7/17/2019 0495008842_182081 http://slidepdf.com/reader/full/0495008842182081 1/60 DVD Transcipt The following pages include verbatim transcripts of twelve role-plays that demonstrate the twelve theories in sections I, II, III, and IV of the book. Each transcript is preceded by a short description of the theory. These descriptions, the role-plays, as well as a discussion that follows each role play (not included here can be found on the accompanying !V! that your instructor may show in class. "s you read these transcripts, reflect back on the chapter with which it is associated and consider if the manner in which the therapist worked was the way you had imagined it to be after having read the chapter. Section I: Psychodynamic Approaches Page #reudian $sychoanalysis %ung&s "nalytical $sychology Individual $sychology ("dlerian Therapy Section II: Existential-Humanistic Approaches E'istential Therapy estalt Therapy $erson-)entered )ounseling Section III: Cognitie-!ehaioral Approaches *ehavior Therapy +ational Emotive *ehavior Therapy )ognitive Therapy +eality Therapy Section IV: Post-modern Approaches arrative Therapy olution-#ocused *ehavior Therapy
The following pages include verbatim transcripts of twelve role-plays that demonstrate
the twelve theories in sections I, II, III, and IV of the book. Each transcript is preceded bya short description of the theory. These descriptions, the role-plays, as well as a
discussion that follows each role play (not included here can be found on the
accompanying !V! that your instructor may show in class. "s you read these transcripts,reflect back on the chapter with which it is associated and consider if the manner in
which the therapist worked was the way you had imagined it to be after having read the
$sychoanalysis proposes that our personality develops through a comple' interaction
between the e'pression of our instincts and our early childhood environment where thechild encounters and internali/es shame and guilt. It is an in-depth therapy that assumes
much of our behavior is unconsciously driven and that there is value in bringing
unconscious motivations to awareness.
In this approach, the therapist is e'perienced as a parent figure, and therapy ideally
evolves as a more positive parenting process. This process occurs over a long period oftime as the client builds what is called a 0transference1 relationship with the analyst. This
transference relationships mimics early family relationships and offers rich material for
the client to e'amine. The transference relationship allows the client to acknowledge
forbidden and repressed thoughts and feelings in a safe environment and to integratethese into conscious awareness. The alternative is that the latent unconscious content
remains destructive to the client&s sense of well-being and personal relationships,
manifesting in such symptoms as an'iety, depression, conflicts, or addictions. The
interpretation of dreams and free association became two of #reud&s primary therapeutictechni2ues for accessing repressed material from the past.
3et&s take a look at how !r. $aula %ustice uses dream analysis in her work with %eannie,
as she e'amines some repressed feelings regarding the death of her father.
Dr. Justice: 4i. ood to see you again. 3ast session I know you said you had a
significant dream that we didn&t have time to really process. I was wondering if you&d
like to start with that today.
Jeannie: I really would because it still is with me, and it feels like a really big dream. It
starts off in a sense of5I&ve been invited to this wedding, and I&m aware that I&m talking
to5I think it&s the grandfather. "nd, well when I say grandfather he&s my age, so it&s notwhite beard or5and I&m aware that5there&s such a masculine feeling talking to him.
I&m aware that his son is also present, and the grandson. The wedding&s about the
daughter. *ut I&m looking at him 6 I mean, talking with the grandfather, and5there are 7ust5all three men, but the grandfather he&s so masculine. I&m aware that he&s
handsome, that he 6 that all of the men in the family are, that there&s a sense of strength,
you know8 I&m 7ust very attracted to the whole family in this way.
Dr. Justice: o there&s these three generations of sort of strong, masculine, handsome
men.
Jeannie: 9es.
Dr. Justice: "nd this is the wedding of the daughter.
Jeannie: +ight. +ight. "nd what seems to be so special about this is that the daughter
gets to have the wedding e'actly the way she wants to. "nd in fact it&s almost as if
she&s5and I don&t want to say spoiled because I don&t think that she&s spoiled, but she
has all this incredible attention by all the men in the family. "nd she is told that she can
have it e'actly the way she wants. "nd it&s an e'traordinary re2uest that she&s asked for.
Dr. Justice: 4mm. ow, these three men; do they remind you of anyone8
Jeannie: 4mm. ow that you&re saying that I, I know that when I see them in my mind&seye they remind me somewhat of my brothers 6 my brothers are very handsome.
Dr. Justice: <hmm.
Jeannie: "nd the5so there&s this sense of the father, the grandfather5I&m aware, I mean,
he looks kind of like my brothers as well. o, there&s that sense of the handsome, strong
male.
Dr. Justice: o you&re the5sister, in a way, to these handsome men.
Jeannie: 9es. 9es.
Dr. Justice: "nd in the dream the sister is marrying. "nd you said she has a very specialre2uest 6 what was that re2uest8
Jeannie: he wants to 7ump from an airplane, on a stallion, into the ocean, in her weddingdress.
Dr. Justice: =hew. "nd what kind of airplane is this8
Jeannie: =ell, it&s kind of like a cargo, I guess you would call it, a cargo plane, because
the back end opens up and it&s like there&s a ramp. I see her, in my mind&s eye again, I
can see her in her wedding dress on this beautiful stallion. The ramp goes down, and sheleaps into the ocean, and the horse&s hoof catches on the ramp.
Dr. Justice: 4mm. o there&s sort of a stumble as she come out of the5
Dr. Justice and Jeannie Together: >ut of the plane.
Dr. Justice: >k. "nd this leaping out of a plane over water 6 does this remind you ofanything8
Jeannie: =ell, the part that really grabs me the most was, one? that she gets to @have it her way& so to speak5the ocean, well I&ve loved the water. That the father has allowed her
to do this, has given her this as a gift so she can have this wedding5
Jeannie: 9ou know, 7ust when I was59eah. 4ow strange, you know8 I 7ust remembered
that my father, who5again, I&m going back and forth in my head about several different
things as a daughter. "nd he was a pilot.
Dr. Justice: 4mm. I remember you saying he died when you were very young.
Jeannie: I was wondering if you had remembered that I had told you that. I was four, and
he was flying in the "ir #orce, and he was lost, actually, over the ulf of <e'ico. 4is
e7ection seat went off, and5
Dr. Justice: o he sort of 7umped out of a plane.
Jeannie: =hat you&re making me think about is the connection with this good-lookinggrandfather too, and the whole masculine piece of it that I feel like I missed in my life.
"nd as you know, my husband5had a terrible accident recently. "nd I&m aware that I
didn&t have my father to walk me down the aisle. I&m aware that I have always wanted to
be a !aughter. I&m aware that I love the sense of my husband, who was for the first timein my life, I think, a very strong masculine force. "nd I have felt protected by him. "nd
now he&s wounded.
Dr. Justice: <hmm.
Jeannie: "nd you know, that idea of that horse stumbling5the ramp reminds me of how
my husband is now paraly/ed. "nd he has to5the only way he can get around is with a
van that has a ramp on it. "nd so he&s now broken, or wounded.
Dr. Justice: o the dream really brings up that longing for the strong masculine, for the
father that you lost so early in life, the masculine strength that you had in your husband
but, in a way that&s been a little lost with his disability, his accident.
Jeannie: 9ou know, and that&s why I think the dream impacted me so much, because of
that sense of longing, and sorrow that comes up, wells up in me. "nd I hadn&t made thatconnection with my loss of my dad. "nd you know, it&s so funny even to say the word
@dad.& I speak of him as a father because I didn&t call him @dad.& I don&t remember that,
or @daddy.& o when I think of a strong masculine, and I had it for a while? the courage.
4e was a 7et pilot, and here&s my husband a motorcyclist, a spelunker 6 all the loves ofthe physical. "nd that&s, I think, what I do connect with the masculine? being strong, and
adventurous, and courageous.
Dr. Justice: "nd in the dream, you sort of leap, as the daughter figure, you leap 6 she
leaps 6 from the plane into the water, which is where your father was lost, in reality.
>ver the water. o you&re almost, it&s almost a wish to 7oin him.
Jeannie: 9ou know, there is5 I think, part of that longing, now that you bring that up, it&s
probably what I would call5I feel like sort of a 2uestioning of being here, when I&ve
suffered so much loss, to 7oin him is what you&re saying8 There&s probably some kind of
longing for me to 7oin with him8 =ow. >k, that makes sense.
Dr. Justice: "nd that would be sort of magic, to be able to 7oin with that strong
masculine? have your father back, have your husband whole again.
Jeannie: If only. If only.
Dr. Justice: "nd that wish, of course, doesn&t mean that you&re spoiled.
Jeannie: =ell thank you for that one. 9ou know I think that there is a piece of it, if I
could have it my way, if I could have the masculine protect me, to give me, to support
me, you know, if I had a father5what would that have been like for me8
Dr. Justice: "nd knowing that, knowing that you have those feelings that this dream has
surfaced for you, how does that sort of inform your waking life today8
Jeannie: 9ou know, in telling you, and you asking me some of these 2uestions, I&m really
aware of a sense of 6 I&ve started breathing better5I think it brings some sort of comfortknowing that there&s a connection this way, you know, that I can make that connection,
In %ungian analysis there is an assumption that the individual achieves well-being through
the e'ploration of what )arl %ung called the personal unconscious and the collectiveunconscious. The personal unconscious contains repressed material from childhood and is
symboli/ed by %ung&s archetype of the hadow self, which represents all parts of the
psyche unacceptable to self and others. %ung believed that the most important task ofearly adulthood is to bring the contents of the hadow self to awareness and integrate it
into the conscious personality. The hadow manifests as the opposite of %ung&s concept of
the $ersona, or our public mask.
In contrast, the collective unconscious is a universal and transpersonal component of the
psyche that contains all human e'perience and potential. >nce the hadow has been
embraced, the client can continue in the process of what %ung called Individuation, agradual incorporation of universal archetypal patterns into everyday e'perience. These
archetypes provide blueprints for creative development and manifest in our dreams, art,
religious symbols, and myths. Two of the most significant archetypes are the anima,
which represents the feminine within all males, and the animus, which represents themasculine within all females.
%ung believed that the unconscious could be accessed through the imagination as
manifested in dreams, free association, images and symbols, as well as what %ung called
"ctive Imagination. E'ploring these symbols and images are a means of understandingthe past, relieving psychological symptoms, and finding guidance in creating a full and
more meaningful life.
In this role-play, watch how !r. $aula %ustice works with )arin as they e'plore dreamimages to help the client acknowledge and embrace her hadow self and how it might be
integrated into her public self in waking life.
Dr. Justice: =ell welcome back, it&s good to see you.
Carin: ood to see you too.
Dr. Justice: "nd the last time we were together, you said you had an interesting dream
that you thought was important to what we were talking about. )an you sort of describe
that at this point8
Carin: 9es. =ell, I was in a shower room, and I remember being surrounded by
e'tremely obsese womenDlike A or B or C pounds. "nd I remember walking thoughit, and we all were naked, we had no clothes on, but I remember being so proud that I was
the only thin one there. *ut all these women5I 7ust was disgusted by them. I couldn&t
believe that they were in this shower room with me.
Dr. Justice: "nd so how did you feel when you woke up from this dream8
Carin: =ell I did feel pretty disgusted at how someone could let themselves get like that.
I 7ust am turned off by it, that lack of self-control. I felt proud also, in my dream, because
I was so different from the rest of them and I had a certain amount of self-control and Iwas doing good. o proud and disgusted.
Dr. Justice: >k. "nd do you have any sense of5we had talked about day&s residue, howthis might relate to your waking life.
Carin: 9es. =ell, I&m doing these pageants? I&m doing <iss Virginia *each and <iss$ortsmouth eawall. "nd especially for <iss $ortsmouth eawall right now I&m really
dieting. "nd I&ve lost about five pounds in the past two weeks, and that&s a lot for me; I
don&t usually fluctuate like that.
Dr. Justice: <hmm.
Carin: "nd so I&m not allowing myself to eat everything I would like to, so I think that
that is definitely being perceived in my dream as my daily residue, is people that can eat."nd I almost like them, but I&m still proud of myself, so it&s that tearing emotionally.
Dr. Justice: >k. o being very conscious about your own eating and your own weight
because of the pageants may have prompted this dream.
Carin: >h yes. *ecause we have to be in a swimsuit in front of everyone.
Dr. Justice: +ight. "nd we had talked about how dreams sometimes present a balance or
a compensation for what&s going on in our waking life. "nd so here we have thesewomen overeating, whereas you&re having to be so conscious of not eating.
Carin: 9eah.
Dr. Justice: "nd I encouraged you to perhaps do some 7ournaling with the dream. =ere
you able to do any of that8
Carin: 9eah, I actually brought it with me. I did a dream dialogue instead of the 7ournal,
where I actually talked to one of the women, and we had a conversation. "nd she said
0=hy are you so disgusted by me81 "nd I told her 0your lack of self-control and whatyou&re doing to your body, it 7ust disgusts me.1 "nd I said 0I never want to be like you.1
o we had a pretty rough conversation.
Dr. Justice: <hmm. !id you feel toward her differently in going through the
conversation8
Carin: ort of towards the end, she kind of encouraged me to, you know 0It&s ok to
overeat every once in a while, you can be indulgent once a week or whenever,1 and I sort
of encouraged her to, you know 0<aybe we can go work out.1 o we both tried to help
each other out at the end. o that was good. It was a very rough beginning but we kind
of came to amends at the end, to a degree.
Dr. Justice: <hmm. o you felt a little closer to her.
Carin: 9eah.
Dr. Justice: I remember in one of our earlier sessions talking about how there are some
weight issues in your family and how you had some weight concerns as a younger person.
Carin: 9eah. =hen I was younger, I know I was e'tremely overweight, and I remember
in Cth rade my parents having to sit me down and say 09ou need to lose : pounds or5you might develop type : diabetes, and this and that51 I also have two uncles who are
e'tremely obese. >ne of them is applying for gastric bypass surgery right now and the
other one is a workaholic and 7ust doesn&t care. *ut his wife is so concerned. o I feel
like5I think I&m especially disgusted by these women because it runs in my family, andI&m afraid that it could be a little too easy for me to get like that because of the genetic
traits that I carry.
Dr. Justice: <hmm. "nd I remember you saying that it wasn&t until you had that
conversation with your parents you becameD
Carin: Delf-conscious.
Dr. Justice: 9eah.
Carin: =e used to do weigh-ins in $E, in front of everyone. "nd I remember that was a
little weird because I weighed more than all the other kids. *ut I really didn&t care untilmy parents told me that there was something wrong with it. "nd then I remember it was
like a snap; I said 0>h, this isn&t right.1 "nd so from then5I remember in Fth rade I
went on my first diet, and I lost about B-C pounds that year.
Dr. Justice: =ow.
Carin: "nd from then on it&s 7ust been sort of an obsession of mine. <y sister has it aswell, we&re both eating-obsessed.
Dr. Justice: o in this dream perhaps you&re seeing sort of a shadow part of yourself, youremember that we talked about the shadow part, the part that 7ust lets herself go.
Carin: 9eah, it&s the part that I&m scared of too, the shadow part that I don&t want to beseen. I don&t want to show people that I have a lack of self-control. I know when people
show a lack of self-control around me I 7ust get very angry, and I know you said that&s a
part of your shadow self, things that you get very angry about.
Carin: I get very angry at very overweight people because I know it&s unhealthy and Iknow that they could dieDmy grandpa died of a heart attack, which was related to
smoking as well, but also his e'tra fat and stuff like that. 4is heart wasn&t strong enough.
o it&s a serious fear of mine.
Dr. Justice: 9eah. o you have these family health issues, you have your parents&
concern, you have the beauty pageantsD
Carin: D"nd also the career.
Dr. Justice: >h.
Carin: *ecause I want to go into television somehow. 4opefully on camera; my dream is
be on camera on TV somehow as my career. "nd to do that I have to be very thin
because TV adds weight to you. "nd I&m to the point right now where I feel like I&ve gotall my studies in line, I&ve got all this in line, I&ve got everything else e'cept for the
weight under control. That&s my mindset. o if I gain weight then it&s like I&m self-sabotaging my career. o it&s e'tra pressure for me.
Dr. Justice: >ne of the things that we work on with the shadow is finding a way toembrace it so it isn&t so frightening or so threatening. 9ou have a lot of reasons to be
fearful of these overweight women in the dream, but is there anything about them that
may be positive8
Carin: 9eah. =e 7ust saw this movieDit had ueen 3atifah in it5I don&t remember
what it was called. he learned that she was going to die in a few months, and so she
lived her life, and she&s a thicker woman, and she was portrayed as so beautiful and 7ustso wonderful, and she had so much to give. "ctually, 4ollywood is sort of steering away
a little bit from the anore'ic models; in Fashion Week they 7ust fired several models
because you could see their bones. o5society&s becoming a little bit more encouraging,and I can really see especially in heavier women, you can see their inner beauty a little bit
more, I think. 3ike in the movie with wyneth $altrowDI don&t know if you&ve seen it
DI don&t really remember the name, but she was able to date this boy because he was
hypnoti/ed to only see her inner beauty.
Dr. Justice: Is that 0hallow 4al81
Carin: 0hallow 4al,1 yes. o that was cool to see, how much inner beauty they have
inside of everyone.
Dr. Justice: <hmm. "nd I remember you saying once that sometimes you associate very
Carin: Very stoic, yeah. 4eavier women5I think of them as more loving and caring.
#or some reason I have that in my head. I think it&s because of some literature courses
I&ve taken; we describe motherly women, loving women, as heavier and skinnier womenas meaner. I don&t know.
Dr. Justice: o even though the overweight women are threatening in terms of yourcareer and possibly your health issues, there&s something about them that&s softer, more
loving, more motherly.
Carin:9eah, uh huh.
Dr. Justice: "nd how might you want that in your life and in your future8
Carin: =ell I do know that I need to calm down on the eating obsession, so it is a part of
me that5I would love to not care about what I eat so much. o that&s a positive thing in
the dream, these women really don&t care what they eat. I&d love to be like that. o that&s
an emotional mindset that I&m going to try to get to. "nd also they&re 7ust so loving and Iwant that as well. I want to be able to be like that instead of being so rigid about
everything I have to do. o there&re lots of positive things.
Dr. Justice: "nd I know you said that you felt like your boyfriend accepts you 7ust the
way you are.
Carin: 9eah, my boyfriend. <att, he alwaysDI know that I&ve gained maybe pounds,
during )hristmas time especially, and then had another pageant so I lost :, but he has
always been there. Every day he says 0you&re so beautiful, you&re so wonderful, you&reama/ing.1 o that&s so encouraging to me because I used to think 0if I don&t lose weight
then I&ll never get a boyfriend.1 "nd now that I&m getting older 0I&ll never get a husband,
never keep a husband if I can&t stay thin.1 o his unconditional love has been soencouraging to me for my body image, to 7ust know that I can be loved no matter what I
look like.
Dr. Justice: o he doesn&t have any problem embracing that part of you.
Carin: ot at all, no. 4e likes it. 4e does like this to my arm, saying 0I love this 7iggleK1
4e likes it.
Dr. Justice: "nd you&re comfortable with him, whatever si/e he is.
Carin: I&m very comfortable, yeah. 4e actually hurt his back and so he gained a little bit
of weight. "nd he was very self-conscious about that, but I think he&s beautiful all the
time so it&s cool for me to see that as well? me not caring if he gains five pounds, and himnot caring if I gain . 4e loves me for more than 7ust what I look like.
"lfred "dler posited that we all develop styles of life that seek to compensate for innate
feelings of inferiority. 4e believed that we attempt to overcome such feelings as we strivefor a sense of superiority, defined as a desire to achieve emotional health and
completeness. 4e also felt that emotional well-being could be gauged by an individual&s
degree of social interest, or sense of connectedness to others and to a worldwidecommunity.
"dler stated that we are often victims of faulty assumptions or inaccurate perceptions ofthe past that drive the kinds of choices we make. These choices are often based on our
family constellation, birth order, and childhood memories.
"lthough considered a psychodynamic theory by most because of its focus onunderstanding the dynamic forces that shape one&s psyche, "dler&s theory has also been
described as one of the first to apply humanistic and systemic concepts. This is because
"dler believed that people can change, create the future, make meaning in life, be goal-
directed, and not necessarily be shackled by past events.
"dler saw therapy as occurring through a series of stages that included establishing acollaborative relationship, analy/ing the client&s problems, sharing insights, helping the
client reorient himself or herself to new ways of living, and reinforcing and evaluating
the change process.
!uring the therapeutic process the therapist will often show empathy, conduct a lifestyle
assessment, e'amine early recollections and dreams, communicate respect and
confidence, focus on strengths and encourage clients, help clients combat faultyassumptions, and focus on goals.
3et&s see how !r. ylinda ilchrist uses some of the above techni2ues to help 0hannon1e'amine her lifestyle as it relates to her family constellation.
Dr. Gilchrist: 4i hannon, what brings you to counseling8
Shannon: =ell I&ve really 7ust recently been feeling really overwhelmed, and stressed
about5I feel like I have so many obligations in my life that pull me in different
directions that I&m not able to give my all to each of those areas.
Dr. Gilchrist: o how long have you been feeling that way8
Shannon: "ctually I said recently, but when I think about it probably as long as I can
Dr. Gilchrist: )an you tell me a little bit about your childhood8
Shannon: ure. I grew up with my mom and my younger brother; he&s four yearsyounger than I am. <y parents divorced when I was H, so for the longest time it was 7ust
my mom, my brother, and me. =e kind of bounced around a lot, she worked two 7obs to
support the two of us as a single mom.
Dr. Gilchrist: o you&ve been feeling overwhelmed for a long time now.
Shannon: 9eah, and actually I&d probably say even before I was H, before they got
divorced, because my dad is an alcoholic, so even when they were together it was 7ust
chaotic. "nd I always wanted to protect my brother and help my mom.
Dr. Gilchrist: 4elp your mom how so8
Shannon: "round the house, and helping out with my younger brother-taking care of him.
I really5didn&t have a childhood, I guess, because I did a lot of adult things.
Dr. Gilchrist: "dult things like8
Shannon: !oing the dishes, cooking dinners, staying in to watch my brother while my
friends are outside at the park and stuff. o lots of things I guess.
Dr. Gilchrist: o it sounds like you had a lot of responsibility for taking care of your
younger brother.
Shannon: Lh huh.
Dr. Gilchrist: =hat did you do for you8
Shannon: <e8 That&s an interesting 2uestion5I guess for me, I got straight "&s.
Dr. Gilchrist: That&s an accomplishment.
Shannon: 9eah, but I really stressed myself out doing that.
Dr. Gilchrist: 4ow did you stress yourself out8
Shannon: %ust5feeling like I have to make straight "&s, and not even or only in school. Ido that at work-I have to be the best employee. I do that at home, I do that with my
friends, my roommates, and even in relationships, romantic relationships.
Dr. Gilchrist: o it seems like you strive to be perfect in school and in other areas. 9ou
Dr. Gilchrist: It sounds like you have this need to be perfect. Is that stressful8
Shannon: It is, it is. I feel very disappointed if I don&t do my best. I beat myself up over
that. o it&s really stressful.
Dr. Gilchrist: =ho places that e'pectation on you8
Shannon: I guess I do, but in order to make people proud of me.
Dr. Gilchrist: >k. )an you tell me your earliest recollection of maybe not being perfect8
Shannon: 9es, and actually when you said that it came to me immediately. In seventhgrade I got my first * and I was e'tremely upset. "nd I cried the whole way home
because it was an awful feeling, 7ust awful.
Dr. Gilchrist: >k. "nd so you said that it made you feel really awful.
Shannon: <hmm. It 7ust5I felt5I had made straight "&s up until that point and that first*, I was so disappointed like I had 7ust let myself down completely from what I e'pected
of myself.
Dr. Gilchrist: ince childhood you&ve always been striving to be perfect. 4ow is that
working for you8
Shannon: It&s really really stressful. ometimes it even makes me sick, like physicallysick. I will stress myself out to the point where I have a stomach ache or a really bad
headache that I can&t get rid of. o I guess it&s really not working.
Dr. Gilchrist: "nd it seems like this stress, this need to be perfect is really causing some
physical symptoms as well as adding to your stress level.
Shannon: 9eah. "nd then when I get sick it takes away time that I need to be using for
E'istential therapy is loosely based on e'istentialism, such as the writings of %ean $aul
artre and <artin *uber. 4owever, its application as a therapy is actually much moreoptimistic than the writings of many e'istentialist authors. E'istential therapists believe
in the importance of discussing the philosophy of e'istential therapy and view therapy as
a shared 7ourney that e'amines meaningfulness in life. Thus, it is not unusual fore'istential therapists to share their knowledge about living (and dying and to even
periodically self-disclose as they attempt to develop an authentic relationship with their
clients. *ecause e'istential therapy is based on the sharing of a philosophy, it does notoffer specific techni2ues for doing therapy. 4owever, some argue that 0sharing a
philosophy1 is a techni2ue in itself. ome of the underlying assumptions of this
philosophy include the following?
. The abilit to sel!"re!lect and be sel!"a#are. "lthough individuals often choose a
life of denial, they are capable of self-reflection and self-awareness.
:. Feelings as a message o! our being in the #orld. "n'iety, guilt, depression and
other feelings are a statement about the choices we make and should be e'aminedin this conte't, not as an indication of pathology.
A. Choice? =e are capable of making positive choices for ourselves and for all ofhumanity. ot choosing is a choice and can lead to what some have called an
0e'istential death or e'istential vacuum.1
B. $es%onsibilit. =e have a responsibility to make choices that will positively affectourselves and others. >therwise, we all will live in chaos.
C. &eaning through our relationshi%s #ith others. =e are constantly redefining
ourselves through our relationships. Therapy is a 7ourney through which the
therapist and the client are e2ual partners in their search for meaning.F. The im%ortance o! authenticit. It is critical that we are real with others.
>therwise we live a life of lies and deceitDa life filled with denial of one&s true
feelings and inner thoughts.G. ' never"ending search !or com%leteness and #holeness. "s we become more
authentic and more aware, healthy choices become more obvious and easier to
make. 4owever, due to the comple'ities of life, we will be faced with choices,sometimes difficult ones, until we die.
3et&s see how !r. Ed eukrug applies this philosophy with his client, *etty, in their
shared e'istential 7ourney.
Dr. (eukrug: =ell *etty, I want to thank you for coming in today and agreeing to share
some of your thoughts and concerns with me and um, wanna 7ust kind of open it up andstart wherever you liked?
)ett: =ell uh, I 7ust recently retired from the police department and I&m moving into a profession now, (into counseling where I understand that I will need to have some type
of closeness, a relationship with my clients, but I really don&t have any, that much
e'perience in that regard because of my work and um, like the only uh, substantial
Dr. (eukrug: It&s fascinating I find the contrast between being a police officer and a
counselor really interesting. Especially when you talk about the fact that it sounds likeyou want some intimacy in your life, but you haven&t really had that e'cept for with your
mother, so there is a stark contrast there between, again between being a police officer
and being a counselor. It sounds like you want to move into that direction of having moreintimacy in your life in general.
)ett: 9es um, I 7ust5 I 7ust find it, I find it hard to talk about um, I umm
Dr. (eukrug: =hich parts to talk about8
)ett: Lh, the intimacy part and I don&t understand how to work it, how to work it out because there&s certain aspects of myself that 7ust didn&t uh, acknowledge, I ignored. I&d
say the emotional part of myself was not honored. "nd now that I&m stepping out of a
role in which I had a script, you know, I had the uniform, I knew what I had to do there
was no 2uestion about what I had to do each day it was like a mantra, it was likesomething I did everyday and now, it&s5 I have to be, I have to come out of myself.
Dr. (eukrug: It almost sounds robot-like. Lm, that you kind of, lived a role you even
said it you wore a uniform. "nd you put a certain image out to the world an image which
was maybe not the real you, as you saw yourself inside and now you&re really searchingfor who that inner being is.
)ett: +ight5 <ore so uh5 also, um, working in an environment that has been
historically racist and se'ist uh... you tend to want to be invisible. >h I mean to say 0youtend to be15 I tend to want to be invisible and not5 and not be in front, so open about
who I was. It was like I 7ust following the role, being like the 0good girl1 and my
womanhood was not honored it was a minor thing and it was not 7ust something, not 7usttalking about the people, I&m talking about with myself and how it&s coming out that&s
who I am.
Dr. (eukrug: >M, so you found that, in that environment being a police officer, am I
correct in hearing that you personally e'perienced racism and se'ism5
)ett: 9es...
Dr. (eukrug: 5 and that was very difficult for you and you kind of hid, is that accurate8
)ett: 9es, yes... um the way I dealt with that was to5 to feel like I had to achieve in
order to be accepted, it was conditional. Lm, I don&t know what else to say about that. It
was... it was uh, hard lessons. I learned a lot I also had to look at5 look at how I, myrole in all of it5
Dr. (eukrug: 9ou made some difficult choices I think as a police officer, in terms of how
you were going to live your life because of the se'ism and racism and the nature of being
a police officer. The choices were maybe they weren&t even that conscious, but it sounds
like the choices where to kind of hide your real self.
)ett: =ell it wasn&t like5 well it was true it wasn&t conscious, uh I had to come to this
point reading, books and looking at other people to reali/e how much of myself was
unconscious of5 what I was really doing was detrimental to me as a person5 andemotionally. o now that I have to work with people in that area, I need to, uh I need to
know myself and how to be in the world authentically.
Dr. (eukrug: =ell I&m certainly impressed that this is, that you&ve switched roles like that
and that this is your new goal for yourself um and I&m really interested in how you were
able to raise your consciousness around your lack of awareness of self and your lack of
intimacy and how you were playing roles. 4ow did you do that8
)ett: =ell, I&d say it happened two different ways. >ne way was books I uh, there was a
book I found called, 0*lack #eminist Thought1 that really opened my eyes a lot and also
when my mother was sick, I reali/ed I was working and I reali/ed that the role of caringand the heart is so much more important to me in this life than5 then the, I don&t know
what other way to put it, but a masculine way of being5 being out there and then the roleof caretaking when my mother was sick was very important. I had to really like, really
open up to that and that takes a lot of courage to uh5 do that5
Dr. (eukrug: 9es it does and I hear how courageous you were. "nd I think I&m also
hearing these kind of two parts of yourself being opened up at the same time and that was
that feeling part of yourself through your mother&s illness and also kind of the intellectual
part of yourself through this book that you read and other books that you&ve read. The both of those kind of raised your consciousness about the importance for you that you
found more authenticity in your life.
)ett: <mm-hmm, that was because, uh when you watch someone suffer which is hard,
I mean with the police work, uh there was uh, it was more of a5
Dr. (eukrug: 5!etached suffering8
)ett: 5!etached pseudo kind of presence I guess and you knew that you had to bind
yourself emotionally to get through it. It&s not a bad thing because, sometimes you needto do that 5 uh you 7ust don&t know what to do with it. "nd when my mother was sick5
Then I had to really look at those feelings and try to integrate then and that was really
hard5 a lot of anger and all that.
Dr. (eukrug: o again, your mother&s illness really made you look at yourself in some
deeper ways.
)ett: +ight, right. I had to make decisions to balance work and was at the hospital with
her a lot so I had to balance work and be there or make the decision to leave work and be
there, you know, leave so I had to uh, it was5 it was like I don&t know if this makes any
sense, but it was like dealing with my mother and father. 3ike the police department, to
me, was like my surrogate father where you were like, not e'actly I would say, a
balanced view of a father, but you had to be there, you had to stay strong, you had to doyour 7ob along with my mom it was5 it was different, I had to be open and receptive and
feeling, like you said get in touch with feeling parts.
Dr. (eukrug: 9eah, I think that I can really understand what you&re saying. I had a kind
of similar e'perience with my mom who was ill a few years ago and passed away and I
was like I was living two lives in some ways. Is that kind of the e'perience that you had8
)ett: 9eah, e'actly5 living two lives5yeah.
Dr. (eukrug: "nd I guess the um, in a way, and I hope you understand how I mean this,the gift that your mom gave you, in her illness, was to help you see a deeper part of
yourself.
)ett: "lright, yeah5 absolutely5 because I did have to, um, walk through that andsee5 I, I mean I really had to 7ust be there and connect with a deeper part of myself
which wasn&t very easy or pretty. 3ife was very messy, yeah5 yeah.
Dr. (eukrug: o now you&ve chosen a field which is, and maybe this was more of a
conscious choice, you&ve chosen a field which deals mostly with authenticity andrealness and now you wanna move on with your life in a new way. In a way where you
have more realness in relationships, more intimacy, um, perhaps realness in your
counseling relationships, perhaps more realness in your friendship and love relationships
and now you can consciously begin to make choices about bringing yourself to this new place. !oes that make any sense to you8
)ett: 9eah , I um, I have to5 well I need to, let&s see5 I would say5 honor myemotional life, which I have not done. It&s, uh, usually a sign of weakness in my uh, my
way of being in the world before5
Dr. (eukrug: That was you before and now we have a new you and I&ve got to say, I
really respect this new you. "s you are honoring yourself, honoring your emotional self
and beginning to listen to it more effectively, more fre2uently.
)ett: 9eah, more fre2uently5 thank you.
Dr. (eukrug: =ell it sounds like it&s been a kind of, hard road for you in recent years, butit, I&m also hearing that you&re making some really good choices for your self as you&re
moving forward in your life. "nd again, I really respect that.
)ett: Thank you. eems like I have to work really, really hard to be uh, anything more
than ordinary 5 so I&ll 7ust uh, 7ust keep working as long as I don&t lose myself in my
Dr. (eukrug: I guess I&m thinking a lot of times we think that, um, life is gonna be easy,
but um5 as you&re showing us, it usually isn&t. There are so many things in life that, thatgive us difficult, hard times and messages to ourselves about who we are and where
we&re going and I think you&re really hearing some of the messages you&re getting about
yourself.
)ett: )an you give me something to uh, take with me85 (laughs
Dr. (eukrug: I guess what I&m hearing5 that&s a great 2uestionK I guess what I&mhearing is that you&ve bee giving your self something and if I can give you anything that&s
what I want to give you and that is to continue to give yourself that sense of inner
awareness that you&ve begun to give to yourself. Thank you for sharing today.
>riginated by #rit/ $erls, estalt Therapy has as its core belief the notion that reality is
often clouded over by unfinished business and it is therefore necessary to urge clients toe'perience the 0now.1 *elieving that awareness e2uals reality and that individuals tend to
avoid unfinished business, estalt therapists are active and directive as they push their
clients to understand how they use e'ternal supports to disguise their past hurts and pains.E'amples of some common e'ternal supports include the use of nonverbal behavior, such
as a client who taps his foot at the mention of an an'iety producing sub7ect;
intellectuali/ing, such as a client who spews facts and figures to avoid feelings; and blaming, such as a client who states that her depression is due to how her husband and
children treat her. In stark contrast to many psychodynamic approaches which slowly
attempt to help clients understand their defenses, estalt therapists push clients to deepen
their e'periences and be freed from their defenses. " few of the many techni2ues estalttherapists have developed to accomplish this include?
. '#areness *+ercises, such as when the therapist asks the client to close his or her eyes
and e'perience all prevalent feelings, thoughts, and senses to 2uickly get in touch withone&s defenses.
:. laing the %ro-ection and sing /I0 Statements are used to discourage pro7ecting
onto others and things. #or instance, the statement? 0I hate her, she doesn&t love me,1
becomes, 0I hate myself; I&ve never learned how to love myself.1
A. *+aggeration Techni1ues are used when the therapist wants the client to get in touch
with the underlying meaning of a word, phrase, or nonverbal behavior. " client who
slouches is asked to slouch more and state what he or she is feeling. uddenly the clientstates? 0I feel as though the world is on my shoulders.1
B. The *m%t Chair Techni1ue is used to help a person dialogue with a part of self oranother person in order to uncover underlying issues and feelings.
C. Turning 2uestions into Statements 'bout Sel! are used because gestalt therapists believe all 2uestions are really statements about underlying feelings, issues, and values.
#or instance, 0=hy don&t people care more about others81 may become? 0I feel that
people don&t care about me.1
3et&s see how !r. Ed eukrug works with 0%ill1 to help her get in touch with some of her
unfinished business surrounding the death of her mother.
Dr. (eukrug: =ell %ill, I really appreciate you being here today and I know that you had
some feelings and thoughts about some issues with your mom that you wanted to talk
about. o I&d love to hear what that&s all about.
Jill: >kay, I&m having a lot of difficulty dealing with the recent loss of my mom. <y
mom died a few months ago and before she died, there was about a year and a half that I
didn&t have any contact with her. "nd I&m having a lot of trouble dealing with that. I was
close with my mom for my entire life, but for the year and a half prior to her death, she
didn&t have any contact with me. "nd fortunately I was able to see her the week before
she died, but it still didn&t heal any of the pain that I felt for the year and a half that shedidn&t have contact with me. o I&m hoping that um, you&ll be able to help me5 get
through some of the, um, emotion that I&m feeling, um, help me resolve some of that pain
by talking about it and coming to terms with it.
Dr. (eukrug: Even as you&re talking I can see 7ust in your face that the feelings are really
near the surface and that there&s really a lot of pain there for you.
Jill: +ight5 a lot of pain. Lm, basically, like I said, my mom and I were close for my
entire life, uh she had trouble with relationships with my siblings and I was the one that
always stuck up for my mom. "n um, about two years ago, she was diagnosed with aterminal disease and I decided to have a family reunion at5 in the >uter *anks. "nd I
invited my entire family, for the family reunion, and she did something very hurtful to
one of my siblings. "nd I didn&t stand up for my mom, and as a result of that she decided
to cut all communication with me and didn&t attend the family reunion. I, um, actuallyhired a photographer, to take a family picture of everyone so that we would have that
remembrance of her knowing that she only had a couple of years to live. <y mom didn&tattend the family reunion; everybody else was there, so now I have this picture of the
whole family minus my mom. I&m having a lot of trouble, (voice breaking up; looking
at the picture knowing that I wasted a year and half of my life not having her in my lifeand now it&s too late to make amends.
Dr. (eukrug: >kay5 so it feels like you had this potential time to be with her and then
she cut off communication with you and so you&re really missing having that closure withher.
Jill: +ight5 knowing it&s too late5 to do anything.
Dr. (eukrug: >kay5 so what I&m thinking is that maybe you need to have a conversation
with her and talk with her about how you&re feeling. "nd that&s something we can dohere, with this chair as if she was here. =hat do you think about5 about that8
Jill: $retend she&s here8
Dr. (eukrug: <m-hmm (affirmative
Jill: I can try5 I can try that.
Dr. (eukrug: <aybe you can talk to her, to you mom. =hat do you usually call her8
Jill: I have (a nickname, well we all have a nickname, we call her 0<u/.1 It sounds
Jill: I stuck up for you and you were the one that turned your back on meK (sobs "nd I
don&t think I deserve that.
Dr. (eukrug: "nd tell her how much you miss her.
Jill: I miss you and I wish I could take back the past two years5 (sobbing I really do. Iwould give anything to take @em back5 it&s so petty now. It&s so petty now; I wish I
could take it back. *ut, I&m grateful, I&m grateful that I got to say goodbye to you.
*ecause that&s the only thing that I can look back on now and be grateful about because Itruly don&t think I could5 I truly don&t think I could deal with any of this now if I didn&t
have the opportunity to say goodbye to you.
Dr. (eukrug: o you did have that opportunity8
Jill: 9es
Dr. (eukrug: o a lot of the feelings that you have is not around your closure, sayinggoodbye, it&s more around the feelings you have, having missed that year and a half with
her.
Jill: +ight, right. E'actly.
Dr. (eukrug: >kay5 and do you ever think about what she&d say back to you if she was
here8
Jill: =ell, my step-father told me a few months ago, he actually came to visit me, and hesaid, 0%ill I 7ust want you to now that your mom loved you very much.1 9ou know, and
that meant a lot to me so I truly think that she was 7ust, you know, stubborn and I don&t
think she meat to hurt me. I think she was 7ust stubborn and had difficulty, you know,making that first move. 9ou know8
Dr. (eukrug: I kind of hear how much you loved her5
Jill: >h, very much.
Dr. (eukrug: "nd maybe you can tell her one last time how much you loved her and howmuch you regret not having had that time with her.
Jill: <u/, I love you. I do regret wasting the past year and a half of your life. I&m gladwe had all those other years and I&m lad we had all those other photographs. "nd I&m
glad that I have %oe, my step-dad. "nd I promise that I will not waste any years with him.
Dr. (eukrug: "nd I5 I sense and feel the loss that you feel from not having that year and
a half and I think that&s gonna be, um, an ongoing issue for you. *ut I hope that you can
continue to have conversations with your mom. <aybe though a chair, though
The heart of person-centered counseling rests on three critical personality characteristics
that )arl +ogers, the founder of this therapy and philosophy of living, believed werecritical? congruence, unconditional positive regard, and empathy.
$eople who are congruent are real, genuine, or transparent with others. Their feelings,thoughts, and behaviors are 0in sync.1 4owever, it is important to note that therapists
who are congruent do not necessarily e'press moment-to-moment feelings with clients as
sometimes such feelings can rapidly change and often deepen over time. 4owever, it isimportant for the therapist to e'press feelings toward his or her client, even negative
ones, if such feelings are persistent. >therwise the relationship would be marred by
falseness or incongruity.
Lnconditional positive regard is the ability to provide the client with a sense of
acceptance, regardless of what feelings or e'periences are e'pressed by the client. uch
acceptance allows the client to feel safe within the relationship and to delve deeper into
him- or herself. $erson-centered counselors believe that individuals are born with a needto be loved, and when significant others, such as parents, do not provide unconditional
positive regard, children end up living as they believe others would want them to be, asopposed to being who they really are.
The last 2uality, empathic understanding, has been one of the most widely used tools ofthe counseling relationship, regardless of theoretical orientation, and has been shown to
be a critical factor in positive therapeutic outcomes. Empathy can be demonstrated in
many ways, including accurately reflecting the client&s meaning and affect; using a
metaphor, analogy, or visual image; or simply nodding one&s head or gently touching theclient during the client&s deepest moments of pain. " therapist who shows empathy is
0with1 the client; 0hears1 the client; understands the client fully, and is able to
communicate such understanding to the client.
3et&s 7oin !r. Ed eukrug as he tries to embody the characteristics of congruence,
unconditional positive regard, and empathy with %ose, who is discussing some concernshe has about his mother and younger brother.
Dr. (eukrug: 4i %ose. Thanks for coming in today. I know you had some things you
wanted to talk about, so where would you like to start8
Jose: =ell actually, I&m very concerned about my brother back home in $uerto +ico.
Dr. (eukrug: >k.
Jose: I think that environment, which I grew up in, isn&t the best for him. o one of my plans is to actually go back to school for a $h.!., and move to #lorida; be able to bring
him with me, and also my mom. o I&m kind of concerned about5if he gets in any
Dr. (eukrug: o in a sense you feel more connected to people in #lorida even though
you&ve never lived there.
Jose: 9eah.
Dr. (eukrug: "nd it feels also more like an environment that feels more similar to where
you grew up.
Jose: )orrect. This time it was kind of5when I went back to $uerto +ico it was kind of
shocking, because for the first time I reali/ed that I won&t be back, it&s not really an
option at this time because of the financial situation back in $uerto +ico. o it was a hard
reality to accept.
Dr. (eukrug: >k. o it kind of hit you when you went back this last time that you
weren&t going to move back there.
Jose: )orrect.
Dr. (eukrug: "nd I guess up until that point in time you were thinking that that might be
something you would do.
Jose: )orrect. That is home, that&s home.
Dr. (eukrug: >k.
Jose: o reali/ing that going back home is not a real option is really challenging.
Dr. (eukrug: I would guess that taking that feeling of home out of your life must be hard.
Jose: )orrect. "nd the little that I have achieved to this point5I don&t think it&s complete
without the opportunity to help my mom, to get my mom out of there and my little brother.
Dr. (eukrug: o you&re not going to feel complete unless you move to #lorida and help
your mom and your brother, who&s been having some issues.
Jose: )orrect. 9eah, especially with things getting worse every time. "nd actually, today
is going to be the burial for a friend of mineDa very good friend of mine. =e grew uptogether, and once again it&s 7ust the environment around there, it&s so so bad. o bad that
they don&t really get to see out of it.
Dr. (eukrug: o you&re going to a funeral of a friend of yours.
Jose: I won&t be able to, but today is his funeral back in my home town.
Jose: 9eah. <y mom called me and she told me about this. o that reminds me of thereal sense of urgency to actually do what I want to do and get them out of there as soon as
I can.
Dr. (eukrug: o somehow the death of this friend of your is making it more present for
you, more urgent for you to do something to help your mom and your brother.
Jose: )orrect. 9es, it&s really5it worries me. "nd I talk to my mom every unday, and I
ask 0how&s my mother doing81 4e&s still running around. "nd I try to help him, I don&t
think anybody else will. 4e&s been living with my mom for several years and he&s 7ust
stuck. 4e&s 7ust living there, he&s not making any progress. o he&s kind of at the mercyof what is around him.
Dr. (eukrug: "nd you&re feeling like it&s a life or death situation for him.
Jose: It may come to that. It&s likely with his5last time5he&s younger than I am, and
when he stands ne't to me he looks older. 4e&s really making it worse.
Dr. (eukrug: o his lifestyle is really draining the life out of him, and again I hear your
love for them, and I hear your concern about them, and I hear the urgency again of youfeeling like you need to do something.
Jose: )orrect, yes. I have to do something. I&m older, and we grew up with a single
family home. o we owe everything to our mom. "nd she&s doing the best she can butshe still worries a lot about him. o he&s wearing her out, even at this stage.
Dr. (eukrug: "nd being the older you feel some responsibility for both taking care ofyour younger brother and taking care of your mom.
Jose: )orrect. "nd he&s a really hard worker. I know that if I&m able to get him out ofthere and moved here, he will adapt and he won&t have that choice of working ne't to a
bar5there&s a bar every ten feet, you know8 o5
Dr. (eukrug: I think one of the things I&m hearing also is the tug, maybe the internal tugof your feelings, between the things that you need to finish up here and also your need to
take care of them.
Jose: +ight.
Dr. (eukrug: "nd move to #lorida. "nd that must be a real struggle for you.
Jose: It is. I feel that in order for me to be able to be more effective in helping them I
must5it&s not something that I really want to do? go for the $h.!. *ut I think if I&m able
to accomplish that I would be more well-positioned to help them out. *ut that would
take me a few years. o that&s my concern, how to balance that.
Dr. (eukrug: "nd do both of those things.
Jose: )orrect.
Dr. (eukrug: o if you get the $h.!. you&re in a better position to help them, but on the
other hand if you get the $h.!. you&re waiting, and you don&t want to wait too long.
Jose: +ight, right.
Dr. (eukrug: =ell it sounds like5what I&m hearing is your concern for your family, your desire and wanting help your family and you want to do it in the best way possible. 9ou
have a lot of important choices to make for yourself, and they&re pretty difficult choices
because people&s lives are at stake.
Jose: +ight. )orrect, yes. *asically it&s weighing those decisions. I&m hoping that I&m
making the right ones. o yes, every day5that&s my decision? am I doing the right thing.
Dr. (eukrug: I guess, I&m sitting here thinking 0boy, I wish I could make those decisions
for you and tell you which one is the right one to make.1 *ut at the same time I&mthinking only you have that inner sense of what&s going to be right for you and your
family.
Jose: I really think I&m the one who should arrive to that decision. I think I&m in a position where I can5not 7ust balance the decisions but also know the details of the
situation. "nd I grew up there, so I know how it is there.
Dr. (eukrug: "t the same time, I hope that maybe I can be helpful to you in helping you
look at some of the feelings you have inside that will help direct you to the right decision
for you. o maybe that&s something we can do here and talk about.
Jose: >k. )ertainly, talking about how I feel about it, and having feedback or a sense of
direction; whether or not I&m going the right way, would be very helpful.
Dr. (eukrug: =ell thank you so much for sharing with me today.
!eveloped during the first half of the twentieth century, behavior therapy is based on
three types of paradigms? operant conditioning, classical conditioning, and modeling.>riginally viewed as a scientific, reductionistic, and mostly sterile approach to
counseling, today&s behavior therapist reali/es the importance of having a strong
therapeutic relationship. #or instance, it is now usual for the modern-day behaviorist touse empathy and develop a collaborative working relationship with the client. This allows
the therapist to build trust and correctly identify targeted behaviors the client would like
to change. "fter behaviors are identified, goals can be established and techni2ues chosen.Today&s behavior therapists usually have a wide-range of techni2ues to choose from, with
some of the more popular ones being?
&odeling , such as when clients observe behaviors, usually in the clinical setting, and later practice the behaviors in the office and on their own. "ssertiveness training has been
particularly used in this fashion.
3%erant conditioning techni1ues, such as positively reinforcing targeted behaviors ande'tinguishing unwanted behaviors (e.g., use of sticker charts for children
$ela+ation e+ercises, such as learning how to progressively rela' oneself in an effort to
reduce an'iety or other unwanted feelings.
Sstematic desensiti4ation, which is often used with an'iety disorders, is the deliberate
pairing of collaboratively chosen hierarchical aspects of the feared ob7ect with learned
rela'ation techni2ues, thus slowly reducing the fear response.
Flooding and im%losion techni1ues both involve the e'posure to intensive amounts of
fearful stimuli, with the assumption being that prolonged e'posure will e'tinguish the
fear response.
"nd,
Sel!"&anagement Techni1ues, which are used when one wants to help clients learn
various behavioral techni2ues and have them practice on their own.
In the following role-play, !r. u/an Thompson works with 0+ayneer,1 who is strugglingwith a panic disorder resulting from a recent car accident. !r. Thompson will assist Ivy in
applying rela'ation techni2ues to her an'iety about driving.
Dr. Thom%son: 4i +ayneer, welcome back.
$aneer: 4i u/an, how are you8
Dr. Thom%son: I&m doing okay. o, how has the practicing been going with the rela'ation
$aneer: =ell, it was kind of hard at first. I 7ust kept having my heart palpitations and the
sweating, and then I put little hearts up around the house and every time I saw a heart, it
helped me remember to do the breathing that you taught me.
Dr. Thom%son: =hat a great ideaK ort of that association
$aneer: =ell, I really need it, cause if I didn&t see something outside of me, I 7ust kept
getting involved in the feeling.
Dr. Thom%son: "nd so that reminded you to bring up that rela'ation that we talked about.
$aneer: <mhmm
Dr. Thom%son: >kay, so well one of the things that we&re going to do today is to talk
about the different components of what&s happened for you. "nd use the rela'ation along
with sort of a hierarchy of events or situations that you might face. "nd eventually what
we&ll do is have you practice the rela'ation along with each of the different pieces of it.!oes that make sense8
$aneer: It does. Lm, that will be good because it&s been really hard 7ust getting in the
passenger side of the car, and somebody else has had to drive me.
Dr. Thom%son: 9ea, I was wondering about that.
$aneer: "nd 7ust getting in the car, it makes me very nervous and I start to sweat and
tremble and feel a little shortness of breath and I&m real concerned that I won&t be able togo back to work cause I drive for everything and if I&m not driving then I can&t make do
for my family.
Dr. Thom%son: <mhm, so we really kinda have some short term immediate things that
you want to focus on, getting in the car even. "nd then maybe some longer term, that
would be getting you back to work, is that58
$aneer: 9es
Dr. Thom%son: >kay, um you said that you had some of the an'iety come up when youwere even getting into the passenger side coming here.
$aneer: 9es, I felt a little like I was choking and I 7ust had this loss of control that if Iwas in the car again, something else would happen. "nd when this accident happened, I
didn&t have any passengers. "nd I keep thinking if it happened again, and what if there
Dr. Thom%son: 9eah, it sounds like it was. =ell, if we have to kind of break things down,
because you&re telling me now of what&s going on now. "nd if we had to break things
down into smaller pieces, let&s look at what those pieces might be.
$aneer: >kay
Dr. Thom%son: "nd I&m going to write some things down so that we can kind of keep
things straight
$aneer: ure
Dr. Thom%son: o um one of the things that you&re having a hard time with is that even
getting into the passenger side. *ut maybe we could back up from there.
$aneer: >kay
Dr. Thom%son: o, what, as you think about even getting into a car, what happens to your an'iety8
$aneer: Lm, it goes up. It&s5I&d say 7ust thinking about getting in the car, it goes up to,
on a scale of one to ten, it goes to like a five. "nd maybe, a four, it&s like it gets to a five
when I get ready to get in the car. *ut I start the heart palpitations and I&m sweating and Istart to tremble a little bit and I 7ust have that fear that I&m going to lose control or
something&s going to happen.
Dr. Thom%son: 9eah, so even 7ust thinking about.
$aneer: <mhmm
Dr. Thom%son: I&m glad that you went ahead and put that scale to it. =e talked about that
last time as an application here. o thinking about getting into the car is about a four or
five.
$aneer: =ell, I think probably, it&s5.I 7ust get so5to me, it&s not 7ust thinking about,
it&s getting into the car. o I guess thinking about it is a three but actually getting into a
car is probably a five.
Dr. Thom%son: >kay, and is that getting into the passenger side or the drivers side8
$aneer: =ell, I&m getting into the passenger&s side, I&ve been too afraid to get into the
drivers side. o the passenger&s side is definitely a five and the driver&s side is higher.
Dr. Thom%son: >kay, so where would you rate getting into the drivers side8
Dr. Thom%son: >kay, and I&m wondering if there&s something in between there. etting
into the driver&s side, or what&s surrounding that8
$aneer: Lm, well you know, opening the door
Dr. Thom%son: >kay
$aneer: "nd once I got into the driver&s side and then usually I kinda put my hands on
the wheel, and then I&ll start the car after I check the mirrors and put on my seatbelt andstuff.
Dr. Thom%son: >kay, alright so you&re doing a great 7ob of starting to break things down.
That&s e'actly where we&re headed with this. Lm, okay so 7ust so I have it straight. It&sthinking about getting into the car even before you go anywhere, even before you leave
the house, is about a three so that brings up some of the an'iety.
$aneer: 9es
Dr. Thom%son: "nd then getting into the passengers side is a little higher, opening thedoor to the driver&s side is a little bit higher than that, but not as high as say, getting into
the driver&s side.
$aneer: +ight
Dr. Thom%son: >kay, and then putting your hands on the wheel, kind of brings it up a
little bit more. "nd then starting the car um, is a little bit more too.
$aneer: 9es, it feels like it would be. I haven&t tried it yet because I&ve been too an'ious
about it.
Dr. Thom%son: "nd that makes sense. >kay, so starting the car and then if we take it one
step further, what would be another step from there8
$aneer: Lm, I guess, um, maybe driving the car, like a short distance, or maybe in the
driveway or something.
Dr. Thom%son: 9eah, a really short distance, so in the driveway. Lm, and then what
would be a ne't step from there that we could aim for8
$aneer: I guess going around the block.
Dr. Thom%son: >kay, and if you had to think5even thinking about that right now.
$aneer: I start sweating all over again 7ust thinking about driving, going around the
block because I know there will be other cars out there, and that really is scary for me.
Dr. Thom%son: "nd I see that in your face, okay. o then, we have sort of a hierarchy ofdifferent pieces of getting back to driving that we can then apply the rela'ation
techni2ues. >kay8 o let&s 7ust do one right now, 7ust for practice and see how that goes,
alright8 That first one that you have on the list is 7ust thinking about getting into avehicle.
$aneer: >kay
Dr. Thom%son: o right now as you&re thinking about getting into the vehicle. I see that
you&re kind of shaking. +emember the rela'ation, talk me through the rela'ation that
you&re aware of.
$aneer: Taking a breath, and holding it for the count of five and breathing out again.
Dr. Thom%son: o, you&re gonna do that, good, 7ust independently, 7ust be in that rela'ed place5great. "nd now as you&re in that rela'ed place, think about, 7ust think about
leaving your house and getting into a vehicle, the passenger&s side. "nd go back to thatrela'ed, take a deep breath, and go back to that rela'ed place.
$aneer: (breathing
Dr. Thom%son: and how is that8
$aneer: =ell, you know thinking about getting in the car is kind of scary but I know Ican put a heart in the car so I know to breathe when I see them, cause I have them in the
house.
Dr. Thom%son: >kay, great idea. o yeah, even right now as you think about getting into
the car, where would that heart be8
$aneer: I would, right now need to put it on the door.
Dr. Thom%son: +ight on the door.
$aneer: >r on the window.
Dr. Thom%son: I almost thought of putting it, slap a big huge heart on the car, but it&syour image so5
$aneer: =ell I&d feel better with a little one57ust a little one.
Dr. Thom%son: >kay, so let&s go back to the deep breath, get to a rela'ed place5and as
you&re in that rela'ed place, think about 7ust going out to your car, that heart is right on
your car right where you put it. o, keep rela'ing, that&s it.
$aneer: I feel more like I have to do it than I&m rela'ed about it.
Dr. Thom%son: =hat do you mean8
$aneer: =ell, if I can&t drive again then I won&t be able to work again.
Dr. Thom%son: =e&re 7ust gonna take it a little bit at a time. o right now, 7ust it&s that one
piece, thinking about going out there. The rest of it will fade away for right now.
$aneer: eat trick5>kay, that does feel a little better.
Dr. Thom%son: >kay, before when we first started talking about that, you rated it as a
three, where is it right now8
$aneer: It&s probably a :.C
Dr. Thom%son: o, we brought it down a little bit. =hat I&m going to ask you to do thenis to keep practicing because the more you practice it, 7ust like you did at home, the more
you practice with the rela'ation and the heart you were able to get to that place. It&s thesame thing with each one of these so we&re going to take it a little bit at a time and we&ll
+E*T is an action- and results-oriented psychotherapy which teaches clients how to
identify self-defeating thoughts, beliefs and actions and replace them with more effective,life-enhancing ones. >ne of the first of the modern cognitive behavior therapies, +E*T
was developed in JCC by "lbert Ellis, $h.!.
Lsing a techni2ue called 0uncovering the "*)s of personality formation,1 +E*T
therapists state that it is not the (" 'ctivating event that causes emotional Conse1uences
(), but (* the )elie! (* about the event. #or instance, faced with the loss of arelationship, one client&s belief system might lead to suicidal depression, while another
client&s belief system might leave him or her feeling fine about the breakup.
>ne role of the +E*T therapist is to create (! a Dis%uting intervention (! for (* the*elief that is irrational. This will (E Effect a new, and better, (# #eeling. +E*T
practitioners teach their clients to ( analy/e episodes of emotional and behavioral
disturbance with the "*) model; (: discriminate between irrational and rational beliefs;
(A distinguish healthy negative emotions from unhealthy emotions and (B utili/e avariety of means for modifying the irrational beliefs that support their emotional and
behavior problems.
In working with clients, the +E*T therapist uses a number of cognitive, behavioral, and
emotive techni2ues, including.
. "ctively disputing irrational beliefs throughout the day.
:. *ibliotherapy.
A. +ole-$laying new ways of livingB. $racticing what might be for the client new, unconventional ways of living in the
world (e.g., an introvert acting e'troverted at a party
C. Imagery e'ercises, where the client imagines how he or she would like to be.F. $racticing new behaviors through traditional behavioral techni2ues (e.g.,
conditioning, modeling, assertiveness training
In the following role-play, watch how !r. Morrie "llen uses the "*) of +ational Emotive
*ehavior Therapy to assist +ebekah with her feelings about a recent break-up with her
girlfriend.
Dr. 'llen: ood morning +ebecca, what brings you here8
$ebekah: Lm, I&m 7ust feeling depressed and upset, and 7ust a little worthless.
Dr. 'llen: is there anything that&s going on that&s different in your life right now8
$ebekah: Lm, my girlfriend and I are having some problems. Lm, she&s been talking about
breaking up and um, actually I think that she&s gonna break up with me.
Dr. 'llen: so that must be really difficult to think about. Lm, what are some of the thoughts that
are going through your head when you think of the possibility of you guys breaking up8
$ebekah: "ll kinds of things like, I need a girlfriend, I really miss here. I mean, 7ust even now
we&re having a lot of problems and ya know, I 7ust miss things being the way it used to be. I want
to have a family one day, we&ve 7ust made all kinds of plans and it&s not going to happen.
Dr. 'llen: "nd what if you were to break up8
$ebekah: =ell, I mean I guess I think about the fact that I mean, we&ve been together for A years.
I&m :C, I&ve already invested A years into this relationship. Lm, we talked about the future and
having kids. I need a girlfriend, I need a girlfriend to have all those things that I planned on
having, that we had planned on having.
Dr. 'llen: I hear you saying that you need a girlfriend in order to have certain things in your life
in place. =hen I think of a need, I think of things that you absolutely must have. #or e'ample, if
you didn&t have food, what would happen8
$ebekah: I would die
Dr. 'llen: "nd what if you didn&t have water8
$ebekah: I would eventually die.
Dr. 'llen: "nd even along a little bit of a different line, have you ever been5.I know you&re in
graduate school, I&m sure you have lots of tests. 4ave you ever been studying, go to get in yourcar and your car doesn&t start8
$ebekah: 9ea
Dr. 'llen: "nd how did you feel at that point8
$ebekah: Lm, really mad. %ust really upset.
Dr. 'llen: !o you recall what was going through your mind at that time8
$ebekah: %ust that I was really upset. Lm, I needed my car to start so I could get to school.
Dr. 'llen: <mhmm, and were you able to problem solve and come up with a solution that you&rethinking 0I need my car to start1, 0I have to have it to start81
$ebekah: yea, well I guess I would 7ust be so upset that my car wasn&t starting that I probably
wouldn&t be able to think about anything else.
Dr. 'llen: <mhmm, do you think it was the fact that your car wasn&t starting that caused you to
feel upset8
$ebekah: 9es
Dr. 'llen: >k, well in +E*T, what we have are called the "*)&s. "nd " is the activating event,which in that situation would be the car not starting, and the * is the belief and ) is the
conse2uence. "nd do you think that it was the fact that the car didn&t start8 >r what you were
telling yourself about the car not starting8 That was causing you to feel upset
$ebekah: Lm, I guess it would be what I was telling myself.
Dr. 'llen: "nd that was8
$ebekah: that I needed to have the car to start to get to school.
Dr. 'llen: <mhm, and in that situation what do you think you might have been able to say that
would have caused you to feel a little less upset, and would have enabled you to problem solve
and come up with an alternative solution 2uicker8
$ebekah: I guess if I wasn&t so focused on you know, my piece of crap car, I could think about
0>k my car won&t start, now what am I going to do81 I guess I need to call a friend, or 7ust
figured out another way to get to school.
Dr. 'llen: +ight, you&d really like it to start but you&re okay. 9ou didn&t die because it didn&t start
$ebekah: +ight
Dr. 'llen: "nd you&re able to get through the problem okay, right8 o in that situation, you cansee that it&s actually the belief that&s causing you to feel upset, not the fact that the car didn&t
start, the activating event. !oes that make sense8
$ebekah: 9ea, I see what you&re saying5yeah
Dr. 'llen: "nd this, to me sounds a little similar to some of the things that are going through your
head about your girlfriend. If you&re saying to yourself 0I need to have a girlfriend, I must have agirlfriend in order to be happy. I&m :C, I need to have a family, that&s what everybody&s doing
that&s my age1, how are you feeling at that point8
$ebekah: !epressed, I mean that&s how I&m feeling now.
Dr. 'llen: +ight, and so how do you think you would feel if you were to say something along the
lines of? 0I&d prefer to have a girlfriend, I&d like to have a girlfriend, but if I don&t its okay.1 4ow
do you think you would feel at that point8
+ebkah? I would still be upset, but I guess it would change my focus.
Dr. 'llen: !o you think you would be as an'ious around your girlfriend8
$ebekah: $robably not.
Dr. 'llen: +ight, and so if you had to e'plain to me the difference between a want and a need,
what would you, how would you describe that8
$ebekah: Lm, I guess like you said you know, if you&re talking about food and water, I mean it is
something that you have to have or you&re gonna die. "nd a want is something that you would
like to have, would be nice if you had.
Dr. 'llen: "nd even if we go back to the car e'ample, if you said to yourself? 0I&d really like to
have a car, I want to have a car, it&s important to be on time1. 4ow do you think you would feelat that point8
$ebekah: Lpset, but I would still5I would feel better about making other arrangements, and not being so focused on being angry.
Dr. 'llen: +ight, so what this models shows is when anybody, it doesn&t matter if you&re black,
white, rich, poor, male or female; whenever you turn a preference or a desire or a want into anabsolute must, you&re going to feel miserable. !o you see how that applies to you8
$ebekah: 9eah, I guess I never really thought about it that way.
Dr. 'llen: <mhm, and today we&ve talked really only about one need that you brought up. The
need to really have a relationship and be with your girlfriend, but can you give me a differentway to think about that that might help you feel a little less depressed8
$ebekah: =ell, I guess I&m gonna still be upset but if we do break up and I don&t have her, I&m
not gonna die. Even though it may feel that way, I&m not going to. I guess it&s a want, I wouldlike to have, I would like for us to stay together, I would like to have her as a girlfriend.
Dr. 'llen: 9eah, and when you&re with her and you&re thinking I would like to be with her, Ien7oy being with her, how do you feel8
$ebekah: ood.
Dr. 'llen: ood, but when you&re with her and you&re thinking 0I really hope she doesn&t break
up with me, I really need this relationship, its important that we stay together.1 4ow do you feel
$ebekah: *ad, I mean, depressed I guess. " lot of pressure.
Dr. 'llen: 9eah, and how do you act around her8
$ebekah: trange (laughing
Dr. 'llen: 9eah, then she&s kinda going 0okay1. 9eah. Lm, so in like I&m sure you&ve
e'perienced many hassles and when you have, for e'ample a test, a lot of times you don&t wantto study for the test but you do. o when you take things like your wants and your desires to have
a girlfriend and turn that into an absolute must, a need, it makes you feel depressed, it leads to a
dysfunctional emotion. 4owever, when you change that to more 0I would like to be with my
girlfriend, it&s important that we&re together and I en7oy spending time with her1 you feel better,and you act differently around her. o one of the things that I really hope you&re able to see now
is that it&s that belief about having the girlfriend that&s causing you to feel depressed than the
activating event, the thought of her breaking up with you. !oes that make sense8
$ebekah: 9eah. I&ve 7ust never thought about things in that way before.
Dr. 'llen: +ight, well that&s great. I&m glad that you&re starting to make that connection cause
that&s really the fundamental idea behind +E*T, that it&s the belief that&s causing us to feel
unhappy. o what I&d like you to do over this week is a little bit of homework. In +E*T wealways give homework. I want you to practice the process we&ve gone over. I&d like you to 7ust
7ot down whenever you feel panicked or an'ious or depressed during the week. "nd then once
you put that down, think about what was the activating event, what was the event that kind of
started that8 "nd then what was the belief that you have that caused you to feel an'ious,depressed, or self-hatred. !oes that make sense8
$ebekah: 9eah.
Dr. 'llen: )an you give me an e'ample from what we&ve talked about today.
$ebekah: =hen I&m studying for a test and I get really really an'ious and I 7ust start thinking
about, 0I have to make an ", I have to study, I can&t be in graduate school, I can&t do bad.1
Dr. 'llen: "nd so in that situation, the " is5the activating event would be5
$ebekah: tudying, I have to study
Dr. 'llen: +ight, and the belief is, the irrational thought is 0I have to do well1
$ebekah: I have to make an "
Dr. 'llen: +ight, and that would cause you to feel an'ious. >kay, so what could you maybe think
a little differently that would cause you to feel less an'ious8 *ecause some an'iety is gonna be
there, but what could cause you to feel a little less an'ious8
$ebekah: That I studied and, you know, 7ust to calm myself down 0>kay, I studied for the test,
I&mgonna do well, I know the material, if I don&t make an " I&m not gonna get kicked out of the
school.1
Dr. 'llen: That&s great, and so what I want you to do this week is focus on those situations when
they come up and really write down, what was the ", what&s the activating event, the belief,
focus on that belief. "nd whether it&s rational or irrational, I want you to really focus on eitherone. "nd try to catch those irrational ones so you can start to really work on those and then
whatever emotions they made lead to. o do you think you would be able to do that over the ne't
week8 %ot down those situations8
$ebekah: 9eah
Dr. 'llen: "nd then we can go over them ne't week and really start to identify some of the
irrational beliefs that may be causing you to feel depressed and an'ious.
$ebekah: >kay.
Dr. 'llen: !o you feel good about that8
$ebekah: 9eah.
Dr. 'llen: >kay, well then I look forward to seeing you ne't week.
)ognitive therapists believe in changing clients& inaccurate perceptions of themselves and
their environments by uncovering faulty beliefs that are causing personal andinterpersonal problems. )oming from the behavioral tradition, cognitive therapists
believe thoughts can be considered behaviors which can be modified. uch modification
occurs through the 0disputation1 of thoughts and by e'perimenting with new behaviors.
<any cognitive therapists believe that problems in living are caused by cognitive
schemas or 0floor plans1 that influence how people make sense of the world. >nce thesecognitive schemas have been identified, the therapist helps the client uncover the
moment-to-moment automatic thoughts that fuel the continuation of the schema. The
counselor then helps the client discover the cognitive errors in those automatic thoughts.
E'amples of 7ust a few of these include? all or nothing thinking, such as believing that lifeis either great or horrible; overgenerali/ation, such as believing that one must be fearful
of flying because planes have crashed; and personali/ation, or seeing oneself as the cause
of negative events such as believing that one was the reason for his or her parents&
divorce.
Today, most cognitive therapists believe in establishing a therapeutic alliance throughcareful listening and by collaborating with the client as they help him or her understand
the cognitive therapy process. )ognitive therapists use 2uestions to probe the client&s way
of thinking. Eventually, therapists help the client ac2uire more adaptive thoughts andassist the client in devising a plan that includes practicing new behaviors that will
reinforce new thoughts. )ognitive therapists believe clients can make dramatic changes
in how they think and act; however, they tend to focus on coping, not curing the client.
)hanging embedded ways of thinking and behaving does not occur easily.
3et&s see how !r. arrett <c"uliffe helps Maren identify cognitive distortions as she
works on issues related to how fear of loss has led her to avoid commitments in her life.
Dr. &c'uli!!e: Maren, hi again.
5aren: 4i
Dr. &c'uli!!e: =e met once before and we talked about your fear of loss, and how itconnects to your fear of commitment at this time in your life. I asked you to monitor
some thoughts you might have had around specific incidents in your relationship and
write down those thoughts when you felt a sense of dread about the current relationshipwith %ohn, your partner. =hat have you noticed this week8
5aren: Lm, I did try to think about my thoughts and one e'ample I was remembering as Iwas driving over here was when %ohn made reference to the fact that I don&t clean out the
refrigerator, that I don&t you know, worry about that as something that I need to do. "nd
um, I remember thinking, um the feelings that came up were like 0ee, I&m not good at
everything. I don&t do the refrigerator, you know, things like that he&s not gonna like, it&s
gonna negatively affect the relationship.1 "nd I mean it 7ust led from one thing to another
um, and that feeling came back you know that the relationship will somehow end. It 7ust
kinda all builds together.
Dr. &c'uli!!e: 4ow likely is that to be true8
M? =ell, based on 7ust the refrigerator incident, probably not very likely. Lm, and I know
that, but somehow those little things 7ust build up and you know that fear feeling comes
up when they happen.
Dr. &c'uli!!e: o you generali/e from before.
5aren: 9es, yes.
Dr. &c'uli!!e: 9ou&ve lost a father when you were very young, and a little brother when
you were 2uite young, and you talked last week about a stepfather when you were an
adolescent and then your older brother in your life. "nd so those are genuine losses thathave happened to you. *ut what&s different about this relationship8
5aren: That&s where I get confused because I know that this relationship is different. *ut
the feelings of loss that come up, 7ust remind me that I don&t want to have to e'perience
that again. o I know it&s different, um, but I don&t want to e'perience loss again.
Dr. &c'uli!!e: 9ou&re afraid of feeling that pain again. 9ou&re saying to yourself on some
deep level, 0Everytime I get close, I&ll e'perience loss. Every time there&s a problem
things will end.1 Is it true that every time there&s a problem you will e'perience loss8
5aren: =ell, not every time. I mean, you know he could die, but not every time, no.
Dr. &c'uli!!e: +ight, relationships do end, but not every time that there&s a minor
problem. 9ou are generali/ing and that&s one word that you can use, overgenerali/ing
from the past and another word that maybe you can remember is catastrophi/ing fromthose situations as if they&re the same as the current one. !o you see how you&re doing
this8
5aren: 9es, yes. Lm, cause every time there&s that little problem I get that pain so, yeah.
Dr. &c'uli!!e: o that pain&s a cue for you and then you start worrying. The pain comes
from deeply embedded, now maladaptive thoughts, that really maybe were effective atthe time but aren&t anymore. There&s a word for that called a cognitive schema, or a
cognitive floorplan. That you&re operating from as if it&s true now what was true then.
9ou&re saying to yourself, 0If there&s any problem then a relationship is going to end.1
Dr. &c'uli!!e: It&s so embedded that you don&t catch the thoughts in the present, as if
they&re different now, but you still can come back to them.
5aren: =ow
Dr. &c'uli!!e: =ith new more adaptive thoughts, not maladaptive thoughts, but notgenerali/ing like you&re doing or catastrophi/ing. =hat type of thoughts do you think that
you can have now8
5aren: =ell, um, I guess when that feeling comes up I know that I can say, you know that
this relationship is different and that we can talk about things. "nd I know that %ohn&s not
gonna leave me, I feel very confident about that. 3ike I said, other than if he dies. Lm,
and he&s willing to work with me so I know I can5I have to 7ust say those things.
Dr. &c'uli!!e: ood, then let&s work on what I&ll call a homework assignment. Is that
okay with you8
5aren: 9es, I will work on it
Dr. &c'uli!!e: =hat situation with %ohn might bring up these thoughts8
5aren: Lm, it will probably be some complaint about the dog.
Dr. &c'uli!!e: <mhm, and what will you say to him8 To yourself.
5aren: I will try to remember and say, you know, 0=e can talk about this. 4e&s not going
to leave, and 7ust because we have a disagreement over the dog doesn&t mean that it&s
going to lead to a loss.1
Dr. &c'uli!!e: reatK 9ou&re reminding yourself not to catastrophi/e; that this
relationship is different from all of those other e'periences in the past. "nd one thing Ithink it&s important to remember is how long did it take to develop this fear of loss, this
floorplan.
5aren: =ell, my dad died when I was three so, my whole lifetime.
Dr. &c'uli!!e: o it&s gonna take some hard work to combat these embedded, we&ll call
them, thoughts, your cognitive floorplan. It&s gonna have to slowly change.
5aren: +ight, I see. I&m really gonna have to work on this.
Dr. &c'uli!!e: I have a suggestion. I&d like you to write down every incident that brings
up those thoughts and then how you&ve combated each incident with the new thoughts
that we&ve talked about today. Is that something you think you can do8
+eality therapy postulates that there are five inborn needs? love and belonging, power,
freedom, fun, and survival, and proposes that every behavior we e'hibit is an attempt to
have these needs met. 4owever, +eality theory also suggests that we sometimes developdysfunctional behaviors to meet our needs and those behaviors become the basis for how
we perceive reality. +eality therapy states that we continue to e'hibit these behaviors in
order to obtain what clients would consider to be their 02uality1 world. Throughout thecounseling process, reality therapists believe that clients can be shown how they create
their reality through the behaviors they choose; thus the term choice theor. #or instance,
a )E> who has spent much of his or her life striving for power at work may becomedepressed because he or she has developed a repertoire of behaviors to meet the need for
power but has neglected his or her need for love and belonging.
+eality therapists often use the =!E$ model to describe the counseling process. 0=1represents asking the client what he or she 0=ants1 in an effort to create a 2uality world
or success identity. ! stands for 0!oing1 and is the point where the counselor asks the
client what choices and behaviors he or she is currently making to obtain a 2uality world.
E stands for helping clients Evaluate what they have been doing to meet their needs andto identify new behaviors that would more effective in obtaining a 2uality life or success
identity. $ stands for developing a $lan for change. The therapeutic process involvescreating a trusting environment, working collaboratively with the client as e2ual partners,
and being committed to the client as they e'plore the change process.
In the following role-play we will see !r. ylinda ilchrist work with 0<ercer,1 a CC-
year old male who has been struggling with $ost Traumatic tress yndrome. 3et&s see
how !r. ilchrist uses the strategies 7ust described.
!r. ilchrist? 4i Todd. =hat brings you here today8
Todd? =ell I&ve been feeling pretty stressed lately, maybe a little down. I 7ust noticed I&m pretty much not the same as I used to be. %ust, um feel a little overwhelmed at times, I&m
not really motivated and that&s pretty much it. I retired probably about two years ago and
I 7ust don&t have the same kind of go that I did before.
!r. ilchrist? o you&re feeling kind of down because you retired8
Todd? Lm, I don&t think its so much because I retired, I don&t know, I think I 7ust don&tfeel motivated, you know it might be because I&m not as focused as I was in the military.
I always had something to do, I knew where I stood, you know I had responsibility,
people depended on me and those things have changed, that might have something to dowith it. I don&t know.
!r. ilchrist? >kay, so you&re feeling a little down because you retired recently from themilitary and you had more responsibilities and your life has kind of transitioned or
Todd? 9eah, that&s pretty much it. I mean, it might also be because I&m real focused on
being a single parent right now, and school and you know, I noticed that if I&m not doing
that then I&m really not doing anything else. 3ike when I was in the military I had friends,I had a big support group and you know, I always had something going on, and it&s 7ust
not that way anymore.
!r. ilchrist? o it sounds like since you&ve retired you lost a lot of your friends and that
support system that you had, while you were in the military it&s now gone.
Todd? 9es ma&am, I think that would have a lot to do with it. I&m pretty much a cave
dweller now, I don&t much get out or anything like that so uh, you know I don&t have5
you know I had a good support group when I was in the military because I was always
working but since I got out they&re all transient so you know I really don&t talk to or seeanybody that I used to work with. o it&s 7ust pretty much me and my eleven year old.
!r. ilchrist? >kay, so what would make you happy or feel connected again8
Todd? I don&t know, I guess um, getting out and getting involved with other people,
talking to them maybe. 9ou know I 7ust, I 7ust really don&t know how to do that. I&m notsure how to go out. I know when my son was playing soccer I didn&t feel as sad as I do
now. "nd I guess because I was talking to the adults on the sidelines while he was out
there playing, and I had a pretty good group of friends then. 4e hasn&t played the lastseason, and we sort of drifted apart you know with me doing school and stuff like that.
!r. ilchrist? o it sounds like you felt better when you were involved in activities
around adults or activities that involved your son that allowed you to communicate withother adults.
Todd? 9eah, I mean that was a benefit of going to those soccer games, I mean it doesn&treally have to be with my son. I mean that was always great, but I mean, you know 7ust
the adult interaction would be, you know, probably better than nothing. 9eah, I&m not
really talking to anybody.
!r. ilchrist? o it sounds like what you would like to have is more interactions with
adults and develop more support mechanisms or support from other adults that you had
when you were in the military.
Todd? 9eah, that sounds like that would benefit me. I think this all started occurring to me
when I threw out my back and I reali/ed that I don&t have the option to be off, or to havea sick day, you know I&m a full time parent now you know I have to go to school I can&t
miss classes or e'ams. "nd you know it occurred to me, I don&t have anybody to call, to
step in.
!r. ilchrist? >kay, so what would you want8 =hat would make you happy8 =hat would
Todd? $robably 7ust some kind of camaraderie but I&m real apprehensive about being
obligated. I don&t want to be in a position5I think that&s what holds me back. I don&t
want to be in a position that I have to do anything. I want to be able to you know, cancelout if I&m going to meet people on Thursday night if something comes up because I end
up feeling really guilty if I don&t meet my obligations and I 7ust don&t want to be pulled
into anything. 9ou know, in the military I had to do what everybody else said. I guessmaybe I&m shying away from that. I guess I want the best of both worlds you know, be in
a group but not be stuck with it all the time.
!r. ilchrist? o you want some interaction or interaction with adults but you don&t want
the re2uired obligation.
Todd? +ight, cause for a time there I was getting involved with the church and they werecalling like twice a week, and it would stress me out cause I felt obligated and I 7ust don&t
want to take any time away from school or my son and that is most important.
!r. ilchrist? >kay, so we&re going to look for maybe activities or maybe something thatwill allow you to interact with other adults and increase your social circle but no time
restraint, no time obligation.
Todd? 9eah, that would be the ultimate cause like I said, I end up 7ust severing ties if it
becomes too overwhelming and I don&t want to have that stress again. o I&d like to havesome kind of adult interaction where I don&t feel re2uired to attend.
!r. ilchrist? o what are you doing to get that adult interaction8
Todd? =ell I&m busy in school right now, and you know my son has a lot of school
pro7ects.
!r. ilchrist? <mhmm, outside of school8
Todd? =ell, I guess if I&m outside of school I&m pretty much focused on my son anddoing stuff with him right now.
!r. ilchrist? 9ou kind of mentioned before that you were a 0cave dweller1. =hat does
that mean8
Todd? I guess I, you know I really don&t go out unless I have to go somewhere. 9ou know
to the store or to school or anything like that, and I guess I&m either inside unless I go tothe gym or something I don&t really go out.
!r. ilchrist? o you&re kind of choosing to stay in your cave.
Todd? =ell it&s not a choice. I don&t have anything else to do, I&m not making that choice,
!r. ilchrist? >kay, but staying in the cave is that giving you what you want with
increasing your friends8
Todd? o, I guess not. I guess I&m really not creating opportunities to meet people.
!r. ilchrist? o we really have to possibly look at other ways to develop more of asupport circle for you.
Todd? 9eah, that would be good as long as, like I said, you know I guess I&m paranoidabout getting pulled into something and being stuck. I 7ust don&t5.I have to go to school
three nights a week, I 7ust don&t wanna have the other four nights of the week5
!r. ilchrist? >bligated to something.
Todd? 9eah
!r. ilchrist? >kay so what are some ways you think you could go and meet people, orsome activities you can try, some groups, military groups, single parent activities, church
groups. "re there some activities out there or places you can investigate8
Todd? I guess I could probably do a web search for local kinds of things. I know you
could probably 7ust type in 0Virginia *each activities1 or something. 9eah, I could probably find all kinds of stuff, I could look into that.
!r. ilchrist? >kay
Todd? I mean, even, there might even be some single parent type groups or something
like that, I don&t know, I never thought of that before.
!r. ilchrist? >kay, so you can go on the internet and search for some activities in this
area. =ould it have to be an activity involving your son8
Todd? o, no. I mean we do things together but you know with adults, it doesn&t have to
involve him.
!r. ilchrist? >kay, so one plan of something we can do, we can actually go on and youcan search the internet and look for activities or clubs that you may be interested in that
would help you increase your social circle, introduce you to other people. "re there other
things that you could possibly do8
Todd? =ell, there is this recreation center that my son and I used to go to in the summer
and I remember there&s all kinds of flyers and pamphlets and all kinds of stuff there withactivities. 9eah, I never thought of that before, I&ve seen them, you know they&re
everywhere. "nd there&s a lot of interesting activities that I didn&t consider before. There
arrative therapy is an insight oriented therapy that seeks to understand how the client
comes to make sense of his or her world. This process occurs through the therapist&sattempts to gain clarity about the client through the stories the client tells about his or her
life. In understanding the client&s life stories, the therapist is open-minded, shows a
respectful curiosity, and may ask many 2uestions. Lltimately, the therapist wille'ternali/e the client&s problem by giving it a name, thus helping the client view the
0problem as the problem1 as opposed to the client being the problem. Then the breadth,
depth, and scope of the e'ternali/ed problem are e'plored. The goal of therapy is todeconstruct the problem story and reconstruct a new, healthy story through reframing the
problem, finding e'ceptions to the problem, helping the client see multiple alternative
stories, empowering the client, and building on successes.
In the role-play you are about to see !r. <illiken is meeting with 0hane,1 a B-year-old
male who is struggling with depression. !uring the first session the therapist used
empathy and open-ended 2uestions to e'plore the depth, breadth, and scope of the
problem story. In the session you are about to see, the problem story will bedeconstructed and a healthy reconstructed story will begin to be developed. >ther parallel
stories will begin to be e'plored. "lso, please notice that in this role-play, !r. Tammi<illiken will be called 0Tammi,1 as the power dynamics are de-emphasi/ed in narrative
therapy.
Tammi: 4i hane welcome back. lad you were able to make it in today. I thought we&d
start out today 7ust kind of summari/ing where we ended up last week after our first
session and you had mentioned feeling down, feeling like there was a cloud hanging over
you, um feeling, 7ust a sense of darkness and that that darkness contributed to you lackingconfidence, not feeling as thought you are connecting as well with people as you would
like. "nd um, it seems like the term 0darkness1 really captures the essence of what
you&re e'periencing. 4ow do you feel about calling what you&re e'periencing0darkness81
Shane: It&s a pretty good assessment. I guess that a pretty good, uh word to use, uh yeahdefinitely.
Tammi: "lright, well, um let&s take a little bit of a different angle with that though, I&m
interested to hear about a time in your life when you didn&t feel like darkness had 2uitethe hold on you that it does today.
Shane: Lm5guess if I had to think back, it might be right around high school I guess. Ifelt more on my 0game1 in high school it seemed like nothing could get me down, I was
pretty successful in that time of my life, so imagine that would be the best time I could
think of.
Tammi: >kay5 what e'actly was it about high school that kept darkness away8 4ow did
Shane: Lm, well I mean, I ran, I was an athlete in high school; I ran track and um, had a
lot of success there. Lm, I um, was good in academics; I mean out of si' hundred-some-
odd people I graduated twenty-fifth5
Tammi: =owK
Shane: 5in my class so that was pretty good. Lm 5 I guess that would pretty much
uh5
Tammi: >kay so really working out gave you a sense of accomplishment and certainly
being so talented academically helped you to feel a great deal of success and those two
things were your tools, essentially, to battle darkness and to fight darkness away.
Shane: 9eah, um5 I guess back then I didn&t feel as cloudy, it was easier to talk to
people, I was uh5 as if no noise was in my head and uh, there clouding up my
thoughts5 things came to me a lot easier than they do now.
Tammi: >kay, okay and so when darkness wasn&t present, it seemed as though you were
able to have more clarity to be able to, uh feel more present, you were able to lift that veiland to e'perience life in a more positive, lighter way, in many ways.
Shane: 9eah, it&s not like it&s there all the time, like um, there is some days where it&s notthere, the darkness is not there it&s a little more lighter. *ut, I would say more often than
not it is there5 definitely.
Tammi: >kay so when it is present, then it&s difficult to focus you have a difficult timeconnecting, but when it&s not you&re able really to focus in and be present, um your game
is on, I think you even mentioned that earlier. o even today you are saying though that
the darkness isn&t present constantly, that you do have the strength to push it away. =hatwould life be like if darkness took a permanent vacation8
Shane: >h I&d be greatK That would be fantastic. It&d be a lot more light in my life asopposed to that darkness.
Tammi: <m-hmm (affirmative
Shane: Things would be a lot easier to get accomplished.
Tammi: >kay5 so in the past, working out and feeling successful were the two of theways that you really fought off darkness and that even today you still do have the strength
to battle it at times. =hat could you do now to help you fight off darkness even more so8
Shane: =ell, I&ve heard5 well I&ve assumed medication would be something I could try.
Lm... maybe working out, I could try that since it was big a part of my life, you know, all
through my life, it&s not now. o I&m thinking of some differences between then and now,
so5 I guess those two things5 probably the best things.
Tammi: 4ow do you see medication and working out actually fighting off that darkness8
Shane: =ell, I guess medication, from what I&ve heard, it kinds brings you at different
levels, so a normal person is here (raised hand then when you medicate, you&re normally
down here (lowered hand and it kinda brings you up to here (meets lowered hand withraised hand sometimes I mean, that&s what I&ve heard. o I guess that would help me
out, um, to maybe work on some things and I guess working out from a physiological
point, I guess it 7ust pump more o'ygen to your brain and kind up wake you up a little bitthere.
Tammi: >kay5 so what I&ve been hearing you say is that you&ve been really dominated
by darkness for a while. !arkness keeping you from fully participating and en7oying lifeand now I&m hearing you taking a new direction and essentially looking at ways that you
can control darkness. 3ooking at potentially using medicine as a way to fight off
darkness, using working out as a way to give you strength and to bring light into your
life.
Shane: 9eah5 yeah no doubt.
Tammi: >kay, well, I would like to definitely see if we could potentially make up a plan
for perhaps giving you some referrals to individuals who could help you to e'plore the possibility of using medicine. I&d also like for us, in our time together, to come up with a
real concrete workout plan so that you can start using that as a tool to fight off darkness.
=here do you think that these changes might lead to8
Shane: =ell, I mean, I guess to steal what you&re talking about, to bring more light in my
life and kinda push that darkness away, maybe lift a veil, fog, I&ve been walking around
with. "nd maybe 7ust be able to en7oy my life a little bit more than I have been.
Tammi: =owK That would be real impressive to be able to do that. =ell then, it sounds
like we should definitely come up with that plan, but before we do that, I also heardanother perspective that you were mentioning, that when you were in high school, you
felt a real strong sense of accomplishment, that a lot of the activities that you were
engaging in resulted in rewards and recognition and you know, as adults we don&t get a
lot of recognition in life. 9ou know, we work really hard and there 7ust aren&t very often, people giving us rewards or pats on the back and that seemed to be a tool for you to fight
off that darkness. I&m wondering if this might be another, kind of story, that we could
take a look at and even think about ways in which you might be able to find reward inyour life today.
Shane: 9eah, that&s pretty interesting, I mean, you don&t get rewards for doing stuff in lifedo ya8 I mean like, it&s not like people hand you good grades for doing certain things and
you&re not gettin& trophies for things you do in life. I guess you gotta find it within so,
yeah, that&s interesting, I never thought about that.
olution-focused therapy focuses on the present and the future in an attempt to find new
and more effective ways of being in the world. In contrast to most treatment modalities,solution-focused therapy states that understanding the client&s problem is not necessary.
In fact, solution-focused practitioners believe that a prolonged problem focus can be
detrimental, as the problem is mired in power struggles and con7ures up negative feelings."s clients and therapists co-construct solutions, therapists are guided by a number of
principles that include?
. " belief that clients already have the strengths and resources necessary for
change.
:. Establishing a collaborative and egalitarian relationship with an emphasis on
client empowerment.A. "ssuming an affirming and supportive stance, and pro7ecting confidence and
optimism about what the client can achieve.
B. " curious, respectful and appreciative 0ambassador perspective1 toward the
client&s cultural conte't.C. "cceptance of the client&s perception of their situation with a focus on the client&s
preferred outcomes.F. 3ooking for opportunities to invite clients to focus on solutions.
G. The belief that if it works, do more of it. If it doesn&t work, do something
different.H. "n emphasis on small, specific, and achievable goals and the belief that small
change can be the path to larger change.
J. #inding e'ceptions to problem behavior and amplifying positive changes that are
already occurring in the client&s life.. The principle of parsimony? keep it simple, use the minimum amount of
intervention needed, and conclude therapy as soon as possible. Treat every session
as if it may be the last.
3et&s see how !r. Tim rothaus applies some of these principles as he works with <s.
3aTonya +iddick on finding balance in her life and integrating a relationship into her busy world. "lso, please notice that in this role-play, !r. Tim rothaus will be called
called 0Tim,1 as the power dynamics are de-emphasi/ed in solution-focused therapy.
Tim: o 3aTonya, it sounds like we&re all set. o more 2uestions about the paperwork or what the kind of process we have here or confidentiality. I did have another 2uestion for
you before we formally stared if that&s okay. Lm, and that is remember when you were
on the phone and made the appointment, you were asked to observe if you noticed any positive changes between the time you made the appointment and the time you came in,
in the area of your concerns did you see any, what we call pre-treatment change that
changed in a positive direction prior to coming in here8
6atona: "ctually no, everything&s pretty much the same.
Tim: >kay, okay5 ow that we are in here today I was wondering if you could share
with me what your best hope would be for today8 =hat would be some signs that things
are beginning to get a little better8
6atona: =ell actually I&m really looking for balance in my life. I&m divorced, I&m the
mother of two, I&m a student and I&m working full time so I trying to find another way to put a dating relationship into the mi'5 trying to have some balance with dating.
Tim: >kay, so you&re already 7uggling an impressive amount of activity and priorities?children, work, school5 I was wondering if you could tell me what are some 2ualities or
skills, what are some things you&re already doing to help you achieve the successful
balance you have now8 4ow does that5 can you describe how that balance works now8
=hat are you doing that makes that work8
6atona: =ell for the things that are already in place, work is essential, school I&m
passionate about and the kids, I 7ust love spending time with. *ut there&s a lot of things
that I don&t do. I don&t do a lot of things 7ust for myself; most of time is spent with mygirls or at school or with work.
Tim: >kay, so to make the balance you have now, be reasonably successful, if that&s
accurate to say, use time management skills, it sounds like, if that&s accurate, um some
discipline and self-sacrifice, and you prioriti/e and make sure that you spend the time inthe areas that are of value to you. =ould that be an accurate summary8
6atona: 9es.
Tim: 4ave you been able to do that anytime in the past5=ith a dating relationship8 To
find that balance with a dating relationship added8
6atona: "ctually no. I meet people all the time. "s a matter of fact I met someone on
my way here and he actually asked if we could meet later for what he called a 0cookie1
and uh he&s %amaican, he had this cute little %amaican accent and I immediately feltoverwhelmed. "nd I remembered I didn&t have a sitter and felt relieved.
Tim: >kay so you had a situation where um, the possibility of a dating relationship came
up and you had some, sounds like some strong unpleasant feelings about feelingoverwhelmed, perhaps in lieu of that balance that you&re trying to create. I&m wondering,
looking at times where the balance has been working for you, if there&s anything that
you&ve added recently, that&s now a part of your balance, but wasn&t there a little while back, where you had a previous balance of all the important things you were keeping
going. "nything that you&ve added recently that&s now part of the balance that&s
working8
6atona: =ell, yes I 7ust recently entered a graduate program and I&ve been able to add
that into our already busy lives, but that&s a little different, I can kind of manipulate my
schedules so that I&m got gone from the house too many nights a week or I spent a lot of
time trying to make sure that doesn&t affect my schedule with the girls.
Tim: >kay5 so to me, that&s still impressive even though there&s some differences that
you identified that you had, would it be accurate to say, a busy, but successful balance
previously for something you decided you wanted and that is to work toward the graduatedegree that you&re presently pursuing and you were able to make the new balance,
transition to the new balance. =hat are some things you did that helped the balance
remain acceptable to you, while working in something new that&s a fairly bigcommitment, something new that&s important. =hat are some skills that you use, what
are some things you did to make that new balance work8
6atona: =ell I think that, for that, mostly it&s 7ust the time management I was able tocontrol my scheduling a little bit more. It seems like with the dating relationship, I don&t
have that control, because it&s another person&s schedule that&s also involved.
Tim: >kay5 certainly with you being able to pick your classes to some degree, I meanyou don&t have control over, perhaps, I&m guessing, when they&re offered, unless it&s an
independent study or unless you know something that most student&s don&t, I&m guessingthat you can&t control when the pro7ects are due or how big they are, so within5but to
some degree, there&s some control you have. "nd then the other pieces that you don&t
have control over, you make work through your time management skills so it&s acombination of elements you can control and then managing those that are not 2uite in
your control5 would that be accurate8
6atona: E'actly.
Tim: >kay5 =ell I&m gonna ask something now that&s referred to as a 0miracle
2uestion1 and that&s common in folks who do solution-focused work. "nd it asks you toenvision a future using your imagination a bit. =ould you mind of I ask you that8
6atona: o, not at all.
Tim: >kay5 3et&s pretend that after you leave here and you go through the rest of your
day successfully, and you go to sleep tonight, have a restful night, and you wake up in the
morning and lo and behold, the problem&s gone. The solution you wish for is actually in place. I&m gonna ask you to pretend as if there was a camera following you before this
wasn&t working, a camera only that you can see, and now tomorrow morning there&s a
camera that follows you for a while and pictures this new balance that is e'actly what youwant. If you look, if we were to bring in and look at the two tapes, what would we see,
what would 7ump out at us as different in the second tape that we wouldn&t see in the
first8 Tell me about this new balance, can you describe it8
6atona: =ell, I think picturing that, I would be in a successful relationship and still have
all of the other elements of my life working 7ust fine. "nd that&s part of the problem, I
can picture the end result, I would like the successful relationship, but it&s 7ust getting
there that I have the hard time with.
Tim: >kay5 well what I hear you saying now is that there&s hope that there is a future
where this established relationship is working. =e&ll look at successfully co-creating a
solution where you get to that point the preliminary stages work out well. o whensomebody with a cute accent asks for a cookie, perhaps it can get to that last stage, would
that be fair to say8
6atona: <m-hmm (affirmative.
Tim: I&d like to ask you to use numbers for a second on a scale. "nd if ten would be that
image you 7ust described, where it&s already working, where things are in balance and therelationship&s established and one would be a place where it&s abysmal and there is
nothing working at all. =here would you rate yourself in terms of adding that dating
piece now in between one and ten8
6atona: I would have to say that I&m a one.
Tim: >kay. )ould you describe why where you are now, you&d see as a one8
6atona: *ecause I don&t see any signs of success. I don&t think that I&m datingsuccessfully at all.
Tim: >kay5 okay. o you&re at a one now, plenty of room to growK Lm, what, looking
at the ne't step, not necessarily biting off the ne't big piece, but we talk about smallchanges leading to bigger changes down the road. =hat would a two look like8 If you
picture yourself successfully at a two, what&s involved with a two8 )ould you describe a
two for me8
6atona: I think that a two would be 7ust having someone that I could go out with every
now and then. omeone that I would talk to maybe a couple of times a week and maybeonce a week or every other week, 7ust go out very casually.
Tim: >kay5 so it sounds like a key point for you to go from one to two would be the
pacing of the new relationship that it wouldn&t be too demanding on your already busy,successful balance you already have. o the pacing of that relationship would be
acceptable to you. >kay5 do you have any non-dating relationships that are of some
importance to you where that pacing is acceptable8 =here you have that kind of pacingthat fits in with your balance8
6atona: 9es, actually I do. I have friendships, friends that are platonic, people, evensome that I&ve dated in the past that now we&re 7ust friends and so, yes, we do to lunch
maybe once or twice a month and we do talk on the phone maybe once or twice a week.
Tim: >kay, so having that pacing in other relationships outside of family, work and
school, you have success with that already. =hat would it take for a dating relationship
to have the pacing that you successfully have with other relationships8 =hat might beinvolved there8 4ow might that look8
6atona: =ell, I think I need to be dating someone who is busy also; someone who alsohad a full life.
Tim: "nd if that person had a full life, how would that be helpful to you in achieving the pacing you would like, that is acceptable and not overwhelming8
6atona: =ell I think that we would be able to maybe balance our schedules so I
wouldn&t have the guilt or feel the pressure of needing to be available as much.
Tim: >kay5okay. =ell if I could kind of summari/e where we are now, and see if
you&re in agreement with what I&m seeing so far. <aybe we can look at what we want
our ne't step would be, if.. have5 you&re busy, sounds like a successful person in termsof balancing many important pieces in your life, work and children, family and school
that you picked up and added recently. 9ou&ve recently e'perienced a successfultransition to a new balance you want to add something new like, as you added graduate
school, although there is some differences, perhaps some of the skills would be similar in
terms of achieving a new balance, you can use some of the same skills perhaps. "nd youwanna look at a relationship that has a pacing, if that term&s ok, that isn&t overwhelming.
"nd you have e'amples of relationships that are important that have that kind of
successful pacing or agreeable pacing that works within your balance. o what I hear is
that, while certainly this is a dilemma, and there&s work to be done to get you to the twoand beyond, some of the pieces that you want to have in place being be able to transition
to a new balance. 4aving successfully e'perienced relationships that have a good pacing,
an idea of where you might find a gentleman that would be able to um, have that similar pacing, somebody with a busy and full life. 4ere&s what I see already in place that we
can draw from this strengths, as I summari/e in that fashion, how does that sound to you
and how do you feel about that8
6atona: =ell, actually it makes me feel hopeful.
Tim: >kay, because5
6atona: %ust being able to look at it from that aspect, 7ust knowing that maybe I do
already have the skills in place and thinking of ways that I can actually employ what Ialready have.
Tim: o perhaps, that can be our ne't step in our time together; is looking at how to useall the skills that you already mention, having all the strengths, all the e'perience that
worked for you to be successful and use those to help you move from a one to a two and
