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Tools
of therapy used in my practice
1.
DNMS
2.
Expressive Arts Therapy
3.Massage
4.
Focusing
5.Psychodynamic
and Interprative
6.
EMDR
7.
SMP
8.
CBT
9.
Hypnosis
10.TIR
11.
TFT
12.
Role of Spirituality
Frequent
questions
Prescribing medication
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This
crushing logjam can make you feel mental pain in the form of depression
and anxiety, relationship difficulties, problems with self-esteem,
a sense that part of you has been lost, frightening gaps in memory,
addictions to substance or process (like chronic self-blame) and
physical pain and disease.
Psychotherapy, as I practice it, is "talk therapy", and
more lately, with Ayrlie MacEachern, the use of Expressive Arts.
Together we work to connect you with awareness of your body's senses,
impulses, emotions and thoughts, to help you find and face the "stuck
points" in order to facilitate your personal growth and ultimately
help you find your own sweet place in the world.
SOME OF THE TOOLS OF
THERAPY I USE IN MY PRACTICE:
1. D.N.M.S. Developmental Needs Meeting Strategy
is a way of identifying and meeting essential needs of childhood
that were not met in early life by the child's caregivers. When
caregivers lack the skills to properly parent a child, leaving the
child vulnerable and damaged, that child as an adult,
will mirror parents' behaviour in an automatic and unconscious response.
DNMS helps to identify these patterns, create new neural networks
in the brain that free damaging log jam messages and allow a person
freedom from painful childhood experiences.When that freedom happens,
it happens at as a joyful, life-affirming feeling of "I get
it!", an epiphany allowing for changes to occur in one’s
relationship to self and others.
Shirley
Jean Schmidt.com
2.
Expressive Arts Therapy
Expressive Arts Therapy (EXART) is a unique interdisciplinary approach
connecting the arts and psychotherapy.
EXART incorporates both verbal and non-verbal communication. It
engages the senses; visual, auditory, and sensorimotor, through
breath and body awareness, movement and dance, voice and music,
painting and collage, sculpture, drama and creative writing. “In
all societies up to the present, the arts have played an essential
role in enabling human beings to make sense of their world,
to live with suffering when necessary and to be able to celebrate
the joy of life.” (Levine, S.)
The arts invite us to explore an inward journey and provide us with
tools to create an outward expression of our perceived reality.
Each and every journey of self discovery and healing
is unique, therefore the creative modalities one chooses is
a reflection of their individuality. Spontaneity, play, imagination,
ritual, containment, and catharsis are essential elements in
EXART. Often we have a narrow view of what ‘art’
is. Expressive arts therapy opens up a space for each of us to find
our own creative self expression.
“Art in its purest form is primarily a ritual activity
that is practiced in an elaborate manner only by humans and has
no evident ‘goal’ other than celebrating creativity
and human potential. All the arts complement and interact
with each other to unify play and imagination in a way that permits
the celebration of our humanity.” (Knill, pg.23) In expressive
arts the focus is on the process and how we arrive at our
creation rather than the end ‘product’. Absolutely
no previous artistic experience is required before engaging
in expressive arts therapy.
The relationship between the expressive arts therapist and
the client is a relationship of mutuality. There is an acknowledgement
or understanding that we are all in a process of self discovery
and “the therapist and client participate as partners in a
process of mutual transformation. Both as creator and
recipient, each is part and parcel of the powerful energy current
that informs the creative process.” When we gather
together in a group we have a combined wisdom that allows for deep
inner work to take place. We become the witness, the
participant and the facilitator of our personal journey.
We welcome you to join us in circle as we support and encourage
our individual and collective creativity and growth. Through expressive
arts and conversation we will gain insight, develop new
skills, get our creative juices flowing, and explore who we
are and where we are growing.
Ayrlie MacEachern is an expressive arts therapist who loves
group work. Creating her company Hugs for L.I.F.E. Inc., training
at ISIS-Canada, working at L’Arche Daybreak, and growing
up on a farm has shaped her love and respect for the healing
power of expressive arts, nature and community. Building intentional
community, creating sacred space and celebrating our unique
relationships is where her passion lives!
If you are interested in participating in expressive arts
or simply finding out more information about group work please
contact Jody, or Ayrlie at 705.444.0550
For more information about expressive arts therapy training
in Canada go to www.isis-canada.org.
For information about the international expressive arts therapy
association go to www.ieata.org.
Levine, S.and Levine, E. Foundations of Expressive Arts: Theoretical
and Clinical Perspectives. Philadelphia, Jessica Kingsley Publishers,
1999.
Knill, P. Minstrels of Soul: Intermodal Expressive
Therapy. Toronto, Palmerston Press, 1995.
3.
Massage
For assistance in relieving pain I refer to: Juliette Reynolds/Thai
Massage - the ancient preventive health practice of Thai Massage
connects your body and mind and allows you to find a peaceful, healthful
resolution to stress and pain. Juliette can be reached at 705.466.5793
Susan
Mcpherson RMT (registered massage therapy) 446-2123
4.
Focusing
Dr. Eugene Gendlin* found in his research that therapy was useful
for his patients only when they remained mindful of their own body
sensations.
The body/mind/emotion connection is a key component to healing and
without this aspect, therapy** will fail to promote permanent change.
*Focusing
by Eugene T. Gendlin 1981 Bantam books
**The power of Focusing by Ann Weiser Cornell New
Harbinger Publications 1996
5. Psychodynamic and interpretative
Listening to the story of my patients over time allows me to feed
back what I hear. I always assume that my interpretation may be
wrong and ask my patient to tell me if my interpretations fit with
how you see yourself.
One interesting concept is one called the Core Conflictual Relationship
Theme (CCRT)*. This can be very useful for work with couples to
figure out what the recurring problems are in the relationship in
order to help them figure out what changes need to occur in order
to make the relationship work.
*Brief Psychodynamic Psychotherapy, The CCRT method
by Howard Book, American Psychological Association, 1997
6. EMDR (Eye Movement Desensitization and Reprocessing)
EMDR is a way to process trauma which continues to reoccur. It was
developed by Francine Shapiro** in the mid- 80’s and involves
holding different aspects of a traumatizing experience together
while moving one’s eyes back and forth in sets. It is a very
powerful way to transform an experience which is interfering with
your life - to an experience which is simply part of your story.
This is only useful, however, once a person has been stabilized
for it does cause some temporary upsets during the processing and
occasionally, for a day or so afterwards. It is important that the
patient is able to contain and regulate upsetness to use this technique
safely. This process is always done with a therapist and not on
one’s own.
**EMDR
by Francine Shapiro and Margo Silk Forrest, 1997 Basic Books
7. SMP (Sensorimotor Processing)
SMP is a new kind of therapy which has resulted from the realization
that treating Post-traumatic Stress Disorder (PTSD)* and Dissociation
(Diss.) requires awareness of the internal experiences of the body
in order to heal from traumas and to facilitate changes in character
structure. SMP seeks to process traumas at a body level - with the
understanding that the processing of a trauma was interrupted, and
to truly heal, one requires completion of this process**(see Peter
Levine).
*The Ptsd Workbook: Simple, Effective Techniques
for Overcoming Traumatic Stress Symptoms by M. B. & Poijula,
S. Williams 2002
**Waking the Tiger: Healing Trauma: The Innate Capacity
to Transform Overwhelming Experiences by Peter Levine
www.sensorimotorpsychotherapy.org
8. CBT (Cognitive Behavioral Therapy)
I use a manual for this called Mind over Mood, by Greenberger and
Padesky,* particularly for depression and poor self-esteem. There
are many excellent similar manuals and books on this subject. The
idea behind this is to help you learn a process whereby you identify
your thoughts, write them down, note your mood, and then look for
the evidence for and against any hot dysfunctional thought. Hence
you can usually come up with a somewhat more realistic version of
a hot thought, such as “I am no good and of no worth”.
In depression there is a rich variety of similar negative thoughts.
Then there are experiments and action plans that can be developed
to help disprove any core assumptions you have about life that are
getting in your way. CBT is very helpful for various anxiety disorders**.
*Mind
over Mood by Greenberger and Padesky - 1995 Guilford Press
Feeling Good by David Burns 1980 Avon Books
**The OCD workbook by Bruce Hyman and Cherry Pedrick New Harbinger
Publ., 1999
Diagonally Parked in a Parallel Universe: Working Through Social
Anxiety by Signe A. Dayhoff 2000
The Ptsd Workbook: Simple, Effective Techniques for Overcoming Traumatic
Stress Symptoms by M. B. & Poijula, S. Williams 2002
9. HYPNOSIS
Hypnosis is simply the induction of the natural state we all enter
whenever we go to sleep or wake up. It is state when the mind is
relaxed and receptive to things we would not ordinarily pay heed
to. For example, in a light hypnotic state
such as at the moment before a car accident, the other person in
the car yells, “We’re going to die!!!”. Often in
this situation we will carry this moment forward in life, and will
frequently be triggered into believing we are going to die, until
we are treated.
Clearly
a patient must trust the therapist to allow the use of hypnosis
in therapy. I use hypnosis for specific reasons and only after discussing
exactly what I am going to do with my patient. I use it for the
following purposes:
• To teach you to go in your mind to a peaceful place, as if
you were really there, and to distance unpleasant events from yourself
- so that you can chose when to deal with these events rather than
have spontaneous flashbacks.
• To teach you self-hypnosis in order to achieve states of
mental and physical relaxation, to help regulate the intensity of
emotional feelings, and to clear your mental space in order to work
on one thing at a time.
• To explore your inner world - particularly to contact those
parts of self which can occasionally be hidden from you, or at the
very least, a part which you push aside and are not friendly with.
• To help improve your sense of self in a positive way (also
called ego strengthening). If one continually has negative ideas
about oneself - one can bypass these usually very wrong notions
and implant some positive thoughts.
• To help control pain
Risks and benefits of Hypnosis:
I think hypnosis received a very bad rap in the 80’s and 90’s
because of the memory controversy. There is no doubt that the person
using hypnosis needs to be trusted by the patient, and trained in
the process. In the past there was much more emphasis on working
with traumatic memories than there is now - and some individuals
were very aggressive in seeking out memories. We have a much better
understanding about memory than we used to. Therefore, I never use
hypnosis to find out about a suspected traumatic memory. I always
tell my patients we have enough to deal with without going to look
for more trouble. Skilled therapists can use hypnosis to help clients
heal from known traumatic memories - and it is a very useful component
of working with traumatic memory. The objective is always to help
one heal from the memory and to stop the flashbacks - not to look
for more memories. The truth of the memory is not important to me
because my job is not to seek justice but rather to help the client
heal from the memory. This is not because I disbelieve the reality
of what you remember.
I avoid
hypnosis if there is any court action, to avoid any legal issues
over the hypnosis. If any allegations against a perpetrator are
in progress I need to know this.
See web site for the Canadian Society for Clinical
Hypnosis
www.csch.org
10. TIR (Trauma Incident Reduction)
This is an effective way to deal with traumatic memories.
TIR
uses the concept of viewing, again and again, the same traumatic
memory with a facilitator in such a way that the facilitator's job
is simply to nudge the memory along with a few very simple pre-set
questions while showing no reaction to the person's process. TIR
requires an open-ended appointment as the process can take 1/2 hour
or 3 hours.
11.
TFT (Thought Field Therapy)
This is an interesting way of dealing with anxiety, anger and traumas,
which uses the energy system well known to the Chinese. This consists
of tapping a series of points in the body, which correspond to end
points on the ancient Chinese meridians.
12. The role of spirituality
I believe in a higher power - in fact I am a Christian. If you have
a faith and believe in the power of prayer, I will use prayer with
you, if you request this.
ARE THERE RISKS IN PSYCHOTHERAPY?
Yes - the stability of the patient is paramount. The reason I do
a very extensive intake assessment is to avoid de-stabilizing my
patient. My function is to decide how quickly or slowly I can work
with you to avoid overwhelming you. The idea is to move forward
and not make the pain more than you can handle. The idea is to process
the pain, not avoid it and remain stuck.
WHO PROVIDES PSYCHOTHERAPY?
Your family doctor as a psychotherapist provides the majority of
OHIP funded psychotherapy. Psychotherapists come from many different
professional disciplines including psychologists, social workers,
family doctors, psychiatrists, nurses, pastors, and teachers among
others.
WHAT IS MEDICAL PSYCHOTHERAPY?
This is psychotherapy provided by a physician
who:
• can bill OHIP and so my services are covered by the
provincial health plan providing there is a ‘medical diagnosis’
• can diagnose. This is both strength and a weakness
as putting labels on people can be counter productive. By and large
it gives us a common language to communicate with other professionals
about you when the need arises, something only done with your full
consent and knowledge, unless you are dangerous to yourself or others.
Having diagnostic labels helps me, together with you, to priorize
and decide on the best type of therapy needed and helps establish
how we move forward.
• can prescribe. This is done collaboratively with the
family doctor after my full assessment. I know that many people
do not have a family doctor, and sometimes the referral comes from
another mental health professional such as a pastor or a CAS worker.
If this is the case I will work with you to find a family doctor
as I believe the family doctor plays the central role in your health
care.
• is trained in the scientific method and will use tools
and psychotherapy techniques which have been proven to be effective.
• can assess whether psychotherapy might be of benefit
for other medical conditions such as chronic pain syndromes, and
irritable bowel syndrome. In the case of disorders for which there
is no discernible cause or pathology, psychotherapy can be particularly
valuable as this is how the body keeps score.
FREQUENTLY ASKED QUESTIONS ABOUT PSYCHOTHERAPY:
1. What is the difference between what my family doctor does and
what you do?
There may be none as all family doctors also do some psychotherapy.
Many family doctors over years take a lot of training in psychotherapy.
Some family doctors practice psychotherapy over 50% of their time,
many a few hours a week and some, such as myself, have decided to
practice psychotherapy full-time. I think those of us who practice
psychotherapy over 50% of our working time end up with very complex
cases. These cases require specialized training which most family
doctors do not have the time to take. So I see those of us practicing
full-time or over 50% of our time doing psychotherapy as specialists
in psychotherapy, as does OHIP.
2. What is the difference between a family doctor doing psychotherapy
and a psychiatrist?
Some psychiatrists practice full-time psychotherapy and many part
time psychotherapy. Many psychiatrists are involved in the important
job of assessing the mental health of individuals, deciding on appropriate
medication and monitoring the medication, overseeing inpatient facilities
- and may not actually have training or interest in psychotherapy.
3. What is the difference between a psychiatrist
and a psychotherapist?
A psychiatrist is a medical doctor who specializes in mental health
and psychopharmacology which may or may not involve psychotherapy.
You must have a referral from your family doctor to see a psychiatrist.
A psychiatrist is at the forefront of crisis medicine - and is able
to admit a patient to hospital. A psychotherapist who may be a physician
from any specialty, uses various forms of therapy such as verbal
or 'talk' therapy, expressive arts, couple therapy or group therapy.
If the psychotherapist is also a medical doctor then drugs may or
may not be used. A psychotherapist is first and foremost a facilitator.
Many other healthcare professionals provide psychotherapy and this
includes psychologists, social workers, nurses, occupational therapists
to name a few.
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