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TRANSFORMATIONS Issue 11 - Spring/Summer 2014

 

TRANSFORMATIONS 

from the office of

Christopher Emerson, Ph.D

Spring/Summer 2014 Issue No. 11  

 

 

Welcome to the current issue of TRANSFORMATIONS. In this issue, Robert Linton, MFT-I writes about emotional reasoning and the difference between feeling and fact.  I address aspects effective psychotherapy in my article entitled "Achieving More Effective Psychotherapy," Finally, Los Angeles-based psychotherapist and author Dr. Beverly Berg shares an excerpt from her new book in our TRANSFORMATIVE VOICES section.

As always, thanks to practice administrator Dylan Maddalena for all of his hard work in putting this issue of TRANSFORMATIONS together. Please visit my website (www.drchrisemerson.com) for more information about my practice and for past issues of TRANSFORMATIONS. I look forward to hearing from you with your comments, questions, opinions and insights!

 

Dr. Chris Emerson 

 

 

 
 

  GETTING AN ANSWER

  

   

By Robert Linton, M.A.  

Robert Linton, M.A.
 

 

 

An acting student tells the story of attending a master class many years ago taught by the great method acting teacher, Lee Strasberg.  At one point, Strasberg asked the class for questions, and another student sitting next to her whispered, "I have a question, but I am too shy to ask in front of the whole class."  The student, who now winces as she relates what she did next, pointed to the student next to her and loudly said:  "Hey Lee - this guy has a question, but he is too shy to ask."  Everyone in the room laughed except Strasberg, who looked at the embarrassed young man, and then back at the student, and matter-of-factly replied, "Then he should ask his question, shyly."

 

When you make a decision as to whether to take action in your life, is it you or your emotions that are in control? We sometimes let our feelings dictate whether or not we will do something that we want, need, or is in our best interest to do.  The process is called "emotional reasoning":  "If I feel (angry/afraid/sad/anxious), there must be a legitimate and justifiable reason for it, and I will act (or not act) accordingly.  For instance, in the case above, because he was feeling fear, the student believed at some level that there was a dangerous situation to be avoided and it deterred him from asking his question.

 

In therapy we look at events such as this, identify the feelings, determine whether the feelings are truly congruent to the situation, verify and challenge the thoughts that arise from the feelings, and creatively choose a different and more useful way of thinking and informing ourselves about the same situation.  We often find that in so doing, the discomfort decreases and is replaced by greater confidence and ability in ourselves to meet our goals.

 

After learning and utilizing the tools of this process, the student's friend might still have felt anxious about asking the teacher the question, but he would have been more able to accept and tolerate that feeling, ask the question he wanted, and meet his goal of receiving the answer he needed.

 

 

 

ACHIEVING MORE EFFECTIVE PSYCHOTHERAPY

 
By Dr. Chris Emerson
 
Dr. christopher Emerson, Ph.D.

 

Many patients, both those who are new to the process of psychotherapy and those who have many years of treatment under their belts, are often unclear about how to gauge the effectiveness of psychotherapy. On the one hand, the positive impacts of psychotherapy are so unique to each individual and so experiential in nature that it's difficult to generalize. On the other hand, a great deal of importance in the field of clinical psychology is attributed to "measurable outcomes;" they can determine which research projects will be funded in the field, the rate at which particular psychological services are reimbursed by insurance companies, and how to most effectively train new clinicians to achieve optimal results.

 

Here's the good news: over the last decade, a group of researchers tracking the outcomes of thousands of clinicians around the world have found that psychotherapy continues to help around 80 percent of the people who seek the assistance of therapists to deal with their problems (The National Psychologist, Vol. 23, No. 1, January/February, 2014). But the bad news, according to these researchers, is that psychotherapy has not shown any measurable

improvement during the last 40 years in how well therapists deliver their services.

 

The question of how to make therapy as useful as it can be in the consulting office is of critical importance to me. To that end, I have identified several specific components of the characteristics and behaviors of effective psychotherapists and their patients: (a) Positive Shared Intention, (b) Preparation and Reflection, and (c) Consultation and Collaboration. 

 

People come to psychotherapy for a wide variety of reasons. Some are seeking symptom relief such as reducing feelings of sadness and hopelessness, or simply to improve their coping skills at work and at home. Some may come to therapy to learn how to more effectively

communicate their needs to others, including a spouse or partner. Some people come with more wide-ranging goals, including increasing their overall self-understanding, addressing long standing relationship patterns, or charting the often difficult existential aspects of entering a new phase of life. This initial reason for seeking therapy is what psychotherapists speak of as the "presenting problem," and often, it opens up and expands into other issues as the process of psychotherapy unfolds.

 

Regardless of the presenting problem or the subsequent issues and treatment goals, it's important that both therapist and patient have a mutual intention as to what they hope to achieve, and the means by which they will go about it (e.g., an agreed-upon frequency of appointments, a commitment to work together through difficult phases of the treatment, etc.). Another key component of positive shared intention is the mutual understanding that progress is indeed possible, and establishing a basis for working together that includes the patient's reasonable hope for improvement.

 

The next characteristic behavior of successful therapists and patients is that of preparation and reflection. I find that the patients that benefit most from therapy are those who are able to somehow "bracket" the therapeutic hour from the rest of their busy day, and allow enough time and space to be fully present for the therapy. It's particularly important for patients who are working through trauma to allow themselves the time and space after the session to come fully back into awareness with the body, their physical sensations, and the powerful thoughts and feelings that can emerge from this work. And the patients who seem to get the most out of psychotherapy also allow for some time to reflect on the issues raised in therapy throughout the week.

 

Therapists, too, need to allow sufficient time to prepare and to reflect. The previously cited research found that "top performing" therapists spend a good deal of time getting ready for therapy sessions, and a lot of time afterward assessing their work. In addition, it's vital that as mental health professionals we are mindful of our limits, that we do not overschedule ourselves or take on more patients that we can handle with clarity, energy, and empathy.

 

This leads to the last characteristic behavior of consultation and collaboration. These important activities take place in several realms. One of the most effective forums for therapists to assess and reflect upon our work is in consultation with other professionals. I regularly meet with colleagues and former clinical supervisors to review cases and solicit new perspectives and feedback. Giving and receiving consultation takes us out of old, established ways of thinking and practicing, helps to ensure that we are acting ethically and in the best interest of our patients, and that we are practicing good self-care as clinicians.

 

Another aspect of consultation and collaboration involves the therapist working with other professionals such as psychiatrists and other medical providers who comprise a patient's "treatment team." Patients should expect that such collaboration be made available as a part of their therapist's treatment plan when appropriate, and they should understand that such consultation can take place only with their express written permission.

 

This is an important and often underutilized aspect of mental health care for both psychotherapists and patients. When we work with the mindset of being a well-functioning, highly communicative team - a team that includes the patient, of course - the probability  for positive outcomes is increased exponentially. After all, health is a multidimensional construct, and no one professional has expertise in every area. We really do need each other for optimal success.

 

By being mindful of these principles, both the therapist and client can better assess the extent to which they are having positive, successful experiences in the shared endeavor of psychotherapy. Perhaps the most important "takeaway" from this article is to remind us that we are indeed sharing in the experience, that it truly is a collaboration, and that only by working well together can we expect to achieve optimally effective psychotherapy.

 

 

 

 

IN THIS ISSUE:
-Getting An Answer
-Achieving More Effective Psychotherapy
-TRANSFORMATIVE VOICES

 

 TRANSFORMATIVE VOICES  

  

This quote comes from psychotherapist and relationship expert Dr. Beverly Berg's new book, Loving Someone in Recovery: The Answers You Need When Your Partner Is Recovering from Addiction (2014, New Harbinger Publications, Inc.). In upcoming issues of 
TRANSFORMATIONS, I will present an interview with Dr. Berg. --CE

 

 

During the twenty years my husband, Brian, and I have been together, we've always had support from a vast network of loving friends and family. Even so, we needed the help of experts to ensure we stayed closer to love than to war. We tried a myriad of couple-improvement programs while "trudging the road of happy destiny" together by working the 12 steps and remaining actively involved with a community of those in recovery. These programs were, and remain, the foundation for our lives, emotionally and spiritually. We used them before we met and continued to do so after we became a committed
couple . . . 
Ultimately, I wrote Loving Someone in Recovery to promote the values of kindness, compassion, and connection that are possible between partners in a committed relationship once addiction has been arrested and recovery has taken its place . . . Yes, it can be tough. But in my experience, most people can succeed if they're armed with the right skills . . . so that slowly but surely you go from disconnection to connection, from unconsciousness to consciousness; from suffering to joy. 

 
 
--Beverly Berg, MFT, Ph.D.

  

 

 

This concludes the eleventh issue of our seasonal newsletter, TRANSFORMATIONS.
Feel free to forward TRANSFORMATIONS to friends and colleagues, and take a moment to check out our archive of past issues at www.drchrisemerson.com. As always, we create our newsletter for YOU, our friends and colleagues, and we welcome feedback, comments, questions, or a simple "Hello". We look forward to our next encounter - Thank you for reading! 
 

Best, 
 
 
Chris, Robert, and Dylan
 

 

Contact Us...

for appointments and comments

Dr. Chris Emerson: 
(310) 550-4560
Robert Linton, M.A., MFT-I: 
(213) 422-3458


Dylan Maddalena, Editor:

[email protected]

(310) 550-4560

www.drchrisemerson.com

 

822 S. Robertson Blvd., Suite 303

Los Angeles, CA 90035 

 

and

 

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Palm Springs, CA 92262

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