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:
- The right mindset within the therapist
- The right skill-set
- The therapeutic relationship
- The client’s own resources
- 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.
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