Theoretical Orientation
BASICS
Therapeutic Relationship
- Where I begin
- Safe place for growth to occur
- give them that place, they will grow
Bio/Psycho/Social
- Assess the concern
Multicultural Competence
- paying attention to my own biases and prejudices
- learning the context and worldview of my clients
SELF-OBJECT RELATIONS
Heinz Kohut
Empathy
Therapeutic Relationship
- real relationships require attunement
Mirroring
- to really know yourself, you have to see yourself from a third person point of view
- Includes affect and cognitive process
- Many clients who had little affective mirroring in childhood and are very uncomfortable with their emotions.
Cohesion and Fragmentation
- Self is fragmented and empathy and mirroring can bring some cohesion to the clients presenting concern.
- Client’s who come in and feel a loss, nothing makes sense anymore, “I don’t know”, I cry all the time.
Conceptualization
- empathy drives my conceptualization
- stop and think what it is like to be the client, sometimes I sit in their chair to do this
Goal: Healthy Narcissism
- requires positive mirroring of client’s accomplishments
- healthy self-esteem
EXISTENTIAL
Soren Kierkegaard, Rollo May, and Irvin Yalom
Reality is both Subjective and Objective
- Behaviorist point of view would say that it’s all objective – what you see is what you get.
- Attractive client who looks in the mirror and see “ugly”.
- We live in both worlds – our subjective perspective helps mold the reality around us.
Ambiguity
- Life is ambiguous
- Splitting (all or nothing) or holding the paradox.
- Nietchze: “Beyond Good and Evil”
Anxiety:
- Kierkegaard once wrote that “anxiety is the dizziness of freedom”
- Anxiety is an inevitable part of living.
Givens of life
- As humans many of our struggles are related to these: Death (the inevitable fate of us all), Freedom (struggling with our free will), Isolation (from others and our self), and Meaning and Meaninglessness (purpose, why?)
MC: It’s important to look at these givens from a multicultural perspective.
- Client’s will react differently to these givens (death less anxiety provoking in some cultures, while isolation may be more anxiety provoking in some)
- Client, pull from their own existential traditions / religions/ to gather meaning for the givens of life.
- Miseducation of African American (Kevin Cokely)
- Movement towards Authenticity: Living by your own free will; not by the rule or governance of the will of others. Example: I won’t kill because I don’t want to kill someone; not because the system will execute me for it.
Choices.
CHOOSING THE FUTURE
- difficult and anxiety provoking
- Break up / not; Act / Not; Move to new place / Not; Change / Not.
1: Remain static (Neurotic Anxiety)
- Don’t choose or don’t change
- In the moment low anxiety
- Built up anxiety over time
- Guilt for missed opportunity or fragmentation from lack of growth
2: Choose (Healthy Anxiety)
- Choose to go towards the anxiety, pain, fear: for hopes in a growth outcome.
- Muscles – tear muscle fibres, grow
- Our program – choose the anxiety, pain, good outcome, growth.
Goal is a paradox:
- Choose the pain to deal with pain.
- Always a risk for clients.
- Kierkegaard: “to dare is to lose one’s footing momentarily. Not to dare is to lose oneself.”
FEMINIST APPROACH
Social Justice stance on my work
- Research to help my clients on a greater level
- Outreach programs help too
- Volunteering – community centers and so on – part of my philosophy.
Goal: Empowerment Reframe
- Power differential in therapeutic relationship
- Constantly empowering client with homework or by positive mirroring.
- (Same as others)
LIMITATIONS
Insight oriented
Not ideal for some specific concerns
Existential is more applicable than some would think.