How Therapists Can Become Seat-of-the-Pants Counselors - PsychCentral.com

I have been a therapist for four decades, working in a variety of settings, serving children and adults, individuals, couples, families and groups. My rolodex brain is filled to overflowing with ideas and interventions. Sometimes when I teach Continuing Education Classes for social workers, I am asked to offer more theory. Although I also have that stored in my cranium, I remind them that they can get theory from books. From me they get hands-on practical skills to incorporate into their practice and their own lives. My take on it is that the more capable we are at exploring our own shadows and strengths, the more adept we will be as guides for our clients.

Therapists are “privileged listeners” — like hairdressers, clergy, bartenders and cab drivers. Clients rely on us to create a safe space for their emotional expression, and to keep those expressions confidential. It’s an honor and a sacred trust. 

Recently, as I have been working with several clients who have symptoms of OCD, I am challenged to come up with strategies to help them circumnavigate the inexorable pull of the obsessive behaviors. Many of them have shared that they compare themselves to others, that they feel they are woefully lacking in some ability or quality, that they will never be enough. As a writer, metaphors are my mainstay.

Today, when working with a tween client, we were taking a look at his most recent symptoms related to body image. What came to me as he was comparing himself to an idealized version of what he though he was supposed to look like, was the Goldilocks and the Three Bears concept. The mama bear and papa bear’s chairs and beds were either too soft or too hard, but the baby bear’s were “just right.” His ursine parents’ porridge was either too hot or too cold, but his was “just right.” I then whipped out a piece of paper and wrote those two words on it and asked him to have it handy in case he forgot.

We then did what I call The Body Love Dance that I learned when becoming a Laughter Yoga Leader. It begins with the participants standing and engaging in a call and response series of affirmations about various body parts. “I love my hair. I really, really love my hair. Thank you, hair,” and so on down to toes and everything in between. Silly? Yes. Fun? Absolutely. Effective in helping people overcome body shaming and comparison? You bet.

My client agreed to do it with his family. He didn’t think he was too cool to do it in my office, so he thought it would be even easier at home. When he was distracted by his obsessive thoughts, he agreed to add that song into his repertoire of skills.

Another client is plagued by sometimes overwhelming anxiety and feels a need to run away mentally from the fear thoughts. He is a master at the “what if?” game. A few days ago, I heard something on NPR (National Public Radio) about the various types of road races. I think the interview subject was a long-distance runner. One of the races had zombies chasing the runners to encourage them to run faster. I suggested that he think of the anxiety as hungry zombies determined to eat his brain. He laughed as I did my outstretched arms, moaning imitation. So, we figured out that if he could chop them up into tiny pieces, then they couldn’t harm him. He also referenced a scene from a Harry Potter movie/book in which sea zombies pulled people under water. In this case, he mentioned something about using fire-making spells to protect him from succumbing. He agreed to incorporate them into his practice.

Sometimes it involves tapping into their spirituality, so they can incorporate it as a therapeutic tool. Even clients who say they don’t have religious beliefs, or a spiritual practice generally have something that binds them to the transcendent. This connection might come through time in nature, a creative outlet or a relationship with a loved one.

A client in addiction recovery who spends time “in the rooms” is likely to be immersed in spiritual lingo. They might hear “let go and let God,” the word “God” spelled out as “Good Orderly Direction,” and the mainstay Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

Several years ago, while I was working in an outpatient drug and alcohol rehab clinic. I’d gone in on a Saturday to catch up on some paperwork. A young man appeared at my office door looking for a Narcotics Anonymous meeting that normally was held at that time.

He’d been clean of heroin for about a month and had promised his rehab counselor he’d go to 90 meetings in 90 days. Visiting the area for a family gathering, he’d looked online for the closest meeting, and our address showed up. The meeting had been canceled, and the website hadn’t been updated. I checked online and didn’t find another meeting in the area.

He asked if we could have our own meeting, referring to Matthew 18:20: “For where two or three are gathered together in my name, there I am in the midst of them.” I gladly agreed. We recited the Serenity Prayer. He read the 12 Steps and 12 Traditions complements of Alcoholics Anonymous, then he shared his story. We talked about music (he was wearing a Jimi Hendrix shirt) and family (his wife was one of his biggest supporters).

Before he left, he asked if I’d write in his notebook that he’d attended a meeting, and I was pleased to do so. We acknowledged that a “miracle moment” had taken place: He’d shown up where we both needed him to be.

Although appropriate boundaries are essential in therapeutic relationships, therapists should remember that we have many of the same deep questions that our clients do. When we connect with them as one human being seeking another, that’s when therapy becomes sacred between us and a therapist can become a seat of the pants counselor.

How Therapists Can Become Seat-of-the-Pants Counselors

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