Principles of Therapy Series

"Ghosts and Guests of Family Past in Relationships and Therapy." Individuals carry expectations, experiences, models, and values of variable functionality that profoundly affect intimacy and relationships. Negative experiences can become neurotic filters that alter perceptions and interpretations of others creating relationship dysfunctionality. The therapist prompts clients to recognize scripts and roles from the family-of-origin that create problems in current relationships. Incoherent versus coherent stories for self-identification, attachment, and family dynamics are shown as affecting relationship success. The therapist is directed to help clients identify and address embedded roles, models, and key cues for problems from developmental stress and cross-generational transmission: illogical values, pseudo-maturity, rigidity of roles, triangulation, implicit rules, and illogical perception. Relationship scripts need to be examined for functionality including the gallant knight-damsel in distress pairing, the fixer-project dynamic, distance-pursuer roles, and various money scripts. Illogical conclusions are examined for compelling symbolic meanings and historical logic that has become nonsensical for current relationships. Intimacy and relationship between a therapist and individual client must be a precursor to other relationships. Whether the unit of treatment is the individual, couple, or family, the therapist is guided to facilitate the person's growth or development with the requirement of another person or other persons in a reparative relationship.

"How Dangerous is this Person?" identifies cues for potential violence, including profiles from mental health along with frustration-based aggression, bullying, cultural influences, substance abuse, psychosis, and special considerations. Key criteria are explained to formulate therapy, treatment, and intervention, including helping laypersons decide when to seek legal and professional assistance. Tragic violence continues to erupt in communities, homes, work, schools, and neighborhoods. Abusive or violent acts target individuals well known to perpetrators, but also total strangers, public figures, and others with spurious, convoluted, or non-existent logic. Perpetrators may be unknown to few other than family and associates until their violence makes the evening news, or they may be famous or infamous in the public eye already. Victims include family members such as spouses, parents, grandparents, friends, girlfriends, boyfriends, political figures, entertainment stars, work colleagues, current and former bosses or supervisors, children, schoolmates, and unlucky bystanders. Violent behavior includes mass murder, homicide, domestic violence, child or elder abuse, or battery. Retrospective examination often finds cues and indications of potential violence lurking in the hearts and minds of eventual perpetrators. This book takes these cues and indications and formulates theoretical foundations for assessing for an individual's potential to become dangerous to others or violent. The theories and process presented are relevant to emotional and psychological abuse as well. Profiles are presented that differentially indicate the potential and process of violence. In addition, key criteria are explained for use not only for assessment but to guide prevention. Written for the therapist and other professionals charged with protecting the public, the information may be also useful for laypersons to examine personal concerns and make sound decisions whether to seek intervention by authorities.

“Born that Way, Temperamental Challenges in Relationships and Therapy.” Temperament, which is a non-experiential characteristic from genetic inheritance interacts with environmental experiences such as family and culture. Therapists will see how in-born temperament influence childhood attachment and later adult intimacy and relationships. Temperamental evaluation provides another perspective- an important non-pathologizing perspective to clinical work beyond children, but also with adult individuals, couples, and families. Evaluation and assessment from non-temperamental perspectives is contrasted to using temperamental theory to determine therapeutic strategies, interventions, and goals. Temperamental traits are shown to have bi-directional mutual influences with a number of impactful developmental factors: attachment, learning disabilities, gender, culture, substance use or abuse, and anxiety and depression along with other psychopathology. Therapists will be charged to identify personal, individual, and systemic gender and cultural values in particular that encourage or discourage specific temperamental traits. Easy to difficult temperamental profiles mitigate or exacerbate any problematic dynamics, including within the family-of-origin or a current adult system such as a marriage. Different profiles can inherently make certain tasks, situations, or occupations more or less difficult. Temperament is a powerfully empowering alternative perspective to the Attention Deficit Hyperactivity Disorder diagnosis that therapists can use to direct affirmative intervention rather than initiate labeling leading to psychopharmacological treatment. Individuals with difficult temperaments have predictable problems with environmental and relationship stresses- in particular starting with peers in childhood and leading to eventual intimate relationships in couples and in the family. These traits can be anticipated for challenges and can be successfully addressed and supported by knowledgeable therapists, teachers, partners, parents, and colleagues/peers. Therapists are directed to evaluate and advocate positive fit between important intimates and challenged individuals. Partners, parents, and other concerned individuals are educated and coached by temperament-savvy therapists. The more powerful or authoritative person such as the parent, teacher, or therapist, or the more aware and understanding individual is often required to monitor and regulate the difficult temperament of the other person. This is clearly required developmentally of the therapist, parent, or teacher for the young child, but may also be relevant for the individual in an intimate relationship with another. Such invested people facilitate conscious development of the other person's abilities to self-monitor and subsequently, self-regulate with appropriate and successful choices and behaviors.

"Down the Relationship Rabbit Hole, Assessment and Strategy for Therapy “ asserts assessment is critical for successful therapy. Individuals often come with issues that affect their ability to have successful relationships, not the least of which are committed romantic intimate relationships. Couples and families come to therapy to repair fractured relationships causing great pain and dysfunction. Straightforward questions help assess the quality and dynamics of relationships and direct therapy. Trust, vulnerability, self-expression, empathy, and investment are presented as foundational to intimate relationships, as power tools to assess relationship quality, and to also direct therapy to build relationships. The seven-step devolution of relationship model also is used to assess quality and status of problematic relationships and to direct therapeutic strategies and interventions to heal and rebuild positive relationships. Assessment, intervention, and evaluation become unified therapeutic processes using the set of beginning questions and the two valuable models presented in this book by a licensed marriage and family therapist highly experienced in working with difficult relationships.

“Out of the Developmental Chrysalis in Intimacy and Relationship Therapy.” Developmental theories offers excellent guidance for assessment, diagnosis, and therapy for adult individuals especially with intimacy and relationship challenges. Expansion of the focus on developmental theories beyond infancy, childhood, and adolescence can enrich therapy for individuals, couples, and families. From the baby's need to be picked up and soothed, early developmental experiences predispose the individual to attachment, intimacy functionality, and relationships in adulthood, including in the couple and in a family as well as in the workplace and socially. Individuals come out of childhood shaped in functional and problematic ways that can enhance or challenge important relationships. Ten basic rules of developmental theories guides assessment and diagnosis of intimacy and relationship functioning, while also providing guidance for enhancing resiliency and reparative therapeutic relationships. Primary defense mechanisms and theories of the cognitive development are re-examined to enable the therapist to evaluate clinical presentations and provide strategy for therapeutic interventions. A person's apparently immature presentation instead is revealed to be clear clinical cues to the developmental history of individuals, the etiology of behavior, and the goals of therapy. Attachment theory and Emotionally Focused Therapy are viewed from these principles and rules. The therapist is directed how take a transitional authoritative quasi-parental role to promote developmental progression of quantitative change to create the qualitative change that are the goals of therapy.

“Therapy Interruptus and Clinical Practice, Building Client Investment from First Contact through the First Session.” Therapy commences immediately with the very first contact and proceeds through the initial phone intake and the first session. The very first contact is in how the therapist or agency presents oneself or itself to the general community in various forms of outreach, marketing, and self-exposure. The practical and conceptual guidance in this book focus specifically in the first contact by phone and the first session, while giving comparable principles for marketing to potential clients and the community. Seven keys to create investment in therapy propose a framework to approaching the client: individual, couple, family, or group during the initial contact and the beginning of therapy for the therapist. When the therapist articulates the process of therapy, the client is more likely to gain confidence in the therapist that he or she can fulfill their needs. Conceptualization of therapy suggest language the therapist can use to communicate rapport, expertise, wisdom, and credibility to prospective clients constituting a “selling” or “marketing” of therapy to clients that enables them to attempt the process and more committed clients. Sound clinical practice in the first contact and first session lead to fewer problems with no shows to scheduled sessions and clients dropping therapy prematurely or unexpectedly. Good therapy can be good business as well.

"Roles, Rigidity, Repair, and Renovation in Relationships and Therapy." Structural theory and therapy principles are applicable not merely with the family, but also applicable to the couple and other relationships, as well as for individual intrapsychic issues among various personas, the ego, id, and superego, or conflicting motivations, drives, needs, feelings versus thoughts, and so forth. Structurally oriented therapy seeks to change organizational patterns of problematic communication and potentially or actively neglectful, harmful, or abusive behaviors. The therapist is guided to take an authoritative position to alter the structure of relationships for the individual, couple, or family. More passive therapeutic approaches are revealed as counter-indicative when the individual for him or herself, or the parents form ineffective executive dyads. The therapist facilitates structural change including lessening or eliminating emotionally and psychologically harmful symptoms. The therapist works to make clients become aware of behavior, situations, roles, and how choices are made. The individual may take, be given, or be compelled to roles and responsibilities that create inherent dysfunction. Rigid and enmeshed extremes in any area can indicate dysfunctional coalitions between and among relationship, couple, or family members. The therapist is directed to specific client compositions that indicate structural problems and are well served by structural therapeutic principles: blended families, step-parents, families in transition, culturally different couples including same sex couples, and so forth. Also certain client issues benefit from structural assessment and strategies: abuse of any type, substance abuse, and addictions. The therapist will learn important relationships and distinctions between equality and equity-based partnerships including culturally-based models that challenge mutually reciprocal intimates. Structural issues from various influences, including rigid versus over-diffuse boundaries may require repair. The therapist is directed to facilitate reparative processes for addressing problematic or broken dynamics, including poor communication and abusive or neglectful behavior. Therapy is guided to accentuate the good and effective, further facilitating healthy recovery and growth. Ineffective or harmful structure and boundaries are minimized and if possible, eliminated. The therapist is prompted to recognize how sometimes, the relationship structure or boundaries may be inherently corrupt if earlier models were never that healthy. Since sometimes old boundaries had never led to mutually healthy reciprocal nurturance and support in the past or the present, beyond repair the system requires therapeutic attention for a major overhaul or complete renovation to achieve functionality.

“Out of the Monkey Trap, Breaking Negative Cycles for Relationships and Therapy.” Therapists can help clients break repetitious cycles of negative behavior in dysfunctional relationships through using strategic principles. Individuals' experiences are to being stuck riding a personal train of intimacy pain suffered in such relationships. Similar to getting out of the trap by getting the monkey to release its grip on a seemingly essential fruit, therapists help clients recognize how they keep themselves stuck. In addition to strategic therapy, therapists will learn how many theories and therapies also target harmful relationship and life patterns that require interruption. These principles and strategies commonly used to address systemic issues in couples and families are also applicable for individual therapy. Intrapsychic confusion because of various internalized personas, values, embedded cultural and family-of-origin models, and social and relationship demands create personal conflict that can cycle relentlessly and fruitlessly within an individual. Therapists will learn two important strategies for healing and growth. The first is identification of positive patterns to perpetuate and accentuate that lead to productive choices and behaviors for the individual intrapsychically and for couples and families. Simultaneously, therapists should guide clients to also identify negative patterns to eliminate or minimize that continually cause stagnation and harm. Together these strategies lead to improving emotional well-being and intimacy. A basic plan, basic questions, six-step and nine-step treatment plans, guidance on interrupting the pattern, techniques from strategic principles of therapy, as well as the use of humor are presented. Therapists are directed to identify five elements in the personal process: another's behavior, interpretation, harm experienced, personal effects, and response that become strategic points for intervention. Assessment focuses on six common indicators that suggest the application of strategic principles for therapeutic intervention: cyclical behavior patterns, stereotyped perception or lack of perceptual flexibility, lack of cognitive insight, presence of unacknowledged implicit values, and authoritarian traditions or patterns. Therapists learn assessment and application of first order and second order change principles for addressing entrenched dysfunctional behaviors in individuals, couples, or families. Therapy from conceptualization and assessment, as well as facilitating crises are discussed to reduce client resistance, increase health, and prompt second order change. Therapists learn how as the monkey squeezes the fruit harder, pulls harder and more frantically, individuals, couples, and families intensify already ineffective processes in frustrating and failed attempts at first order change. Therapy becomes like the monkey who releases the golden fruit to reach towards more a more enticing reward and almost magically frees itself, as it shifts clients fundamentally to become unstuck through second order change.

Mirror Mirror... Reflections of Self-Esteem in Relationships and Therapy. The request for communications oriented therapy often assumes a need for self-esteem focused therapy. Poor communication directly harms self-esteem and relationships as individuals poorly mirror each other. Comment, complaining, criticizing, contempt, defensiveness, disconnecting emotionally, and divorce are both stages of relationship devolution, but also concepts to assess communication dynamics, relationships, and direct therapy. Blocked or inappropriate expression or feelings, covert communication, open versus closed communication, congruence and connection, stances, games, and dysfunctional rules and rituals are examined for recognizing key relationship problems and therapeutic strategies. The development of self-esteem, relationship to socialization, the Four Principles of Self-Esteem, and mutually reciprocal affects between confrontation and conflict lead to two specific tools: the Four Honorings of Communication and the Working It Out Plan for therapy. In addition, the book presents the eight-step process to build the self-reflective foundations of self-esteem and the projective formulative seven-step process of self-esteem and the 90-Second-A-Day Self-Esteem Prescription Plan.

"Therapy? What's Therapy!?" Therapy takes many forms and requires the therapist to flex among many potential roles: judge, referee, facilitator, mirror, guide, educator, fixer, interventionist, parent, and cross-cultural guide. The therapy becomes the vehicle of hope- building, finding, and perhaps, final elimination of hope, and the therapist in various roles managing hope for the individual, couple, or family. The therapist who holds inflexible or moralistic stances risks inflicting his or her values upon the client, and taking away self-determination. Successful therapy involves reconciling the goals of the client- potentially multiple and different goals between partners or among family members with many other issues, including therapist goals. Challenges to therapy include family-of-origin experiences, cross-cultural and gender issues and counter-transference from being triggered and liking or not liking clients, and recruitment of the therapist by partners or family members in couple and family therapy. Principles of relationship therapy relevant to couple or family therapy are shown to be applicable to individual therapy through conceptualization of different perspectives and personas within the individual.

"All Relationships and Therapy are Multi-Cultural- Family and Cross-Cultural Complications." The therapist must conduct therapy as inherently cross-cultural and multi-cultural, not only between and among clients but also between the therapist and clients. Cross-cultural or multi-cultural perspectives are not an occasionally helpful or enriching tool in therapy, but a, if not the primary assessment and treatment strategy for effective interventions. Family-of-origin experiences are comparably compelling to functioning and relationships as culturally-based experiences that can cause matched and mismatched dynamics that can complicate and harm intimacy and harmony. There are important problematic approaches to cross-cultural conflicts that the therapist should avoid, including knowledge approaches that overwhelm the therapist. In addition, a practical approach will be presented that facilitates connection and intimacy, while addressing the client expressed therapeutic roadblocks of cultural determinism and cultural relativism: “I have to,” and “You don’t understand.” Therapy can be mismanaged with clients who appear to have identical demographics, who nevertheless present significantly different attitudes, values, and behaviors based on family experiences comparable to cultural modeling. The harm of dismissal and disconnection from some universalistic approach to diversity (“I see you as an individual. I don’t see color or differences”) are examined as existential annihilation counter-indicative to good therapy. The therapist is guided how to adapt clinical strategies to fit the cultural styles of clients. In the challenging but not uncommon situation, when the therapist is not familiar with client’s cultural background, the therapist will be directed to effective therapeutic strategies using expression areas of cultural differences.