Dr. Soren Petter –

Working with states of hyper arousal in GAD, OCD, ADHD and Trauma: Positioning a transdiagnostic salutogenic model


This presentation seeks to explore a conceptualisation and treatment approach for the systemic impact of compulsive and impulsive flight into hyper vigilance from a symptom network perspective. Often the phenomena of compulsivity/ impulsivity as well as hyper vigilance are conceived as discreet symptomatic variables indicative of a specific pathology, such as GAD, OCD, Health Anxiety, ADHD, further BPD amongst others. This has been reinforced by assessment tools such as GAD7 / PHQ9 or BDI / BAI, which assess affective states in a de-contextualized pathologising manner. However, this presentation seeks to demonstrate how ReAttach allows for conceptualising states of ‘neurological’ hyper arousal in a way whereby they can again be distinguished into clusters of fear, rage or mania, and how all of these have both a pathological as well as potential salutogentic role in the function of affect and information processing.
Thereby, specific focus is placed on utilising the ReAttach Protocol to de-alarm (mentallize) phobic / overwhelming affect states of hyper arousal (‘obsessive objects’), utilising CBM1 (Cognitive Bias Modification stage 1) to differentiate affects in pathological-destructive (dysfunctional / maladaptive) and salotugenic-intuitive (functional) aspects, and finally utilising CBM2 to introduce learning and broadening out commitment and value-based utilisation of affects and threat-based hyper arousal. The presentation will conclude by utilising a network or transdiagnostic model to demonstrate the interrelatedness and symptomatic overlap of GAD, OCD, ADHD in a generic trauma model that can be approached from a salutogentic multi-sensory vantage point.

Keywords: affect phobia, affect re-integration, affect differentiation, transdiagnostic


Dr Soren Petter is a Consultant Psychologist and Psychotherapist with 20 years of clinical experience in psychiatric inpatient and outpatient settings, as well as corporate stress-management and prevention consultant, he manages a psychological consultancy in central London. He is a former faculty member at Regents University London, now a visiting lecturer at the University of Surrey and City University London, as well as a research supervisor for organisational salutogenisis at the University of Gloucestershire


  • Petter, S. (2011). Multimodal Interventions for Pre- and Co-morbid Shame. Lambert Academic Publishing
  • Evans, R. E., Petter, S. (2012). Identifying mitigating and challenging beliefs in dealing with threatening patients: An analysis of experiences of clinicians working in a psychiatric intensive care unit. Journal of Psychiatric Intensive Care Vol 8 (2)
  • Petter, S. (2014). Between Freedom and Belonging: Coaching on Covert Clinical Motivators. A presentation given at ‘The British Psychological Society’s 4th International Coaching Congress’, December 2014 London

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    I would like to present in an effort to progress transdiagnostic salotugenic ways of working