Can Psychotherapy Feel Good?

Can psychotherapy feel good?   Or is psychotherapy all about swimming in the muck of shameful impulses?  “Getting help”  has come to mean exhibiting one’s dysfunction in front of a stranger.   What if there was another way to think of psychotherapy?  I believe that psychotherapy can feel good.  It may sometimes even be fun -- and maybe it’s more effective when it’s fun.

Freud and Shame

What are the origins of this aversion to psychotherapy?  Let’s go back 100 years or so.  Remember Sigmund Freud?  It seems that we as a culture can’t forget him.  And we shouldn’t.  But we may want to question some of his biases.  At the root of Freud’s theory is the idea that our Id -- our impulsive, untamed “inner bad-boy” (or girl), is continuously in conflict with our Superego; our conscience. We wish we could get rid of our mom and marry our dad, and we feel miserable because our superego tells us No.  Our desires and drives get us into trouble.  In this worldview the human condition is fundamentally unworkable.  We experience a never-ending conflict between what we want to do and what we “should” do.  What would a therapy session be like in which the therapist perceives the human condition as unworkable?  What would it be like to talk to a therapist who believes that he has to fix you?  How would the therapist interact with a client whom he/she believes is inherently dysfunctional?  I’ll call this psychotherapist Therapist 1.

Our Parts Love Us

Now imagine a therapy session in which the therapist believes that the human psyche is innately functional, maybe even sacred.  This therapist (Therapist 2), believes that our impulses are good.  She may ascribe to the Internal Family Systems model -- a model that identifies “subpersonalities” that help us cope.  She knows that all our subpersonalities or “parts” want the best for us, that each part is valuable and lovable. What Freudians call the Id, Therapist 2 might call an inner child.  What Freudians call the Superego, this therapist might call a taskmaster.  Therapist 2 would listen to the inner child, hear out the taskmaster, call on the inner nurturer, bring forth the Wise Self. She might encourage the inner parent to calm the child.  She might listen while the Wise Self counsels the taskmaster. Therapist 2 would facilitate a dialogue among parts, knowing that all want the best for their person. In other words, our inner wisdom, under the right circumstances, (and sometimes with a little nudging), can gracefully ease us towards health.  Humans are not inherently neurotic. We are inherently wise. Healers like Therapist 2 can help us access that wisdom and honor each part of ourselves. That kind of therapy session feels good!

Comparison

Here’s an analogy that might help.  Most of you have probably received a massage.  As psychotherapy aims to improve psyche functioning,  massage therapy aims to improve body functioning.  Using the model of two hypothetical massage sessions is a good way to compare the two psychotherapy approaches described above.  Massage Therapist 1 believes that bodies can’t self-regulate.  She may bully the body in order to bring it to her vision of health.  Massage Therapist 2 believes that bodies have inner wisdom and the capacity to self-heal.  She will approach the client gently and respectfully.  She may give a little boost to the body’s self-healing ability.  Massage Therapist 1 would probably (unintentionally) inflict pain, while Massage Therapist 2 would playfully partner with the body to facilitate equilibrium.

 

Is It All In Your Head?

What happened to the term “psycho-somatic?  For some reason it is no longer common parlance.  What does the term mean?  In popular usage, the term implied that the ailment referred to was “all in ‘your’ head.”  The roots of the term are the Greek words psyche which means mind, and somato which means body; therefore a true translation would be mindbody.   A psychosomatic disorder, for instance, can be described as “a disease which involves both mind and body.”1  I’m glad the term is not used in a derogatory way anymore, but I wonder why it’s rarely used at all.  Perhaps we have retired the term because research has confirmed the mind/body connection.

Can an ailment be “all in your head?”  Let’s think about it.  Is there a part of the body that is not affected by our thoughts and feelings?  Test anxiety may bring on sweaty palms.  Chronic emotional stress can cause adrenal fatigue.  Imagining hamburgers stimulates salivary glands.  Depressed feelings can translate into slumped posture and fatigue.  And researchers have discovered that even our DNA can be affected by emotions.   “According to the new insights of behavioral epigenetics, traumatic experiences in our past, or in our recent ancestors’ past, leave molecular scars adhering to our DNA.”2  So trauma, and the resulting emotions, can change molecules.

Does this have implications for psychotherapy?  As a body-centered psychotherapist and integrative healer,  I’d like to propose that the best psychotherapy is embodied psychotherapy.  Since emotions can have physical expressions, and since our bodies dialogue with our psyches,  it makes sense for client and psychotherapist to tune into the body.  Client and therapist can better understand and heal if we notice sensations in our bodies.  Tuning in to our bodies helps us to access information below the level of consciousness.  In the words of Candice Pert, “...the deepest oldest messages are stored and must be accessed through the body. Your body is your unconscious mind, and you can't heal it by talk alone” 3   By tuning in to the tension in your shoulders, you may realize that you feel the “weight of the world” and need to delegate responsibilities.  By noticing a subtle pain in your jaw you may take account of the repressed anger towards your spouse.  Your neck muscles may be tight for fear you’ll “lose your head.”  You may be weak in the knees, dizzy with love, or live with a “pain in the neck.”   Your hip may hurt because you feel “out of joint.”  The body speaks in telling symbols.  It behooves us to listen.  

We are psycho-somatic beings -- and to me that means it’s not all in our heads.  It’s also in our hips and our necks and our backs and our shoulders....

1 https://patient.info/health/psychosomatic-disorders)

2 http://discovermagazine.com/2013/may/13-grandmas-experiences-leave-epigenetic-mark-on-your-genes

3 Pert, C. B. (1997). Molecules of emotions. New York, NY: Scribner.

CranioSacral Therapy and Person-Centered Psychotherapy

As an integrative psychotherapist I utilize elements of both CranioSacral Therapy and Person-Centered psychotherapy in my work with clients. I’d like to share what each means to me and how each mirrors the other.

CranioSacral Therapy (CST) is a healing approach that was formulated by Dr. John Upledger (1932-2012), who followed in the footsteps of William D. Sutherland (1873-1954). Both men were osteopathic physicians and visionaries. Upledger developed a system of assessing and easing restrictions in the central nervous system (cranium to sacrum) to optimize functioning of the whole body/psyche. Central to the approach is the premise that the cerebral spinal fluid has a pulse. By assessing this pulse throughout the body, the CranioSacral therapist notes areas of restrictions to which he/she then attends.

What I love about CranioSacral Therapy is the deep listening that it entails. Because the pulse of the cerebrospinal fluid (CSF) pulse is very subtle, therapists use a very light touch and a deep focus. We tune in in order to deeply listen. And because we’re listening deeply, we can sense more than just the pulse of the CSF. We’re physically and emotionally attuning. The therapist’s hands and heart attune to the client’s physical and emotional “body,” and the client’s body and psyche responds to that respectful touch. It feels to me as if the body appreciates the attention and is therefore receptive to change. The psyche and the body don’t feel judged; they feel affirmed and ready to self-correct. You might call this non-judgemental approach listening from the heart, deep empathy, or focused empathic attending. To paraphrase John Upledger, we place our hands on a client and touch her soul. We energetically enter the client’s world; not to change or influence, but to listen to and partner with.

Another thing that I love about CST is we sensitively follow. We trust the client’s “Inner Physician” to advise and lead.  CranioSacral therapists believe in the body’s wisdom; we refrain from guiding, advising or “adjusting” the client. Physically, this means that the therapist’s touch is so light and and receptive that he/she sensitively follows the tissues as they unwind.  The restrictions in the fascia release with very little help from the therapist. It is as if the therapist attends to, then partners with the body to facilitate the release.  If, for example, the fascia of the abdomen shifts more easily to the right, then the therapist will not force the fascia to move to the left.  He/she would partner with the fascia in its unwinding. The body in CST does not react against the therapist’s touch -- our touch is so gentle that the body feels respected receptive. Similarly, we don’t emotionally manipulate, advise, or counsel, we listen and allow.

I think of CST as a bodywork version of Person-Centered psychotherapy. Person-Centered psychotherapy is a psychotherapeutic approach that was pioneered by Carl Rogers (1902-1987), an influential American psychologist active in the mid 1900’s. Some of the basic tenets of his approach are the therapist's unconditional positive regard for the client, the importance of congruence between the client's ideal and perceived self-image, and a genuine relationship with the client which facilitates the client's self-valuing. Rogers stated “...the client ...has the capacity and the tendency to reorganize himself and his relationship to life in the direction of self-actualization and maturity ...the function of the therapist is to create such a psychological atmosphere as will permit this capacity and strength to become effective rather than latent or potential.”* Implied in this statement are the beliefs that each person has an innate tendency towards health, and that the therapist's job is to nurture this impulse, not to guide, advise, or counsel. Rogerian therapists facilitate health by verbalizing an empathic understanding of the client's internal frame of reference.  They enter into, honor, and acknowledge each client's unique world. They nurture an instinct towards self-actualization by offering the client unconditional positive regard. By “capacity and tendency to reorganize himself,” Rogers means that not only do people want to be healthy, they instinctively know how. Rogerian therapists create a space in which clients can heal themselves. Like a watered seed, a person grows when given the right emotional nurturance. When affirmed with a skilled, congruent therapist's empathetic listening and warm regard, clients thrive.

CranioSacral Therapy parallels Person-Centered Therapy in many ways. Perhaps a motto for these approaches would be ~ what you judge won’t budge… and what you affirm thrives.

*Rogers, C. R. (1950). A current formulation of client-centered therapy. Social Service Review, 24(4), 442-450.