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Psychotherapy
I think of Psychotherapy as having several different aspects. These can include:
- Helping my clients understand and organize something that has happened in their lives in order to cope better with its effect. For example, loss, divorce, an accident, or other unsettling event.
- Helping my clients understand and organize themselves to deal more effectively with some current life circumstance. For example, a situation at home, in their social life, or at work that is causing stress.
- Helping my clients understand and organize themselves so as to cope better in general. For example, anxiety, depression, “hyperactivity,” anger control.
- Helping clients who have difficulty coping because of early experiences that have shaped fundamental aspects of their personality. Children who have suffered major trauma, or adults who suffered significant trauma in childhood are examples.
In order to help my clients, there are certain things that I do. These basic dimensions change in relation to each other depending on the levels described above. They are:
- I try to listening without judgment. This basic element of psychotherapy comes from a fundamental belief that virtually everything we do is with an effort to do well. Sometimes, our good intentions are obscured by other aspects of our situation, but I believe that we generally do the best we can do at the given moment in the current context of our lives.
- Based on this belief, my work is to help the client strip away the obscuring and interfering elements, draw on their deepest resources, and bring their fullest self to their lives. This is done through:
- I provide understanding of, and support for, the various feelings that my clients present.
- I help them explore the cause of particular feelings.
- I help them explore the consequences of their past actions or future action decisions.
- I “teach” about important, consistent aspects of being in the world and how to approach typical situations.
- Particularly with children, I provide the opportunity for their non-verbal expression of feelings, understandings, etc., in play or expressive methods such as art, before they are able to be expressed verbally.
- I help my clients to re-focus responsibility from others to one’s self, where appropriate, and/or,
- I help my clients to assign responsibility to others instead of one’s self when that is appropriate.
My method is basically to listen carefully to whatever the client has to say or show, and encourage full exploration of the story being told. Along with this listening stance, I will ask questions to help the process along. Some gentle confrontation is occasionally necessary, but I believe the more effective way to gain trust and cooperation is to patiently explore the client’s presentations, encouraging and supporting them as they tell their story.
As the telling unfolds, I will make comments or ask questions to help the client move into parts of their story that haven’t realized were important, or were difficult to reach. The more full the story is, the more opportunity there is to find and explore the ideas and functions that may be at the root of the problem. While I think the deepest aspect of psychotherapy is to help the client resolve problems and understand issues from within their own inner resources, there are times when a suggestion from me can help relieve an immediate source of difficulty. I make these suggestions in the hope that they can be useful in the present, and also, as we continue the work, lead to the client’s strengthened ability to draw on their own resources.
I am using the idea of communication is used in a special sense here. Obviously, it means being able to listen, speak clearly, “get” the meaning of what’s being said, etc. But I believe that effective communication, when it really works, operates at several levels at once.
First, of course, it helps to accomplish whatever task is being attempted. Examples might be effectively giving instructions for how to do something, directions for how to get somewhere, describing a feeling or an idea accurately.
Second, while the task part is happening, communication inherently involves a mutual exchange of, recognition of, and reaction to feelings about the relationship. For example, “I want you to (do something)”, may be communicated lovingly, authoritatively, demandingly, or with or without any recognition that the receiver is important, loved, respected, feared, etc. These attitudes and their accompanying feeling-states are shown automatically, by voice tone, facial expression, posture, etc., and they are crucial to both the immediate and long-term effects of the communication. We may (or may not) follow an instruction out of love, fear, respect, anger. Further, how we actually go about doing the task will depend on which of those feelings was communicated and what those communications mean to us. Research is now telling us that the doing is very dependent on the feeling. In fact, our brains process the feeling parts first, connect the feelings with the ideas, instructions, etc., then decide on a course of action.
Third, research tells us that effective communication builds neurological pathways that enable it to happen more effectively in the future- and, of course, vice versa. The brain grows in a healthy direction when we are able to communicate effectively. The opposite is also true, but it is important to know that the brain is also forgiving. Virtually no one is on top of the game all the time. We all- parents, teachers, bosses- mess up, and that includes how we communicate as well. Our occasional missteps are natural and will most likely cause no enduring harm. In fact, when we can “repair” the mistake later on, the combination of the mistake and the subsequent correction is a very powerful inducement to healthy social growth. It may be that correcting social-emotional mishaps is the most powerful growth- providing experience of all. Many theorists believe it is one of the fundamental parent-child building blocks of emotional health.
Therefore, I believe that therapy is grounded in effective communication at all levels. This means that I have to be an effective communicator, and I try to help my clients be effective communicators. Sometimes, this means discussing a communication that took place between the client and me, as well as in the clients life. So awareness of and attention to the many levels of communication, and modeling effective communication, recognition of “errors,” and how to correct them are central aspects of the way that I work in therapy.
Therapy needs to have a framework in time. While it is hard to set out a specific time-table, the following may be helpful:
In the beginning phase, the relationship is established and the problem is laid out. In the middle period, the problem-resolution work is done. In the ending phase, the client incorporates the new learning into their own repertoire
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