.
So then finally there's a negative reinforcement mechanism which kind of suppresses these keywords.
And the idea is that the silences generated by the erasure technique tell us much more about the patient, or as much about the patient, as any form of communication.
The silences are structured but they reflect sentence structure and semiotic and semantic words of the patient.
So where the patient has to be silent because he cannot utter a certain keyword tells us that this silence denotes some connotative field, tells us a lot about the inner world of the patient.
So that's an example of a technique.
Then what we do, we recover the speech and we interpret the silence together with the patient.
We have a look at the patterns of the gaps in the speech, the distribution in the context of the gaps, contextual gaps.
And then we reconstruct and deconstruct narratives so that the patient gains much deeper understanding of how the traumatic words reflect the structure of the trauma, reflect the infrastructure of the trauma.
And then we have a very cohesive trauma.
Another technique we have, and I of course won't be able to go through all the 25, but another technique we have is hypervigilant referencing.
Trauma and abuse are a kind of perpetual narcissistic injury.
And obviously they lead to hypervigilance.
Obsessive compulsive behaviors, rituals, irritability, rage, sensory sensitivity, anxiety, arousal, exhaustion, and scanning constantly for threats and insults, often when there's none.
So it's a kind of referential ideation.
So hypervigilant referencing strives to learn from the content of the delusional thinking about the locus of the primary originating trauma.
It deconstructs the disparity between emotional and reality states in a highly specific way.
Another technique we have is called grandiosity reframing.
And it's a bit unusual in that it treats grandiosity not merely as a psychological defense mechanism, but also as a cognitive distortion extending the work of Danner Kruger and their effect.
Grandiosity is justified only in as much as it is an adaptation or a survival strategy, but with a narcissist it is neither.
It's not an adaptation because it's maladaptive.
And ultimately it leads to the narcissist downfall and implosion.
It's a self-destructive strategy.
Grandiosity provides capabilities to overcome traumas.
That's true.
And in this sense, it's a kind of skill and it results in winning in various settings.
But what we do, we leverage the narcissist's grandiosity in order to get rid of it.
For example, we tell the patient when you are grandiose, you are not acting optimally or efficiently.
You are not perfect.
So we use grandiosity against itself.
If you tell the patient when you are grandiose, you are not perfect, you're actually making a statement about grandiosity.
This is very similar to the way we strengthen the host personality in dissociative identity disorder.
Another technique which of course is borrowed is the technique of guided imagery.
But again it's proprietary in the sense that we have modified it very considerably and we call it imaginal technique.
So what we do is we encourage the patient to catastrophize actually.
We leverage catastrophizing.
We ask the patient to imagine the worst and in a controlled way.
But to imagine the worst and to live through the worst.
We control the patient's malignant optimism.
We imagine the fantastic.
We have something called mid-lick and that is to locate the middle ground and to render the adult side of the patient the winner by meeting a strict rigorous reality test.
We have controlled depersonalization.
When we deconstruct the whole self, the patient remains basically exposed, naked, vulnerable.
And so what we do, we encourage the patient to depersonalize because if the patient does not depersonalize and derealize, the patient is in such pain and hurt that it could lead to suicide.
Depersonalization and derealization which are encouraged in this phase are intended to protect the patient against the hurt and the pain that the false self used to cater to, used to block out.
But ultimately we validate reality. We acknowledge the patient's transference and the client's own language. We echo it. You know, we mirror the patient and we acknowledge his state of mind.
But we compare it to reality in such a way that reality intrudes and replaces all these.
Another technique we have is called negative iteration.
In negative iteration what we do is reframe situations and events as traumas. We design special coping strategies, winning strategies and defenses for various situations and events instead of catastrophizing.
We observe, we hold, we freeze. We use a lot of techniques from cognitive processing therapy. We try to engender personal safety, trust, a dynamic of power control which is not out of control. We try to foster esteem, self-esteem, intimacy by reconsidering or reframing negative thoughts about self, others, the world and the environment, exactly as is done in many, many types of cognitive behavioral therapy.
We encourage assertiveness, communication, social support. But we do all this by forcing on the patient and encouraging the patient to develop a kind of repetition compulsion.
This repetition compulsion is then brought to awareness, it is mastered and it is used, its power, its energy is used to obtain different outcomes. It actually leads to resolution and reconciliation.
So one of the most powerful techniques we have and we use utterly independently of cold therapy with patients who don't undergo cold therapy is the happiness map.
Happiness map is a kind of happiness space and what we do, we ask the patient to list everything that makes her happy and then we narrow it down by finding common denominators. We reduce the number of happiness-inducing factors by finding common denominators. We drill down in a way, we reduce and so we do this in the face of reactivity and denial.
There is a lot of resistance to the happiness map because happiness map yields counterintuitive results. You may think that your children make you happy but by the time you are finished with happiness map, we discover that it is not your children at all.
You may think that some activity makes you happy but then you discover that actually it is not the activity but it is excelling at the activity and so on.
What we try to do is we try to create new intuition in you, new ways of thinking about your happiness.
Of course we use mirroring in cold therapy.
The patient or client is requested to play the devil's advocate via dialectic, Hegelian dialectic, theses which is the abuse and the trauma, antithesis which is not abuse, not trauma and then synthesis.
Trauma is not an objective scientific factor event but a subjective reaction to an objective or scientific factor or event. Traumas are reactions not reality. They are a subjective form of exegesis, of interpretation.
They are reactivisual.
There are many other techniques.
There is escalation where we construct a scenario, what could have been worse, what could have been even more wrong.
There is role play where the patient is encouraged to be the abuser.
There is other scoring where the patient is actually encouraged to develop empathy by placing herself or himself inside the mind of meaningful or significant others in his or her life in ever more complex nesting algorithms.
So I'm thinking about the other, then I'm thinking about how I'm thinking about the other, then I'm thinking about how the other is thinking that I'm thinking about the other, etc, etc, etc.
So it's ever evolving tree, nested tree until the complexity is such that it breaks down defenses and absolutely forces the client to become someone else and develop a form of empathy through a dimension theory.
But there.
And then we have a simulated confabulation where we encourage the patient to identify gaps in his memory, dissociative gaps and ask himself why did he repress these memories.
And that's very similar to some psychoanalytic, the techniques in psychoanalysis, psychoanalytic and psychology.
And where the gaps are imbridgeable, where the memory is totally gone, you don't want to have an ab reaction, in that case we construct confabulations and that's why it's called the simulated confabulation, this technique.
We construct confabulations to bridge the gaps and then we ask the patient to rank the plausibility of such confabulation and we demand that the patient owns the confabulations and assimilates them.
And then once the patient tries to assimilate the confabulation, we monitor, we observe the reaction, does he react with egotisthenic unease or does he react with egosynthenic happiness.
Egotisthenic teaches us that there is a discrepancy or discontinuity or disjointedness in the patient.
And the discontinuity of course indicates congruence, narrative coherence.
So we assemble gradually, lego-like, healthy core narratives about functioning in happiness that can be assimilated by the patient, can be accepted.
And one thing we do for example in this therapy, we share our therapy with the patient, the process is completely transparent.
The patient is a partner, not an ally like in our classic therapeutic alliance, but a full scale, full fledged partner with equal status to the therapist with some of the techniques.
We're talking about the phase after retro-matization.
Very important technique is reparenting.
And that's why we encourage transference and we actually foster engender with this kind of shared psychotic disorder, a kind of narcissistic foliad.
At the beginning we encourage so that the patient can feel that we are his abusive parents and shift the potential locus of trauma from himself to the therapist.
And the therapist is the one who owns the bad object.
The therapist owns the pain, owns the trauma in the hurt.
The bleeding is encouraged, even leveraged and the patient now ends up owning only a good object.
When this good object is introjected, the patient can begin to feel good.
Projective identification and introjective identification are very powerful tools.
Therapist picks up and contains via projective identification what the patient cannot think about at the unthought known.
We have also emotional re-regulation.
We encourage a patient to externalize, externalizing to internalize.
We encourage a patient to shift from grievance to task orientation to avoid rumination.
We encourage a patient to move from counted dependence, defiance to co-dependence in some respects.
We encourage a patient to move from social withdrawal to social functioning.
And from child psychology we borrow techniques like emotional intensity control, behavioral control or termination, interpretation of modes of emotional cues, including his own cues, interpretation of social cues, avoidance and aggression balancing, focusing on the positive attention and focus control, impulse control, modeling and not demanding desired behavior, freedom versus constraint and self-regulation, no overstimulation, no excessive frustration, identifying and countering discriminating thoughts and emotions and moving from internal construction to external representation.
All these I must emphasize are after the initial stage of re-traumatizing.
In the initial stage of re-traumatization, the therapist is the abusive parent and the patient is the child.
Emerging from the re-traumatization phase, the therapist is the bad parent holding the bad object and the patient is rendered a good adult, identified with a good object.
Co-therapine is a highly unusual treatment modality in that it actually makes use of all the artifacts in other therapies which are considered negative and to be avoided.
And in that it does not coddle or coddle the patient or the client.
On the contrary, it's adversarial, it's much more like a court of law than a classic therapy setting.
But through this conflict, through this repetition compulsion, a new adult emerges with firm boundaries, with healthy core and with absolutely no need for narcissistic supply or any other forms of external ego function regulation.
A healthy, stable sense of self-worth, totally regulated in all environments and all settings.
And isn't this the very definition of a healthy, normal individual, socially functional and happy in his interpersonal relations?
This is the aim of Co-therapine.
Thank you very much for listening.