Free online webinar: How to break the negative interactional patterns with others

Welcome to join the free online Chinese Support Group monthly events. They are targeted at Chinese-speaking individuals and families, who are caring for a loved one with mental health issues.

Part I: Free Online Talk
Date: Saturday, September 10, 2022
Time: 1:00 p.m. – 2:30 p.m.
Topic: How to Break the Negative Interactional Pattern with Others
Guest Speaker: Jenny HSU, M.C. R.C.C.
(Presented in Mandarin with Cantonese interpretation)

Do you find yourself falling into the same interactional pattern with others, even if you long for a close connection? Are you frustrated that you and your family or partner seem stuck in the same negative interactional pattern? Deep in your mind, you said, here we go again. Emotion affects how we interact with others and can shape how we feel about ourselves and others. In this workshop, the speaker will use attachment-based emotionally focused therapy to determine how we fall into a negative interactional pattern and how to break the cycle. The speaker will also use a hypothetical clinical case of withdrawal attachment style and anxious attachment style match to illustrate.

Part II: Support Group Sharing
Date: Saturday, September 10 & 24, 2022
Time: 2:30 p.m. – 4:00 p.m.
Language: Cantonese and Mandarin

The support group meets twice a month on the 2nd and 4th Saturday of the month. It is a volunteer-led mutual aid group established for the members of the Chinese community, who have experienced psychological distress and for their caregivers. Through the confidential interaction and mutual support among members, it aims to help members relieve their emotions, exchange ideas and listen to different perspectives and experience sharing with an open attitude, learn skills and methods to deal with their problems, and maintain a positive outlook in work and life so as to achieve the purpose of helping people to help themselves. We have a Cantonese-speaking group and a Mandarin-speaking group for sharing. You are welcome to join the mutual aid group. New members are required to sign a confidentiality agreement.

Registration:
Please call or WhatsApp Lee MA at 604-761-3723 or send an email to pathways.csg@gmail.com.

各位朋友，歡迎參加開創會所華人愛心支援小組於9月舉行的活動。

第一部分：健康專題講座
日期: 2022年9月10日 (星期六)
時間: 下午1時至2時半
題目: 如何打破人際關係負面互動模式 (國語講座、粵語翻譯)
講員: 徐萱芳 (註冊臨床心理諮商師RCC)

即使內心渴望與人有更親近的關係，您是否發現自己慣用同一模式與人相處？您是否正在煩惱如何打破與家人或伴侶的負面互動模式？情緒牽連著我們與人互動的關係及模式，會塑造我們對自己和他人的看法。講者將會從依附和情緒導向理論的角度，以及運用最典型常見的逃避依戀型和焦慮依戀型的關係組合來作為例子，講解負面互動關係模式的成因，怎樣打破負面互動模式，建立更親密和健康的關係。

Free online webinar about emotion and relationship on July 9 2022

Host by Pathways clubhouse

Part I: Free Online Talk

Time: 1:00 p.m. – 2:30 p.m.
Join Zoom Meeting: https://us02web.zoom.us/j/82673671044
Meeting ID: 826 7367 1044

Guest Speaker: Jenny Hsu, M.C. R.C.C.
Topic: Emotion and Relationship
(Presented in Mandarin with Cantonese interpretation)

Have you ever wondered where your anger came from when interacting with others, especially your loved one? Do you have a hard time expressing your emotion? Do you find yourself falling into the same pattern with people? Feeling and emotions give us a clue about how we feel and respond in a certain way. Over time, it shapes how we think about ourselves and others. In this workshop, the speaker will discuss emotion and how it relates to our relationship with our early childhood caregiver and our intimate relationship from the angle of the attachment-based approach. By the end of the workshop, you will learn about your attachment style: why you feel and react in a certain way to your loved ones, such as anger, lash out, withdrawal, and stonewalling, and how it affects how you think of yourself and others.

第一部分：在綫公益講座

時間：下午1時至2時半
參加Zoom會議：https://us02web.zoom.us/j/82673671044
登入Zoom 會議 ID：826 7367 1044

講員: 徐萱芳 (註冊臨床心理諮商師RCC)
Jenny HSU, M.C. R.C.C.
題目: 情緒管理與人際關係 (國語講座、粵語翻譯)

您有沒有想過在與他人，尤其是您所愛的人互動時，您的憤怒從何而來？您是否很難表達情緒嗎？您是否發現自己慣用同一模式與人相處？感覺和情緒可讓我們知道自己的感受，以及為什麼我們會以某種方式做出反應。漸漸地，它會塑造我們對自己和他人的看法。
在本次工作坊中，講者將會從依附理論角度，討論情緒與童年時照顧者的關係，以及怎樣影響我們的親密關係。在工作坊結束時，您將會了解自己的依附類型：為什麼您會對親人有某種感覺和反應，例如憤怒、嚴斥、退縮和阻撓，以及它會如何影響您對自己和他人的看法

Celebration of Pride Month: honouring history of LGBT movement

History
During the 1960s and early 1970s, the literature about lesbian, gay, bisexual, and
transgender (LGBT) populations mainly focused on classifying homosexuality as a mental
disorder rather than understanding this marginalized population. In 1961, Illinois became the first
state in the US to abolish its sodomy laws, which decriminalized gay homosexuality. The public
became more aware of and understood the LGBT subculture through the media, news,
documentaries, and publications. Nevertheless, same-sex relationships were still illegal except in
Illinois. Except for that state, bars and restaurants in the US were prohibited from serving alcohol
to known or suspected LGBT individuals to avoid LGBT social gatherings until 1966. On June
28, 1969, the Stonewall Riots, also called the Stonewall Uprising, lasted about six days at the
Stonewall Inn, a private popular gay bar located in New York city’s Greenwich Village. Police
raided the Stonewall Inn, arrested 13 people, including employees and suspected cross-dressing
individuals. A police officer hit a lesbian over the head during the riot as she was forced into the
police van. The lesbian shouted to the angry patrons and neighbors gathered around the
Stonewall Inn for help. The angry crowd reacted by throwing objects at the police. Shortly, the
Stonewall Riots gathered hundreds of people and eventually involved thousands of people who
continued in the area for five more days of protests.

After the Stonewall Riots, the activism of LGBT individuals increased. Many public
figures, including politicians, came out of the closet and increased the visibility of the LGBT
community. The Stonewall Uprising had catalyzed the US gay and lesbian liberation movement
in the US and worldwide. The other revolutionary movements of the 1960s were civil rights,
antiwar, free speech, the New Left, and women’s liberation. Eventually, as the social and
political attitudes about homosexuality shifted, homosexuality as a psychiatric disorder was
removed from the second edition of the Diagnostic and Statistical Manual of Mental Disorders in
1973. During the 1980s, the AIDS crisis occurred, and the gay men’s community became, once
again, the target of discrimination and stigma. Unfortunately, the US government did little to
address the early epidemic. However, there was street activism by gay and lesbian activists to
protest the government’s weak response to the AIDS epidemic. Lesbian, gay, bisexual, and
transgender (LGBT) liberal movements have advocated for LGBT people to obtain equal rights
against discrimination since the Stonewall Uprising. Eventually, in 1992 the International
Classification of Diseases (ICD) removed homosexuality as a mental disorder.

As homosexuality was de-pathologized both in the DSM and ICD, the social construct of
homosexuality as a mental disorder has changed. In 2001, the Netherlands became the first
country to legalize same-sex marriage, followed by Belgium in 2003 and Spain and Canada in
2005. Meanwhile, in Canada, the Federal human rights code protected citizens from
discrimination and harassment, including sexual orientation in 1996 and gender identity and
gender expression in 2017. Provincial and territorial human rights code protection added sexual
orientation from 1977 to 2009 and gender identity from 2002 to 2017. Canada is considered the
most gay-friendly country globally, being ranked among the five safest in Forbes magazine since
2019.
Many experts believe that conversion therapy is a violation of human rights law and is often ineffective, which results in feelings of intense shame, stigma, denial and self-hatred (Wells, 2019). Fortunately, in 2020, a
federal ban on conversion therapy bills was introduced. On Nov 29th, 202, the House of
Commons unanimously passed a ban on conversion therapy. However, social, religious, and
legal contexts continue to discriminate and marginalize sexual and gender minorities (SGM).

Homosexuality is a socially constructed term that has changed across time and is a social
category that “should itself be analyzed, and its relative historical, economic and political base be
scrutinized” (Nardi & Schneider, 1998; as cited in Gamson & Moon, 2004, p.48). The attitude
toward homosexuality depends on the social-cultural construct at a particular time. Social and
political values and systems have made heterosexuality the norm in our society, and people’s
expectations are often implicitly internalized. When individuals find out their sexual orientation
falls outside the norm, they often go through sexual identity formation to explore and accept their
sexual identity. However, the process of sexual identity formation is unique for every person.
Sexuality is unique to each individual and should be respected.

What is attachment theory?

Attachment Theory Attachment theory is a joint work of John Bowlby (1969, 1973, 1980, 1988) and Mary Ainsworth (Ainsworth, 1985; Ainsworth et al., 1978; Ainsworth & Bowlby, 1991). It came from two main ideas. Longing for a felt sense of security and connection with close others, especially in times of threat, risk, pain, or ambiguity, is hard-wired (Johnson, 2019). The other is that early interactional experience with key caregivers shapes one’s attachment style and one’s internal working models of self and others (Bowlby, 1969).

Early interactional experience with a primary caregiver helps an infant shape their internal working model of self and others, which forms their perceptions and expectations of self and others and guides one’s interpersonal responses. Through interaction, infants learn whether they are lovable and whether they can trust others to be accessible, responsive, and engaging in times of threat, stress, and ambiguity. These working models and the infant’s felt sense of security are determined by the infant’s perceived primary caregiver’s accessibility, responsiveness, and engagement.

Based on the strange experiment (Ainsworth et al., 1978), three basic attachment styles were identified in children when they responded to separation from their primary caregiver: secure, avoidant and anxious-ambivalent.

A secure attachment style develops when caregivers are warm and responsive to children. Children with a secure attachment style display confidence and calmness. They can view themselves as lovable, entitled to care, and rely on their caregiver. They could explore their surroundings with confidence that their caregivers will be available and responsive when they need them.

An avoidant attachment style occurs when children learn that their caregivers are not accessible and responsive to their attachment needs and longings. Children with an avoidant attachment style show very little emotion when their caregiver leaves or returns. They are less likely to rely on their caregiver and withdraw by focusing on toys and objects in the room.

An anxious-ambivalent attachment style occurs when children learn that their caregivers are less accessible, responsive, and engaged. Children with an anxious-ambivalent attachment style show separation distress when their caregiver leaves. When their caregiver returns, they tend to cling to their caregiver and are angry or panicking.

Ainsworth’s strange situation has high internal validity for a controlled setting but low external validity such that an artificial environment cannot be easily replicated to the real world. There is also a generalization issue as their samples were primarily white middle-class mothers and children. More cross-cultural field studies are required to understand attunement in different cultures.

Otto and Kelly (2014) pointed out that Bowlby and Ainsworth were reformers and theorists that emphasized the critical developmental importance of sensitive, warm and responsive childcaring for healthy child development in the western context. In West African farming communities coming from a collective culture, children do not have one primary attachment figure. Mothers may seem less responsive and accessible to the children than mothers of western White middle-class mothers, but the community helps take care of the children (Otto & Kelly, 2014).

cited from Jenny Hsuan Fang Hsu (2021). Emotionally Focused Therapy with Lesbian Couples.

JennyHsuanFangHsuCapstone.pdf (cityu.edu)

How effective is Emotionally Focused Therapy?

Emotionally Focused Therapy is attachment-based a short-term structured relationship therapy between eight to 20 sessions (Johnson, 2020). EFT focuses on building trust and secure bonds between couples. Attachment-based EFT is based on a universal need for human survival in times of stress, threat, and ambiguity. Before the 1980s, studies on relationship counselling were rare, and there was a lack of theoretical and research contributions (Gurman & Fraenkel, 2002). Emotionally Focused therapy (EFT) was one of three new schools of thought in relationship counselling that emerged in the 1980s.

Over the past 30 years, there has been substantial empirical support for its outcome and process of change (Wiebe & Johnson, 2016). Empirically validated Emotionally Focused Therapy (EFT) (Johnson & Greenberg, 1985) is effective in relationship repair and in creating lasting change for couples (Beasley & Ager, 2019; Johnson et al., 1999). In one meta-analysis, a review of early EFT outcome studies found that 86%-90% of couples had a significant improvement with a recovery rate of 70 to 73% (Johnson et al., 1999). In addition, the couples, who received EFT counselling services in the research, reported that they had more satisfaction in their relationship and intimacy and had fewer complaints than the couples who received strategic problem-solving-based psychotherapy (Wiebe & Johnson, 2016). Beasley and Ager (2019) did a systematic review based on nine randomized control trials (RCTs) studies to study EFT effectiveness. They found that marital satisfaction improved post-treatment, which was sustained at follow-up. Some studies have shown that significant numbers of couples continue to improve their relationship satisfaction even after the therapy (Johnson & Talitman, 1997; Wiebe & Johnson, 2016). Wiebe et al. (2017) found an increase in relationship satisfaction, secure base behaviour, and decreased attachment anxiety throughout therapy and through 24 months follow-up in their study of 32 couples.

EFT for Partners with Mood Disorders.

EFT researchers have also tested the effect of EFT in treating post-traumatic stress and depression (Denton et al., 2012; Johnson & WilliamsKeeler, 1998). EFT’s goal is to build a secure bond between couples. Couples with secure attachment can better regulate distress emotions and are more resilient to stress. They are more willing to turn to each other for emotional support and see each other as a secure base. Building secure bonds also help partners who suffer from post-traumatic stress and depression reduce depressive symptoms. Depressive symptoms could increase relationship distress (Wittenborn et al., 2019). Outcome studies have shown EFT efficacy in reducing traumatic stress symptoms (Johnson & Williams-Keeler, 1998) and depression (Alder et al., 2018; Denton et al., 2012; Dessaulles et al., 2003; Wittenborn et al., 2019), while these issues co-occur with relationship distress. The first two studies (Denton et al., 2012; Dessaulles et al., 2003) evaluated the efficacy of EFT compared to pharmacotherapy, and the samples were 12 and 24 women, respectively. Results from both studies suggested that EFT is an effective treatment for reducing depressive symptoms, especially when combined with pharmacotherapy concurrently. In addition, because there are sex differences in etiologic pathways and clinical presentation of major depressive disorder (Wittenborn et al., 2019), the findings for both studies have generalization issues. Later studies (Wittenborn et al., 2019) included men in their samples. They found that mild to moderate depression in men and women can be treated effectively with EFT relationship therapy compared to other usual care, including behavioural, narrative, Gottman, Bowen, psychodynamics, and eclectic approaches. However, the research is only a start to understanding the mechanisms of therapeutic change in reducing depressive symptoms through EFT.

EFT for Couple Facing Specific Concerns.

EFT researchers also tested the efficacy of EFT among couples facing specific concerns such as sexual dissatisfaction (Burgess Moser et al., 2019), medical illness (McLean et al., 2013), childhood trauma (Dalton et al., 2013; Macintosh & Johnson, 2008), and attachment injuries (Halchuk et al., 2010; Makinen & Johnson, 2006).

EFT has been used widely across different cultural contexts such as cultural, spiritual, religious, sexual and gender orientations and differing forms of families and socio-economic conditions (Johnson, 2019; 2020). However, like many other psychotherapy, cross-cultural studies are under-studies, previous EFT outcome and process research “has been conducted almost exclusively on White, middle-class, heterosexual couples” (Johnson & Greenman, 2013, p. 57). Growth-oriented and attachment-based EFT is suitable across culture. The caveat is that therapists gain knowledge of client’s cultural dynamics, know how to adapt specific EFT interventions, and attune client culturally. The ability to attune with client culturally relies on the therapist’s ability to recognize when minority stress interplays in their negative interaction cycle and the therapist’s ability to be a temporary secure figure.

Written by Jenny Hsuan Fang Hsu, R.C.C.

cited from her capstone JennyHsuanFangHsuCapstone.pdf (cityu.edu)

Theory of Adult Love

Hazan and Shaver (1987) later extended attachment theory to adult love relationships. They further tested and expanded attachment theory with adults and found that child/caregiver and adult love relationships share fundamental similarities in attachment needs and longing. Adult attachment combines three independent, interconnected, and innate behaviour systems: caregiving, attachment needs, and the sexual system (Mikulincer & Shaver, 2016). A fully functioning adult attachment system promotes adaptation, reproduction, and survival for humans (Johnson et al., 2015). If secure attachment functions well, partners co-regulate each other in times of threat, stress, and ambiguity, which helps to build resilience. When one faces a threat to their well-being or relationship, their attachment system is activated and triggers their partner’s caregiving to help them regulate their nervous system (Johnson et al., 2015).

The basic laws of human love are proximity maintenance, safe haven, secure base and separation distress (Brubacher, 2018).

Proximity Maintenance.

Attachment theory is based on humans' survival needs for forming bonds with others, especially in times of threat, stress, and ambiguity (Allan & Westhaver, 2018). Having a felt sense of security is when you call your intimate partner “Are you there?” and you will hear their answer as “yes.” Longing for close connection for safety, security and comfort is an “ancient wired-in-survival code design to keep us safe” (cited in Johnson, 2020, p. 11). Wiebe and Johnson (2017) argued that having a predictable physical and emotional connection with an attached figure can help individuals calm their nervous system and regulate their affect with each other’s nervous system in times of threat (Johnson, 2019). Couples with secure bonds have better resilience to stress, better physical health, more adaptive coping and reduced risk of depression (Johnson & Williams-Keeler, 1998; Wiebe, & Johnson, 2017).

Safe Haven

A secure attachment figure serves as a safe heaven. “Seeking a safe haven is a sign of strength, not enmeshment or weakness” (as cited in Johnson, 2007, p. 5). An individual with a secure attachment bond with their partner can return to their partner for comfort and safety when facing fear or threat in life because the safe heaven provides a source of strength to reach for and use that secure connection when needed (Johnson, 2007).

Secure Base

Individuals with secure attachment can focus their attention on exploring and adapting to their environment because they know that their attached figure is accessible and responsive in times of stress, uncertainty, and threat. Mikulincer (1997) examined five studies on the association between adult attachment style and information processing. It was found that secure individuals can engage more in information searching and have a higher tolerance of ambiguity. Because they trust that their secure figure will be accessible when they need help, they can allocate their energy to focus on processing information. Having a sense of felt security with others helps individuals learn that autonomy and distance are not in conflict with a close connection and dependency on secure others (Mikulincer & Shaver, 2016).

Separation Distress.

Johnson (2007a; 2017) claimed that the couple’s distress is due to unresponsiveness, which is like the distress experience of the children in Ainsworth’s “still face experiments” (Tronick, 2018). In the still face experiment, when the mother is physically present but emotionally absent, the infant shows the pattern of protest and may exhibit abandonment rage. The mother's still faces did not signal any emotional cue, creating attachment panic. Furthermore, Johnson argued that relationship distress is due to emotional disconnection, which triggers attachment fears. Partners feel separation distress when they sense a threat to their attachment, and their felt sense of secure connection is lost (Johnson, 2019).

Written by Jenny Hsuan Fang Hsu, R.C.C.

for more related reading JennyHsuanFangHsuCapstone.pdf (cityu.edu)

Does the early attachment style learned from childhood influenced the current attachment style?

Bowlby’s (1969, 1982) early hypothesis was that internal working models learned in early life provide essential information on the self, others, and relationships and guide interpersonal relationships throughout the lifespan. The attachment style learned in early experiences can serve as a prototype for friendships and romance throughout our life span (Johnson, 2017). Hazan and Shaver (1987) later translated the three infant attachment styles developed by Ainsworth et al. (1978) into three adult love attachment styles: secure, anxious, and avoidant. Besides childhood attachment patterns, Bowlby (1969, 1982) also proposed that the habitual interaction patterns that develop between adult partners are also fundamental in developing secure bonds. Hazan and Shaver (1993) pointed that childhood attachment patterns can change and be modified in adulthood by new interactions with a loved one.

However, Bowlby stated that the attachment pattern learned in the first few years of life has an important influence on peer attachment and romantic love attachment. He also noted that the attachment pattern is not permanent. It is relatively stable unless one is open to new experiences and flexible to adapt to their new environment by calibrating their internal working models against early environmental inputs. Researchers claimed that adult attachment styles are strongly correlated with one’s internal working models of self and others and early interactional experiences with primary caregivers (Collins & Read, 1990). Similar to most of the old researches, the samples of their studies were pre-assumed heterosexuals. Therefore, the results obtained from their studies cannot be generalized to the LGBT community. Feeney and Ridge’s studies suggested that lesbian and gay parental history does not strongly influence current attachment style. The studies suggested that the quality of close friendship attachment for same-sex couples may play a more significant influence in forming an adult love attachment style (Feeney & Ridge, 1998).

Written by Jenny Hsu, R.C.C

read more on JennyHsuanFangHsuCapstone.pdf (cityu.edu)