Blog Posts

  • Therapy and the Hero

    Lately I have been re-reading the work of one of my heroes, Joseph Campbell. Campbell was a brilliant scholar who focused on the importance of the role of mythology in guiding people toward learning how to fully live life. Campbell is well known for his concept of the Monomyth or what is known as “the Hero’s Journey”. This is a narrative pattern that consistently appears in ancient and modern myths and rituals.

    Joseph_Campbell_circa_1982

    Jospeh Campbell (1904-1987)

    Campbell believed these mythic narratives were really just variations of a single great story. He also believed the true purpose of the Hero’s Journey was a really a way for humans to understand our search for the force that is the source of all things and into which everything will eventually return. I think the process of therapy can also be seen as part of the Hero’s Journey and may even represent the entire journey in itself.

    Here is a quick overview of Campbell’s stages of the Hero’s journey:

    1. The ordinary world: The hero becomes restless and uneasy. He or she is being pulled in a different direction which caused him or her to feel dissatisfaction or emotional turmoil.
    2. The call to adventure: Some situation occurs that shakes the foundations of the Hero’s beliefs or way of life. He or she is dealing with a major change in his or her life.
    3. Refusal of the call: The hero becomes frightened of the coming change and avoids exploration into this unknown realm.
    4. Meeting with a helper or mentor: The hero comes into contact with someone who holds knowledge and experience that can assist him or her in moving into the unknown realm which he or she fears. The helper/mentor aids the hero by supplying training or advice that aids the hero in developing skills and wisdom to deal with the oncoming challenges.
    5. Crossing the threshold: The hero armed with the wisdom form his or her helper/mentor leaves his or her ordinary existence and moves forward into unfamiliar territory.
    6. Trials and ordeals: The hero is severely tested in the new territory and sometimes stumbles with his or her new skills and wisdom. During this time the hero may gain allies or additional helpers to assist him or her in moving through the unknown territory.
    7. Approach: The hero and allies begin their move toward the major challenge the hero will face
    8.  The ordeal: The hero confronts his or her worst fears. The hero’s old perceptions and identity shift.
    9. Reward: The hero obtains the source of what he or she has been seeking. While this is a joyous period there is also the possibility of losing the source in the future.
    10. The road back: The hero is working toward completing the journey but may have issues with committing to the last part of the journey. He or she may have to deal with additional dangers not previously realized.
    11. Resurrection: This is the hero’s major confrontation with the death of the old self.  If the hero does not succeed, other people close to him or her will suffer. In the end the hero does succeed and emerges from the confrontation reborn.
    12. Return: The hero returns to his or her home bringing the source of the treasure sought. The hero is transformed and can aid others with his or her new found knowledge.

    These stages can relate to the latest Hollywood adventure movie or the work our clients perform in therapy. We may even be undertaking this journey as therapists as we move through our professional lives attempting to create our own identity as healers.

    If we think about our work as therapists, we are clearly embodying the role of Mentor/Helper in our client’s hero journey. What an amazing way to think about the therapy process! You are your client’s Obi Wan Kenobi, Gandalf, Dumbledore or Mr. Miyagi. You are a necessary element on their “quest”. The trials and tribulations (and setbacks) your clients have do not make them resistant or difficult clients, rather it is part of their journey as they are being tested and facing the challenges leading up to their “ordeal”.  From this perspective, the client’s depression is no longer just a serotonin issue but rather a voyage into the unknown in which the client will have to face a variety of frightening situations that are necessary for him or her to emerge with an enlightened mind and rejuvenated spirit. A client’s emotional battle with past trauma now takes on the form of the hero’s ordeal and road back which can lead him or her to a resurrection as a new person who accepts, forgives and uses the lessons of the past to forge a new beginning in the world.

    Are you up for the challenge of being someone’s therapeutic “wizard” who has been sent to give them the special teachings that will aid them on their journey?

  • Identity or Process?

    I have found that the people who have the most trouble changing their lives are often the ones who have identified with their “problem” so much that unconsciously they feel if they change they will cease to be who they are. When a client has taken on the identity of his or her issue, it is difficult for them to consider their lives could be different. Consciously the client may desire to be different but unconsciously he or she is limited in his or her options due to the sense of identity invested in the problem.

    Identity

    If clients have invested their identity into being the “anxious person”, the “depressed person”, the” bipolar person”, or the ”anorexic person”, how can we help them move out of that fixed state of identity? I have found that it comes down to being able to do two things:

    1)      being able to convince the client there is more to him or her than their problem

    2)      getting the client to begin viewing their problem as a process rather than a fixed identity

    If we view the way the client is acting or feeling as a process it gives us a variety of tools to alter the process that we could not do when the client believes he or she IS the depression, anxiety, etc.

          Here is an example: Terry shows up in the therapy office stating that he is depressed. Terry lets us know he feels like he has always been depressed and we learn that this emotional state has been the gauge by which he measures much of what goes on in his life. He may have a variety of valid reasons why he has become depressed but if we want to separate him from identifying with his problem, then we need to be more interested in the process he is doing in order to become and stay depressed.

    We may ask Terry how he “does” depression, in that we mean what process he uses to feel the way he does that has been labeled depression? We could write out a list of the daily actions he takes to get the result of being depressed. It might have things like:

    Constantly think about the worst case scenario for any decision in his life

    Feel hopeless and apathetic about his place in the world

    Withdraw from others, sleep too much (or too little) and eat too much (or too little)

    Move his body very little

       Now at this point we have a blueprint of the process Terry uses to feel depressed. This is his recipe for feeling terrible:

    Think about worst case scenario + feel hopeless + withdraw from others + no  physical moving + bad eating/sleeping pattern = DEPRESSION

    Instead of viewing his problem as “who he is”, we instead can see how he continues to create and maintain this process of depression. If Terry has been this way for a long time he may feel that he can offer very little different in the world as he IS a depressed person.

    We may now give Terry a few things to do over the next 2 months:  

    Volunteer his time for a worthy cause where he can meet people and feel a sense of contribution

    Learn to challenge his thoughts

    Move for 20 minutes a day (walking, bike riding, etc.)

    Change his diet to food sources that provide energy and nutrients

    Changing to a more consistent sleep schedule

       Just by adjusting a few things Terry is doing, it is difficult for him to continue to create the same kind of process he has been doing. His volunteer work has made him interact more with others (and maybe seeing how some people have lived the worst case scenario and moved on) and his exercise and diet routine has made his metabolism change (which could increase his energy). This alone may not be a cure all but it will go a long way toward showing Terry that he has the ability to respond to the world in more ways than his presenting process. More importantly, he can now experience that “Terry” is more than an emotional or behavioral state.

    As Carl Rogers often wrote about, the core of who we are is not the behavior we perform. Our identity is not the process we perform. Our client is not the anorexic process or the borderline process or the obsessive compulsive process he or she performs.  I believe it is when we assist our clients to experience who they really are as different from the process they have been doing is where therapy becomes transformational.     

     

  • Routines and procedures?

    I couldn’t have said it better myself:

    “Psychotherapists cannot depend upon general routines or standardized procedures to be applied indiscriminately to all their patients. Psychotherapy is not the mere application of truths and principles supposedly discovered by academicians in controlled laboratory experiments. Each psychotherapeutic encounter is unique and requires fresh creative effort on the part of both therapist and patient to discover the principles and means of achieving a therapeutic outcome.”

    – Milton H. Erickson, M.D. (1901-1980)

    milton_erickson

  • What kind of shrink are you?

    Today I was reflecting on an article I read about therapists finding their “professional identity”. The article encouraged therapists to claim their theoretical orientation and become an expert in that specific kind of therapy. The author stated that the client will only feel comfortable if you can tell them exactly what type of therapy you do. In essence it asked the reader, “What kind of shrink are you?”

    psychotherapy

     In the past every now and then I would get a client who would ask me specifically, “What kind of therapy do you do?” I would usually tell them. “I work from a base of Existential/Humanistic and Systemic/Brief Therapies, in which I blend with alternative treatment modalities”. After I would state this, the client would usually just stare at me nodding his or her head with the type of nod that says “I have absolutely no clue what you are talking about.” My response did not give them any real information about what we would be doing in our therapy work and as a result I noticed that they were not any more hopeful or optimistic about the work we were going to embark on.

    It is important to me that my clients are optimistic and open to changing their lives from the moment we begin the therapy process. I now tell clients who ask what style of therapy I do that I engage in “transformation therapy”, which is designed to assist them in breaking through mental and emotional blocks that stand in their way of enjoying their life on their own terms.  The sound of this description of my work intrigues them. I also tell them that my goal is to not to see them every week for the rest of their lives but rather to work in a manner that assists them in creating their own rapid personal change. I explain that even though I may like them as people I do not want to see them forever! I want them to be able to leave my office after a few sessions with a new mindset and attitude that embraces life rather than feeling as if they cannot endure life’s challenges. Even though I haven’t changed the way I do therapy, I have found that just by changing the description of my work my clients seem to be more open and interested in the therapy process.   

    This has reaffirmed in my mind that it is not really the “style” of therapy, the list of credentials, or the degree of the practitioner that really give a client hope and comfort, but rather it is the therapist’s expectations and desire for the client to change that aids in creating a climate of exciting possibility for the client to begin the process of transformation. Shouldn’t every therapist be doing his or her own kind of “transformation therapy”? 

    In the end, I believe it is not the “name” of what I do that is important to my client. What is important is my compassion for the client and the results we get in our work. 

    So what kind of shrink are you?

     

  • Creating Directives

    I found this video on youtube and wanted to share it. It is a close to 2 hour presentation by Dr. Jeff Zeig teaching a short segment on using directives for creating dramatic change. Even though it is a fairly long clip it holds a lot of good information for therapists who are wanting to learn how to move from insight oriented methods of performing therapy toward more experiential, interactional methods. Dr.  Zeig is the Founder and Director of the Milton H. Erickson Foundation, having studied with Dr. Erickson for more than six years, He edited, co-edited, authored, or coauthored more than 20 books that appear in twelve foreign languages. He is also the organizer of The Evolution of Psychotherapy Conferences, the Brief Therapy Conferences, the Couples Conferences, and the International Congresses on Ericksonian Approaches to Hypnosis and Psychotherapy. In addition, he is on the Editorial Board of numerous journals; is a Fellow of the American Psychological Association (Division 29, Psychotherapy); and Fellow of the American Society of Clinical Hypnosis. He is a Distinguished Practitioner in the National Academy of Practice in Psychology of the National Academies of Practice.. He is also president of Zeig, Tucker & Theisen, Inc., publishers in the behavioral sciences and the Erickson Foundation Press.