Blog Posts

  • Changing beliefs through experience

    I have always found great value in cognitive approaches to therapy. The role our thinking has on the quality of our lives is enormous. I really appreciate the work of the many masters who helped move the focus of therapy from past psycho-sexual struggles to a more effective focus on how a clients’  thoughts and beliefs can determine their happiness in life.

    As much as I respect the many variations of cognitive therapy, I have often found that it can sometimes be very challenging to really shift a person’s belief only through the use of left-brained logic. I agree that by teaching clients (and maybe even arguing with them) about how they think, we can give them rational information about how to change their perspectives.  Yet many times clients know that they have a choice of what to believe and the role of their thinking on their quality of life, but still feel stuck in limiting beliefs about themselves and the world around them.

    To remedy this type of situation I have often found that an easier way to change a person’s belief is to direct them to have an experience in which they are forced to view their situation and themselves differently.  Rather than to struggle with getting clients to constantly question their thinking about a particular situation, I find giving clients an “out of the ordinary” experience can have real generative healing on clients’ beliefs.

    comfort-zone

    An example of this process involved a client I had a couple of years ago who was going through many life stressors. She had every right to feel bad about all the different changes she reluctantly had to endure. The problem for the therapy process was she was in a stuck mindset in which she believed that she was dealing with something that she could never overcome. She felt victimized with no hope of change. No matter what we talked about in the session the topic always returned to her “poor me” attitude. After several sessions of feeling frustrated in getting her to change how she thought about her situation, I finally decided to give her an experience to help her. I told her that it was important for her to spend one week doing something nice for other people. I told her it would help lift the depression she was feeling just a little. I directed her to go to the local children’s hospital and offer to help for just one week. She agreed to do the task for me and went to a short volunteer training in order to begin her week of service.

    After two weeks I saw her again and she was a changed person. She did not wallow in her poor me attitude at all. I asked her why she seemed so different and she told me that just by seeing what those poor children and their parents were going through made her realize that she was not as bad off as she thought. She described her brief interactions with children who had lost all their hair due to chemotherapy, children who were in constant pain and agonizing parents who were scared their children could die soon.   After a week of experiencing those situations she changed the way she thought about her own life and vowed to not take things so seriously from that point on. She began to quickly improve in session and become more interested in taking charge of her life.

    Another example of changing a person’s belief through directed experience was that of a woman seeking help for her abandonment issues. She clung to any man that would have her because she feared that she could not make it on her own. Her most irrational belief was that she could not survive if someone else was not there to take care of her. She knew this was illogical and irrational yet it persisted despite her constant thought stopping exercises and journal writing excursions.

    She had mentioned to me that she enjoyed the great outdoors and loved to go camping with her friends. I told her how dangerous it was to go camping if she did not have adequate survival skills. I let her know that at any time she might get lost and not have anyone to help her. I recommended she take an intense, accelerated outdoor survival course which would fully prepare her to be safe in case she became separated from her friends. She agreed that taking a course would be a good idea and signed up for one that was several days in length and really required all participants to perform the survival skills in real time to make sure they could do them under pressure. When she returned to therapy a month later she had somehow relaxed a little in her fears of being alone. When asked what accounted for this difference in her, she related how knowing without a shadow of a doubt that she could survive in a harsh environment on her own made her more aware of how she had limited herself in her life due to fear. She began over time to think less of herself as helpless and more about how she could design her life on her own.

    I am not advocating doing away with a cognitive style of therapy. I am merely stating that we can change the beliefs of our clients in more ways than educational sessions which take place in the confines of our offices. A combination of in office education and out of office unique experience may assist both the right and left brain in working together to change our clients’ beliefs for the better and faster.

     

  • Worst and Best

    When we are worried about taking a new path in our lives we often can only focus on the things that could go wrong. We ruminate on what the worst thing that could happen, sometimes to the point that we become paralyzed from moving forward by fear. This fear usually keeps us from fully committing to doing something different in our lives.  In order to transcend this fear it is important that we face it and fully allow ourselves to feel it. Once we have done that we need to allow ourselves to fully feel the opposite emotion. So often we don’t give ourselves permission to focus on the best that can happen.

    This past week I was working with a client who was terrified of making a wrong decision about changing her career.  She had a stable job that provided for her family but she wanted something more in her life. The lure of going into a totally different career was intriguing to her but she was also consumed with fear. In her mind, changing jobs might not work out and pursuing something new could put her family in economic hardship. She was a single parent who prided herself on taking care of her two children. Leaving a job that was certain was not a good thing to her as she needed stability to provide for her kids. At the same time her soul was tired of doing meaningless work. Her present job paid the bills but did nothing to inspire her. She had recently been offered an opportunity to begin working with a new company which, if it continued to grow, would be a springboard for a much higher wage and more responsibility. The problem is the beginning wage was a little bit lower than what she was presently earning. The wage was enough to get by on but she wanted security for herself and her children. To her the choice was security or living her dream. She was stuck about what to do.

     

    best-worst

     

    I asked her to write down everything she thought could go wrong, a worst case scenario list, if she took the new job. She quickly compiled a list of all the terrible events which could happen if she embarked on her dream. She listed things like homelessness, poverty, illness, etc.  When she could not think of anything else, I asked her to look at her list and allow which ever emotions emerged to be felt. She looked over the list and her eyes moistened a little. I asked her to not hold back and really allow herself to feel those emotions in her body.  She did as requested and told me she was experiencing a feeling of despair. I asked her to tell me any thoughts that came along with her emotions. She told me she had a thought of not being good enough and the thought she could never do what she wanted. I thanked her for being courageous enough to allow herself to feel those emotions. I then told her she could relax and let those thoughts and feelings drift away.

    Once she centered herself I asked her to write me another list. I wanted a list of the best case scenario. I wanted her to write me all the amazing things that could happen if she took the new job. I told her to not hold back, let go and write as much as she could daring to see all types of wonderful possibilities. She found this exercise a little harder because all she had been doing is looking at the worst that could happen. She finally finished her list with a huge smile on her face. I asked her to look at her new list and let me know any emotions or thoughts that come up. She sat quietly for a little while. She then told me she had a warm feeling of being on purpose> She said her main thought was that she could do great things if given a chance. I thanked her and told her she could relax and let those thoughts and feelings drift away.

    I then asked her to look at both lists at the same time. I wanted her to look at those lists and feel both sets of emotions simultaneously. She did and suddenly she seemed to relax even more. After a minute or so, she told me she felt she should take the new job opportunity. When I asked her why she had decided this, she replied that even though the worst case scenario was still a little frightening to her, by looking at the best case scenario it showed her she was capable of so much more than she had previously believed. By allowing herself to fully see, think and feel both the best and the worst she now seemed to feel more balanced and could make a more informed decision about her future.

    How often do we mostly focus on our worst case scenarios? If we do this we lose the magic of creating a new possibility in our lives. At the same time how often do we mostly focus on our best case scenario? If we only pay attention to this aspect we may lose the ability to be rational in our decision making as our head is too far in the clouds. It is only when we accept both parts that we can have a balanced view. It is by allowing ourselves to acknowledge both sides that we can see clearly.  I recently used an exercise similar to what I gave my client on a particular decision that had been plaguing me. I was a little anxious about how a certain situation would be resolved. When I allowed for all possibilities to be examined and I found that I too was more balanced in my outlook and could move forward with the anxiety.

    Try it. If you are already worried about the worst that could happen then examining the absolute best that could happen won’t hurt you.

  • Back to the future

    Many years ago much of the focus of therapy was on the past history of clients. The therapist would thoroughly investigate what had happened to clients during crucial developmental periods of their lives and then have repeated in depth discussions on how clients felt about what had occurred to them. It was proposed that if the history of a client was worked through in this manner he or she would be better equipped to deal with the day to day challenges of the present. Therapists believed it was difficult for clients to have productive, happy lives if they were weighed down by what Fritz Perls called “unfinished business”.

    I am hoping one of the next trends in psychotherapy will be working with clients with more of a focus toward the future instead of the past. It is the future that is the only place in which change can occur. The past is over and can not be changed. It is by examining what could happen in the future where a person really can create a new life. I believe in the importance of clients having what Bill O’Hanlon calls a “future pull”, a purpose or task that motivates and energizes them to begin the process of change and growth.

    To the future

    If a therapist is only focused on the client’s past he or she may be missing an important part of the change process. If a client does not recognize all the possibilities that could happen in the future, then it is no wonder he or she feels stuck and unable to get past their “past”. Too often many therapists focus their attention (and indirectly their client’s attention) on what was not working in the past.  Repeated in depth explorations of the client’s past do little to “pull” the client into a more resourceful state of relating to his or her issue. When the client has some form of motivation or inspiration to focus on in the future, it aids in speeding up the healing process as the client can now move beyond a stuck present/past.

    I believe that no matter what style of therapy one does, having a “future pull” is something that can be adopted into most any session. I think it is important to honor clients’ past but at the same time we must also assist them to finding the inner resources they need to guide them toward a positive future of their own creation.

  • If it happens, it happens….

    I remember talking with a group of students who were training to be future counselors. The topic of using humor came up and I whole heartedly endorsed using it in therapy sessions. I explained that one of my main therapy heroes was Groucho Marx. I watched the Marx brothers constantly when I was growing up. I found Groucho’s way of responding to the absurdity of the world around him to  be a cornerstone of how I interact with the people today. One of these students began to scribble down notes in her notebook and then said to me, “How do you use humor in therapy?. I told her that it just happens when it is supposed to happen. “Yes, but how will I know when to be funny?”  I told her she would be funny when it was time to be funny. She persisted in trying to pin me down about when to be funny.

    Groucho!

    The Great Humor Therapist Groucho Marx

    She then asked me if she was to be funny at the beginning or the end of the session or when the client says something funny first. I kept telling her she will know when to be funny when the moment presents itself. Finally, she sighed and said, “I guess I won’t be funny then because I have never been funny.” I told her not to feel bad if she was not great at using humor. It is better to be authentic in one’s responses and actions rather than forcing some unnatural behavior or technique onto the client that may not even be needed.

    Too often we as therapists try too hard to make a certain technique or style work when it clearly is not natural. If we are to operate in a spontaneous way in our therapy sessions we cannot get bogged down by trying to make something happen. “It” either happens or it doesn’t. You are either funny or you’re not. By the time we finally get our favorite technique out to use,  the moment of being present with our client has passed us by.  If it is time to be funny, then be funny. If it is time to challenge, then challenge. If it is time to listen, then listen. No magic formulas , just alive spontaneous interactions.

  • Therapy Zen

    I believe being a good therapist involves the ability to get to that Zen quality of “no thought”. If one has to think long and hard about what he or she is going to do or say in an alive therapy session, then the heart centered aspect of the moment has been passed over in favor of left brained technical exercises. In the beginning of our education as therapists, we all flounder at times and we need to learn how to perform certain skills, however, once we have internalized our lessons we are then free to let any intervention come from our creative self. This involves having the courage to become open to the part of our self that knows just the right thing to say or do to assist in helping our clients change even when that thing initially appears to be slightly illogical or irrational.

    Zen-circle-symbol

    Last week I was working with a woman who had recently lost her father and she had just learned her mother is in the early stages of terminal cancer. She is doing the best she can in moving past guilt and fear to be present with her mother and siblings as they all experience her mother’s final days. After a little while in our therapeutic conversation I had a question bubble up from my unconscious which initially appeared to have absolutely no bearing on anything we were discussing in the moment.

     
    I asked her what she wanted to be when she was a child. She was surprised by the question but told me she always wanted to be a photographer. She had always dreamed of traveling to different parts of the world where she would photograph people from a variety of cultures. The more she talked about this long ago dream, the more alive and centered she became. The homework assignment I gave her was to take a picture of one thing over the next week so she could get in touch with that part of her where childhood wonder resides. The tone of our therapy session shifted from her feeling hopeless and resistant in dealing with the reality of her mother’s condition to a rekindling of a sense of awe in the world around her. I cannot tell you I learned of this “technique” or “intervention” in any book of therapy skills. It is only by allowing myself to be open to the moment and allowing what comes up to come up.

    I really like how Minuchin and Fishman stated this idea clearly at the end of their book, “Family Therapy Techniques”:

     
    “After this book is read, it should be given away or put in a forgotten corner. The therapist should be a healer: a human being concerned with engaging other human beings, therapeutically, around areas and issues that cause them pain….The goal, in other words, is to transcend technique. Only a person who has mastered technique and then contrived to forget it can become an expert therapist.”

     

    Or from Japanese sword master Yagyu:

    Behind the technique, know that there
    Is the spirit:
    It is dawning now;
    Open the screen,
    And lo, the moonlight is shining in!