Blog Posts

  • Focus not on the problem

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    Too often therapists ignore the positive resources that clients brings with them to therapy. Graduate school counseling programs hone students’ ability to spot problems and disorders while labeling behaviors with codes that define more about insurance billing than the client healing.

    Many times this history of training sets the therapist’s brain in the pattern of looking for problems instead of seeking client resources. If a client has a resource that can assist them in healing and changing it should be utilized in session.  Sometimes the very “problem” the client brings in can have a positive intention that can activate the client’s own ability to change.

    Here is a personal example:

    I  worked with a young woman in her early 20s named Erin (not her real name). She came to seek help due to the encouragement of her mother that she speak to someone concerning her repression of her emotions. Erin stated that she often times was the person who her family came to when they were angry and upset as she would listen to them and not outwardly be affected by their anger. When people did things to make Erin angry she would shut down and not acknowledge how she felt and would never address her anger with the offending party. Her constantly bottling up of her emotions was beginning to cause some health issues for her which is why her mother began to notice that she might need to talk to a professional.

    When asked what the motivation for swallowing her anger was, Erin replied that she was scared that she would lose her temper to the point that it would make life unpleasant (or worse) for her and her family. She was uncomfortable with any expression of anger which was why she would work hard to calm people down in her home. At the same time she was growing tired of feeling caught in the middle of the many family battles that were taking place.

    At this point many therapists would be either examining Erin’s family history, challenging Erin’s irrational belief that something terrible would happen if she showed anger, or invite Erin to feel the feelings she has avoided feeling within the therapy session. All of these are good interventions but are still rooted in the context of a problem directed approach.

    Coming from a resource directed approach I found out that Erin’s emotion swallowing behavior had a positive intention. The positive intention I found was that she felt by doing this action she was trying to protect her family from her anger.

    At that point I praised her desire to protect her family and cited it as a resource she can use. Erin was then instructed to make a name tag that she only wears at home that reads “Anger Protection Specialist”. I informed her that she should be proud of the fact that she has decided to care more about the safety of her family than her own emotional state. She is then sent home to begin her new “work” as an Anger Protection Specialist.

    On returning to the next session, Erin informed me that over the past week she got so angry that she went into another room of her home and kicked a box. She was surprised that she showed any physical response to her feelings and admitted to feeling better after she kicked the box. She also reported that she was not wearing the name tag anymore. I made sure to comment to her that it must be nice that she can stop being an “Anger Protection Specialist” when she wants.

    On her third session Erin reported that she was no longer feeling extremely stressed and her health had improved. She stated that her family had noticed a major shift in how she related to them and also began to notice that she was occasionally getting angry but in “a good way”. Erin was feeling more comfortable expressing her anger and sadness to her family and others. At this point she did not feel she needed to come back to therapy for this issue.

    Erin had all the resources inside to change her behavior and emotions. By looking through the lens of resources instead of the lens of problems I feel we were able to have faster progress in our work that was on her terms.

  • Challenging the need for insight

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      I have sensed a shift backwards in the practice of psychotherapy over the past few years. In many cases the field has become a lifeless, empty process where therapists spend much of their time attempting to guide clients into insight and understanding of where their problems began. This noble endeavor is a hold over from the days of Freud who believed that insight was crucial to therapeutic change. While insight is not necessarily a bad thing, I assert that it often has little to no bearing on whether a client changes his or her life.    

    In spite of exciting new discoveries in the field over the past several decades, in many cases therapy has gone backwards and become a process where therapists have clients go on a psychological archaeology expedition of their lives. These therapists hope that by having clients see where their patterns of behavior originated they will obtain a new insight that will cease their pain. This occasionally may work but I think more often than not it doesn’t.

    If we want our clients to become transformed we as therapists need to be transforming! We need to get our clients DOING something different rather than just searching for causes. In the 1960s and 1970s amazing therapies (and therapists) began to show up that shook the foundation of established past oriented approaches to change.  The work of people such as Milton Erickson, Jay Haley, Virginia Satir, Salvador Minuchin, and many others gave the field a shot in the arm. There was aliveness and creativity in their sessions with very little exploration of where client behaviors originated. These therapy masters got results by changing what their clients were DOING not spending excessive time exploring and interpreting the history of why their clients behaved as they did.

    How many times have we had  a session with a client who seemed to have a wonderful, life changing moment of insight into why he or she exhibits certain negative patterns only to see them two weeks later complaining of the same emotions, behaviors, or situations? It is far too common. I think more therapists need to move away from solely encouraging insight and instead begin to find creative ways clients can begin DOING something new and different.  If the process of therapy is not much different from what clients are already doing what is the point of coming into session?