Therapeutic Lenses
The unique backstory, life-experience, and present position of a given client will guide the therapist in selecting which therapeutic methods may be delivered in a given course of therapy. Not always, but in most cases, some mixture of the following therapeutic lenses may be employed.
Cognitive Behavioral Therapy
A cognitive behavioral approach says in essence: “We are all habit-forming creatures, and in addition to physical habits, we are also engaging in countless ‘thinking’ habits throughout the day, which we may not even be aware of”. To use an analogy, let’s first take a look at a typical job scenario:
Think about it for a minute: Could anybody else walk off the street and sit at your desk (or in your place of work) and do the exact same job that you do at the same level as you do it? Probably not – at least not without a lengthy training course. And the reason for this, is that you have already spent hours upon days upon weeks learning in small increments, better ways (better habits) to be more efficient at your job. This has inevitably led you to hundreds or even thousands of mini-habits which help you optimize not only the way you ‘do’ your job but the way you ‘think about’ and ‘engage’ with your job. You have taken your own prior knowledge and skills, and applied your own unique behavioral and thinking habits to your work – improving your overall productivity and engagement to help you better engage with it.
But even though the vast majority of these ‘habits’ allow for a smoother and more efficient work day; it could also be possible that there may be some areas where the habits themselves could be causing us to miss something. Of course, no one is perfect, and everyone is susceptible to various flaws in their formations of habits. And this could look different for different situations, and come from a variety of different reasons (For example sometimes we may base work habits on false assumptions, or other times we may make the mistake of applying an old habit to new criteria which calls for something different).
Cognitive Behavioral Therapy (CBT) suggests that just like in the work-scenario mentioned above, we also pick up habits in our general thinking and reasoning over the years that we may not even be aware of, including in social contexts, family or professional settings, or even in relationships. In other words, we oftentimes don’t ‘think about the thinking’, but instead we simply ‘do the thinking’ without noticing that there may be certain ‘habitual’ characteristics of our thinking pattern which in some instances is A) no longer serving us well in our present life and/or B) may not be completely accurate in content.
Thus, a CBT approach to therapy first identifies ‘automatic thoughts’ and/or habitual or frequent thought patterns, and then proceeds to ask the questions A) Are those thoughts serving any purpose in your life and B) Are they completely accurate? CBT then serves as a vehicle for awareness of the unwarranted habit and then begins (through collaboration with your therapist) to create new, more accurate, and better-serving habits of thinking and behaving.
Existential Therapy
An existential approach asks a few simple and fundamental questions such as: What do you value in your life? What’s important to you? And most importantly: Are you living according to your values?
Research shows that when we don’t live according to our values, we may be more susceptible to shame, anger, doubt, anxiety, or depression – all of which can bring forms of discomfort and distress into our lives. Through the process of existential therapy, we aim to find out more about your values and how they have grown or changed over the years. We will take some glimpses into possible times of transition of those values, and any inner-conflicts which may have arisen through these changes. We will also look at the extent to which you may have certain high-end values with specific behaviors attached, which might be at-odds with a separate high-end value, thus causing you inner-conflict. Through the process of existential therapy, we allow for the time and space to reflect on your value system, as well as the behaviors (or lack of behaviors) found in your current life which support those values.
Below is a basic example of a low-grade existential dilemma:
Let’s say you have a steady job – one in which you are content with, and feel fairly productive in. But your boss has recently asked you to change to the early shift – arriving at the office at 7 AM instead of the normal 9:30. You are very hesitant to make this move and you begin to wonder if maybe you should just find a different job which has better hours. But in actuality, you are able to wake up at that hour fairly easily. In fact, the only problem you have with this change, is the extent to which this move is going to affect your morning exercise routine. In past years you have always woken up at 6:30, gone to the gym for an hour, and then straight to work by 9:30. You have come to realize in these past years that a ‘morning workout’ is right up your alley. Working out in the morning allows you to stay healthy and fit, and gives you a good surge of energy for the work-day starting later in the morning.
In this present state you are experiencing a mini existential conflict. Two of your highest values (financial independence and health) are at odds with one another. If you choose to quit your job, your financial independence could take a hit, but if you stay with your current employment and change to the early shift, your health could suffer. Based on the decision you make, one of these values are going to take a hit, and you fear that you will end up regretting your decision whichever way it goes.
Through an existentially geared conversation you would be encouraged to get to the bottom of these issues. Through the collaboration with your therapist, you may begin to dig in to some of the following issues: 1) Which value is most important to you and why? 2) In making this decision, which value is at risk for the most pervasive and long-term hit, and can you accept that hit? Why or why not? 3) Are there alternative or creative actions you could take which might allow you to avoid these two values taking much of a hit at all? 4) Can you feel confident and content about your final decision or solution, knowing that there were very few simple or easy ways to respond to the conflicting options?
The above example is of course an extremely ‘simplified’ look at an ‘existential’ dilemma - in reality the ways we act upon our values are complex and interwoven with the various activities of our lives, but through a ‘values-focused’ discussion with a therapist, some of these complexities can be addressed and untangled.
Solutions Focused Therapy
Every individual has thousands of nuanced experiences in their life which are unique to any other person’s. Even if we take a very common experience that most people succeed in such as graduating high school; While yes, it is true that the “finish line” of this experience looks very similar to everyone (graduation), the challenges which were presented to each individual person along the way will inevitably look very different person to person. For example, one person might have been raised to have strict study habits and finished top 10 in their class, while another person might have had a more care-free upbringing, and focused more on their social life – only finishing in the top 200 of their class, etc. And of course, countless more nuanced examples could also be presented for all of the other unique ways in which people got to a similar “finish line” using completely different avenues to do so.
If you look at the example above you can imagine that no two people follow the exact same path even on the way to the same ‘finish line’. Thus we all are gaining highly specific ‘skills’ and ‘experiences’ along our own journey that others may not get (although others may gain different flavors of ‘skills’ and ‘experience’ than we do).
The bigger point here is that as we go through our adult life, we can sometimes forget about all the specific, creative and nuanced ways in which we have problem solved and moved through challenges in previous years of our lives. And when we forget some of those self-specific tools we have created for ourselves and used over the years, we sometimes mistake a current obstacle in our lives to be ‘unsolvable’, feeling like we ‘don’t have the tools to overcome it’.
Solutions Focused Therapy helps people to connect the dots in their life in a way which allows them to pull from their strengths to solve a current problem. It allows someone to recognize all of the past (or present) obstacles or challenges which they have already found creative solutions for, and then use some of the knowledge gained through those experiences to solve for some current obstacle which may have previously been determined to be too difficult. A solutions-focused approach not only pulls from your past library of strengths and abilities to combat a present challenge, but it can also help to create new strengths through the process of employing “old” skills to be used in “new” ways.
Narrative Therapy
A narrative approach to therapy suggests that people have a natural ability to relate their own experience to stories and narratives. Just think about it for a moment.. what do most of us do in our ‘free-time’? Watch TV or movies? Socialize? Sleep? Read? Daydream? When we watch TV or movies we are enjoying stories with plots – both fictional and non. When we are sleeping, our mind is naturally creating its own stories in the form of dreams. Even when we read books or articles in the media, we are latching on to a certain succession of events which are complete with a ‘past, present, and a future’ aspect. This means that we are always looking for certain ways in which one story-line can lead to the next outcome, and we are also routinely analyzing various stories for their components of ‘good and bad’ things, ‘helpful and harmful’ things, and ‘successful and unsuccessful’ things.
When we look at therapy through a narrative lens, we are acknowledging the fact that it is quite common for people to think in terms of stories and narratives – this can include ideas of right and wrong, and/or ideas of cause and effect etc. Most notably the narrative view suggests that people not only tend to see things in the context of a story, but that they also (without necessarily being fully aware of it) simultaneously see themselves as a central character in their own ‘internal narratives’.
An example of an ‘internal narrative’ could be small and insignificant, such as; ‘Fast food is bad for me and everyone else’. Or it could be larger, and much more impactful upon your own personal development – i.e.: “I’m never able to cope well when presented with a new social situation”.
It turns out that when a narrative is fairly simple in nature, it has a better chance of complete accuracy: For example: "Fast food is not good for me” is a simple, succinct cause-and-effect type of thought, and by most people’s account is a fairly accurate assessment.
But the more complex the narrative becomes, the more chances there are for us to over-simplify it and potentially skew it in a negative direction, even though we may not deserve it. For example, from the second narrative above: (“I’m never able to cope well when presented with a new social situation”) – the person interpreting this narrative about themselves has taken an extremely complex subject area (socializing with others) and has over-simplified it in a negatively skewed direction – ultimately putting themselves at risk for “believing in a story” about themselves which is quite possibly untrue.
In fact, it’s highly possible that this narrative has been formed by taking just a few negative interactions from childhood, and overgeneralizing those experiences into a destructive and unfair self-view – a self-view which could potentially cause them to form a ‘self-fulfilling prophecy’ towards future social events. Yet in reality this person may be suffering needlessly with an unfair narrative which they never gave themselves a proper chance to disprove or dispel
Thus, Narrative Therapy can then be said to be a process of examining certain narratives which A) Could be inaccurate and unfair to you, B) Could be creating self-fulfilling prophecies, or C) Could have been accurate at one specific past scenario in your life, but have since been over-generalized in an unhealthy way.
Through collaboration between client and therapist a number of possible avenues can be explored: 1) Challenging the accuracy of the narrative 2) Exploring the potential for actively changing it 3) Uncovering alternative evidence that has been previously overlooked which is not consistent with this narrative.
