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  #11  
Unread September 26th, 2006, 05:25 AM
Janet Doron Janet Doron is offline
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Default Re: CBT, religious faith, current events....

Not at all, John, I did not perceive your post as an attack. I find your words inspiring, helpful, and I sense genuine involvement and a willingness to go out of your way to assist.

What has served me best so far, is a very flexible approach which combines or alternates working hypotheses depending on specific aspects.
When dealing with mundane issues that concern coping on a day to day basis with relationships, work tasks and expectations, we made evident progress and achieved significant success with standard CBT that also explored the origins of thoughts and assumptions in early experiences. When dealing with belief systems and deeper schemas, I find it more helpful to abandon this approach, and adopt a no-hypothesis-at-all approach. I then work more or less along the lines that you and the others are suggesting.

It is for the latter approach I needed validation and support from the forum, as well as more ideas, or otherwise correction from more experienced colleagues. I also simply need to deepen my understanding of faith and philosophy to empower me in this case with more ideas. It is not so much that I feel stuck with this client, but rather that I felt uncertain in my professional approach. The input from other professionals is valuable because this is a challenging and unusual case, and I hate the thought of leaving any stone unturned - including the possibility that my approach is lacking or misguided. The support, ideas and validation given here strengthen me and I now have more ideas to develop and work with.

I completely agree with your list of seven goals, and I acknowledge and accept the challenges that each item presents (example - the challenge of opening a resource of love to an individual who rejects being worthy of love - even God"s love). I will continue to do my best, and I will put in all the extra research and effort neccessary to generate ideas and make "my best" much better than "good enough".

As I mentioned before, I see this as an experience of personal growth also for myself, and I believe both of us can learn and benefit from this interaction.
No, this difficult client has not discontinued the sessions, and it"s been well over a year with significant landmarks of improvement, so yes, I must be doing something right. I"m just being extra careful and self-questioning in this unusual and challenging situation, so I have asked for as much input as I could get, to make up for my limited experience.

Thanks for everything, John

Janet.
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  #12  
Unread September 26th, 2006, 11:25 AM
Healer Healer is offline
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Default Re: CBT, religious faith, current events....

I hope that you don't mind if I reply from the point of view of a meditator, and someone who has had a fair amount of exposure to a variety of belief systems, both from religion and psychology.

The answer always lies within.

No belief system can take away his power, not psychology, not religion, not the state.

I suggest that he take the risk and expose himself to many belief systems, as crazy and dangerous as they may seem to him (exposure therapy?). Demonstrate to himself that his relationship with God is strong, and he can maintain the integrity of his "self". And, the benefit might be, although I would not suggest this to him, is that he may find that he broadens his belief system, embracing more empowering notions of qualities such as humility. He may deepen his spirituality. I tend to think that Hindu belief are perhaps the most empowering in this way.

I also suggest that he become quiet, and listen to his heart, or his gut, or his intuition, whatever resonates with him. Suggest that perhaps he scan all the things that he has tried to deal with this, until he finds the one thing that either has not been tried or that has done the most damage in the act of trying to fix the problem. Call it contemplation. He may find the answers there. He may ask himself in this process, "What do I need in order to heal, and how do I get it?" This is a long-term process. It may take months before the answer is revealed. It may not work at all. But, I've always found that eventually, when I stop trying to problem solve, and I listen to the heart, the gut, the pain, that that is the voice that leads me. What's the heart trying to say, what's the message that the pain is trying to convey?

I've been doing this for many years now. Religion is not my innate interest. It was born of necessity and chance. Most people who are very deeply spiritual are driven, much like a gifted child is to math or the piano. He may just be one of those people. And just a thought, someone once said to me, a religious person fears going to hell. A spiritual person has already been there and back.
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  #13  
Unread September 26th, 2006, 10:55 PM
Janet Doron Janet Doron is offline
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Default Re: CBT, religious faith, current events....

Hello, Healer.

Thank you for your suggestions. I am afraid I am simply not personally qualified to offer instruction, guidance and follow up in the direction you recommend. Somebody else would have to do that with him if he so chooses.

I do know he spent considerable time researching other religions in the remote past (including Hindu) and integrating principles from various other belief systems into his Christian faith, which he eventually strengthened by doing that. We never went into the details at length. He actually takes pride in the rigorous analytic and comparative 'furnace' he has already put his faith through, and that for many years.

He is most certainly a spiritually oriented person, and what seems to have the most calming and healing effect on him is creative pursuits. When he is involved in art (or music), his "right side of the brain" takes over, he forgets time and place, he thinks in forms, colors and design rather than in words, he perceives the whole rather than the fragmented/analyzed, and becomes relaxed. It seems to have as good an effect as I believe meditation has.
He doesn't seem to define his goal as 'needing to feel better' but as 'needing to overcome concrete obstacles', and it appears that he values challenging them/himself intellectually, seeing that he chose the approaches of CBT.
I am trying to 'deliver the goods' according to his wishes, and with the tools that I do have. It'll be up to someone else to guide him along different paths.

Interesting quote you posted (a religious man fears hell; a spiritual man was already there - and back); It makes intuitive and poetic sense - I am enjoying it rather than implementing rigorous analysis here

Thanks very much for your input

Janet.
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  #14  
Unread September 27th, 2006, 01:11 AM
Healer Healer is offline
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Default Re: CBT, religious faith, current events....

I was thinking that he could look outside of psychotherapy, perhaps to things such as courses offered at centers that offer instruction ranging from meditation, to massage, to herbal medicine, and yoga. Right off the top of my head there are five that I can think of in the region in which I live.

It's emotional. He's not going to be able to logic his way out.
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  #15  
Unread September 27th, 2006, 06:50 AM
Janet Doron Janet Doron is offline
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Default Re: CBT, religious faith, current events....

Quote:
Originally Posted by Healer
It's emotional. He's not going to be able to logic his way out.
1)Of course it's emotional - even the most rigorous systems in philosophic thought rest on premises or axiomes we either embrace or reject for reasons that are deeply personal and have little to do with logic.
Emmanuel Kant, for instance, is unanimously accepted as a thinker who broke ground and created immense impact on modern civilization. Yet many find it hard to resonnate with him, and consider him cold and detached from 'the human condition'. Dig deep enough into his personal history and you will discover the 'whys'. Dig deep enough into the personal history of his followers or opponents and you will also find the 'whys'. The same goes for diametrically opposed thinkers from Plato to Sartre, for political activists and for spiritual leaders. The stronger the stand, the deeper the 'whys'. We identify accordingly....
We choose the axiomes and conclusions with our hearts. We then use our minds as tools to better serve and justify the heart. I have no doubt that my client is no different.

2)He is not trying to 'logic his way out'. He is not looking for a way out at all. I daresay he doesn't even want to change....not in the deep sense of the word. He once said to me: "you help me make sense of the whirlwind": it's the whirlwind he creates with, and it's the 'making sense' that he applies to the mundane side of his life, relationships and work-demands. He wants and needs both, and is very aware of both the empowering and debilitating aspects of his emotions.
I don't see the role of therapy as 'finding a way out', but rather as 'working better with that which is a given'.... opening up additional resources, offering tools to cope better.

3) I realize that meditation, Yoga, alternative medicine and other approaches outside of psychotherapy can benefit people. Forgive my shortcomings, yet I personally can only bring myself to see them as additional tools. Allow me to make a provocative comment: I believe that even just ONE very suitable life partner can have the soothing, comforting, validating, empowering and healing effects that some therapies offer
I also feel that each client responds best to a specific, tailored approach.
This particular person is a thinker. That's what he likes to do....use reason...
challenge himself...

I can only walk the path that I personally believe in most, and it is up to the clients to choose according to what they feel suits them best. He is well acquainted with various options on the market, yet he acknowledges significant achievements by means of CBT. As long as he feels that way and I have more to offer, I don't feel justified to turn him away. He seems to believe in the benefits of the method and to enjoy the challenges it offers.

All that said, I am keeping an open mind, I re-evaluate progress continually, and I have no qualms about referring clients as a rule. Thank you for making me rethink this

Janet.
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  #16  
Unread September 29th, 2006, 01:12 PM
John Simon John Simon is offline
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Default Re: CBT, religious faith, current events....

Janet,

You may want to read "The Answer Within" by Steve Lankton. It is a book about the legacy of Milton Erickson. He discusses at length about the concept of Utilization. Utilization is at its core a tool that allows the clinican to use what the client brings to therapy as a resource to help them change. It is the opposite of confrontation which often makes the client want to resist the therapist. I think that this book will provide you with the theoritical justification that you are seeking for working within the belief system of this client. I also wanted to ask you if your client discusses his ideas with some other person in order to get a diverse set of opinions on the matter? I know you said he won't talk with a pastor but what about another spiritual mentor? If he talks with such a person, can he bring that person into the session?

John
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  #17  
Unread September 29th, 2006, 08:34 PM
Janet Doron Janet Doron is offline
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Default Re: CBT, religious faith, current events....

John,

Thank you for suggesting 'The Answer Within'; I included it with my upcoming book-order, together with a few other relevant references.
I have to say, I like your approach (I've just read your reply in the other thread as well) and I have given considerable thought to some of the specific ideas you brought up in order to develop them further.

To answer your question: there is no spiritual (or any other) authority of any kind that this person looks up to re his faith, or anything else for that matter. He believes people can easily be deceived (the bible warns explicitely of that) and he trusts his own studying and judgement above anyone else's. He researched these topics for years, and he feels his system is coherent and comprehensive. He tells of discussions he has had in the past with theologians, in which his own reasoning had the upper hand. I don't know all the details, but I tend to believe him

There is some authority issue here (childhood experience), as well as objective circumstances: in the community where he lives now, he is probably one of very few well-read, well-educated, intellectually inclined people. His work (art and writing) is mainly done alone, family takes up much of his time, and when topics of faith or politics come up among friends, it is him that the others listen to, and his discourse is usually respected and enjoyed. So I'm afraid at the moment there is noone such as you describe that can be invited to the sessions.

It is extremely difficult to portray a complete and accurate picture in a forum such as this, and I most certainly emphasized the anxiety issues because those were my concerns. I should really do this person more justice by pointing something out: his is one of the brightest, most independent and creative minds I have come across in my life, and I have had the good fortune of extensive education, travel and exposure to many cultures. My goal is to open up resources for him while changing/influencing as little else as possible.
I am doing a lot of homework on this: everything from investigation of possible additional approaches such as ACT (Dr. Pretzer's thoughts), to familiarizing myself intimately with the bible

I'll let you know

Thank you, John.
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  #18  
Unread November 22nd, 2006, 12:43 PM
John Simon John Simon is offline
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Default Re: CBT, religious faith, current events....

Janet,

How are things going with this client?

John
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  #19  
Unread November 24th, 2006, 11:36 AM
Janet Doron Janet Doron is offline
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Default Re: CBT, religious faith, current events....

John,

Thanks very much for your interest, I appreciate it !

I think it best at this stage to answer you by pointing out a few specific observations, rather than offering an overall assessment. I've changed my approach as we previously discussed, and am continually evaluating and tailoring it to suit better.

It seems I have a busier client these days. He is very productive both in his writing (political and other) and his artwork, and seems to spend more time and effort on the creative process itself. He has new ideas which he works on and develops with a sense of purpose, and I can't help but notice some positive energy being put to work almost incessantly. He seems to have less time for prolonged bouts of depression and inactivity, and I hear less about physical complaints as well. He completed work for which he received much praise, and he is also undertaking to teach himself additional (and challenging) skills. Now, I am very careful about over-interpreting this, because I am well aware of the fact that people go through better and worse periods alternatively, but this is what I am seeing for now. It's as if he has less time for being anxious because he's too busy working out his ideas.

Another development is that there seems to be less resistance and more openness. With my previous, 'predominately CBT ' approach, many of the discussions were very intellectual in nature, and he went to great lengths to 'prove his points'. We probably both enjoyed the challenging discourse, but this is where I felt I was encountering resistance and not making progress. With the change of approach, I now hear him voicing doubts and pointing out the incongruent and contradictory in his own belief systems, while acknowledging that he very much needs to adhere to them as a source of hope and purpose in his life. There seems to be more acceptance and more utilizing, rather than debilitating anxiety. I realize it's all still deep in there,
but there seems to have emerged a better coping strategy. I know, it's still far too early to tell.

It's a long road, I am very careful about drawing far-reaching conclusions, but I feel this direction is more 'right' for him. As he puts himself to work more readily and energetically, opportunities for positive reinforcements abound, and that in itself is a great thing. I honestly believe that his own internal strengths, will power and defiance are pivotal to his wellbeing, more so than the sessions. I am growing gradually more confident in thinking that the best service I can render is to boost and help utilize this, rather than work toward effecting changes on deeper levels.

Thank you, John

Janet.
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