Methods
Firstly the therapist becomes 'non-verbally attuned' with the child's affective state. The therapist then attempts to explore 'themes' with the child whilst remaining attuned. Whilst this is done, the therapist then 'co-regulates' (helps the child to manage) the child's emerging affective states with 'matched vitality affect', and develops secondary affective/mental representations of them which is co-constructed with the child for purposes of integration (the therapist tries to help the child gain a coherent narrative about their experiences and an awareness of the positive aspects of themselves). According to Hughes "The therapist allows the subjective experience of the child to impact the therapist. The therapist can then truly enter into that experience and from there express her/his own subjective experience. As the therapist holds both subjective experiences, the child experiences both. As the child senses both, the child begins to integrate them and re-experience the event in a way that will facilitate its integration and resolution." Hughes (2004) In the anticipated frequent disruptions, due to the child's traumatic and shaming experiences, the therapist accepts and works with these and then 'repairs' the relationship.
This 'nonverbal dance' should run through both positive and negative experiences. It is posited that maintaining/re-establishing attunement during negative affective experiences prevents the child from entering into a state of affective, behavioral, and cognitive disregulation (the child's feelings becoming out of control). The aim is for the therapist and child to develop a new common meaning for the traumatic experiences, shame-based behaviors, and the dyadic process itself (how you experience another, and how they experience you), and for the child to feel safe, understood and validated at a sensory-affective, pre-verbal level of experience.
According to Hughes, the primary inter-subjective stance is one of acceptance and curiosity, empathy, (love) and/or playfulness, (later reduced to the acronym PACE or PLACE), all the while committed to remaining emotionally engaged and available to the child. It is an active, affectively varied, dyadic interaction that interweaves moments of experience and reflection. According to Hughes it is non-coercive and is intended to lead to the child feeling better understood and having a better understanding of themselves.
According to Hughes, what he describes as the 'attachment sequence of attunement, disruption, and repair' occurs frequently in an attachment-based model of therapy, just as it does in the parent-child relationship. 'Resistance' is described as a disruption in the relationship that is then co-regulated by the therapist. This involves the therapist guessing how the child feels in order to be able to empathize and express the feeling. Curiosity and acceptance are considered crucial to this process. The therapist 'co-regulates' the child's dysregulated responses to 'co-construct' a new meaning.
The ultimate aim is for the child to be able to construct a new and coherent autobiography that enables the child to be in touch with their inner feelings. "As the therapist gives expression to the child's subjective narrative, s/he is continuously integrating the child's nonverbal responsiveness to the dialogue, modifying it spontaneously in a manner congruent with the child's expressions. The dialogue is likely to have more emotional meaning for the child if the therapist, periodically, speaks for the child in the first person with the child's own words." (Hughes 2004 p18)
Read more about this topic: Dyadic Developmental Psychotherapy
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