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 (stands for “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.
Traumatized clients may be living with the fear center of their brain perpetually activated. Because of this, other parts of their brain—the ones allowing for reasonable decision making, for example—may get “turned off”. This can make it difficult for traumatized people to function in and learn from the world around them.
As a therapist or coach, our job is to work with our clients to move their lives forward in meaningful ways. But this is often easier said than done.
Obstacles can arise both on the part of the client and the therapist. If you’re finding that words are coming a lot more easily than actions for your clients, here are 3 common traps that you and your client may have fallen into:
Living in chronic fight- flight- freeze mode and having an overactive sympathetic nervous system can cause all sorts of health problems.
During normal states of stress, the hormones and other chemicals our body releases enhance endurance, strength, and focus. However, when constantly secreted in large amounts due to chronically being in survival mode, the same hormones can impair learning abilities, memory, physical function, and the immune system.
A number of medical conditions have been linked to PTSD and its chronic stress level. These include, among others, chronic fatigue syndrome, autoimmune disorders (Boscarino 2004), fibromyalgia (Boscarino 2004; Cohen et al. 2002), multiple chemical sensitivities (Scaer 2014), thyroid abnormalities, and other hormone dysfunctions.
Emerging from the CBS (cognitive behavioral science) and ACT (acceptance and commitment therapy) literature as a set of evidence-based psychotherapy processes, psychological flexibility involves the development of expanding and adaptive behavioral repertoires that can be maintained in the presence of distressing events that typically narrow behavioral repertoires.
Before you begin using ACT (acceptance and commitment therapy) with your clients, it’s best to have a good sense of the entire ACT (acceptance and commitment therapy) model. This includes knowing a variety of core metaphors and exercises you can use and having a working understanding of the basic theory.
The flexibility processes—acceptance, defusion, committed action, self-as-context, values, present moment awareness—are sometime presented as if they were separate. However, they are actually interdependent. Thus it’s important to allow time for a period of growth with the theory and therapy. Lacking a basic understanding of one process could lead to difficulties in implementing other processes, as well as confusion and dead ends in therapy.