Content Warning: This article discusses ideas that may not be suitable for someone who is early on in their therapy/self-healing journey and is more geared toward clinicians as well as clients who are ready to hear more about the intricacies of how therapy works.
Effective therapy is a balance between the “Magic” of deep dive processing modalities (like Sensorimotor Psychotherapy, MFR, EMDR, IFS, and other bottom-up internal process-based approaches) and the “Spinach” of doing hard work (studying, working out, applying yourself, etc), facing fears, sitting with grief, regulating anger, learning about faulty thinking, and recognizing that some current modes of being are no longer helpful (as in CBT, DBT, and other top-down (brain to body) systematized approaches). I am intentionally oversimplifying the intricate nature of the therapeutic process to shed light on a heuristic (framework for thinking about something) as I discuss the "Magic/Spinach" dynamic. Making "spinach" changes means having to feel some productive shame (although shame certainly comes up in the "magic" processes, too). I got the term “Spinach,” which refers to rote work and doing hard things, from Harvard professor of happiness Arthur Brooks. Love it. Before I continue, I am going to take a pause and discuss how shame can be productive: The concept of "productive shame" refers to a perspective where the experience of shame is channeled in a way that leads to positive outcomes and personal growth. While shame is generally considered a negative and distressing emotion, shame can also be viewed as a potentially transformative force when navigated effectively and in the appropriate context. Here are some ways in which shame might be considered productive in a therapeutic context: Awareness and Insight: Experiencing shame can bring attention to underlying beliefs, values, or behaviors that may be contributing to distress or maladaptive patterns. It can serve as a signal that there is something important to explore within oneself. Motivation for Change: Feeling shame about certain behaviors or aspects of yourself may motivate you to seek help and make positive changes in your life. The discomfort of shame can act as a catalyst for personal growth and self-improvement. Fostering Empathy: Experiencing shame can enhance empathy for others who may be going through similar struggles. It can create a sense of connection and understanding, both within oneself and in relationships with others who have faced similar challenges. Practicing Vulnerability: Acknowledging and working through shame requires a degree of vulnerability. Therapeutically, being able to share and explore these feelings can strengthen the therapeutic alliance and create a safe space for deeper emotional processing. Promoting Accountability: Shame can be a powerful force for promoting accountability. Taking ownership of your actions and their consequences, even if this accountability initially involves feelings of shame, can be a crucial step in the process of change and growth. Catalyzing Change in Belief Systems: Shame can prompt individuals to reevaluate and challenge their belief systems. The discomfort of shame may lead to a willingness to question long-held beliefs that are no longer serving them well. Cultural and Social Reflection: In some cases, experiencing shame may prompt individuals to reflect on societal or cultural norms that contribute to these feelings. This broader awareness can lead to social change and advocacy for more inclusive and compassionate communities. It's important to note that the term "productive shame" doesn't imply that shame is inherently positive. Rather, it suggests that within a helping context like therapy, acknowledging and working through shame can contribute to personal development and positive changes. Therapists must approach this aspect of therapy with sensitivity, empathy, and a deep humility regarding the individual's unique experiences and cultural background. Ok, back to Magic Spinach… or is it Spinach Magic? Anyhow: “Magic” refers to any modalities that provide what Bruce Eckert calls memory reconsolidation. Memory reconsolidation can be thought of as brain surgery by means of words. The therapist supports the client in opening their memory pathways that are trained on past wounds. The therapeutic dyad then reroutes those pathways by inserting reparative experiences. You can think of this as redirecting history as far as the brain is concerned. History itself does not change, but emotional aspects of the brain act as if history has, in fact, changed in a way. At times, clients experience a change in their belief system or behavior following as little as one session. It usually takes a few passes plus integration work to really make that change. It's so spectacular, you really need to experience it in the role of a client to see how strong the change can be. The original neural pathways of the wound never go away and can be triggered again but can greatly diminish in their ability to influence a person. “Spinach” refers to the work that reveals places where magic is needed and then helps the magic stick in the long run. There are a few different situations where the Spinach looks different. I will discuss two main situations: client in crisis and client who is stable but dissatisfied. If someone comes to therapy in a crisis, after we validate and regulate, the “Spinach” is looking at and acknowledging one’s part in the crisis as well as where one needs to let go of control and grieve. One’s part is anything that the person could reasonably take responsibility for and not something that was actually out of their control. On the other hand, someone might need to face and grieve existential realities like aging, death, loss, and random chance accidents. Facing pain and shame can be a challenging process, but it often leads to a sense of empowerment and the ability to make different choices. Some individuals may find themselves stuck in the validate-regulate-take ownership/grieve cycle for many years, continuously grappling with these challenges without reaching a point of empowerment. It's important to acknowledge that this phase can extend for a very long time and, in some cases, clients may not progress beyond the validate-regulate phase, and that's okay, but, unfortunately, feelings of empowerment in this instance might be scarce, which is not ideal. Empowerment is a product of taking ownership and/or grieving depending on what the situation requires. While all three actions—validate, regulate, and take ownership/grieve—are crucial, the emphasis on validate-regulate may persist for an extended period due to the need to address deep-seated wounds causing significant nervous system dysregulation. Initially, taking ownership may involve recognizing that the dysregulation is not the client's fault but is their responsibility.The process of taking ownership for life choices may occur later on. Take the classic example of an adult who was abused as a child. As a child they adapted to a bad situation. The adaptation was helpful and right at the time. Now, as an adult the adaptation is no longer getting the person the results they want or need. The adult must recognise that the adaptation was perfect in the past and came about due to bad circumstances. Here the adult will feel the scary feelings from the past, recognize them as “true” and regulate by coming into the present moment, recognising the danger is no longer present. Believe it or not, the process of updating the system can take years and decades. This process looks so simple and straightforward written out, but there are many trials, traps, and illusions that the adult must face as they come out of the past and into the present moment. Part of this process includes occasionally coming to terms with time lost to the adaptation, harmful beliefs, and, therefore, feelings of shame and regret that the person did not have more control over themselves. As a clinician, one can easily see that the mind prison that traps the client is not the client's fault, but just like the little child in the abuse situation, the adult once again blames themselves for problems outside of their control. Whether or not the person should feel shame and regret, they typically do at some point in the updating process. Even though the abused person left the abusive situation, they continue to choose people and situations that feel like the original abusive configuration. Jobs, friends, and partners perpetuate the conditions that created the mind prison in the first place, which not only continues to color the worldview of the abused but also deepens the neural pathways that reflect the impact of that abuse on the victim. Confronting the belief system of an abused person is a process that may span several years. However, I've consistently observed individuals in such situations reaching a crucial moment when they are finally ready to recognize their distorted worldview. The abused person begins to comprehend how the abuser's actions contributed to their belief system which led the victim to repeatedly choose similar situations in life. At this stage of therapy, the person has invested significant effort, enabling them to adopt a new belief system. Prior to this work, their nervous system dysregulation posed a barrier to such a choice. It's essential to clarify that the term "spinach" may suggest we are taking this lightly, but this confronting work is anything but casual. It can be the most challenging experience in one's life. Unfortunately, when the abused individual realizes they've been misled into this mindset, self-blame arises which becomes a period of shame and regret as they work to undo the damage. Consequently, shame, regret, and grief become an unavoidable yet natural part of the healing process. Moving on to situations that are post-crisis: Once the crisis and deep trauma have passed or a client comes to therapy because things are going well on paper but they feel “flat” or “blah,” that means the spinach is to encourage the client to “get stirred up” by doing something scary in their life that they have discussed wanting to do but are avoiding. That could be starting a business, pursuing a romantic relationship, adopting a suitable health regimen for themselves, etc. Basically, you support the client in introducing the pursuit of a major or minor life change that the client says that they want deep down but are avoiding due to a limiting belief system. Therapy sometimes takes on a more “coachy” feel, especially when using modalities such as CBT and DBT. In these methods, therapists offer clients an educational framework and employ motivational techniques to guide them in adhering to that framework. I believe it's crucial to incorporate goal setting and structured learning in therapy because solely focusing on the present moment process can lead to patterns of avoidance between clients and therapists. Clients may resist stepping out of their comfort zones to avoid potential triggers, while therapists might shy away from addressing client discomfort or distress, either due to a lack of understanding or a reluctance to confront areas of avoidance in their own lives. Striking a balance is essential to respect client autonomy, ensuring that encouraging clients to step outside their comfort zones involves a considerable amount of informed consent from the client. We never want to override resistance because it's there for a reason. Indulge resistance too much, however, and you wind up with conditions like agoraphobia and kindling (when triggers proliferate and become stronger rather than decrease in number and weaken). Facing fears is a skill. When someone comes to therapy traumatized, using compassion to help a client face fears in a controlled way is a top priority. As a therapist and not a coach, it is important to let go of the outcome of the client's actions. We are not so concerned with getting the client material world results like a coach is. Rather, we are observing how a client reacts to pursuing a goal or even the thought of pursuing a goal. When you are engaging in potentially triggering territory with a client, like goal setting, you must monitor for dissociation and other adverse reactions that indicate the client is too triggered, out of their window of tolerance, and needs support in decreasing the triggering stimuli. A client getting triggered by something is still useful, however, because it reveals the client's belief system; where there is a trigger there is an unhelpful belief and/or a wound to be processed. Is it better to find the wound and beliefs without triggering the client? For the most part, yes. But it is not the end of the world if a client gets triggered. At best, it's a rich learning opportunity and a moment where we can make some real changes if handled correctly. And so, we encourage the client to pursue a goal, the client begins to do so, gets triggered, and then we can swoop in with the magic of processing and begin memory reconsolidation, installing a new pattern. After this process, the client may realize they want the goal to look different from what was originally imagined. Often, something more in alignment with the client is determined, and the client successfully completes a similar but improved goal in the end. While the client pursues the goal, the therapist has to watch for when the client needs to be encouraged to face their fears (spinach) or if the client needs to process (magic). These two, together over time, create a positive feedback loop, ultimately launching our clients towards their dreams with as little time lost and, frankly, as little discomfort as possible. Again, therapists sometimes avoid supporting clients in pushing themselves because it's uncomfortable, but if you understand this positive feedback loop, you are drawn to empowering you clients in this way because you have confidence that your clients will potentially be able to extract themselves from the pain of avoidance and into the bliss of agency. The longer the client is in avoidance, the longer the pain is prolonged. Timelines may vary here so it is important to expect this process to take years or, at times, be impossible to complete. Therefore, this does not mean you are overwhelming your clients with pushiness. Rather, you are testing the waters regularly to find the best pace and direction for them. To recap, effective therapy can be thought of as threading the needle between the transformative "Magic" of deep processing modalities and the essential "Spinach" of confronting challenges and acknowledging faulty modes of being. The "Magic" involves memory reconsolidation, akin to rewriting emotional history, with the potential for rapid shifts in belief systems or behaviors. Meanwhile, the "Spinach" represents the hard work and processing of difficult emotions required to make these changes enduring. Whether addressing crises or encouraging clients to stir up their lives during moments of stagnation, therapists navigate a fine line between coaching and therapeutic interventions. Emphasizing the importance of facing fears and engaging in deep processing, therapists play a crucial role in steering clients toward their goals while remaining attuned to the balance of discomfort and growth. By understanding and embracing the positive feedback loop between "Magic" and "Spinach," therapists aim to guide clients towards agency and fulfillment, reducing the duration of pain associated with avoidance. This nuanced approach, avoiding undue pushiness and adapting to individual needs, creates a therapeutic journey that minimizes discomfort and maximizes progress over time.
0 Comments
Leave a Reply. |
Details
AuthorProsopon Therapy Archives
April 2024
Categories |