By Elizabeth Dickson, LCSW
Over the course of my career, I have increasingly realized that the most powerful role for the therapist is to facilitate a client’s natural healing process, including the client’s ability to connect with their own wisdom and emotional intelligence and to find answers within. In that regard, I would call myself a “client-centered” therapist, but that does not mean that I am passive.
The Art of Psychotherapy
I think of the “art” of psychotherapy as the therapist’s ability to do two somewhat contradictory things simultaneously: to listen and respond in a way that helps the client find their own voice, while at the same time having the ability to draw from an extensive knowledge base in a way that is seamless, organic and suits the unique moment with the particular client. It is like having a “tool kit” of many theories and approaches that the therapist can access and use spontaneously in the session.
I am an “eclectic” therapist in that I believe in having an extensive “tool kit” to work with. I have a passion for learning, integrating and applying new theories and approaches in my work with clients—and my practice, philosophy and theoretical orientation keep evolving and growing as I continue to add to my knowledge base.
Many of the concepts that I integrate come from cognitive therapy. For example, when clients are caught in one of the 10 classic cognitive distortions, we can practice substituting thoughts that are more accurate for the negative, distorted thoughts.
Clients also may appreciate learning about common “schemas” (such as emotional deprivation, abandonment, defectiveness, subjugation, etc.) so that they can recognize the counter-productive, self-perpetuating nature of these schemas and have exercises and strategies to address them.
Specific cognitive therapy treatments are available to help reduce distress stemming from anxiety, panic, phobias, depression, perfectionism, obsessive-compulisve disorder (OCD), attention deficit hyperactivity disorder (ADHD), etc. Symptom relief is often the first step before more exploratory therapy can be successful.
The following are some examples of ways that I work with clients who prefer a proactive approach. As with any concept or technique, the test is whether it resonates for the client.
- Experiential Focusing: Focusing involves teaching a client to be in touch with bodily feelings or a “felt sense” and to learn to explore and find words from this deeper place. By gently checking inside and trusting a client’s organic process, our perspective can evolve and feelings can be transformed.
- Guided Imagery: In guided imagery, a client is asked to visualize a scene, often from the past, and then is encouraged to reconnect with the thoughts and feelings that they experienced at that time. The therapist validates and supports the client’s experience and may guide the imagery to create, in the image, something that the client needed at the time.
- Sub-Personalities/Gestalt Therapy: We all have different sub-personalities or modes within us, such as “vulnerable child” mode or a “conscientious” mode, etc. In this work, clients identify and explore their different modes. The goal is that, through non-judgental exploration, each mode can develop to its highest, healthiest level.
I am attuned to the importance of timing and readiness when considering a coaching approach. Research on the stages of change has shown that more than half of people who go into therapy are at the “pre-contemplation” stage, and another 30%-40% are at the “contemplation” stage—meaning that they are thinking about changing bust are not committed to action.
That leaves only a small group at the “preparation” stage where they are making preparations before they can take action, or at the final “action” stage where they are ready to modify their behavior.
The therapist must first assess which stage a client is at and not just assume that they are at the “action” stage. Then, the therapist helps the client move forward one stage at a time so that the client is truly ready before beginning behavioral change strategies.