Yesterday I got to demonstrate skills associated with four different therapy approaches: Reality therapy, psychoanalytic therapy, cognitive-behavioral therapy, and Adlerian therapy.
Overall the video shoot went well, but I was surprised that of these four approaches, in many ways I felt most comfortable with reality therapy. I hadn’t expected that. Many people don’t “get” reality therapy and think it’s either a form of cognitive-behavioral therapy or a highly confrontational approach wherein therapists sternly confront their clients with cold, cruel, reality.
But reality therapy isn’t a form of CBT and it’s not confrontational. What I found myself doing in the reality therapy demo was following the sage guidance of Robert Wubbolding who formulated four BIG questions that stand at the heart of reality therapy. The questions would be good for everyone to memorize and can, when applied gently and persistently, help get people back onto a positive track. The questions are:
1. What do you want?
2. What are you doing?
3. Is it working?
4. Should you make a new plan?
Wubbolding has written several books on reality therapy and is taking up the torch for William Glasser, who was the original developer of this approach. In particular, I recommend Wubbolding’s books because they will help guide you in how to ask questions to help clients explore these four very important questions. I can even use them right now:
What do I want? — A good night’s sleep.
What am I doing? — Typing up this blog
Is it working? — Nope!
Should I make a new plan? — Good night!
The following material is adapted from Tough Kids, Cool Counseling.
Although we generally suggest not taking your client’s degrading comments personally, in the real world, we all get our buttons pushed sometimes. A graphic example of a therapist over-reacting to provocative client behavior was captured in the feature film, Good Will Hunting (Van Sant, 1997).
You may recall the scene. The main character, Will, played by Matt Damon, is an extremely intelligent but emotionally disturbed young man with mathematical genius. His would-be mentor, in an effort to help Will fulfill his potential, sends him to several different counselors, none of whom are able to help Will. Finally, Will ends up in the office of Sean McGuire, played by Robin Williams.
During his initial session with McGuire, Will is his provocative and nasty self. He begins insulting McGuire’s deceased wife which “activates” McGuire’s emotional buttons. The result: McGuire grabs Will around the neck and slams him up against the wall. Of course, McGuire also decides to take on Will as a client and eventually (and rather magically) he successfully helps Will move forward in his life.
We’d like to emphasize two key points related to this excellent example of resistance and countertransference from Good Will Hunting. First, be aware of your emotional buttons. If you’re getting your buttons pushed, seek support and counseling for yourself. Second, no matter how provocative your young clients may act, avoid using Robin Williams’s “Choking the client” technique. It may play well in Hollywood, but physical contact with resistant, aggressive, and/or angry clients is highly ill-advised. If you think rationally about the “Will Hunting” character and the fact that he had a history of physical trauma, touching him in an aggressive way would be ESPECIALLY contraindicated.
If you’re having your emotional buttons pushed occasionally by teenage clients or students, consider yourself normal. On the other hand, if the button pushing begins to cause you to contemplate acting on destructive impulses, it’s time to get therapy for yourself, and/or support from a collegial supervision group. Many psychoanalytically-oriented writers have warned about the powerful regressive countransference impulses that young clients can ignite in their counselors (Dass-Brailsford, 2003; Horne, 2001).
There’s nothing quite like experiencing embarrassment in the Here and Now.
Today Rita and I started a several day video shoot to produce counseling and psychotherapy demonstrations to go with the second edition of our theories text (Counseling and Psychotherapy Theories in Context and Practice. Rita did demos of Person-Centered and Feminist therapy and I got to do a Gestalt therapy demonstration.
In honor of the Gestalt approach, below I’ve inserted a short excerpt from our text describing the Gestalt principle of the figure-formation process. Tomorrow or the next day or whenever I’ve recovered I’ll post a short description of the Gestalt demonstration for those who may be interested.
The Figure-Formation Process
Humans are able to constantly shift their cognitive or perceptual focus. This may be especially true in our contemporary, media-based society where distractibility is normative. In Gestalt psychology, this is referred to as the figure-formation process.
An amazing human quality is the ability to intentionally shift the focus of consciousness. If you’re reading these words your focus (or figure) are the words on this page (or screen) and their meaning. This process puts you in your head—literally. You’re all eyes and intellectual processing.
This visual and intellectual experience is a function of your focus, but you might just as well focus on something else. If, as you read these words you intentionally shift focus to your ears, what happens? Or, if you are listening to this book instead of reading, shift to the smells in the room. Can you simultaneously focus completely on every sound wave or every odor bouncing around you without losing your intellectual focus? You may still be seeing or hearing the words, but now they’ve drifted into the background. If you consciously focus on auditory perception, then sound will take over the foreground or figure. And if we take this further we could have you alternate between different sounds and smells in your environment (maybe there’s music or a dull hum of lights, or your breathing, or someone’s perfume or your gym clothes in the corner, or . . .). In each case, your attention is shifting, more or less, and placing different perceptual experiences at the forefront. You’re engaging in a figure-formation process.
Perhaps an everyday example will help even more. Let’s say you’re driving the Interstate in Montana. The speed limit is 75 mph (yes, thanks to the federal Department of Transportation, we do have a speed limit). There aren’t many cars on the road because you’re in Montana. A signal from your cell phone pops into your awareness, triggering a social need, which then produces disequilibrium, and so you decide to take action and check your new text message. You steer with one hand, hold your phone with the other, and shift your eyes back and forth from the road to the phone. Three seconds on the road, 3 seconds reading text on the phone. At first the road and steering wheel is figure and the phone in your hand is background. Then the phone and text message is figure and the road and steering wheel is background.
Suddenly, you have a background thought about what you’re doing. Having passed your driver’s test you possess internal knowledge about how far you travel in three seconds at 75 mph. You’re covering 333 feet—over the length of a soccer or football field—every 3 seconds. This internal memory emerges from background to figure along with a realization that you could have run over 111 deer on the highway standing side-by-side while checking three-seconds of your text message. Another linked thought crystalizes into figure and you can almost hear your parents in your head telling you they love you so much that they’d like you not to text and drive.
The figure-formation voice in your head brings with it a surge of anxiety and you tap your brake and slow down to an unheard of 55 mph so that you’re only covering 243 feet every 3 seconds. Somehow you rationalize and justify that you’re safe enough to text and equilibrium is restored.
The point is not so much that you’re endangering your life and the lives of hundreds of innocent deer, but that you’re always missing something when figure recedes into background and gaining something when figure-formation occurs. This losing or gaining is, to some extent, under voluntary control. You may choose to miss out on the text message or you may choose to miss out on the 333 feet of road—but you can’t have it both ways because something has to be figure and something has to be ground.
From the Gestalt perspective, you’re always just a little bit aware of the ground (or background) and part of the purpose of therapy is to turn up background noise volume by shifting your focus or awareness so you can evaluate whether whatever’s bubbling around in the background might be meaningful or useful. During Gestalt therapy not everything you focus on will be meaningful or useful. However, many parts of your human experience (including unfinished business from the past that’s affecting you in the present) might prove useful and meaningful.
This is the essence of Gestalt therapy: Shift your focus and then shift it again to embrace here and now awareness and the personal development it might stimulate. At the same time, you recognize that not every 333-foot stretch of Montana highway will be immediately and profoundly important, but you stay with that focus because to do otherwise threatens your existence.
The figure-formation perceptual process, as applied to therapy, suggests that the primary or dominant needs of an individual can emerge from background (ground) into focus (figure) at any given moment. This is why Gestalt therapists believe that a client’s unfinished business from the past will inevitably be brought into focus as therapists keep clients in the here and now.
And here’s my grandson’s performance for those who haven’t seen it yet.
This morning I woke up tumbling through a dream of Margaret and Davis and Chelsea and Seth and Rita. We were all walking together and I got the honor of carrying Margaret on the way home. . . her 21 month old arms around my neck and then—poof—I am awake in Montana and the twins are in Connecticut.
And Rylee is in Scotland.
This past Thursday, as a part of my closing Keynote speech for the Montana Prevent Child Abuse and Neglect Conference, I managed to weave in a 90 second video clip of my grandson Davis walking around with a bucket on his head. I thought my speech was awesome. I was on fire, stringing together clear, clean, and polished sentences. But afterwards most people seemed to think the best part was watching that little boy with the bucket on his head.
This morning instead of reading and grading papers I’m reading Rylee’s blog. http://thecolorlime.wordpress.com/
Yesterday we Skyped, which was fine, but sometimes it’s even better to sift through her blog and catch a little glimpse of what she’s thinking, feeling, and doing across the pond. Freud said “Words were originally magic.” This morning my little Rylee’s magical words make me smile and miss her more than usual.
What makes people so desperate and disturbed that they would abuse children? I have a few academic answers to that question. Maybe it’s their old abuse history, their new stress, emotional troubles, needs for power and control, frustration, misdirected anger, twisted inner worlds of confusion about what they want and what they’re doing. But you know what they say: There are many good excuses, but no good reasons.
On this rainy Missoula morning I’m missing the children in my life and wanting to offer tribute to the human service providers and foster parents I met this past week in Helena who have dedicated their lives to protecting children from abuse and neglect. You all deserve a raise. Even better, you deserve to have your dream of preventing child abuse and neglect come true.
Thanks to Mary Peterson, who asked if I could return to Helena again this year to do a break-out session and closing keynote, I’m heading to Helena tomorrow morning for the 2012 Prevent Child Abuse and Neglect Conference. This is a conference attended by an array of social workers, foster parents, and a ranger of other professionals who work hard to prevent and reduce child abuse in Montana. This is a fantastic group of people and I’m honored to spend a few hours with them tomorrow and Thursday. The title of my break-out session is: “How to Get Parents to Listen to your Excellent Advice” and the Keynote is “Your Wild and Precious Life” (in honor of the Mary Oliver poem). Wherever you are and whoever you are spend a moment to think about how to contribute to reducing child abuse . . . an all too frequent and disturbing pattern of behavior that gets very little focus or attention in the media.