Category: Psychoanalysis

Does Experiencing Therapy Make a Better Therapist?

00Cognitive Behavioral Therapy, Emotion Regulation, Emotional Intelligence, Empathy, Featured news, Psychoanalysis, Therapy February, 16
John Sloan on Flickr

Source: John Sloan on Flickr

It seems intuitive. Psychologically adjusted clinicians should provide better psychotherapy.

Aside from the stressors of their own daily life, therapists face the emotional struggles and traumas of their clients on a daily basis. To meet these challenges effectively and to avoid burnout, therapists need to maintain a high degree of self-awareness and personal wellbeing.

So how does experiencing therapy help clinicians with their work?

British psychotherapist Drew Coster says that personal psychotherapy has helped him broaden his repertoire of techniques and taught him to focus on achieving his clients’ goals instead of focusing on a prescriptive model of treatment. Similarly, Chicago psychologistGerald Stein has explained that going through therapy can help clinicians identify problems in their treatment approach based on their personal experiences.

Studies have also shown that the therapist’s wellbeing affects the quality of the relationship developed with the client. The clinician-client relationship is often referred to as thetherapeutic alliance and it is related to better therapy outcome regardless of the therapist’s specific style or school of thought.

Psychologists Leslie Greenberg of York University and Shari Geller of the University of Toronto, authors of the Therapeutic Presence: A Mindful Approach to Effective Therapy, argue that therapist self-care builds the foundation for developing a good therapeutic relationship with the client. Only through personal balance and stability can clinicians be fully present, attentive, and helpful during sessions.

Self-care can take many forms and can include going through therapy. For practitioners, experiencing their own therapy helps promote self-awareness and personal growth. And it allows them to address private issues and biases that would otherwise hinder progress in their clients. Becoming aware of one’s strengths and limitations can help therapists determine what clients to take on and when to refer clients to other therapists.

Traditional psychoanalysis is the only therapeutic orientation that requires the therapist-in-training to actually go through the therapy process. Self-reflection and exploration are key components of humanistic and experiential therapies. And while cognitive and behavioural approaches do not emphasize personal development on the part of practitioners, mounting evidence for the importance of solid therapeutic alliances may be shifting this tradition.

Psychiatrist Steven Reidford, argues: “At the most commonsense level, a therapist who knows what it is like to be a patient may be more empathic, and may anticipate unstated feelings more readily than a therapist without this first-hand knowledge.”

Reidford cites the requirement for practitioners of psychoanalysis to undergo therapy, explaining that the Freudian concepts of emotional transference and countertransference between patients and therapists are readily applicable to other therapeutic styles like CBT. Instead of relying on theory and patient-report data, he suggests experiencing the phenomena firsthand. He explains that therapists’ primary tool is their emotional sensitivity, which can be honed by attending psychotherapy and getting familiar with one’s own feelings and biases. He also notes that being in therapy de-stigmatizes the process and can help therapists see their patients as individuals instead of maladies.

Experiencing therapy may be helpful from a simpler, more practical standpoint. Associate professor James Bennett-Levy of the University of Sydney found in a recent study that students learning the cognitive therapy approach found personal therapy helpful in enhancing their understanding of the theory and process of treatment. They also found it helpful in gaining a better understanding of their role as a therapist, developing greater empathy, and gaining a better understanding of themselves.

Personal counselling also allows the therapist to experience what it feels like to be the client. Clinicians in Bennett-Levy’s study stated that personally experiencing the treatment process, beyond reading about it or conducting it, provided a deeper understanding of the models and techniques they were studying.

It is important to keep in mind that this research was based on the therapists’ self-evaluations. Are these benefits reflected in psychotherapy outcomes for clients?

Most research on therapy for therapists has focused on self-evaluations of the positive and negative effects. While clinicians purport to gain insight and professional skills by attending therapy, little research exists measuring the specific impacts of therapy for therapists on client satisfaction. Nevertheless, as with anyone, therapy can help clinicians gain self-awareness and empathy, which may otherwise wane as a result of life stress.

– Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Treatments Available to Long Term Abduction Victims

10Animal Behavior, Cognition, Depression, Dreaming, Family Dynamics, Featured news, Health, Parenting, Psychiatry, Psychoanalysis, Sleep, Stress, Therapy, Trauma April, 15

Source: artmajor24//Flickr

Between 2002 and 2004, 16-year-old Amanda Berry, 21-year-old Michelle Knight, and 14-year-old Georgina DeJesus were abducted from the streets of Cleveland, Ohio. They were lured into the home of Ariel Castro where they spent the next 11 years in captivity.

Often kept in restraints and locked rooms, the women regularly had their lives threatened to deter any plans of escape.  They were given little food or the opportunity to bathe. Sexual abuse led to Knight being impregnated several times, only to be beaten and starved in order to force miscarriage.  It wasn’t until May 2013 that the women were finally rescued and Castro arrested.

Other cases popularized by the media include that of Elizabeth Smart, held captive for 9 months, and Jaycee Dugard who was held captive for 18 years. These victims are now free, but living with the emotional aftermath.

In a 2000 study by the Department of Neurological and Psychiatric Sciences at the University of Padova, interviews with kidnap victims showed common after-effects of abduction including vivid flashbacks of the events, nightmares, and feelings of depression, all common symptoms of Post-Traumatic Stress Disorder.  Hypervigilance was also reported, where individuals anticipated danger and frequently felt guarded, leading to trouble sleeping, eating, and social withdrawal due to difficulty trusting others.

Mental health professors David A. Alexander and Susan Klein, from the Aberdeen Centre for Trauma Research in the UK also add that some victims end up “shutting off’ their emotions or denying that they even experienced a traumatic event, which may stem from a desire to avoid anything that reminds them of their trauma.

How does someone this traumatized even begin to recover?  Clinicians who work with these victims help them find opportunities to make their own decisions, to slowly understand that they are no longer powerless.

Clinical psychologist Rebecca Bailey, therapist to Jaycee Dugard, is the author of, “Safe Kids, Smart Parents: What Parents Need to Know to Keep Their Children Safe.” In an interview with the Trauma and Mental Health Report, Bailey explained: “Number one is helping victims find their voice.  When you’ve been kidnapped, so much of your world is about having choices made for you…From day one you have to give them choices for everything, Do you want a glass of milk, or do you want a glass of water? Things like that.”

Another important aspect to recovery is the role of the family.  It is through a strong connection with the family that the victim can feel safe, comforted, and empowered.  Bailey mentions “tribal meetings” with families soon after rescue to reunify both parties and create a support system. Through these family systems, further recovery is possible.

Specific therapeutic approaches for victim recovery really depend on the individual.  In some cases Cognitive Behavioural Therapy can be used, in other cases experiential therapy or a more psychodynamic approach can be implemented.  Common techniques used in therapy with kidnapping victims are role-playing, therapeutic pets, music, or even walking through the wilderness in an attempt to trigger underlying feelings that must be dealt with.

Often, different therapies are combined to see which works best for the individual. Bailey reminds, however, that client interaction with the therapist also has a large impact on recovery.

Bailey: The most important thing is for the therapist to be mindful, authentic, and purposeful. Counterproductive would be having a therapist who says very little.  This could almost reinjure [the victim] because they need a certain amount of modelling as well.

Modelling how to have an authentic healthy relationship—after the abusive one they had with their abductor—is crucial to helping the victim integrate aspects of normal everyday life.

Still, even with proper therapy and a strong support system, the trauma of being abducted and held captive for years is unlikely to be erased.  In the case of the young women in Cleveland, along with many others, the journey to recovery has been a challenging one, but one that has been described as worth taking:

“I may have been through hell and back, but I am strong enough to walk through hell with a smile on my face and my head held high,” says Michelle Knight in a YouTube video addressed to the public.  “I will not let the situation define who I am.  I will define the situation.”

– Contributing Writer: Anjali Wisnarama, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today