Overview of Therapy

An initial agreement I make with clients is that therapy is a search for what is true for the client, and we will speak the truth to one another even if that truth is not pleasant or agreeable.  Building trust is particularly important, so I invite full disclosure when and only when the client chooses that freely.

Often clients have mixed feelings about doing therapy.  Some issues produce enough suffering to motivate change, but protective functions may operate to divert attention away from sensitive or wounded parts of self.  Therapy brings more conscious awareness, so can produce unconscious resistance.  To succeed in therapy, it is useful to appreciate protective parts and join the protector’s goal of security, while renegotiating the tactics used to stay safe.  We find new tactics that do not have unintended negative consequences, and that allow increased awareness of vulnerable or painful experiences.

Process-oriented Therapy
My usual approach to therapy is a process one, which means that we look for what is true following your conscious and unconscious signals.  We develop awareness on multiple channels – thinking, feeling, intuiting and noticing the five senses within the body.  Sometimes therapy involves providing information to you – facts, research results, theories explaining behaviors, etc.  Other times we will try small experiments to increase comprehension of patterns that unconsciously affect a person.  There is no right or wrong outcome to these experiments, only new information.

Inherent in a process approach is the belief that healing and insight belong to the client, and that the resources and knowledge already exist within each of us to heal.  This healer within is not necessarily conscious to you.  A benefit of process therapy, with its focus on what emerges from you, is that there is less imposition of the therapist’s beliefs.  It is one of the most respectful forms of therapy, while still being active, effective and powerful.

Inner Resources
Whether you are dealing with trauma, depression, or some other condition, I have found that developing internal resources and allies is important to being able to face what’s stored inside and to find healing.

The most consistently helpful ally I have found in working with clients is what psychiatrist Arthur Deikman calls “The Observing Self.”  Some of the properties of the observing or witnessing self are that this part of you notices everything, down to the smallest detail, with no judgment or blame.  It is a compassionate witness to whatever happens.  This part of you is OK with whatever happens – it just notices.  This is the primary distinction between this part of you, and your critic.  The critic also notices, but filters that noticing through a screen of condemnation or blame.

Learning to deal well with anxiety is useful to all of us, and critical to some clients who have phobias, agoraphobia (fear of going out in public), obsessive-compulsive thinking, or anxiety and panic attacks.  There is a section of my www.connectingself.com website showing a variety of ways to lessen anxiety.

If you are dealing with depression, one of the causal factors may involve a repetitive pattern of imagining that there is something fundamentally broken inside.  Instead of attending to the present moment, you often look to the future and think that things will turn out badly.  When this pattern is repeated often enough, it leads to giving up.  When you stop trying, you fail.  Often this failure is pointed to as further evidence that something is wrong with you.  The psychologist Martin Seligman called this pattern “learned helplessness.”

A frequent companion to this self-fulfilling prophecy of failing is a pattern of emotional avoidance.  Often in relationships, you are so hurt by someone you love that you develop an unconscious reluctance to open your heart to anyone else.  This can start early in childhood, for example by being hurt or disappointed by your mother or father, and the avoidance pattern is established without you being aware of it.  Not being able to tolerate your emotional pain leads to numbing, and this flatness of the emotional colors in life contributes to depression.

Many clients are dealing with some kind of trauma experienced earlier in life.  This doesn’t have to involve major events.  It could be something like a sibling having a condition that required extra attention, so you weren’t given much.  Some clients were brought up by emotionally distant parents, or there could have been overt abuse or loss of loved ones.  If you have large memory gaps for parts of your childhood, or find yourself spacing out at times you wouldn’t choose to do so, or find some time periods painful to think about to the point of normally avoiding thinking about that period, you may have unresolved trauma that can be brought into consciousness and healed.

One of the reasons the Observing Self is important is that it is a primary component of healing.  To give you an example from my own life, when I was 3 years old I fell out of an automobile traveling 60 miles per hour on the highway.  I was told growing up that I had fallen out of the car, that it resulted in 10 stitches in my scalp, and that otherwise I was OK.  I accepted that, although later I suspected that this accident had strongly affected me in ways I couldn’t see clearly.  As an adult, when I tried to remember the accident, one of two things happened.  As I tried to remember what I felt, often I got this sense of pain and terror, but I couldn’t fully feel it.  It was like trying to put my hand on a hot stove burner – when I got too close it hurt so much my hand would veer away.  Sometimes I could fully feel the pain, but then I became the 3 year old and I was lost in the fear.

The Observing Self, with its ability to be OK with everything, allows the adult to bear the pain and fear, and to re-experience (and reconnect) with the younger self, without becoming overwhelmed and drawn completely into that young self’s intense pain.  The adult can bring the coping skills learned over their life to the young self.  Instead of that young self being abandoned and frozen in an overwhelmed emotional state, which can be triggered and unconsciously take over the adult’s functioning, the adult and child parts integrate.

Internal Family Systems Therapy (IFS)
Psychologist Richard Schwartz developed a way of working with the different internal parts of a person utilizing techniques learned from working with families and their conflicts.  Basic IFS premises include the belief that we have a part called the Self that contains qualities like curiosity, calmness, clarity, courage, connectedness, compassion, confidence and creativity.  Our access to Self gets covered up by parts that struggle, particularly our managing and protecting parts.  We identify unconsciously with conflicted parts, and lose clear awareness of Self and our trust in Self-leadership.

Often as children, we have sensitive vulnerable parts that get overwhelmed with intense feelings (like grief, sadness or anger) and we split away from awareness of them.  In order to function, manager and protective parts step in to push the vulnerable parts out of consciousness.  The vulnerable feelings or parts become exiled.  When they attempt to come back into conscious awareness, the manager parts call in firefighters like alcohol, drugs or excessive television watching to divert our attention away from the exiled vulnerable parts.

Schwartz developed techniques to negotiate with protectors and managers to get them to temporarily step aside, uncovering your Self awareness.  Self can then work with the vulnerable exiled parts to bring understanding and healing, which then calms the whole polarized system of manager/protectors and wounded exiles.

EMDR stands for Eye Movement Desensitization Reprocessing, and is a powerful technique that has been researched in over 20 different studies that have found it to be an effective treatment for processing trauma.  Currently it is used to address a variety of conditions, including mild to severe trauma, dissociative disorders, anxiety and phobias, complicated grief and panic attacks.  It has an integrative effect on memory networks that have previously not been linked, and breaks links that do not belong together.  For instance, trauma that happened in childhood is often stored in a way that can be retriggered by a perceptual cue, like a certain shape or smell.  There can be a false negative association between that perceptual cue and pain, and a disconnection between the childhood memory network and the adult memory network that knows that despite the early trauma, the person survived.

Stimulating quickly and repeatedly the right brain and left brain has the effect of breaking associations that do not belong together, like between the perceptual cue and pain, and making connections between networks, so that the child for instance, may realize that he or she indeed did survive.  Another way to understand this is that traumatic memory is unprocessed, and stored in a way that our natural processing ability cannot access.  EMDR hooks up disconnected memories with our processing capability, which assigns meaning and puts the memories into a linear sequence.  When this happens, the trauma is no longer stored in a way that can easily trigger flashbacks or distress.

Rather than just talking about something that was disturbing, EMDR is one of the techniques I use that reaches more deeply into the body and unlocks unconscious frozen patterns.  EMDR is not appropriate for every person and situation, and usually won’t be used in the first few sessions.  The initial EMDR session is normally a double session, to allow plenty of time to process and integrate the session.  Depending on the client’s processing speed, additional EMDR sessions may be done in the normal single session time.

Sensorimotor Therapy
Sensorimotor therapy draws from the latest neurophysiology research to deal with how people organize to respond to difficulties faced as fundamental character structures were formed in the face of loss, fear or parents who were less than optimally attuned to their children.  Trauma, neglect or frightening or frightened parenting can interfere with how we related with our mother or primary caregivers, and these can continue to color how we deal with ourselves and others as adults.

This therapy pays close attention to body postures, movements and instinctive fight or flight responses and helps people develop the ability to recognize when they become emotionally or neurologically dis-regulated and what to do to come back into a balanced calm center from which we can optimally function.  Mindfulness, which is present moment attention that is accepting of what is and curious about the details of how we respond is used to both deepen understanding and to contact formerly unconscious processes and internal parts.

Attention is also paid to fundamental character strategies that develop to cope with how we were raised, in order to expand our choices as to how we respond.  These strategies are contacted, affirmed, understood and expanded upon to broaden the tools we use in any given situation.

Existential Therapy
I draw upon a number of techniques when doing therapy.  I think what happens in the therapy office – the present-moment experience, with its thoughts and emotions, what’s said and not said – is a rich source of healing.  It has the benefit of us being able to stop and look step-by-step at what is happening or has just happened.  It’s a life laboratory, where you can experiment with trying different approaches, receive mirroring and feedback, and then take those insights or skills out into your other relationships.

When I pay attention to what is being said and what I feel inside, I receive valuable information about what patterns and processes are operational in your life.  Experiencing someone (me) who pays close attention to who you are and what you say and do, with love and caring, and having someone believe in you fully, is healing in and of itself.

Cognitive/Behavioral and Other Therapies
I also work with you to examine beliefs and thought structures, to see whether these are true or not, to look at what life would be like if you believed the opposite – this is a cognitive/behavioral approach.  We look at what is going on inside your body – both sensations and emotions – and use this to track and uncover what is significant in your life.  I rely on five years of intensive training in facilitating psychodrama to help identify missing experiences from childhood (of being loved, fully accepted, encouraged to express yourself, etc.) to help you regress to times where you might be emotionally stuck, and to provide a different patterning.  I use a variety of energetic techniques including tapping on acupressure points to communicate to more primitive brain structures than the cerebral cortex to address states and issues that are not typically dealt with in talk-only therapy.

Couples Counseling
Couples therapy draws on most of the same techniques as individual therapy, but there is a different emphasis.  It is the therapist’s job to provide the couple communications skills training, insight into the unconscious patterns each operates under, the creation of a venue safe enough that anything can be discussed, and emotional support so that the couple can decide what is best for each of them.

One of the most difficult things to learn if you come for couples counseling is to move your focus from the things your partner should change to being willing to learn what you do to contribute to the problems between the two of you.  It is easier to see what’s wrong with your partner and where they are unconscious.  For couples counseling to be effective, each partner must be willing to work on her or his own issues.

It is crucial to discover if both people really want to understand each other – to learn what the other is thinking, feeling and wanting.  Reflective listening, where you practice saying back to your partner what you heard, until your partner says you’ve gotten it, is a powerful way to accomplish this.  When both know their partner cares enough to actually listen and understand, then it is possible to negotiate and arrive at mutual agreement.

Communication skills’ training covers a number of levels.  Many arguments are conducted on a logical level while ignoring the emotional communication which contains the actual conflict.  It is useful to learn how to detect when two people are interpreting the same sensory data in different ways, and what to do to at least understand each other’s interpretations.  Arguments occur often because the “movie” you watch is a different one than the one your partner is watching.  This is important, because people react emotionally based on what is interpreted.  Finding a way to arrive at the same interpretation (or at least understand that your partner’s interpretation is different than yours) often defuses conflicts based on misunderstandings.

It is also important to discuss openly what each person wants in any particular communication.  Talking about this in terms of preferences instead of demands, and letting the other person know what action you are willing to take promotes negotiation.

What starts as couples counseling often leads to recognizing the need for one or both to do individual therapy.  Some individual work can be done in couples counseling sessions, focusing on one partner for part of the time, and then on the other partner.  If the unconscious behavior is deep-seated, one or both partners would benefit by doing individual work with another therapist.

Informed Consent
You should know that therapies like cognitive/behavioral and EMDR have been well-researched, and the benefits are supported by scientific experimentation.  Some of the other approaches to therapy which I describe (and use) may be viewed as higher risk or without proven benefit.  If you choose to work with me, it is important that you understand both the risks and potential benefits, and consent to being treated by both evidence-based and non-evidence-based therapies.

I would not work with techniques that I did not think were safe and effective.  I have found that therapies that include a strong focus on a client’s self-awareness of what is happening inside the body are often more effective than talk-only therapies.  I continue to learn from others, so over time the way I do therapy has changed significantly – I expect it to continue to do so.  Each of our personalities is different, and so the way I work is not appropriate for everyone.  It is important to keep that in mind, to pay attention to whether you respond to these methods or not, and to choose your therapist accordingly.

Frequently, you will know within a session or two whether we are a good fit to work together.  Sometimes it takes a few months for that to become clear.  Please know that if at any time you choose to find another therapist, I will assist you if you want referrals, and will not take it personally that something did not click between us.  I will also let you know if we find issues or patterns that I think I cannot work with effectively, and hope you know that this also is not a personal rejection or abandonment.

Doing therapy is a sensitive, vulnerable and exciting journey.  As we work together, we will meet deeply.  The relationship that develops will matter very much to me and the feedback I receive from clients is that this will likely be true for you as well.  Some clients have never been able to trust anyone, and relationship is not their goal.  With these clients, I respect that, and work with them on self-mastery.  I invite relationship without demanding it.

It is deeply healing to have a place to go where everything you say and feel is most welcome, and caring without judging or blaming is available if you choose to receive it.  Doing therapy in a process way uncovers things that continue to be a surprise.  From that deep learning, change is possible, without having to be forced.

My hope is that these words have given you a better sense of what it would be like to work together and the encouragement to pursue therapy.