Affirmative therapy has been recognized as an effective therapeutic treatment approach when working with gay men. Acknowledging that affirmative therapy is not a stand-alone model of treatment, this article suggests that Accelerated Experiential Dynamic Psychotherapy (AEDP) offers a model that is easily integrated with affirmative therapy and that is beneficial in helping to heal the traumatic experiences and internalized heterosexism many gay men carry in a heterosexist society. This paper begins by exploring the negative impact that minority stress, heterosexism, and masculinity ideologies may have on attachment models, particularly focusing on the relationship with male caregivers. The paper then asserts that AEDP, when combined with a gay affirmative approach, helps clinicians working with gay men to provide a corrective emotional experience and create secure attachment in the therapeutic relationship. In the process, the client is safe to shed his false self and the true self is free to emerge. Four central tenets of applying AEDP with a gay affirmative approach are explored: the stance of the therapist, the accessing and dyadic regulation of affect, metaprocessing core affective experiences, and reaching and metaprocessing core state experiences. A case example illustrates how these techniques are employed by the gay affirmative AEDP therapist.
M y client Jeff sat across from me, having just completed an emotional portrayal in which he interacted with his younger self in his imagination after recounting a painful experience with his father. True to accelerated experiential dynamic psychotherapy (AEDP) methods, I began to metaprocess with him asking, "What is this like to do with me?" A Duchenne smile (Damasio, 1999;Harker & Keltner, 2001) spread across his face, genuine and deeply felt. He answered, "It's very beautiful. We took a very dark moment that was very defining and traumatic and brought it back to life and threw new energy into it . . . and we're now allowing it to exist on a different plane." In the portrayal, Jeff had been able to viscerally experience his feelings of sadness and grief associated with this memory in the safety of the therapeutic relationship. In this new, imagined experience, my client was then able to do something that had not occurred in real life: to experientially access his grief because he was no longer alone with it, and then to comfort, soothe, and encourage his younger self. He imagined his younger self receiving his care and reacting with joy and pride. What was once a "dark" and painful memory now felt lighter to my client. This is one example of the effectiveness of portrayals in accessing and processing emotion to completion.A portrayal is an experiential technique in AEDP that is used to help clients access, heighten, and deepen the visceral experience of core affect and then process it to a satisfying completion (Fosha, 2000). This technique originated with Davanloo (1990) in intensive short-term dynamic psychotherapy and then was expanded and refined by Fosha (2000) in AEDP (Welling, 2019).
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