Piggybacking off the post I shared a few weeks ago, I wanted to expand upon the statement that there are many ways to heal. What I see in the field of psychotherapy, as I see in many other fields and areas in our lives, is that at we’ve divided the mind, body, and soul into “modalities”: CBT/ERP; family systems, depth psychology; psychodynamic; psychoanalysis; trauma healing; somatic psychology. While I understand the need to categorize as the field is too broad to place every approach under one umbrella, there also seems to be a subtle competition between modalities, a way in which depth psychology turns up its nose to CBT and a way in which CBT consider “psychoanalysis” to be a dirty word, as Pete Weiss recently said in this interview.
That said, most therapists do draw on multiple modalities, and I’m also seeing a willingness in the field to refer out when a client needs something in addition to what the therapist is trained to address (more on this at the end of this post). So, as in other areas of our lives – from culture to gut health to farming practices – we’re recognizing that diversity is more effective than one approach. Diversity, it seems, is the name of the current game.
In this vein, when it comes to the healing of the psyche, we may find that:
Sometimes we need a cognitive correction.
Sometimes we need to learn how to feel our feelings, process trauma, and attend to early wounding.
Sometimes we need to balance our physiology.
Sometimes we need to make behavioral changes.
Sometimes the soul is dry and needs to be watered.
Let’s take panic attacks as an example. I’ve seen panic attacks recede quite quickly with a cognitive correction, by which I mean somebody is struggling with depersonalization, for example, and once they learn what depersonalization is – that it’s a thing – they’re no longer afraid of it and it goes away. As a significant element of anxiety and panic is fear of the fear, it makes sense that a cognitive correction that tells you what’s happening, explains that a panic attack can’t hurt you and that it’s normal, can quiet the fear of the experience, which allows the experience itself to diminish.
I’ve also seen panic attacks be resolved with behavioral changes, what we call Exposure and Response Prevention, or as Barry McDonagh teaches in his brilliant book Dare, to learn how to run towards fear. Through this lens, we can talk and talk and talk about a panic attack, but until we take the action that dissolves the fear, panic will still retain its power.
Continuing along through the realms of self, I’ve seen panic attacks resolve when the root cause and the trauma elements are addressed. This means recognizing that, for some people, in order to make behavioral changes, they need to understand where the panic attacks are coming from and place them in a greater context.
I know I speak for many of my clients and course members when I say that without the element of meaning and the understanding of root source, it’s much more difficult to make the behavioral changes. From a depth psychological perspective, we understand that symptoms emerge from the unconscious and carry important messages. Not everyone needs to understand the messages in order to make the changes, but many do.
Furthermore – and this is not true across the board but it is true in many cases – without addressing and resolving the root cause embedded inside the symptom of panic, for example, you can resolve the symptom only to find that the root cause finds another way to express itself. This is why I say that when we seek to reduce anxiety only through symptom reduction a game of whac-a-mole often ensues.
Lastly, we come to the spiritual realm. I have seen panic disappear when somebody commits to and embodies their spiritual practice. Why? Because seen through one lens, panic attacks are opportunities to learn how to surrender into groundlessness, move toward existential terror, and make peace with uncertainty. Fundamentally, these are spiritual tasks.
For most people, different interventions will be required at different stages of life and with different symptoms. This is why therapists who are trained in a holistic model are most effectively able to help their clients. If a Jungian-trained therapist is attempting to treat compulsions exclusively from a depth perspective, they may overlook that what’s actually needed is a cognitive correction or a behavioral change. Similarly, if a CBT-trained therapist is unable or unwilling to explore a client’s emotional and psychological background and possibly trauma, the symptom reduction may be ineffective or short-lived.
This is why I believe that a community or collaborative model of psychotherapy and healing is emerging, one that recognizes with humility the limitations of an individual clinician or healer. When a client comes to me, for example, and is needing to do a round of EMDR, I am in full support of that person seeking the help of another therapist since I’m not trained in EMDR. The mainstream model of psychotherapy teaches that it’s a conflict of interest for a client to work with more than one therapist. I don’t see it this way, nor do many of my colleagues who have been working in the field for decades.
Again, it comes down to one of the precepts that I often teach in relationships: one person cannot be all things. This is true in romantic partnerships, in parenting, in friendship, and in our work lives. Just like one or two parents cannot fill all of the needs of their child and, thus, the phrase “it takes a village”, so one therapist cannot meet all of the needs of their clients – nor is it their job to meet all of the client’s needs. Ultimately, good therapy, as good parenting, teaches the client or child to take responsibility for their own well-being and learn to accept the imperfection of any one person.
As we see the patriarchal models and mindsets crumbling all around us, I believe we are going to see this in the healing professions as well, for it is an arrogant mindset that stems from the masculine principle gone awry that expects a therapist to be all things to all clients. The collaborative approach is the feminine approach in all areas of life. This is what is needed, and I believe that this is where we are headed.
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Note: I very much value your comments as they pertain to each post and I love hearing about your insights and breakthroughs. However, if you’re struggling with relationship anxiety, I know it’s tempting to ask for reassurance or guidance, but unfortunately, I’m not able to offer advice in this format. I encourage you to read through this Collection, consider the Break Free From Relationship Anxiety course, and, as always, work with a skilled and loving therapist who can be a guide and witness for your healing. If you’re struggling with other anxiety themes, please see my book, The Wisdom of Anxiety, and read through my hundreds of free blog posts on a variety of topics.
“One therapist cannot be all things to all clients” – I definitely agree with this, but I don’t think it necessarily means one needs to rush out to find another therapist in addition. A lot comes from accepting that much of the work needs to come from within, not without. At least that is how I see it.
Absolutely, J!
I think this is especially true when RA is manifested between client and therapist (as is the case with me)
Agreed. Thank you for bringing this into the conversation.
I agree with this, plus the need to consider other forms of self-help outside of therapy.
This might interest other midlife women reading this – I’ve been working on myself quite hard following poor mental health last year.
Through my contact with others my age group on various social media groups, I’ve noticed that a not so frequently mentioned symptom of menopause is quite severe rumination. In fact, a friend of mine who is the same age as me (53), is suffering from near identical symptoms!
We are keen to resolve our symptom through therapy, and I’ve done a lot, but so far nothing Is easing this behaviour.
Anyone got any ideas, please?
How inciteful your commentary is on this matter. Before working through Breakfree from Relationship Anxiety, I’d had a few pockets of ‘therapy’ for anxiety over the previous 15-20years with CBT being used for the anxiety I felt about my relationship. I went along to the sessions, worked through and with the advice and guidance, but I felt it wasn’t quite hitting the mark.
I then found your work and not only did it help with the RA, but it got me to delve into my roots and it has unearthed and untangled many of the causes of my anxiety, whereas I now know I have the skill and tools available to me to repair as I need to rather than getting to the point of my world falling down.
I have in mind that that CBT is like putting a sticking plaster over an infected wound, but when that plaster falls away, the wound reopens, whereas your work in more of a removal of the infection so the wound can heal.
I’m so glad my work has been helpful, Donna. Thank you for sharing your story and I’m so glad you’re here.
“The collaborative approach is the feminine approach in all areas of life. This is what is needed, and I believe that this is where we are headed.”
Excellent conclusion, Sheryl! I totally agree. Thanks as always for your insights.
Thank you, Paulette!
I definitely agree. Therapists are there to guide us, not heal us in my opinion. They’re here to hold our hand through the healing process, not do the healing for us by giving us some magic healing potion.
I also want to share that I made a breakthrough with my anxiety today, Sheryl. I have been “stalking” these posts for quite a while now and have yet to comment. I was reading an article on how the word “should” is very harmful to our psyche. Something about it spiked my anxiety because I think back to times when I talk about my partner to my family. Ever since high school, I’ve always been extremely awkward and closed off when it comes to talking about significant others. With my current partner, I try to make the effort to talk to my family about her more and more even if it’s uncomfortable because I want them to know she’s different than past relationships and that she’s special to me. My brain immediately went, “What if you’re just acting how you think a good boyfriend should act like and you don’t truly love her.”
I immediately started journaling and getting my feelings down, but I stopped myself and responded with, “No you do love her, or otherwise you wouldn’t be going to the extent of getting over your uncomfortableness to show she is special.”
I know that was a lot, but I just wanted to share that with you!! Anything you have to say is welcomed.
That sounds like a wonderful breakthrough, AJ! Thank you for sharing.
“Again, it comes down to one of the precepts that I often teach in relationships: one person cannot be all things.”
This hits so close to home. As I am in my first real relationship, I’m starting to learn about this and the idea of needing to fill up my own well instead of relying on my boyfriend to do so.
I recently read your article on not being attracted to your partner and it was amazing. When you talked about what draws you to your partner, it spiked my anxiety a little bit. I’m worried that I’m only attracted to my partner because of their physical appearance. My partner and I have the same sense of humor, but I always feel like I’m forcing a laugh with him. I’m gonna keep working on my anxiety, but I’m just a bit worried!
I personally think that a mixture of traditional talk therapy and CBT can be useful – once the core trauma has been identified and processed first. In my personal experience, I attended a therapist for my relationship anxiety. This person had a lot of experience treating anxiety via CBT. Almost immediately, she correctly identified my anxiety as being caused by early childhood trauma (I was aware of this myself for a number of years now and other therapists had confirmed this) and said that she would need therfore need to offer a slightly different course of ‘treatment’. Even though I felt she meant well, I feel that she was too entrenched in a very matter-of-fact, CBT style approach which I felt did not help me at that stage in my healing. I would be sitting in a Therapy session, sobbing about my family of origin and she would sit there and offer me phrases to help me make ‘sense’ of my feelings. I don’t think it was at all intentional but I actually almost felt retraumatised as it reminded me of my family ignoring my feelings of extreme sadness, fear etc as a very young child. I subsequently changed therapist, this time to a therapist who practiced depth psychology and who didn’t offer any ‘quick fix’. We worked alot on my very strong mother wound and I realised how much my insecure anxious attachment style impacted my relationship. Now, a year later, I feel ready to incorporate CBT, having grieved alot, and I may explore this in the near future – anxiety in many forms has been a feature of my life since early childhood. In my personal case, as a very emotional, creative and sensitive person who ironically became an extreme over thinker due to these traits not being honoured in my childhood, I feel it was essential to feel my feelings first and then deal with the behavioural aspect of my anxiety
This makes so much sense. Thank you for sharing your experience.
I have not worked that in-depth with mental health (yet), but I have found this to be true in my physical health. I was diagnosed with ulcerative colitis at age two- extremely rare at the time. I look around and I see most people trying medication after medication, being hospitalized several times a year, often needing surgery, and I’ve never had any of that. I’ve been hospitalized only twice. I was on one medication as a kid, and after it stopped working I switched to a different combination. Obviously, it’s all anecdotal, but I know that the reason for this is I’ve never relied solely on Western medicine, or even on alternative medicine. I’ve used a combination of both since I was diagnosed, and back then none of it was accepted as valid (unfortunately, lots of alternative healing methods still aren’t). My GI doctor for years would say “I don’t think it’s doing anything for you, but it’s not hurting you”, and two minutes later would say “I don’t know how you’re this healthy, but keep doing what you’re doing.” I’m encouraged now that we’re starting to see MDs who work in the alternative realm as well because I agree. We need collaboration from our healers.
Yes, I agree, Riley.
Thanks for this article Sheryl. As a social worker and therapist I sometimes feel the pressure to know how to do everything and “treat” everyone. This was very reassuring that I’m on the right path being myself and doing my best with my eclectic approach.
I’m so glad the post was helpful, Mel.
Great post, Sheryl!
Does grieving about the unrealistic expectations for a relationship and learning to be okay with that count as healing?
Of course!
This hits home to me on so many points! Thanks for sharing this insight. I love reading your blogs.
I’m so glad, Danica!
Thanks for this post, Sheryl! I think this approach is important b/c it encourages honesty: from the client when maybe a particular therapy isn’t quite hitting the mark, and honesty from the therapist when they realize the client needs something more. Without the acknowledgement that there are many valid and useful modalities, I think there’s the temptation to force each person/issue into an overly narrow framework and that does everyone a disservice. With this honesty, everyone feels more freedom to explore and find what works. Its harder b/c you can’t just assume one modality will fix everything, but I think its better in the long run b/c you learn to listen to what you really need, to what your heart and soul are resonating with. Thank you for modeling this honesty, it makes me trust you even more!
Beautifully articulate, Lori. Thank you. Self-trust is KEY!
Wow, Sheryl. I love this!
When I was told I have ROCD and told about all the different medical terms, it was scary. I was introduced to ERP and was super scared because it sounded so daunting and “medical”-y. It was actually extremely helpful, but traditional methods always comfort me the most. Something more grounded about them and I can feel the rich history of them, which makes it all the better in my opinion. I love history!
When it comes to relationships and RA/ROCD, your work is more helpful than you’ll ever know. I’m currently learning to rewire my expectations of love and I’m working through the OYH course. I recently worked on the Document of Attraction exercise and I have to say it spiked my anxiety a bit. I’m worried that there’s nothing internal that I love about my partner so I only wrote a couple of things down. It sort of sent me down a rabbit hole of, “Do I even like my partner?” or “Have I always not liked my partner?” – Stuff like that.
The OYH course is so much more helpful than any therapy workbook, I love it. Just wanted to share that and see if my thoughts are normal. Thank you :).
Try doing the document of attraction when anxiety isn’t in the driver’s seat. It’s highly unlikely that there’s nothing intrinsic that you like about your partner.
I am the opposite of you, Young – ‘medical’ models and terminology turn me off – I am not a ‘machine’ that needs to be ‘fixed’. But I’m super glad you found something helpful for you. We are all different, aren’t we! 🙂
Sheryl-
All the psychology terms scare me and I’ve always felt like there is only ONE way into the healing of a wounded soul so thank you for this article!
As I am currently healing my RA with ERP, it feels nice to read this and realize there are many different routes to healing.
Could you possibly go in-depth into feeling like a lie and you are really just faking your happiness and blaming it on RA? In all my relationships, I’ve struggled with feeling genuine laughter around my partners. Is this because I haven’t found someone I truly love? Sorry for going off-topic :(.
agree with this, plus the need to consider other forms of self-help outside of therapy.
This might interest other midlife women reading this – I’ve been working on myself quite hard following poor mental health last year.
Through my contact with others my age group on various social media groups, I’ve noticed that a not so frequently mentioned symptom of menopause is quite severe rumination. In fact, a friend of mine who is the same age as me (53), is suffering from near identical symptoms!
We are keen to resolve our symptom through therapy, and I’ve done a lot, but so far nothing Is easing this behaviour.
Anyone got any ideas, please?