As a psychology undergraduate working at a psychiatric half-way house in late 70’s Seattle, I had my first therapeutic epiphany. The clients were severely mentally ill. The pay was minimal and the working conditions drab. The consultation was amazing. Mike Flowers and David Calof were consultants to SMHI, the community mental health center to which most of our residents went for therapy. They were young, brilliant, “hot-shots” who advocated Strategic Therapy. They taught that a good therapist should know several therapeutic modalities; be able to conceptualize each case through the lens of each modality; know how to do the therapy; and tailor the technique to the particular client. If your client was incurable under particular therapeutic philosophy, you found another therapy with which you could heal the client. While using this frame, our staff found ways to help previously immovable clients. For twenty-eight years, this philosophy has allowed me to continually adopt new therapies without having to throw out the ones I already use.
I started at UW social work school the next year, with the intention of gobbling up all the modalities I could. In school, I learned cognitive-behavioral, neuro-linguistic programming and systems approaches. Out of school, I studied Murray Bowen’s Family of Origin work and Ericksonian hypnotherapy. Everything I learned, I connected with what I already knew. The new ways of seeing and working started to flow together in the presence of my clients. Since 1981, when I graduated, I’ve adopted many new therapies. But only three modalities have rapidly and radically changed my work: movement therapy, EMDR, and attachment-based therapies.
Just out of school, I attended a lecture about movement therapy. How radical! A therapy that goes from the neck down! Emotions live in the body! You can access stuck affect and motion and “move” them to a new level! As an intellectual Jewish girl from the Midwest, I knew all about living from the neck up. My first movement class was a revelation. I could move angrily and no one would die. I could cry and I wouldn’t die. I could immediately access my feelings and know what I wanted. In movement class I learned to read bodies, to notice the stuck places, and to help clients free themselves from rigid holding patterns. While I didn’t become a movement therapist, the movement principles of affect release, grounding, and noticing the stuck places became part of nearly every therapy session.
In 1993, after I had been in practice for twelve years, a colleague told me about a new trauma therapy that involved eye movement. The EMDR training was grueling and enlightening. After sixteen hours in two days, including three practices of the technique, I was amazed at how fast and easily the trauma went away. Now, instead of helping clients merely cope with PTSD, I could help them rid themselves of all their symptoms. I embraced EMDR with a passion. Day after day I watched clients free themselves from trauma. I lived for the times I heard the magic words, “It’s gone!” and in the next session learned that the nightmares had gone away, the sex life had resumed, the feared obstacle had been surmounted. In the years that followed I went to advanced EMDR classes and conferences. I belonged to two online EMDR therapy communities. I became a consultant and then one of the first independent trainers of EMDR. I loved watching my students do their first EMDR session and exclaim, “My god! It works!” For two years I contributed to and edited a book, EMDR Solutions: Pathways to Healing (Norton, 2005), of my favorite EMDR remedies for particular client problems and populations.
In the meantime, I kept learning. I studied Object Relations theory for two years. David Schnarch, John Gottman, and Ellyn Bader and Pete Pearson’s work informed my couples therapy. At the EMDR International Association meetings, Daniel Siegel and Allan Schore introduced me to the fascinating world of brain development and attachment theory. While I connected with attachment-impaired clients, I watched them grow the capacities to self-soothe, connect, and relate. I learned the power of being with. Slowly, my work, my teaching, and my consultation became infused with attachment language and action. Sit close. Breathe with your client. Mirror them. Contain their affect with your words. Meet them at the level of intensity that they show. Let them know that you are truly present with them, any way you can.
In July, I attended Diana Fosha’s Immersion Course in AEDP, (Accelerated Experiential Dynamic Psychotherapy). Fosha taught us specific techniques (including elegant language) for enhancing attachment between client and therapist while moving through distressing affects. We watched many videos of Fosha working. Everything she did connected with one or more of my favorite modalities. She spoke hypnotically, while pacing and leading clients through their work (hypnosis). She monitored their postures, breathing, and expressions, by the second (movement), she used her Self (object relations). She moved trauma, with the enhanced attachment being the “dual attention stimulus” (as in EMDR.) She paid attention to differentiation issues (Schnarch, Bader, Pearson). I never felt so validated by a workshop, or so happy to gain a set of tools that was an enhancement of everything I knew. Nearly every session, since then, has included relationship and affect enhancement, courtesy of Diana Fosha.
Do I still do EMDR? Yes. Cognitive work? Yes. All my old modalities? Of course. As I continue deepening my understanding of the known modalities, I continue to collect new ones. My new favorite is David Grand’s Brainspotting, an offshoot of EMDR that appears to go deeper faster and with which my clients and I have had great results.
This blog will feature my take on psychotherapeutic modalities and issues. In January, I will start a monthly psychotherapy reading group featuring books on trauma, attachment, and affect-based therapies. After each group I’ll post the group’s idea of the therapeutic lens and most useful techniques from each book. If you’ve read the book (or written it!) you can post your opinion. Since this is not a secure site, we can’t write about individual clients or give specific advice. We can talk about theory, technique and whatever works.
Expect weekly postings.
Robin Shapiro, Seattle