Philosophy and approach

Humanistic therapy

Most therapists will say that “it’s the (therapeutic) relationship that heals.” While I think there is more to the story about want contributes to health and happiness, the “therapeutic alliance” (a good relationship with your therapist) is, I think, the heart of most therapeutic work. Empathy, genuineness, and positive regard are still the bread and butter of personal and relational healing, because wounds that were caused within relationships can also be healed within relationships. Having a good relationship with a therapist not only creates a receptive space in which you can receive new perspectives and tools, it gives an experience of being in healthy communication and open-hearted resonance with another person, which reaches us at a deeper, non-intellectual level.

I wrote a more detailed summary of humanistic therapy here.

Psychodynamic therapy

Psychodynamic therapy involves looking at our pasts and childhoods to better understand our subconscious and unconscious “soul” (“psyche”) and their conflicting powers (“dynamis”) upon us. We’ve all noticed that powerful patterns of emotion, thought, and behavior act upon us in an automatic and instinctual way, often when under stress. These reactions tend to have roots in some combination of our genes and our early childhood experiences, that form our protective “defenses” (also called “survival skills”) that served some purpose or function in the past, but also came with costs (e.g. suppressing valuable parts of ourselves). People often find themselves in therapy when they start to realize that these protections are outdated and their cons are now outweighing the pros. Psychodynamic therapy can help identify the nature of the patterns, as well as their origins, which can provide insight and courage to start making some difficult attempts at dropping the defenses and moving forward in life in new, exciting (and often unsettling) ways that we believe will take us to more satisfying relationships and experiences.

I wrote a more detailed summary of psychodynamic therapy here.

Acceptance and commitment therapy (ACT)

ACT is one of several mindfulness-based cognitive behavioral therapies that, unlike CBT, emphasizes getting distance from our thoughts rather than trying to change them. In this way it incorporates eastern mindfulness approaches to mental health, and assumes that often the best thing to do with thoughts is simply to observe them with “acceptance”, or even redirect focus to a “commitment” our higher goals and values, from which troubling thoughts can be a distraction. This involves willingness to “ACT” while leaning into uncomfortable emotions, in order to keep our options and lives expansive, rather than avoiding our experience and thus diminishing ourselves.

I wrote a more detailed summary of ACT here.

Existential therapy

Existential psychotherapy looks at emotional pain through the lens of the unavoidable “ultimate concerns” of existence that we all go through.  These include the fact of death, the burden of freedom and responsibility(including consequences and tradeoffs involved in our important life choices), existential isolation (no one can ever know what it is like to be us or be totally merged with us), and the burden of needing meaning in a world that appears to have only subjectively created meaning.  While our past experiences may contribute to our abilities to weather these existential dilemmas, the emphasis in this therapy is on how these universal, human concerns impact us.  For example, fear of death might be looked at more as an underlying reason for anxiety, rather than a overlying symptom of anxiety.  This therapy assumes that repressing the truth of existential concerns to the unconscious leads to suffering, while looking consciously and directly at them leads to greater health and peace.

Cognitive behavioral therapy (CBT)

CBT aims to change core beliefs and inaccurate thoughts, as well as trying new behaviors. Rather than examining the origins of limiting beliefs (often from childhood), CBT uses examination of evidence to see situations clearly. Seeing reality accurately is a key part of good mental health, because most of our suffering comes from believing thoughts that aren’t true and are usually skewed toward the negative.

I wrote a more detailed summary of CBT here.

Narrative therapy

Narrative therapy is based in post-modern and constructivist philosophy that assumes that our psychosocial reality is subjective, which means that we can choose our personal “story” (about ourselves, others, the world, and life). “Problem-saturated” stories are those that magnify negative events and meanings of those events, which leads to suffering. Narrative therapy aims to disidentify the with the problems in our lives, resurrect forgotten victories, and create helpful meaning from (past, present, and predicted future) events in our lives. In essence, it is the craft of deconstructing and then rewriting our personal story in a way that makes us happy rather than unhappy. While I don’t believe that all of reality is subjective, and we should not deceive ourselves with baseless narratives, it is true that much of our interpretation of reality is a flexible narrative, and how we choose to look at our experiences determines a great deal of our mental health, peace, and happiness.

I wrote a more detailed summary of narrative therapy here.

Solution-focused therapy

Solution-focused therapy (SFT) is a practical and relatively simple theory that is based in doing more of what works and less of what doesn’t work.  It assumes that people have the solutions to their own problems, and the therapist’s job is to facilitate the process of uncovering and building on those solutions and client strengths.  One method is to talk about “exceptions” (times when problems were not present or were smaller), and what solutions may have been present during those times.  SFT emphasizes clarifying goals, sometimes by visualizing a future scenario in which the problem were not present (the “miracle question”).  It also attempts to break down large goals into small, easily achievable steps, which compound into significant progress over time.  Interventions include imagining potential solutions, visualizing the achievement of goals, incrementally taking effective action, monitoring progress, and adjusting strategies based on what is working.

Imago therapy for couples

Imago therapy is a popular approach to improving intimate/romantic love relationships.  It examines how childhood experiences influence who we choose as a partner, and how we can help heal each other by providing what was missing (e.g. connection, autonomy, etc) from each other’s childhoods.  It assumes that we go into romantic relationships with an unconscious agenda and “unfinished business” and are seeking a corrective experience from someone who sufficiently resembles the “imago”(image) of our family of origin.  Because our deeper emotional needs often conflict with those of our partner, it involves learning about and understanding our partner’s childhood history in order to be attuned to each other, rather than aggravating each other’s old wounds.  It also emphasizes turn taking of careful and methodical reflective listening.  Imago therapy can be helpful in individual therapy, by examining your and your partner’s needs and histories privately in order to go into your relationship interactions better informed and prepared to communicate and look more deeply at needs and unconscious factors that underly problems. 

I wrote a more detailed summary of imago therapy here.

Emotion-focused therapy for couples

Emotion-focused couples therapy is an attachment-theory-based form of couples therapy that emphasizes the primary, more vulnerable emotions (hurt, sadness, fear) that individuals in a distressed relationship feel, and are not fully aware of or focused on.  Normally couples focus on behaviors, thoughts (about themselves and each other), and the surface level emotion of anger.  Both partners usually feel angry, and one tends to respond by criticizing/pursuing and the other by withdrawing/neglecting, which is based in their attachment style and their attachment fit with each other.   This leads to an increasingly negative and reinforcing cycle of blame and reactivity.  Underneath the judgment, vies for behavior change, and anger, is hurt, fear of loss, and sadness about their mutual disconnection.  These “under the surface” feelings need to be felt, seen, acknowledged, and expressed, to themselves and to each other, in order to increase empathy for one another.  The two partners typically are in pain for different reasons (one fears abandonment and the other fears engulfment/smothering).  Fundamentally, they each want to feel cared for, so they can feel emotionally regulated in the presence of the other and connect without feeling threatened at a primal level.  Interventions largely include being asked repeatedly to focus on, and communicate, what underlies the anger, complaints, and judgments of self and partner.  I think that EFT-informed individual therapy can be an effective vehicle for improving a person’s relationship, by introducing tools and understanding that can then be carried outside of sessions into their relationship interactions.