Psychotherapy: the "How"
I am psychodynamically trained and use that as a perspective. Like most therapists, my working base is also drawn from evidence-based approaches such as psychoeducation and cognitive behavioral methods, theories of temperament, and recent findings in neurobiology. I have a conviction that no one approach fits everyone; I think that each successful therapy experience must be tailored to the unique client and circumstances.
I use some therapy approaches which are less well-known and may not be familiar to the reader:
EMDR, poorly named Eye-Movement Desensitization Reprocessing, is the use of alternating bilateral stimulation to slightly alter the mental associations and mental anchoring for what one is experiencing. It’s used as one of the ways therapists can keep a client grounded in the present reality and experience so that examination of the past can occur without the experience of reliving it. Looking from side to side by following the therapist’s hand was the first method used and how it got its name, but there are various methods including headsets that split music so it is heard first in one ear, then the other.
Not everyone is comfortable with alternate bilateral stimulation.
From the use of EMDR has sprung quite a number of protocols for exploring and relieving symptoms and also for anchoring positive feelings and other safe and comfortable mental contents so that their positive influence on the brain can be expanded in ways that benefit the client’s coping and self-soothing.
Some of these protocols, including AMST and DNMS, can be successfully used without the bilateral stimulation.
AMST (affect management skills training) is an technique in which positive cognitive and sensory memory are used to hold the client’s experience safely in the present while diminishing the damaging impact of old fear, shame, etc. which have been too readily accessible, too easily activated, in a client’s daily experience.
DNMS, the Developmental Needs Meeting Strategy, again makes use of mental-emotional mind anchoring, but the protocol allows very strong, lasting, vivid mental anchoring with accompanying imagery and guided internal experiences that lead clients to feel that the strongest, kindest, best parts of themselves are increasingly able to sort of wear away at old tendencies to become triggered, and to nudge the brain to use different, new pathways to handle input that might have made trouble for them in the past.
IFS, Internal Family Systems. All of us have at least some ability to dissociate as one of our many necessary defense/coping mechanisms, and this is a way of thinking about and working with the dissociated bits of ourselves that become symptoms and trouble spots.It’s a great, creative way to approach dysfunctional parts of oneself, such as unwanted mental states and stuck, repetitious, non-adaptive behaviors.
A good further description can be found at http://www.selfledsolutions.com/resources/aboutifs.html
DID -- This isn’t a method, but a diagnosis, involving dissociation with amnesia between some or all parts of self, producing a particular sort of multiple selfhood; there are also conditions on the continuum that come very close to DID, involving loss of control to another part of self, while maintaining some mutual awareness; this is a different diagnosis from DID, technically, but calls for the same understandings about group self or fragmented self. I do work with DID, but I have no single best approach to it; I use perspectives learned from the ISSTD clinical training for providers of care to people with DID, as well as everything else I have learned and pieces of what I’ve listed above. If you are looking for a therapist who can work with this, you’d need to check me out with a consult, just as any other prospective client does, to feel into whether I’m “getting it” as you talk, and to determine whether your insiders are inclined to accept me.
The body often carries one’s history of hard times and trauma, in the form of chronic muscle tension, habits of posture and breathing, reflexive movement, etc. Thinking together about the client’s life may not give therapist and client the access they need in order to fully free up the client for untraumatized living.
One way a therapist can help a client to change internal, emotional and cognitive experience is to bring the client’s awareness to his or her own physical traits and sensory experiences, let them become a source of information about how past harm is affecting the present, and coach the client through various small, experimental, self-conducted changes in physical experience, with the goal of (1) identifying “safe” ways for the body to rest and feel more whole and free, and (2) allowing the body to discharge its part of the trauma which might be contained, for instance, in a once-prohibited impulse such as pushing away a source of danger and hurt.
THE POINT OF ALL of all these various procedures is to establish ways to strengthen a client, jumpstart more positive neurological path-building, and relieve symptoms, while using methods most comfortable for that particular client.