Before Therapy

  1. Setting intentions

Intention is more than wishful thinking, it is willful direction (Jennifer Williamson)

The process of articulating what you want to achieve through your activities is known as setting intentions. It’s a declaration of what you want the journey to be like as you move on.

Examples:

Goal: Be in bed at 10 p.m. five times a week.

Body intention: I’m well rested and feel energized in the morning

Goal: Healthy eating patterns – regular portioned meals 3x a day and regular supplements

Intention: I ‘m nourished

Goal: See my therapist fortnightly

Intention:  I embrace self-nurturing and allow healing to take place

Setting intentions help you have a higher degree of awareness and being attentive to the moments happening in your therapy.

  1. Therapeutic Alliance

Building trust and communicating your needs and experience help the working relationship with your therapist.

Qualities such as warmth, trustworthiness, flexibility, alertness, relaxed, confident and respectful, are therapist characteristics associated with a stronger alliance according to a research by Ackerman & Hilsenroth in 2003.

Give a few sessions to decide if this is the therapist you are comfortable with and can trust in facilitating the shifts you want internally.

  1. Types of Psychotherapy

Counseling is usually short term while Psychotherapy tends to be longer term and focuses on patterns. There are various types of therapy available. Getting some information on what you would be experiencing in therapy can be useful.

Practitioners usually draw from variety of psychoanalytic theories to use in their assessment and practices. Approaches can be cognitive, behavioral, existential, integrative, and holistic.

While we are used to hearing about CBT (Cognitive Behavioral Therapy), Pharmacotherapy (Medical assisted such as anti-depressants), there are a lot of research that shown that EMDR (Eye movement Desensitization Reprocessing are effective in numerous meta and clinical research.

‘A 2017 study by Bossini et al analyzing shifts in the brain following EMDR treatment found no changes in brain scans for controls after three months, while finding significant changes in brain scans of the EMDR patients. These changes included increased grey matter volume (GMV) in left parahippocampal gyrus and a significant decrease in GMV in the left thalamus region. At the end of the study, 16 out of 19 patients in the EMDR group no longer met criteria for a diagnosis of PTSD, which was reflected as a significant improvement on the Clinician Administered PTSD Scale.’ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839656/)

Internal Family System IFS are gaining popularity. Dr Schwartz originally did his post grad thesis on Satir’s family therapy works. IFS has evolved over the past 20 years and more guidelines have developed in its use for individuals, couples and family.

Lesser-known therapies like Psychodrama, Family Constellation, Group therapy could be worth exploring as well.

Group Therapy Works

  1. Boundaries and Confidentiality

A well-trained therapist will adhere to the professional standards of confidentiality but would inform you of the limitations of it. It is important to know that your records are kept in a safe manner.

A therapist is not a friend, or a family member, nor a perfect being or sage. The protocols and stages of therapy help guide the overall process of reaching your therapeutic goals and intentions.

An openness to communicate and be honest is highly important. It is you informing your therapist what is happening to your alliance and the process of your therapy. This is how you could work towards the joint outcome.

  1. Progress versus Miracle

The therapy process is unique to every single individual. Some see changes rapidly while others may take a longer time.

We do not compare an apple to an orange. Likewise, each person’s sense of SELF is a unique Context and Canvas.

Mental health may seem a pathology and curse to some yet being chronically unwell may mean a lot of patterns need to be shifted and a slower process could allow one to learn how to soothe and de-role our self-neglectful part or critical part.

Everyone needs to have the space and right to decide when they want to let go of their burdens and patterns.

References

  • Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23(1), 1–33. https://doi.org/10.1016/S0272-7358(02)00146-0
  • Gainer, D., Alam, S., Alam, H., & Redding, H. (2020). A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Innovations in clinical neuroscience17(7-9), 12–20.
  • EMDR as Add-On Treatment for Psychiatric and Traumatic Symptoms in Patients with Substance Use Disorder. Carletto S, Oliva F, Barnato M, Antonelli T, Cardia A, Mazzaferro P, Raho C, Ostacoli L, Fernandez I, Pagani M Front Psychol. 2017; 8():2333
  • Brown SH, Gilman SG, Goodman EG, Adler-Tapia R, Freng S. Integrated trauma treatment in drug court: combining EMDR therapy and seeking safety. J EMDR Pract Res. (2015) 9:123–36. 10.1891/1933-3196.9.3.123
  • Pérez-Álvarez M. Third-generation therapies: achievements and challenges. Int J Clin Heal Psychol. (2012) 12:291–310.
  • Shapiro, F (1989). “Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories”. Journal of Traumatic Stress2 (2): 199–223. doi:10.1002/jts.2490020207.