Dr Lafrance mixes up emotion focussed therapy with a ‘theoretically informed’ treatment room style – that involves interacting with the patient

“There’s been an evolution in psychedelic therapy, says Dr Lafrance, "I’m presenting all this next year, so you’re getting a sneak preview.” 

Contemporary psychedelic medicine began with ‘experience’ sessions were ‘non-directed’, that is, given as little intervention as possible. (Psycholitic is the name given to experiences where talk therapy takes place). Soon they became ‘inner directed’ encouraging the voyager to get in touch with their ol’ inner healer.

But now, “We’re moving towards a theoretically informed way of being in the treatment room,” Dr Lafrance reports, “especially when the inner healing intelligence is most active.”

If like me you’re wondering what ‘theoretically informed’ means, well, from my Googling I figure it’s an academic term for ‘rooted in reality’ and usually involves some form of research and sense-checking from folks actually doing the thing in question.

For instance: one paper I found, which researched ways to encourage intravenous drug users to be tested for hepatitis C, insisted it employed ‘evidence based and theoretically informed techniques’ gleaned from social workers.

Dr Lafrance later describes herself as “a theory-based person” and I for one will happily accept her theories when it comes to ‘ways of being in the treatment room’, because she’s been a top-flight clinical psychologist for decades. 

“They indulge in maladaptive coping behaviours and problematic relationships to cope… or risk more serious mind fractures” 

The bubbly brainbox is also a renowned expert on Emotion Focussed Therapy (EFT); she’s the author of Emotion Focused Family Therapy: A Transdiagnostic Caregiver Focused Guide, published by the redoubtable American Psychological Association. 

According to The International Centre for Excellence in Emotionally Focused Therapy (ICEEFT) website, EFT is closely related to John Bowlby’s Attachment Theory of Human Relationships. ‘Attachment views human beings as innately relational, social and wired for intimate bonding with others,’ it reads, ‘The EFT model prioritises emotion and emotional regulation as the key organising agents in individual experience and key relationship interactions.’

Dr Lafrance says EFT focusses on emotion regulation and processing: “If they have low skills regulating emotions and stressors, and their resources are insufficient, they have to indulge in maladaptive coping behaviours and problematic relationships in order to cope – or they risk more serious mind fractures.” 

In the EFT model, seemingly destructive patterns like addiction fend off worse outcomes like suicide.

“You get this activated self rising like a phoenix. And it’s freaking awesome”

Addicition’s an example of a coping mechanism that’s arisen to swamp the torturous emotional quagmire within.

“Cross-diagnostically patients have problems with identifying and processing emotions,” says Dr Lafrance, “the symptoms are thought to be emotion regulation strategies. But if we can offer them support, including in strengthening their emotion regulation and processing skills, they receive co-regulation that in turn leads to self-regulation. Then they don’t need the coping patterns. It’s tackling the problem from the inside out.”

“The key term,” says Dr Lafrance, “is self-efficacy,” meaning the power to deal with things yourself. “If you feel it with emotion processing,” she claims, “it’s incredible armour for the challenges of life: both the skills, and the support it provides.”

Our emotional landscapes, though, can be foggy territory. Dr Lafrance has even felt the compulsion to hold free public workshops helping the great unwashed map out their own internal geography. Many of us are simply not literate enough to know that behind the emotion of ‘sadness’ there’s a need for ‘comfort’ from another – the common reaction is to withdraw for time alone instead. 

“Which emotional states do they find most challenging to identify, label, meet and need?” advises Dr Lafrance, “Stick with the sense of helplessness and that turns into ‘it’s not fair!’ And then there’s a healthy rising up of assertiveness. Latch on to something, work with it in specifics ways that help it along, and you get this activated self rising like a phoenix. And it’s freaking awesome,” she says.

As a people we’re so emotionally retarded that Dr Lafrance has found it’s sometimes best to simplify troubled emotions down into two categories.

“In the past when I would’ve said ‘Feel into that space with me’ now I’d just say, let’s not go there if you’re not sure”

‘Anger, resentment and disappointment’ indicate a client who shies away from vulnerability. ‘Anxiety, sadness and despair’ point to low assertiveness.

But “hate and resentment can feel like a comfy blankety” advises Dr Lafrance: “Some people subconsciously live their lives by the mantra ‘I’d rather die than feel’,” she says.

This is where “accessing and understanding the genus of their difficulties” comes in. “One patient told me that their medicine sessions were the first time they’d sat in fear and sadness with memories they were trying to hide from,” she explains, adding that psychedelics can quieten a harsh inner critic that usually directs repressed feelings towards their holder, away from the recognition of painful events. 

But, “EFT is less about the memories than it is about processing,” says Dr Lafrance, “they’re regulating, avoiding or suppressing affective material. Understanding the pattern can diffuse shame and assist in moving through the emotion.”

To quote humanist psychologist Carl Rogers: ‘Once an experience is fully in awareness, fully accepted, then it can be coped with effectively, like any other clear reality.’