Talk Therapy

Talking. As a species, we’ve gotten pretty good at it. You might even say we’re obsessed with it. The ubiquity of cell phones has fed this obsession by making talking available in settings that were previously solitary. Even at concerts, where people purportedly go to have a listening experience, they can’t seem to stop talking.

But the talking that happens in a therapy session is much different from what characterizes your typical conversation over coffee or dinner, or yelling over the band you paid good money to hear. Every hour I spend with clients is an invitation for them to say the things they usually keep to themselves. It’s a promise that they will not be judged for their truest thoughts and feelings. Their words will never be met with criticism, but always with curiosity. In this environment, people tend to be surprised by their own words, set loose on the air like never before. I’ve witnessed clients have countless epiphanies just from hearing themselves say something out loud…

A reason people often give for avoiding therapy goes something like this: “What are they [the therapist] going to tell me that I don’t already know?” But good therapy is not a question of what I (the therapist) am going to tell you (the client). Rather, it’s a question of what you’re going to tell yourself, given the space and safety to speak freely. And you can never predict what you will hear yourself say, nor how you will respond to hearing it.

Of course, effective talk therapy isn’t just about feeling free to say anything. My role as the therapist is to ask the kinds of questions and make the kinds of observations that most people aren’t used to hearing. An eclectic array of modalities guides me in choosing what to say and when to say it. My favorites of these are Internal Family Systems, Modern Psychoanalysis, and an amalgam of somatic (body-based) approaches.

Internal Family Systems (IFS) provides a rich framework for exploring the different “parts” of the self. All of us has about fifteen of these sub-personalities that come to the fore in different situations. Getting to know ones different parts is, in my experience, an essential part of healing and growth. When working from the IFS perspective, I might ask clients questions like, “In espousing this belief or directing this behavior, what is that part of yourself trying to protect?” Or, “If that part of yourself were to walk into the room right now, how would you feel about it?”

Modern Psychoanalysis uses the therapeutic relationship (the dynamic between client and therapist) as its primary reference point. Working from this perspective, I might point out moments in which I feel disconnected from a client during the therapy session, or I might ask a client if he or she is bringing a certain behavior (like people-pleasing) into the session. Modern Psychoanalysis also borrows from its traditional predecessor in the importance it places on early childhood experiences. I tend to agree with this theory’s assertion that most of our present day psychological struggles originated in our family of origin, in preverbal experiences. Therefore a question I commonly ask is, “How old is this feeling?”

Finally, somatic approaches to counseling involve getting curious about ones physical experiences in the here-and-now of the therapy session. Questions like, “Are there particular sensations coming up as you talk about this experience?” and “If that sensation could talk, what would it say?” are typical of this modality. Many of us are well-versed in the goings on of our discursive minds, but rather oblivious to what’s happening below our necks. Stripping away all the neck-up messages and tapping into our immediate, felt experience as it exists in the body is an essential element in reducing all kinds of suffering.

I find that IFS, Modern Psychoanalysis, and somatic inquiries complement one another in effectively addressing anxiety, depression, eating disorders, complex trauma, and other issues that pervade our society. Mindfulness-based modalities like Acceptance and Commitment Therapy (ACT) are also invaluable for contacting the truth and safety of the present moment, as is a continued focus on self-compassion.