".....And Yet?"

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-Bill

And?

Thank you for wanting to read this brief essay on what I consider to be the best one-word question a psychotherapsit can ask.  It has been moved one quick click awayhttps://billherring.com/node/486 to my primary website, which I hope you will visit today.  Thanks!

Look For 70's And Above

I've previously written about the value of a good therapeutic question as being indispensable in helping people reframe their view of a problem and make progress toward a healthier way of thinking, feeling and acting. I recently found myself using an "old favorite" with a married couple struggling with some deep relationship problems. It involves the use of a "1 to 100" scale to quantify a goal. Here's how it works:

The man and woman sitting in front of me were very frustrated and exhausted by the problems in their relationship. As so often happens, their dissatisfaction was negatively influencing even the healthy aspects of their life together. Just like a toothache can make you feel bad all over, their areas of difficulty were infecting every aspect of their relationship. This is a vicious cycle that can spiral downward at an alarming rate once is takes root. Part of my immediate job was to instill some much-needed hope and to help this couple distinguish the healthy from the problematic aspects of their functioning.

I asked both parties to rate the overall state of their relationship on a scale of 1 to 100, with 1 being the absolute worst and 100 being perfection. (I've never had anybody choose either of the extreme numbers). The husband said "50" and the wife said "30". Sometimes just this one question can lead to productive discussion about differences in perception that can be useful to explore.

I then asked them to pick a number representing the minimum level of satisfaction that would allow them to feel that they were making progress and to therefore feel hopeful about the prospect of making future improvement. Like most people they were pretty realistic about this question and both agreed that a "70" would represent the smallest improvement that would be meaningful to both of them.

I suggested that they devote their attention before the next session on any situations that seemed like a "70" or above to either of them, no matter how small. (I've previously written about the use of "homework" to clients who are open to this approach.) I emphasized that "70's" can be short-lived and come at the strangest times, requiring them to be alert for these momentary examples of adequate functioning. I also made it clear that each person may have different examples of what a "70 or above" looks like and that it's not important that they agree with each other or even mention it as long as they noticed it. I told them I would ask what they observed the next time we met.

As almost invariably happens, both people were able the next session to describe examples of times when they noticed aspects of their relationship to be at least a "70". Often the situations are seemingly minor, which is great news. When people start to realize that their problems are contained to certain areas of their lives and that other areas are relatively functional, they begin to combat the notion that everything is broken. The wound stops infecting the whole system. It also becomes powerfully evident that perfection is not needed to feel hopeful or healthy. A "70" may be far from perfect but if it can qualify as a passing grade then the prospect of failure ceases to loom so large.

This question in itself is not perfect (few things are) but it's one of very many tools that I've found useful for building functionality and resilience in relationships. Thousands of years ago the Greek mathematician Archimedes famously said "Give me a long enough lever and a fulcrum on which to place it and I shall move the world." Similarly, the right questions and conversations will shift perspectives sufficiently enough to transform lives.
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The Value Of 12-Step and Support Groups

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What's The Difference between Counseling and Therapy?

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Searching In The Darkness

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Two Types of Challenges

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Nia: Moving Toward Health and Happiness

I do a lot of talking with my clients, which often results in substantial improvement in life satisfaction, interpersonal effectiveness and self-esteem. My practice has also benefited from incorporating less talk-centered therapies such as EMDR and Brainspotting. Although I don't often use the hands-on techniques of my Reiki training, I'm respectful of the healing available through that approach. I can heartily recommend the numerous physical and mental health benefits from Laughter Yoga. But I have also become fully convinced that many healing processes can be greatly strengthened and accelerated through movement therapies, and the approach that stands out for me is called Nia.

Nia (which stands for Neuromuscular Integrative Action) is a personal growth, body-mind-spirit fitness program that combines a diverse blend of Eastern and Western movements, concepts and philosophies from the healing arts, martial arts, and dance. It helps develop self-awareness, range of motion, and physical and emotional well-being. Nia uses components of various movement disciplines and healing practices such as taekwondo, aikido, t'ai chi, dance, yoga, Feldenkrais and the Alexander Technique. I didn't know what some of these techniques were until I researched them, and it really doesn't matter. Nia looks a little like an aerobics class, except that the movements are generally softer, gentler and have more "flow". An instructor guides the class with the use of music, and participants put a lot of their own "personality" into the movements.

What I have found to be of utmost benefit is the connection Nia gives between the physical, emotional and spiritual components of body movement. Some exercises bring in energy while others release it. I've personally experienced peace, joy, tranquility, humility, heroism, compassion and tears of emotional release during a single Nia class.

I am so convinced of the benefits Nia can bring to people involved in personal growth and healing that I am willing to write off the $15 per-class fee for clients who take a class offered in nearby Decatur by the wonderful Sandy Bramlett of Nia Atlanta.

There are several other movement-based techniques that go a long way toward integrating the mind, body and spirit. These include not only t'ai chi and qi gong but also Bikram hot yoga (the links will direct you to local studios not far from my office). But in my experience Nia is unique in its vision, scope and unique combination of power and gentleness.

Asking The Right Question

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Therapeutic Homework

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A Conversation Unlike Any Other

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Thoughts on Therapy Trends

Every few years a new fad blows across the therapy landscape like a fresh breeze. Now that I've been in practice long enough to see some of these trends come (and sometimes go) I am able to appreciate the many valuable approaches to the promotion of personal growth and development that so many of them have brought to the profession.

In the 1970's Transactional Analysis was the "in" thing. People learned how to determine whether they were acting from their "adult", "child" or "parent" center, and dynamics between couples could be understood through the various combinations of the above three patterns as expressed between two people.

The 1980's brought some exciting trends into psychotherapy, including strategic and structural family therapies, approaches which emphasized altering behavioral patterns and interjecting paradoxical or directive interventions to alter or disrupt these patterns to promote healthier adaptation. (I realize that tried to say a lot with a little, but since I'm just breezing over these topics that's OK for now.) The 80's was an exciting phase of development in the family therapy field. Other approaches, such as Neuro-Linguistic Programming, began exploring the intersection of language, hypnotic suggestion and behavioral change.

The advent of Prozac and other "newer-class" antidepressants in the late 1980's ushered in a new era of "better living through chemistry" approaches to symptom relief. I remember when the majority of my clients were taking some sort of anti-depressant, often with my blessing. Now the proportion of my clients on medications is much less.

The advent of the 90's was the heyday of the "Men Mars/Women Venus" approach to couples communication. It was also the age when "solution-focused therapy" swept across the profession, partly in response to the increased managed-care limitations on the length of reimbursable therapy.

Toward the start of the new century narrative approaches to therapy, which had been around for a decade or more, really took root in the general therapeutic consciousness. The idea that stories frame life experience has been very valuable in "contextualizing" how people view their lives. Similarly, social constructionist theory began to be expounded with greater frequency: the idea that reality is greatly influenced or "constructed" in a social contract became very influential.

The trend this decade seems to be "mindfulness". This is the ability to remain self-aware through the ebb and flow of emotions and events. A person who is mindful of his or her own reactions is less likely to act in ways that will alter be regretted. All sorts of therapeutic approaches have a mindfulness basis. Dialectical Behavioral Therapy (DBT) is a psycho-educational technique to increase self-awareness during times of emotional stress. EMDR and brainspotting, which I've previously written about, both help to create a richer depth of self-awareness. Other techniques similarly advocate the benefits of increased self-observation as a way to manage life's ups and downs. It's a strategy that has essentially been around for thousands of years in meditation, and now seems to be entering the mainstream of public awareness.

What will be the next "wave" of therapeutic interest? I think the mind-body connection will be one major focus. I'd love to think a more altruistic, less ego-centered focus will bring people together around a greater sense of community rather than techniques which upgrade clients to a better room on the Titanic, so to speak.

This has been a very brief sketch of therapeutic trends across recent decades. I think all these approaches have a useful place in the toolkit of a well-trained therapist, and each requires the focused, empathic "self" of the therapist to facilitate the power of human change. I consider this profession to be deeply rewarding of the effort I bring to it and this very moment is an extremely exciting time to practice. I hope to be able to say the same sentiment for as long as I am in this business, as I plan to continue learning to perfect my craft for the remainder of my days.

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The Value of Messing Up

The best therapy, like any other form of personal growth, involves moving from poor to adequate to exemplary behavior. A person may not ever reach an ideal state of being (is there such a thing?) but the very definition of positive change is the ability to move from a lower to higher level of functioning. So it may come as a surprise to learn that I advocate and even advise my clients to "mess up" from time to time.

There are two main reason why I encourage clients to risk failure. The first is to learn to make it not such a big deal. It's pretty well accepted that we avoid what we fear, and that avoidance tends to make the object of our fear so much greater. Think of times in your life you've taken a risk that you had avoided for a long time and then said "that wasn't so bad -- I wish I had done that long ago." That's a pretty significant victory. Of course, it's foolish to expect every thing you try to work out the way you hoped every time, so a healthy tolerance for failure is an excellent characteristic of a healthy individual. Trying new things is a wonderful way to widen your experience, your resilience and your perspective. A little failure is a modest invest for such growth.

The second opportunity for creative failure comes near the end of the successful therapy experience. A classic example I often implement is when I am working with a couple who has experienced dramatic improvement in communication and harmony through hard therapeutic effort. It's one of my great joys as a therapist to observe two people successfully negotiate a situation that would have previously ended in bitterness and misery. Sometimes such improvement can be like going from the bottom of a pit to the top of a mountain in a relatively short period of time: once they've reached the heights it's anxiety-provoking for a couple to contemplate experiencing the inevitable decline in harmony that can often occur in the ebb and flow of relationships.

So when things are going very well I sometimes suggest that the couple may want to allow a situation to revert back a little toward the old unhealthy ways for a brief period as an experiment to prove that each person has the skills to bring the relationship back on course. I may encourage either person to bring up a topic that has been avoided because of the risk it represents. If it was possible to measure blood pressure in a session, I'm sure this very suggestion has often initially resulted in a sharp spike upward.

Here's an analogy I sometime use to demonstrate my purpose in proposing this counter-intuitive instruction. When a person learns to fly an airplane, he or she always has an instructor in the cockpit to give guidance and instruction. Near the end of training, the student flies the plane with no instruction and the teacher just observes, ready to step in only if needed. This is the role of the therapist working with a couple learning to "fly" their new-and-improved relationship ("More powerful engine! More maneuverable! Quieter! Better gas mileage! More leg room!")

A really shrewd instructor may lean over and shut off the engine to send the plane into an initial nosedive in order for the student pilot to gain the confidence to take the correct actions to bring the situation back to normal and flying straight again. It's better for this to happen with the instructor in the next seat rather than two weeks after the lessons are over!

For this same reason I want my clients to experience the initial feeling of an emotional nosedive so they don't freak out and panic when it happens for real. It's very comforting to know that a regression doesn't have to spell disaster. The fact is that we are all going to mess up from time to time, and we need successful protocols for getting back on track as soon as we can. Learning how to successfully fail is one of the great and essential paradoxes of life.

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Atlanta EMDR and Brainspotting Services

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The Problem of Psychiatric Diagnosis

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How To Get The Most From Therapy

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Reiki: "Handing" It To You

I just received initial training this weekend in the Reiki method of healing touch. Although I don't anticipate using it directly in my clinical practice, I am impressed by its theory and techniques for transmitting healing energy.

Reiki uses the hands to transmit the universal life force ("rei" means unseen or spiritual and "ki" means energy or life force) to the self or another person in order to promote healing across the physical, emotional or spiritual levels of life. It was originally developed in Japan in the early 20th century by Mikao Usui. Reiki utilizes and promotes a high level of spiritual intuition and intention in both the practitioner and recipient and is said to be incapable of causing harm.

Reiki "treatments" are done fully dressed and although the original technique involves physical touch on various parts of the body it can also be used without physical contact. It is essentially an active meditative practice, which on the surface seems like a paradox. Reiki advocates the daily practice of five principles which are simple and valuable in their own right. The original principles as set forth by the founder are:

Do not be angry
Do not be worried
Be grateful
Work hard (on improving yourself)
Be kind to others.

This is a marvelous distillation of wisdom which is immediately useful to anyone.

Reiki is in essence a gentle technique to encourage healing on the self and others which can be learned by anybody, and I encourage anyone interested to receive instruction in its use. The people who who "attuned" and trained me are Mayanne Horne, Ph.D. and Carole Sfekas, Ph.D.at Healing Arts Spiritual Center in Dacula. It was a bit of a drive, but their fee was very reasonable and they are both very warm and welcoming individuals who I recommend highly.

As I said, I doubt I will be directly providing Reiki treatments in my clinical practice but I am grateful to have learned another healing art to help me and others through this world of rich experience.

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Basketball Therapy

I'm an active therapist. Although I know when to be quiet and allow the healing process to move at its own pace my tendency is to ask lots of probing questions to draw out the issues, themes and assumptions that my clients have. I tend to guide the conversation toward productive topics, offer suggestions, suggest possibilities, gently challenge preconceived notions, point out and support healthy functioning and in general work actively to keep the therapeutic process moving toward greater emotional health and improved life satisfaction.

Sometimes I think of the process like playing on a basketball team. My client and I pass the ball back and forth to each other. Sometimes I take a shot -- an insight, a fresh perspective, a useful reframe -- and experience that satisfying moment when the ball falls right through the basket with a satisfying swishhhhh. Two points! I just as often "pass the ball" to the client, positioning him or her through our conversation to make the goal. In this way therapy is a process of ongoing, ever-shifting teamwork.

The ball doesn't always go through the net. Earlier this week I suggested to a client how one of his difficulties could relate to an event from his childhood. The client thought for a moment and said "Bill, I understand what you're saying but it doesn't feel true for me." I love this kind of honest interaction because it shows me a client isn't going to agree with something just to please me. When someone says "no" then I am more trusting when they say "yes".

You can't score points if you don't shoot the ball, so I like my clients and I to take lots of shots. Sometimes the ball makes the basket, sometimes it bounces off the rim and sometimes it's a total "air ball". But just like a good team, when we get into a good rhythm with each other, it's poetry in motion, a thing of real beauty and a joy to behold.
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The Most Important Question In Couple's Therapy

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