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Time Frame for Therapy

Everyone is different with vastly different personalities and struggles to work with that there are no cut and dry time frames for good therapy to be transformative.

That said, for the majority of clients that I work with, it takes about 1-6 sessions before knowing that this approach is right for them. That they can experience that visceral “feel” of change beginning. I tell many clients to give a therapist the benefit of the doubt  for at least a month. But within 6-10 sessions, a client should be able to sense if this work is going somewhere. That change will occur with this therapist and this approach.

My main approach: AEDP, had grown out of a brief therapy approach in the 1980’s and 1990’s but grew well beyond brief therapy. It now provides an extremely flexible time frame for change.

I have seen cases of life long issues dissolve in the first or second half of a session. Sometimes right from the start, much more often it takes weeks to months for that to occur.

Although I work towards change as quickly as possible, quick change is not always possible. Some people have traumas and struggles that require a more long term approach.

Although numbers are artificial, about two years is a relative maximum time frame. That is a whole lot of therapy in any case. If no change occurs within 6 months to a year with the client’s engagement in the work, something would be very much missing and a new approach, angle, or therapy would be required.

 

The Mighty Social Engagement System

I remember the first time in my adult life where I was “seen” by a therapist. It was like being a child and seen by a parent in an almost embarrassing manner. As if all my defenses dropped away and I was immensely “with” that person.

The second time I felt something, like a something I was holding onto dropping and being seen but I didn’t feel as young this time. This therapist had an extensive background in Zen meditation and Catholic spirituality.

The third time this occurred I was seen by a certain individual who was sort of like a facilitator of an obscure meditation group. He was just so immensely present with me, that it felt like every fiber of my being all throughout my body relaxed in a quality of relaxation that took me by surprise. It was an intense rush of feeling alive of which was much much more powerful than the first two experiences.

I mention these experiences to highlight how powerful something called the Social Engagement System is for human beings and how it is utilized in relational approaches to psychotherapy.

This idea comes from a neurological theory called the “Polyvagal Theory” which simply states that our social behavior, or lack thereof is mediated by specific parts of the Vagus nerve. The nerve that runs down our entire torso and branches off to where he normally feel those sensations called “Feelings” when an emotional system is activated.

You know, when you feel something in the front of your body.
The polyvagal theory from the work of Dr. Steven Porges is for my work in this approached of AEDP, more important than Attachment Theory in my opinion. Attachment theory focuses a bit too much on the early past attachments and mother-infant relational dyads (one on one relationships). Whereas The Polyvagal Theory focuses on any relationship and moment in a person’s life span. This comparison and how both theories inform relational-experiential psychotherapy is more for another post

What I want to summarize about the social engagement system is that social engagement, true deep trust in being oneself in another’s or a group’s presence more rare than we may imagine and immensely precious.

It is a rare occasion indeed when we let ourselves be completely seen, relax with others, let down our normal defenses against relating, behold the true person in front of us and share the deepest and most hidden parts of ourselves. Or what we were not even aware of but seems to bubble up to be worked through in rare moments with trusted others.

This is why feasts occur in religious traditions such as holidays. Or people go out to eat for dates. Eating together means a sense of trust and we relax when we eat, in an indirect way saying that we trust that we can relax to eat around the others.

Or why in states of love and infatuation, deep secrets and feelings arise.

This is not mere relating as we would others on the street, coworkers, or other casual meetings between people. This is feeling existentially with someone. Feeling understood, never judged or reacted to, held in presence, related to authentically and so on.

I won’t go into the neuroscience of this theory. I’m writing this post to express the power of this deeply wired but usually latent potential for deep relating. It usually occurs in moments of love, such as with parents or family as a child, or with one’s closest friends or partners.

What sets the AEDP approach apart from any other relational approach that I have had the pleasure of coming across, is how explicit it makes of expressing joy and appreciation of the other, of boldly making the positive aspects of the client as visible as possible and expression of positive relational experience. AEDP therapists are also significantly more active in this process than other relational psychotherapy approaches.

When methods such as this begin to bring the latent social engagement system back online, people can begin to thrive in live, to relate to others without projections as “true others.”

It has been my path as an adult to cultivate my social engagement system so that I can relate to others authentically and to spread it to others both to accelerate the psychotherapeutic process.

For more on these ideas, look through these links:

Dr. Steve Porges Polyvagal Theory

Good Summary of the Social Engagement System

Using the Social Engagement System

 

 

The Seven Channels of Experience

I want to briefly summarize a teaching from my approach to therapy that has been a novel innovation in the past five or so years. I want to put this out to the public because of how impressed I have been on the precision that this construct gives me as a therapist.

 

These set of ideas was created by the psychotherapist David Mars PhD who also had innovated a particular form of couples therapy based on AEDP called AEDP-fc (AEDP-for couples).

 

For anyone familiar with mindfulness and other awareness work, there is usually some emphasis on the difference parts or facets to direct-experience-in-the-moment. I need to emphasize that hyphenated statement about direct experience as many modern people in this information age are unfamiliar that there is actually embodied experience deeper and more fundamental than thinking and ideas.

 

What I mean by parts or facets to experience are things such as body sensations, senses or outer perceptions and emotions or feelings.

 

Many “experiential” psychotherapy schools in the past had emphasized emotion or behavior and expression but missed many other parts to direct embodied experience. (The body is the only place where change really happens. Even if thoughts change, there is still a change in the body associated)

This particular teaching on the seven channels teach this: everyone uses different experiential language. Some emotion focused therapists work and work to get a client to feel their emotions only to be met with a blank stare and confusion. Or some prefer to carry out therapy through imagery and this may change the life of some, moderately help others, and some may find this not helpful.

 

Dr. Mars had discovered (several other therapies may have similar teachings though) that if you can precisely speak a client’s experiential language, or their particular way of experiencing themselves and their inner experience, you can reach your clients with much greater precision.

I’ll list the seven channels below:

  1. Visual: seeing, emphasis on the eyes and viewing
  2. Imaginal: use of imagery and imagination
  3. Movement: use of bodily expression of emotion and emphasis on acting
  4. Emotion: feelings, emoting, the big six emotions (anger, joy, disgust, love/attachment, fear, sadness)
  5. Bodily sensation: such as clients who feel things like tension instead of direct emotion
  6. Energy: felt-sense of oxygen ions (secular version of energy in the body), meridians and other forms of the bodily experience of energy
  7. Voice: vocalizations, verbal expression, emotion expressed verbally

This teaching goes further in that each of us has about 1-3 preferred channels in which we express who we are and feel our inner experience of our lives. And we have about one that is “defensively excluded.” Meaning one or two channels are cut off from experience, usually because of traumatic experiences but I would also say culture, family environments and other factors can cut us off from these parts of ourselves.

 

To get an idea on how this plays out, I’ll disclose my experiences as a patient going through experiential psychotherapy myself:

Despite fixating on the idea that working directly and boldly with emotion was the most accessible way to deep and lasting change, I had extreme difficulty feeling much of anything, especially in front of a therapist. It actually took me some time, too long, to contact the real issues in me and come to deep integration and transformation.

The problem is, that I used to live with the emotional channel excluded from awareness. Powerfully defended against. I would feel weak and out of control to contact any feeling or spontaneous expression. I used to have an avoidant attachment style. I avoided emotion in myself and others. Half of my family are Mid-Westerners, the masters at avoidance, so of course that would be my preferred method of relation to myself and others.

 

Looking back, I can now clearly see what led to all of the change I went through: My preferred channels were visual and imaginal. I took to ego-state or parts work strongly, despite first judging it as goofy. “Yeah right, like I have these parts in me that are like separate entities… oooohhh okay parts do exist.”

Parts work tends to emphasize the imaginal channel, meaning spontaneous rather than guided imagery (I rarely use guided imagery, I prefer the mind to reveal itself spontaneously) which led to an unlocking of the emotional and other channels, such as sensation, movement and energy.

 

When I work with a client, I am on the lookout for which channels they prefer (subconsciously) and what may be excluded. And work from their precise experiential language to truly meet them where they are at.

 

I am in great debt to Dr. Mars for this innovative set of ideas and his fantastic form of couples therapy.