Tuesday, August 13, 2013

What Heals in Psychotherapy?


As a psychotherapist who is interested in alleviating suffering the most important underlying question is, what really works?  What really allows people to heal the wounds of the past?  To make peace with whatever their history has been?  To be open to warm connection with themselves and with others?  To feel free to be authentically who they are and make their own unique contribution to this world?

There are as many answers to the above questions as there are modalities of psychotherapy—and, like the movie, Rashomon, they all contain elements of truth.  The cognitive-behavioral approach (also known as CBT) emphasizes correcting distortions in thought.  So, for example, a person with whom I worked who had had critical parents developed the belief that he had to be perfect to deserve love, and was extremely self critical because of this history.  He had to learn in therapy to effectively counter that belief, to replace it over and over again with a more realistic thought.  Something like “As a human being I am inherently worthy of love, and my worthiness is not contingent upon performance.”

But the cognitive, conscious work was difficult for him, because of all the years of negative programming.  So an important aspect of our work became relational—that is, this person had to experience in our relationship what he had never experienced before--what it feels like to be truly valued and respected, without having to be perfect.  (As an imperfect human myself, it’s pretty easy to offer this!) 

The approach to relational work that I find to be most powerful is called AEDP (Accelerated Experiential Dynamic Psychotherapy).  It is based on current neuroscience, which teaches us that emotional healing is fostered by the experience of warm, safe connection with the therapist—not a linear, logical, left-brain process, but an intuitive right-brain process.  AEDP invites the therapist to be fully present, expressive of her caring feelings, as well as to share parts of her own story that demonstrate her empathy and understanding of the client’s plight.

As an example, Ted (not his real name) came into therapy during a life crisis, when his mother had been diagnosed with dementia.  She had been a difficult, demanding woman whose parenting had caused him enormous suffering—and he was wrestling with a welter of difficult feelings contemplating her decline and death.  As Ted was speaking of this, I felt tears welling up in my eyes, remembering my own mother’s death.  On that day, I felt the deepest grief I had ever known, as well as the greatest sense of relief that her suffering was over.   My sharing this with him created a bond between us that made it safe for him to express all of his conflicting feelings toward his mother without guilt, and to begin to heal from the legacy of her past.

One of the approaches that has been most powerful to me personally as a client in psychotherapy--and most effective as a therapist helping others--is called PBSP, or psychomotor therapy.  PBSP invites people to work with the therapist to create an experience, called a symbolic memory that is reparative of early emotional wounding.  So, for example, a woman named Deirdre, who had a violent, abusive father was able in a safe, supportive environment to express all the feelings about who he actually was and the harm he caused, but then to explore in a very profound way what she would feel like and what the world would look like, if she had not experienced the negative history with him—if she had had a loving father who had been supportive, rather than abusive, for all those years.  (For more information on this work, please go to www.integrativepsychotherapy-nyc.com and click on the tab “Healing Early Trauma”).

The above is just a sampling of the many approaches to psychotherapy that can be helpful.  The most important thing to realize--whether you’re focusing on correcting distorted thoughts, or experiencing the healing that comes from a close, safe relationship, or working on creating reparative symbolic memories—is that healing is possible.  You can’t erase, but you can transcend the past.   You can develop the peace of mind and self-acceptance that makes it possible to live well in this world, to feel accepting of who you are, and open to close and fulfilling relationships with others.  This is your birthright—and it is the goal of psychotherapy to help you claim it.


Portia Franklin is a psychotherapist based in New York City who has more than 20 years experience helping people move beyond depression, anxiety, trauma and relationship difficulties to lead fuller, richer lives.  Check out her web site:  www.integrativepsychotherapy-nyc.com.

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