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By David D. Burns, MD

Years ago, I read an article on the psychoanalytic view of empathy. The author defined empathy as: the analyst’s feelings when in the presence of the patient.

It is certainly important for therapists to be in tune with our feelings during therapy—that can be an important source of information about what’s going on in the therapeutic relationship, especially when there’s some tension in the room.

The following article has been adapted  from an excerpt of Brief Interventions for Radical Change  by Kirk Strosahl, PhD, Patricia Robinson, PhD, and Thomas Gustavsson, MSc

Author: Janina Scarlet, PhD

Losing a parent can be devastating. Losing a parent and a sibling in one week can be excruciating. That is exactly what happened to “Joe” (not real name), after his father and brother both died a few days apart, following a car crash.

Experiential avoidance is an attempt to mitigate or evade contact with unwanted psychological events. Experiential avoidance becomes clinically relevant if it promotes acting in an unhealthy manner or prevents moving in valued directions and toward meaningful outcomes.

Notice that we used the tenuous word “attempt” in defining experiential avoidance. It’s important to understand that actions aimed at reducing contact with private events—such as emotions, sensations, and feelings—don’t ensure that these events will go away or won’t arise again. In fact, avoidance moves might eventually exacerbate the problematic repertoire.

 

The discoverer helps us push out to the edges and learn through trial and error.

Harnessing the power of the discoverer is one of the coolest aspects of DNA-v, the youth model of acceptance and commitment therapy (ACT). Step inside the discoverer with me for a moment, and imagine it for yourself.

You are a baby discoverer. One day at meal time you push that sippy cup right to the edge of the highchair tray, watch it fall to the floor, and listen to the pleasing clatter. Your parent laughs, picks it up, and places it back on the tray.

The current mindfulness craze—if we take it seriously enough—may just change who we think we are and what we’re trying to do in therapy. It can lead us, and our clients, away from our comfortable constructs and toward a radical reappraisal of who we are and what our life is all about, upending our psychotherapy practices in the process.

We can discover through sustained mindfulness practice that our sense of being a separate, coherent, enduring self is actually a delusion maintained by our constant inner chatter—chatter that generally features “me” at its center. From mundane decisions (“I think I should get the salmon with wilted spinach tonight—I’ve been eating too much junk lately”) to existential fears (“What will I do if the lump is malignant?”), this chatter fills our waking hours. Listening to this inner narrative all day long we come to believe that the hero of this drama must of course exist. After all, I’ve been thinking about “me” and my desires for as long as I can remember. So when emotions arise in my awareness, I naturally assume that they’re mine.

EMDR (eye movement desensitization and reprocessing) has been thoroughly researched and shown to be an effective treatment for acute trauma and post-traumatic stress. But what do you do with clients who have experienced ongoing relational trauma? What about neglect? Can the effectiveness of EMDR techniques be extended to these clients as well?

Regardless of their theoretical approach, clinicians often notice that successful therapy leads to a profound sense of self-reconciliation. We believe that compassion for oneself and one’s inevitable failings, past, present, and future, is a key element in such self-reconciliation.

Exposure therapy is a behavioral treatment that involves gradually approaching a feared situation in a controlled and systematic manner. Exposure therapy is used to treat anxiety disorders, obsessive-compulsive and related-disorders, posttraumatic stress disorder, as well as other anxiety-related problems (Abramowitz, Deacon, & Whiteside, 2011; Nathan & Gorman, 2015).

Contextual behavioral science (CBS) is based in an evolutionary perspective of behavior. Behavior varies and is selected for continuation or repetition according to its functionality in serving the organism’s goals. Variation in behavior occurs through learning.

Humans are unique in their capacity to make use of arbitrary symbols as cues to transform how they respond to events. However, in order to talk about that, we have to  briefly mention the more ancient processes of respondent and operant learning.

 

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