When you think of “going to therapy” and imagine what that looks like, you’re probably initially thinking of “psychotherapy” – this is the aspect of our work that relies primarily on verbal interactions between us. There are many different ways to address this verbal exchange between client and therapist, and I use a combination of approaches that I see as complementary to each other. These include:
- Acceptance and Commitment Therapy
- Mindfulness-Based Interventions
- Psychodynamic Therapy
- Cognitive-Behavioral Therapy (especially Dialectical Behavioral Therapy, or DBT)
Acceptance and Commitment Therapy (ACT)
This form of talk therapy is extremely useful for people experiencing painful thoughts and feelings that they can’t seem to shake. We will combine mindfulness and behavior change strategies to support psychological flexibility – the ability to remain fully conscious in the present moment, despite the discomfort the present moment may bring. The goal is to be able to identify your personal values and make choices that bring you towards those values, even when obstacles present themselves and threaten to thwart your efforts.
I’ve worked with many clients who think of mindfulness (or more specifically, “meditation”) as something “new-age” and thus not really accessible or useful. On the contrary, however, research in mindfulness is positively exploding in the fields of medicine and counseling. Engaging in meditation does not mean your mind will become still or crystal clear (to be honest, I don’t even know what that means – and I’ve had a lot of training in meditation!). What it does mean is that, with practice, you will develop the ability to observe your mind and all of its antics – without judgment, and without a need to change what’s happening. ACT and DBT, two approaches I frequently use in sessions, both stress mindfulness skills as a basic tenet.
Cognitive-Behavioral Therapy (CBT)
(including Dialectical-Behavioral Therapy, or DBT)
CBT draws from the idea that our thoughts influence our behavior. When we are under stress, we can be prone to hyper-exaggeration, catastrophic thinking, and other distortions that keep us from seeing the big picture. Using CBT, we can identify harmful thoughts and assess whether they are an accurate depiction of reality; if they aren’t, we can challenge them by acknowledging a different perspective.
Dialectical Behavioral Therapy (DBT) is a modified type of CBT that emphasizes skills in: mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation. The use of the term “dialectical” implies the integration of opposites – i.e., rather than thinking in black-and-white terms, we can learn to see in shades of grey. This form of therapy is a particularly helpful approach for clients who struggle with self-harming behaviors or chronic suicidal thoughts.
This approach focuses on developing self-awareness and an understanding of how your past experiences inform your present self. There is a focus on identifying and overcoming negative feelings and repressed emotions so that you can develop healthier interpersonal relationships.