Outline: Process and Goals of Psychotherapy

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OUTLINE: THE PROCESS AND GOALS OF PSYCHOTHERAPY

 

I. COMMON THEMES, PROBLEMS, AND PATTERNS

 

1. Specific symptoms

 

• Self-hatred and/or grandiosity. Internal focus. Forgetting that “you are less than you think you are, and also more.”
• Lack of meaning: idea that my life does not matter, my actions do not matter
• Not seeing things clearly
• Fighting with the world, trying to change the things that are beyond our control
• "Escape" activities; addictive/compulsive behaviors
• Impulsivity; overidentification with “small I” impulses
• Inactivity, lethargy, helplessness
• Isolation, lack of intimacy with others
• Disconnection from self, others, world; addiction to self, disregard for others, forgetting that we can and should be here for others
• Missing forest for trees; what is the big picture? What is the job of a human being?

 

 

2. Relationship disturbances/estrangement

 

• From self (body, emotions, cognitions, behavior)
• From others (trust/mistrust; clinging)
• From the world (disinterest, fearfulness, distortion)
• From the transcendent (or the “big picture”) (disbelief, cynicism, fearfulness,       disinterest)

 

 

II. TYPICAL GOALS, HOPES, WISHES

 

• To feel good, to not feel painful emotions
• To stop doing certain things
• To start doing other things
• To get others to change, i.e., to stop causing me to suffer

 

III. REALISTIC GOALS

 

• To live a good life
• To be reasonably comfortable in my own skin
• To see myself, others, and the world clearly

 

IV. TASKS OF THERAPIST

 

• Education
• Empathy, fostering self-compassion
• Coach/cheerleader/motivator
• Human connection (deep, intimate, non-invasive, supportive)
• Spiritual companionship
• Monitor of progress
• Assistance in goal-setting
• Model for a way of being-in-the-world and being-in-relationship
• Resource for referrals and materials

 

V. TASKS OF CLIENT

 

• Commit to completing homework between sessions
• Goal setting
• Adequate self-care
• Daily meditation
• Exercise (aerobic), at least 20 min, at least 4 times per week
• Keep records of completed homework
• Awareness practice, at least 3 times daily

 

 

SPECIFIC PRACTICES, HOMEWORK, AND ACTIVITIES

 

I. Keeping written records: This is a proven method to increase positive behaviors, and to decrease unwanted (negative) behaviors. It also helps us to enhance the clarity of our perception (what is really going on?), and provides a way to objectively assess progress toward goals

 

II. Meditation: the Body Scan, Sitting Meditation, Walking Meditation. With these practices, the primary focus is internal (cognitions, feelings, impulses). The reasons for these practices include the following:

 

1. To loosen the connection between impulse and action
2. To become familiar with one’s internal terrain, including preoccupations, thought      patterns, dominant feelings
3. To understanding that thoughts and feelings are transitory phenomena and relatively      unimportant

 

 

 

III. Exercise: Aerobic exercise at least 20 minutes, at least 4 times per week. Exercise is important for the following reasons:   

 

1. It enhances brain functioning, including the serotonin system
2. It helps us to re-engage with self/body
3. It works to reverse inactivity, lethargy

 

IV. Awareness Practices: Three practices: Sensory Inventory; the Breathing Space; and Befriending the Sky. With these brief exercises, the primary focus is external (sensations). The reasons for these practices include the following:

 

1. They help us to re-engage with the external world
2. They help us to “get out of our heads” (where things are distorted)

 

V. Meaning, Values, Goals, Activities: The big question is this: What is the job of a human being? And the follow-up question is: How am I to do my job (in concrete terms: Goals, and Activities in Support of Goals)?

 

Related Question: Are Cause and Effect Clear?

 

1. What is the relationship between looking for good feelings (craving stuff, wanting      things to be different) and unhappiness?
2. What is the relationship between my thoughts and my feelings?
3. What is the relationship between my actions and my feelings?
4. What the relationship between my actions and the lives of others?
5. What is the relationship between my actions and the life/condition of the earth?     

 

 

 

 

 

COPYRIGHT 2008: Delany Dean, PhD