How Contemporary Psychotherapy Has. Changed - Part 2

In Part 1 of this topic, I gave a history of the early psychoanalytic views of psychotherapists' reactions to clients (also known as countertransference) and gave an overview of more contemporary views on this subject.

How Contemporary Psychotherapy Has Changed

There are many ways for psychotherapists to share their reactions with the client--too numerous to write about in one blog article.

In this article, which is Part 2, I provide an example of contemporary psychotherapy with a fictional clinical vignette which illustrates one way that the psychotherapist's willingness to share her views with the client can accelerate the work in therapy and help to heal the client.

Fictional Clinical Vignette: Psychotherapists' Reactions to Clients

Nina
After struggling on her own for years with low self esteem, Nina began psychotherapy again to deal with this issue which was getting in the way of her personal life and her career.

She had been in therapy a few times before in the past and, although she developed intellectual insight into her problems, nothing changed for her.  Overall, her experiences in her prior therapy were not good because her psychotherapists tended to remain silent, and this made Nina feel uncomfortable.  But she decided to give psychotherapy another chance with a psychotherapist who was recommended to her.

As Nina was providing her psychotherapist with a family history, she discussed feeling unlovable in her family, especially after her younger brother was born (see my article: Overcoming the Emotional Pain of Feeling Unlovable).

She explained to her therapist that she found out as an adult that after her birth, her mother was depressed and unable to care for Nina, so Nina's maternal grandmother and various aunts took turns caring for her.

She also found out that after her younger brother was born a year later, her parents were ecstatic to have a boy.  They had always wanted a boy to carry the family name.  And, whereas Nina continued to be shuttled off to various relatives for care, her brother was treated as precious and special throughout his life.

Apparently, by the time Nina's brother was born, the mother was no longer depressed, but she never bonded with Nina.  Her focus tended to be on the brother.  Her father also doted on the brother.  So, from a young age, Nina felt there must be something wrong with her since her parents practically ignored her, and she grew up feeling unworthy of love.

Although she loved her brother, Nina felt angry and resentful towards him.  Intellectually, she knew it wasn't his fault if her parents favored him over her but, on an emotional level, even at a young age, she had fantasies that he would die from a mysterious cause and then her parents would love her more.  These fantasies, which continued into adulthood, caused Nina to feel guilt and shame.

Although she dated in college, at the age of 33, Nina had never been in a long term romantic relationship. Whenever a man expressed interest in her beyond casual dating, Nina would begin finding faults with him in her mind and, eventually, she would end their dating relationship.

At the same time, Nina said, she was very lonely, and when she wasn't dating anyone, she longed to be in a serious relationship.  She would tell herself that she wouldn't be so critical of the next man she dated, but it was an ongoing cycle (An Emotional Dilemma: Wanting and Dreading Love).

Psychotherapists' Reactions to Clients 

The psychotherapist listened to Nina's history with compassion.  She recognized that Nina was caught in a dilemma of wanting love at the same time that she dreaded it.  She wondered if Nina would be able to form a therapeutic alliance with her to do the work or if the therapeutic relationship would be too threatening to Nina.

She also recognized that Nina used the defense mechanism of avoidance in her relationships with men. She could see that this was a necessary emotional survival strategy that Nina developed unconsciously when she was child to ward off the overwhelming feelings of hurt and still maintain a tenuous attachment to her parents (see my article: Understanding Internal and External Defense Mechanisms).

With regard to her career, Nina explained, she lacked confidence in her ideas in a field that was very competitive.  As a result, junior staff, who had much less experience but who were more willing to take risks in presenting their ideas, were getting promoted ahead of Nina, which was discouraging for her.

In the next psychotherapy session, the psychotherapist noticed when Nina spoke, she tended to defensively avert her gaze, and she decided to ask Nina if she recognized this about herself.  At first, Nina hesitated, and then she responded that other people also told her this.  When her therapist asked her if she had any insight into what caused her to do this, at first, Nina said she didn't know (see my article: The Therapist's Empathic Attunement Can Be Emotionally Reparative For the Client).

Her psychotherapist decided to explore this further with Nina, and asked Nina if she feared what she might see in her therapist's eyes.  In response, Nina looked directly at the therapist and then looked away again.

Her therapist asked Nina what she saw when she looked into her eyes, and Nina responded that she saw a lot of compassion and empathy, which she liked, but she was not accustomed to it.

Her psychotherapist decided to share her reaction with Nina regarding the neglect that Nina experienced when she was a child by telling Nina that she was moved by what she said in the first session.  By sharing her genuine reaction about Nina, her therapist hoped this would be the beginning of a positive relationship, although she was aware that Nina might feel a little uncomfortable.

The therapist's disclosure to Nina was in stark contrast to the more traditional stance in psychotherapy  that she had experienced with her prior therapists.  In the traditional stance, the psychotherapist wouldn't disclose any personal reactions about the client because it would be considered "overly gratifying."  But, in this case, the psychotherapist, who worked in a contemporary way, used her clinical judgment with the hopes of forming a positive relationship with Nina.

When Nina heard her psychotherapist's words, she looked up and smiled, "Thank you.  No one has ever said that to me. I can see that you really are moved, and that feels good."

As they continued to work together in therapy, the psychotherapist saw that Nina sometimes minimized the neglect that she experienced in ways which Nina, unknowingly diminished her own self worth.  Minimization was another defense mechanism that Nina used.

One day Nina talked about something that occurred when she was five years old.  She said she overheard her mother tell a maternal aunt that she felt Nina was a "burden." Her psychotherapist could see that there was a moment when Nina felt sad.  But then Nina swept her feelings under the rug by minimizing the incident, "My mother was probably having a bad day, so I shouldn't feel bad about that.  Anyway, it happened a long time ago."

Rather than allowing Nina to discount her own feelings about overhearing such a hurtful remark from her mother, her psychotherapist said in an empathetic tone, "That would be a nightmare for a five year old to hear her mother say" (with emphasis on the word "nightmare").

Nina seemed surprised by her psychotherapist's reaction.  As she allowed her therapist's words to sink in, she began to cry, "Yeah, it was.  I went back to my room and cried myself to sleep.  You're the only person that I've ever told this to."

Her psychotherapist explored with Nina what it was like for her to hear her therapist express her reaction to what happened as "a nightmare."  In response, Nina said that it felt good to have someone who understands what it was like because, back when she was five, she had no one.  She said she felt it gave her "permission" to feel her emotions rather than trying to ward them off.

Then, her psychotherapist explained that, even though this incident and many more like this happened a long time ago, these experiences had a significant impact on Nina emotionally and they were at the root of her problems (see my article: Understanding Why You're Affected By Trauma That Happened a Long Time Ago).

During the course of her therapy, there were many more instances where Nina's therapist used her reactions to Nina to help her to overcome defensive strategies that worked when she was a child but were now creating problems for her.

Over time, Nina was able to catch herself as she was about to use a defense mechanism to ward off uncomfortable feelings.  This allowed the work in therapy to deepen.

When Nina was ready, her psychotherapist suggested that they use EMDR therapy to help Nina to overcome her unresolved childhood trauma and also work on current problems (see my article: Experiential Therapy, Like EMDR Therapy, Helps to Achieve Emotional Breakthroughs).

The work in therapy was neither quick nor easy.  But over time, Nina became increasingly comfortable with her psychotherapist's more contemporary way of working, as compared to the more tradition way of her prior therapists.

She found her psychotherapist's expressions of compassion and empathy to be healing, and this allowed Nina to open up more in therapy.

After a while, Nina was able to feel on a deep level that she had been a lovable child, and it wasn't her fault if her parents were so unloving towards her.  This understanding was not just an intellectual understanding--she felt it deeply.

Gradually, Nina became more self confident.  She no longer feared developing a loving, committed relationship with a man.  So, when she met someone that she really liked and who cared for her too, she didn't push him away like she did in the past.  She allowed the relationship to grow and flourish, and she was able to accept her own feelings and that he cared about her without feeling threatened by the emotions.

She also became more confident in presenting her ideas at work, which her director noticed.  Eventually, she received the promotion that she had wanted for such a long time.

Conclusion
In traditional psychotherapy, psychotherapists don't divulge their reactions to their clients.  They attempt to maintain a neutral stance.

In my clinical opinion, there is no such thing as a neutral stance--no matter how much a psychotherapist attempts to hide what s/he feels.  Even if a psychotherapist attempts to maintain a neutral stance, clients can be very perceptive and sense what a psychotherapist is feeling.

Attempting a neutral stance is not only outmoded, in opinion, it's actually hurtful for the client, especially a client who was raised in an abusive or neglectful environment as a child.  In many ways, attempts at therapist neutrality are often retraumatizing for the client.

But, even though the field has progressed, many psychotherapists are still being trained to be neutral with their clients, as I was when I was trained more than 20 years ago.

This doesn't mean that a psychotherapist should share whatever comes to her mind without regard for how it will affect the client.  That could be equally hurtful.  Instead, a psychotherapist needs to make clinical judgment calls with each client and in each session with each client as to what would be helpful for the therapist to share and what would not.

For many clients, as in the fictional vignette above, having a psychotherapist who can, in effect, go back in time with them to explore the client's history in a compassionate and empathetic way, is a healing experience that they might never have experienced before.  It helps the client to open up and accelerates the work in therapy.

Getting Help in Therapy
Many people, who experienced early trauma, never come to therapy because they're fearful of being retraumatized (see my article: The Benefits of Psychotherapy).

A skilled psychotherapist with good clinical judgment and who is trained in trauma therapy can provide the client with a healing experience that allows them to work through early traumatic experiences (see my article: How to Choose a Psychotherapist).

If you have unresolved trauma that is having a negative impact on your life, you owe it to yourself to get help from an experienced trauma therapist.

Working through your trauma can free you from your history and allow you to live a more fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I am a trauma therapist, who works with individual adults and couples.

I have helped many clients to overcome past and current trauma so they can move on to live happier lives.

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.

How Contemporary Psychotherapy Has Changed - Part 1

In the past, in classical Freudian psychoanalysis, as it was practiced in the United States, psychoanalysts in training were taught to be neutral towards their clients and avoid any outward display of their personal feelings about the client (referred to as countertransference).

How Contemporary Psychotherapy Has Changed

At that time, the psychoanalyst sat behind the client with the client lying down on the couch. The idea was that the client wouldn't be distraction by seeing the psychoanalyst, so the client could free associate, and the psychoanalyst could focus on listening to the client rather than looking at the client.

How Contemporary Psychoanalysis and Psychotherapy Have Changed
Of course, as most contemporary psychoanalysts and psychotherapists know these days, Freud may have espoused a neutral stance on paper but, by all accounts, he was warm and personal with his clients in person.  He would often walk with them in his garden or have them over in his home.  But American classical psychoanalysts followed Freud's written word rather than his actual practice.

I believe this is why traditional psychoanalysis came to view the psychoanalyst's reactions (or countertransference) to the client as being something to overcome rather rather than the reactions being useful clinical information about what the therapist was intuiting about the client and their therapeutic relationship.

Fortunately, this has changed significantly and most contemporary analysts and psychotherapists view their reactions to the client as being a useful part of the therapy which can be shared with the client when it is clinically appropriate to do so.

In many ways, this has freed up the psychotherapist to be more emotionally accessible to the client.  It opens up a new avenue for the therapist to use him or herself in a new way.  It also helps to create more of an egalitarian relationship with the client when the psychotherapist is more accessible and shares reactions when they are useful to the client.

In addition, for clients who grew up in an abusive or neglectful environment as children, interacting with a psychotherapist who is free to be more open and emotionally accessible is a welcome change from what traumatized them as children (see my article: The Psychotherapist's Empathic Attainment Can Be Emotionally Reparative For the Client).

But it also makes being a psychotherapist more complicated.  Without the strict practice of the psychotherapist taking a neutral stance with the client, the psychotherapist has to make many more clinical judgment calls about when and how to be more open with clients.  There is always the chance that if the psychotherapist shares his or her reaction to the client that the psychotherapist might make a clinical mistake and share something that the client isn't ready to hear.

Although there is room for error in this more contemporary and open way of working in psychotherapy, I believe it's a refreshing change from the old traditional way.

Under the traditional way, too many clients, who grew up in abusive or neglectful homes were retraumatized by psychotherapists who remained silent most of the time, and these therapists only made occasional comments or interpretations, which could take a long time--weeks, possibly months.

I believe that, generally, clients in psychotherapy need a more empathetic and emotionally accessible psychotherapist who is comfortable sharing his or her reactions to the client when it is clinically appropriate.

I say "generally" because, occasionally, there are clients who still want a traditional stance of neutrality and prefer that the psychotherapist not speak or speak very little.  

Although this is not what most clients usually seek, there are some clients who felt so impinged upon by one or both parents that a psychotherapist who is more interactive would feel like another impingement to them.  In those cases, it's up to the psychotherapist to respect the client's wishes or, if this way of working is so foreign to the psychotherapist, s/he would have to make a referral to another psychotherapist.

The Psychotherapist's Responsibility For Ruptures and Repairs in Psychotherapy
With regard to the possibility of the psychotherapist making mistakes, mistakes can usually be repaired between the psychotherapist and the client (see my article:  Ruptures and Repairs in Psychotherapy).

In fact, it's inevitable that, as a human being first and a psychotherapist second, a therapist will make some mistakes with some clients, especially since psychotherapy is as much an art as it is a science.

Hopefully, these "mistakes" are few and far between and don't involve ethical issues or boundary violations (see my article: Boundary Violations and Sexual Exploitation in Psychotherapy).

Aside from ethical mistakes, which are more serious than the usual mistakes, the mistakes that I'm referring to are clinical mistakes, possibly with the regard to the timing of a comment or a misunderstanding between the client and psychotherapist.

Whatever is involved with the clinical mistake, it's up to the psychotherapist to acknowledge the mistake and make reparations by giving a heartfelt apology to the client and working together with the client to repair their therapeutic relationship.

Most clients are aware that psychotherapists make mistakes at times, and they are able to work through these issues.  If they came from homes where parents never acknowledged mistakes, let alone make attempts at reparations, the process of reparation in psychotherapy can be a healing experience for clients.

In my next article, I'll continue this discussion with regard to the types of reactions or countertransference that contemporary psychotherapists often share with clients (see my article: How Contemporary Psychotherapy Has Changed - Part 2).

Getting Help in Psychotherapy
Attending psychotherapy is a unique experience that provides an opportunity to get to know yourself better, overcome traumatic experiences, and work through current and past problems (see my article: The Benefits of Psychotherapy).

Choosing a psychotherapist often involves meeting with more than one psychotherapist to determine who you feel most comfortable with before you begin the therapeutic process (see my article: How to Choose a Psychotherapist).

If you have been struggling on your own with an unresolved problem, you could benefit from working with a skilled psychotherapist who can help you to work through your problem so you can live a more meaningful an fulfilling life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work in a contemporary way with individual adults and couples, and I provide a empathetic and supportive environment.

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.

Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy

The concept of resistance in psychotherapy originated with Sigmund Freud while he was developing psychoanalysis.  He noticed that some clients refused to talk about certain aspects of their life or, from Freud's perspective, they unconsciously behaved in uncooperative ways that sabotaged the therapy.  Ever since that time, the concept of resistance has taken on a negative connotation and, in my professional opinion, is pathologizing of the client.  

In an earlier article,  Reconceptualizing the So-Called "Help Rejecting Client", I discussed the importance of depathologizing this concept because calling the client "help rejecting" is neither helpful to the client nor to the therapist to understand what's going on in therapy.  Similarly, in this article, I'm advocating for psychotherapists to redefine resistance in therapy and to take a more nuanced look at what's going on.

Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy

The Traditional View of Resistance in Psychotherapy
Freud conceptualized resistance to be any unconscious behavior by the client in therapy that was, from his perspective, oppositional and uncooperative.

He indicated that there could be different types of resistance, including transference resistance where the client responds to the psychotherapist as if the therapist is someone from the client's past (typically, parents), self sabotage, ego resistance where the client regresses to an earlier stage of development, repression where the client unconsciously pushes down memories that s/he is avoiding, and other similar forms of so-called resistance.

There might still be psychotherapists, including Classical psychoanalysts, who see the concept of resistance in the same way that Freud did, but many more contemporary psychotherapists have taken a less pathologizing perspective of resistance, and I include myself among those contemporary therapists.

Depathologizing the Concept of Resistance in Contemporary Psychotherapy: Shifting Self States
The traditional way of looking at resistance sees the psychotherapist as being authoritative, someone who knows what's best for the client.  Looking at it from that perspective, when a client is being resistant, the therapist's view is that the client isn't following what the therapist says is best for him or her.

Needless to say, this traditional way of working with clients in therapy is from a time when there was little to no mutuality in psychotherapy between the client and the therapist.  The therapist was seen as the expert and the client needed to follow the therapist's ways of working or, it was believed, the client wouldn't get better.  This way of working tended to shame the client.

During the last 20 or so years, there have been many changes to psychotherapy and, fortunately, this traditional way of seeing the therapist as the authority figure and the client as being in a subordinate position is, for the most part, not practiced any more.

Most contemporary psychotherapists work in a collaborative way.  There is a recognition that psychotherapists don't have all the answers and that the client and therapist need to work together in therapy (see my article: Why It's Important For Your Therapist NOT Have All the Answers).

In my opinion, along with working in a collaborative way, it's also important to recognize that there are two people in the room and there's an intersubjective experience between the client and the therapist (see my article: The Psychotherapy Session: A Unique Intersubjective Experience).

Rather than the psychotherapist being the all-knowing authority figure, I believe it is much more helpful for the therapist to use her clinical skills and expertise to be attuned to what is going on with client in the therapy session and help the client to formulate his or her own understanding (see my article: The Psychotherapist's Empathic Attunement).

This is a much more client-centered way of working in psychotherapy and tends to help the client to feel more comfortable with the therapist and the therapeutic process, as opposed to the former traditional stance in therapy where the psychotherapist was the authority figure and was "always right."

In a prior article, Understanding the Different Aspects of Yourself That Make You Who You Are, I discussed that we all have many different aspects of self (or self states) that make us who we are, and these self states are continuously shifting in all of us (see my article: How Your Shifting Self States Can Affect You For Better or Worse).

Depending on the person, these self states often shift in a barely perceptible way because they are integrated as part of the person's overall makeup of who s/he is.  Or, in some cases, they might be less integrated, which would mean that shifts in self states might be more intense and noticeable.

As I've mentioned in other articles, when I discuss self states that are shifting, I'm not referring to multiple personality disorder or, as it's currently known, dissociative identify disorder.  I'm referring to shifting self states as a natural part of what occurs in everyone.

When we look at the concept of resistance in psychotherapy as part of shifting self states, it's a much more useful way of looking at it.  Rather than seeing the client as being resistant, when we take into account shifting self states, we can see that there are different parts of the client that might feel different ways about a particular part of therapy.

Let's take a look at a fictional clinical vignette that illustrates these concepts:

Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy

Ken
Ken began psychotherapy because he felt stuck in his personal life and in his career.

Contemporary Psychotherapy: Redefining the Traditional Concept of "Resistance" in Therapy 

He was unable to sustain a relationship for more than a few months.  After that initial stage of dating, Ken would become fearful of being engulfed in his relationship and he would end it.  Afterwards, he would have regrets, but his fear of engulfment kept him from trying to reconcile his former relationship.  Then, the pattern would begin again with the next person.

At 32, Ken was starting to despair that he could ever be in a long-term relationship.  He was afraid  that his fear of engulfment would continue to sabotage any potential relationship and he would be alone.

With regard to his career, Ken was a middle-level manager, and he usually had problems with his superiors.  Intellectually, he understood that there was a hierarchy at his company, and he understood the reason for the hierarchy.  But on an emotional level, he resented it, and he would sometimes challenge his bosses in subtle and not so subtle ways at staff meetings, which tended to cause problems for him.

Ken was told by the senior vice president at his company that he was viewed as a hard worker and a creative thinker, which was valued at the company, but his "attitude" towards his superiors was getting in the way of his career advancement.

The senior vice president told Ken that, even though Ken was seen as being capable of advancing in terms of his work and creativity, he was also seen as "difficult" and some of the senior managers were hesitant about having Ken as a direct report.  He advised Ken to work on changing his attitude because if he didn't change, he was probably jeopardizing his future with the company.

Deep down, Ken knew that the senior vice president was right.  He knew he could be provocative at times with his boss.  After these incidents, Ken wasn't sure what came over him.  He regretted his behavior and he would apologize to his boss.

Even though his boss was very understanding, Ken knew that he couldn't continue to do this and survive at the company.  He knew he needed to understand himself better and change.

He explained to his current psychotherapist that he had been in therapy in his late teens and early 20s, and he found it to be a discouraging experience.  He would often challenge his psychotherapist's interpretations and it caused friction in their relationship, especially when his therapist called Ken "resistant."

That therapy ended when Ken felt too ashamed to continue, and both Ken and his therapist ended the therapy feeling frustrated.  This experience in psychotherapy kept Ken away from therapy--until now.  He decided to give therapy another chance because he knew he wouldn't be able to change without help.

When Ken's current psychotherapist heard Ken describe his family background, she began to understand what might be contributing to his problems in relationships and in his career.

Ken grew up as the older of two sons.  His father, who was a successful attorney, tended to be cold and authoritative with everyone in the family, including Ken.  Ken said, "My father definitely ruled the roost and everyone had to fall in line with what he wanted, and I resented this."

Ken's mother tended to be overly protective and "smothering" of Ken and his brother.  Even when he was a child, Ken felt overwhelmed and engulfed by his mother's anxious ministrations.

In his teens, even though he loved them, Ken often felt angry with his parents.  He would frequently argue with them and, once, almost came to blows with his father.  By that time he was 18, he was relieved to go away to college to get away from both parents.

Ken's current psychotherapist explained that she worked in a contemporary way that is interactive and collaborative (see my article: Why It's Important For Psychotherapists to Provide Clients With Psychoeducation in Psychotherapy).

His therapist also explained the concept of shifting self states to help Ken understand his ambivalence about relationships and his career.  Specifically, it seemed to her that part of Ken wanted to be in a long-term relationship, but part of him was fearful.  The part of Ken that was fearful would become dominant as the relationship got serious and this part contributed to the demise of the relationship (see my article: Wanting and Dreading a Relationship).

Similarly, his psychotherapist explained, that it seemed that part of him wanted to be more cooperative with his boss at work, but another part resented that the boss was an authority figure, and this part would dominate at times and get Ken into trouble.

Then, rather than assuming that she was right, his therapist asked Ken if what she said resonated with him.

Ken responded by saying that he never thought of himself as being made up of different parts, and this idea intrigued him.  As he thought about it, he could see how the different aspects of himself interacted with others at various times.

His therapist also explained that it seemed as if these parts of him that were creating problems for him were based on his earlier experiences, and these parts were actually trying to protect him from feeling overwhelmed like he felt when he was younger.  But now, these parts were getting in his way (see my article: Understanding Why You're Still Affected By Trauma That Occurred a Long Time Ago and Coping With Trauma: Becoming Aware of Triggers).

Since Ken was open to the idea, his therapist recommended that they do Ego States work, which is an experiential form of therapy, to help him to differentiate the different parts of himself, understand when they get triggered, and address the fears that were contained in these parts.

Rather than talking about the different parts of himself, Ken would experience these parts in Ego States work (see my article: Experiential Therapy Helps to Achieve Psychological Breakthroughs).

At first, Ken agreed that this was a good idea, and he was enthusiastic about it.  But soon after they started doing Ego States work, Ken got anxious and he wanted to stop.

When his therapist attempted to explore with Ken what happened, Ken told her that he didn't know--he just didn't want to do it.

His therapist explained that she respected his choice.  She just wanted to understand and help Ken understand what shifted for him.  She said that if Ken was open to this exploration, it might help him to understand what shifted for him in terms of shifting self states.

The particular memory they were working on was an experience Ken had with his former girlfriend when he felt overwhelmed by her suggestion that they talk about where their relationship was going.  He remembered feeling the same as when he was younger and he felt engulfed by his mother.

It was at the point when Ken wanted to stop doing this experiential work and he said to his therapist, "I know you're going to tell me that I'm being 'resistant' just like my prior therapist used to say to me."

But Ken was surprised that his current therapist told him that she didn't find it especially helpful to tell clients that they're being "resistant."  Instead, she went back to the concept of shifting self states and that a particular self state, whose motive might be protective, might be the cause of this change in him.

Ken was relieved that his therapist wasn't blaming him, and he became less defensive.  This allowed him to think about what shifted for him internally as they were doing Ego States work.  As he calmed down, he realized that he thought of his mother while they were working with the memory and he remembered how he felt so overwhelmed by his mother when she was too much for him.

His therapist said she understood and introduced the idea of internal resources.  As part of developing internal resources, she asked Ken if he could imagine someone who could have been helpful to him when he felt engulfed by his mother (see my article: Using Imagery as a Powerful Tool in Therapy).

Ken thought about it for a few minutes and said he thought his uncle, his mother's brother, would have been helpful.  In fact, when his uncle was around and he saw Ken's mother being intrusive with Ken, he would tell Ken's mother to relax and she would back off.  But, unfortunately, he wasn't always around.

Ken's therapist asked Ken if he would be willing to imagine his uncle being here with him now when he went back into that memory.  Ken agreed, and he was surprised that by using his imagination and sensing his uncle was with him, he felt calmer.  At that point, with the help of this internal resource, they were able to go back to doing the Ego States work.

As they continued to work together doing Ego States work and discussing it afterwards, Ken developed a better understanding of himself.  He also noticed a positive shift in how he interacted with his boss at work, and his boss commented that he noticed it too.

When Ken began dating again, he recognized when a fearful self state was about to get in the way and he was able to calm himself.  He also continued to explore this issue with his psychotherapist.  This allowed Ken to remain in a relationship with a woman that he really liked.

Overall, Ken felt calmer and more emotionally integrated at work and in his romantic relationship.

Conclusion
In my opinion as a psychotherapist, the traditional view of resistance is not helpful to the client, the therapist or to the work in therapy.

It tends to be an all-or-nothing concept that doesn't take into account that people are much more nuanced in their behavior.

As I mentioned before, calling a client "resistant" is pathologizing. This also makes it shaming, which creates a lot more problems for the client in therapy.

Taking a more contemporary view in psychotherapy and seeing what might be called "resistance" as shifting self states helps the therapist and the client to understand ambivalence and to work through that ambivalence with the parts of the client that are getting in the way.

Getting Help in Therapy
If you feel stuck in your life, even though you really want to make changes, you might be struggling with self states that are ambivalent about the change.

Ego States therapy is one way to work in therapy to help to distinguish the different self states involved in the ambivalence, give them "a voice," and work towards overcoming whatever fear might be contained in the particular self state.

When you're able to overcome the obstacles in your way, you can live a more fulfilling and meaningful life free from your earlier problematic history (see my article: The Benefits of Psychotherapy).

Rather than blaming yourself or remaining stuck, you could benefit from working with an experienced contemporary psychotherapist who works in a non-pathologizing way (see my article:  How to Choose a Psychotherapist).

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who tends to work in an integrative way in therapy (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

I have helped many clients, in a nonjudgmental and interactive way, to overcome the obstacles that are keeping them from leading a more fulfilling life.

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 regular business hours or email me.

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

A common myth about psychotherapy, especially among people who have never been in in-depth psychotherapy before, is that clients primarily "complain" to their psychotherapists about their families and their lives or come in to "fix" a particular problem. 

Balance, Gratitude and the Evolution of Contemporary Psychotherapy

This is a very narrow view of psychotherapy and does not take into account the full richness and experience of the in-depth psychotherapy process as a place where clients, in addition to resolving particular problems, often find balance and gratitude in their lives, their relationships and for themselves as well.

During this Thanksgiving season, when we tend to be more aware of the people and things in our lives that we are grateful for, I'd like to focus in this post on how in-depth psychotherapy often leads to a greater sense of balance and gratitude.

Often, when people first begin psychotherapy, they either come for a particular problem or they have a sense that "something is wrong" in their lives, but they don't know what it is. In our culture, our tendency is to approach problems in a logical, linear way: identify the problem, analyze the various options, chose an option, fix the problem, and the process is finished.

There's nothing wrong with this approach and, in many instances, it works very well. It also often works well for some specific problems in psychotherapy and hypnosis, like smoking cessation or overcoming a particular fear or phobia. However, in-depth psychotherapy can be so much more than this for people who are interested in finding a greater sense of balance and contentment in their lives.

How Contemporary Psychotherapy Has Evolved Over the Years:
As psychotherapy has evolved over the years, there has been more of an emphasis on cultivating and building a more balanced sense of self. As opposed to more classical ways of working in psychotherapy where the emphasis was primarily on uncovering and working through problems, contemporary psychotherapists also help clients to build a stronger sense of self.

This is done, in part, through the development of clients' internal resources. These internal resources can take many different forms. Sometimes, they're coping abilities that clients have had all along but have been overlooked and under utilized. Often, they're internal resources, or parts of ourselves, that are discovered and developed during the psychotherapy process.

When people are depressed or anxious, it's common to focus on what's wrong or missing in their lives. This is understandable. Often, under these circumstances, their view starts out being narrow until they begin to feel some relief from their anxiety-related or depressive symptoms in a supportive psychotherapy treatment environment.

In contemporary in-depth psychotherapy, clients can begin the process of building a stronger sense of equanimity: a greater capacity to soothe themselves, love and value themselves more, appreciate subtle and richer aspects of themselves, and develop a stronger sense of identity.

With a greater sense of balance for themselves often comes an increased capacity to value and have a greater sense of gratitude and compassion in their relationships, their work, and other important areas in their lives. So, what might have started as a narrow view at the start of psychotherapy begins to open up and broaden to include a more holistic and nuanced view of themselves and others: Not just what's wrong--but what's right too.

Keeping a Gratitude Journal:
I often recommend to clients that they keep a gratitude journal as a way to start developing a greater awareness and appreciation for the positive things that occur in their lives on a daily basis. 

The gratitude journal can be a simple list of two, three or more things that you feel grateful for each day. Over time, cultivating a sense of gratitude, even for the small things in life, can help to create a greater sense of balance, appreciation, and compassion in how we see our world as well as how we see ourselves.

About Me
I am a psychotherapist and hypnotherapist in New York City. 

I have helped many clients to develop a greater sense of self and an increased sense of balance and gratitude in their lives.

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

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