The Therapy Process

The Therapy Process

 

 

About The Therapy Process

Various things happen on multiple levels in psychotherapy.  There is the relational aspect- learning from the experience of being in a relationship with me and trying out different ways of being. There are ‘cognitive insights’ that will do their jobs in your unconscious mind to make change happen once realized. There are the experiential activities we do, that changes things in not just an intellectual level but a deep and emotional way. There can also be homework and behavioural strategies we practise.

In regards to the process, I formulate an understanding of your difficulties through an integrative theoretical model, and then I use a combination of therapeutic techniques in the process with you. Still, the best way is to get to know you and find out what best resonates with you- for instance, some people prefer a more intellectual way of working whilst others get more benefits from experiential or intuitive ways of working.

I believe therapy or coaching is not just about these techniques- after all, you can read them in a book! It is about the relational space we create together and giving you an embodied experience of something new. There is a difference between ‘downloading’ skills and theories versus learning and growing in a relational field. Especially if the original psychic injuries happened in the relational world (with our attachment figures or peers when we were young), relational healing would be the most powerful. I will explain this further in the section below (See ‘Corrective Experience’).

 

About Theories

In my thinking, to understand what causes what you are going through, I mainly use ideas from Psychodynamic (Object Relations), Jungian and Systemic theories.

Psychodynamic Theories

Being psychodynamics in my thinking means I believe in getting to the emotional roots of your current challenges and the power of insights as a proponent for change. We want to create a safe and non-judgemental space for you to explore your childhood, developmental history, how your early caregivers were with you (object relations), how you might be projecting ideas onto your current relationships (transference), and how that affects how others relate to you (counter-transference). We will look at some survival strategies you have adopted (defense mechanisms), and see how they have served you and how they may hold you back. By freeing you from emotional burdens from the past, it is hoped that you would be freed to reach your creative potential in the future.

Please note that whilst I empty psychodynamic theories to understand your past and present, I do not practise classical psychoanalysis. Which means it will not be a ‘blank-slate approach. ( This is when the therapist holds back from facial expressions or saying anything, in order to encourage projections from the client) I will provide feedback, insights, and we will have a back-and-forth. Sometimes, if I think it would be beneficial to you, I may disclose something about myself, and you will get to know more about me as a person.

Jungian Theories

Jungian theories also inform a big part of my thinking; ideas such as the Persona, Shadow, Individuation help me understand your challenges and how to move forward. We may also employ creative techniques to explore your unconscious and look at the symbolic meaning of your dreams and emotional landscape.

Systemic Theories

Psychodynamic theories help us understand what is happening inside of you, but we deal not only with the intra-psychic but also the interpersonal. This is when System theories come in. The fact is that we do live amongst others, so how relationships play out in different groups (family, friendship groups, workplace, political and cultural system) will inevitably have an impact.

For example, as a sensitive and intense person, you might have been unconsciously ‘elected’ by your family to take on the role of a caretaker, the ‘capable one” who is not allowed to break down. Or, on the contrary, you were framed as the family scapegoat or black sheep. These roles would have impacted your view of yourself, and subsequently, your mental health today.

Taking on a system theory perspective, we will identify deeply entrenched patterns in your relationships, as well as the role you have taken on within systems. Usually, we tend to carry one set of pattern and apply that to most aspects of our lives, so understanding your family dynamic, for example, may help us resolve problems in your work and in your marriage.

Humanistic-Experiential Approach

In terms of how I am in the space with you and what we ‘do’ during a session, I borrow many techniques from the Humanistic-experiential approach. Sometimes, talking through things is enough, but these exercises can reinforce our insights and hopefully shift your intra-psychic materials on an emotional, embodied level. Activities such as ‘Chair work’, visual imagery, journaling, role-play may be used. The goals of them are to allow you to get to knows different parts of yourself and integrate them, so you feel less inner conflicts. Some therapy models that you may have heard of that also heavily use these techniques are Gestalt Therapy, Internal Family System, Schema Therapy, Art Therapy. I may give you homework with the same goal of helping you to integrate your shadows and become self-actualized.

Cognitive-behavioral Approach

To a lesser degree, sometimes, I use cognitive or behavioural strategies. I will help you reframe how you look at certain situations or work collaboratively to design an’ exposure therapy’ project. Exposure can be applied not just to things like phobia but also trauma. In Prolonged Exposure, for example, we will help you approach your trauma-related memories in a step-by-step way by identifying a range of possible triggers. Slowly and gently, we will help you get accustomed to them, where eventually, your body learns they are not to be feared, and you could live a liberated life.

Corrective Experience

Above all theories, however, I believe in the value of a ‘corrective experience.’ There are various definitions of this in the field, I subscribe to the original description offered by Alexander and French (1946) who proposed that in order for someone to be helped, they must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experiences. The idea itself is simple, but the theory behind it can be complex.

It turns out, when we have been traumatized, we would unconsciously repeat dysfunctional relational patterns. You may notice yourself repeating specific behaviours or emotional patterns in many of your relationships, such as being a people-pleaser, being competitive, having the tendency to ‘push-pull’, idealizing others initially, then be disappointed later, etc. You may also have certain life scripts (e.g. ‘I am not lovable’, ‘people eventually get annoyed with me as I am too much’) that pervasively affect how you interact with other people. This tendency is known as repetition compulsion. In repetition compulsion, you may reenact a situation or relational dynamic. People who have been traumatized often feel an inner compulsion, bypassing logic, to repeatedly expose themselves to conditions reminiscent of the original trauma. A cliche example would be how we are always eerily attracted to people who resemble our parents or treat us like our parents do. Repetition compulsion happens partly because, as human, we all seek familiarity. We may also repeat the same pattern because we have internalized ideas about how we deserve to be treated. At the core of re-enactment is actually your deep desire to heal— you want to repeat the same beginning but have a deeper ending.

One of the biggest goals of our relationship is to offer you a safe place to heal. Once you have built a solid relationship with me, it is natural that you would replay the dysfunctional patterns and life scripts in our therapeutic relationship, and I may be ‘drawn in’ to a particular role and play out these patterns with you. To offer a corrective experience, hopefully, I would notice what is happening and resist the temptation to ‘play along.’ In an ideal situation, through authentic exchange and even a few ruptures and repairs, you get to internalize a new experience about who you are and how others see you. This is a process that requires commitment on both parts and is not easy. After all, if you have been relationally traumatized, feeling raw again with another person is exactly what frightens you. But what is the most bitter is also the best medicine. When done well, this is one of the most potent healing there is.

Healing through experience is essential and powerful because often, intellectual insight alone is not enough. This is something that underlies whatever it is that we ‘do.’ Essentially, by having a relationally corrective experience, hardwired neuropathways in your brain are rewired. This has now been validated by abundant research.

In a nutshell, an emotionally corrective experience offers you a powerful, first-hand experience that challenges distorted self-beliefs and behavioural patterns that were residual of your relational trauma. It opens the doorway to building secure and stable relationships with people in your life, and more peace and freedom.

 

There will be days when you feel too alone, your baggage feels too heavy, and the journey seems too long.

These are the times to focus on nothing but the next smallest step, simply putting one foot in front of the other.

 

My Training

 

More than a decade ago, I received a Master in Mental Health from The School of Medicine at the University of Queensland, Australia; through this training, I obtained a solid understanding of most mental health diagnoses in the DSM, their evaluation and assessment principles, and the evidence-based treatment protocol for each diagnosis. This training was invaluable throughout my years of working in the mental health system. Alongside my training in mental health, I was also trained as an Art Psychotherapist, and my training has placed heavy emphasis on Psychodynamic, Jungian and Systemic Theories.

After graduation from my postgraduate studies, I have pursued further training in various modalities, and many of them are integrative models that have combined the above theoretical orientations and more. Mainly, I am qualified to practise Schema Therapy (which combines psychodynamic thinking with gestalt technique and behavioural change strategies), Mentalization-based Treatment Practitioner (which brings together aspects of psychodynamic, cognitive-behavioural, systemic and ecological approaches), Philosophical Counselling (I am trained in Logic-based Therapy, a philosophical variant of rational emotive behaviour therapy), and Mindfulness-based Cognitive Therapy (combining Buddhist wisdom with somatic elements and cognitive therapy).

I have also received training/ are pursuing training in Radically-Open Dialectical Behavioural Therapy (an evidence-based treatment protocol for overcontrol), Jungian Psychology, EMDR (a classic, evidence-based trauma treatment), Relational Psychoanalysis, Sandtray therapy, The Enneagram, and Buddhist Counselling.

(For more about my training and background, please see here)

 

The Sessions

 

As an integrative therapist, the approach I use depends mainly on the person I work with. I will assess your goals, what you are likely to feel comfortable with, and what might be effective for you.

I have various ‘tools’ in my ‘toolkit’, but I need to get to know you better to develop a plan. For instance, I want to understand the nature of your distress or ‘symptoms’.  If the origin is unconscious trauma (the point here is not to blame your parents or dwell in the past, but some investigation work of where things come from and what holds us back is often helpful), techniques such as inner child work may work. In other instances, you may want directions and establish a more solid sense of self, and we may do some solution-focused coaching work, regarding how to unblock your insecurities to harness your strength and creativity.

Because the work we do is synergistic and dynamic, each session will be different, and there won’t be a strict structure. However, in general, it goes like this:  You may bring up what has been happening/ bother you that week; then, using that as a lead, we explore deeper. ‘Deeper’ may mean we look at unconscious materials, repressed memories, or explore dynamics of your current relationships. We may even touch on themes such as cultural values and internalised oppression. Sometimes it is about making sense of or healing past wounds, but it can also be us seeking practical solutions to an imminent problem. If you feel ‘nothing much’ is happening in your life, then we may think about some general themes such as the patterns or factors that are blocking you in life, what issues in the system are hindering you, or hopes, dreams, and goals that would drive you forward.

So in other words, there is not a strict ‘procedure’ per se; a lot depends on your goals and the way of working that echoes with you. The integrative approach is different from a strictly standardised model such as CBT or DBT. It is a relational process that evolves organically. I do understand how most of us would feel more comfortable with a bit of sense of knowing, structure, and directions; and these are things we can discuss and evaluate along the way.

How Often Do We Meet

Regarding frequency, it is like going to the gym for a physical workout. We may go to the gym and train our muscle every week, but the effect is not immediate- it is only after some time, say a month or so, that we feel the benefits and changes from within. Everyone uses therapy differently; I have clients who do two sessions a week, some come once a month. It all depends on many factors, from what they hope to get from therapy, their existing resources, and ways of functioning.

There is no ‘rule’, but for most people, in the beginning, fortnightly or weekly is good to build trust and understanding in the relationship. It can then be changed in the future.

I trust my clients to find their own pace. I encourage people to look around, shop around, and become in tune with their internal compass. And of course, I am always happy to evaluate the process with you along the way.

If you are contemplating therapy, I must congratulate you for your courage and commitment to reaching your healing and thriving potential. You deserve to live a life where you don’t have to carry your emotional burdens for life or deal with everything on your own without help.

I hope the above helps and clarify what the process looks like.

I look forward to hearing from you!

Imi