Sunday, August 10, 2014

Healing through Experience and the Limitations of Talk Therapy

Clearly I am in invested in psychotherapy as an avenue towards healing.  I enjoy providing a safe, open space for people to recover from trauma, address mood related concerns, or dissociative symptoms (for example). We can offer skills, help increase mindfulness around unwelcome patterns of thought or behavior, process traumatic memories, and help navigate internal narratives about self and the world.  I have often felt that it can be a struggle to facilitate a connection between the reasons clients have sought therapy (depression, anxiety, PTSD, dissociation, stress) and the experiences that may have fostered what may characterize their struggle.  When exposed to a traumatic event, we don't often have the conscious thought "I am helpless" or "It's my fault."  Those struggling with depression may believe they are not good enough or feel worthless, while those with anxiety may feel pulled towards perfectionism in order to feel in control. These are typically subconscious, unarticulated beliefs that therapy can help pull from the back of the brain to the front, increasing the opportunity to renegotiate such narratives.  Without minimizing the value of this, sometimes it doesn't seem to be enough.

Adding homework assignments to someone who is depressed or telling an anxious person not to avoid something they fear is easier said than done and can cause people to feel badly about themselves because they just didn't have the strength to do it on their own.  What I want to do is to stop talking about it with my clients and offer opportunities for a different kind of experience.  Our thoughts are a reflection of our experiences, so why not start there?  There does seem to be some nods towards utilizing experience as a healing tool (such as with somatic therapies or psychodrama). In my group practice, we have started to play with various approaches to inviting the body to be part of the healing process.  The more I think about this concept, the more I play with it, the more I realize the body could be a missing link.  I know I am not the first one to think about this (Peter Levine, Pat Ogden).  I guess the difference is that I would like to offer experiential healing in a lot of different ways.  These are some of the things we are doing now:

1. Acupuncture, Massage, & Reiki in adjunct with Psychotherapy:  All of these are intended to calm the central nervous system for those who are fearful, anxious, or hypervigilant. They can also help to invigorate those struggling with depression or to offer the experience of nurturance and safe touch.

2. Equine Therapy in adjunct with Psychotherapy: This has been such a profound and beautiful experience for me as a therapist.  Watching my clients who have specific phobias (being up high, being in a group) or who are very protective of themselves find comfort through working with an animal has been a gift.  There are moments I will never forget in this work, and those moments were those where the experience underneath of a negative belief (i.e. "I am not safe) is challenged through doing (versus thinking).

3. Yoga: We aren't there yet, but I'm working on finding a trauma sensitive yoga practitioner.  This would provide an opportunity to do something physical in a safe environment.  An active body and meditation have so many mental health benefits that I can't list them all here.

There are so many other concrete ways one can begin to challenge negative beliefs or expectations of others/the world around us.  I hope to continue to expand opportunities to address mental health concerns outside of the therapy office.

Athena H Phillips, LCSW
Integrative Trauma Treatment Center

Monday, June 30, 2014

Survey: What would you want your physician to know (or not know) about your mental health?

In preparation for a presentation to a group of physicians in August on the topic of mental health in a primary care setting, the wheels have started turning on what the "patient" perspective might be.  There is a significant push towards coordination of care between disciplines, which clearly is beneficial in many ways. From my perspective, coordination of care can mean advocating for sensitivity and communication during medical appointments.  Clients reflect a reluctance to go to the doctor because of mental health concerns.  One might feel judged because of a struggle with addiction, because depression makes it difficult to get to the doctor or even make an appointment, or trauma makes doctor or dental visits frightening, for example.  I realized that as I prepare, I too may be making assumptions about how medicine is experienced by those who are struggling with mental health. So....

I propose a question: What are some things you would like to share with your physician but don't out of fear or in effort of showing respect (or something else)? What are things you hide from your physician? What would help you be more transparent in a medical setting?

If you respond, please leave out identifying information.

If you don't respond, it's okay!