Therapy begins by addressing the reasons why an individual/couple seeks therapy. This is what I refer to as “content”. Understanding the way individuals interpret what they hear and why they react the way they do adds to uncovering the whole picture. This is what I refer to as “process”. Too often focus is primarily on the content while ignoring deeper unaddressed patterns. Therapy begins in the very first session. What the problem is begins the session. Understanding why the problem exists completes the session.
A good theoretical orientation as well as instinct are essential ingredients in the working through process of therapy. I focus on earlier life experiences as well as later in life experiences and believe that we “wear our past”. My evaluation and therapy is based on understanding how your unresolved material remains active in current behavioral choices and decision making.
There are times when people come into therapy because their coping skills no longer work. They are ridden with anxiety/depression/agitation/insomnia/fatigue or some other physical form that causes great distress. When issues are unaddressed over time, the coping mechanisms give way to symptoms. For some, symptoms appear from nowhere and feel unrelated to anything presently going on. While others suffer from long standing symptomology. In either case, symptoms (unless there is a medical basis) simply are a byproduct of ignoring feelings, trauma, disappointments, to name a few. In most cases, emotional and /or physical distress is unexplored but not forgotten material. My approach is to awaken, address and understand issues that remain dormant but continue to control the individual.
At times repressed material is not experienced in terms of physical discomfort but rather is expressed through acting out patterns i.e., marital cheating, some form of self-medication, and aggression to name a few. These patterns are passive aggressive in nature. The acting out is always destructive and leads to long term damage toward self and undermining the trust within the relationship. Yet there is an avoidance to directly address deeper issues. There are a myriad of reasons why people cheat or self-medicate. There is always a reason as to why we do what we do. My approach is to understand the underlying issues driving a person to make destructive choices and replace unhealthy patterns with higher functioning alternatives. This is accomplished through the desire to address issues, work through issues, and learning to react in a more appropriate manner than simply outing out or numbing ones emotions.
This category in my opinion is greatly misunderstood. With any condition there are degrees of severity and with narcissism this is certainly true. Let me be clear that dealing with a narcissist is both possible and in most cases successful. Therapy begins by identifying the narcissist and educating both the individual and partner about narcissism. There are certain behaviors that are associated with narcissism such as how a person reacts to disappointment, input, or how they personalize a situation. All these reactions fall under the heading of “narcissistic injury” with the narcissist reading much more into a situation than is really there. Once the injury has occurred the response is extreme for the situation. The narcissistic needs to understand that their reaction is severe. They also need to understand their reaction and learn more appropriate ways to deal with feelings. The partner needs to learn how to approach a narcissistic in a way that will not intensify the triggers. All this is accomplished when treating narcissism.
One’s behavior tells a story about where the person is stuck and how they act out their emotions. People that suffer from eating disorders turn their repressed issues toward the self. For whatever the background dynamics, there is an inability, a fear, a distrust to feel, speak, and be themselves.
As such emotions are kept hidden from awareness but never leave the psyche. Those unaddressed issues find expression thru acting out in very unconscious ways. Eating too much (binging), purging, or depriving oneself of nutrition are avenues that serve only to distract an individual from their true struggles. People that suffer from this condition focus on superficial issues such as body image, weight, fitting in with others, etc. The real focus needs to be on understanding the deep seeded core issues.
There are several dynamics that need to be considered when treating eating disorders. First and foremost stabilizing the physical self. Second, individuals need to look past the eating issue to understand what is being ignored, numbed and not addressed. When the focus gets redirected toward the real issues the need for acting out toward self gets greatly diminished.