Tag Archives: theories

Thinking About Counseling and Psychotherapy Theories

Theories III Photo

Definitions happen.

The process through which words and concepts are defined is fascinating. By definition, definitions need to be sharp and make distinctions, and yet they also sometimes be inclusive and blurry on the edges.

In the latest (3rd) edition of Counseling and Psychotherapy Theories in Context and Practice, Rita and I take aim at the definitions of counseling and psychotherapy. Read on, and if you’re inspired to do so, let me know what you think.

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Definitions of Counseling and Psychotherapy

Many students have asked us, “Should I get a PhD in psychology, a master’s degree in counseling, or a master’s in social work?”

This question usually brings forth a lengthy response, during which we not only explain the differences between these various degrees but also discuss additional career information pertaining to the PsyD degree, psychiatry, school counseling, school psychology, and psychiatric nursing. This sometimes leads to the confusing topic of the differences between counseling and psychotherapy. As time permits, we also share our thoughts about less-confusing topics, like the meaning of life.

Sorting out differences between mental health disciplines is difficult. Jay Haley (1977) was once asked: “In relation to being a successful therapist, what are the differences between psychiatrists, social workers, and psychologists?” He responded: “Except for ideology, salary, status, and power, the differences are irrelevant” (p. 165). Obviously, many different professional tracks can lead you toward becoming a successful mental health professional – despite a few ideological, salary, status, and power differences.

In this section we explore three confusing questions: What is psychotherapy? What is counseling? And what are the differences between the two?

What Is Psychotherapy?

Anna O., an early psychoanalytic patient of Josef Breuer (a mentor of Sigmund Freud), called her treatment the talking cure. This is an elegant, albeit vague, description of psychotherapy. Technically, it tells us very little but, at the intuitive level, it explains psychotherapy very well. Anna was saying something most people readily admit: talking, expressing, verbalizing, or sharing one’s pain and life story is potentially healing.

As we write today, heated arguments about how to practice psychotherapy continue (Baker & McFall, 2014; Laska, Gurman, & Wampold, 2014). This debate won’t soon end and is directly relevant to how psychotherapy is defined (Wampold & Imel, 2015). We explore dimensions of this debate in the pages to come. For now, keep in mind that although historically Anna O. viewed and experienced talking as her cure (an expressive-cathartic process), many contemporary researchers and writers emphasize that the opposite is more important – that a future Anna O. would benefit even more from listening to and learning from her therapist (a receptive-educational process). Based on this perspective, some researchers and practitioners believe therapists are more effective when they actively and expertly teach their clients cognitive and behavioral principles and skills (aka psychoeducation).

We have several favorite psychotherapy definitions:

  • A conversation with a therapeutic purpose (Korchin, 1976, p 281).
  • The purchase of friendship (Schofield, 1964, p. 1).
  • When one person with an emotional disorder gets help from another person who has a little less of an emotional disorder (J. Watkins, personal communication, October 13, 1983).

What Is Counseling?

Counselors have struggled to define their craft in ways similar to psychotherapists. Here’s a sampling:

  • Counseling is the artful application of scientifically derived psychological knowledge and techniques for the purpose of changing human behavior (Burke, 1989, p. 12).
  • Counseling consists of whatever ethical activities a counselor undertakes in an effort to help the client engage in those types of behavior that will lead to a resolution of the client’s problems (Krumboltz, 1965, p. 3).
  • [Counseling is] an activity … for working with relatively normal-functioning individuals who are experiencing developmental or adjustment problems (Kottler & Brown, 1996, p. 7).

We now turn to the question of the differences between counseling and psychotherapy.

What are the Differences Between Psychotherapy and Counseling?

Years ago, Patterson (1973) wrote: “There are no essential differences between counseling and psychotherapy” (p. xiv). We basically agree with Patterson, but we like how Corsini and Wedding (2000) framed it:

Counseling and psychotherapy are the same qualitatively; they differ only quantitatively; there is nothing that a psychotherapist does that a counselor does not do. (p. 2)

This statement implies that counselors and psychotherapists engage in the same behaviors—listening, questioning, interpreting, explaining, and advising—but may do so in different proportions.

The professional literature mostly implies that psychotherapists are less directive, go a little deeper, work a little longer, and charge a higher fee. In contrast, counselors are slightly more directive, work more on developmentally normal—but troubling—issues, work more overtly on practical client problems, work more briefly, and charge a bit less. In the case of individual counselors and psychotherapists, each of these tendencies may be reversed; some counselors work longer with clients and charge more, whereas some psychotherapists work more briefly with clients and charge less.

A Working Definition of Counseling and Psychotherapy

There are strong similarities between counseling and psychotherapy. Because the similarities vastly outweigh the differences we use the words counseling and psychotherapy interchangeably. Sometimes we use the word therapy as an alternative.

To capture the natural complexity of this thing called psychotherapy, we offer the following 12-part definition. Counseling or psychotherapy is:

(a) a process that involves (b) a trained professional who abides by (c) accepted ethical guidelines and has (d) competencies for working with (e) diverse individuals who are in distress or have life problems that led them to (f) seek help (possibly at the insistence of others) or they may be (g) seeking personal growth, but either way, these parties (h) establish an explicit agreement (informed consent) to (i) work together (more or less collaboratively) toward (j) mutually acceptable goals (k) using theoretically-based or evidence-based procedures that, in the broadest sense, have been shown to (l) facilitate human learning or human development or reduce disturbing symptoms.

Although this definition is long and multifaceted, it’s still probably insufficient. For example, it wouldn’t fit for any self-administered forms of therapy, such as self-analysis or self-hypnosis—although we’re quite certain that if you read through this definition several times, you’re likely to experience a self-induced hypnotic trance state.

*To learn more about our Counseling and Psychotherapy Theories text, all you have to do is Google it. If you’re looking for an instructor’s copy, Google the book title and then go to the Wiley website and request one. If you have troubles with that, email me . . . and I can likely help out.

Breathing New Life into Your Dead, White Counseling and Psychotherapy Theories Course

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Artwork by Rita Sommers-Flanagan**

On April 18 at 1:00p.m. EST, I’ll be doing a Wiley Webinar. This webinar is free, and especially geared toward academics who want to expand their repertoire for teaching counseling and psychotherapy theories. Because this webinar is sponsored by my publisher, John Wiley & Sons, there will be some minor marketing of my textbook, Counseling and Psychotherapy Theories in Context and Practice (3rd ed.). However, you can attend this webinar regardless of the textbook you use. My goal is to help open all of us up to how we can integrate new ideas into existing “older” theoretical perspectives.

Here’s the link to register: https://www.wileyplus.com/wiley-webinar-series/#john-sommers-flanagan

And here’s the official blurb for the webinar:

Teaching traditional counseling and psychotherapy theories courses can feel dull and boring. In this webinar session, John Sommers-Flanagan will share pedagogical strategies for integrating culture into theory, and engaging students with here-now activities that bring the dusty old theories to life. This webinar will include specific recommendations for how to integrate culture and feminist ideas into traditional theories. Learning activities will be demonstrated, including: (a) early intercultural memories; (b) sex, feminism, and psychoanalytic defense mechanisms; (c) empowered narrative storytelling; and (d) spiritual and behavioral forms of relaxation. Handouts for each activity will be available later on this blogsite.

Beyond this short description, I also want to acknowledge the obvious. As a living White person who writes about, teaches, and practices theory-based counseling and psychotherapy, I know that my ability to claim expertise in making cultural adaptations is limited. I don’t want to be the expert on this (or most things). The purpose of this webinar is NOT to “tell” anyone exactly what diversity modifications “should” be made when teaching counseling and psychotherapy theories. Instead, my purpose is to talk about and illustrate ways in which new diversity-sensitive ideas might be creatively integrated into old theoretical perspectives. From there . . . the application of these and your own ideas about how to breathe new life into old theories is up to you and your unique personal and professional worldview.

Given this big preceding caveat, the webinar’s learner objectives are to help participants:

  • Identify compatibilities of culture, spirituality, and feminist thought with traditional counseling and psychotherapy theories
  • Implement an intercultural memory activity with large or small groups
  • Implement and discuss diverse sexualities along with psychoanalytic defense mechanisms
  • Implement a multicultural empowered storytelling strategy
  • Implement and debrief spiritual and behavioral integrations to achieve relaxation

Soon (right around 4/18/19) I’ll be posting more information related to this webinar. In the meantime, let me know your thoughts on this topic. As always, I value alternative perspectives and enjoy hearing your reactions to the posts on this blog.

News Flash: The 3rd Edition of Counseling and Psychotherapy Theories in Context and Practice is Now Available!

Theories III Photo

Hello Theories Fans.

I have exciting and good news! The third edition of Counseling and Psychotherapy Theories in Context and Practice is NOW AVAILABLE. Here’s the publisher’s link: https://www.wiley.com/en-us/Counseling+and+Psychotherapy+Theories+in+Context+and+Practice%3A+Skills%2C+Strategies%2C+and+Techniques%2C+3rd+Edition-p-9781119473312

The “less good” news (as the MI folks like to say) is that I wrote up a promotional piece for our publisher to distribute, but they thought it was TOO POSITIVE:) . . . so I’ll do what I can to temper my enthusiasm here.

What’s new in the Third edition?

Other than a massive reference overhaul, empirical updating, and re-writing and editing in response to reviewer feedback, the biggest news is that we added sections Sexuality, Neuroscience, and Spirituality.

The other good news is that our book (2nd edition) already had the highest average Amazon customer rating of all Counseling and Psychotherapy Theories texts, a whopping 4.6 out of 5.0 stars! [for comparison, 4.6 is the same rating as John Grisham’s “The Firm” and higher than Mary Pipher’s “Reviving Ophelia” . . . although, not surprisingly, Grisham’s and Pipher’s works tend to get a few more reviews]

It’s also important to note that our textbook is still relatively inexpensive (compared to other Theories textbooks).

This text also has excellent ancillaries. There is an accompanying video, test bank, online instructor’s resource manual, and a student study guide. The video clips are imperfect and spontaneous demonstrations of specific counseling skills that include counselors and clients with various cultural backgrounds.

Rita and I are humbled and happy to have the opportunity to publish the third edition of our Theories text with John Wiley & Sons. As in previous editions, our primary goal has been to translate complex theoretical material into prose that is engaging, reader friendly, easy to understand, and has a practical/skill-building emphasis. Most, but not all, of the reader reviews on Amazon are affirming and give us hope that we’ve accomplished this goal. To capture some of the positive responses, I’m sharing several Amazon reviews below:

  • The best text book I’ve ever read! Thoroughly enjoy the humor. Each chapter is written slightly different to capture the feel of the theory it describes. Laughed out loud at the final fantasy writing.
  • I love the writers of this book, it is like a conversation and sometimes humorous. Got the book right away.
  • Absolutely amazing read! Every line has important information and I actually enjoy when chapters are assigned for my theories class in this book!
  • While this was purchased for a class, I am really enjoying the information and case studies the author’s present. I do not mind reading this material and think this is one textbook I will not sell back to the bookstore, instead using it for reference throughout my new career.
  • This book was incredibly helpful to me as a counseling student. This is my first semester in the counseling program and this book was full of useful information, very easy to read and understand, and provided a vast overview of the different theories. I will definitely be keeping this book to use as a resource on future papers.

To see all 43 reviews, you have to go to the 2nd edition: https://www.amazon.com/Counseling-Psychotherapy-Theories-Practice-Resource/dp/1119084202/ref=sr_1_1?ie=UTF8&qid=1527631412&sr=8-1&keywords=John+Sommers-Flanagan

And here’s the 3rd edition on Amazon: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119473314/ref=pd_cp_14_2?_encoding=UTF8&pd_rd_i=1119473314&pd_rd_r=229a780b-638c-11e8-890c-a735446468c0&pd_rd_w=A4Hos&pd_rd_wg=zISf0&pf_rd_i=desktop-dp-sims&pf_rd_m=ATVPDKIKX0DER&pf_rd_p=80460301815383741&pf_rd_r=SY3RS8RHYZYD8HPR7W7Y&pf_rd_s=desktop-dp-sims&pf_rd_t=40701&psc=1&refRID=SY3RS8RHYZYD8HPR7W7Y

As always, let me know if you have questions or comments on this post or on our third edition of Counseling and Psychotherapy Theories in Context and Practice.

Sincerely,

John SF

 

Can Male Therapists Do Feminist Therapy with Male Clients? You Decide — A Feminist Case Example

Fishing Big Davis

The 3rd edition of Counseling and Psychotherapy Theories in Context and Practice will be available very soon. Just in case you’re longing to see the cover as much as I am, there’s a link to the new edition on Amazon. Although I’m betting your longing is much smaller than my longing, here’s the link anyway: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119279127/ref=dp_ob_title_bk

To celebrate this forthcoming epic publication (it’s not really epic, but some days it felt like a long poem), I’m posting a case presentation from the feminist chapter. Honestly, I don’t know who gets to decide what’s epic or what’s feminist therapy. That being the case, you can decide on both points. Or you can decide you’ve had enough of JSF for today.

Here we go.

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In an interesting twist, we’re featuring a case with a male therapist and male client in the feminist chapter to illustrate how working within a feminist model can work for boys and men. This case focuses on a 16-year-old male’s struggle with emotional expression. John SF is the therapist.

Josh was a White, 16-year-old heterosexual sophomore in high school. He had never met his biological father and lived in a middle-class neighborhood with his mother and three younger sisters. His mother was diagnosed with bipolar disorder. Josh’s main loves were consistent with his gender identity. They included basketball, cars, girls, and sarcasm. He very much disliked school.

Josh and I met for therapy for several years. At the beginning of one of our sessions Josh handed me a packet of photos.

“Hey, what’s this about?” I asked.

He responded with a half-mumble about a recent awards ceremony. I thought I discerned pride in that mumble. I looked through the pictures while he told me about each one. There was one in particular that he gently lifted from my hands. It was a picture of him in a line-up with five other people. He carefully pointed out that he was standing next to the Lieutenant Governor of Oregon. I teased him because there were no pictures of him and the actual governor.

“What’s the deal?” I asked. “Wouldn’t the Guv pose with you?” Josh rolled his eyes and signaled for me to move on to the next photo.

The Problem List and Problem Formulation

Unlike CBT, feminist therapy doesn’t involve collaboratively generating a concrete problem list and formulating problems as if the problems resided in the client. Instead, because problems and problem-formulation are inseparable, we can’t talk about the problems without also talking about cultural factors creating and contributing to the problems.

If client issues are discussed as problems, they’re likely discussed as situational challenges. In Josh’s case, his mother initially had brought him to therapy for anger management. Anger was consistently a regular focus in Josh’s therapy. Like many 16-year-old boys immersed in the dominant U.S. culture, Josh’s emotional life was highly constricted. He was living by Pollack’s boy code (2000) and unable or unwilling to risk feeling anything other than anger and irritation. From the feminist worldview, this wasn’t Josh’s problem; his issues around anger stemmed from him living in a culture that kept him in an emotional straitjacket.

Josh’s issues (and case formulation from a feminist perspective) looked like this:

  1. Learning to deal more effectively with sadness, grief, and anger within the context of a repressive emotional environment.
  2. Coming to an understanding that his beliefs and views of emotional expression were not in his best interest, but instead, foisted upon him by toxic cultural attitudes about how boys and men should experience and express emotion.
  3. Developing trust and confidence in himself—despite not having a father figure or a mother who could provide him and his sisters with a consistently safe and stable home environment.
  4. Learning to talk about what he really feels inside and pursue his life passions whatever they might be instead of reflexively pursuing culturally “manly” activities.
  5. Expanding Josh’s limited emotional vocabulary through consciousness-raising.

Interventions

Feminist therapists are technically eclectic; they use a wide range of interventions imbedded in an egalitarian and mutually empathic relationship:

  1. Encouraging Josh to speak freely and openly about his life experiences.
  2. Empathic listening with intermittent focusing on more tender emotions, depending on how much of this Josh was willing or able to tolerate.
  3. Therapist self-disclosure and modeling.

As Josh and I looked at photos together, I responded with interest and enthusiasm. Because interpersonal connection is a core part of therapy, I didn’t rush him to move on to our therapy agenda. Instead, I shifted back and forth between saying, “Cool” or “What’s going on there?” to making sarcastic wisecracks like “Why exactly did the government let you into the capital building?” Sarcasm was used to express interest and affection indirectly, mirroring Josh’s humor and style. After seeing most of the photos I asked, “Who’s the person standing next to you?” I could tell from his response that I had asked a good question.

“Oh, yeah, her. Her name is Sharice; her mentor was getting the same award as my mentor. I danced with her. She’s a good dancer.”

We talked about dancing and what it was like for him to feel attracted to her. We were ten minutes into therapy and both of us had completely ignored the fact that we hadn’t been able to see each other for five weeks. Finally, I decided to break the avoidance pattern. I asked “So…how are you doing with all that’s been going on?”

He looked toward me, glancing downward.

“I’m doing okay, I guess.”

Because this was a young man who had been socialized to keep his emotions tightly wrapped, I probed, but gently.

“I understand it’s been pretty wild times?”

He looked up, eyes fixed on some invisible spot on the ceiling. I recognized this strategy—a surefire way avoid crying in public. An upward gaze constricts the tear ducts; tears cannot flow.

He looked back down and said, “I’ve been busy. My mom’s been in the hospital for about a month.”

“I heard she had a pretty hard time.”

He grunted and then, in a quiet growly voice, the words, “Let-me-tell-you-about-it” seeped out from behind his teeth. Silence followed. I cautiously probed a bit more by sharing more of what I knew.

“I talked with your mom yesterday. She told me that she got pretty caught up in some housing project.” This statement lit a fire in Josh and he plunged into the story.

“You won’t believe what she did. It was so f*ing stupid. Some punk developer is gonna build three houses. Three houses at the end of our street. This is no big deal. She just f*ing freaked out. She chained herself up to a tractor to stop them from building a house. Then she called the f*ing senator and road department and I don’t know who in hell else she called. She was totally nuts. So I told her she had a choice. I told her that she could go back home or I’d call the police and have her committed. She wasn’t taking care of my sisters. She was being a shit for a mom. So I just gave her a choice.”

I nodded and said, “You must be practicing to be a parent. That’s the kind of choice parents give their kids.”

His voice grew louder: “I gave her the choice five times. Five f*ing times! She tried to buy a Mercedes and a Volvo over the phone. So I called the cops. And the woman asked ME what to do. I’m f***ing 16 years old and they f *ing ask me what to do. I didn’t know what to say. I told ‘em to come get her. They finally sent some really big cops over to take her away.”

“Then what happened?”

“My mom was still acting nuts and my sisters were crying. So I just picked them up and held them and they took her away. We sat and they cried and we snuggled a while. And then I drove us home. I don’t have my license, but I can drive. My mom is still pissed at me about that, but I don’t give a shit!”

While listening to Josh, I formed an image of him in my mind. I saw an awkward 16-year-old boy “snuggling” his sobbing sisters, as the cops take their mother away. The girls were 9 and 6 and 4 years old—the same sisters he had complained about in previous therapy sessions.

Talking with teenage boys about emotional issues is tricky. Too much empathy and they retreat. No empathy and you’re teaching the wrong lesson. Throughout Josh’s storytelling, I used sarcasm, empathy, and emotional exploration, like, “What was that like for you to gather up your sisters and take care of them?” I suspected that if I asked too much about feelings or forced him to go too deep too fast, I would lose my “coolness rating” and there would be a relationship rupture.

Much of the session focused on empathy for Josh’s anger. Josh ranted and I listened. He was immensely angry and disappointed and hurt about his mother’s behavior. But I wanted to find a way to let Josh know that it’s okay, even a positive thing, for boys and men to feel and express more tender feelings.

About halfway through our session, I asked:

“So Josh,” I said, “When was the last time you cried?”

After a short pause he spoke with extreme deliberation, “I… don’t… cry… I… just… get… pissed.”

Josh expressed this masculine emotional principle very efficiently and then offered more about his socially coerced, but internalized emotional philosophy.

“Crying doesn’t do any good. It doesn’t change anything. It’s just stupid.”

“I know, I know” I said. “The whole idea of crying sounds pretty stupid to you. It’s not like crying will change your mom and make her better.”

“Nothing will ever change her.”

I renewed my pursuit of when he last cried. He insisted that was so long ago that he couldn’t recall, but we both knew that several years ago, after an especially hard week with his mother, he had sat on my couch and sobbed himself to sleep. Instead of bringing that up, I asked him what might make him cry now. Would he cry if his girlfriend broke up with him… if he lost his cell phone… if one of his sisters got cancer… if he didn’t graduate high school? Josh fended off my questions about tears by repeating his resolve to get “pissed” about everything that might make him feel sad. But the question about one of his sister’s getting cancer stumped him. He admitted, “Yeah, I might cry about that…” while quickly adding, “…but I’d do it alone!”

I responded, “Right. Absolutely. Some things might be worth crying about… even though it wouldn’t change things… but you’d want to do the crying alone.”

We talked indirectly and intellectually about sadness and tears, trying to model that we can talk about it—once removed—and if he cried someday, it would be perfectly okay, there would be no need to feel ashamed.

Toward the end of the session, I decided to lighten things up by teasing Josh about his social insensitivity. I said, “I can’t believe that we’ve talked this whole hour and you never asked a single thing about me.”

Josh grinned. He knew therapy was all about him and not about me. He probably thought I was playing some sort of therapy game with him. He was a good sport and played along.

“Okay. So what am I supposed to ask?”

I acted offended, saying, “After all those questions I asked you, at least you should ask me when I last cried.”

“God you don’t know when to drop things. Okay. So when did you cry?”

I said, “I think it was yesterday.”

Our eyes met. He looked surprised. I continued, “Yeah. I feel sad sometimes. It can be about really hard stories I hear in here or it can be about my own life. Even though it doesn’t change anything, it can feel better to let my sadness out.”

It was time for the session to end. We both stood and I said, “We have to stop for today, but we can talk more about this or whatever you want to talk about next time.”

 

Existential Spirituality

Bikes Snow 2

An impromtu word search of the existential theory chapter for the 3rd edition of Counseling and Psychotherapy Theories in Context and Practice revealed 17 appearances of the word “spirituality.” That’s nice. Seventeen is a prime number. Seventeen is also one of my favorite spiritual numbers. Back in 2nd grade in Sunday school in a synagogue in Portland, my teacher asked us to guess a number from 1 to 20. The winner had the honor of taking a special Bible story book home for the week. My guess was a perfect 17. I got the book for the week. Obviously, the number 17 is a spiritual force in my life.

More important is the sublime integration of spirituality into existential theory. Or not. It seems to go one way or another. Either existential theorists are deeply spiritual/religious or they’re atheist/agnostic. There is no middle ground. Or maybe there is? [More on this conundrum below]

What follows are several short excerpts from the Existential Theory chapter. These excerpts culminate with the short section on Existential Spirituality.

Soren Kierkegaard

The Danish philosopher Soren Kierkegaard (1813–1855) lived nearly his entire life in Copenhagen. Kierkegaard was devoutly religious. He was shaken when he discovered, at age 22, that his father had not only cursed God, but also seduced his mother prior to marriage. Subsequently, Kierkegaard’s writings focused primarily on religious faith and the meaning of Christianity. Eventually he concluded that religious faith was irrational and attainable only via a subjective experiential “leap of faith.” For Kierkegaard, virtuous traits such as responsibility, honesty, and commitment are subjective choices—often in response to a subjective religious conversion. Kierkegaard did not describe himself as an existentialist, but his work is a precursor to the existential philosophical movement, which formally began some 70 years following his death.

Friedrich Nietzsche

In contrast to Kierkegaard who began from a position of religious faith, the German philosopher Friedrich Nietzsche (1844–1900) had negative feelings about Christianity. It was he who, in his book Thus Spake Zarathustra, wrote, “God is dead.” Although he may have been referring to societal emptiness, he also claimed that religion used fear and resentment to pressure individuals into moral behavior. Instead of following a religion, he believed, individuals should channel their passions into creative, joyful activities. Irvin Yalom offers a fascinating view of Nietzsche’s psychological suffering in a historical fiction piece titled When Nietzsche Wept. In this novel, Yalom (1992) weaves existential principles into a fictional therapeutic encounter between Breuer, Freud, and Nietzsche.

Kierkegaard and Nietzsche represent an interesting paradox or dialectic in existential thinking. A dialectic is a process where learning is stimulated from the integration of opposites. On the one hand, some existentialists embrace deep religious faith, whereas others are staunchly atheistic. Still others claim an agnostic middle ground. These differences in fundamental beliefs represent a wide sweep of human intellectual diversity and provide for fascinating philosophical exploration. You will glimpse existential dialectics intermittently in this chapter.

Four Existential Ways of Being

There are four primary existential ways of being-in-the-world. They include:

  1. Umwelt: Being-with-nature or the physical world.
  2. Mitwelt: Being-with-others or the social world.
  3. Eigenwelt: Being-with-oneself or the world of the self.
  4. Uberwelt: Being-with-the-spiritual or over world.

Boss (1963), Binswanger (1963), and May et al. (1958) described the first three of these existential ways of being. van Deurzen (1988) added the fourth.

These dimensions of existence are ubiquitous and simultaneous. Some people focus more on one dimension than others or shift from one to another depending on particular intentions or situations. For example, while on a hike up the Stillwater gorge in Montana, it’s easy to experience being-with-nature as water powerfully cascades around you. However, depending on other factors, this experience can take people inward toward eigenwelt, toward an uberwelt spiritual experience, or stimulate a deep mitwelt (albeit a nonverbal one). In most cases, the direction your being-ness moves within a given situation is likely a combination of several factors, such as: awareness, anxiety, previous experiences, intention, and/or your spiritual predisposition.

The Daimonic

According to Rollo May, “The daimonic is any natural function which has the power to take over the whole person” (1969, p. 123). Historically, Daimon possession was used to explain psychotic episodes and is popularly referred to as demonic possession. However, May repeatedly emphasized that daimonic and demonic are not the same concept: “I never use the word demonic, except to say that this is not what I mean” (May, 1982, p. 11).

The daimonic is an elemental force, energy, or urge residing within all persons that functions as the source of constructive and destructive impulses. May wrote, “The daimonic is the urge in every being to affirm itself, assert itself, perpetuate and increase itself .… [The reverse side] of the same affirmation is what empowers our creativity” (May, 1969, p. 123).

Similar to C. G. Jung, May considered harnessing and integrating the daimonic as a central psychotherapy task. He viewed psychotherapy as an activity that plumbs the depths of an individual’s most basic impulses … the purpose of which is to acknowledge, embrace, and integrate every bit of being and energy into the whole person. May commented specifically about the danger of leaving the daimonic unintegrated:

If the daimonic urge is integrated into the personality (which is, to my mind, the purpose of psychotherapy) it results in creativity, that is, it is constructive. If the daimonic is not integrated, it can take over the total personality, as it does in violent rage or collective paranoia in time of war or compulsive sex or oppressive behavior. Destructive activity is then the result. (May, 1982, p. 11)

The goal is to integrate natural daimonic urges and energies in ways that maximize constructive and creative behavior.

Existential Spirituality

A spiritual-oriented client was engaging in guided imagery with an existential therapist. The client “discovered” a locked door in the basement of his “self.”

“What’s behind the door?” the therapist asked.

“It’s darkness,” he said. With shivers of fear, he added, “There’s dread. It’s the dread of being unacceptable. . . of being unacceptable to God. Even worse, it’s my dread of being unforgiveable.”

“Shall we go in?” asked the therapist.

Silence followed.

The therapist noticed his client’s reluctance and said, “Let’s wait a moment and breathe. I’m wondering if you can even get in the door. I’m wondering if you want to get in. There’s no rush. We know where the door is. We can wait. Or we can create a key and try to get in. Or we can leave the door shut. But first let’s wait here and breathe before deciding anything.”

For two minutes, client and therapist sat breathing together. The paralyzing fear diminished and the client said, “I have a key. Let’s look inside.”

“Yes. Let’s look inside.”

The key opened the lock. The door creaked open. In the dreaded darkness, there was light. A dialogue with the dread and unforgiveable ensued and the client found a broad sense of love and acceptance. There were tears of relief. His spiritual load was lightened. His basement demons were exorcised.

In this chapter we’ve discussed the deep and profound quality of existential psychotherapy. Schneider (2010) called it the “Rediscovery of Awe.” Frankl and Wong referred to it as the pursuit of meaning. In existential therapy, meaning and awe are individualized, as is spirituality. There’s great potential in combining the existential and the spiritual in psychotherapy, but clients should be forewarned and informed: combining the spiritual and existential isn’t about formulaic or surface explanations; it requires a commitment to go deep and explore doubts, uncertainties, and core vulnerabilities.

Here’s a link to the new Theories 3rd edition cover: https://www.amazon.com/Counseling-Psychotherapy-Theories-Context-Practice/dp/1119279127/ref=dp_ob_title_bk

 

 

Counseling Theories Lab Activities

With Wubbolding

Hi All.

Below I’m pasting links to a variety of lab activities that I’ve used in teaching Counseling and Psychotherapy Theories. Although I’ve got a textbook that I’d love you to use: http://www.wiley.com/WileyCDA/WileyTitle/productCd-1119084202.html, this post is about free stuff that I’m happy to share to help make your theories teaching experiences more practical and more fun.

Here are the activities:

This is a short guide to conducting an Adlerian Family Constellation Interview: Chapter 3 Family Constellation Interview and Earliest Memories

This is a short guide for doing and debriefing a person-centered interview: Chapter 5 Person Centered Activity

Dreamwork can be enlightening. This guide helps students explore each other’s dreams: Chapter 6 Jungian and Gestalt Dream Work

This handout helps your students practice conducting a behavioral or cognitively oriented symptom interview. Chapter 7 Analyzing Symptoms Interview

This isn’t really an activity, just a sample Ellis ABCDE form. Chapter 8 Ellis ABCDE

These two handouts provide tips for doing a CBT Six Column intervention, as well as a sample Six Column form, filled out using an angry teen example. Chapter 8 Six Column CBT Tips  and Chapter 8 Six Columns Youth Anger Example

Here’s a video clip (just a snippet) of me doing a CBT example:https://www.youtube.com/watch?v=LQ8hNDHoyDU

This is an interview activity to give students and role-play clients a taste of solution-focused interviewing: Chapter 11 Solution-Focused Activity

I hope these materials are helpful for you. As always, if you have feedback to share, you can share it on this blogsite or via email: johnsf@mso.umt.edu

 

 

 

 

 

 

 

 

Three Pounds of Theoretical Elegance in 888 Words

Rita and Driftwood 2017

As you may or may not recall, we have several new features in our forthcoming Counseling and Psychotherapy Theories in Context and Practice (3rd ed.) text. Here’s a draft of what we’ve tentatively titled a “Brain Box” from Chapter One.

Brain Box 1.1

Three Pounds of Theoretical Elegance

John Sommers-Flanagan

This Brain Box is a brief, oversimplified, description of the brain. I apologize, in advance, to you and to brains everywhere for this oversimplification and likely misrepresentation. The problem is that even if I took a whole chapter or a whole book to describe these three pounds of elegance, it would still be an oversimplification. Such is the nature of the human brain.

You may already be familiar with the concepts described here. If so, it’s a review. You may be less familiar; then, it’s an introduction. For more information on neuroscience and therapy, we recommend Neuroscience for counselors and therapists: Integrating the sciences of mind and brain by Chad Luke.

Brain Structure: The human brain has indentations, folds, and fissures. It’s slick and slimy. Put simply, it’s not a pretty sight. But the brain’s form maximizes its function. One example: If you could lay out and spread its surface area onto a table, it would be about the size of two pages of a newspaper. The folds and fissures allow more surface area to fit within the human skull.

Scientists describe the brain as having four lobes: The frontal, parietal, occipital, and temporal (see Figure 1.2). The fissures or sulci of the brain demarcate the four lobes. At the bottom of the brain is the brainstem and cerebellum.

Each lobe is generally associated with different brain functions. I say generally because brains are specific and systemic. Although individuals have similar brain structures, individual brains are more unique than a fingerprint on a snowflake.

The frontal lobe is primarily associated with complex thought processes such as planning, reasoning, and decision-making (much, but not all, of what psychoanalysts refer to as ego functions). The frontal lobe also appears involved in expressive language and contains the motor cortex.

The parietal lobe includes the somatosensory cortex. This surface area involves sensory processing (including pain and touch). It also includes spatial or visual orientation.

The temporal lobes are located symmetrically on each side of the brain (just above the ears). They’re involved in auditory perception and processing. They contain the hippocampus and are involved in memory formation and storage.

The occipital lobe is located in the back of the brain and is the primary visual processing center.

I’m using all four lobes right now to type, read, edit, re-think, re-type, re-read, shift my position, and recall various relevant and irrelevant experiences. The idea that we only use 10% of our brains is a silly myth. They even busted it on the Mythbusters television show.

The brain includes two hemispheres. They’re separated by the longitudinal fissure and communicate with each other primarily via the corpus callosum. The hemispheres are nearly mirror images of each other in size and shape. However, their neurotransmitter quantities and receptor subtypes are quite different. The right hemisphere controls the left side of the body and is primarily involved in spatial, musical, and artistic/creative functions. In contrast, the left hemisphere controls the right side of the body, and is involved in language, logical thinking, and linear analysis. There are exceptions to these general descriptions and these exceptions are larger in brains of individuals who are left-handed. Woo-hoo for lefties.

The limbic system is located deep within the brain. It has several structures involved in memory and emotional experiencing. These include, but are not limited to the: amygdala, basal ganglia, cingulate gyrus, hippocampus, hypothalamus, and thalamus. The limbic system and its structural components are currently very popular; they’re like the Beyoncé of brain science.

Neurons and Neurotransmitters: Communication within the brain is electrical and chemical (aka electrochemical = supercool).

Neurons are nerve cells (aka brain cells) that communicate with one another. There are many neuron types. Of particular relevance to counseling and psychotherapy are mirror neurons. Mirror neurons fire when you engage in specific actions (e.g., when waving hello) and the same neurons fire as you observe others engaging in the same actions. These neurons are central to empathy and vicarious learning, but many other brain structures and systems are also involved in these complex behaviors (see Chapter 5).

Neurotransmitters are chemicals packed into synaptic vesicles. They’re released from an axon (a part of a neuron that sends neural transmissions), travel through the synaptic cleft (the space between neurons), and into a connecting dendrite (a part of a neuron that receives neural transmissions), with some “leftover” vesicles re-absorbed into the original axon (referred to as “reuptake,” as in serotonin-specific reuptake inhibitors).

There are somewhere between 30 and 100 (or more) neurotransmitters (NTs) in the brain, divided into three categories: (a) Small molecule NTs (e.g., acetylcholine, dopamine, GABA, Glutamate, histamine, noradrenaline, norepinephrine, serotonin, etc.); (b) neuropeptides (e.g., endorphins, oxytocin, etc.); and (c) “other” (e.g., adenosine, endocannadinoids, nitric oxide, etc.). Neurotransmitters are classified as excitatory or inhibitory or both. For example, norepinephrine is an excitatory neurotransmitter, dopamine is both excitatory and inhibitory, and serotonin is inhibitory. Although several chemical imbalance hypotheses regarding the etiology of mental disorders have been promoted (e.g., “low” serotonin at the synaptic cleft causes depression), when it comes to the brain, I caution you against enthusiastic acceptance of any simplistic explanations. A significant portion of the scientific community consider the dopamine and serotonin hypotheses to be mostly mythical (see Breggin, 2016; Edwards, Bacanu, Bigdeli, Moscati, & Kendler, 2016; Moncrieff, 2008, 2015).

Figure 1.2: A Look at the Brain — If the image was here, you would see it. In its absence, use your brain to imagine it. Yes. It’s beautiful. In the real textbook, we’ll have a real image of a brain and not my snarky suggestion that you use more than 10% of your brain to imagine a brain.