The Therapeutic Alliance: The Essential Ingredient for Psychotherapy

 I am currently writing on the ‘therapeutic alliance’ – its relation to mindfulness, psychotherapy, understanding, and ‘being listened to…’   What follows is an interesting article that I came across that may interest some of you…

Excerpt:

Have you ever tried to change the way you do something? It could be anything — the way you hold your tennis racket, blow into a flute, meditate — you name it. If so, think about that experience. No matter how motivated you were to change, and no matter how much you knew that it would help your serve, musicality, or sense of inner peace, it can be difficult and scary to change even the smallest thing. In order to change, you have to give up your old way of doing something first and then try the new way. That means that for a while you’re in a free fall — you no longer have your old habit to rely on and you don’t yet have the new one.

The anxiety of trying to change something as complex and entrenched as how you relate to people close to you or manage stress takes the feeling to a whole new level. Yet, that’s just what you do when you enter psychotherapy. Just as you had to put yourself into the hand of your teachers and coaches, in therapy you need to gradually do just that with your therapist to help you through what can be a harrowing adventure. The foundation for therapy is called the therapeutic alliance (1, 2). When it’s there, you know that your therapist is there to help you, no matter how hard the going gets.

The therapeutic alliance might be the most important part of beginning a psychotherapy. In fact, many studies indicate that the therapeutic alliance is the best predictor of treatment outcome (3-5).

See entire article:

http://www.huffingtonpost.com/deborah-l-cabaniss-md/therapeutic-alliance_b_1554007.html

 

A mad world A diagnosis of mental illness is more common than ever – did psychiatrists create the problem, or just recognise it?

When a psychiatrist meets people at a party and reveals what he or she does for a living, two responses are typical. People either say, ‘I’d better be careful what I say around you,’ and then clam up, or they say, ‘I could talk to you for hours,’ and then launch into a litany of complaints and diagnostic questions, usually about one or another family member, in-law, co-worker, or other acquaintance. It seems that people are quick to acknowledge the ubiquity of those who might benefit from a psychiatrist’s attention, while expressing a deep reluctance ever to seek it out themselves…

…While a continuous view of mental illness probably reflects underlying reality, it inevitably results in grey areas where ‘caseness’ (whether someone does or does not have a mental disorder) must be decided based on judgment calls made by experienced clinicians. In psychiatry, those calls usually depend on whether a patient’s complaints are associated with significant distress or impaired functioning. Unlike medical disorders where morbidity is often determined by physical limitations or the threat of impending death, the distress and disruption of social functioning associated with mental illness can be fairly subjective. Even those on the softer, less severe end of the mental illness spectrum can experience considerable suffering and impairment. For example, someone with mild depression might not be on the verge of suicide, but could really be struggling with work due to anxiety and poor concentration. Many people might experience sub-clinical conditions that fall short of the threshold for a mental disorder, but still might benefit from intervention.

See link for interesting article on psychiatry…and bits about the importance of psychotherapeutic intervention…

http://aeon.co/magazine/being-human/have-psychiatrists-lost-perspective-on-mental-illness/

Complex States At Being

Emotions can be incredibly complex states of being/mind.

People (particularly in this western culture) are afraid to experience emotion due to heavy amounts of socialization and conditioning, especially in school. You know, we’re taught to sit still, to be quiet, to “use our inside voices”, to line up, to avoid disorder and be orderly, to obey, to submit, to share. To share, but not to cooperate. There is a difference. Sharing does not necessarily imply or guarantee cooperation. In school, sharing is a behavioral technique; used as a means to control the behavior of a room full of pinging (that is, naturally rambunctious and curious-minded) short beings.

Let me tell you a story: a sad story about a little girl who cried.

To get to City Island one can walk across a 2,800 foot long truss bridge, which was exactly what I was doing when I spotted a brief exchange between a little girl and her father. The little girl’s father, pushing another child in a stroller, told the little girl to look around as well as look at all the fish visible in the River below. The little girl was throwing bread over the side of the bridge to the fish, and seemed very happy.

Later, having crossed the bridge, I was sat under a pavilion and saw the little girl and her family again as they were passing by. The little girl tripped over a rise in the structure of the sidewalk and fell very hard. So hard that I winced when I heard the sound. She immediately bawled, as I’m sure that hurt her terribly. Probably terrified at the pain, you know, she ran to her father for solace. . . and he admonished her. He yelled at her as he brushed the dirt from her clothes, “You gotta watch where you’re walking. You can’t be looking around while you’re walking!” He seemed actually angry with her that she tripped, an accident on her part, no intent to spoil his day whatsoever. She only cried harder asking then for her mommy. At this, her father really became angry and shouted, “That’s it! You’re going back to the car you can’t act right!”

Did you see the contradiction?

Just moments ago, on the bridge he was telling her to LOOK around, then minutes later punished her for doing exactly that. These are the kinds of happenings that disturb me in the world. What did that do to the mind of that little girl? How could she possible understand that kind of contradicting information from such a trusted and authoritative figure as her father? What was the impact upon her consciousness? What did she just unconsciously learn? How did that affect her ego? Her sense of self in the world she knows and how will that affect her sense of self in subsequent years?

Which brings me back to emotions and the horrors some humans have undergone. That suffering. What I think not many humans grok is that suffering can be soft, horror is not always large, it can be very subtle. . . like entropy, changing and developing small vibrations over time that then result in the current personality/identity of that child in the form of an adult.

What happened to that little girl is a subtle terror, an event that will accompany who knows how many more and will shape her as a human being. It’s systematic, to get children all to sit still or to behave as one being so it could be easier (or more efficient) for the teacher to educate them. A good idea, sure, but in actuality what happens is that the children become standardized. The spark, the inspiration for creativity and innovation and imagination breaks down because the channels created have no room for them, no means to categorize something as unpredictable as a room full of children all having ideas simultaneously.

This is one way that fear of emotion is installed in the collective consciousness. That fear to really let go and be fully in the space. . .

“. . . and I’m free, free falling.” ~Tom Petty, ‘Free Falling’

*Image credits (used with permission through CC license)–
“I just want to be happy” by bravelittlebird
“cry, baby, cry” by Barbara Pellizzon
“The Girl Who Cried Wolf” by GaelForce Photography

Related articles

• Empathy: Why is it important for leaders? (petergagliardo.wordpress.com)
• Poor Mental Health in Adulthood Triggered in the Womb (counselheal.com)
• How does complex behavior spontaneously emerge in the brain? (phys.org)

The Aftermath of Trauma: Four Common Characteristics

Definitely click on the link at the end of the post to read about the Four Common Characteristics.

Crying for you

How do you look upon your tears?

Note on Sunday night.

by louisey

Working on empathy in lament, in the written-down song of grief that is also weeping aloud. In front of me a videotaped discussion between academics on the lament of Thetis in the Iliad, Thetis the sea goddess who sits on the beach cradling the head of her  son who lies prone on the ground, unmoving, although he is not dead. He will die in battle and both mother and son know this. There are no secrets between them. Not all the love in the world can save  the son, and all the mother can do is to be with him and wait for what must happen, to grieve her  loss even while he lives

She is mourning him before he dies, the professor says, and his co-facilitator on the video begins to weep, pushing a bunched up tissue under her spectacles and  getting up, apologising for ‘losing it’. Watching her weep for a  mother mourning her  son who is to die, an unbroken continuum of mourning, a deep heart-broken mourning that  has gone on for perhaps five thousand years since this lament was first sung and wept aloud, I too  feel my eyes filling with tears, shared grief spilling over, I reach for a tissue and  pause the video as I dry my eyes.

Continuum, empathy that is echoed and re-experienced unbroken through civilizations, centuries, generations,  the grief of a mother’s loss spilling out everywhere. Grief wild and bitter and unending as the  ocean itself, but contained by song. Unending grief but also shared grief, the gift of empathy. Those who will  weep with us and  wipe our eyes.

About the author

• National Grief Awareness Day (divineorchestrations.wordpress.com)
• The physicality of grief (amomentwithgod.com)

Sometimes the best people leave us first

–>

Loss. Heart-wrenching pain lurching in every corner. Memories that haunt us, tears that fill oceans. Such is the pain of loosing someone you love, and there is no other way than let them come: The feelings, the memories and the pain. The pain is just a proof of our ability to love, a proof that we can do everything for anyone, if we decide to. The hurt has meaning, and no-one can take that away from us.

 

The following post is from tersia burger: Vic’s final journey.  Vic was the precious daughter of the author of the post, and the blog is about the lifelong battle she had.