Monday, March 23, 2015

A Fourth Stage to Therapy

     I've briefly discussed my ideas before relating to a way of engaging in therapy that allows symptoms to be addressed first in order to decrease the minute-to-minute pain that a client might be feeling. Behaviorism is the best therapy to use here, because its call to action only treats the observable. Next is a slightly deeper therapy that would target the thoughts. This would allow the client to understand the relationship that thoughts have with their behaviors. On the way to some form of "normality" or "therapist-assisted self-actualization," understanding one's own thought patterns and being able to identify positive and negative thoughts are very important and can only help the deeper therapeutic levels.
     Previously, I have added in a portion after symptom regulation about education. This portion is to provide the clients with more information about their suffering and to add more normalizing language into their world. I still agree with this approach, but I could see it being a very interspersed "stage" in that it could pop up really at any point it is needed. Education is important in therapy and is not a stage or method that should be eschewed just because people don't want to deal with it.
     Next, we start engaging in more depth-based work. This is an interesting transition. Many clients may want to stay with surface work, but the problem therein has mainly to do with recidivism/relapse. It is very simple for anyone to re-engage in their past behaviors if they have never gotten to the root of the problem. A popular example is cutting off the stem of a very lively weed only to find it growing back next season because the roots were never dug up. Another good example is seeing a rogue iceberg int eh water and blasting the visible part, but being hit by the non-visible portion laying in hiding just under the water's surface.
     Depth-based work takes the form of many different types of therapy, including, but not limited to, psychoanalysis, psychodynamics, Jungian analysis, existentialism, Gestalt therapy, etc. There are many different types of therapy styles here and the foremost similarity is that the therapist is adding in his or her own "interpretations" into the mix in order to guess at the underlying issue(s) facing the client and disallowing their full "recovery." Perhaps another way to group many depth-based therapies together is to say that depth psychotherapies require a counselor or psychotherapist in order for therapy to continue. Practices involving theories like behaviorism or REBT could be learned from a book and applied without the use of another person.
     I do think that this progression is a positive one. Clients who go through such a system could be changed (if such a thing is needed) fundamentally and never need the help of a therapist ever again. After all, it is the aim of the therapist to make himself or herself obsolete by guiding the client toward his/her ideal self.
     Oddly, there is a stage that is deeper than really any depth-based psychotherapy can go. This stage is a realm that requires no techniques or theories. This stage is realized most likely at the end of the real "change phase" and consists of the therapist talking not as a therapist, but as a fellow person. The therapist uses the "power of their personality" (Kottler, p unknown). This means that the therapist and client are so comfortable with tone another that the client's own anxieties in session are almost nil, allowing the therapist to help them to simply identify problems and solve them (or create possible solutions) in sessions.
     This stage supposes a couple of things. The relationship itself must be deep enough that any personality traits seen as deleterious in earlier stages are now seen as endearing. The client must also remember previous stages and be able to use some of them in his/her own life.
     I think that very few therapy dyads come to this last stage because a client gets some instant gratification from the first step or two and then quits therapy, happy with their progress. On the other end of things, it's possible that the last stage is never engaged because this can herald the end of the relationship altogether (and ends up with the client understanding their own power over themselves). There is no moving past this stage and going to a previous stage. This stage most likely sees a lot of work done because the trust required for it is already there and the styles of both parties are so in-line that observations, advice, and interpretation are organic.

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