Therapist Use of Self

Friday, December 18, 2020 12:28 PM | Anonymous

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by Kaye Bishop, LMFT

Kaye Bishop is an LMFT in private practice for 34 years. She attended two month-long Process Communities in Colorado with Virginia Satir, studied with Satir for six years until Satir’s death in 1988. Kaye is a member of the Virginia Satir Global Network. Kaye was an Adjunct Professor at Santa Clara and JFK universities and worked for nine years as Counseling Supervisor at Silicon Valley Independent Living Center. For the last 15 years, she has been supervising associates and trainees at Almaden Valley Counseling Services. Kaye has had extensive experience as a group leader and workshop presenter working from a Satir model perspective. She can be reached at 408-837-5973.

At the turn of the 20th century, society was patriarchal. Women did not yet have the right to vote. Men were the authority figures. In the family, the husband/father made the decisions that his wife and children were expected to follow and obey. The therapeutic interaction at that time was also based on this hierarchical model, expert and patient. The early treatment model for psychology introduced by Freud and his followers was a traditional doctor-patient relationship, expert and patient. In this model, the client trusts the expert: the therapist. The aim of treatment was to focus on the symptoms and the treatment modality was individual therapy.

In the 1950s-1960s, with the development of humanistic psychology, a new model for treatment was developed based on an understanding that people affect one another. New treatments unfolded based on the interaction between therapist and client to promote change and growth. This led to the realization that it might be a good idea to treat members of a couple and families together. The realization that people affect one another and need to express what they think and feel about their situation was a significant move away from Freud and his followers whose model was individual treatment. During this time, couple and family therapy models were developed. In these new humanistic models, the therapist’s use of self became the main vehicle for growth and change.

Virginia Satir, a skilled psychotherapist, group leader and teacher, was a pioneer in the development of humanistic psychology. She became the first president of the Association of Humanistic Psychotherapy. With her development of a family systems approach to therapy and the publication of her book People Making in 1967, Satir cemented her place as a leader in humanistic approaches to treatment. People Making was translated into 13 languages and with the revised and augmented publication of The New People Making in 1988, her work became the model for family systems approaches to therapy. Family and group approaches joined individual therapy as valid treatment modalities.

I first met Virginia Satir in the summer of 1983. I heard that she was leading a month long Process Community in Mt. Crested Butte, Colorado. The focus of the Process Community was on teaching the Satir model and on personal growth. I signed up and it proved to be a life changing experience for me. I attended the advanced training in 1984, again in Mt. Crested Butte, a much loved place for Virginia, and continued to study with Satir until her death in September 1988.

In Satir’s model and other humanistic models, the therapist’s use of self is the main vehicle of change. Basic elements of all psychotherapy models are:
−  A therapist,
−  A client,
−  A context,
−  The interaction between therapist and client,
−  A model for treatment.

My training and 34 years of experience have taught me that there is no such thing as objectivity in the therapeutic relationship. Each client, each context is unique. It seems evident that therapist and client cannot help impacting one another as human beings. The influence of the therapist’s self or personhood occurs regardless of, and in addition to, the treatment philosophy or approach used. Therapeutic techniques, per se, seem to have little to do with results. The person of the therapist is the catalyst for change. It is who the therapist is as a person, not what she or he does, that makes the difference.

In this view, the therapist is the agent of change. The realness of the therapist and how she or he uses the self in the therapy, through modeling congruence and other interventions, will shape the world the client is headed toward, the new possibilities for change and growth the client is learning.  For this reason I believe that we, therapists, need to be in our own therapy if we are doing therapeutic work with others. It is true that we cannot take our clients any further than we, ourselves, have gone.

I have had a long interest in Buddhism and how Buddhist philosophy speaks to what I have learned through my teachers’ teachings and years of practice. In the early 2000s, I joined a Rigpa meditation and study group led by a student of Sogyal Rinpoche, Buddhist teacher and founder of Rigpa, a Buddhist sect. His work teaches meditation,  contact with the self, and presence. His work also teaches that in order to teach or practice psychotherapy, it is necessary to have gone through the process yourself. Otherwise, it is like teaching without the knowledge.

The Power of the Emotional (Limbic) Brain

How, then, does the therapist affect change and growth in the client? It appears to have a lot to do with our emotional brain, the limbic system. Neuroscientist Paul MacLean, in his research at the National Institutes of Health in the 1960s, discovered that our brains are made up of three parts, different in structure and function. There is the neocortex, the limbic system, and the R-system, the old survival brain. McLean described the limbic system as a vibrational energy system, unlike the neocortex which is an axon/dendrite system. He and other researchers in the last twenty-five years suggest that it is the limbic (emotional) transmission between therapist and client that is the key to healing. Limbic transmission refers to the therapist’s attunement and empathy toward the client as well as the regard the client develops for the therapist.

At the beginning of the 21st century, three psychiatrists/researchers at the University of California San Francisco Medical School, Thomas Lewis, Fari Amini, and Richard Lannon, wrote and published a terrific book based on their limbic brain research titled A General Theory of Love. They discovered that our minds seek one another through what they call limbic resonance, the process by which two people become attuned to each other’s inner states through mutual exchange and internal adaptation. An example of limbic resonance is courtship where lovers can become so attuned to each other that they can seemingly read each other’s minds or complete the other’s sentences.

The way in which an attuned mother regulates her child’s emotions is another example. If the mother is upset or frightened when her child falls, the child also reacts with upset or fear and cries. If the mother remains calm, the child tends to be calm also. When any two people form an attachment, they become emotional regulators for one another. This is certainly true in the therapeutic relationship as well.

We know also that emotions affect physiologic rhythms of the body. For example: a tailgater pushing from behind causes a body response in us. An anxious, rushing person elicits a different response in the body than a calm person. Research has shown that people who have contact with others do better emotionally and physically and live longer than those who do not.

Lewis, Amini, and Lannon (2000) show that we actually change one another’s brain through a process called limbic revision. According to the researchers (2000), “In a relationship one mind revises another; one heart changes its partner” (p144). It seems that attuned human beings have the power to remodel the emotional parts of those they love. Because of this, what we do in a relationship matters more than any other aspect of human life. Who we are and who we become depends, in part, on whom we love. This, of course has important implications for psychotherapy and therapist use of self.

Applications of Brain Research to Psychotherapy

We as therapists, then, have the power to revise the minds of our clients. In fact, that is what therapists do and seek to do. This is accomplished through attachment (joining and establishing a relationship), limbic resonance (empathy), and through limbic revision. Interestingly, the therapeutic relationship, then, the emotional interaction between therapist and client, and psychotropic medications both act on the limbic brain system in similar ways to affect changes in mood.

Power

Virginia Satir taught that the use of power is a function of the therapist’s use of self.  The therapist is in a position of power due to his or her training, role, status, and person. By contrast, the client is in a position of vulnerability. Satir stressed that due to this difference in power between therapist and client, it is important for the therapist to remember that power can be used either for controlling the other or for empowering the other. Therefore, the therapist must guard against:
−  The relationship becoming a negative use of power,
−  Developing a dependency in the client.

Therapists wish to serve and not to harm our clients. We can unknowingly do harm, however, if our own unresolved issues get in the way of therapy. The danger here is unrecognized counter-transference and its resulting projections. Signs of counter-transference include:
−  Feeling stuck,
−  Protecting the client,
−  Rescuing,
−  Taking sides,
−  Rejection of a client.

Therapist as Model

A major way in which a therapist uses the self is as a model for their clients. Through their humanness, behavior, and way of being, therapists model:
−  Acceptance,
−  Congruence and realness,
−  The joy of learning and growing,
−  Humanness,
−  Self-care,
−  Self-valuing,
−  Attending to and responding to the self.
If we are not careful we can also model:
−  Lack of acceptance of self and other,
−  Incongruence,
−  Unwillingness to admit mistakes,
−  Lack of self-care and self-valuing,
−  Self-abandonment.

Satir believed that emotional honesty between therapist and client is the key to healing. If the therapist’s words and affect do not match, this creates an unsafe environment for clients that often replicates the client’s childhood experience and can cause further wounding.

There is a close relationship between what the therapist believes and how she or he acts. How the therapist uses the instrument of self depends upon:
−  How complete one is as a person,
−  How well one cares for oneself,
−  How well one is tuned into or present to the self,
−  How competent one is at one’s craft.

Virginia Satir, (2000), stated that “the person of the therapist is the center point around which successful therapy revolves” and, “it’s who you are, not what you do that counts” (p. 25). Remember that the greatest instrument you have for healing is yourself. It is how you use the instrument of self that leads to successful therapeutic outcomes.

References 

De Beauport, E. (1996). The three faces of mind: Think, feel, and act to your highest potential.
Wheaton, IL: The Theosophical Publishing House. Lewis, T., Amini, F., & Lannon, R., (2000). A general theory of love. New York, NY: Random House.
Satir, V. (1972). People making. Palo Alto, CA: Science and Behavior Books.
Satir, V. (1988). The new people making. Palo Alto, CA: Science and Behavior Books.
Satir, V. (2000). The therapist story. In Baldwin, M. (Ed.), The use of self in therapy (pp.17-27). New York, NY: The Haworth Press.

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