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Karen E. Giunta, LMFT, LLC ~ Consultation and Therapy

a Resource for Clients & Therapists

2019 Tidbits & to-Do's - morsels to spark curiosity 

Phase 1 - Self Q & A

9/21/2017

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Before moving on to Phase 2, let's check-in on a few key questions for the first phase.

What is emerging for you as you consider your emotions, thoughts and behaviors as a therapist?  

Considering a case that you are challenged by, what are your key moves?  What is your go-to for dealing with the tough spots?

When reflecting on your experiences as a therapist, also consider what these might be like:

* sitting with a highly anxious person
* sitting with a very angry person
* experiencing contained fury in a withdrawn client
* working with a withdrawn, shut down individual
* a client being angry at YOU

Some of the greatest benefits of Self of Therapist work is to better know yourself in the process of being a therapist, addressing items that might be unresolved in your own story, and then learning how the knowledge and new experience around your own issues can actually benefit you, as opposed to simply blocking you, in the process.

Author's Reflection:

As I consider the evolution I have been through in becoming a therapist, what I have grown to appreciate most of all is how deeply I experience the energy of emotions.  I believe the term for this type of individual is "Empath".  My body experiences the energy in a very deep, felt way.  As I work with other therapists, I am finding more and more of us have this somatic experience in our work.  I believe this can be both powerfully helpful, and powerfully exhausting and debilitating for a therapist.

Self-care is such an important part of being a therapist.  Please consider, how do you take care of yourself in your work, and your life?  How do you rejuvenate and replenish?  My self-care go-tos come in many forms: exercise, reading, writing poetry, hanging out with my sons watching GOT, just to name a few.

Next Up ~ I am heading out of town to a conference the week of September 25, therefore, the next posting, Phase 2 ~ Exploration and Expression, will be introduced the following week, the week of October 2.  Please enjoy this time to reflect on the initial phase of this process!
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Phase 1 ~ Awareness and Acceptance of Self ~ Post #2 of 2 – Interdependence, Case Example

9/14/2017

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Once the therapist has gotten a sense of his/her side of the relationship, the therapist can explore the interaction and interdependence with the client. Oftentimes, what’s happening in the client may be the catalyst for exploring the therapist’s side.  Regardless of where it begins, just like with our clients, we can track a pattern of interaction.
 
Questions to explore – interdependence:
 
These questions take last week’s inquiry and look at the interdependent cycling back. When B is impacted and reacts, how it will then impact A.

  • When I feel/think/do (choose from last week’s blog), my client may feel _____ (feeling), may begin to think ________ (thoughts), and may ________ (action).
 
Case Example:
 
To better illustrate this, let me tell you about a case I had a number of years ago where I was in a fascinating dynamic with the couple, specifically with the male partner.  I presented this case at my 2013 presentation.  The videotape of the session showed this cycling full-on.  I will try to do it justice verbally.
 
Sam and Sally, young 30-somethings, were making headway in treatment.  Sally was sharing an important fear that she experiences.  While she was trying to express this, Sam kept interrupting her.  Initially, I asked Sam to pause and wait her out.  He would pause for a moment, and then a few minutes later would attempt to interrupt Sally again.  I continued to ask him to give her space to explore; however, he continued to pause and then interrupt.  The more I asked him to pause, the more frustrated he became.  The more frustrated he became and interrupted her, the more I became frustrated and asked him to pause.  Eventually he was so frustrated, he stood up and began pacing the room.
 
Using the above exercise, I felt frustrated (feeling) with the client, I started thinking “he isn’t listening to her, or me (thoughts), and I kept interrupting him (action) to get him to stop interrupting her.
 
As he was interrupted, he probably felt dismissed and frustrated (feelings) with me, may have started thinking that I don’t care or his thoughts/needs don’t matter (thoughts), and he kept interrupting, and eventually began pacing (action).
 
The more he interrupted, the more I paused him.  The more I paused him, the more he interrupted.  And so on, and so on. The more and more this happened, the more out of attunement we became, getting further from each other’s understanding.
 
In a future post, I will explain what this was all about for me and for him.  For the moment, just notice the interdependence and pattern.
 
Reading Reflection:  Consider your cases and explore possible interdependent patterns.  Map out the pattern in your journal; share any relevant experiences you notice.  I welcome questions for clarity at all times.
 
Next Up ~ Phase 2 - Exploration and Expression of Self 
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Phase 1 ~ Awareness and Acceptance of Self  ~ Post #1 of 2 ~ Awareness of Internal Process

9/6/2017

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In Phase 1 of the A-E-I Framework, the emphasis is on creating awareness and insight regarding the therapist’s experience in the treatment process, including his/her experience of the client, the treatment, and the outcomes of treatment.  Additionally, the therapist’s successes and struggles in work are explored, leaning into the positive affect and resourcing, as well as the blocks and challenges the therapist experiences.
 
Many different resources can be utilized to increase awareness for the therapist, such as an Attachment Style Questionnaire, or producing an Attachment Style Genogram of the therapist’s family of origin (focusing on the attachment strategies of members and how the therapist’s own attachment strategies were developed).  Additionally, exploration is made with attention to identifying thoughts, feelings and behaviors of the therapist.  A therapist will be exploring his/ her personal action tendencies as they pertain to moments during the treatment process and clarifying a normative behavior along the four quadrants of attachment (secure, insecure-anxious, insecure-avoidant, insecure-disorganized).  For more information on attachment theory, google John Bowlby,  Mary Ainsworth.
 
As the attachment style is uncovered as it presents in the work, the therapist can explore unmet attachment needs, as well as connections to the therapist’s own story, including values, moral compass, religious ideation, political beliefs, etc. (moving into phase 2).
 
Summary of key components:
 
  • Explore relationship with and recognition of Self in the treatment process, identify interactional patterns with client and within Self, and understand impact on treatment
  • Attachment needs/emotions: i.e., competence (not good enough therapist), learning style (challenges of learning, kinesthetic vs. cognitive learner)
  • Nonjudgmental acceptance of behavioral patterns and needs; grounding strategies for calming through understanding, empathy, and compassion for Self.
 
For consideration, these elements are kept in mind throughout this process:
 
  • Giving ourselves permission for our own survival strategies
  • Interdependence occurs in any number of relationships, including with clients (Partner, Parents, Children, Friends, Colleagues, Pets, God, Self)
  • “All of us, from cradle to grave, are happiest when life is organized as a series of excursions, long or short, from the secure base provided by our attachment figure(s).” – John Bowlby
  • Drawing from systems theory, A impacts B, which then impacts C, we consider the systemic impact first in one direction.  The focus is on emotions, thoughts and behaviors.
 
Reading Reflection: Consider the following questions ~ Awareness of Self.  Note in your personal journal.  Please share in Comments to the degree you are comfortable.
 
  • When a client is angry, I feel _______ (emotion), and say to myself __________ (thoughts), and I tend to _______ (action)
  • When a client is quiet and not responding to questions, I feel _______ (emotion) and say to myself __________ (thoughts), and I tend to ______ (action)
  • When a couple is fighting, I feel ________ (emotion), and say to myself __________ (thoughts), and I tend to __________ (action)
  • When a couple is engaged and responsive, I feel ________ (emotion), and say to myself __________ (thoughts), and I tend to __________ (action)
 
 
Next Up:  Awareness and Acceptance of Self ~ Post #2 of 2 – Interdependence, Case Example
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    Author

    Hi and welcome to my blog!  I am excited to have this endeavor underway.  It has been many years in the making.  

    You will learn a lot more about me and my experiences along the way.  

    Enjoy!

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