Permission to be Patient

Permission to be Patient

“Whether you’re patient or not, time will pass, life will continue to move forward.  Choosing patience simply makes the journey less nerve-racking.”   Franco Colomba

   One of the greatest gifts we can offer ourselves and clients is permission to engage patience.   Our American culture is full of messages of urgency, action, don’t miss out, move faster, do more.  Just writing these messages I feel my stomach clenching, my arm muscles tensing, my breath shortening and feeling more constricted.   The physiological response to the sense of urgency is powerful.   The timer gets set on our physical system, and without awareness, can end in an emotional explosion.   Imagine, just thinking about running late, or trying to get something done, or moving faster sends a message to our brain “urgent”, “possible danger”, “high alert”.  This kickstarts the process in the brain that readies your body to survive a possible threat. Adrenaline kicks in, cortisol starts flowing, muscles tense, shortness of breath, tightening of muscles.  Pretty amazing!  And it all started with a thought.  Now imagine that we live in that state all day every day.  Without a break.  Knots develop in our shoulders, pains in our stomach, aches in our back, chronic headaches, high blood pressure, forgetfulness.    I know, I’ve been there.  And many of our clients come in presenting this way too.  And they come in and share with you their urgency.  “I need to feel better quick or …..”, “My wife said I need to figure this out or we are done”,  “I can only meet for 6 sessions so can we hurry this along?”, “I’ve heard EMDR is quick, that’s what I need”.   Pretty soon, without awareness they’ve shared urgency with us like a cold virus sneezed out and traveling through the air around us.  

We breathe it in. 

Now imagine what happens when we, ourselves, take a deep breath, settle in our chairs and invite the client to notice how they are experiencing urgency right now in their body.  Maybe they can’t access the awareness of it yet, so you observe, “I’m noticing this pressure to get this done quickly, and the more you’ve shared the faster you’ve talked.  I’m wondering if there is any part of your body that feels really tight right now?”  

I drop my own shoulders, intentionally slow my speech, smile.  Mirror neurons kick in and as I calm they calm (co-regulation).   

Then I’m curious how urgency has served them in their life.  How close of a friend has it been?  What does urgency whisper in their ear.  How does their physical system respond to the whispers?   Then I’m curious, I wonder what it would be like if they had permission to take as long as they need?  What if they had permission right now to just drop their shoulders and for a few minutes just let the couch hold them up.  

What would it be like to have a brief experience of not having to work so hard?  

Sometimes relaxation is a wave of relief that washes through the room, wrapping everyone in a warm cozy embrace.  Sometimes urgency is more reluctant to let go, has multiple hooks, and frustrates the client raising the tension in the room.  Sometimes the best response is repetition of patience, permission just for the moment, an invitation to experiment the right now without a commitment to future practice.  

The invitation to slow down, take a breath, relax the muscles; reverses the physical process in the brain.  Oxygen flow increases, blood flow returns, calm descends over the brain allowing easier access for information and thought.   

The process of change just began. 

I’m reminded of a moment in the “Will You Be my Neighbor” documentary where Francois Clemmons, who played Officer Clemmons, shared an experience he had with Mr. Rogers.  Every day Fred ends his show with “I like you just the way you are” or “It’s ok to just be you”.  One day Francois reports he noticed Mr. Rogers looking at him off screen as he was saying this statement.  After the cameras were turned off, Francois went to Mr. Rogers and said, “Mr Rogers, were you talking to me?”  and Mr. Rogers responded, “I’ve been talking to you every day for 2 years, today you could hear it.” 

Be patient, keep repeating permission.  One day, they will be able to hear it. 

Welcome and Trust: Journey to Authentic Spirituality

"Faith in the biblical sense does not mean maintaining that certain assertions are true; rather it is a relationship of trust between humanity and God. God believes in us. God trusts us and hopes that we return the compliment. Because God has confidence in us, we can develop a healthy self-confidence."

Richard Rohr

You don’t have to work so hard.  This statement feels scary, exciting, and impossible all at the same time.  It brings up skepticism, curiosity, and hope as I read it again.  I wonder what happens for you as you read it? 

In my own journey (and by journey I mean life journey of growth in professionalism, spirituality, mom-hood, wife-hood, womanhood), I am hearing this message from the Lord of “you don’t have to work so hard”.   I’m learning that this phrase means rest in him, salvation comes from him, trust in him, lean on him, look to his guidance; trust, trust, trust. 

EMDR therapy is a powerful therapy that taps into and uses the brains already created natural ability to move towards healing (AIP model).   In my faith tradition, I believe this incredible system that was created to move towards healing was created by God.  In my practice, I’m learning that when I stop working so hard to figure out how to help someone, I get to rest in the knowledge that God created a system that is designed to move towards healing.  When I rest in this and trust that the system knows what to do, the healing process emerges.  My job in this process is to trust. Trust the process of EMDR therapy.  Trust the AIP model. Trust that the person’s system knows what to do.  And Trust that God will reveal to me what is in the way of the person moving towards the healing they so desperately want.  Then my job is to welcome.  Welcome the blocks. Invite the big feelings.  Treat anything that gets in the way as Jesus treated the woman about to be stoned for her sinful acts.  Welcome it, and offer God’s grace. 

Want to learn more about how to use the EMDR model in this way?  Would you like to learn specific mindfulness practices to incorporate into your work with Christian Clients?  Would you like to know how to work with blocking beliefs that come up for Christian clients that keep them from experiencing a closer relationship with God?  Would you like to learn how to incorporate spirituality into your EMDR work with Christian clients?

I will be answering all of these areas and more in my webinar  “Working with Spirituality in EMDR: A Christian Perspective” on January 11^th and 12^th, 2019.  

Click the link below to register.
https://emdr-training.net/emdr-training-event/working-with-spirituality-in-emdr-a-christian-perspective/   

Relationship, Balance and Connection with Authentic Spirituality

I identify myself as several things.  I am a mom, a wife, a marriage and family therapist, a trauma therapist, a friend, a Christian.  With each part of me a commonality among all, is relationship.  I can’t seem to get away from it.  It shows up in all I do, and every part of who I am.  And at the center of every relationship I find me.  And the me that shows up varies with each relationship.  Sometimes that’s necessary sometimes it’s not….but it is what it is.  The same is true for us all.  The things we do in the presence of others, comes up….in the presence of others.  In PTI we refer to these things that we do as The Answer.  The Answer is those things we do to stay safe or stay connected in relationships.  And if we use those answers over and over, we tend to get really good at them.  And a pattern of relating to others begins.

In my work over the years I have seen another triadic relationship emerge with all my clients, the triadic relationship of emotion, physicality and spirituality.  Some clients come in dominant in one over the others.  Some come in disconnected from all three.  The use of EMDR therapy is such a natural organic tool that when used, seems to balance out this triad and clients experience more connection to their whole selves.

Many Christian clients come in disconnected from their emotions, their body, and God.  I could go into all kinds of theories and rants about why that is the case in this modern church age; but I wont.  What I will share is when we begin to integrate their spiritual concerns, worries, blocks, into the EMDR process, more happens than what they came in for.  They experience an emergence of the natural order of the triad.  They begin to experience healing in their relationships. They begin to feel connected to their emotions and their body.  And they begin to experience growth and authenticity in their relationship with God.

For a Christian, living out of their faith system means to learn how to Love God, love self, and love others.  The EMDR process is a beautiful tool that allows this to be attainable for Christian clients.

In my practice I also see a lot of people wounded by the church or by others who have identified themselves as Christians.  Sometimes these wound experiences were violent and extremely abusive.  Other times it’s pervasive emotional wound experiences that confuse and overwhelm a system with doubt.  These clients present extremely guarded and hurt in therapy.  The slow climb to trust is tedious and often times feels insurmountable for them and me.  At times it can be a struggle to even identify, “where do we begin?”.

In all scenarios though one thing remains the same; relationships.  Relationship with family of origin, caregivers, present friendships, present intimate relationships, relationship in their current place of worship and relationship with God all carry patterns.  As we notice the patterns emerge we begin to see the imbalance.  And from there, the treatment process can begin. 

In PTI one of the core principles is non-violence.  This concept of non-violence in therapy means we do not impose on our clients, we are collaborative, we are patient, we ask permission.   In my personal relationship with God, I find the non-violent principle as Biblical.  When I can keep these principles as the foundation of how I walk with people in the therapeutic journey, healing happens.   All that to say, the healing process is done in relationship.  And that starts with me.  Before they come in.  My foundation is set.  My ability to be grounded in my own trust in my relationship with God allows me to be in the present moment, in a non-violent way, with them.

My passion is to share what I have with others.  On September 7 and 8, 2018 I am launching a training on ‘Working with Spirituality in EMDR: A Christian Perspective'. In this 2 day training I will share a way to conceptualize a case through the lens of relationship. I will share tools I have used with clients that help balance out the triadic system.  And I offer a way to see and work with clients from the core Biblical Principles of non-violence.

Therapist will experience many of the tools I use throughout the training, because what I have learned through my own journey, is when I can authentically live out of my own spiritual connection, my relationship to clients is the starting point for change.  In our relationship they experience safety, security, authenticity, and a genuine care.

My guiding principles are: Be Still and Know God, love thy neighbor, let your gentleness be evident to all, trust in the Lord with all your heart, see people as a creation of God.  I hope you will join me. 

Alice

Getting Your Money's Worth

As I move into different seasons of my life I have reflected on seasons gone by to see if there is anything I can glean from my time there.  It’s interesting that as I am now more in the supervisory role I reflect on my time in the learner role.  I have often asked myself, “did I get my money’s worth?”  For me it’s a value thing.  Did what I walk away with equal what I invested into it.   I have realized it’s more about what I personally invested vs. what I monetarily invested.  The experiences where I allowed myself to be vulnerable, (not knowing), showing up in my mistakes and insecurities were the most valuable of all.  So it’s interesting that it wasn’t necessarily about the supervisor I worked with, but what I brought into the supervisory process, that made it valuable. 

Now on the giving end of supervision I see the same truth.  Those supervisees who come prepared with hard questions, wanting to explore their mistakes, who are willing to show up and be taught in their uncertainty are the clinicians who grow so much.  The value of our time together is time and money well spent.  On this end of the relationship I so enjoy the invitation into another clinician’s growth process. 

When continuing to grow as a clinician and move through hard things, get your money’s worth!

             A) Be vulnerable-  what are you unsure of, what are mistakes you may have made, what are                      uncertainties about moving forward.

             B)  Be prepared- write out your case in a conceptualizing way: history, facts, clinical opinions,                 safety concerns, legal and ethics, treatment goals, where you are stuck.

             C)  Be Teachable- take in the feedback and be curious about it. Ask questions about how to apply             the feedback. Write down the feedback and form a plan.

We are always learning and growing in our profession and often have limited time and resources set aside for this growth.  To make the most of what you have, invest wisely with vulnerability, preparedness, and teachability.

Becoming a good therapist

How do I become a good therapist?  I remember asking myself this while I was in school (truth be told I still ask myself this). Of course this is part of who I am….all about being good or even the best I can be at something.  Sometimes in my life this drive can get in my way, but in my profession it’s really helpful.  It helps me keep being better at what I do, moving forward, changing what I do and looking for different ways to do good therapy.

The longer I work in this field, the more I know “not all therapists are created equally”.   You may be saying….well duh Alice…but really, the community doesn’t always know this.  When you are hurting and you are desperate for help, you reach out trusting you will get that help.  The truth is, there are some in our profession that are not helpful at all.  And then there are some that are very helpful.  Luckily, there are researchers out there who have looked at the difference between the two.   Wampold and Imel give us a body of information in their article The great psychotherapy debate: The research evidence for what works in psychotherapy.

What Doesn’t Matter:

Theoretical Orientation – They all work

Experience – Therapists earlier in their career are actually better than those with more experience

Therapist characteristics of age and gender

Therapists rating

How many of us spend time trying to get more experience, or working hard to find the best theoretical model?  We spend a lot of time and money here.  Research tells us, at the end of the day, these things don’t matter when it comes to being a good therapist. 

What Does Matter:

Alliance - Learn to form a collaborative working alliance with a range of clients (even challenging clients)

Make it Simple – Can explain aspects of therapy effectively and succinctly

Attuned – Can recognize metacommunication happening as it happens (example picking up on body language, seeing facial expressions that are in discord with words)

Grounded- warm, accepting, empathetic, modulate own emotional response while staying focused on client and his/her problems

Humble- questioning our own effectiveness and work to improve

Understanding- offering an explanation for client distress and a means to overcome it. (why do they do what they do and how do they minimize what is limiting them?)

So if you are like me, and you want to be the best therapist you can be, spend less time doing what doesn’t matter and more time doing what does.  If you are not sure about your ability to build an alliance with all clients, get training in that.  If you struggle taking hard concepts and making them simple, get coaching on this.  If you are not very good at being attuned to clients, consider extra learning in that area. 

To summarize, to be a good therapist, evaluate how you do on what matters. Spend less time and money on what doesn’t matter, and more time and money on the things that do. 

Wampold, B.E. & Imel, Z.E. (2015). The great psychotherapy debate:  The research evidence for what works in psychotherapy (2nd ed.). New York: Routledge.

Wampold, B.E. (2016 September/October)  Can we become better therapists? Yes, we can!. Family Therapy Magazine, 15(5), 16-19.

Taking it Home

“This client is really driving me crazy.  I don’t know what to do with them anymore.  No matter what I say they have a reason or an argument for why it wont work.  I find myself dreading the session”.

Anyone else been here?  At some point in our careers we all find ourselves in this place.  Sometimes it’s with the ‘resistant’ client.  Sometimes it is with the client who is really good at asking for help….over and over and over….and only from you.  Sometimes it’s with the client who is in so much pain and hurting that it’s hard for either of you to see any light at the end of the tunnel.  What do all of these have in common?  No matter how hard we try, these are the clients that follow us home (figuratively…I hope). 

So what do we do with them? Respond vs. React.  More often than not, when these clients are in our room, one of them triggers us into our own stuff, which causes us to react out of our old patterns.  This reaction sets off a chain of events and before we know it we are in really deep, feeling what they feel, imagining what they imagine, carrying what they carry.  All of these are reactions.  For us to do our best work, we are called to empathize without taking it on.  The best way I have found to do this is with the notion of response vs. reaction.  So here are some tips on how to respond…

11)      Setting up the internal awareness- Take a moment to close your eyes, center yourself, and then imagine an object out in front of you that represents what it is with this particular client that seems to stay with you.  As you get an image of this object, keep it out in front of you and notice it’s shape, size, texture.  As you take time with this, notice if there is a color.  Then take a moment to position your arms around the object as you currently feel like it is positioned in relation to your body.  Notice how uncomfortable that feels.  When you are ready, push the object out away from you so that it is just the right distance out. Where ever you place it in the room is just right.  Now hold your hands up like a boundary and position them just how you need them to be so that the object stays out from you vs. on you.  Anchor in that position to where it feels ‘known’.

22)      Get perspective – Consult with a colleague, see if they can offer any insight on counter-transference that you may be experiencing that pulls you in.

33)      Prepare before the session – Prepare in a way that allows you some time before the client comes to ground/center yourself into the most professional and wise self you have to offer.  Do your internal awareness exercise to put the object in it’s place. Remind yourself of your clinical goals for the session.

44)      Consider your own therapy – If the issue continues, consider exploring what it is about this particular client dynamic pulls you in.  Having the perspective of a therapist to help you work through this pull can benefit you and your current and future clients.

We are all human, and with that humanity brings the pull to connect with others.  Sometimes that connection is a reaction which is unhealthy for us and the client.  Choosing response vs. reaction is a hard choice and sometimes not one that comes easy.  However, this choice lessens the consequence of ‘taking it home’ which is something I know many of us strive for. 

The Power of Why

The Power of Why?

One of the things I have realized I do in my practice is ask myself “why?” This is really a powerful question.  I remember in school they always said avoid the question why.  So my starting off with this simple but complex word my trigger some of you or completely put off others.  If you can stay for just a few more seconds maybe an opportunity will open up for you. 

When a client comes in my office I immediately start an internal question of “why are they here?”  Really this word is motivated by curiosity, and curiosity keeps me grounded and objective.  Then as they share in the initial session of why they are here I’m asking myself “why is their problem a problem?”  Then as I form a hypothesis about this I ask myself “why are they sharing what they are sharing?”

All of these ways of asking why begin forming a hypothesis in my mind to help inform my exploration and treatment with clients. As treatment begins, I continue with the “whys”. The “why” helps me with evaluating countertransference, transference, resistance, success.   Consider curiosity to help ground you in the following treatment steps.

·       Setting client goals: “why are they here?”, “Why is the problem the problem?”, “why does the problem continue to be a problem?”

·       Client Stuck Place: “Why is the client stuck in this specific way?”, “How could this problem be helpful?”, “Why would this problem have been helpful to them at some time in their life?”

·       Countertransference: “why does this client bother me so much?”, “why do I dread this client?”, “why do I look forward to this client?”, “Why am I bothered when the client doesn’t meet treatment goals quickly?”, “why do I feel relief when the client does this?”

·       Transference: “Why am I the one the client keeps calling?”, “why is the client yelling at me?”, “why did they choose me as their therapist?”, “How is what they are doing right now normal for them?”,  “What purpose doe s this serve for them?”

·       Success: “Why did they get better?”, “Why did this work for them?”

Asking the question of why and staying in a curious place can help inform every phase of treatment.  If you ask the question why and are struggling with the answer maybe be curious about that, or call a colleague and see if they can help with exploring why.  If “why” is just too difficult for you,  try “How” or “what” inserted in the same type questions and just see what happens in your treatment process.