HOW I THINK ABOUT THERAPY: Part 1

HOW I THINK ABOUT THERAPY: Part 1

Whether they are an MFT, LCSW, school psychologist, etc., every therapist learns different therapeutic orientations in school. Some therapists will choose the theory that fits the most with the kids they want to work with and master that specific therapy. I’m not one of those therapists. 

You see, I come from a perspective that I am treating an individual, and what works well for one person may not work well for another. Therefore, I find having only one theory to pull from is limiting, and after a while, it can also feel like progress in therapy has stalled. So, instead, I practice Eclectic Therapy. I draw on several different theories and have several other treatments that I use interchangeably to work towards helping my clients feel better. 

I believe that most mental health issues stem from experiences that have created unique neural connections in a child’s brain and give them their perspective of the world. These events begin before birth and become part of the child’s personality. 

The genetic makeup of the family has a significant impact on who that child could be. Couple that with prenatal development, and already there are several potential pathways. For example, if the mother is more stressed, an infant could be more difficult to soothe, but they could also be less susceptible to stress because they’ve built a higher resiliency. 

Then the actual birth can be a trauma. Even if everything goes well during labor, the child’s genetic disposition can impact whether they perceive the uncomfortable and sometimes hours-long trip through the birth canal and out into the open world as a “fun ride” or the “scariest thing that has ever happened” to them. And even though we do not consciously remember birth trauma, it lives on in our implicit memories. 

Implicit memories are all the memories we have before we have the language to describe an event and our experience of that event. Implicit memories are stored in the body and can impact everything that makes up who we are. For example, how we relate to ourselves, other people, how sensitive we are to touch, sounds, if a bad experience becomes additional trauma or no big deal. We even use these early memories in our understanding of reality. 

In Cognitive Behavioral Therapy or CBT, early ideas about ourselves, others, and the world are called schemas. Our implicit memories are what underlies our schemas which then drive our behaviors. For example, think about something you liked from your childhood. Why did you like it? Sometimes we can’t say why we like something; it just brings us joy. I’ll bet that the thing we feel connected to for “no reason” is attached to implicit memory. 

Now there is another piece of the puzzle that can lead us to have mental health problems: the conscious thoughts we have. These are called cognitions. Just like implicit memories and schemas, our cognitions or thoughts can be both positive or negative. Often when we experience trauma, we attach a label or thought to it. Our conscious thoughts can then impact our behaviors and decisions. 

A big part of therapy is helping people become more aware of these thoughts and learn to control them because changing our thoughts can change our schemas and help us see the world differently leading us to behave differently. For example, if you have to give a speech and you put yourself down by thinking, “I'm going to mess up, I'm never going to be able to do it right, everyone is judging me,” then your lack of confidence is going to show and you are not going to do as well as you could. Then the next time you have to give a speech, you will be stuck in this cycle of a negative thought, negative behavior. It becomes a self-fulfilling prophecy.

Then we attach a negative emotion to our negative thought and negative behavior. This trifecta of negativity is succinctly labeled as trauma. When I say trauma, I don't always mean something big like physical or sexual abuse. Everyone has different things that they find traumatizing. It could be a minor problem that feels unbearable, like embarrassment from public speaking or tripping over your feet. Other common labels for this type of trauma are anxiety and depression.

Therefore, a combination of genetic predisposition and experience leads to a diagnostic level of mental illness. While everyone feels stress and has periods of mood fluctuation, it does not necessarily mean that they have a disorder; other specific criteria must be met. However, mental illness is a normal human experience that affects everyone and can be improved with knowledge, practice, and time.

In the next post, I’ll discuss how I begin treatment for children and how I incorporate parent involvement into the healing process.

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