Therapeutic Modales

---

I am a client centered therapist. Basically, what this means is that I am accepting and affirming (and certainly not judging). It is you who decides the directions we take - I will not tell you what you need to be working on. I believe that self-acceptance/acceptance toward growth and change. Though I may (if you would like for me to) offer suggestions and thoughts on day to day coping (the pop psychology world calls these "coping skills," I ultimately believe that each individual has their own unique and creative ways of coping in the world. My job is to travel with you, with acceptance of who you are and of where you are on your journey. Though I may introduce tools, techniques, and perspectives, I do not and will not consider myself to be an expert on your life. Therefore, part of my philosophy as a counselor involves checking in regularly with my clients to make sure we are on the best path for your journey and to make sure the approaches and therapeutic languages that I am using with you are helpful. Part of my philosophy as a client centered therapist involves transparency. This means I feel it is important for me to be open with you about the approaches I work with. With this in mind, here is a little bit of information on some of the therapeutic approaches I use most often. I also welcome any questions.

  “One of the most crippling prisons is the prison of reduced identity.” John O’Donoghue

Narrative therapy is rooted in the belief that individuals’ identities develop within the context of their culture, including the language of their culture. Narrative approaches thus aim to help clients “re-author” their lives, in part by helping them to recognize and see themselves a part from the problematic stories that have been bestowed upon them. My job as your therapist is to first bear witness to your story. The next goal of narrative therapy is to help liberate the person from the problem. Often it is cultural beliefs, or knowledge/power constructs, that trickle into our families' belief systems from our culture. When an individual is defined a certain way…such as to be the “problematic” person in the family, other “stories” about that person (that aren’t the dominant narrative) get lost. Narrative therapy approaches thus aim to deconstruct the constructed identity of the person by acknowledging these “unique outcomes,” or times that the problem isn’t present. It also aims to “externalize” the problem from the identity of the person.  In a sense, it aims to help individuals and families “story” their lives and construct a better “reality” for themselves. 

Because of narrative therapy’s attention to context and culture, it is often considered an approach that works through a lens of social justice. Narrative therapy can therefore be an approach that is useful with individuals who have experienced and internalized oppression. Narrative therapy has historically been used in family therapy and with individuals who have struggled with eating disorders. The book Life Without ED by Jenni Schaffer is a great example of a narrative therapy approach used by Jennie and her therapist. ED is the externalization of (you may have guessed it) her Eating Disorder. The book chronicles her work to free herself from the abusive relationship with ED. Narrative therapy’s adage is, “the person is not the problem; the problem is the problem.”

Our thoughts our just thoughts. Acceptance and Commitment Therapy is a value based and mindfulness based approach that involves a number of techniques to help individuals navigate toward directions that are more purposeful and to let unhelpful thoughts float on by. This approach holds that anxiety happens when we are fused to our thoughts. Thus, one goal of ACT is to help clients diffuse/separate themselves from their thoughts. When we are up too close to our thoughts, we can lose perspective. A molehill can become a mountain. ACT can often involve playful thought exposure techniques, and also metaphors. Here is an ACT metaphor that I particularly like: You are driving a bus, and there are a bunch of monsters/bullies (i.e. your not so helpful thoughts) on the bus. They keep yelling at you, really mean things. But you have somewhere to go (i.e. your meaning, your purpose). You could stop the bus and go to the back and fight with the bullies, or you could just keep on driving. Pulling ourselves away from our thoughts is often facilitated by striving toward a greater sense of what feels meaningful and purposeful to us, which can also lead to an essential distance (from our thoughts), which we call perspective.

In a way, IFS takes narrative therapy and ACT a step deeper. Narrative therapy is about our stories; ACT is about the thoughts (which is a part of what stories are made from), and IFS is about the “parts” of ourselves, as well as the burdens (stories or beliefs) that we carry. The IFS theory believes that, just like family members function in a family system,“parts” of ourselves - internalized representations of family beliefs - function within us. The first step in the IFS approach involves recognizing these parts as their own separate entities (see the similarity with ACT’s diffusion). IFS is about first accepting and understanding all parts of ourselves, including the parts we might not like – like our inner critics and pessimistic parts – and then freeing these parts from the burdens/beliefs that these parts carry. IFS theory holds that we all have innate capacity for (the 8 C’s) Compassion, Curiosity, Creativity, Courage, Clarity, Connection, Confidence, and Calm. According to IFS, healing the parts of ourselves involves self-love and compassion. It involves a mindful acceptance of “all” of our parts. Carl Rogers, founder of client-centered psychotherapy, coined the  paradox of acceptance, which is: “The curious paradox is that when I accept myself just as I am, then I can change.” Thus, awareness and acceptance of all of our emotions and “parts” is the first step toward growth and transformation.  The Internal Family Systems approach further believes that it is our culture which helps shape the values and beliefs, and thus relational patterns within a family. For more information on IFS, you can check out this website: About Us | IFS Institute

This approach was created by Marsha Linehan. It is an approach that she based on what she felt could have been most beneficial to her younger self, when at the age of 17 she was hospitalized with self-destructive urges and behaviors. DBT is comprised of 4 core skills: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. DBT holds the tenant that the fundamental nature of reality is change and process. It aims to help clients become more comfortable with change, while teaching that we must first radically accept ourselves as we are in the present moment. Radical Acceptance involves the balance of understanding that events through time have landed us where we are…that we are partly responsible for where we are currently in our lives, and that we are partly not responsible for where we are in our lives. In order to truly accept ourselves, we must also have awareness of the context of our lives. In a 2011 New York Times article, Linehan described her own epiphany moment of radical acceptance which for her, occurred in a church. The article states how Linehan had tried to harm herself many times because, “the gulf between the person she wanted to be and the person she was left her desperate, hopeless, deeply homesick for a life she would never know. That gulf was real, and unbridgeable.” This acceptance, she described, allowed her to view her symptoms as “making sense.” Acknowledging her suffering, rather than fighting it, allowed her to care for herself and to slowly take control over her life.  

CBT is about the relationship between thoughts, feelings, and actions. It teaches us that we can change our behaviors by changing our thoughts. CBT approaches assist in awareness of belief patterns called automatic assumptions or cognitive distortions. If you have heard the term “catstrophic thinking,” then you are familiar with CBT and automatic thoughts. All/Nothing Thinking, Assumpting, Overgeneralizing, and If/Only thinking are also examples of this type of thinking that can wrap itself around us like a prison. Once we are aware of these bricks comprising our prison walls, we are able to kick out the bricks to let in the light of other perspectives/ways of thinking. CBT aims to do this. CBT might also include looking at the rules we have had for ourselves, and assessing which rules are currently working (and which rules are not). I will sometimes tell my clients that breaking rules (that don’t work) can - because they are rules - induce guilt and discomfort. Allowing ourselves to move through discomfort – to be vulnerable, for example – is how we grow. Thus, I refer to this type of rule breaking as growth guilt. I often blend CBT concepts with other approaches.

Footnote on the therapeutic approaches: Really, all of these approaches have overlapping similarities, as well as some differences. Each approach carries its own language. We’ll work together to decide which languages connect best with your experiences, and which approaches deem to be the most helpful to you on your journey. Together, we might even come up with new, unnamed therapy approaches that work best. My guess, too, is that you may already have some of these.