Jon Baylin & Dan Hughes “From Mistrust to Trust: A brain-based therapy model” DDP UK Conference Proceedings Birmingham 10-11 Nov 2014

In their presentation "From Mistrust to Trust: A Brain-Based Relational Model for Helping Defensive Children Learn to Trust", Dan Hughes and Jon Baylin presented a model of the change process in attachment-focused therapy that is based on social developmental neuroscience. With thanks to Jon Baylin and Dan Hughes for giving permission for their presentation to be reproduced here.

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Dan and Jon discussed the neurodynamics of early mistrust or ‘blocked trust’, the relational processes that appear to promote positive change in attachment- focused therapy, and the brain processes involved as children go through various stages of learning to trust trustworthy caregivers.

This science-driven model relates the use of PACE (Playfulness, Acceptance, Curiosity, Empathy) to processes such as reversal learning, fear extinction, conflict resolution, and reappraisal, learning processes that depend upon the prefrontal cortex.

They focused on the need to reawaken the child’s capacity to feel the need for connection and comfort, a process of making it safe enough for the child to experience the separation pain that he or she suppressed early in life in order to adapt to an environment of poor care.

Using examples from therapy sessions, they illustrated the process of ‘sadness induction’ that primes the suppressed attachment system and enables the child to seek and receive the nurturing care that was unavailable earlier in life.

This model highlights the importance of creating ‘good surprises’ or what neuroscientists call Positive Prediction Errors (PPEs), relational experiences that conflict starkly with what the defensive child expects from caregivers. PPE's serve as triggers for shifting the child’s attention to a new, unexpected experience of being treated with compassion, creating a window of learning that helps the child begin to change the habitual strategy of defensive avoidance of caregivers.

Key to the process of creating these new positive experiences is the caregiver’s state of mind, the ability of the caregiver to sustain a caring, compassionate state of mind towards a mistrusting child.

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