At PCH Treatment Center, psychoanalytic psychotherapy is a cornerstone in the treatment of most clients. However, we also incorporate cognitive behavioral therapy, intertwined with our approach to treatment and client care. Our professional staff is well versed in psychoanalytic psychotherapy, both as an independent modality and as a useful and productive part of our comprehensive program of evaluation and treatment. We take to heart the idea that treatment is often a collaborative partnership between therapist and patient. Overall, we never try not to narrow our options to a particular theory or school. Instead, we use the many effective tools at our disposal in the combination that will best help our patients to heal. The PCH clinical team assesses each client and develops a specific treatment plan, assigning specific therapists who may be focused on psychoanalytic therapy or cognitive behavioral therapy, depending on the needs of the clients. (Read more about Psychoanalytic Psychotherapy Treatment here)
Cognitive Behavioral Therapy
Cognitive behavior therapy helps a client to develop a more positive way of thinking about life situations. The client is responsible for discovering and nurturing better mental attitudes and subsequent positive emotional responses. The client is in control of his or her therapy by setting achievable goals. The therapist is there to assist and direct the client’s progress.
Clients unlearn old patterns of thinking and behaving and learn new thought patterns and techniques. They also learn to turn off negative thinking patterns. This is accomplished through purposeful dialogue with the therapist. The learning that takes place during a session is bolstered through the assignment of homework. A client is usually given additional reading as well as some practice drills that reinforce the new thinking and feeling techniques. For example, a client will go through real life scenarios that elicit negative patterns with their therapist and then “practice” managing their thinking on their own in their life.
Somatic Experiencing Therapy
Somatic Experiencing (SE), developed by Dr. Peter Levine, offers a holistic strategy to achieve healing and resolution of trauma or emotional wounds. Somatic Experiencing is based on the premise that a person’s autonomic nervous system (ANS) becomes dysfunctional in relation to sudden arousal during trauma. SE attempts to help a person relearn to automatically regulate the release of energy associated with past trauma. SE Therapy targets the ability of the ANS to regulate and restore itself to balance in order to allow a client to regain a normal level of functioning after experiencing trauma. At PCH Treatment Center, Somatic Experiencing is practiced through individual therapy sessions. This form of therapy is often used for developmental traumas and can be combined with other forms of psychotherapy. Somatic Experiencing attempts to promote awareness and release of physical tension that proponents believe remains in the body in the aftermath of trauma. (Read more about Somatic Experiencing Therapy here)
Sensorimotor Psychotherapy integrates sensorimotor processing with cognitive and emotional processing in the treatment of trauma. Sensorimotor Psychotherapy uses the body (rather than thoughts or emotions) as a primary entry point in processing trauma. Sensorimotor Psychotherapy directly treats the effects of trauma on the body, which in turn facilitates emotional and cognitive processing. This method is especially beneficial for clinicians working with dissociation, emotional reactivity or flat affect, frozen states or hyperarousal and other PTSD symptoms. In this article, we discuss Sensorimotor Psychotherapy, emphasizing sensorimotor processing techniques which can be integrated with traditional approaches that treat these symptoms. Because the therapist’s ability to interactively regulate clients’ dysregulated states and also to cultivate clients’ self-awareness of inner body sensations is crucial to this approach, three sessions are described illustrating the clinical application of this method.
Dialectical Behavioral Therapy
Dialectical Behavioral Therapy (DBT) is a mode of psychotherapy developed by Marsha M. Linehan. It is used to treat persons with emotional dysregulation and impulse control as typified in Borderline Personality Disorder and other psychological illnesses. DBT is also appropriate for persons affected by psychological trauma or struggling with chemical dependency or self-injurious behavior. DBT is derived from Buddhist meditative practices and mindfulness concepts, and has become a cornerstone in treatment for Borderline Personality Disorder. With DBT, Linehan attempted to address what she saw as three longstanding failings of cognitive-behavioral therapy. First, clients were threatened by treatment that focused on change when it failed to simultaneously acknowledge and accept the client’s existing identity, with some clients experiencing that focus as fundamentally invalidating. Second, the need to address immediate issues like suicidal and self-injurious behavior often took precedence over work on the development of effective behavioral skills, sometimes supplanting that work completely. Third, Linehan noted that client behavior frequently steered therapy in counterproductive directions: If tackling difficult subjects engendered client hostility, the therapist might avoid those subjects despite their importance to successful treatment.
In light of these obstacles, DBT makes therapeutic acceptance central to its approach, addressing one of the most difficult issues encountered in helping individuals with personality difficulties – treatment compliance. Using mindfulness techniques grounded in both eastern and western meditative practice, DBT seeks to forge a therapeutic alliance between client and therapist. In that alliance, treatment becomes dialectical by resolving the tension between two poles: acceptance of the client as he or she is and the necessity of change for the client’s own sake. DBT resolves that dichotomy by synthesizing acceptance and change in a highly structured system of therapeutic interaction. There is much more than acceptance of the client by the therapist. Internal acceptance, in which the client comes to accept both feelings and external situations non-judgmentally, is equally important. From a new perspective, the client can learn to acknowledge difficult situations, develop greater tolerance for distress and regulate emotions that would otherwise be overwhelming. Linehan called DBT a dance. The therapist must constantly balance acceptance and change strategies, often in the face of enormous client resistance, in order to keep treatment moving forward. DBT provides a detailed framework for this very delicate process. (Read more about Dialectical Behavioral Therapy here)
Mindfulness Based Stress Reduction (MBSR)
Mindfulness Based Stress Reduction (MBSR) is a structured program that teaches the practice of mindfulness in an effort to alleviate pain and improve physical and emotional well-being. The program was established by Jon Kabat-Zinn at the University of Massachusetts Medical School. Mindfulness is sustained moment-to-moment awareness of physical sensations, perceptions, affective states, imagery and thoughts. It is the process of focusing attention to direct experience without judgment, comparison, or evaluation. In MBSR, mindfulness is directly practiced in sitting and walking meditation, movement, and eating. Participants are taught techniques for bringing mindfulness and the associated benefits to all parts of their lives. Two decades of published research indicate that people who complete a MBSR program report greater ability to cope more effectively with both short- and long-term stressful situations. By learning to actively participate in the management of health and well being, many participants report they are better able to manage stress, fear, anger, anxiety and depression both at home and in the workplace. Participants have stated that they feel less judgmental and critical of themselves, and subsequently of others. Many also report a decrease of the frequency and length of medical visits to hospitals and other professional health-care providers. There has also been a noticeable decrease in the use of prescription and non-prescription medications among students of MBSR.
Mentalization-Based Therapy (MBT)
PCH Treatment Center offers a mentalization program for clients experiencing emotional dysregulation. We also have a psycho-educational group based on the work of Drs. Peter Fonagy and Anthony Bateman. Mentalization refers to one’s ability to recognize and understand one’s own and another’s thoughts, feelings, and beliefs that are behind emotional experience and behavior. Most mental health disorders involve some type of difficulty with mentalizing. Research studies indicate that enhanced mentalization is correlated with better affect regulation, greater sense of self-agency, and improved interpersonal relationships.
Exposure and Response Prevention (ERP)
Exposure and Response Prevention is a form of behavioral therapy. Under supervision or on their own, a person is exposed to something that they fear (contamination, crowds) and then they are supported in refraining from their compulsion, avoidance, or escape behaviors (hand washing, fleeing). The exposure may be done indirectly, using verbal cues and imagination or directly.