Interact Journal Integrative Ideas for the Process-Oriented Psychotherapist
Q: My other supervisor’s style is this way…. I think a more involved, enactive style like process therapy is better.
A: From psychoanalysis to behavior modification, whenever a therapist has her attention on the process in the room and is not countertransferred, a therapeutic environment is created. Resolution is invited. In that way, all effective psychotherapy is process therapy. Every therapist adopts a theory and a repertoire of techniques that is compatible with her belief system and her personality. Successful therapists attend to process rather than content although they do not necessarily name it in those words.
Q: When I suggest that someone do an enactment, most of the time I have no trouble wanting the enactment to be done or not. But from another person’s point of view, when I say, “Do this,” it must sound like an order.
A: Your invitation may indeed sound like an imperative. However, you know that it is not. So if you suspect someone perceives your suggestion as an order, then “perceiving suggestions as ordering” might be the process to work with. Trust your intuition. The worst that will happen is that the person will not know what you are talking about and you will have to discover that sometimes your intuition is incorrect. So use your perception as an invitation and work with the response, whatever it is.
Q: I stepped out of the therapeutic role last time and just lectured to an uncooperative client. Now I feel bad because, as he pointed out, I’m just one more authority figure who tells him he’s not doing it right.
A: While you (on your own time) work through your issue of wanting this man to be different than he is, in session take advantage of your countertransference and find a way to use it in the work.
Q: In the middle of a family session I go a little crazy and think, what the heck am I Doing in here?
A: You will find your question more useful if you will change the pronoun. Instead of asking yourself what you are doing in here, ask yourself, “What the heck are THEY doing in here? ” Better yet, think, “I wonder how I could enact what they’re doing in here. Okay brain, if you will come up with an idea, I’ll implement it.” Then breathe, connect with yourself and wait for your organism to do something. Whatever it comes up with, it probably will not be the perfect intervention. It might not even be in the ball park. It does not matter. Give up needing to know what you are doing. Work with the response to what you do.
Q: He disregards her wishes, doesn’t consider negotiating and does what he wants. She disregards her wishes too, then stock-piles anger and blames him.A: They will repeat this pattern many times during sessions, usually cloaking their process by discussing many Very Interesting Things. En-courage them to stop, introspect, acknowledge, and take responsibility for their own part in the dance. Each time you notice them doing it again,
Q: A four-year-old has been kicked out of three preschools because of his angry tantrums. Basically, his mother neglects him. She spends maybe ten minutes per day with him. She complains she has trouble getting him to do what she wants.
A: It sounds as if the boy needs a safe place to rage. And if mother and son will come in to session together, there will be an additional fifty minutes per week that this boy will have his mother’s attention. Call their process to their attention and devise interventions to work with it as it changes.
Q: Do you ever provide for a person to get a reward after they’ve connected with their anger in session?
A: Usually, when even a small amount of anger has been released, the release of the grief and the love that follow it are enough reward in themselves. Frequently however, a reward phase to end a fantasy may seem appropriate to the client. Find out. Ask.
Q: He has done things such as allowing himself, while high on marijuana, to be driven around closed up in the trunk of a friend’s car. He plans to have a big party when his parents go out of town next week and I’m thinking of telling the parents. Should I?
A: If he told you he was not going to do his homework next Tuesday, would you tell his parents?
Q: Sometimes I feel like I’m not earning my money. I mean I’m not doing very much. The client is working and maybe even resolving something but I’m not doing very much besides just sitting there watching.
A: What you are being paid for is to provide an environment of unconditional positive regard. That is worth about a million dollars an hour. It is my perspective that an hour in such an environment is a respite from the culture and is therapeutic all by itself.
Q: I often feel afraid when I intervene in certain ways. However, if I don’t try out different interventions, I won’t learn what I’m supposed to be learning.
A: In session try following this credo: If you hear a train coming, get off the tracks. In other words, if you feel afraid, then there is danger; so protect yourself. Your internal alarm system does not differentiate between internal or external jeopardy. When there is danger, it goes into alert mode and signals, “Red light! Change activities!” by pumping fear-producing (fight or flight) biochemicals into your bloodstream. Over time, should you mostly not pay attention, your automatic system, in order to insist you protect yourself, has to up the ante, either by starting earlier or by increasing the amount of fear.