Posts from the ‘Clinical Approach’ Category

The Process of Therapy

There is an art and a science to this work. I experience the art as a kind of intuition, listening not only to what a client says openly but also listening between the lines. Sometimes this feels like I’m serving as a satellite dish, or a stethoscope, picking up emotional signals. I’ll catch a feeling that a client perhaps doesn’t yet know that he or she feels and comment on it. Then there it is, out in the open, to examine and try to understand.

I experience working with clients as something like an artistic collaboration. The joint effort is aimed at reaching a shared understanding and striving for desired change by weaving together threads of the past and present, current relationships and the working relationship between myself and a client.

This is not simply a matter of making a tapestry that depicts the client’s life–it’s also about the rhythm and coordination required to create something of meaning and value together. Ultimately this process informs what the client may begin to do differently in his or her life, particularly around the quality of relationships with others.

The science of this work involves application of a certain body of professional knowledge. It’s an ability to recognize patterns within a particular client’s life and understand what’s happening from multiple perspectives—theories of personality development, statistics of diagnostic categories, biological and socio-environmental influences of behavior, to name a few. The challenge is to derive meaning from multiple frameworks and then offer what the client needs in such a way that collective professional experience has shown is most likely to work.

Research on psychotherapy is overwhelmingly consistent in its conclusion that the therapeutic relationship that is the primary agent of change. I experience this agency not simply in what I may say, but more generally in an attitude conveyed to a client–a feeling of being valued, a conviction that life can make sense and become more satisfying, that what was once a burden in one’s life can change into lightness, humor, and curiosity about oneself.

Individual Psychotherapy

The focus is on you in individual therapy. Many people seek individual therapy to gain an objective perspective on their life circumstances. You may have already sought the advice of friends or family and realized that a professional’s input is needed.

On one level, individual therapy can provide just that: a relatively unbiased source of feedback and guidance. A therapist may help you form connections among your thoughts, memories, feelings, and experiences, allowing you to understand yourself and your life circumstances in helpful new ways. Therapy may help you learn alternate ways of dealing with difficult experiences, including relationship problems, adjusting to changes in your life, and learning to manage emotional problems such as anxiety and depression.

On a deeper level, individual therapy can involve a unique relationship between you and your therapist. Many people who pursue psychotherapy achieve growth and healing by virtue of being listened to, understood, and valued. If you did not consistently have such experiences as you were growing up, then going through therapy today may jump-start your growth and development in ways that may render presenting symptoms obsolete.

I aim to help you define your personal objectives for therapy and to help you work toward achieving them. Psychotherapy may help you attain a greater ability to handle life’s challenges, increased quality of relationships with significant others, more complete self-knowledge, and increased satisfaction with your life.

Professional Experience: Group Psychotherapy

An integral aspect of my training and professional identity as a psychologist has centered around the practice of group psychotherapy. In this continuing series on my experiences prior to private practice, I present highlights of my graduate training and professional experience in group therapy.

Graduate Training

The doctoral program in clinical psychology at Antioch University New England is heavily group-based. Learning experiences typically involve dialogues among small groups of students and formation of student groups to carry out projects by team effort.

Thus, I experienced the formation and study of groups an integral part of becoming a psychologist, as each working group not only had a specific task to accomplish, but also was an object of study in relation to the challenges that people encounter when working together.

The graduate curriculum included coursework in group psychotherapy, for which the main text was Irvin Yalom’s classic Theory and Practice of Group Psychotherapy. The course was divided into experiential and didactic components.
The experiential hour invited the class to form a group and study itself. Not an activity for the faint at heart–I recall our professor saying at one point, “Your class seems to have joined around not liking one another.” Yet this experience was beneficial beyond measure, at minimum to understand the tension and anxiety that participants in group therapy often feel as they form a therapy group.

With respect to didactics, I sought out readings and training experiences inspired by psychoanalytically-informed models of group psychotherapy, particularly models of group therapy developed by the Tavistock Institute in London as well as Yalom’s theory of group psychotherapy.

I had the privilege of co-leading many groups during my training practica and internship, including an existential group on an inpatient psychiatric unit, a grief and loss group at a university counseling center, and two different interpersonally-focused relationships groups at university counseling centers.

Professional Experience

For three years I led three-to-five therapy groups per week in a continuing day treatment program that served people with serious and chronic mental illness. These groups included Interpersonal Psychotherapy, Experiences in Groups, and Increasing Life Satisfaction.

I developed written protocols for over fifty different kinds of psycho-educational, psychotherapeutic, and ‘recovery’-oriented groups, cross-referenced to current research to establish an evidence base for our program’s groups that would satisfy the standards of the New York state office of Mental Health.

Perspective on Group Therapy

Many people repeatedly run into the same difficulties over and over in relationships, but seldom have an opportunity to receive honest, impartial feedback.

Group therapy presents an opportunity for a live learning laboratory. It is hoped for and expected that difficulties you may experience in your life will get played out in your interactions with the other members of the group.

For example, if you’re ‘shy’ in social situations, you’ll most likely be ‘shy’ in the group.

In this way, group can become a miniature version of your social life, your workplace, or your family. The difference in a group is that everyone is there to make adjustments in how they relate to others. You’ll have a chance to hear feedback from other group members about how they experience you, and you’ll then have opportunities to try out new ways of relating to others.

Participants are carefully selected to develop a small, mutually trusting group. While great diversity exists among participants, the shared objective is to learn from one another the impact that each person makes on others.

The group may help you understand yourself, how others see you, and illuminate ways in which you may improve your relationships.

Current Group Offering

I am pleased to be launching a new psychotherapy group in the Fall of 2007. This will be a psychodynamic, process-oriented group limited to six carefully selected participants. If you’re interested in applying for the group, I would encourage you to contact me.