Monday, February 12, 2007

My Journey as a Therapist as a Symphony in Six Movements

Entry for 12 February 2007:

After I showed them a video clip from my client with panic/bridge phobia last term, the students in the Monday Part-time Diploma course requested that I come talk to them about what they called my Journey as a Therapist. Never having had such a request, I accepted, and last night put together a “multi-media” show, complete with poems, videos and Powerpoint slides… plus discussion of course!

Going in today after a very harried morning, I felt somewhat nervous, but was looking forward to seeing how it would go. I decided to frame the presentation with readings from several of my poems. The following is the outline of the presentation, including the information from the Powerpoint slides:

Prolog: Poems on why I became a therapist:
*Magic My Dad Taught Me (for his 75th birthday, available at: www.murraycreek.net/elliott/robert/dad75.htm )
*On Leaving the Shire (section 1; poem given at my retirement/going away party last August; available by request)

A. Training (1972-1980): Assembling the elements of the Process-Experiential approach
1. Basic therapy treatment: UCLA, Goodman - broad client-centered, community psych
2. At the same time: Liked the idea of early proto-CBT/behavioral self-control therapies (e.g., Mahoney): organized & systematic; but discovered this didn’t work for me and my clients
3. Psychodynamic/interpersonal training and clients; much creative work going on: research by psychodynamic process researchers: Luborsky: CCRTs; Sampson-Weiss: Control-mastery theory; current interest in empathic processes (therapy attunement/misattunement); short-term dynamic approaches
4. Through Society for Psychotherapy Research, met Laura Rice, Les Greenberg ("adopted"): added Experiential

B. Eclectic Experiential/psychodynamic phase (1980-85):
1. Base: Empathy, warmth, genuineness
2. Used psychodynamic formulation and interpretation
3. Plus experiential techniques: focusing, chair work
4. My research: phenomenological/experiential: Interpersonal Process Recall, qualitative methods

C. Return to pure experiential approach (1985)
1. Confronted by analyst in 1985: You interpret your client’s dream, but won’t interpret clients in your research. Isn’t that inconsistent?
2. Research approach was more important that therapy approach: decided to change practice
3. Other reasons: (a) worries about dangers of eclecticism (lack of grounding); (b) better research possible within a particular model.
4. What I eventually discovered: I felt more grounded and oriented as a therapist in a more purely experiential/person-centered approach
5. Laura Rice helped me stop interpreting my clients
6. Began collaborating with Rice & Greenberg to develop a new, integrative experiential therapy

D. Development of Process-Experiential (PE) Approach: 1985-1993
1. U Toledo Depression project; formulation of depression developed
2. Worked out main elements of practice: Treatment principles; Therapist experiential response modes; main tasks: Unfolding, Focusing, 2-Chair, Empty Chair, Prizing
3. Followed by York Depression Study (Greenberg, Rice, Watson)
4. Facilitating Emotional Change published in 1993

E. Emotion-Focused Therapy (EFT) Phase: 1993- 2005
1. Developed emotion theory: types of emotion response, emotion schemes, emotion regulation; emotion change principles
2. Application to Trauma (Paivio, Greenberg, Elliott)
3. Added tasks: Empathic Exploration, Space Clearing, Narrative Retelling, Alliance Repair
4. Clearer, student-friendly/training focus
5. Several books; Learning Emotion-Focused Therapy published in 2004
6. Videos: Greenberg
7. Depression research: York 2 project (Greenberg); U of Toronto CBT vs. PE (Watson)
8. PC/E outcome meta-analysis

Interlude: At this point, I showed two videos in which I helped clients do chairwork, one with client 31 in about 1986 (one of the case examples in Facilitating), and the other my client with panic/bridge phobia, from 2000.

F. Time of Turning: The Present Moment: 2006+
1. Anxiety (panic, GAD, social anxiety)
2. Severe problems (Borderline processes)
3. Dialogue with Person-Centred Approach (Strathclyde)
4. Dialogue with Pluralistic approach (Cooper, McLeod)
5. Political challenges
6. Personal challenges/issues: feeling that it's up to me to make something happen; getting caught up in clients' hopelessness; and dealing with clients who have great difficulty accessing their internal experience.

*Epilog: Poems: Where I am moving to now in my life:
*On Leaving the Shire (sections 2 & 3) (ran out of timefor this one)
*On Beginning Work at the Counselling Unit (available on this Blog for Octoberg 2006: pe-eft.blogspot.com/2006/10/poem-on-beginning-work-at-counselling.html )

References:
Elliott, R. (1999). The Origins of Process-Experiential Therapy: A Personal Case Study in Practice-Research Integration. In S. Soldz & L. McCullough Vaillant, Reconciling empirical knowledge and clinical experience: The art and science of psychotherapy (pp. 33-49) . Washington, D.C.: APA Books.
Short biographical summary; part of dropped material from Learning Emotion-Focused Therapy: www.process-experiential.org/learning/elliott.html

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