The DMM Coffee House session for Tuesday September 3, 2024, will be a video replay of an interview with Dr. Kasia Kozlowska, a child and adolescent psychiatrist at the Children’s Hospital at Westmead, Australia. In 2020, she wrote the remarkably advanced book Functional somatic symptoms in children and adolescents:A stress-system approach to assessment and treatment. (The electronic version is available in full as a free download.) Dr. Kozlowska brings a broad array of scientific methods to understand somatic disorders, including the Dynamic-Maturational Model of Attachment and Adaptation (DMM), Interpersonal Neurobiology, polyvagal theory, stress response, a modern medical approach, etc.
Session overview
In early January 2021, DMM Coffee House attendees discussed her book and developed a set of questions for her. On 18 January 2021, in DMM Coffee House #40, we interviewed Dr. Kozlowska and explored the questions. The discussion was wide a ranging exploration of leading edge medical, psychological, social, and attachment topics.
Dr. Kozlowska talked about a number of complex topics including findings from her research on the prevalence of DMM attachment strategies among people with functional somatic symptoms (FSS). (She found that virtually all people being treated for functional somatic symptoms had higher level DMM self-protected strategies.) She talked about her view on the difference between stress and danger, and the stress response system vs. the attachment/danger response system, how somatic memory systems relate to other memory systems and information processing. She described how the autonomic nervous system can become dysregulated by an FSS experience. Using a case example (pain in a child’s legs which eventually led to somatic paralysis), she described the simple technique which almost instantly terminated the paralysis. (Establishing a safe and trusted relationship together with medico-neuro-psycho education were key components, which are often facilitated by children’s ability to often be more flexible and open to new information, and use play as part of treatment.) Dr. Kozlowska talked about some of the different behaviors she sees in the DMM’s A and C attachment patterns.
A transdisciplinary discussion
In a spontaneous moment, Éadaoin Bhreathnach, a world-leading occupational therapist in Northern Ireland and who was present in the session, was invited joined the conversation. She and Dr. Kozlowska spent quite a few lovely moments sharing thoughts and experiences, and talked about their views on interventions, regulation, and when to take a top-down or bottom-up approach to interventions. They also shared thoughts on causes and interventions for challenges to body function problems.
We had a brief discussion about how different professions have slightly different relational-approach needs. Lawyers and doctors have to establish safety and protection, and move to an action step very quickly, whereas an occupational therapist has time over some number of sessions to reach deeper. Yet, the framework and strategies for healing and helping people move past their attachment traumas remain generally similar. Establishing a trusted relationship and sense of safety for the client is always a key issue.
Dr. Mike blows, a child psychiatrist in the U.K. raised a discussion about developing a community approach to the problems.
Éadaoin Bhreathnach developed the Sensory Attachment Intervention approach, which incorporates DMM attachment science and theory into her occupational therapy model. She presented her research findings and ideas in DMM Coffee House #89 on 25 January 2022.
For more information
For more information about the session and to request a link for the Zoom session, please see the notice for DMM Coffee House session #40.
Here is a link to a summary of her book on Functional Somatic Symptoms. Here is a link to a summary of her two-week list of techniques for managing Functional Somatic Symptoms in children and adolescents. Dr. Kozlowska finds that the majority of her patients completely heal from their functional somatic symptoms. Her interventions are broken down by a focus on the body, mind, and relationships. The list of techniques is fully consistent and largely compatible with CSI’s Integrative Client-Centered Model (ICCM) for client counseling.
DMM Coffee House #40 was hosted by Mark Baumann, a family law litigator and mediator in Washington State, USA. He is trained in multiple DMM attachment assessments, the owner of CSI, and is the developer of the Integrative Client-Centered Model for client counseling.