November 12, 2013

Main Models and Approaches

One psychotherapeutic model I use is the Solution Focus Method, which seeks practical solutions to a problem.  For example, I would not tend to ask “Why do you have this problem?”, but rather “What would you be doing/thinking/saying differently if this problem were solved?”…”What would be the first small step in that direction?” I have found that this approach allows solutions to spring forth. Like Dorothy found out in the Wizard of Oz, many of the answers to problems lie within you and can be unlocked.  In most cases, you already have answers to these issues, at least in part. I can help you discover them!

Another model I use is the Cognitive Behavioral Therapy approach, which is based on the premise that our actions/feelings evolve from our thoughts.  If we use a methodical approach to change, say, dysfunctional anxious thoughts into more rational ones, it will change anxious feelings into calmer ones. Once in control of your thoughts, you gain control of your feelings!

noname (7)

Many clients who come in to do therapy with me benefit from a tool that I developed called a “Solution Focus Notebook”, which incorporates these approaches. It is divided into 5 sections (Goals/Mission Statement, Strengths/Resources, Gratitude List, Cognitive Behavioral Therapy, Solution Focus Exceptions).  If you do just a little homework (or, as I like to say, “changework”), several days a week, our work together will be more fruitful. Homework may be something as simple as writing down one or two things you appreciate (even little things, like, say, the smell of cinnamon), or may involve challenging a thought that is in your head that may be causing depression or anxiety using the methods of cognitive behavioral therapy.

To explore personality issues,  I tend to use a model called the Enneagram. This tool divides personalities into 9 types, each with their more evolved and less evolved traits.  It allows us to understand you without going on an “archaeological dig” into your past.  I have highly talented colleagues to whom I refer for deeper exploratory work. In case neuropsychological testing is needed,  I also work with an excellent Ph.D. neuropsychologist who does in-depth neuropsychological testing.

Most of my patients also benefit from psychotropic medications.   I have been fortunate enough to help some folks who have even failed other medication regimens.

Pat Kirsner multi-tasking with expert assistance.

Pat Kirsner multi-tasking with expert assistance from family pet Gravity.

Although I take mental illness very seriously,  I do have a sense of humor, and like to use this in concert with you to combat mental health problems. A quick example of this is a recent occasion when a married woman complained that her husband, a practicing Buddhist and meditator, continued to verbally harass her. I suggested that the next time this happen, she points out that his attitude was not consistent with that of his Holiness the 13th Dalai Llama, face him, grab his hands with her hands, and then chant loudly “Ommm”! this may serve as comic relief and help turn a tense situation into a lighter one. We’ll see how this works.

Therapy does not always accomplish everything you may expect or hope for. It requires commitment on both of our parts to do such things as arrive for sessions on time and maintain certain boundaries. The good news is that adhering to these commitments tends to make therapy a more effective and pleasant experience for everyone.