This is How Therapy Works…Sorta…

The title of this blog mostly speaks for itself. My goal here is to take this thing called therapy, rip it apart, show you its insides, show you how it works and simplify and demystify the entire process. Obviously, this is a large and weighty subject so this blog will be a vast oversimplification that glosses over many things but hopefully gives a good survey of the subject (hence the ‘sorta’ at the end of the title). Along the way, we’ll encounter both theory and application. A delicate balance of vague, amorphous ideas and concrete mechanical behavioral interventions. A little something for everyone. There might even be cookies at the end.

No. There will not be cookies.

First, let us assume what the humanists did and do; human beings are basically good. As I’ve mentioned in previous blogs (or at least I meant to) I believe, that although humans don’t always act in the healthiest manner, inside of all of us resides a core of goodness. In an organic way, we all lean towards health and wellness and balance and wholeness. Included also are qualities such as a drive towards growth and development, a self-healing mechanism and a particular “path” that tugs at us and unfolds naturally when given the right amount of nurture.  Assuming the right conditions are present, this propensity towards the positive unfolds and the individual will be compelled to express the full range of his or her potential in the healthiest manner possible. When I say “the right conditions” what I mean more specifically is the presence of strong, healthy, caring, stable relationships, especially early on in a person’s life. Unfortunately, this is where we start to see the first signs of trouble.

As we are imperfect creatures, things in our existence also do not go perfectly.  It is our sad fate as humans to be beset by tragedy and heartache. Over time, as traumas and negative life experiences accumulate, the core of goodness becomes obscured. It gets covered under this mountain of negativity. It remains but we forget that it’s there. Our parents and other caregivers often further this process with poor treatment in our relationships with them. This helps to form an unconscious narrative that goes something like this; “These people are the ones who gave me life; at an early stage, they were, literally, the only people I knew. They are the ones who are supposed to be taking care of me. If they, the ones who gave me life and the ones who are meant to be working in my best interests at all times, are not doing so, then perhaps I’m not worthy of good treatment. Perhaps I’m flawed, damaged. I’m unfit for care and concern. I do not matter”. This narrative covers the core of goodness further and diminishes its power.

Again, however, the core of goodness does not disappear, it only becomes fainter. It continues to show itself in a push towards healing that, although healthy in its origins, often manifests itself in a maladaptive manner due to its stunted growth. When an obstacle is placed in front of a child he attempts to cope with it through a myriad of skills. Perhaps it is the abused child who learns to “fly under the radar” of an all too quick to anger father. Or perhaps he is picked on at school for being short and learns to retreat into a world of make believe and fantasy where he’s a highly skilled ninja. Or maybe as a teenager he witnesses his mother routinely passed out on the couch after a round of binge drinking and learns to cook and take care of himself and his younger brothers. Perhaps it’s the drug addicted teen who abuses substances as an escape from the war zone at home. These are but a few examples of the self-healing mechanism at work. They’re sending signals to the individual that say “survive, cope, manage, stay on the proper path”. And strangely, they sometimes almost work too well.

Those coping skills that are learned in childhood are then carried forward into adulthood. The immature subconscious brain reasons, “this has gotten me this far, KEEP GOING”. It may have been adaptive as a child to not allow yourself to be vulnerable as it was in that vulnerable state you were taken advantage of. It may have been to your benefit as a child to use physical violence as a means to gain power to solve conflict. It may have been proper and healthy to avoid feeling as a young ‘un so as to not have to deal with potentially destructive and overwhelming emotions.

Very often, however, those same tactics don’t work later on. They’re simply not a good fit. They’re like using a rock to hammer in a nail. It’ll work but a hammer would get the job done far better with much less effort. It’s the appropriate tool for the work. These skills may have literally kept one alive as a child. They may be the very reason why you survived at all. However, childlike coping strategies are rendered inappropriate in the adult situation. Consider the child who’s learned to fight physically for everything he has. This may have served him well in the poverty stricken neighborhood in which he was raised. However, in his office job, punching a coworker in the head for “disrespect” would end, not only in termination, but also a big fat felony assault charge to boot. A child who avoids closeness and connection, as he has learned that that those who are closest to him will be the ones to harm him, may be benefited from not lowering his physical or emotional guard around the cousin who molested him. But this will certainly backfire as an adult if his goal is to successfully marry and have children.  Individuals with physical and emotional walls, generally don’t have successful marriages and relationships with their children.

It is said that in therapy “it’s the relationship that heals”. The relationship that exists between a therapist and client is the vehicle by which change occurs.  Although techniques and theory are important, they take a backseat to congruence and a real genuine encounter with a client. In each of the examples mentioned above, there is the theme of relationships. With most of the examples I cited, the relationship is parent/child but any relationship could be substituted; extended family/child, teacher/child, society/child…the list is potentially endless. What these examples also all have in common was a state in which the relationship was less than nurturing to the child. The self-healing mechanism and innate leaning towards growth and health was not given the proper relationship soil in which to take root and flourish so it, instead, took the survival path, which then carried on into adulthood backfired.  In therapy, then, the aim is to use the relationship between client and therapist (or what is often called the therapeutic relationship) and use it as a substitute for the original harmful relationship(s), thus taking the already present core of goodness and self-healing mechanism and bringing it back to its full strength.

What this looks like in actual practice, can be explained as “stages”. The word stages is in quotes as the stages are vaguely defined and often bleed into one another and flip flop for dominance. It’s not NEARLY as linear of a process as will be described here.

When a client enters therapy, he or she is usually in the Exploration stage. This is the stage where the client is asking “what’s in there…what’s the stuff…how did it get there…what maintains it”. After some time, he or she moves to the Insight phase. In this phase, the client has a better understanding of “the stuff” and how it got there and what maintains it. Next, we move to what I call the “Feeling of Feelings” stage. In this stage, the client experiences and processes the emotions related to all of the exploration and insight gained in the previous sessions. This ground zero for the self-healing mechanism. Often, this the most difficult time for clients. I’ve had many, many clients report feeling worse in this stage than they did before they started therapy. Unfortunately, I’d argue that this is an unpleasant but necessary part of the process. In therapy, we are taking the things that have been pushed into the background, all the things that one doesn’t want to think about or feel or acknowledge and we’re setting them on the table before us and forcing a confrontation with them. Surely, this will cause some upset.

If the client is able to withstand the previous stage, and generally it doesn’t last long, he or she gets to the fun part; The Action stage. In the Action stage, the client has reached a new baseline. He or she is able to say “I’m starting from a new platform. I’m no longer willing to let the old traumas be the primary narrative of my life. I’m ready to begin writing a new story for myself”. In this stage, simple behavioral tricks become more effective. Once one has worked through the other stages in therapy and more or less healed the old wounds, things like diet, exercise, self talk, increased structure, healthy sleep schedule and various other interventions can have their maximum benefit. Now that the muscle has been repaired, we can begin to exercise and strengthen it.

In closing, allow me to make 2 final points; again, this is a survey of the process of therapy. In many ways, it’s as simple as what’s been presented; engage the core of goodness through the use of the therapeutic relationship. As the naturally existing healing mechanism is restored to its original strength and does its work, one moves to an action phase where simple behavioral practices enable one to express the full range of potentials that each human has.

On the other hand, in the therapy I’ve experienced as a client, I can only compare it to something mystical and magical. As a giver of therapy, I’ve had the privilege to witness this same magic from a different chair on the other side of the room. I’m not sure a blog or any other written account could ever fully describe what transpires in the therapy room. This is how therapy works. Sorta.

And this brings me to my final point; YOU SHOULD DO IT. It’s an unspoken theme that runs through these words. Therapy is a magical enterprise that may be able to be explained in a simple linear process but to truly understand it, you should experience it yourself. Schedule an appointment today!

 

Unrelated Song: Oathbreaker, “10:56/Second Son of R”. Two songs in one! The video is stupid but the song, THE SONG!!!

Unrelated Book Recomendation: The Stranger by Albert Camus

About Brandon Peters, LPC

Brandon Peters began his career in mental health approximately 11 years ago while pursuing a bachelor's degree in psychology from the University of Arkansas. During his training he worked as a psychiatric technician at the Piney Ridge Treatment Center for adolescent sex offenders in Fayetteville, Arkansas. He later relocated to Houston, Texas and obtained his master's degree in counseling from the University of Houston. Since then, he has worked with clients in residential treatment, psychiatric hospitals, school based therapy, home based therapy, support groups and outpatient therapy. He has worked with children as young as 4, adolescents, and adults in areas such as individual therapy, group therapy, family therapy, case management, play therapy and crisis intervention. Brandon Peters now owns and operates a private psychotherapy clinic conducting individual, group and family therapy and specializes in Existential Therapy. Additionally, he is a board approved LPC Supervisor.
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