Advanced Dissociation Training:
Adaptive Internal Relational (AIR) Network Model
of Complex Neuro-dissociative States Therapy
Adaptive Internal Relational (AIR) Network Model: An Overview
Copyright © 2015 McClelland, Miller & Solon. All Rights Reserved
Adaptive Internal Relational (AIR) Network therapy is a neuro-developmental, competency-based model of therapy developed over the past 20 years by Dawn McClelland Phd, LP, Patti Miller MA LP and Phyllis Solon PsyD, LP. The Adaptive Internal Relational (AIR) Network model is primarily oriented towards giving people the freedom to engage fully with themselves and in relationships with others. Clients who live with complex neuro-dissociative states, a developmental-neurological organization of experience, have very different relational and therapeutic needs than those who have trauma histories without more complex types of dissociation. When working with these more complexly organized clients, Adaptive Internal Relational Networks, mandatory for safety and multi-directional attention to be mastered, need to be built and solidified over time. Interactive Adult Awareness/Most Resourced Self is a critical piece of the Adaptive Internal Relational Network that must be developed for healing to occur. Most of the AIR Resourcing Strategies initially focus on building clients’ abilities to develop an internal stance where there is at least a neutral noticing and awareness. Overtime these internal relationships move towards more cooperation and caring, which allow them to also connect externally without violating themselves or others.
The Adaptive Internal Relational (AIR) Network model is grounded in the position that therapy must be informed by in depth knowledge of developmental neurology, information processing and the existence of conditioning and programming. The use of AIR Resourcing strategies underlies the ability to create neural network associations outside of the terror and fear conditioning created in the context of early trauma. The most recent neurological research shows that there are fewer and slower connections in the fear extinguishing feedback loop between the medial prefrontal cortex and the amygdala for those who have developmental trauma. Through AIR resourcing, connections are strengthened in orbital and medial prefrontal fibers increasing clients’ abilities to manage automatic fear and numbing responses which were adaptive to survival.
We have developed very specific AIR Resourcing Strategy sequences that meet the needs of our clients who have more complex symptoms and neuro-dissociative states. We are very deliberate about containing traumatic memory while working to bring dissociated aspects of self or P/parts into relationship with the Interactive Adult Awareness/Most Resourced Self . This present orientation includes the ability to hold multiple perspectives. AIR Network Resourcing Strategies help clients to define themselves separate from the memories, conditioning and programming that they have experienced. This phase of therapy can take many years depending on the severity of symptoms the degree of neuro-dissociative states and the complexity of the organization of the Core Survival Networks. Next, clients can decide with us in the context of the therapy if they want or need to process memories. The Adaptive Internal Relational (AIR) Network Model supports effective and competency based traumatic memory processing through a number of different memory processing therapies like EMDR and Sensori-Motor Psychotherapy after the Internal relational Networks have been established and strengthened.
An understanding of developmental neurology and information processing theory is critical to an understanding of the Adaptive Internal Relational Network Model. Subcortical areas including the brainstem and limbic structures, and the somatosensory and motor areas of the brain encode information first, both developmentally and in times of danger. Information moves from those areas to the neocortical and left hemispheric language processing areas of the brain. This normal and adaptive process allows people to work through critical or traumatic incidents that happen to every person at some time. Intense, complex or repeated traumas can interrupt this adaptive process such that trauma patterns and reactive or Core Survival Networks get encoded and solidified over time.
Trauma affects how networks of somatic experience, emotion, thought and perception are formed and neurologically embedded. For all people, regardless of trauma, neural networks form in a developmental sequence and are impacted by environmental and relational experiences and resources. Human competence, potential and neuroplasticity are all foundational assumptions of the Adaptive Internal Relational (AIR) Network Model. The Core Survival Networks that our clients present with are completely adaptive for the time and place that they were created. What makes them currently problematic is that these Core Survival Networks, in present reality, are no longer working to meet the legitimate needs of clients. Still operating within a past framework due to how trauma memories get encoded and stored, these old, Core Survival Networks “feel” necessary to clients and therefore remain running and active. This type of neurological ‘bottom up’ activation gets triggered when clients feel unsafe or are activated by internal or external triggers to traumatic memories. Our therapeutic stance is that no one is trying to do anything wrong. We believe that clients are doing the best that they can given how they see their situation or perceive their available resources.
The Therapeutic Relational Stance
Clients are forming a primary relationship with self verses with the therapist. The therapeutic relationship is a resource for clients as they build Adaptive Internal Relational Networks consisting of relationships between their internal parts. Those parts exist on a continuum from fully separate to overlapping and any combination at different times. Clients do not need to “trust” us in order to do this work. Often it is a relief to them, as they may not have the capacity to do so.
Words such as resistant or non-compliant are not a part of the Adaptive Internal Relational Network conceptualization. Rather, all of the ways that clients use their internal sense of what is happening are viewed as strengths and resources. The focus remains on their need to form consistency and/or trust with themselves and their insides, whether they have fully dissociated P/parts or not. Over time, what client’s come to trust is their experience of themselves in relationship with whoever they are in the room. The Interactive Adult Awareness/Most Resourced Self, through the integration of orbital-prefrontal top down “thinking” processes and observation of bottom up limbic processes, engages with parts on the inside to calm the limbic and brainstem structures which hold traumatic memory in ways that intrude upon them.
In the normal developmental process children are conditioned to understand the intentions of others within the primary attachment relationship. The mirror neuron system enables people to experience the world through the eyes of another and develop empathy in relationship. In the context of trauma, children come to expect the world to be a scary, dangerous and or unpredictable place. Fear and sexual arousal in the context of bonding creates profound conditioning and external control. At times, perpetrators consciously and intentionally use these processes to set up internal systems of self-doubt, second guessing, and shame so that the predator is in control through physiological arousal. Core Survival Networks are created in this context and then reinforced through programming and conditioning. One of the reasons why programming is so powerful and difficult to neutralize is because it essentially ‘hijacks’ a person’s core values. This creates internal traps of conscience where people feel like they are betraying their core sense of themselves in the world when they are trying to act against programming.
Clients can often understand this theoretically but do not know how to change it due to the bottom up, automatic nature of traumatic activation. It is important for both client and therapist to understand that they cannot talk themselves into these needed changes and that no amount of power struggle, internally or externally, will ever accomplish the desired outcome. Many clients who live with complex neuro-dissociative states have protector Parts that are programmed to see change as dangerous. Thus, any therapeutic change is interpreted as life threatening. This “trauma logic” needs to be skillfully and graciously addressed in the therapeutic context on an ongoing basis for clients to be successful. Internal identification of trauma logic patterns without judgment over time allows clients to build caring, compassionate connections between P/parts within Adaptive Internal Relational Networks.
Within this model, the therapeutic relationship does not act as the regulator of the limbic and brainstem activation. It is a “natural” thing to want to help clients regulate, and we still will help with this, but traumatic bonding in the therapeutic relationship, which is common with clients who have trauma histories, often impedes their abilities to form Adaptive Internal Relational Networks and create an internal locus of control. Traditional theories of working with trauma have been based around concepts of parent-infant attachment and creating a therapeutic relationship that mirrors the care, trust and safety that children need to develop healthy relationships. To this end, therapists have traditionally worked to attune to and help clients regulate in the hopes of helping them to develop this capacity. Current research indicates that an adult brain has developed beyond the capacity to have needs met completely from the outside. Creating a container of holding and safety on the outside helps to balance primitive brainstem structures to a certain extent, but also can recreate the conditions of programming and reinforce trauma neurology. Thus, clients continue to rely on external structures and systems to help regulate and keep them safe. The Adaptive Internal Relational (AIR) Network model works with the real needs for attachment, attunement, help and trust from the framework of the Interactive Adult Awareness/Most Resourced Self . Once a child or adolescent is in a safe external environment, their Most Resourced Self can connect to adult supports in an age appropriate manner.
The extensive amount of time it can take to make needed changes can feel overwhelming and discouraging for both clients and therapists. We relentlessly focus on building and resourcing Adaptive Internal Relational Networks, creating new possibilities of internal relationship. Through the internal process of building neurological bridges, parts learn to connect and help each other and decisions are made through the Interactive Adult Awareness/Most Resourced Self , functionally located in the orbital prefrontal cortex. These connection and decision processes, built through AIR Networking Resourcing Strategies, develop stronger abilities to regulate emotional, sensory and somatic arousal in the subcortical, brainstem and limbic structures, and somatosensory areas of the brain. Coming back to this focus over and over again within a gracious and competency-based stance allows clients the freedom to build the internal structures that will serve them in their lives and relationships beyond the therapeutic context.
The Arc of Therapy
The Adaptive Internal Relational (AIR) Network model consists of three overlapping phases that make up the Therapeutic Arc. These phases are similar to and take into account the Transtheoretical Model of Trauma treatment.
Phase One: Creating Context and Resource Stabilization
Phase Two: Developing Networks and Advanced Resourcing
Phase Three: Future Resilience and/or Memory Reprocessing
Phase One: Creating Context and Resource Stabilization
First, context is created by teaching clients about the neurology of trauma and the components of the Adaptive Internal Relational (AIR) Network model. During this first phase we focus on client resilience, competence and understanding of their core survival strategies. The concept of Interactive Adult Awareness/Most Resourced Self becomes a central part of how we help clients to interact with themselves and the therapist during sessions. Throughout this phase we help the client differentiate and label P/parts, memory and programming/conditioning, which increases internal safety. Containment of memories away from parts is a primary tool of this phase. Assessment of existing adaptive networks is also ongoing. A detailed history of what created the complex dissociative states may or may not be gathered at this point based on a client’s abilities to stay present and stable while talking about traumatic experiences or childhood memories.
Phase Two: Developing Networks and AIR Network Resourcing
Strengthening clients’ abilities to build Adaptive Internal Relational (AIR) Networks and AIR Network Resourcing are the primary focus of the second Phase. Adaptive Internal Relational Networks are neurological structures and relational systems that allow a client to be in a present oriented relationship with all of who they are at any given time. A physiological state of awareness and cognitive alertness is a crucial component to building Adaptive Internal Relational networks. The Interactive Adult Awareness/Most Resourced Self/Most Resourced Self, standing in ‘real time’ works with the Adaptive Internal Relational Networks in a fluid and dynamic system that is always moving and always changing. This intentional weaving together of the Interactive Adult Awareness/Most Resourced Self/Most Resourced Self and the Adaptive Internal Relational Networks is foundational to clients’ sense of competency and mastery in their own healing and recovery.
It is our goal to help clients understand that they are not the events that have happened to them. Who they are, including every P/part, is separate from the trauma, memories and programming/conditioning. Traumatic memories get encapsulated because of a number of interrelated neurological realities at the time of the trauma. The Dorsolateral-Prefrontal Cortex (D-PFC), the timekeeper of the brain, shuts down and causes the memory to be, in a sense, displaced from time. In addition, cortisol and adrenaline, two stress hormones, flood the hippocampus and prohibit the encoding of episodic or narrative memory. Thus, traumatic memories are stored in the nonverbal, sensory-motor and emotional centers of the brain. Because of this, when a traumatic memory is triggered, people are ‘transported’ neurologically to a place in their brain where they only have the capacity that was available to them at the time of the trauma. In the Adaptive Internal Relational Network model, we experience this as part of the self or for some, a dissociated Part, being stuck in that neurology and, because of being displaced from time, that part or fragment of the person experiences that traumatic event as being ongoing in the present. Similar to phantom limb pain, when the memory is triggered the motor and somatosensory cortices fire in patterns that are the same as if the actions were actually occurring currently. Fragments of the self or fragments of P/parts or even P/parts themselves are then “rescued” and memories are contained so that the arousal and subsequent trauma response can be bypassed. The goal is to have memories contained away from P/parts, activation soothed, and choice created for the client in whether or not the trauma memory will be processed at some future point.
Compartmentalization, a core survival strategy is employed in an attempt to isolate memories but this leaves people vulnerable to triggering and random activation. Containment on the other hand, allows the memories to be safely stored until such time that resources are sufficiently developed and the internal system, including all the P/parts and the Interactive Adult Awareness/Most Resourced Self/Most Resourced Self are oriented towards the present. At that point, clients can choose whether or not they want to open traumatic memories up for reprocessing.
Clients in this phase of therapy also begin to recognize their Core Value Networks and learn how those have been ‘hijacked’ by programming in ways that cause them to be continuously placed in double binds. Over time, they learn to “step around” their programming and initiate actions for their present benefit. Understanding their core values and working with the dynamic interplay of the Interactive Adult Awareness/Most Resourced Self/Most Resourced Self and the Adaptive Relational Networks allows clients to access their ‘will’ and take these actions on their own behalf.
Phase Three: Future Resilience and/or Memory Processing
Clients may or may not choose to do memory work. Some people are able to keep memories contained without intrusions into daily life. Some choose working with memories at a later time. It is a central value in the Adaptive Internal Relational Network Model that clients must be able to decide from their inside versus be coerced in any way by well meaning clinicians to process memories. Clients’ owning this decision further enhances a framework of free will and choice. This strengthens their ability to decide and thus, provides further healing from the conditioning and programming. Intrusions of traumatic material into daily life may direct the decision to work with previously contained memories. Because P/parts have been “rescued” from traumatic experiences, it is understood that clients will not “re-live” their experiences. Clients maintain their present reality even when they have strong emotions. Multi-directional attention is maintained so that the clients simultaneously attend to the traumatic material while accessing previously developed and strengthened Adaptive Internal Relational Networks. This process decreases distress and increases experiences of cohesion and community among P/parts of self. Positive experiences of self are reinforced through AIR Network Resourcing Strategies as a component of Future Resilience.