Psychodynamic Therapy, Narcissism and Shame

I have been slowly reading a book on Skills of Psychodynamic Counseling. Psychodynamic counseling theories and methods stem originally from Freudian Psychoanalysis; however there are some inherent differences. The book is interesting as it focuses on the foundations of the theory. One really great quote about this style of therapy is "Psychodynamic therapy involves the interaction of two minds which influence each other both consciously and unconsciously" (Howard, 2010, p. 15). The book talks about the therapeutic alliance being important to the method, just as it is in other methods such as Person-Centered Therapy. The difference is, that it indicates that there are two relationships occurring simultaneously. The first is the relationship between the counselor and client as adults. The counselor honors the client for coming to them and provides an environment where trust can be encouraged and fostered. The second is the subconscious relationship which involves the counselor as an adult and in a position of authority and the client's subconscious, which can be likened unto a child. In order for the client to have a positive counseling experience and to process childhood subconscious issues, the adult-adult relationship must be well-established. Where narcissism and shame come into play has to do with the relationship. A client who comes to me may have feelings of shame due to the fact that they have not been able to deal with their problems on their own. This can result in a hurt ego, and narcissism itself, is damage to the ego which resulted in shame; then, the ego overcompensates for the shame by inflating itself and becoming grandiose. Therefore, in order to heal, the issues of shame must be addressed at a child-like level which cannot happen unless the first relationship is established. I find these ideas fascinating and wonder how often we try to exert power over others due to our positions of authority and how it affects their own childlike egos. Just some food for thought. Dr. Jamison Law Howard, S. (2010). Skills in psychodynamic counselling & psychotherapy. California: Sage Publications, Inc.

Carl Rogers' Counseling Skills CAN WORK!

I just returned from a week long Residency experience with a National University. During this Residency faculty members are assigned to train Mental Health Counseling students in basic counseling skills. Many of the skills are based on, though not limited to, skills that Carl Rogers suggested. Much of Rogers' Human Centered counseling approach was based on the idea that all people are inherently good, and that if individuals are provided the opportunity to receive unconditional positive regard from a professional, then the chances of personal growth increases. Carl Rogers also said that the therapeutic relationship is necessary and sufficient for change. Therefore, counselors are trained to utilize methods such as reflective listening (i.e. being an emotional mirror), echoing, paraphrasing, summarizing, appropriate use of open/closed-ended questions, validation, etc. to help clients feel that they are receiving an empathetic ear to their problems; thus having the environment to promote change. If you want to learn more about it, click on this youtube link to see Carl Rogers talking about his method and demonstrating it in the all-too-familiar case of Gloria. What I find to be interesting is that the basic counseling skills can transcend just the counseling office. There have been times that I have worked with couples where they have an issue with communication. It is interesting to see what can happen if they are taught how to use these basic communication skills in their relationships. They can learn how to talk with their significant others and be able to come to a better understanding of one another. They can also be used as a teacher or instructor communicates with learners. As counselors begin their training in the field, I would strongly suggest that they study the methods that Carl Rogers and other humanist psychotherapists utilized as a means to understand how a therapeutic relationship can help a person change. Think about it, how often do we need an understanding ear to work through our own problems? Being skilled in these methods allows that to happen and can often lead to a person discovering the answer to their own questions. Thus, the client is left empowered and accountable to themselves for their own change and growth. The counselor then becomes a willing observer and partaker in their process, though they do not provide the answers, which strengthens the counseling relationships and maintains ethical boundaries. When I began as a counselor, I remember being overwhelmed with how many clients who wanted the "answer" to their problem. Can you imagine how much knowledge one would need, as well as how much responsibility one would have if they truly did have all of the answers? Also, can you imagine the liability and accountability one would have if their answers are not "correct" for the client? Therefore, a person who can competency use basic counseling skills can provide a means to help their client/learner find their own answers. See you later. Dr Jamison Law

Disney, Service, Compassion, and other things...

It’s amazing what you learn from the people you are trying to serve. You may approach a task with the idea, like most, that you are an expert at the task, and that you might know best. However, the point of serving is to exercise an empathetic eye and ear to those who are receiving your services. This thought has come to my mind as I have been reading “How to Be Like Walt.” I already wrote a small blarticle (blog+article) about this book, but the further I delve into the author’s information and humor about Walt Disney, the more I see the innovation behind Disney’s approaches to business and human beings. First, the author indicated that Disney was never trying to make money. He loved what he did, he believed in it, and it required money to do it; therefore, it was only a means to an end. We all know who Walt Disney was, and we know that he was no slouch when it came to money, as well. Then, why do we seek after money in trying to serve? It doesn’t make sense. I’ve tried it and I was miserable. I tried it the way others said to do it; the way the universities told me I had to do it; and the way that the “experts” said. I wonder if it is the incorrect way, though. Therefore, these are just my thoughts on some observations I’ve been thinking about. I began my career path as a mental health counselor about 12 years ago. I had spent two years as a volunteer for my church in another country where I served others. My parents paid my way for the experience and I worked hard. During that time, I found that I enjoyed working with people, getting to know them, learning from them, and teaching them. Therefore, when I returned back to the States, I decided to pursue a service-oriented career. I talked at times with my dad and others about opening up a ranch for at-risk youth. The focused activities would include learning how to care for and ride horses, as well as do cattle drives. Other activities would include care for their camp and cabins as an attempt to instill a desire to work hard and to find the joy that work can bring. Alas, it did not happen, but it was the beginning of my pursuits. Now, I have been working as a clinical director for a residential treatment facility for addictions for the past year. It was a great career move and I have spent the past 12 months learning, a lot. During my time there I began doing exit interviews with residents during their last day of treatment. I would ask them a few questions at first, but then narrowed it to one: “If you returned here a year from now, what would you like to see change and what would you like to see remain the same.” Almost always, and I don’t exaggerate this, they would say that they do not want the atmosphere and environment to change. They said that the front-line staff and the therapist staff members worked well together. They treated each other as equals. Most importantly, they felt the compassion that the staff members have for them and the other residents. They felt welcome and a part of a community. They felt on equal ground with the other residents, the line staff, the therapists, the administrators, etc. The residents said that the therapy was good (whatever that means) and that they learned a lot, but the emphasis was on equality and compassion. It makes me wonder if that is a catalyst for change. Is it possible that having compassion for your fellow man is a huge piece of successful change? My guess is yes. There is plenty of evidence to demonstrate such whether its from Christian texts, Buddhist beliefs, or psychological texts by Carl Rogers. Therefore, I would make a few suggestions to those who are in the service-oriented field. 1. Get to know your clients on an individual basis (by clients I mean anyone you serve whether you are a therapist, scout leader, parent, parishioner, or music teacher). 2. Do not be afraid to be human with your clients. Many people see us (therapists, etc.) as being an expert, and therefore, there is a power differential, which can lead to defenses and resistance in clients or ourselves. Don’t forget that you eat, sleep, and that your heart pumps red blood just as your clients. Be a vulnerable human. For more information on vulnerability, see http://www.ted.com/talks/lang/en/brene_brown_on_vulnerability.html 3. Holistic approaches: Not every client is the same. Be open and willing to help the client from their viewpoint, not yours. At times, yours may have to be the voice of the expert, but most people are an expert at their own lives. If you don’t know how to help a person, ask someone who does. You don’t know everything and you’re not supposed to. Be bendable and ethical. 4. Watch for patterns of behaviors that are indicators of your clients’ needs. They will show you what they need if you just pay attention. 5. Be equal with the people you serve. 6. Have fun with your service. If you don’t know how to live after the manner of happiness, it is hard for others to want to follow you. A. Bandura indicated that people need social models to follow at times. Social models are people with similarities of a others that provide a model or likeness that others can follow. These are just my ideas for now. Until next time.

ACA Podcast on Carl Rogers--A Brief Review

This is a brief review of a podcast from the American Counselors Association (ACA). The ACA provides podcasts wherein they interview key professionals and specialists. This particular podcast was aired on February 8, 2009 with speaker Dr. Howard Kirschenbaum regarding the esteemed Carl Rogers. Carl Rogers was the developer of person-centered therapy which is now one of the front-running therapeutic philosophical approaches worldwide. Below you will find a few notes I took and a brief summary (some verbatim) of the podcast, as well as the URL where one can listen to the podcast. I recommend it!

HT007 -- CARL ROGERS, the Person-Centered Approach

Sunday, February 08, 2009 7:42 PM

Speaker Dr. Howard Kirschenbaum is the author of The Life and Work of Carl Rogers . He is Professor Emeritus and former chair of Counseling and Human Development at the Warner Graduate School of Education at the University of Rochester, in New York. Dr. Kirschenbaum is the author of more than 20 books on education, counseling, and history.

Dr. Kirschenbaum first talks about some of the personal issues that Carl Rogers had. Carl Rogers struggled with alcohol dependency for the last few decades of his life. It is one of several areas that show him as a more dynamic and “human” individual.

Kirschenbaum stated, regarding Rogers that “Person centered approach is a context of counseling and psychotherapy is an approach by which the relationship between the counselor and client is paramount. Rogers described the relationship as consisting of 3 necessary and sufficient conditions…core conditions. The therapist’s congruence or realness, empathy for the client (sensitive understanding of the world as the client experiences it), and an unconditional positive regard for the client (appreciation and respect as a person of individual worth and autonomy). If those conditions were offered by the therapists…and the client could perceive the conditions to a minimum degree, then a relationship would be developed that would enable the client to change in positive ways. The client-centered approach changed over the years, but the core is the three conditions.”

The counselor serves as a helpful and supportive person to enable the client to do their own work. The client is their own expert. Before Rogers, the therapist was the expert on the client. Rogers’ approach was “revolutionary.” Each person can arrive at their own answer.
Rogers never said that human beings were inherently good. He said that they are basically trustworthy when provided with the positive conditions for growth and self-actualization. Negative conditions bring about a warped individual. They will do what they must to meet their needs, even if done in a warped manner. Rogers was optimistic that if nurturing conditions were provided, a client would grow.

Person-centered approach is less of a theory and more of a philosophical means of being a therapist (in the U.S.). In other countries, it is the leading means of therapy. It is taught as a distinct approach and is empirically supported.

To learn more, listen to the full podcast.
http://www.counseling.org/sub/podcasts/feed.xml