There are so many theories out there that us therapists draw upon to guide our work and our thinking. Some are true acolytes of one theory and others take whatever occurs make use of several like a grab bag. For my part, I consider myself grounded in psychoanalytic/psychodynamic theory, but have also found that nearly ever theory has something worthwhile to offer to my work.
I’m usually making use of this perspective when my clients have “light bulb” moments and respond to me, “Whoa. I’ve never thought of it that way. But, yes…” This framework has trained me to listen very carefully so that I can pick up on what may feel unknown to you or what is, in other words, unconscious or subconscious. We have so little time to pause and reflect in our busy lives that we often end up acting out emotionally or reacting to people and situations without really knowing what button has been pushed or even just why we’re so upset. Coming to know ourselves better is, I believe, where real change starts. The moment we see ourselves and our behaviors more clearly is the moment we have room to pause and to decide another course of action or another way of thinking.
Sometimes, this process of coming to know ourselves better can even be facilitated by the therapeutic relationship itself. We’ll look to see if similar relational patterns and assumptions about the other emerge. And, unlike in “real life,” we have more room to explore such dynamics and to see our relational selves with more clarity.
Emotion-Focused Couple Theory:
I find this theory quite useful even with individual clients, particularly clients struggling with challenges in their relational lives. Intellectual or cerebral insight can be profound and jumpstart the beginnings of change, but I find that this change is far more enduring and impactful when we embolden ourselves to be with rather than defensively avoid the difficult emotions that accompany many of our deep-seated beliefs about ourselves. We can find that we feel far more grounded and peaceful in our lives when not always scrambling to block our run away from our “negative emotions” in whatever specific way we’ve chosen: drinking or drugs, over-exercise, sex, work, etc. Additionally, this theory has really helped me in identifying the feedback loops or cycles we can get in with our partners, or the way in which our partner does something that produces a certain reaction in us and that reaction produces a reaction in them and so on and so on. Knowing this cycle can help us to interrupt it and to move past what have felt like insurmountable impasses in our relationships.
Gottman Couple Theory:
The Gottmans are a couple who have researched couples in the lab to find exactly what it is that contributes to successful (and unsuccessful!) partnerships. I’ve found it very useful to have their findings in the back of my mind when working with clients, so as to help me more readily identify clients’ relational strengths and what it is that may be going awry. They’re also full of helpful practical advice that I draw upon when it comes to, for instance, effective communication. For some, this direct roadmap can make a huge difference in actually managing to speak in a way that is heard.
Less contemporary versions of psychoanalytic theory can make (what I believe to be) the mistake of attributing patients’ neuroses exclusively to their inner lives and processes. This is why I’m so appreciative of Narrative Theory: for drawing attention to the way in which our social contexts and pieces of our identities (sexual orientation, gender, class, race, religion, etc.) impact our lived experiences and our self-concepts. Rather than immediately jumping to interpretations about my clients’ neuroses, I work to recognize the contexts in which they’ve been shaped and of each individual’s relationships to such contexts. I also really appreciate this theory’s emphasis on how our sense of self is the result of the stories we tell ourselves. In other words, most of us tend to rehash certain previous experiences in our minds and to tell those stories in a particular way that may leave us feeling both down on ourselves and rigid in our self-concept: I am this way because of ____ and will always be this way. It’s when we question how we tell these stories—and also recall others that may challenge our beliefs about ourselves—we make room to wiggle out of stagnant ways of being and move beyond a sense of stuckness.
Cognitive Behavioral Theory:
I’ve found this theory useful when clients are in search of something that feels just a bit more…practical. It can also be useful for constant ruminators, or people who find themselves frequently stuck in destructive thought-patterns. For instance, completing a “thought record” can help such people to really identify their go-to thoughts–rather than having them function as static or background noise—and to get accustomed to challenging their validity. (This is also a process of moving from one’s “emotional” mind to one’s more stable and calm rational mind.)