On Therapy
This page is for the therapy-curious, therapy-considering, and therapy-skeptic.
Let’s say you’ve read the “on the Foundations” page, and you are a person for whom your Old Self is beginning to unravel. Let’s talk about how therapy can help. We’ll start with a little Q&A and move to types of therapy that I find helpful.
Question One: “Why would I go to therapy?”
First, I’ll start with myself. I have been going to therapy for the last 15 years and I have no intention of stopping. It has been life-changing for me. There’s just no way I can see the things I’m blind to on my own.
Secondly, you don’t have to go. There are other ways to grow and learn about yourself and get unstuck. Really good wise friends and authors and speakers and pastors and mentors and books and retreats and seminars.
Thirdly, you have to want help, or it won’t help you. We humans will keep doing what we are doing until it stops working. I’ve never had someone show up in my office and say, “You know, everything is working great in my life. I’d just like to dig around in the roots a bit and see what we can stir up.” You can’t rush the timing on a person’s sense of needing help. So if now is not the time for you, I won’t try to convince you otherwise.
BUT if you are in pain, or you’ve hit a roadblock you can’t shift, or other ways of growing aren’t doing it for you, maybe it would help. There’s something powerful about having the undivided attention of a wise and kind person who is trained to help you see things you can’t see alone. You could keep trying alone, but you just really don’t have to keep doing it that way.
Therapy is not a magic pill. The therapist cannot (and should not!) fix your problems. It won’t help if you aren’t ready to do your own work. But since we humans are such habitual creatures, it can be so helpful to set your intentions in the direction of growth by committing to consistent therapy visits, giving yourself the space, time, and regular rhythm of attending to the issues of your heart.
*A caveat— If you’ve had a bad therapy experience, consider trying again. As in any profession, therapists also can be naive, not well-trained, misunderstand you, or simply not a good fit for you. A therapist-client relationship is just that, a RELATIONSHIP, and sometimes when it’s not working, it needs an exit and a re-try.
Question Two: What good would it do to talk about the past?
“I/He/She just need(s) to get over it.”
“Oh, that? I’m really not affected by that anymore.”
“I forgave him a long time ago and I’m never looking back!”
“Shouldn’t we “lay aside what is behind and move toward what is ahead?”
These are all versions of a similar idea, and I’m just going to say it: They are“red flags” for me in the counseling room because of their possible short-sightedness, lack of nuance, and rigidity.
I would offer that true healing has to take an honest look at the wound, and it must be thoroughly cleaned for healthy tissue to develop around it. When fighting deep infection, the body pours tremendous energy into self-preservation and begins to show general signs of unwellness that may not be immediately obvious. If we are not paying attention, the symptoms usually grow more severe. In the same way emotionally, we can experience “secondary symptoms” that point to something under the surface we don’t yet know. Anxiety, depression, lacking motivation, needing to numb, surges of rage, addictions, fantasies, needing to be in control, unable to live within healthy limits, needing approval, hiding, needing power over others, and many others, can be symptoms pointing to a deeper origin.
Do you want to get to the root of the infection and experience true healing, or do you want to spend your life switching out band-aids? (Let’s be honest?!)
Question Three: I’ve never been to therapy. What’s it like?
What a brave thing, to come to therapy for the first time! I personally wish I had stuck with it longer, sooner in my life. (Yet, I didn’t think I needed it, so clearly I wasn’t ready!)
Initial contact with a therapist would involve determining if your needs and the therapist’s style/training are aligned. Many therapists, practices, and search engines offer profiles for you to read and consider. Do these person’s words ring true? Do they have experience with my areas of concern? Will we meet online or will I come in person? Would I prefer a man or woman? Does this person accept my insurance, or fit my financial needs? Does this person feel like a fit to me? Often an email exchange and/or phone call can address all of your initial questions. (Do ask your questions!) Then you will fill out initial paperwork.
Let’s say you proceed and schedule a first session…
In the first session(s,) the therapist will hear your initial concerns and want to get to know you. They will go over policies as well as answer logistical questions about payments, cancellations, scheduling, frequency, and privacy. They will ask questions about your specific goals for coming to therapy, as well as seek a big picture overview of your present life. (In general, how are you physically, vocationally, relationally, emotionally, mentally, spiritually?) Some will gather a detailed family history. Occasionally, if after hearing your concerns, the therapist feels they are not able to help you, they will communicate this and offer a referral to someone else who is more qualified. But more commonly, you and the therapist begin to chart a path together toward your specific goals.
People often tell me that the first session feels to them like they are spilling out something messy. This is not unusual. Since you’ve lived decades of life, there’s a lot to share, right? I think of the initial sessions like spilling a puzzle out on the table and spreading out the pieces. You can’t quite see what the puzzle will look like yet and the pieces are not sorted. Also, by the time someone shows up in a therapist’s office, they have usually been sitting in something hard for a while. Sometimes a LONG while. So, it can feel like dumping the puzzle out all at once. Or for others, you may not feel ready to hand over the all the pieces of your puzzle, or some of the pieces may feel missing even to you. All of this is normal.
As clients begin therapy, I hope they feel they are building a relationship with a kind and trust-worthy person. Not a perfect person. Definitely a fellow human. But someone who will seek to know, understand, support, encourage, and tell them the truth. These are also qualities of a good friend, but a therapist is different than a good friend. There’s a reason your therapist isn’t sharing their troubles with you. (They should not be doing this. And it’s not because they don’t have their own challenges.) It’s because the boundaries of this unique relationship are meant to provide a safe space for YOU to process. It is designed on purpose to address your needs and concerns, not the other way around. Also, a good therapy relationship is one where you feel support to see more clearly how YOU want to move forward in your life. Therapy is not about giving you advise or telling you what you should do. If you leave the first sessions and feel that something is off, please discuss your concerns with your therapist. Therapists cannot read your mind but DO want to understand how you are feeling and want to address it directly so that the experience is helpful to you.
In the middle, (and sometimes from the beginning!) therapy often feels hard. Wounds are exposed, painful stories emerge, anger pours out, embarrassing insecurities arise. Cleaning out the wound, admitting your part, resetting old habits take time and repetition and humility! It might even feel like you are moving backwards and you are not “getting better.” It might feel like a part of you is dying. Guess what?! It is!! Your Old Self! But there can be no resurrection without death. I join you in how ridiculously painful this can feel!
Question Four: How can faith and therapy be integrated?
So glad you asked. Let’s talk about that!
Many of my clients desire their work in therapy to integrate with their spiritual life. From my perspective, a person’s spiritual life reflects a key part of how they are made, even if they don’t practice a particular faith.
When I ask about a person’s faith, I’m asking more than if they attend a type of worship service. I want to know their growing-up history with faith experiences and traditions, and how these have shaped them. And I’m also wanting to know how they view (at this point!) fundamental questions about themselves and the world around them. What do they believe about…
Where did humans come from? What are we designed to be?
What went wrong? What isn’t working about the way humans are living, and why?
What can be done about the problems? And where are we headed? And really, what’s the point of it all?
My view of the Author as loving and wise; stamping-each-human-with-the-gift-of-Divine-design; never-minimizing-a-problem; always-telling-the-truth; doing-what-it-takes-to-make-everything-right Author and Finisher, informs my sense of what we humans are designed to be, what goes wrong, and what to do about it. (See the“On the Foundations” page for more on this.)
Sometimes I hear a different concern from faith-based circles. It sounds something like— “If I’m walking authentically in my faith, why would I need therapy? Shouldn’t my trust in the Author be enough? I don’t think I can trust someone with psychological training anyway.”
To this person, first I’d say, let’s have coffee. But if that can’t happen, here are a few thoughts.
*Good therapy and growth in the Author’s design are meant to go together. A person’s spiritual and emotional well-being are meant to complement one another. In therapy, a person can begin to untangle life events, make sense and let go of burdening patterns, distinguish false beliefs about self and others from true ones, develop skills of internal listening and relational wisdom, learn to recognize and repair hurt between themselves and others, and grow in an ability to discern and trust what is good and life-giving from what is not.
*Also, consider: We humans are super complex, all-tangled-up creatures, are we not? To honor this, wouldn’t you want someone who has specialized training? Not only someone who knows the Author, but also someone who is a life-long learner in the ways that bodies, brains, emotions, and relationships go awry and heal, too? If you find someone who only shares your beliefs but doesn’t understand these areas of your humanity, that could be problematic too.
Types of Therapy I like to use with clients:
Each person who comes to therapy is a unique in their personality, needs, and goals. This is part of why I enjoy the work—it is such a creative process! As I get to know them, I’m looking for which combination of approaches may best make sense of their challenges and help them move toward healing. Below are some of the techniques I find really helpful as the client and I begin to put the puzzle pieces together.
Psycho-education: [Can we make sense of what is wrong with me?!]
Let’s start with your Autonomic Nervous System (ANS) and Polyvagal theory.
Why would I start there? Probably because I just REALLY like to understand what’s going on in my own body and brain. Because when I understand these things, I feel less crazy, and many others feel this way too. A little knowledge can feel so validating. While we aren’t yet striking the deepest chord here, I promise this is really practical. So many of our distressing symptoms begin to make sense once we unpack this! Notice the user-friendly diagram on the right.
Your ANS is the part of your body that is continually monitoring how you are taking in the world— do you feel engaged and at ease in the world? Or do you feel threatened in some way? Unbelievably, all of this assessing happens without the need for your conscious approval. It is highly shaped by past experiences. The track of awareness runs along what we call the vagus nerve, and there are generally 3 recognized “vagal states,” thus it’s termed “POLYvagal theory.”
When your ANS senses no threat, this is called the 1)“ventral vagal” state. Look at that chill guy. He’s relaxed and ready to engage in his world. BUT, when a threat is sensed, (as your body reads it!) the alarm system alerts with what we call 2)“sympathetic activation.” We typically refer to this as “fight or flight,” but its much more nuanced than punching an opponent or fleeing the room. It happens when you are gearing up for a problem, and the characteristics show up distinctively in your body: increased heart rate, blood pressure, muscle tension, temperature increase, etc. His distressed face (back to the diagram) says it all! When this state can’t be resolved inside and/or increases, we tend to move into a collapsed state, which we call 3)“dorsal vagal.” You might notice this when you feel temporarily shut down, disengaged, heavy, and lacking energy/motivation. Poor guy— he’s wrapped up in a ball, feeling all alone, and stuck in the dark.
I find when I talk about this with clients, it helps them make some initial sense of the angst that caused them to seek therapy to begin with. You can learn to recognize these signs in your own body, learn the triggers that set you off, and learn how to help your own body settle again. The human body is truly a fascinating piece of work!
Some feel like this is all they want out of therapy. But I hope you stick with it, because these truths do not change the way you relate to yourself or others, and they don’t change the beliefs that you hold because of the story you’ve lived. Let’s dive a little deeper.
Attachment Theory: [Why do I keep falling into the same relational ditches over and over?]
Attachment theory is all about naming the patterns of your relationships. (Returning to “On the Foundations” page, we’re referring to patterns of your Old self.) When you were a baby, before anything you can remember, you unconsciously started learning things about connecting with your caregivers. While you were fussing, crying, cooing, or giggling, your brain started concluding things about how relationships work based on how your mom/dad/caregivers connected with you (or didn’t.) Naming those basic patterns is what attachment theory is about. Knowing this doesn’t fix your problem, but it tells us a lot about what specific beliefs shape YOUR insides and where that came from.
There are four basic categories referred to in attachment theory:
1) Secure Attachment patterns are seen when someone feels generally safe, internally and externally, with themselves and others. They feel able to connect with others meaningfully, and they feel OK to be alone. They are able to communicate their needs, regulate their emotions, can receive and give comfort. This description is unsatisfyingly non-nuanced, but you get the basic idea.
2) Anxious Attachment can be in play when someone feels frequently worried about their connections with others. They aren’t sure where they stand; they often feel they’ve done something wrong. They long for continual reassurance that everything is OK. Others may experience them as clingy, or frequently insecure.
3) Avoidant Attachment patterns name someone who tends toward isolation. They don’t feel the need to cultivate a connection with others. They feel a strong desire for independence and find it difficult to trust others. Others may find them aloof, distant, disengaged, and unexpressive of emotion.
4) Disorganized Attachment is seen when someone has a chaotic pattern in their relationships. They may move toward or away from others in destructive ways. They have great difficulty regulating their emotions and may lash out or cut off from others in extreme ways.
I have given basic descriptions of adult patterns, but there is so much more to be said about how these patterns are formed. If you are curious about this, you may enjoy learning about the Infant Strange Situation experiment and research, out of which Attachment patterns were named and developed. Many types of therapy utilized today have Attachment Theory as their foundational philosophy. While I don’t think Attachment Theory gets us all the way there in our healing, I do feel its helpful in the patterns it and names and in pointing the way toward wholeness.
Internal Family Systems (IFS): [Why am I so complex and conflicted inside?]
a) Managers- These are parts of us that try to manage, or control stuff in our own or others lives. Examples would be, a perfectionist part, a harsh inner critic, a pleaser, a fixer, a rigid scheduler, etc…
b) Firefighters- These parts do what firefighters do— they put out fires. In other words, these are parts of us that try to numb stuff we don’t want to feel. Examples would be obvious behaviors like addictions such as gambling, sex, drugs/alcohol, and less obvious numbing like internet scrolling or binge-watching shows.
I find these are the parts (managers and/or firefighters) that usually prompt a person to seek therapy. A person begins to notice when a protective part seems to be “breaking down” or not working the way it used to. [For example, I recognize something destructive about my perfectionism, and I see it is beginning to have big costs in my life.]
In IFS language, if protectors are “protecting” us, this assumes that something inside me is seeking protection. IFS calls these parts:
2) Exiles- These younger (meaning they formed when I was younger) unhealed parts hold the hardest stuff of our stories that we (often unconsciously) buried a long time ago, such as stories of deepest shame, grief, loss, tragedy, powerlessness, violation and despair. Exiles take on the burdens of negative beliefs about self and others. Lies such as “I’m unworthy of love” or “I’m only acceptable if I make others happy” or “I’m stupid". There are many more. The false beliefs I hold about myself are often reinforced and deepen over time.
What can be done about this? The goal of IFS involves movement toward the development of my True Self.
IFS work involves (in the most basic of terms!)—
1) Getting to know and working with Protective Parts (my Old Self). It is important to name to name the ways my internal system has developed self-protection and understand how these function in my life. The goal of work with protective parts is to gain their permission to access Exiles, where the deeper wounds lie. The Old Self has tried so hard to save me, but now I can see she was never meant to fulfill this job.
2) Working toward the healing of Exiled Parts. When I return to the places of deepest burden, I find where the deepest healing is needed. As I come to know an embrace of these parts of me, I can see myself as I’m made to be. Protective parts can begin releasing their rigid stances and I can begin to believe what is true about me. I am made for love, and made to love!
3) Discovery and growth of my True Self. I am stamped with the design of the Author in me to receive and offer love. As I grow toward the Light, I can grow in wisdom, honesty, grace, courage, empathy, creativity, and so much more. IFS would say that though our True Self can seem lost, missing or buried, each human HAS this stamp within and it can be uncovered. As my True Self develops, I feel more freed to move ahead in my life with this solidness, rest, humility, self/others compassion, playfulness, and confidant conviction. As I grow, I am not perfect nor have I fully arrived, but I can flourish in learning to love.
This explanation of IFS is so brief it hardly feels sufficient to honor the healing work it represents, yet it can be a powerful tool.
I appreciate IFS in how it honors the complexity of what it means to be human. We all have so many different parts of us that act different ways at different times! IFS gives language and understanding around our various parts and what they are seeking to accomplish.
IFS also dove-tails well with Old Self/New Self language, as well as the Enneagram (see below), as both of these tools help us see the particulars of our Old Self and also paint a specific picture of what my New Self can look like.
IFS offers the following basic categories for our complex human parts: First, we have parts called 1) Protectors; There are two types of those—
Eye Movement Desensitization & Reprocessing (EMDR): [How can my trauma be addressed?]
First, a word about trauma. Here’s an understatement: Trauma is a massive topic. When I first sought training to offer trauma therapy, I felt that EMDR would be the golden ticket. What is discovered is that trauma is a huge field of learning and there are many, many paths. EMDR can be one helpful approach.
EMDR stands for Eye Movement Desensitization and Reprocessing (a mouthful, yes!)
EMDR is a form of therapy that seeks to access and integrate multiple aspects of healing in a person’s brain in the midst of traumatic or highly distressing memories, helping to rewire self-beliefs adaptively. Let me break it down a bit.
The “Eye Movement” part speaks to the method, and simulates what occurs in the Rapid Eye Movement stage of sleep. This happens through employing a type of “bi-lateral stimulation” (BLS) that occurs while someone is processing a distressing story or event. The BLS can be done by moving the eyes quickly from right to left and back; or can be experienced passively with a device held in the hands with a slight buzzing sensation from right to left and back.
The Desensitization part means we’d like to take an event in one’s life that causes significant distress, and make it less distressing. Sounds good, right?
The Reprocessing part means we’d like one step even better— We want to remove the old obstacles so that someone can actually believe something different (something real and true!) about themselves rather than the negative belief they took on when the original story occurred. Some powerful neuroplasticity can happen! (More on this later.)
EMDR is not magic, and it doesn’t change a person’s character. To say it playfully, if you were a jerk before EMDR you will be a jerk after. But for someone who is stuck re-experiencing the painful, on-repeat, negative beliefs of past trauma, EMDR can feel pretty amazing in its hopeful, adaptive brain-pattern re-shaping.
The Enneagram: [Why do I do the things I do?]
There are MANY personality assessments that are super helpful for understanding your and others’ human behaviors, and that’s a good start. But the brilliance of the Enneagram lies in its seeking to identify one’s MOTIVE, which is an entirely different thing. This is why some can take a long time for some to know their “number” with certainty, because sometimes we just don’t understand our insides very accurately. WHY you do what you do is the bigger fish.
Further, more than just identifying “what you are like,” the Enneagram helps identify the “Old/False Self.” What are the strategies you’ve developed in life to protect yourself? These patterns develop EARLY in life and we often think, “This is WHO I AM; This is my personality.” No! Rather, it’s who you’ve learned to be.
Which leads me another gift it can give— What does it look like, for YOU SPECIFICALLY, to change, and grow? What does my New Self look like? The Enneagram paints that picture for you, AND helps you see a specific path to get there.
If you’d like more info, let me first refer you to enneagraminstitute.com. It has a research-validated, affordable assessment (which is going to save you a lot of time over various free assessments) and offers great introductory tools for understanding the many specific terms (types, wings, direction of integration/disintegration, levels of maturity, crossing types, etc.) If you really want to be helped by the Enneagram, invest in some further learning. The nuance is pretty fascinating!
This tool has some fascinating ancient history attached, but over the last 5 years or so, more clients come in asking about it. I was introduced to it by my therapist about 15 years ago, and over time I’ve learned how he uses it organically in session with clients. Among personality assessment options, it’s the most useful tool that I know. Unfortunately due to its recent notoriety, I think its super-power discernment has become easily misunderstood. Some learn enough to say, “here’s my number; here’s what I’m like!” but this is just the beginning!
Final words on the helpfulness of therapy…
All of these are just tools. Do me a favor and don’t take these introductions out of context, OK? (Feel free to let me know via the contact page if you have questions, since I have only so briefly described them!) These are tools that help us name Old stuff and make sense of what is going on inside and in our relationships, and give us pathways toward healing. I find ALL of them helpful for different people, and none of them are magic wands or guarantee healing. Some are more educational, some more feeling-oriented or thought-oriented or action-oriented, some more integrative of all of those.
This is in part why I love the work of therapy. It’s so creative! In front of me sits a unique human being with dignity and longing and mess and I have the privilege of joining them for a portion of their journey. Together we can explore the stories that led them here, and where the path takes them is a story yet to be written.