So the big question is if treatment using psychedelics is here to stay or whether it’s a ‘flash in the pan’. Those who advocate for it claim that it lowers habitual defenses in a way that allows the mind the neuroplasticity to expand. This often allows for a new perspective on blockages and situations that have prevented the person from living more fully. Yet, others view the use of psychedelics as an attempt to find a ‘quick fix’ shortcut that hopes to bypass the rigors of a more traditional therapy style designed to help the person toward gradual but long term change. In truth, these 2 aspects can be integrated as new understandings gained under the influence can be reinforced and explored in follow-up regular therapy sessions.
However the introduction of a drug or substance means that there needs to be an added level of medical supervision, since people may have varying physiological responses and reactions. In the podcast we will also consider the importance of creating a safe environment based on the trust level between the client and the attending team. Although this aspect is often not fully considered, it is by creating a trusting alliance that the client can be guided through his personal experience in a way that ensures a positive therapeutic outcome.
We don’t often hear about this topic in seminars or training. This is one of those things that most of us don’t want to think about. The hope is - If we don’t think about it, maybe we won’t ever have to deal with it.
Usually if there is some kind of difficulty, we try to work with the client to come to an amicable agreement. However, if you work long enough in this field, inevitably there are situations or circumstances where the client may be more interested in pursuing a court settlement. Sometimes a frustrated client my become intent on harming your reputation through legal action or filing a complaint to the professional board.
In this podcast we will explore various scenarios and how to recognize potential warning signs and pitfalls, along with ways to avoid and address them.
Which type of therapist are you? Are you more the ‘expert’ therapist that guides your client in a ‘top down’ approach to behave in an appropriate manner, think more rational, or see things in a more realistic way. Or are you more the ‘explorer’ type who works from the ‘bottom up’ to help realign blocked emotions, ‘parts’, or thoughts to encourage internal integration and growth.
Either way the therapist comes with a ‘helping agenda’ designed to move the client forward to achieve the end goal of being more ‘functional’. The problem, of course, is that even the most motivated of clients’ are not always ready to keep up with their therapist’s well-meaning ‘helping agenda’.
This leads us to suggest a third possible option that is beyond ‘top down’ or ‘bottom up’; what might be called a ‘Here & Now’ approach. Here, in a paradoxical manner, the therapist is willing to let go of his personal agenda to change the client. In so doing, the focus of treatment is to simply strengthen the alliance based on enhancing a trusting relationship that is not dependent on changing behavior, emotions, or thoughts. The focus is to simply accept the client ‘as he is in this moment’.
Instead of trying to encourage the client to be or do more of ‘who he is not’, - in the ‘here & now’ we offer empathy, humor, and genuineness to relieve the client’s underlying experience of abandonment, isolation, and feeling stuck. This unconditional acceptance results in feeling a profound sense of internal relief. When done correctly, this instigates an organic, unplanned, and unexpected level of change that is not subject to a linear or logical agenda.
Many therapists might think that Somatic therapy is new to the therapy scene. However, Fritz Perls from Gestalt Therapy incorporated many somatic type interventions in facilitating his work. Often he would tell clients, “Lose your mind, and come to your senses!” The direction of therapy would guide clients to get in touch with their body’s inner energy and sensations. In this way he would encourage people to express and release the wordless blocks that prevented their energy from flowing more freely and openly.
Dr. Peter Levine expanded on this concept with his work in Somatic Experiencing. He recognized how trauma and stress could become “locked” in the body. When this occurred, such trauma would not only effect people emotionally and psychologically, but lead to physical symptoms of anxiety, depression, shallow breathing, and many other physical issues.
On the surface Somatic therapy seems to focus mainly on becoming aware of tension in the body, followed by the process of learning to release these blockages. But a good somatic intervention does much more than this…
In this podcast we will address how the somatic approach provides therapy with an agenda and direction, but will also explore the often overlooked underlying ‘active ingredient’ that is necessary for such interventions to be successful in ensuring long term healing.
Therapy has evolved quite a bit since the 1970’s and ‘80’s. Even at that point psycho-analysis no longer had a monopoly on therapy. While John Bowlby had already introduced his work regarding parent-child attachment, its significance was not yet recognized. Back then, behavioral therapy and CBT had come to dominate the field. The assumption was that by rewarding positive behavior or using logic and rational approaches it was possible to get people to change their behavior and thinking. While this had an effect on more superficial cases, there were many clients who did not benefit from these approaches.
However over the years, the importance of Bowlby’s work became more evident as to the impact of attachment and disrupted attachment (aka: trauma) had on influencing child development. We now understand that untreated trauma does not simply go away, but rather influences the personality into adulthood. As a result our awareness of trauma related issues, the underlying question in therapy is no longer "What's wrong with you?" but rather "What happened to you?"
Fritz Perls of Gestalt Therapy recognized that blockages in people’s daily lives were caused by early forms of trauma. He called these blocks ‘unfinished business’. In today’s podcast we will discuss what needs to be done to address unfinished business and how far we need to dig.
Everyone knows that therapy is serious business. We help people from broken families with broken dreams to put back the broken pieces of their lives. So suggesting that there is a place for ‘joking and absurdity’ in therapy may seem a bit counter-intuitive. However, ultimately it is the client’s ability to integrate his trauma and suffering that will determine how quickly he heals. Part of this process often depends on the clinicians’ ability ‘lighten up’ the dark cloud the client carries. Of course, showing the absurdity of the client’s situation must be done with caring and empathy. But when done correctly it often can provide a new perspective and a ray of hope to move beyond the burden of their dilemma.
A humorous remark can sometimes reveal the thin line between laughing and crying as a way bring a person to the next level of his healing process.
The problem with teenagers is that they are neither here nor there. Sometimes they act like adults and sometimes like children. For therapists’ this can be challenging because we don’t always know who will show up. On the positive side, teens have a lot of energy, that when channeled in the right direction, can overcome difficult obstacles. On the negative side, teens often try to assert their independence and believe they can run things better than their parents. When parents’ sense that their authority is being questioned they feel they need to be more strict and controlling. This often triggers a reaction in the teen to further assert his independence, thereby perpetuating a parent-child power struggle. As you might imagine, this often leads to a stale-mate where everyone is miserable.
When these families end up in family therapy, the usual assumption is that parents need to be taught communication skills, and learn techniques to retain control, while responding in a calm way. This type of therapy is tedious, time consuming, and requires constant monitoring.
Paradox therapy has a different idea. Rather than engaging in power struggle with the teen, the therapist acknowledges that the teen is indeed ‘in control and in charge’ of the family. At first, the teen is thrilled that he gets to be the ‘authority’. He can’t believe it!
But after 10 minutes, when he realizes that he is responsible to make all the decisions, he suddenly has a change of heart and doesn’t want this ‘job’ any more. At that point, when he admits that he is really still a child in the family, he willingly surrenders control back to his parents.
Therapists often seek to learn about new modalities and gain innovative skills designed to improve their practice. While searching for new methods is certainly important, what often goes unaddressed is the ‘other side of the coin’.
This ‘other side’, refers to the therapist’s ability to trust his personal awareness or ‘use-of-self’ in the therapeutic process. In this manner, the therapist is conscious of himself as a ‘tuning fork’ to gauge his ability to connect and empathize with the client. This means engaging and trusting the flow of treatment on a non-verbal level. Within this non-verbal interaction, the therapist is sensitive to the client’s needs combined with the ‘right timing’ to introduce a promising intervention or technique.
In therapy, ‘timing is everything’. While it is surely possible to learn new techniques, the timing aspect of use-of-self is an abstract idea that cannot be learned by reading a book. Use-of-self means that the therapist is in touch with his own feelings, and uses this awareness as a way to strengthen his flow with the client.
Therefore the use-of-self is not a ‘one-way street’ designed to only influence the client, but rather encompasses a broader perspective toward a ‘two-way’ interactive bond. From here we recognize that the implementation of new and various techniques are actually secondary to the main function of developing a trusting and healing alliance. When the therapist is able to balance the ‘inside and outside’ of doing both, he becomes a catalyst for change.
People often enter therapy because they experience emotional or psychological ‘suffering’ in their life. As therapists’ our goal is to relieve suffering. However, what does ‘suffering’ actually mean?
Is ‘suffering’ based more on behavior, emotions, thoughts, or trauma from childhood? Often the hope is that therapy can correct the above symptoms, merge ‘parts’, or roleplay the client toward different solutions to help the client get beyond their suffering. Clients who suffer, but are motivated to get beyond their pain are easier to work with. .
But what if the client’s suffering is so great, that they do not even know the degree and depth of their emotional pain? Is it possible to reach even those who avoid or are unmotivated to cooperate in therapy?
In this podcast we will explore the central aspect and underlying dynamic that leads to suffering. We will also identify what therapy needs to accomplish in order to bring true relief to both motivated and unmotivated clients.
Video: Carl Rogers with Richie who is ‘coasting through’
Roleplay – I want to stop eating cake…
As part of therapy it is common to hear therapists looking for ways to get the client to ‘buy in’ to the treatment process. Some try to convince the client that it to their benefit, some offer rewards, and some will warn of the negative consequences. But essentially the hope is to figure out how to get the client to cooperate and accept our therapy agenda… And of course, once the client ‘buys in’, then with a little more cooperation the therapist will surely feel successful…
But hold on…. Am I missing something here?
It seems to me that pushing for a ‘buy in’ basically is asking the client to do the therapist a favor?! And as you might imagine, for the savvy client who fakes a ‘buy in’ to treatment, this may be an easy way to get a lot of perks and privileges.
There’s gotta be a better way!
Many therapists get overwhelmed even just thinking about doing couple or family therapy. Offhand it seems much easier to do individual therapy where the therapist can focus all his attention - without distraction - on the client. However, the problem with individual therapy is that we are hearing only one side of the story. When doing individual therapy we do not have access to the dynamic interchange between the client and the other ‘players’ that are part of his system. The advantage of couples and family therapy is that we get to see a more whole picture of the ‘real world’ that the client is functions within. As strange as it might sound, in some ways working with couples and families is easier than individual treatment. The reason is because even if just one person changes in family therapy, this influences everyone else. Please join us and check out ways of widening your practice and learn exciting ways to engage with families.
Bed wetting and Encopresis are common problems in childhood. Many times a child may just grow out of it. However, sometimes parents become concerned depending on the age of the child, or how long the issue persists. Some parents resort to medication, and some try behavioral techniques. There are also sleeping mats that are designed to wake the child up using alarms if he starts to wet the bed. However, many of these methods seem to have a ‘behavioral’ or ‘shame’ based quality to get the child to stop. Pdxi has a short-term, unique, and counter-intuitive way of addressing the issue. Interventions tend to challenge the child to utilize his subconscious free-will to control his bladder. As a result, the process often raises the child’s self-esteem as he takes free-will control of his bodily functions. This video included is called the Puppet Dance. It highlights how pdxi often encourages clients to exaggerate spontaneous movements and thereby become more aware of energy patterns they may tend to dismiss or suppress.
Therapists must be very sensitive in handling suicidal ideation and threats. The main and primary factor in working with such ideation is taking away the person's underlying experience of being alone. In order to help people with suicidal ideation, it is important to quickly convey a personal connection. Our approach toward the person should be non-threatening and avoid any kind of power struggle. Sometimes the goal is to 'buy time'. With a client who is 'standing on the ledge', I might acknowledge that he certainly has the ability to end it all now, however "Is there a reason it has to be right now. Let's talk it over, and see if we can resolve it. If not then you can always end it tomorrow." It is also helpful to remind the client that suicide is a "long term solution to a short term problem." National Suicide HOTLINE phone # is: 988
DeCarte said, “I think, therefore I am”. As a result, many people have tried using their internal process of thinking through ‘self-affirmations’ to think differently. Some work very hard to convince their mind to change negative beliefs and thought patterns. Inevitably such affirmations don’t work because their underlying sense of isolation and aloneness remains the same. However in pdxi, the goal is not to change thinking directly. Instead we want to offer the client a change in perspective. Sometimes this might mean even encouraging or exaggerating an old behavior, thought, or emotion. Suddenly the client becomes aware of his old behavior in a new way. It is from this perspective that he is able to make the necessary changes. While it is true that his thoughts will also change, this is the result of a spontaneous shift and not the result of self-affirmations.
In the video, we see how the wife tries to ‘litigate’ the husband to think differently.
Many therapists get overwhelmed even just thinking about doing couple or family therapy. Offhand it seems much easier to do individual therapy where the therapist can focus all his attention - without distraction - on the client. However, the problem with individual therapy is that we are hearing only one side of the story. When doing individual therapy we do not have access to the dynamic interchange between the client and the other ‘players’ that are part of his system. The advantage of couples and family therapy is that we get to see a more whole picture of the ‘real world’ that the client is functions within. As strange as it might sound, in some ways working with couples and families is easier than individual treatment. The reason is because even if just one person changes in family therapy, this influences everyone else. Please join us and check out ways of widening your practice and learn exciting ways to engage with families.
As therapists, we all want to be 'competent'. But it sometimes our very desire to be competent that gets in the way of allowing the client to grow and discover their own solutions. At times the direction the client needs to go is obvious to us. However by giving the client OUR answer, we take away the clients' ability to search and discover solutions that work for them. When the client is able to make choices and take responsibility for their OWN solutions, this is when true healing and growth happens. Therefore in counter-intuitive fashion, it is often the therapist who is ‘incompetent’ by not giving the client the ‘right answers’ – but is able to guide him in the right direction – that ultimately makes the therapist competent. In the video, the client wants the therapist to confirm her BPD - Borderline diagnosis, but the therapist unexpectedly turns the tables on her.
In 1965, Gloria (a patient) met for a half-hour session with 3 well known therapists of that time; Carl Rogers (Client Centered Therapy), Fritz Perls (Gestalt Therapy), and Albert Ellis (Rational Emotive Behavioral Therapy – REBT). In this podcast we get to explore a shortened video version of these 3 meetings. We explore and comment how the originator of each of these therapies demonstrates their technique.
Rogers outwardly projects warmth, empathy, and genuineness. Gloria was relaxed and receptive as Rogers tended to mirror Gloria’s words and thoughts. However with Perls, Gloria is already defensive from the start. Perls remained relaxed and kept the session in the ‘here & now’. His focus is more on her ‘non-verbal’ expression and how she defended herself. Ellis tended to focus on Gloria’s thinking and unrealistic messages that she may be giving herself that prevents her from moving forward.
t is important to be aware of transference and counter-transference. Transference is when the client projects on to the therapist emotions and perceptions they may have experienced earlier in life. Often a client may see the therapist as having similar qualities to that of a parent. At the same time, the client may also bring up feelings and emotions in the therapist that is related to his personal history. For the therapist in particular, he should try to work out these type of conflicts in supervision so that it doesn’t muddy the session. For the most part, the therapist should approach the client in a centered and neutral way. The videos show 2 therapy clips. Roger demonstrates an accepting and neutral approach with no evident power struggle between himself and client. Linehan however acknowledges that she has an agenda of what she expects from the client. As a result the seeds of a power struggle are sown.
Here we explore a direction in which Artificial Intelligence (AI) technology is being used to advance therapy. A brief video showed how a computer avatar could be used to help people diagnosed with schizophrenia, and who had been previously paralyzed by critical and debilitating voices in their head. By using the computer to generate an avatar voice with face image, the client could finally have a conversation with that ‘other voice in their head’. Apparently this method has shown to be very effective with people experiencing this condition. In the podcast group we discussed how such technology could be used in other areas of therapy including individual, couple, and family therapy.
In this podcast I do a 20 minute roleplay with a regular participant to the podcast. Although he tries a few attempts to get me ‘off track’, I remain in the ‘here & now’ and coach him how to better avoid ‘being responsible’. After the roleplay, I and the participant review the ‘session’ and discuss what he learned from it. He noted that it helped him discover that he was working harder to get his client unstuck than the client was for himself. As a result, he was looking forward to the next session with his client to try some ‘new ideas’.