Saturday, December 30, 2017

How Clients Internalize Their Experience of Their Psychotherapists

One of the benefits of attending psychotherapy is that you learn so much about yourself, your relationships and the world around you (see my article: The Benefits of Psychotherapy).  Another benefits is that when you have a good relationship with your psychotherapist, you internalize your experience of your therapist.  I'm addressing this internalization process in this article and how it's beneficial to clients in therapy.

How Clients Internalize Their Experience of Their Psychotherapists

The relationship that you have with a psychotherapist is unlike any other relationship in your life.  Aside from the fact that you have a regular time and place that's just for you every week, the focus is on you and the changes you want to make in your life.

People begin psychotherapy for all different reasons.  Some people come because they have longstanding psychological trauma that's interfering with their life and they want to free themselves from the effect of the trauma (see my article:  Working Through Emotional Trauma in Psychotherapy: Learning to Separate "Then" From "Now").

Other people are interested in personal growth or performance enhancement.  Their lives are basically going well, but they believe there are areas where they can improve either in their personal life or in their career.

Regardless of what brings a client to therapy, part of psychotherapy is a learning process.  While it's not the same as being in a classroom, a skilled therapist will provide clients with psychoeducation about the therapeutic process as well as ways that clients can improve their life (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation About How Psychotherapy Works).

In addition to psychoeducation, clients also internalize their experiences of their psychotherapists and, it's a good match, the client benefits from this process.

Let's take a look at a fictional vignette which illustrates how this internalization process in therapy usually works:

Fictional Vignette: How Clients Internalize What They Learn in Psychotherapy:

Jack
Jack started therapy because he was having problems setting boundaries with his mother, and it was affecting his relationship (see my article: Setting Boundaries With Family Members Who Want to Interfere With Your Relationship).

How Clients Internalize Their Experience of Their Psychotherapists

The main problem was that Jack, who was in his early 30s, had problems setting limits with his mother, who continually attempted to interfere in Jack's relationship with his girlfriend, Cathy.

Even though Jack didn't like that his mother constantly interfered in their lives, he didn't know how to talk to his mother about this, which annoyed Cathy.

Whenever Jack and Cathy came home from a visit to see his mother, Cathy would be fuming and Jack would feel ashamed that he couldn't bring himself to talk to his mother about her constant interference.

Jack and Cathy were talking about getting married, but Cathy told him that she didn't know if she could handle his mother's constant interference, which she assumed would only increase if they were married with children.  So, Jack knew he needed to address his fear of asserting himself with his mother because if he didn't, his relationship with Cathy might end.

Jack told his psychotherapist that he didn't experience any major trauma or loss as a child.  He described a fairly stable family.  He was the younger of two sons who grew up on the Upper West side of Manhattan.

The one issue that was constant throughout his life was that his mother tended to dominate everyone's life in the family.  She was also highly critical and she would give many reasons why she thought Jack and other family members were "wrong" and she was "right."

Jack's father was happy to allow the mother to control the family finances and to have the final say on all major family decisions.  His mother also became the family matriarch for her siblings after their mother died, so she was used to being in charge.

Jack's brother, Ted, resented the mother's domineering personality.  He and the mother would constantly argue.  By the time Ted left for college, he and the mother were barely speaking.  Once Ted graduated college, he moved out with his college roommates and only came to visit on holidays.  Even now, Ted's relationship with the mother was strained.

Jack quietly observed his older brother's relationship with their mother, and witnessing their battles left him feeling even more intimidated about being assertive with his mother.

As Jack and his therapist worked together, he realized that his mother's attitude that she "always knew best" undermined his self confidence and left him feeling that she was probably "right" so he couldn't assert himself.

Since the holidays were coming up, Jack told his therapist that he dreaded having to tell his mother that he and Cathy would be there for Christmas day, but they were spending Christmas Eve with Cathy's family.

On the one hand, he knew his mother would be upset.  On the other hand, he knew that Cathy would be angry if he tried to convince her to spend part of Christmas Eve at his parents' home just to appease his mother.  He told his therapist that he didn't blame Cathy.  He blamed himself.

Jack acknowledged that he thought the way that he and Cathy decided to split the time between their families was fair, but he didn't know what to say to his mother.  He feared alienating her.

Jack's therapist suggested that they use Ego States Therapy to see if there was a part of him that felt courageous enough to stand up to his mother (see my article: Understanding the Different Aspects of Yourself That Make You Who You Are and How Your Shifting Self States Can Affect You For Better or Worse).

So, while Jack was in a relaxed state, his therapist asked him to remember a time when he stood up for himself.

At first, Jack couldn't think of anything, but then he remembered a time when he was a teenager and he stood up to a bully in high school who was bothering Jack's best friend.  At the time, Jack surprised himself by confronting the bully, telling him to back down and watching the bully defer to Jack and walk away.

Jack told his therapist that it felt good to remember how courageous and powerful he felt that day.  His therapist told him that she noticed that when he talked about standing up to the bully that his demeanor changed--his eyes were shinning with pride, he sat up straighter and his chest was out.  Even his voice was different--it was stronger with a confident tone.

When his therapist asked Jack to stay with that feeling and enhance it by seeing what else he was feeling, Jack said he was feeling much more powerful than how he felt before he recalled this memory.

Jack's psychotherapist explained to him that this courageous part was an aspect of himself and that they could continue to work to enhance that part.  She also asked Jack to keep a journal to write down every time he was aware of accessing this courageous part of himself in his daily life.

As Jack worked in therapy to enhance the courageous part of himself, he noticed a shift in how he was feeling.  Between sessions, he remembered his therapist's words about how he could continue to work between sessions to strengthen this aspect of himself, and these words encouraged him to continue to work at it.  Remembering his therapist's words was part of his internalization process of his therapist.

As the holidays got closer, Jack continued to talk to his therapist about how he could deal with his mother's insistence that he and Cathy come on Christmas Eve and Christmas day.

Even though Jack was feeling more confident about it, he still struggled with ambivalence.  He told his therapist that he wasn't sure if he was ready to stand up to his mother, and he wondered if maybe he and Cathy could go along with his mother's wishes just this one time.

His psychotherapist responded by telling Jack that if he didn't assert himself this time, based on what he told her about how Cathy felt, he might be endangering his relationship, aside from continuing to make himself small by always acceding to his mother's demands.

When his mother called Jack to finalize the details of the holiday plans, before he responded to his mother on the phone, he summoned that courageous part of himself that he worked in therapy to enhance.  He also remembered what his psychotherapist told him.  Not only did he remember his therapist's words, he also felt, in a way, that she was with him, as if she were standing beside him and encouraging him.

Accessing the courageous part of himself and his sense of his psychotherapist, he told his mother what he and Cathy decided about the holidays.

At first, there was silence.  Then, his mother protested that she expected them to come to the house on both Christmas Eve and Christmas day, and she wouldn't hear of anything different.  Jack responded by standing his ground.  He told his mother that he didn't want to argue with her about it, but he and Cathy had an obligation to Cathy's family too and they already made their plans.

His mother sounded surprised and unhappy, but she told him that he and Cathy should do whatever they wanted to do.

When Jack returned to his next therapy session, he told his therapist how proud he felt that he asserted himself with his mother.  He also said that Cathy was happy and gave him a big hug after the phone call with his mother.

How Clients Internalize Their Experience of Their Psychotherapists

Jack told his therapist that he intentionally summoned his the courageous part of himself because this is what he and his therapist planned when they discussed talking to his mother about the holiday.  But he was surprised that he had such a strong sense of his therapist while he was talking to his mother.

His therapist told Jack that this is common in therapy: Clients internalize their psychotherapists on an unconscious level so that, at various times, they get a sense of what their therapists would say or do in a particular situation and they're able to use that to deal with the situation.

She also explained that sometimes this phenomenon occurred without an idea of what the therapist might say or do--it was more of a feeling.  She said Jack that this seems to be what happened with Jack at the point when he was facing the challenging situation with his mother.

Jack continued to work on asserting himself with his mother.  He was tactful and respectful with her, but he also stood his ground.  Whenever he needed to, he called on the courageous part of himself and his internalized sense of his psychotherapist to help him.  Over time, his mother resigned herself to the fact that she wasn't going to be able to dominate him anymore.

Conclusion
In the vignette above, the psychotherapist helped Jack to access a courageous part of himself through Ego States therapy that he was barely remembered before he started therapy.  He was able to recall, enhance and use this part of himself to overcome his problem.  In addition, since Jack and his therapist had a good rapport, he was also able to access his internalized sense of his therapist to help him.

No matter what the issue, most clients, who have a good rapport with their therapists, experience this internalization of their therapists and they are able to use it to make changes in their life.

Getting Help in Therapy
Clients are often surprised by what they learn and how they change in therapy.

Part of the learning involves an internalized sense of their psychotherapist.  Whether it's a conscious sense of what the therapist might do or say in a particular situation or a more general sense, this helps the client to deal with difficult situations.

For many clients, this internalized sense of the therapist helps so they don't feel alone with their problems.

If you've been struggling with problems that you've been unable to overcome on your own, you owe it to yourself seek out a licensed mental health professional who can help you to overcome your problems (see my article: How to Choose a Psychotherapist).

Once you're free from the obstacles that have been in your way, you can lead a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works collaboratively with clients and uses an integrative approach in therapy to develop the treatment plan that works best for each client (see my article:  The Therapeutic Benefits of Integrative Psychotherapy).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.