How Deep Nuclei Therapy was born?

Deep Nuclei Therapy, or DNT, is an integrated method of brief therapy developed to meet the growing demand for efficiency and effectiveness for patients who turn to psychotherapy. This method aims to achieve goals that until recently were considered incompatible, such as speed in making profound changes, overall restructuring of the personality, and stabilization of results.

DNT was founded on three basic steps:

1) to extract the theoretical and operational instruments that are most effective («the keys of change») from the main models of psychotherapy and approaches for change

2) integration of these tools in order to produce a powerful synergy in the treatment plan («laser effect»)

3) coding in terms of protocol procedures to make them easily transferable and thus able to replicate the results («replay factor»).

Under the auspices of a logical-mathematical theory, the theory of logical types was developed in the early part of the last century by Russell and Whitehead; DNT shows how the psychopathological condition is not the result of a simple conflict, but a state of paradox.

As happens to those who fall into quicksand, the more you try to get out, the more tightly you are caught or trapped. In therapy, it is possible that the paradox is treated as a conflict, which has, in fact, the paradoxical effect, making the process of change long and arduous.

As happens to Sisyphus, condemned to dragging an enormous boulder up to the summit of a mountain only to then see it roll back down to the valley, the patient trapped in a position of paradox may have the impression of crawling along an endless path, struggling to see tangible results.

At this point the question naturally arises: what creates the condition of paradox? According to the theory of logical types, it’s the confusion between the individual as a whole and its parts, which can be summarized by the Latin pars pro toto, the part that takes the place of everything.

What are the characteristics of this method?

The NPT aims to contribute to the attempt to give scientific status to psychotherapy in preparation methodology. Up to now we tried to validate, in terms of effectiveness and efficiency, the various methods that already exist, through randomized, controlled or observational trials.

In the history of clinical psychology, the development of methods of psychotherapy was therefore entrusted largely to the genius and creativity of the founders of the various models. In an attempt to formalize the methods already in the pipeline, the construction of NPT was applied to the following criteria:

• integration
• congruence
• consistency
• globality
• communication
• transferability

The criterion of integration is the starting point for the elaboration work and begins with the question: «What is the best method of psychotherapy?». The answer can only be «any or every one». This unanimity consensus is justified by the fact that no approach is able to deal – with equal success – with the various forms of psychopathology. This is why the work of integration between various methods and theories is the most promising frontier of present research in the field of clinical psychology. Each method is demonstrated potentially effective against a particular aspect of the problem of the patient. Putting together a certain number of them, you should therefore get a potentially valuable method in dealing successfully with the most human psychological problems.

DNT is thus the result of integrating some of the greatest systems of traditional psychotherapy, including psychoanalysis (see especially the contributions of Alexander and French, Fairbairn), cognitive-behavioral approach, Gestalt therapy (Perls) psychodrama (Moreno), the analysis bioenergetics (Lowen), the client-centered therapy (Rogers), transactional analysis (Berne), cybernetics, the systemic and family therapy (Bateson, Milan approach), and the pragmatics of communication (Watzlawick et al.).

Integrated approaches to rapid change were also included, such as the model of Milton Erickson's hypnosis, neurolinguistic programming (Bandler and Grinder) and the brief strategic therapy (Nardone and Watzlawick).

The criterion of congruence comes into play because the “keys of change” so drawn must be appropriately integrated, rather than simply juxtaposed or compared, in order to avoid potential conflicts within a theoretical or methodological framework and to produce the most powerful synergy potential, or the laser effect.

The criterion of consistency underlines the need for a theory that encompasses a vision of the personality, the discomfort and the therapy, in order to establish a substantial connection between these different dimensions. Thus, the psychopathology is aligned with the psychology of normality, creating a continuum between these two poles, rather than a dichotomous opposition between the two.

The criterion of globality proceeds from the consideration that it is important to refer to a theoretical model that includes the key generators of the psyche, behavior and relationship dynamics. The theory of the four generators, which provides support for the operating aspect of DNT, takes into account four key factors: needs, emotions, beliefs and values.

The criterion of communication is crucial in terms of applying the DTN method, by virtue of the fact that communication is the chosen instrument – and very often the only one – that the therapist has at his disposal to bring about change.

More generally, it constitutes the broader framework that is common to each psychotherapeutic model. It is therefore necessary to identify the different tools of change in terms of what we can define as the therapeutic communication.

The criterion of transferability provides, finally, an accurate description of the different phases of the therapeutic procedure, on the continuum defined by «theoretical abstraction-concrete-operational» poles. The precise encoding of the method in terms of the sequence of therapeutic steps makes DNT a therapeutic procedure which can be directly transferable to other professionals, thus amplifying of the opportunity to replicate the results.

The aim is to enhance the importance of the methodological variable, increasing the efficiency and effectiveness of the therapist in the total interest of the patient.

How does it work?

DNT considers human problems as indicators of a sort. The symptoms or suffering, which is the vibrant core of what we call a «problem,» is like an Arianna's thread that can guide us toward its origin, allowing us to retrieve the first time that it occurred.

While the thread that Arianna gives to Teseo guides the hero out of the labyrinth, the thread of emotion has the power to allow us to penetrate the ancient heart of our childhood. Following this line we find ourselves, unexpectedly, in the presence of characters that enliven our inner world: the child who we were, her parents and those figures who played a major role in the emergence of those same emotions.

These are the characters of our inner theater, or the Deep Nuclei. Far from belonging to the past, they continue to this day – no matter how many years apart – to stage those same plays, reciting the exact same relational script. Clinical experience suggests that the therapist acts as a stage director, guiding the action of the different actors, shaping and giving expression to a choreographic dimension.

The solution to the old trauma, or imprinting, is somewhat unexpected and, in some ways, contrary to common sense. Rather than trying to erase it, deny it, cover it with pleasurable experiences or merely accept it, instead of all these it’s made to evolve further.

Imagine that childhood trauma is a seed. The moment we allow this seed to germinate and grow, once it becomes a plant, it will no longer exist as such– even if we do not try to eliminate it. Its nature will be forever changed.

We can therefore think of childhood trauma as something to eliminate – which will leave us with the impossible task of destroying the unpleasant emotional energies that characterize traumas as such – or as something to evolve – as is the case of the seed.

Similar to what happens in a family where communication problems are the basis of a shared malaise, we can not eliminate someone who comes into conflict with someone else. We must think of a solution which takes the needs of everyone into consideration.

In this case, it becomes evident that there is a need to evolve communication between all members in a positive and productive way for everyone, without exception. In a similar way, the conflict between the characters of the inner theater of the patient can easily be reassembled, restoring a form of communication between them.

The establishment of a different way of communicating is therefore the starting point of a profound change. The therapist, in his capacity as director, then allows each character to enter the scene, to be recognized and expressed. Here the seed is allowed to germinate and grow, thus favoring its natural tendency that will lead to a profound and stable transformation.

Thus, this kind of inner family will once again be united and the symptomatic behavior, the inappropriate reaction, or whatever was the source of suffering – which gave the signal of the need to change something – will be no longer needed and can therefore begin to melt like snow in the sun.

The goal is that DNT provides for the harmonization of the psychic world, integration of the Deep Nuclei.