How does counseling work?
“I feel that I am so inadequate.“ A woman recently told me. “I’m retired from being a bookkeeper. But I was just a bookkeeper, nothing special. And now I’m not even that. I’m retired. So I sit around all day, bored. I feel so worthless!“
People come to counseling when they are perplexed by painful emotions. They might feel sad or hurt, or they might be experiencing loneliness or lack of sense of meaning and purpose in life. They try to push away, thoughts and emotions that feed into the pain, but the thoughts and emotions come back.
So they go to counseling.
They explain these problems to the counselor, who tells them what to do to make it better. They do it the counselor says and are instantly cured!
No, of course it doesn’t happen that way.
Life is much more complicated. The problems are not usually very obvious. A person might be sad, but is that because they are socially isolated? Are they dwelling on the past or the future?
Are they overthinking on issues blowing them out of proportion.? Are they grieving someone else’s loss? Are they grieving their own loss of health?
All these were going on with the woman Who was talking at the start of this article.
When therapist identify the main issues, then they have and try to see what came first second and third, etc. Then they look for clues in a persons history for why they seemingly do things that are so hurtful to themselves. Often this isn’t the first time it’s happened. And so there’s a reward for behavior that keeps it going. A person might keep up with self blame because they were taught that’s what it means to be a good person or they overthink about things because that’s what their mom did and now they can feel close to their mom and feel good about Acting like a member of that family. They are doing what the family does.
Brothers, they were raised in a home where substance abuse was common. Were only valued for what they did. People were often put down because of what they did, or didn’t do, But the messages are only valuable because of what you do. People raised in that kind of home, there is a psychological reward for continuing that behavior. You can feel close to the mother or father, who is never nice to you. Of course, this is going down a rabbit hole, often, when the parents are deceased, and then the person will never have a rewarding interaction with their parent. Or the parents continue to be condescending and discounting, no matter how many nice things you do for them.
When you can find a reward for the self-defeating behavior then a solution can be found. If you can accept that the family or parents were dysfunctional in ways that were repeated, now you can see your trying to for example be nice to the world, so it gives you the approval you never got from your parents. Or maybe your afraid of authority figures and Sawyer Being anxious to them, to please you’re angry father never said you were doing a good job.
When you’ve exposed the underlying incentive for the self-defeating behavior than you can accept it and replace it with self affirming behavior.
So one patient accepted that Are born and people die. That’s just the way it is and it’s not the way she wanted it, but that’s the way it is in life. She finally accepted this even included her parents, both of them were now deceased. But she’s carrying on their legacy with her passion for Kraft and telling stories about them. So innocent, they haven’t passed away, their legacy is living on after them. in the past, she was focused on how she wished that people would never die, wish that her parents would never have died, but now she’s identified that toxic. Wish she something that just goes against reality and ruins, her mental health. She replaced that with acceptance. She accepts her family has a wonderful legacy of caring people, and a passion for craft and nature. She accepts she’s a good daughter, having carried on the legacy of her parents. Likewise she’s teaching children in the community how to do crafts, such as painting, and so her parents, Legacy is getting past dozens of other people in the community. Acting on what she accepts, she’s created her therapeutic experience. She’s now having a rewarding experience, teaching crafts, and she feels good about being a member of her family and good about, passing on these family traditions.
This is an example of cognitive behavior therapy. She identified the cognitions, or thoughts, that were keeping her stuck, namely, I wish people didn’t die. She replaced that with new thoughts, excepting people are born and people, die, but families live on, communities live on, carrying the traditions that our life sustaining. She acted on these new thoughts. That is especially powerful. She transformed her suffering into rewarding experiences, improving the lives of others.
Skilled therapist will be able to tease out what are the underlying issues. It might be from a patient’s tone of voice, or how they said things, or it might be knowing about, someone’s history, or any of the number of other hard to define sources of information. But the therapist will eventually find out the one or two key issues. Then the therapist will come up with a plan, something to do to those issues to make them better.
A good therapist will not only identify issues, but educate the patient on how they got stuck in those issues. Then Therapist needs to be motivational. Often progress likes this takes five or 10 sessions. It’s a lot of work, taking time off from school or work to spend half an hour or 45 minutes with the therapist, bearing your soul. to help with motivation, therapist might tap into underlying motivations.
In the woman, not at the start of this article, a therapist might say something like, “it will feel so good to work through this issue so you can feel good about all those great times you had with this person who passed away. You and her had so many trips, so many fun times eating out, there’s so many great memories there. It’ll feel good to have those in your mind instead of your friends last couple months before passing away I’m sure your friend would appreciate you taking time to appreciate the good times instead of dwelling on the bad times.“
Hearing that, the patient said, “yes that’s a good way to honor her memory. She would like it that way. May dwelling on the bad times just takes away from all the things she did. She said time aside for us, working together on crafts, other times, we went on trips and so she spent all that time and money to spend time with me. It would be really selfish of me to just well on her last couple months and ignore 20 years of great friendship. Thanks for giving me that perspective, that was really helpful. I need to start being a friend to myself, like she was to me.“
I saw Therapist can provide insight with the new perspective, tapping into a patient values and experiences, and so help the patient realize the new way of thinking about themselves and their world that is encouraging, rather than self-destructive.