APPROACH / THEORY
My
Approach
The clinical psychology marketplace is incredibly difficult to make sense
of. The field is full of people with different licenses, using different
methods, based on all forms of training and experience.
Part of the problem is that, being a relatively young field, psychological approaches are constantly being created or modified. On top of that, psychological theories are often complicated. To be as helpful as I can, I have broken down my approach, Characterological Psychology, into the following values:
A "No-Fault" Approach To Problems
An Emphasis On Deeper Thinking
An Emphasis on Personality Styles
An Interest in Plain English
An Interest in Collaboration
An Awareness That Psychological Information Is Self-Evident
An Interest in Basic Humanistic Ideas
An Interest in Flexibility
A
"No Fault" Approach To Problems
A problem with many psychological and self-help methods is that they view
people as defective. They
do this by casting the client as either ill or victimized. In these systems,
blame plays a key role. For example, a person might be faulted directly,
with the inference that he can change just by willing to. Or blame will
be assigned with the idea that he is the victim of his biology, his parents,
his childhood or his "incorrect" thinking.
However, this is not how psychology works. To the extent someone is neurotic (meaning, can't be himself), it is because he is afraid to express true feelings, or he identifies with attitudes he doesn't fully believe in. It is the conflict between a person's genuine and assumed feelings that produce psychological symptoms. As opposed to the "illness" idea, conflicts (and the symptoms they produce) arise because a person has trouble identifying with how he really feels.
An
Emphasis On Deeper Thinking
It is a fact of life that we conduct much of our business on "autopilot,"
based on reflex, or thinking that is not thought through that much. A
good deal of what goes through our minds on any given day will be preconceived,
conventional, even contradictory--especially in interpersonal situations.
Even the most thoughtful people (and organizations) suffer this.
Helping people think can take many forms, including: feeling entitled to one's own thoughts, considering if what one thinks is what one believes, noticing differences between what is felt and what is expressed, identifying assumptions, planning, or just feeling the right to think more boldly.
An
Emphasis On Personality Styles
The
nature of an individual can be understood through her personality or character.
Character consists of a system of attitudes, ways of thinking or modes
of action that are often highly consistent and self-sustaining. Being
part of the character, personal problems also have typical patterns. To
the layperson, certain actions or tendencies may seem random and illogical.
From a characterological understanding, however, most actions can be seen
as understandable within the logic of the character it is coming from.
An
Interest In Plain English
Anything
having to do with psychology can and should be expressed in plain English.
An
Interest In Collaboration
As
opposed to systems where the clinician instructs, keeps up a front, or
takes an authoritative tone, this approach calls for a friendly atmosphere
free of power differences. The process is truly collaborative, based on
the client becoming progressively better at reading her own instincts,
false and true.
An
Awareness That Psychological Information Is Self-Evident
As
opposed to other methods, we don't believe therapy involves pursuing certain
subject matter, digging up things, or generating particular emotions.
Under this theory, what is clinically relevant can't help but express
itself in the immediate attitudes and actions of the person.
An
Interest In Basic Humanistic Ideas
The Characterological approach emphasizes values and ideas more commonly
associated with philosophy or human rights (such has equality, self-determination,
freedom of expression and freedom from persecution). For example:
--We equate health most closely with genuineness.
--We are interested in the extent to which a person experiences his senses.
--We put an emphasis on intuition, which we see as the marriage of thought and feeling.
--We believe a person's feelings constitute the most essential part of his being.
--We believe that, if you follow the interest, the meaning will follow (not the other way around).
--We believe that there is a direct connection between self worth and social conscience.
--As psychotherapists, we believe in life-long. active study and training.
An
Interest In Flexibility
I
believe that the psychotherapy profession needs to be flexible about the
form and scope of clinical relationships. For example, I have as much
experience with short-term and "fixed-term" work (including
3, 4, 5 and 6 contracted meetings) as I have with opened ended psychotherapy.
I believe in consultation meetings, aware that people often need to "try before they buy." Also, it is important to appreciate that different people can have vastly different goals and levels of interest in the therapy process.
Characterological
Psychology
Characterological
Psychotherapy
Within the field of clinical psychology, perhaps the best known and most respected theorist on character is Dr. David Shapiro, Professor of Psychology at the New School for Social Research in New York. Dr. Shapiro was a student of Hellmuth Kaiser, who was a student of Wilhelm Reich, one of the founders of psychoanalysis with Sigmund Freud. Dr. Shapiro is a household name among the psychological community, highly regarded for several books, most notably Neurotic Styles, which has become a classic text in the field of psychotherapy.
According to the approach, neurotic behavior tends to fall into particular typologies or styles, each with a constellation of particular attitudes and attributes. Although never completely alike in any one person, there are distinct commonalties to the mindsets. An obsessive character, for example, is constantly vigilant and cannot let in his softer side. A histrionic character, on the other hand, functions in an impressionistic world and cannot appreciate his capacity for deeper thought.
In each case, these neurotic styles of thinking are narrow and inflexible. Because the person tends to see himself through the constrained attitudes attendant with the style, the person is unable to accurately view, understand or relate to his real instincts. Instead, the neurotic person is estranged from true feelings, values and inclinations. Applying this theory, neurotic behavior becomes understandable, not as an abstraction, but in completely practical terms. In other words: A neurotic person is someone who demonstrates consistent contradictions between what he says and what he does, or between what he thinks and what he feels.
Shapiro generally classifies neurotic styles into one of two categories, impulsive or rigid. Included in the impulsive category are histrionic, impulsive, passive-impulsive, passive-dependent or sociopathic. Rigid styles include obsessive/compulsive or paranoid. Depending on the particular neurotic style, the Characterological clinician uses his understanding of the character style to help the client identify with those modes of thinking and action that inhibit freer, more autonomous expression.
Characterological Psychotherapy
It is important to understand that neurotic problems are primarily problems of consciousness. When a person thinks things he doesn't mean, acts out, or experiences conflict, he does so in a detached kind of way, in which he genuinely doesn't feel like himself. Specifically, someone being neurotic is consciously disconnected from a more authentic, aware perception of himself.
We understand insight to occur when people have a conscious, in the moment experience of neurotic thoughts or behaviors. In other words, the client actually experiences himself being who he isn't. Often times, this awareness comes about in a straightforward way, in an atmosphere of acceptance and respect. However, to create this experience sometimes requires some art. At that point, the question for the clinician is: how can you capture the client's attention and interest in a state of mind that he is probably embarrassed of, and do it subtly enough so the mindset is not disrupted (or warded off), but appreciated?
At such times, a somewhat elliptical comment might be offered to the client, one that produces an initial curiosity or surprise about what they are doing. As in a Zen koan or a resonant metaphor, the comment allows the client to put the meaning together in his own head, bringing the fullest range of sense and experience together. The best comment not only highlights some contrived attitude present in the moment, but also suggests to the client the difference between his expressed stance and his true one.
This experience is quite liberating for the client. The insight is "true insight," around which the client can orient and reintegrate his experience of himself. This is in contrast to other systems that confuse insight with intellectual explanation, encouragement or self-talk.
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