How I Do Therapy

                                                                                             by Mary Bratton, LPC

I believe every one of us has all the tools we need to heal inside us. Many people seek therapy when feelings become overwhelming or coping mechanisms become counter-productive and begin to interfere with life functioning. Rather than label those feelings and coping mechanisms "sick" or "bad" or even "crazy", I prefer to help my clients understand the historical significance of their adaptive patterns. All human behavior makes sense if we understand the context in which it was learned. The feelings and behaviors that are troublesome today may, in fact, stem from protective devices adopted to deal with threat or pain or hurt or rejection in the past. Because they worked well back then, they were overpracticed, and reliance on those limited tactics prevented learning new life skills or expanding the coping repertoire.

Once the significance, or even brilliance, of old behaviors is recognized, they can be gently relinquished from a position of strength and gratitude, rather than fought against and condemned as "bad". We can recognize they were extremely useful and helpful in the past, but they are no longer useful or helpful in our changed circumstances. Repeating problematic patterns is not an indication of weakness or defectiveness; it simply means we haven't had a chance to learn other, more positive strategies. We can't know what we haven't learned.

As a therapist, I am first a teacher. Clients need to understand the bio-physiological dynamics of depression, anxiety, post-traumatic stress disorder, substance abuse, and eating disorders, both to reduce self-blame and shame and to establish an accurate framework for developing a practical, workable plan to address the issues. Then my role is to explore with the client new approaches to problems and to make the therapy session a safe place to practice looking at things differently and doing things differently. Thinking and talking about the problem is often not enough; it takes doing to catalyze meaningful change. The old patterns were learned through action, and they must be actively unlearned and replaced. Empowering exercises, like rescripting an event, reenacting or role-playing a situation, writing a no-send letter, or drawing a series of pictures, add energy to the therapeutic process. I encourage mutually agreed upon homework assignments to be done between sessions, because practice reinforces the momentum of therapy and solidifies progress more rapidly for the client.

I see therapy as a partnership, an alliance between client and therapist, based on the client's agenda. Client and therapist each share responsibility for giving and receiving feedback, making suggestions, and growing and changing as the result of that interaction. The following excerpt from my book, From Surviving to Thriving, provides the clearest explanation of who I am as a therapist:

"I compare my role as therapist to a long-distance runner's coach. The race is not run by the observer. I cannot do the work. The race is run, and won, by the client. I stand on the sidelines, point out the markers and mileposts, and cheer when the course seems productive. Sometimes I urge my clients on with gentle nudges. Sometimes my clients are running pell-mell downhill, and I slow them down and encourage them to pay attention to all the scenery along the way ... I have found my clients know so much better than I their own individual paths to healing. It is my goal to help them free themselves to follow those paths and to help them see and celebrate their progress. It is my purpose to bear witness to both their pain and their healing ... But I never fail to be energized by the power of healing that lies before me. And I never cease to admire those who strive to heal."

For a review and further excerpts from From Surviving to Thriving, Click Here.

The following are some articles written by Mary Bratton that you might also find interesting:

Resolution Fantasy: A Technique for Mastery of Traumatic Flashbacks, Annals of the American Psychotherapy Association, May-June 1999.

The Initial Intervention (for Survivors of Childhood Sexual Abuse),The Counselor, March-April 1992.

Keep It Simple: Basing Recovery Plans on Strengths not Weakness, Focus, April-May 1990.

The Intervention Connection for ACoAS, Focus, February-March 1989.

Inside the House of Mirrors: Blurred Boundaries and Identity Confusion in the Alcoholic Family (with Chris Galvin), Focus, August-September 1985.

Rehearsal for Recovery: Who to Involve? Changes, September-October 1987.

From Denial and Delusion to Reality and Recovery: A Family Therapist's Guide to the Intervention Process Focus, July-August 1987.

Family Intervention: Tools for Getting Adult Children of Alcoholics to Treatment Focus, January-February 1987.

Reframing the "Missing" Family Member for Interventions, Focus, January-February 1985.

Family Intervention: The Calm before the Storm, Focus, March-April 1984.

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