Psychologists adhere to conceptual models or organizing theories, known as theoretical orientations, to inform their thinking and guide their methodology when working therapeutically with individuals, couples, or families. A theoretical orientation is a set of assumptions that combine to explain what humans need in order to achieve successful outcomes in life, and what might go awry, when those conditions are not met. Accordingly, psychologists often refer to a preferred theoretical orientation to understand
- the nature of a client's difficulties,
- how those difficulties may have developed, and, from there,
- what must be addressed, in order for the client to experience relief from his/her troubling symptoms, or to more effectively pursue the desirable outcomes s/he hopes to achieve, or both.
There are many different theoretical orientations, and a psychologist ought to be able to articulate which one s/he adheres to, and why. Importantly, there is no single theoretical orientation with a monopoly on effectiveness; research establishes that most theoretical orientations work, when work is defined as bringing about improvement, or fostering progress with respect to a client's goals for therapy.
That said, some theoretical orientations are thought to work more efficiently than others for certain presenting problems. Demonstrating some flexibility in one's approach to treatment is thus important, as the approach most likely to generate successful therapy outcomes is often discernible only after one's client has thoroughly described the problem(s) and clearly defined the goal(s).
Ultimately, all approaches, if they are to be helpful, must provide clients with practical, measurable strategies that can be practiced to overcome that which undermines well-being and to foster that which supports it. In addition to prioritizing practical help, some approaches to therapy, including mine, also prioritize exploration of the underlying factors, circumstances, or vulnerabilities that contribute to a client's presenting problem, as well as seeking to understand how and why the symptom picture first appeared, and thereafter progressed, as it did.
Such comprehensive triangulation locates the problem squarely within my site, so I can, in partnership with my client, neutralize it efficiently and effectively by aiming interventions at the source of the symptom, rather than at the symptom, itself. In my experience, brief exploration of my client's past usually exposes its relevance to the presenting problem quite readily, often demystifying the persistence or intensity of the issue, in the process. Therapy undertaken at this level of inquiry results in solutions that my clients describe as being clearly applicable and readily accessible, yet resonating with core relevance and without the feelings of self-deception that sometimes occur when practicing solutions obtained from other therapeutic approaches. Solutions assessed to be applicable and accessible, which also resonate as rational and relevant, offer the benefit of congruence, rather than the dissonance of self-deception, which helps to promote consistency in maintaining successful therapeutic outcomes, and prevents problematic relapse.
The model that figures most prominently in my work incorporates both conceptual and practical interventions. Theoretically, the main ideas around which my model organizes include the following:
- People are "hard-wired" for meaningful and satisfying connection to others. Many, if not most, of our most troubling issues occur because that need:
- was not adequately met in the past, or
- is not being adequately met in the present, or
- won't be met in the future, we fear.
- Critical relationships from the past and present cause us to develop characteristic ways of thinking about (a) ourselves, (b) others, and (c) our expectations for relationship. These perceptions shape our expectations, drive our behaviour, and sometimes shape our capacities--seemingly limiting them. When our need for safe, meaningful, and satisfying connection is complicated by difficulty of some sort, we develop troubling symptoms (such as anger, sadness, fear, avoidance, or a sense of inadequacy). The more chronic or ongoing the disappointment, the more long-standing, or severe, the debilitating symptom -- this is especially true when the difficulties occurred early in one's life, persisted for some time, and remain unaddressed.
- Fortunately, once maladaptive perceptions are identified, they can be modified at a deep level, transforming the way we think about ourselves, others, and/or relationship, and thus changing our assumptions, expectations, feelings, and behaviour. As these changes unfold, new norms develop and symptoms and difficulties very often resolve.
- The course of counselling, therefore, is intended to understand how present complications (such as depression, anxiety, lack of self-esteem, lack of intimacy in one's relationship, etc.) may be informed or shaped by earlier experiences that are negatively impacting one's current functioning. Once the template is understood, we then work to bring about meaningful, significant, and practical change. The focus of treatment is on the present, with the outcome being a transformation of whatever is compromising one's current capacity for satisfaction, contentment, internal peace, and effective functioning.
- A prominent goal of therapy is to practically improve one's emotional and interpersonal functioning. Another prominent goal is to improve the feelings about self and others that occur "deep down in one's gut." Often, we know things in our head, but nagging gut-level doubts remain, and they are difficult to silence. Our behaviour is largely driven by those gut-level beliefs. We may "know," for example, that we are adequately intelligent and competent, but feel continually tormented by a deeply held belief that we are, in truth, "a fraud." The work that I do with my clients is often aimed at modifying the deeper belief - the one in the gut - which is too often louder, and seemingly more credible, than any other voice we hear.