Blog Posts

  • Playing with Patterns

    Patterns

    Many times our clients will exhibit patterns of behavior that are less than resourceful. It is not uncommon for therapists to attempt to make clients aware of their patterns as a way to extinguish the activation of the harmful pattern. Other times therapists will attempt to have clients gain insight into “why” they have the patterns they do. These approaches can be useful for client history but as a method of change I have found them to be hit and miss.

    One of the reasons clients will continue performing the same dysfunctional patterns of interacting with the world is due to a lack of behavioral flexibility on their part. The more flexible  clients can become in their behavior, the easier it will be for them to change their negative patterns. In order to create a shift in clients’ rigid patterns, we as therapists need to create interventions that will give clients more flexible responses to their problems they bring to therapy.  Just the act of by giving clients an extra degree of flexibility could cause some portion of their symptom to be changed.

    I have found that changing the way in which clients perform their problems is often one of the simplest methods to create change.  Sometimes it does not have to be a huge shift in a pattern to have a dramatic effect. The late Milton Erickson would often direct his clients to perform small changes in how they performed their problem which would then snowball into greater shifts in his clients’ lives.

    By altering how our clients’ perform their problems we can change the context in which the problem occurs. Instead of forcing a huge new action for the client to perform, by adjusting even just one little aspect of the performance of the problem can often create the possibility for change in other areas of the problem. Many times even the smallest disruption of a pattern can have far reaching consequences for how and if clients continue to perform their problems in the future.

    Not only can this approach be effective it also by passes the need for therapist to rely on insight or interpretation in assisting people to change.

    A recent example of this happened when I was working with a couple who fought most every evening after dinner. They were nice people who just could not seem to stop themselves from engaging in the incredible intensity of their loud, screaming arguments. After talking with them for a while I learned that both of them really worried that the neighbors would hear their arguments and think badly of them. It was very important to each of them to have a good reputation in their community. When I learned of this I directed them to agree to cease arguing inside the home after dinner. They could continue arguing only outside their home in full view of their neighbors. They reluctantly agreed to change the location of their arguments. At their next session two weeks later they disclosed that they had argued less and even when they did not go outside to argue the intensity of the arguments had considerably decreased.

    By adjusting one part of the pattern (where they argued and also playing on their fear of losing social standing), this couple learned they had all the resources they needed to change how they related to each other. No need for me to dig deep into anyone’s relationships with their parents to identify where someone was breastfed harshly during their Oral stage in order for change to occur.

    I end this short post with a great Erickson story about playing with a pattern:

    Erickson worked with a man who had a fear of traveling past the city limits of his home. If he did go past the city limits he would become ill and lose consciousness. Erickson had the man drive to the edge of the city at a very early hour. He was then to stop his car when he reached the city limits. The man was directed to lie down in a ditch near the road until his nausea ceased. Then he was directed to drive only to the next telephone pole and repeat his action of lying in the ditch. Erickson told the man to continue this pattern at every telephone pole he came to on his drive. The man did do the task but eventually got tired of the silliness of it that he decided to just continue driving without stopping. As a result he was able to drive where he wanted.

    It’s rather magical, isn’t it.

  • New Book

    I have not posted anything recently as I am hard at work on several projects. One of these projects is an upcoming book I am writing on the techniques of Ericksonian Therapy for counselors who are interested in learning how to move toward a focus on client potential rather than a focus on pathology. I agreed to submit the work to the publisher within the next 7 months. I am hoping to be done early. I am excited to get this information out.

    Stay tuned and wish me luck! 🙂

     

  • Using Rituals in Psychotherapy Part 2

    rituals--

    I have received a lot of nice compliments on a previous post I wrote on Using Rituals in Psychotherapy but the most common question I have been asked about the post is, “how do you create a ritual?”.  In this post I will give you a quick idea of how I come up with rituals for my clients (when appropriate). Please feel free to share some of your ideas and concepts on this topic as you may have some great ideas of which I had not previously thought.

    My goal for using rituals in psychotherapy is for the clients to have an experience that supplies them with a resource needed to create a change in their situation. The reason clients comes to therapy is they believe there is a problem that is unsolvable, which to me means clients feel they do not have the necessary resources to effectively cope and transcend a situation labeled by them as a “problem”. If by performing a specific set of actions clients are given the needed resources (or reminded of the resources they already possess), they can begin to solve their own problems which helps increase their sense of control and self-efficacy in their lives.    

    Often I construct rituals based on what I pick up from the unconscious metaphors and analogies my clients use. The words a person uses tells us a tremendous amount about how they view the world. By paying attention to similar patterns in a client’s speech we can gain an enormous amount of information on what resources a client needs to access.   

    For example, an older man came to therapy who complained of feeling depressed. He had lost his wife a year previously and he had moved into a new neighborhood where he did not quite feel at home yet. In the discussion he says the following: “You know, I just feel like a fish out of water here. I don’t know if I fit in. It is has been a struggle to get moved in and in getting to know the other people in the neighborhood. I am afraid that I am a little different from many of the folks here. I don’t want to come into a new community and rock the boat too much. There is a lot to do in getting set up in a new place and it can be overwhelming to me. Sometimes I feel like I am swimming upstream. I don’t feel like I can catch a break these days.” 

    You can easily see a metaphor pattern involving the following:

    Fish out of water

    Rock the boat

    Swimming upstream

    Catch a break

    The ritual given to him was to go to a special store for fishing enthusiasts, buy a rod and reel and begin to practice fishing in his backyard for 15 minutes a day. As silly as it sounds, he reports back that the practice allowed him some quiet time to reflect on emotional things he had been avoiding (including beginning to let go of some of the grief associated with losing his wife). He noticed also had begun to relax more in his new neighborhood and even invited a new friend he had met to go fishing with him.

    Another example of designing a ritual based on metaphors involves a woman seeking counseling for high stress levels associated with her work. She states: “I am just so damn knotted up all the time. I am overwhelmed. I desperately want to be able to relax but this job ties me down to such a tight schedule. I am still hoping to advance with this company but lately I am afraid they are stringing me along and the thought of that makes me even more stressed.”

    Key phrases:

    knotted up

    Ties me down

    Stringing me along

    This client told me exactly what she needs. She needs to be released from the ropes of her stress. Her ritual was based on what she unconsciously told me. She was directed to go to an old thrift store in her town and be on the lookout for an old doll. She was told she would instantly know which doll was the right doll when she saw it. She was to purchase the doll, take it home and clean it up from the dust and grime of the thrift shop. She was then to name the doll a name that she liked. After this she was to get 3 different kinds of yarn and wrap the yarn tightly around the doll from top to bottom. After she tied up the doll she was to put it in a dark closet for 8 hours. When she came back to the doll, she was to then cut off all the tight yarn off the doll and place it at a seat of honor at the dining room table for one night (she lived alone so she did not have to explain this ritual to anyone).

    Again, this was a very ridiculous task but the client returns to the next session and states she has for some strange reason been able to relax and breathe easier as of late. She ended up working on the doll’s dress with material she had left over from another craft project and then gave it to her young niece. She discovered that she enjoyed sewing and found a new hobby to help her stress levels.

     In both of these examples the clients needed to gain certain resources to solve their problem. From the therapist’s perspective they already had exactly what they needed but just needed an experiential process to be reminded they already had all the resources necessary to change. By listening to the underlying messages outside of the client’s awareness, the therapist can create rituals that may seem odd to the conscious mind but give the unconscious just what it needs to heal.

    Have fun with the process. It will make your session become more alive and enhance your ability to listen and communicate at multiple levels.

  • Deconstructing Mr. Wizard

    I have been asked often by my students and some colleagues why did I decide to become a psychotherapist. The answer I used to give them was that I wanted to “help people”. In the past few years I have to come to realize that this was not true at all. I was merely lying to myself when I told people what drives me to do therapy was assisting in healing. Certainly it is part of why I do psychotherapy but if I am really 100 percent honest with myself (and you the reader), I have to tell you the reason I got into the field was that I wanted to feel significant. It was all about me.

    As I write this, part of me wants to hide behind the couch as I feel slightly ashamed to confess this fact to the world. So often therapists are painted as beacons of selfless compassion for their clients and now here I am openly stating that wasn’t about the client, it was all about me. The other part of me is glad I am being open as I feel that many others have jumped into the helping profession not just because they want to help but also because it is a way for them to feel that their lives matter.

    When I began working in the therapy field I so desired to be a super shrink and show off how good I was. I learned everything I could about cutting edge therapies that could rapidly transform people. I immersed myself into such brief therapies as CBT, NLP,  EFT, EMDR, TLT RRT, and other alphabet soup sounding methods to facilitate fast change in my clients. I was constantly researching new developments in everything from clinical hypnosis to neuroscience and physiology to stay up with anything that could assist me in being better and faster at helping people heal. I would quietly look down my nose at other therapists who took a little longer in their work and focused more on building relationships. In workshops I taught or co-taught I was so proud to show off how quickly I could get clients to change their thinking and actions. This may have been good in some ways but it also reinforced my juvenile mental image of myself as a “special” dynamic healer.

    I became so attached to the role I was playing that the image I thought I was began spilling over into my personal life. I found I was micromanaging and trying to fix my family and friends because I “knew” that they could feel better and do things more effectively with my insight and input. I was living all my life through what Carl Jung would call a persona, which is the mask we wear in order to function in specific situations. My excessive identification with the persona of the special dynamic healer was having harmful effects on my connection with others and my own emotional development.

    This became very clear to me one day in a couple counseling session in which I was one of the clients. At one point the therapist, after listening to me attempt to rationalize my behavior for controlling my wife’s emotional state by my magical therapeutic abilities, bluntly said to me, “You are not her shrink. You are supposed to be her husband.” This hit me like a ton of bricks. My discomfort with emotion and not being in control was being masked by this persona. My wife didn’t really get to see much of the real me. Instead she got too much of my persona which she has since dubbed, “Mr. Wizard”. She really liked Mr. Wizard when he was helping other people but she disliked him when he tried to be her “Mr. Husband”. I couldn’t blame her. I wouldn’t want to be married to him either. This insight began a process of really looking inside myself in order to find out what motivated me to go into the field of therapy.

    wizard

    For several years I have really pondered my reasoning for becoming a therapist. As I stated earlier I came to the conclusion that I wanted to feel significant. I wanted to have people feel glad they came to see me for help. I desired my name to be known for great healings. I wanted other therapists to wish they were like me. I wanted to be remembered after I passed away. I wanted to be adored. It was all pure narcissism on my part. It was all about me!  I did not want to admit it to myself but there it was anyway.

    After this insight, I was not really into doing therapy for a while. I still enjoyed helping others but I did not want to continue anything that reminded me of how shallow I had become. The obvious realization then hit me: I had my own inner work to do before I could truly help others. I had to take my own advice, get humble and get therapy. In my own therapy process I found out how much of my life was about avoiding intense emotions and anxiety. I learned that “Mr. Wizard” is really a codename for distracting and avoiding those things about myself I fear to acknowledge: my selfishness, my inner martyr, my need for constant reassurance that I am good, my fears of death, etc. The therapeutic process I was partaking in was not brief nor did it involve a rapid dynamic techniques to end my suffering. It mainly shined the light on what I need to see about me.

    Now I realize I still have a desire to be significant and that is OK to have this desire as long as it is not my main reason for helping others. If I am going to do therapy now I work to truly make it all about the client, not about me or my latest technique. The more I work through my own “stuff” the better I get at connecting with others.  I now know it can be a wonderful thing to be wizardly for my clients as long as it is for the purpose of helping my clients and not for egotistical gains on my part (I even recently wrote about the positive aspects of being comfortable in being the wizard figure in your client’s Hero’s Journey).

    I have drawn inspiration from one of my heroes, Dr. Milton Erickson, who had countless cases in which he facilitated a profound change in his clients without the client being aware of how or why it happened. He was perfectly happy to see his client change even if the client did not know Erickson had anything to do with it. He was a true healer. His focus was on the client and nothing else.  I am a work in progress but I think I am making gains in this area.  By being honest with myself I have accepted my “shadow” and continue to learn from it.

    I would love to know your reasons for embarking on the path of a healer and what shadow issues you noticed in your journey. Please feel free to share them.

  • Goodbye Dr. Glasser

    We lost one of the greats in the field of psychotherapy this week. Dr. William Glasser, the creator of Reality Therapy and Choice Theory, died on August 23, 2013. Dr. Glasser’s groundbreaking therapy concepts, in which the focus of therapy is on the choices that each client makes in his or her life, aided in transforming the lives of many people.

    William Glasser

    Willaim Glasser, M.D. (1925-2013)

    At the time he began spreading the concepts of Reality Therapy, his ideas were considered controversial by many other psychiatrists. Glasser, a psychiatrist himself,  often bucked the establishment as he was known to warn the public of the potential problems of psychiatry’s labeling and medicating people based on behaviors that he often felt were not the result of biological issues but rather due to the limiting choices and actions people were performing in order to meet their needs. Dr. Glasser also was very involved in spreading his ideas on the importance of a person’s choices to broader fields such as education.  

    Goodbye Dr. Glasser. We will certainly miss your wisdom.