From the moment their child dies, parents are faced with the two extremes of loss and life – the suffocating loss of a child, and the ongoing, daily demands from their surviving children, says Fleming, co-author of the recently published book, .

“The challenge that parents face is this: In the midst of grief, how do you stop parenting the deceased child while you are simultaneously struggling to meet the parenting needs of the children who remain?”

Fleming and co-author Jennifer Buckle (MA ‘98, PhD ’03), now a professor at Memorial University, did the research for the book when Buckle was a graduate student in the Faculty of Health at 91��ɫ. Their research is based on in-depth interviews with parents who had lost a child and had one or more surviving children.

They found bereaved parents do not “recover” from the loss. Instead, bereaved parenting is an act of regeneration – picking up the pieces in the face of the devastation, and regenerating both a sense of self and a sense of the family.

“Dads tend to be instrumental grievers. They go back to work, commit to working for the family and they tend to overcome the fear of putting their children out into an unsafe world sooner than moms do,” says Fleming. “Moms tend to be more intuitive grievers, more focused on internal feelings, and they have an almost paralyzing fear that if one child can die, another could die as well. So, often, moms are dragged back into parenting by the surviving children.”

Left: Stephen Fleming

Parenting After the Death of a Child, published by Routledge, fills a gap in the research about the impact of a child’s death, because it focuses not only on the grief experienced, but on the balancing act of grieving and parenting at the same time. A clinical psychologist, Fleming says he hopes the guide will educate counsellors about the importance of looking for psychological complications in mourning the loss of a child − for example, depression, generalized anxiety disorder and post-traumatic stress disorder. Too often, parents are not assessed for these reactions, and they may be traumatized by images of their child’s death or illness and re-living it, he says.

The qualitative research and excerpts from the parents who were interviewed are also intended to help bereaved parents deal with the expectations they put on themselves and those imposed by the outside world. The research reassures parents, for example, that it is healthy to honour the role of the deceased child in the family by continuing to talk about the child with the surviving siblings.

It may also offer comfort by busting myths – for example, the myth that losing a child increases the likelihood that parents will divorce and that surviving family members will be split up. Roles change and parents often struggle to be consistently present physically and emotionally for their children, Fleming says, but bereaved parents rebuild their lives because their children need it.

Republished with files courtesy of YFile – 91��ɫ’s daily e-bulletin.

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Last week, 16 therapists from as far as Israel, Hong Kong, Denmark, Portugal and Australia, as well as the United States, were at 91��ɫ for four days of in-depth skill training at the Emotion-Focused Therapy Level Two 2010 Summer Institute led by Greenberg. The week before, Level One was offered. Both sessions, which were full and had a waiting list, were held at the new  at the 91��ɫ Psychology Clinic (YUPC).

Right: Leslie Greenberg instructs therapists from around the world on emotion-focused therapy

“It’s the only place in the world they can do this in-depth training that I developed with my collaborators, and it’s becoming a world-recognized approach,” says Greenberg, who and the 2010 Carl Rogers Award from the American Psychological Association's Society for Humanistic Psychology (Division 32).

Although ideas about EFT began percolating when Greenberg was completing his doctorate in psychology at 91��ɫ, the approach really started to come together in 1993 following the book , co-authored by Greenberg. He has since authored and co-authored several books on the subject, including . It was in 1995 that Greenberg began doing evidence-based research to support the approach.

Cognitive behavioural therapy (CBT) was the dominant treatment at the time and had already generated evidence that it worked, but as Greenberg says, “it’s not an in-depth approach to how humans function. It’s good at helping people cope, but not really good at dealing with the core problems people have. So it seemed important to develop a much more in-depth approach to human emotions.” And in the 1980s, there was a greater understanding of the role emotions played. “More and more scientific evidence began to show how important emotions were in life.” That included some of the unpleasant emotions.

Left: From front left, therapists Timothy Downing Brown from the United States and Ben Shuhar from Israel, and from back left, Nels Klint Karsvang and Belinda Lange from Denmark, in the Emotion Focused Therapy Level Two 2010 Summer Institute at 91��ɫ

There is strong evidence now that EFT, with its focus on developing emotional intelligence and the importance of secure relationships, helps couples having marital difficulties, as well as individuals suffering from depression, anxiety and eating disorders, says Greenberg, who was awarded the 2004 Distinguished Career Award by the Society for Psychotherapy Research, an international, multidisciplinary, scientific organization.

EFT is designed to help people accept, express, regulate, understand and transform emotion, not deny or suppress it. Emotion alerts people to what is important in any given situation and acts as a guide to what is needed or wanted, says Greenberg. Working with these emotions helps people to figure out what they should do.

Right: From left, Eve Alon from Israel, Leslie Greenberg, Chui Fan Yip from Hong Kong, Melissa Harte from Australia, Candice Knight from the US and João Salgado from Portugal were just a few of the therapists who came to 91��ɫ to learn emotion-focused therapy

“EFT focuses on helping people become aware of emotions, express their emotions in the right way at the right time, learn to tolerate and regulate them, and to reflect on them to make sense of them and transform them,” says Greenberg. It is not enough to learn about emotions; people need to experience them in a safe environment, such as in a therapy session, and learn how to manage and use them in a flexible manner. It’s not about eliminating emotions, but working with them.

Therapeutic approaches such as CBT and psychoanalysis have their place and have helped a lot of people, but they don’t address the whole picture, he says.

Now that EFT is an internationally recognized approach, Greenberg will be spending much of his upcoming sabbatical training therapists around the world who couldn’t make it to 91��ɫ this summer, starting in his home country of South Africa.

The Emotion-Focused Training for Couples 2010 Institute is the next session Greenberg will offer for therapists at the Emotion-Focused Therapy Clinic from Nov. 22 to 25.

For more information or to register for future training institutes, visit the YUPC Continuing Education Web site.

By Sandra McLean, YFile writer

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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Right: Robert Muller

“Trauma therapy is difficult to begin with, but when patients reject help it becomes that much more challenging,” says Muller, a professor of clinical psychology in 91��ɫ’s Faculty of Health. “Unfortunately, a large segment of people needing therapy fall into this category. Rather than simply labelling them as resistant to treatment, it’s important to try and devise alternative means of offering them help,” he says.

In his book, Muller, who specializes in treating trauma within families, explains the defensive and interpersonal patterns seen among avoidant individuals and lays out a game plan for effective treatment. Through detailed case examples and practical clinical instruction, readers will learn how to build trust with clients, help them connect with and commit to the treatment process, and facilitate mourning to face the loss associated with trauma.

The theoretical framework driving Muller’s approach is that of attachment theory, pioneered in the 1970s by psychiatrist John Bowlby. He posited that humans form attachments as a survival mechanism to seek protection from real or perceived threats. Even when a protector’s caregiving skills are lacking, the developing child does what’s necessary to maintain the relationship; this shapes negative patterns of defence and affect, carrying over into adulthood.

Muller offers practical advice on how to address the “I’m-no-victim” identity often adopted by such clients, who tend to see people as either strong or weak and have difficulty understanding that there are shades of grey.

“These types of clients split their life stories in two in order to keep the two worlds of strength and vulnerability compartmentalized,” Muller says. “Despite their personal histories of trauma, they will maintain a defensive veneer so that they’re viewed as and feel strong, independent, self-reliant and normal.”

This can be resolved, he writes, by gently and tactfully pointing out narrative discrepancies, bringing the focus back to the original attachment and using the client’s symptoms as motivators.

Muller also offers candid advice based on his personal experience dealing with counter-transference – a phenomenon in which the therapist’s personal issues can sometimes get in the way of therapy.

In addition to his role at 91��ɫ, Muller is a supervising psychologist at the , specializing in the areas of trauma, attachment and psychotherapy. He is lead investigator in a multi-site program to treat intra-familial trauma and has over 20 years of clinical experience in the field.

Muller’s lab is funded by the at the .

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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The title will be conferred on Armstrong at the Spring 2010 Convocation on June 16 at 10:30am and on Greenberg during the June 17 ceremony at 10:30am.

A Distinguished Research Professorship is awarded to a professor who has demonstrated scholarly achievement by sustained publication or other recognized and accepted demonstrations of sustained authoritative contributions to scholarship.

Right: Pat Armstrong

Armstrong, who is appointed to graduate programs in health, political science, science & technology, sociology and women's studies, holds a (CHSRF)/ (CIHR) Chair in Health Services. She is also a professor of sociology in the Faculty of Liberal Arts & Professional Studies and an executive member of the 91��ɫ Institute for Health Research and the Graduate Program in Health Policy & Equity .

She recently received Social Sciences & Humanities Research Council of Canada () funding through the program to identify promising practices for understanding and organizing long-term residential health care. Armstrong's project seeks to learn from and with other countries to understand the approaches, structures, accountability practices and ownership arrangements that create conditions prompting respectful and dignified treatment for both residents and caregivers.

Another SSHRC-funded research project looks at the risks nurses face in health care, while a Canadian Institutes of Health Research-funded project compared the workplace conditions and levels of violence faced by long-term care workers to those in Nordic countries.

She has authored, co-authored or co-edited over 20 books, including , , and .

Armstrong chairs Women & Health Care Reform, a working group that crosses the Centres of Excellence for Women's Health, and is acting co-director of the National Network on Environments & Women’s Health. She is currently a principal of the Ontario Training Centre in Health Services & Policy Research, a board member of the 91��ɫ Institute for Health Research, and has served as both chair of the Department of Sociology at 91��ɫ and director of the School of Canadian Studies at Carleton.

In addition, Armstrong has served as an expert witness in more than a dozen cases heard before bodies ranging from the federal court to federal human rights tribunals on issues related to women’s health-care work and to pay equity.

Left: Leslie Greenberg

(PhD ’76), appointed to the Graduate Program in Psychology, is among the pioneers and is primary developer of emotion-focused therapy (EFT) for individuals and for couples, which is based on the findings that emotions influence thought and behaviour. It is a psychotherapy technique that promotes the resolution of unpleasant emotions by working with them rather than suppressing or avoiding them. Greenberg is interested in couple and individual therapy using EFT, as well as examining how people deal with unresolved emotions and how that affects their ability to forgive. In recent years, he has used EFT to help couples when one person has had an affair. He is also interested in how EFT can help people with depression.

EFT is now recognized as evidence-based treatment for depression as well as couple conflict, and there is also growing evidence of its effectiveness for trauma, interpersonal problems and eating disorders. In a 2002 study, Greenberg and his colleagues studied individuals who had suffered injuries ranging from emotional to physical abuse and found that those who were treated with EFT had much better results than individuals who were treated with psycho-educational therapy. Greenberg has devoted over 20 years to EFT research and has conducted EFT workshops for therapists interested in learning his theory and technique around the globe. Closer to home, he is providing training in EFT for professionals from around the world at the 91��ɫ Psychology Clinic.

Greenberg has won many awards, including the Award for Excellence in Professional Training from the Canadian Council of Professional Psychology Programs, the Carl Rogers Award from the Division 32, the Distinguished Career Award from the Society for Psychotherapy Research and the Professional Award for Distinguished Contributions to Psychology as a Profession from the .

His professional publications include more than 100 peer-reviewed papers, 89 book chapters and some 17 books, including , , and .

He is a founding member of the and the Society for Constructivism in Psychotherapy, and a past president of the .

In addition, he is on the editorial board of many psychotherapy journals, including the and the .

For more information about Distinguished Research Professorships, visit the Faculty of Graduate Studies Web page. The list of current and past Distinguished Research Professors is available on the 91��ɫ Research Web site.

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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