‘What is AEDP?’ I get asked that question a lot, by colleagues, friends, family and of course by people who are thinking of finding a therapist for themselves. AEDP — Accelerated Experiential Dynamic Psychotherapy — is not yet very well known in the U.K., so it’s understandable that people are puzzled.
My answer to the ‘What is AEDP?’ question usually involves me fumbling to give some sort of explanation. And because verbally explaining things is really not my strength, the listener tends to end up only more confused than when we began! I generally say things like, ‘Well I think it’s really amazing; it’s to do with emotions and working with the powerful relationship between the therapist and the client.’
‘AEDP (Accelerated Experiential Dynamic Psychotherapy) is an integrative, non-pathologising, attachment-, emotion- and transformation-focused therapy that places the somatic experience of affective experience in relationship and its dyadic regulation at the centre of how it clinically aims to bring about change.’
Yeung & Fosha, 2014; Fosha, 2000
‘AEDP assumes a healthy core within all people, emphasises adaptive motivational strivings, works actively and explicitly to create the experience of safety in the therapeutic relationship, and stresses the importance of experiential work with adaptive affective change processes.’
Yeung & Fosha, 2014
What Does That Mean?
Those were two long sentences containing lots of therapy jargon; what does that all mean in practice? I’ll see if I can unpick some of it for you.
AEDP is About Healing and Transformation
AEDP is non-pathologising. Instead of starting from ‘What’s wrong with this person?’, AEDP therapists are trained to be ‘transformance detectives’. This means that we actively look for glimmers and signs of the healthy strivings towards growth and wholeness that are inside everybody. This can be profoundly powerful, and it means that even in the first session the client may feel that something true and deeply meaningful has been touched on. AEDP teaches therapists ways to work with a client’s strengths that can bring out the person’s ‘self-at-best’ in order to deeply accompany and heal their ‘self-at-worst’ (i.e. their hurt, traumatised, depressed or anxious self).
AEDP is an Attachment-Based Therapy
Many types of depth psychotherapy work to help the client develop an internal ‘secure attachment’. AEDP is particularly good, I have found, at offering clear, specific ways that secure attachment can be developed. This isn’t about making a client get attached to the therapist in an unhealthily dependent way. Instead, it’s about helping a client build an inner sense of stability. The therapist and client together use their authentic presence and relationship to build tools that the person can now have in all their important relationships, and in their relationship to themselves too.
By being explicitly inter-relational, in the here-and-now the AEDP therapist leads the client to reflect on the actual experience of what it’s like to explore these emotional layers of healing together. Through explicitly naming the gains and experiences in rounds and spirals of exploration– of doing this work and finding these epiphanies, and what it’s like being accompanied by the AEDP therapist– a client builds an inner sense of stability.
Judy Silvan, Certified AEDP Therapist and Supervisor
AEDP Works With Emotions
Most people who seek psychotherapy and counselling are having some kind of trouble with their emotions. It may be that they are having trouble accessing their emotions, instead finding themselves landed with symptoms like anxiety, gut problems, depression, or a feeling of flatness and ‘what’s-the-point?’ in life. Or it may be the opposite: their emotions are too big, too chaotic, too scary, and out-of-control. The most effective psychotherapies place emotion processing and emotion regulation at the heart of the work, because our emotions are fundamentally important to our lives. AEDP teaches very straightforward ways to process emotions, which means that we learn to allow our emotions to flow in a way that helps us feel better and clearer. Then we can use emotions as they were meant to be used: as ways to guide us and to solve problems.
Emotion is the experiential arc between the problem and its solution: Between the danger and the escape lies fear. Between novelty and its exploration lies joyful curiosity. Between the loss and its eventual acceptance lies the grief and its completion. Linked with adaptation, emotions are “ancestral tools for living” (Panksepp, 2009).
Diana Fosha, 2009
AEDP is Experiential
Therapy that works with here-and-now experience is very different from the kind of therapy that is focused on developing cognitive insight alone. In experiential therapy, there is a focus on helping the client to have an experience (e.g. of feeling an emotion) right there in the session, and to reflect on that experience with the therapist. (The opposite might be only spending the session talking about thoughts and ideas, and about experiences that have happened outside of the session). Experiential therapy is really valuable because it gets us using our whole brain, building new neural pathways between brain areas, and including the crucially important ’emotional brain’. Experiential therapy maximises neuroplasticity (the ability of the brain to physically change) and creates deeper capacity for transformation.
AEDP is Relational
Multiple studies and meta-analyses have shown that across all types of psychotherapy/ counselling, by far the biggest factor in therapy outcomes, is the quality of the relationship between therapist and client. AEDP is certainly not the only type of therapy that has a relational focus. However, AEDP goes a step further than other relational psychotherapies, because it offers specific tools (such as meta-processing) by which therapists can use the therapeutic relationship to help the client process their experiences more deeply and more powerfully.
AEDP is Person-Centred
AEDP is a profoundly person-centred model of therapy. It’s deeply creative, interactive, and respectful of each person’s unique process. AEDP is rooted in person-centred values of authenticity, the real two-person relationship, and unconditional positive regard from the therapist. Although AEDP does use maps, flowcharts and techniques to help the therapist know what they’re doing and why, it feels quite different from other models that also make use of protocols, manuals and charts (like TA, CBT, CAT, and EMDR).
AEDP is a Somatic Psychotherapy
Somatically-based psychotherapies recognise that human experience cannot be split off into ‘mind’ and ‘body’. (Soma is the Ancient Greek word for ‘body’). Since neuroscience and brain imaging technologies started being used to inform psychotherapy, it is widely accepted that any effective therapy — particularly where trauma and attachment are concerned — must involve the body. AEDP therapists carefully track clients’ experience, frequently asking questions such as ‘Where do you feel that in your body?’ These interventions can help clients strengthen their emotional regulation skills, get clues from their own intuitive knowing, and sense into what feels ‘off’ and what feels like the path they want to take.
AEDP is Positive
AEDP focuses on building and developing the client’s strengths and resilience (for therapists interested in how to help clients and themselves build resilience, I highly recommend ‘Restoring Resilience: Discovering Your Clients’ Capacity for Healing’ by Eileen Russell). In AEDP the term ‘positive’ refers to what feels true, right and authentic in that moment. Depending on the person and the situation, this might well involve processing emotions that often get labelled ‘negative’: deep grief and mourning, or intense anger, guilt or shame. AEDP offers ways to allow the client to move through those darker emotions in such a way that they feel profoundly accompanied and can then ‘come out the other side’ with more wisdom, peace and strength.
“People have a fundamental need for transformation. We are wired for growth and healing. And we are wired for self-righting, and resuming impeded growth. We have a need for the expansion and liberation of the self, the letting down of defensive barriers, and the dismantling of the false self (Ghent, 1990). We are shaped by a deep desire to be known, seen, and recognized (Sander, 1995, 2002) as we strive to come into contact with parts of ourselves that are frozen (Eigen, 1996) ….”
(Diana Fosha, 2008, p. 290)
AEDP Helps Undo Aloneness
At the core of trauma and psychopathology, says Diana Fosha, lie profound experiences of unwilled, unwanted aloneness at times of pain and suffering. AEDP therapists work to help clients undo their aloneness. Clients get to experience what it can be like to feel emotionally accompanied, and to feel that somebody truly ‘gets them’. AEDP then takes this a step further, inviting the client to process with the therapist what it feels like to be accompanied, to be sharing their suffering or joy or whatever else they’re experiencing. This can often feel very moving and even mind-blowing for the client (‘this feels so weird – but in a good way!’) AEDP teaches therapists how to then explore this further, enabling the client to head into a place of deeper peace and connection.
AEDP is Creative
As an Integrative Arts Psychotherapist (a modality that interweaves beautifully with AEDP!) I place the highest value on creative approaches to therapy, transformation and growth. Lots of things about AEDP are deeply creative, and the use of imagination and right-brain processes in ‘portrayals’ are a great example. In portrayals, the client is encouraged to use their embodied imagination in a way that integrates different layers of the brain, as well as both brain hemispheres, in partnership with the therapist. Portrayals are used ‘for completing interrupted action sequences, meeting unmet needs, making repairs and reparations, doing in the here-and-now what was needed in the there-and-then.’ (Fosha, 2018)
AEDP is Integrative
One of the things that I particularly love about AEDP is that it draws on and integrates a very wide base of psychotherapeutic and neurobiological wisdom. “Donald Winnicott is my patron saint” announced AEDP’s founder, Dr Diana Fosha, in the first AEDP training that I attended, and I instantly felt reassured that I was in the right place. I felt even more at home when she then went on to talk extensively about how Attachment (Bowlby & Ainsworth) is at the heart of AEDP. AEDP also draws deeply from somatically based trauma studies (Van der Kolk, Levine, Porges, Ogden, etc), and affective neuroscience (Schore, Siegel, Panksepp, Damasio, etc).
Is AEDP the Best Therapy for Me?
Maybe, but not necessarily. No single type of therapy is right for everyone. AEDP may — or may not — be the best kind of therapy for you. And AEDP therapists are all unique; one might be ideal for you, whilst a different AEDP therapist might not be a good fit for you at all. Also, AEDP therapists will have different levels of training (click here for an explanation of the different levels), with some therapists more ‘AEDP-ish’ than others.
Looking for an AEDP Therapist?
If you’re looking for an AEDP therapist in the U.K., visit https://www.aedpuk.com You can also find a directory of AEDP therapists around the world at https://aedpinstitute.org/find-an-aedp-institute-therapist/listings/
Are You a Therapist Interested in Learning More About AEDP?
The original AEDP book, ‘The Transforming Power of Affect’ by Dr Diana Fosha, was published in 2000. In 2021, ‘Undoing Aloneness and the Transformation of Suffering into Flourishing: AEDP 2.0 (edited by Diana Fosha) was published. This is a very comprehensive and up-to-date discussion of AEDP in its current form. It’s quite pricey, but packed full of valuable insights and practical ideas for any therapist who is interested in relational, experiential, and transformational work.
AEDP therapist Judy Silvan has written a very readable article, ‘Bottom-up Gratitude’ in which she discusses an AEDP session.
Other fantastic AEDP-related self-help books that I recommend include ‘Living Like You Mean It: Use the Wisdom and Power of Your Emotions to Get the Life You Really Want’ and ‘Loving Like You Mean It: Use the Power of Emotional Mindfulness to Transform Your Relationships’ by Ronald J. Frederick, PhD; and ‘Emotional Medicine Rx: Cry When You’re Sad, Stop When You’re Done, Feel Good Fast’ by Penelope Young Andrade, LCSW.