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Saturday, October 20, 2018

The Psychotherapist's Role in Holding Open the Possibility for the Client's Transformation

Aside from creating a holding environment where the client feels safe and comfortable with the therapist and the therapeutic process, an experiential therapist also holds open the possibility for the client's transformation.

Transformation

What Does It Mean For the Therapist to Hold Open the Possibility for the Client's Transformation?
Many clients come to therapy feeling doubtful and pessimistic about making positive changes.  There is obviously a part of them that hopes they can change, but there is often a bigger part of them that fears they won't change and they'll be exactly where they started before they began therapy.

A skilled experiential therapist creates a space first in her own mind and then intersubjectively between the client and the therapist for the possibility of positive change--and not just any change but a transformation that makes a significant difference for the client (see my article: Psychotherapy: An Intersubjective Experience Between the Client and the Psychotherapist and A Psychotherapist's Beliefs About Psychotherapy Affects How the Therapist Works With You).

The therapist can often see possibilities even when the client cannot.  This isn't a Pollyanna notion or something that is "woo-woo."  This is based on the therapist assessing the client's personal strengths and history as well the signs of resilience in the client (see my article: Discovering Your Personal Strengths in PsychotherapyHow Experiential Psychotherapy Can Help You to Develop Your Personal Strengths and A Strengths-Based Perspective in Psychotherapy).

Fictional Clinical Vignette: The Psychotherapist's Role in Holding Open the Possibility For the Client's Transformation
The following fictional vignette, which is based on many different cases with no identifying information, illustrates this particular aspect of the psychotherapist's role:

Sam
After he relapsed on alcohol after five years of sobriety, Sam began psychotherapy.

During his first session, Sam expressed the despair about achieving sobriety again.  He talked about his relapse, which occurred while he was on a recent company retreat, "I allowed my colleagues to persuade me to drink after our meeting, even though I knew it was a mistake.  I convinced myself  that I could control it and have just one beer.  Then, I was off to the races and one drink turned into five and then I drank the whole weekend.  When I got back from the company retreat, I spoke with my A.A. sponsor and he recommended that I get into therapy.  So, here I am, but I feel like a total failure and I don't think I can get back to where I was in terms of my sobriety."

Listening to his history of struggling with alcoholism from the time he was a teenager, his long family history of drinking, childhood emotional abuse, and Sam's five year history of recovery, his therapist could tell that Sam had a lot of personal strengths (see my article: Why Is It That It's Often the Healthiest Person in a Dysfunctional Family Who Seeks Help in Therapy?).

Not only did Sam begin attending Alcoholics Anonymous on his own in his mid-20s, even though his family tried to dissuade him from going, he also successfully worked the 12 Steps with his sponsor and felt he benefited from doing it.  He was also an active participant on his A.A. meetings in terms of providing service for the meetings and he welcomed newcomers who were struggling with alcoholism.

As a teenager, despite his drinking, Sam achieved above average grades and got a college scholarship, even though his family placed little value in education and tried to persuade him not to go because they thought it was a waste of time.

When his therapist asked Sam if he had emotional support from anyone else in his family or from a mentor or coach, Sam said he had no one.  But he said he was determined to move out of a dysfunctional family environment where his father and older brothers drank heavily and he knew that a college education was necessary for him to realize his independence.

After he graduated college with honors, despite heavy drinking, he went onto law school and landed a good job in a top law firm.

Right around the time that Sam began his new job, he realized that he couldn't continue to drink heavily if he wanted to succeed, and he sought help in Alcoholics Anonymous.

He explained to his therapist that it was especially challenging for him to get sober because, similar to his family, many of the attorneys at his company, including the partners, drank heavily.  In fact, drinking was part of the culture in his company, and the attorneys were expected to take out their clients for drinks.

Sam said he knew that he wouldn't stand a chance of achieving sobriety without the support of a sponsor, so he jumped at the chance to talk to an A.A. member with many years of sobriety who was among the members who stood up at the beginners meeting and offered to be an interim sponsor.

His sponsor, who was also an attorney, helped Sam to work the 12 steps and become aware of his triggers to drinking.  He also helped him to navigate the tricky situations at work where there would be heavy drinking with partners and clients.

Sam explained to his therapist that, looking back on it, he realized that his alcohol relapse began even before he picked up his first drink.  He said it began when he cut back on the number of A.A. meetings he was attending and stopped talking as frequently to his sponsor.  Then, it culminated in not using the tools that his sponsor helped him to develop and in believing that he could have just one drink to be "one of the guys" at the company retreat.

When she heard about his family history, his psychotherapist could see that much of Sam's self doubt and fear were rooted in his history with a father who constantly criticized and belittled Sam.  Even though Sam struggled against his father's emotional abuse, there was a part of him that internalized and believed what his father said about him.

During the initial stage of therapy, his therapist sensed that Sam wasn't ready to hear her assessment that he had a lot of strengths and that if she said it at that point, he would deny it and might even leave therapy.  So, instead, she asked him if he was willing to work hard in therapy to see if he could become sober again.  When he told her that he was willing, they set up a treatment plan, which included increasing his A.A. meetings and talking to his sponsor daily as well as once a week therapy.

As his therapist formed a therapeutic alliance with Sam and felt that he was comfortable with her, she began to point out and praise him for the positive steps that he was taking.  She also pointed out his positive qualities that helped him to begin making changes.

Since his therapist was an experiential therapist, she was actively engaged in the therapy and expressed her genuine delight as he got back on track with his sobriety because she knew that this corrective emotional experience was necessary, especially given the history of emotional abuse in his family (see my articles: With Experiential Psychotherapy, There Are No Blank-Slate Psychotherapists - Part 1 and Part 2).

At that point in therapy, Sam was able to take in his therapist's emotional support and her view of him as someone who had the personal strengths to achieve an emotional transformation.

After Sam had a few months of sobriety, his therapist introduced the idea of EMDR therapy to work on the underlying trauma that was a factor in his relapse (see my articles:How Does EMDR Therapy Work: EMDR and the Brain and Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

Over time, Sam's confidence increased and he was able to acknowledge that he had many personal strengths that he could use to cope and maintain his sobriety in addition to therapy and his sober support system.

By the time Sam completed therapy, he realized that his therapist had believed in him all along and that this was a big part of his being able to sustain his sobriety and transform his life.

Conclusion
A skilled psychotherapist is able to hold open the possibility for clients' transformation even when clients are at a low point in therapy.

Being able to assess clients' personal strengths, as well as their challenges, and keeping in mind that with help most people's inclination is to move towards health and well-being, an experienced psychotherapist can hold open a space for positive change--especially when clients cannot see it for themselves.

Even when this holding open of a space for transformation isn't articulated by the psychotherapist, I believe that it is transmitted unconsciously in the intersubjective space between clients and their therapists.

Many clients recognize in hindsight that the therapist's role of holding onto the possibility of positive change was instrumental in helping them to achieve these changes.

Getting Help in Therapy
Experiential psychotherapists tend to be more present and actively involved in therapy.  They have seen clients' transformation against all odds and recognize the signs and signals that clients have the personal strengths necessary to make positive changes (see my article: Why Experiential Therapy is More Effective Than Regular Talk Therapy).

If you're struggling with problems that you have been unable to overcome on your own, you could benefit from working with an experiential psychotherapist who can help you to achieve a transformational experience in your life.

About Me
I am a licensed NYC experiential psychotherapist who uses contemporary psychodynamic psychotherapy, EMDR, Somatic Experiencing, clinical hypnosis, and emotionally focused therapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients to overcome their history of trauma as well as their own self doubts to achieve transformational experiences in their lives.

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

To set up a consultation, call me at (212) 726-1006 or email me.













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