Archives for Therapeutic Relationship
Is therapy not working for you? Do you feel disappointed in how your therapist and you interact? Do you not seem to be getting to the root of your problems? Do you feel that something is missing? Sometimes in these cases, patients don't know what to do except let therapy drag on until they find a new therapist. Or, they let the feelings of dissatisfaction build up until they reach the point of total frustration and then suddenly quit. Either right away or after a time, they search for someone new. Is there anything you can do to stop this vicious cycle and get the help you want? If you are dissatisfied, you might consider discussing with your therapist the problems with how therapy is going. Tell your therapist why you aren’t happy with therapy or with him (or her). Your genuine feelings should be validated. Your therapist should not be defensive. Give your therapist the chance to correct issues that are alienating you. (Sometimes, your therapist might offer an explanation of why certain processes are in your best interest. Try and stay open to this. You can always discuss anything questionable with a friend, mentor or another therapist.) Remember, you can be your own best advocate.* Preventative Measures One of the best ways to thwart problems is
Your Belief System: The Longer-Shorter Path In the last post, we focused on coping skills and strategies, which are the emotional scaffolding upon which your life reconstruction can begin. In this post we'll discuss your general belief system. This may include beliefs about who you are, how much self-determination you believe you have, spirituality/religious beliefs, what your life is truly about, and so on. These are the foundation upon which your life actually rests. A dysfunctional belief system is a set belief or group of beliefs that impair an individual’s ability to function in a mentally, emotionally, intellectually, spiritually, and physically healthy manner.
Your Emotional Scaffolding: Developing Coping Skills The systematic, yet personal approach that I believe really works is a combination of the use of proven treatment methods and the therapist’s techniques. Effective therapists primarily use proven treatment methods supported by their own studiously developed personal techniques. Whenever possible (and that is the vast majority of the time), it's important for your therapist to first help you improve—or, if necessary, develop from scratch—your emotional scaffolding comprised of your coping skills and strategies, before digging up and exploring your past.
*Let's begin answering this essential question: What is therapy, really? By definition, psychotherapy is “The treatment of mental or emotional problems by the use of techniques that are tailored to the unique problems and backgrounds of the individual and that may include talk therapy, behavioral modification, medication, and other treatments.” The goal of psychotherapy is to help resolve an individual’s mental and emotional problems and, at the same time, teach that individual how to attain the skills needed to deal with life on life’s terms. Therapy is also an inner journey with the therapist as guide. With a good therapist assisting you, your emotions (what you feel) begin to get in sync with your intellect (what you know). When your head leads and your heart follows, the world becomes an easier, more meaningful place in which to live. Therapy is not about
A therapist I supervise came to me with a case: F. struggles with relationships and socializing. The sensory processing and cognitive issues she's struggled with since childhood cause her to misunderstand or miss social cues. Therefore, her responses to people's words, gestures, or tone of voice often were often wildly inappropriate and misfire. One of the biggest issues for her used to be her inability to read when someone was belittling or bullying her. Her social awkwardness made her an easy target. With the guidance of her counselor as well as support in developing a healthy response to bullying, she began to be able to assert herself and even stand up for herself, too. She learned about healthy boundaries and in cases where she used to get overly involved in other people's lives, especially people who were using and/or abusing her, she began to be able to recognize
It’s safe to say one of the main goals of therapy is to teach you how to help yourself so you don’t actually have to be in therapy, at least not for a moment longer than necessary. If you don't have a diagnosis which requires ongoing therapy, then ask yourself:
A clinical philosophy or style is the general approach a therapist subscribes to, believes in, and/or uses in treatment. Some common clinical approaches therapists may take include: reality oriented (therapy that focuses on counseling and problem solving in the here and now as well as offering instruction in how to create a better future)
Dedicated, skilled, and caring therapists will, together with you, discuss the right time to end therapy. Usually they'll discuss it with you in the first few sessions so you can be prepared for about how long therapy might take. They'll share with you possible treatment time-frames, and together you'll decide how to proceed. Your therapist and you will schedule regular progress check-ins, every few sessions or even once per session, and assess how effective the therapy is for you. If it isn't after a reasonable period of time, a responsive therapist will try other approaches with you or might even suggest a different therapist. But suppose that you decide your therapist isn't for you and you are planning to leave therapy, either to work with someone else or because you feel you no longer need therapy—what should your course of action be?
Does therapy absolutely require you to "talk about your past?" Do you need to "go down that road?" My answer, adapted from Therapy Revolution: Find Help, Get Better, and Move On, may surprise you. Your therapist will, beginning from the very first session, evaluate how you cope with problems and challenges. Where your coping skills aren’t as strong as they might be, a good therapist will teach you how to strengthen them. I believe that generally, only then, should your therapist ask your permission to go ahead and explore important events in your past.
A well-trained and dedicated medical doctor will consider whether or not there is an emotional component possibly triggering a physical issue, such as stress in the case of fatigue. But often, those in the mental health field, especially psychotherapists, might not evaluate and rule out medical or other issues in the case of a client presenting with a mental illness. In training sessions with interns and therapists-in-training, I emphasize the importance of doing a comprehensive evaluation before diagnosing—and doing therapy with—a client. I explain that when it comes to a mental health evaluation it is as vital for therapists to determine which factors are contributing to or causing mental illness, whether that mental illness is mild or more severe. Yet many therapists jump right into talk therapy at the first or second visit; not everyone in private practice examines medical records or asks their clients to get blood-work done.