Five Essentials of Transformative Psychotherapy

A few weeks ago I had someone ask me, “How can you see client after client and not be exhausted?  Don’t you feel drained after?”  My short answer to her was that I don’t.  As a matter of fact, I feel exhilarated and full of life after a good therapy session.  If I had more time to think about it, I probably would have told her that there are times, though, when I do feel exhausted and drained.  However, those are times when I was not at my best in the session. 

Later, as I thought more about this conversation, I had an epiphany regarding what makes for good therapy and what makes for true healing and transformation.  I quickly pulled out my phone and recorded what I consider the five essentials of transformative psychotherapy:

1.      The right mindset within the therapist
2.           The right skill-set
3.        The therapeutic relationship
4.      The client’s own resources
5.      God / Higher Power / Holy Spirit

I want to expand on each of these here.  This is my list.  Another therapist might have a different list.  My main inspirations for this list are my own years of experience, my studies in Rapid Resolution Therapy and A Course in Miracles, and counseling theory in general.

The Right Mindset

It is important that I be in the right mindset if I am going to be of help to my clients.  As a matter of fact, being in the wrong mindset will assure that the session will be of no benefit.  The wrong mindset will occur if I am distracted, tired, or mentally confused.  Also, the worst thing for me to do would be to see my client as flawed, unworthy, separate from me, or as defined by their presenting problems or diagnosis.

A Course in Miracles says that the one responsibility of the miracle-worker (the one the Holy Spirit works through to heal someone’s mind) is “to accept the Atonement for himself.”  This means that the miracle-worker or therapist will have to know (even if briefly) who she truly is as God’s creation and have a healed mind before she can be of help to others.  This knowing might be fleeting for the therapist.  It might come and go.  The point is to come from this healed, whole, holy mind as much as possible as we work with our clients.  Another term used for this mindset in the Course is “right-mindedness.” 

I often will use a prayer from the Course to help me get into this mindset before a session:

“I am here only to be truly helpful.  I am here to represent Him Who sent me.  I do not have to worry about what to say or what to do, because He Who sent me will direct me.  I am content to be wherever He wishes, knowing He goes there with me.  I will be healed as I let Him teach me to heal.”

In Rapid Resolution Therapy and in A Course in Miracles we learn the importance of having a clear goal for our client at the outset.  This is a vision of the client with their mind restored and healed – where they are operating at the highest level their mind would intend for themselves.  This is another important part of the right mindset that is needed for true healing and transformation to occur.

Finally, Carl Rogers also spoke about three qualities that are needed in the therapist for good results in therapy (sometimes called the core conditions): 1) unconditional positive regard, 2) empathic understanding, and 3) congruence / genuineness / authenticity.  These are core conditions that all therapists will want to work at cultivating within themselves – no matter their theoretical orientation.  They are the building blocks of the right mindset.

The Right Skill-set 

The skills of the therapist must be honed and practiced.  It is a rare thing that a person has such skills without extensive training, modeling, feedback, and practice, practice, practice.  However, such skills are rarely taught in graduate school and are even hard to come by in workshops for clinicians.  It is my experience that therapists have to be proactive in making sure they get the training they need to be effective at their craft.

Anyone can be a “rent-a-friend” (a phrase Dr. Jon Connelly likes to use).  This is a therapist who simply allows their clients to vent about their problems and offers some support and occasional words of wisdom.  The client might leave the office feeling better (let’s face it, venting with a friend does help us feel a little better).  However, they have not learned what they need to do to actually get and stay better.  The therapist has not set the session up in a way that true healing and transformation can occur.  In other words, the therapist either doesn’t have or is not using the right skill-set.

In my opinion an effective therapist is going to have a combination of 1) relationship / interpersonal skills, 2) non-defensive communication skills, 3) rational / cognitive skills, 4) mindfulness/contemplative skills, and 5) hypnotherapy skills.  The needs of the client at the time of the session will determine which skills are called upon.  The most transformative therapy sessions will utilize all skills in a seamless flow.  A therapist also needs to be a great communicator and teacher.  They also need to be a model for the client – demonstrating what they are teaching. 

I have had training in or have studied extensively the following therapies and techniques to acquire the above listed skills.  I recommend all therapists seek out similar training for themselves – no matter the cost.  As a social worker, I have an ethical obligation to make sure that I am competent and trained well in the interventions I use with clients.

Imago Relationship Therapy and the Imago Dialogue

Interpersonal Process Psychotherapy

Rogerian / Person-Centered Therapy

Motivational Interviewing

Nonviolent Communication / Powerful Non-Defensive Communication

Rational Living Therapy and Rational Hypnotherapy

The Work of Byron Katie

Mindfulness-Based therapies like DBT, ACT and others

Mindfulness Meditation

Centering Prayer

A Course in Miracles, Buddhist psychology, Yoga, Christian Mysticism and Theology, and other diverse spiritual / religious paths

Integrative Restoration (iRest) Yoga Nidra

Rapid Resolution Therapy

Memory Reconsolidation

The Therapeutic Relationship

There has been much research on the importance of the therapeutic relationship and how it is the relationship itself that is one of the biggest factors when it comes to therapeutic results.  This relationship has been described in various ways.  One of the best descriptions comes from Carl Rogers and has already been described above under the right mindset.

This relationship is very different from the ones that the client is used to.  They might come to therapy with a history of unstable, abusive, unhealthy relationships.  The therapist’s job is to remain present, maintain the right mindset, and to give the client a very different experience from all other relationships in their life.  It is this new experience that has the potential to heal the client.  I actually like to describe therapy as “a relationship that heals.”

Dr. Jon Connelly (developer of Rapid Resolution Therapy) teaches that many things have happened to our clients before they come to see us – sometimes very bad things.  Our job as therapists is to “happen to them” in such a way that healing occurs.

A Course in Miracles would call this relationship a “holy relationship” or “holy encounter.”  A holy relationship is one where both members of the relationship give up their separate interests and join together with a common goal.  This joining then allows the Holy Spirit to enter into the relationship and use it for healing.

In Rapid Resolution Therapy we also come up with a shared goal with the client (that the therapist leads them to with feedback and input from the client).  Having this shared goal means that the client’s and therapist’s energies are now joined, and this energy can’t help but to expand.  This energy is also power and fuel to bring about the shift from how things have been for the client to how things are now intended.  This therapeutic relationship (this healing / holy relationship) with a shared goal sets the process of change and transformation in motion and keeps it going in that direction even after the session is over (For more about this see my last entry on “Goal-Powered Synergy”).

The Client’s Own Resources

The client has within them what is needed for true healing and transformation.  There is nothing uniquely special about the therapist.  The only difference is that the therapist is temporarily more aware of the truth of themselves and of the client.  The therapist knows that the client has resources that have been unused and knows how to guide the client to find and use them. 

There are times when true healing and transformation happen without any interventions by the therapist.  Oftentimes change comes about from factors outside of the therapy setting – from resources that the client has and brings to the table.  These can be inner or outer resources.  Examples of inner resources are: insight, faith, awareness, talents, skills, past coping mechanisms that were forgotten, etc.  Examples of outer resources are: family support, getting a new job and increased income, “chance” encounters with someone who says just the right thing at just the right time, spiritual support systems, etc.

Another important part of the client’s own resources has to do with what the client does between sessions.  I always tell new clients that one of the main factors in them getting better is what they do between sessions.  Sometimes they are given homework assignments.  Sometimes I ask them to practice certain techniques.  Those who actually follow-through with such instructions are the ones who usually progress much faster.  I always tell my clients that it is essential they do their part.  

God / Higher Power / Holy Spirit

In my opinion true healing and transformation comes from a power much greater than anything of our own making.  The above factors – when combined – can act as a channel for the Divine to do its work.  The therapist, the interventions, the relationship, and the client are all used by the Divine to bring about true change. 

Not all therapists have a spiritual orientation.  And, the therapy sessions themselves do not have to be overtly spiritual for them to have a spiritual component.  It is not necessary that the therapist has a spiritual belief system or that the sessions have a spiritual component to them.  The Divine can still operate through us without us even being aware of it.

Other terms or phrases that can be substituted for the Divine are: grace, mystery, love, synchronicity, power greater than ourselves, energy, creative power, spirit, the universe, etc.  We are all spiritual beings having human experiences whether we realize it or not.  Those of us who are spiritually oriented can be very intentional in “opening the space” for God to work through us.  We can also ask about the client’s own spiritual orientation and encourage those who have one to utilize the practices of their path.

Conclusion

For me, when the above five factors are in place, my job as a therapist is very fulfilling, very effective, and very energizing.  I do not feel tired at the end of the day.  I actually feel “in-spired” – filled with spirit.  There is no doubt that, for me, being a therapist is my calling – my vocation – or, as A Course in Miracles would say, my “special function.”    

I am curious to hear what others think about these five essentials for transformative psychotherapy.  Are there others that you would add?  Do you have a different take on the five I listed? Maybe your list would be totally different from mine.  I look forward to hearing from you.

Goal-Powered Synergy in Psychotherapy

I have been thinking about Global Positioning Systems (GPS) a lot lately, and it seems that I am not the only one.  I have come across a few articles and books that contain the GPS metaphor.  It is usually used to illustrate how goal-setting works. 

                            

Two of the most important influences when it comes to my way of thinking about goals with my therapy clients have been my studies in A Course in Miracles and my training in Rapid Resolution Therapy (RRT) with Dr. Jon Connelly.  Both of them have taught me the importance of having a clear goal at the outset – a vision of my client and the goal of our work together. 

In Chapter 17 of the Text of A Course in Miracles, in a section called “Setting the Goal,” we read:

“The clarification of the goal belongs at the beginning, for it is this which will determine the outcome.”

“The value of deciding in advance what you want to happen is simply that you will perceive the situation as a means to make it happen.  You will therefore make every effort to overlook what interferes with the accomplishment of your objective, and concentrate on everything that helps you meet it.”

Dr. Connelly has made it very clear to me that the most important step in RRT is for me to set my intention for the client before they even enter my office.  He also calls this the “target.”  I am to conceive of the client with his or her mind working to their best advantage.  I like to think of it as a “vision” of my client – where they are clear, focused, fully present – where they are healed, whole and holy.

Once I have this target in mind I will clarify it and make it more specific to my client as I get to know them better and understand how things have been for them.  Once I understand how things have been for them, I can then clarify the goal and communicate it to my client.  I communicate both my understanding of where they have been and my vision of the target.  Once this vision is shared and the client agrees with it, we now have a shared goal.  Now, their energy and my energy are joined, and the joining of energy can’t help but to expand and power the shift in the direction of the goal.

Here is where the GPS metaphor comes in to play.  Now that we have programmed in the goal and are clear on how things have been for the client, everything else that happens in the session will be “set up” to lead the client from how things have been to how things are now intended.  Our internal GPS has been programmed.  Anything that I need to do to help the client reach the target will come to me as I keep these two things clear in my mind – maintaining a dual focus: 1) how things have been, and 2) how things are intended. 

Even if I make a “mistake” or lead the client down the wrong path, the internal GPS will “recalculate” and get us back on track.  In reality, then, there are no mistakes.  There is no way we can fail to reach the target as long as we maintain our shared goal.  The means is clear when the goal is clear. 

Through my training in RRT I have learned many tools to help people along the way to the target.  When I was first training in RRT, I was very nervous about whether or not I was going to remember all of the various processes Dr. Connelly was teaching.  He assured me that it would all come to me as long as I maintained this dual perspective.  I decided to trust him and to trust the training I was receiving.  Since then, I have been amazed at how much I do remember and at how easily each process comes to my mind when I am working with a client.  Even for therapists who are not trained in RRT, keeping this dual perspective can be very helpful. 

If I am traveling somewhere and I want to use my GPS to get there, I have to know where I want to go first.  I can’t just tell my GPS, “I want directions to somewhere, but I don’t know where.”  Once I decide where I am going, I program that in the GPS.  The GPS then gets my current position and calculates the best route to take to get me where I want to go.

No matter what approach to therapy you might utilize, it is important to have a clear goal in mind for your client.  As you meet with your client, you can clarify the goal based on your understanding of where they have been.  Notice the use of past tense – “where they have been.”  Clients are going to talk about how things are currently going for them and might even talk about how it will always be this way.  Subtly changing the tense when we talk with our clients can make a big difference in how they see themselves and in how they conceive of the “problems” they are seeking to alleviate.  They talk about how things are and will always be.  We talk about how things have been for them and how things are intended. 

Of course as clients are coming to see us their difficulties are current.  However, we reflect it back to them with this tense change (from present to past) as a way to move them in the direction we want for them.  If we use the same tense and continue to talk about the problems as if they are current realities, we are reinforcing the “stuckness.”  We also remind them over and over again that the events of the past are over.  RRT does not change what happened.  Instead we are transforming the way the mind has been processing what happened.

I have been trying to think of what “GPS” can stand for in therapy.  What I have come up with is “Goal-Powered Synergy.”  “Synergy” is defined as the interaction of elements that when combined produce a total effect that is greater than the sum of the individual elements, contributions, etc.   It is basically a form of “cooperative action.”  Coming up with a shared goal with our clients sets in motion this “Goal-Powered Synergy” that can’t help but lead us in the right direction.

Ultimately, keeping the goal clear in our minds – keeping our eyes on the prize – is the best way to galvanize all of our resources towards achievement.  A Course in Miracles teaches us that the goal has already been achieved.  We have already arrived.  All we are doing in therapy is clearing the blocks in our client’s minds (and, in our own) that keep them from realizing this truth.

The Avacado Pit: A Metaphor for Traumatic Memories

A metaphor for understanding trauma that I have learned from my training in Rapid Resolution Therapy:

When zebra sees lion the brain of zebra causes him to feel fear.  The fear serves three specific purposes – 1) it causes zebra to be very alert, 2) it increases zebra’s motivation, and 3) it increases zebra’s strength.  This allows zebra to run very fast to get away from lion.  When lion catches another zebra and is no longer a threat, the fear is instantly gone.  Zebra returns to his grazing and everything is fine.  If I could speak “Zebra” I could ask zebra, “So, what do you think about that lion that was just chasing you?”  Zebra would look at me and ask, “What lion?”

Our brains differ from the brain of the zebra in many ways.  One of the main ones is in how we store and recall data.  You might be able to remember some mundane incidents from yesterday – what you were wearing or a conversation you had.  You might not be able to recall what you were wearing a year ago today.  However, we could say that the memory is stored in your brain.  It is just not that easily recalled.  On the other hand, you might be able to recall in great detail something traumatic that happened five years ago.  More than likely that data is experienced in “high definition.”  Sometimes it is experienced as if it is happening right now.

You might be familiar with how a garbage disposal works.  Spaghetti, bell pepper stems, cucumber peels, and pretty much anything you put down the garbage disposal goes right through – no problem.  But, the garbage disposal doesn’t work so well when it comes to the avocado pit.  It gets stuck in the garbage disposal.  We would then need to use some sort of avocado-pit-destroyer to break it up so that it goes through and is no longer stuck.  

The data in someone’s mind related to traumatic experiences are like that avocado pit.  It is “stuck data.”  We can call it a “data clump.”  Some people have many data clumps that are stuck and that still cause them problems.  This data is stuck in a part of the brain that is close to “the surface” – close to where current incoming data passes through.  If incoming data is similar in content to the stuck data, it will “trigger” the stuck data and the brain will cause the person to think it is happening all over again.

A woman who was raped by a man with alcohol on his breath when she was 16 yrs. old smells alcohol on her boyfriend’s breath when he kisses her six years later.  She panics, pushes him off of her, and locks herself in the bathroom.  A man who witnessed several of his buddies die in an explosion while serving in the military in Iraq hears a car backfire in his neighborhood.  He falls down on the floor and covers his head.  He no longer realizes that he is home and all is safe. 

Our objective in Rapid Resolution Therapy is to clear out these data clumps.  That way the person is finally able to live fully in the present moment – free of fear.  A kiss is just a kiss.  A car back firing is just a car back firing.  The avocado pit is through, and the garbage disposal is working as good as new.  

(To learn more about RRT visit www.rapidresolutiontherapy.com.  If you or someone you know is interested in scheduling a session with me, please visit www.billyledford.com)

I Am Doing This Unto Myself

In my dream I was in a very old, antique-looking, building.  I was alone and the building was dark and ominous.  I walked towards a room and reached over to turn the light on.  The light switch was outside the room in the hallway.  The moment I touched the light switch with my right hand, someone grabbed my hand.  I turned around to see no one there.  However, the unseen hand was still grasping my hand.  

In bed, next to my partner, I must have been breathing hard or making a noise because he realized I was having a nightmare.  He woke me up by touching me on my arm.  For a moment I was in a twilight state between sleeping and waking.  I was breathing very hard.  I still felt the hand from my dream grasping my right hand.  I shook my hand to release the grip.  At that moment my own left hand released my right hand.  I was then fully awake from the nightmare and all was well.  

You see, the unseen hand that grabbed my right hand in the dream was my own left hand while lying in bed next to my partner.  It was only when he woke me up that I realized that I was doing this to myself.  This is a common occurrence with my night dreams.  Something will happen in “real life” while I am dreaming, and my dreaming mind will incorporate that something into the dream.  

Later in the morning I was on Facebook and saw a status update by a fellow Course in Miracles student.  She was talking about the idea in the Course that says “you are doing this unto yourself.”  The two paragraphs that explain this beautifully are found in the chapter called “The Healing of the Dream” in a section called “The ‘Hero’ of the Dream.”    

The secret of salvation is but this: that you are doing this unto yourself.  No matter what the form of the attack, this still is true.  Whoever takes the role of enemy and of attacker, still is this the truth.  Whatever seems to be the cause of any pain and suffering you feel, this is still true.  For you would not react at all to figures in a dream you knew that you were dreaming.  Let them be as hateful and as vicious as they may, they could have no effect on you unless you failed to recognize it is your dream (T-27.VIII.10).

This single lesson learned will set you free from suffering, whatever form it takes.  The Holy Spirit will repeat this one inclusive lesson of deliverance until it has been learned, regardless of the form of suffering that brings you pain.  Whatever hurt you bring to Him He will make answer with this very simple truth.  For this one answer takes away the cause of every form of sorrow and of pain.  The form affects His answer not at all, for He would teach you but the single cause of all of them, no matter what their form.  And you will understand that miracles reflect the simple statement, "I have done this thing, and it is this I would undo" (T-27.VIII.11).

My dream illustrated this teaching very clearly to me.  While fully immersed in the dream, I thought I was being attacked by something outside of myself – a ghost or a demon perhaps.  It was only when I was awakened from the dream that I was able to see that I was doing it to myself.  It was my own hand and not the hand of a ghost or demon.  After I woke up my partner asked me if I was okay.  I said that I was.  He said, “Are you sure?”  I said, “Yes.  It was just a dream.”  He couldn’t see it in the dark, but I had a slight smile on my face.  It was funny to me to realize that the “dream hand” was my own hand. 

What the passage from the Course is saying is that this is the case no matter the situation.  Any time I suffer, I am doing this to myself.  No matter the outward form of the suffering, I am doing this to myself.  This is indeed a lesson that the Holy Spirit teaches me over and over again.

I don’t always learn the lesson right away.  I might go through days or weeks thinking that I am the victim of some outside person or situation that is the cause of my suffering.  As long as I believe this way, I am in a hopeless situation.  The only way my suffering will end is if the other person or situations changes in some way.  

Usually, a passage or lesson from the Course will “wake me up.”  It will show me, in one way or another, that I am the cause of my own suffering.  It also shows me that I am the cause of my release.  "I have done this thing, and it is this I would undo."  Learning this lesson over and over again is freeing to me.  As my Facebook friend (Myron Jones) said, “What has been done to me leaves me a victim.  What I have done to myself, I can undo.”  

I am so grateful for this lesson.  It is my prayer that I will fully internalize it so that I never forget.  Thank you, Holy Spirit, for your patience with me and your willingness to teach me.

The Real Enemies

The recent suicide of a transgender female in Ohio has brought this issue to national attention.  I have seen this story shared many times on social media.  Many of my friends are very angry with her parents for their lack of support and their attempts to have her change and be a boy.  While this anger is understandable, I feel that it is misdirected.

Whether the issue is equality for transgender individuals, gay, lesbian, and bisexual individuals, people of color, religious minorities or any other group, the enemy of equality is not people.  Our tendency is to focus on the people that perform acts of evil – bullies, parents, police, suicide bombers, etc.  We then label them evil and demand that they be punished.

However, the truth, spoken so powerfully by Martin Luther King, Jr., is that “evildoers are also victims and are not evil people.”  The third principle of nonviolence that Dr. King taught is stated in full: 

PRINCIPLE THREE: Nonviolence seeks to defeat injustice not people.

Nonviolence recognizes that evildoers are also victims and are not evil people. 

The nonviolent resister seeks to defeat evil not people.

- See more at: http://www.thekingcenter.org/king-philosophy#sub2

The real enemy, then, is injustice.  And, injustice arises as a result of misinformation (a nice way of saying “ignorance”).  When we perpetuate misinformation in our various institutions (church, schools, government, family, etc.), we are creating the breeding ground for injustice.  It is important that we keep our focus on the real enemies – misinformation and injustice. 

When we know who the real enemies are, we then know what our tasks must be if we are to create change.  Our tasks are to inform, to educate, and to demand that the institutions that inform and educate our children do a better job.  The problem is a systematic one.  Our systems of injustice must change.  Those systems ultimately emerge from a thought-system of fear, separation, division, and irreconcilable differences.  It is our institutions and the thought-system that gives them birth that must change.   

This young woman’s parents are not the enemies.  Christians are not the enemies.  Republicans or Democrats are not the enemies.  Ignorance and injustice – those are the enemies.  We all have to live together on this planet, in this country, in our local communities.  The only way we can do that is if we all work together to defeat all systems of injustice.

The task I give myself is to “think globally, act locally.”  I think globally by being aware of all of the systems of injustice on the world stage.  I act locally by first and foremost, starting with my own mind.  Am I feeding the thought-system of fear, separation, division, and irreconcilable differences?  Or, am I feeding the thought-system of love, oneness, communion, and reconciliation?  I then act locally by practicing the thought-system of love in all of my relationships with friends, family, co-workers, clients, strangers, etc.  I then act locally by being aware of systems of injustice in my local community.  What am I doing to make a difference?  Am I taking action, or am I waiting for someone else to take the first step? 

If all of us do this, all of our local acts of justice and compassion will transform the world.  So, I encourage all of you to “think globally, act locally.”  Start with your own mind.  Then move out into your most local relationships.  Then expand this to your community.  And, always remember that our goal is to defeat evil, not people.