apa 2014 - libet
TRANSCRIPT
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Life themes and plans Implications of
biased Beliefs: Elicitation and Treatment
(LIBET)
Sassaroli, S., Caselli, G., Bassanini, A., RedaelliC., & Ruggiero, G.M.
Studi Cognitivi, Post-graduate cognitivepsychotherapy specialization school, Milano,Italy
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Life themes and plans Implications of biased
Beliefs: Elicitation and Treatment
(LIBET, Ruggiero & Sassaroli, 2013)
We propose an integrated model of case
conceptualization of emotional disorders
called Life themes and plans Implications of
biased Beliefs: Elicitation and Treatment
(LIBET, Ruggiero & Sassaroli, 2013)
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Life themes and plans Implications of biased Beliefs: Elicitation
and Treatment
(LIBET, Ruggiero & Sassaroli, 2013)
The LIBET model aims to merge:
the Italian constructivist attention to emotions
and clients personal development
the rational and directive style of Ellis REBT
(Rational Emotive Behavior Therapy)
the procedural rigor of empirical research, in
order to produce a testable model
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Life themes and plans Implications of biased
Beliefs: Elicitation and Treatment
(LIBET, Ruggiero & Sassaroli, 2013)
In the LIBET framework, the emotional
disorder is conceptualized as depending on
two factors:
Painful life themes
Rigid and unflexible plans
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LIBET: Painful life themes
Painful life themes are attentional
focalizations on negative mental states related
to appraisals of events and of relational
patterns learnt in significant experiences and
relationships evaluated as intolerably painful
and grievous (Wells, 2008; Panksepp, 1998)
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LIBET: Rigid and unflexible plans
Rigid and unflexible plans are avoidant,
controlling and/or over-compensative
strategies even at cost to renounce to
significant areas of emotive, cognitive and
behavioural growth and personal and
relational satisfaction (Williams & Garland,
2002).
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Rigid plans: from semi-functionality to
dysfunctionality
These strategies can be partially functional in
given periods of life, but can also hinder
personal development and may lead to a
psychopathological onset depending on a final
failure of the rigid plan in which the emotional
cost of the renounces becomes too high
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The themes
We use the metaphor of the "nest" in order to
express vividly the relational patterns learnt in
significant experiences and relationships
evaluated as intolerably painful and grievous
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4 themes: the destroyed nest
Theme of the destroyed nest, in which the
individual has experienced a threat to the
basic need to be fed and cared for; the threat
to this need can lead to panic and paralyzing
fear, the so-called freezing (Ogden et al., 2006;
Solomon, 2011).
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4 themes: the secure nest in a
unsecure environment
The theme of the secure nest in a unsecure
environment in which the individual
experienced a warm and welcoming
environment, but also conceived the idea that
the external environment is dangerous and
that it is not convenient to venture into the
world. The exploratory system is compromised(Bolwby, 1968).
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4 themes: the cold nest
Theme of the cold nest, in which the base is
safe and the need for exploration is not
opposed, but care is provided in an
atmosphere of emotional deprivation and
emotional distance, where body contacts are
rare (Bowlby, 1968).
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4 themes: the punitive and criticizing
nest
The punitive and criticizing nest, where the
safe base is present, the need for exploration
is not opposed, but there is also a severely
criticizing relational style, controlling and
oppressive in where the values are lived
regulatory and transmitted in a manner
oppressive guilt and punishment
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3 plans: the prudential plan
The prudential plan, in which the subject tries
not to think about his painful topic avoiding it
through mental and behavioral strategies that
prevent him from having to deal with thecircumstances and / or thoughts that may be
connected in some way with the painful topic.
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3 plans: the striving plan
The striving plan, in which the subject believes
that the issue can be excluded through strict
and efficient strategies hypercontrol that
prevent the possibility of the most traumaticaspects of the theme painful to come true or
at least present themselves at the center of
the individual.
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3 plans: the self-himmunizing plan
The self-himmunizing plan, in which the subjectmanages the painful issues and tryingexperiences intense emotional states and
overwhelming that ipercompensino contrast topositive states of depression, anxiety andrimuginativi typical of painful issues, almosttrying to expel the attentional space. The person
seeking an alternative to the extreme negativestates associated with painful issues, but in doingso also confirms the inability to handle
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Assessing LIBET
We developed a procedure for assessing LIBET
and a booklet that helps the implementation
of the procedure
The procedure allowed the collection of
quantitative data in order to test the validity
of LIBET to discriminate clients and controls
and to assess pathological variables
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Validation procedures
We administered the LIBET booklet to 10
clients and 9 control
We measured the prevalence of each theme
and plan
We compared the intensity of themes and
plans in clients and controls
We assessed in each individual one theme and
two plans (primary and secondary plan)
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57.90%
42.10%
Sample
Male
Female 84.20%
15.80%
Marital Status
Single
Married
5.30%36.80%
52.60%
Scholastic Education
Medie
Superiori
Laurea (BA or MA)
36.80%
5.30%15.80%
36.80%
5.30%
Primary Problem
Anxiety
Depression
Relationship
Existential
Impulsivenes
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0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
50.00%36.80%
47.40%
15.80%
Primary Strategy
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
15.80%
21.10%
26.30%
Secondary Strategy
0%
10%
20%
30%
40%
50%
60%
70%
Destroyed
Nest
Secure Nest
in Unsecure
Environment
Cold Nest Punitive and
Criticizing
Nest
0%
26.30%
63.20%
10.50%
Life Theme
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0
10
20
30
40
50
60
70
80
90
100
30.5
62.4
55.5
80.33
18.6
57.8
98.2
15.2 13.7 15.3
22.6
28.933.33
39.44
2.67
41.78
68.78
11.5610.67
18.22
Clinical
Control
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2.66
2.51
2.41
2.29
2.21
1.98
1.89
1.17
0.26
-0.15
-0.34
-0.91
-1.02
-1.35
-4.00 -3.00 -2.00 -1.00 0.00 1.00 2.00 3.00 4.00
t value
change
alternative
Willing to do
Avoid suffering
automatic
goals
Faith in change
Libero altre cose
Worry about
Damage with life choice
Damage with personal goals
Damage with Others
Low Control
Ought to do
Fatigue
Linear (change)
Linear (change)
Linear (change)
Higher inControl Higher inClinical
PLANS ITEM SIGNIFICANT DIFFERENCES IN CLINICAL AND CONTROL SAMPLE
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Preliminary results
The intensity of painful themes is higher in clientsthan in controls
The cold nest seems the more frequent in thetotal sample
The more frequent primary plan is the prudentialplan in the total sample
The more frequent secondary plan is theself-immunizing plan in the total sample
We are selecting the more efficient items inshowing differences between clients and controls