At PCH Treatment Center, psychoanalytic psychotherapy is a cornerstone in the treatment of clients in our general programs. 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 with expertise and experience that will most benefit the client.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of psychotherapy that helps clients examine the relationships between thoughts, feelings and behaviors. CBT teaches that thoughts, not external factors, cause feelings and behaviors. Thus, a client can change the way they think so that they will feel and act more positively. CBT evaluates the negative thought patterns of thinking that lead to self-destructive and self-sabotaging actions. CBT elucidates the deep-rooted beliefs that direct these thoughts. CBT differs from traditional psychodynamic psychotherapy because the therapist and the client actively work together to identify negative thoughts and behaviors in a collaborative manner. CBT therapists can be problem-focused and goal-directed, and CBT can be time-limited depending on the specific goals of therapy.
Examples of negative patterns of thinking include a person with low self-esteem who may have the belief, “I am worthless,” or a person with severe anxiety who feels like they are always in danger. With CBT, the client is encouraged to overcome these irrational beliefs. CBT is an evidence-based treatment for Obsessive-Compulsive Disorder (OCD) and other types of anxiety disorders. At PCH Treatment Center, CBT may be offered primarily, such as in our OCD program, or adjunctively, in our general program.
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.
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.
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.
This is a psycho-educational group based on the work of Drs. Peter Fonagy and Anthony Bateman. Mentalization is a mental and emotional processing capacity by which we interpret behavior (both our own and others) as being driven or motivated by underlying mental states. Research indicates that enhanced mentalization is correlated with better affect regulation, greater sense of self-agency, and improved interpersonal relationships. It is the ability to see the inside story (the thoughts, feelings, intentions, etc.) that motivate people’s actions. Normally, we are able to do this automatically, without much conscious effort. However, when a situation is upsetting or confusing, we switch into explicit mentalizing. For example, we might ask, “why is he so abrupt with me, perhaps he is angry that I haven’t returned his email?” When people are suffering from a variety of mental health issues, mentalizing is often compromised. This workshop explores mentalizing and its role in promoting healthy interpersonal relationships and good self-regulation skills. A variety of exercises and jumping off points are utilized to bring these concepts alive.
Clients are encouraged to share thoughts and emotions regarding their current mood and life situation, while receiving feedback and support from the facilitator and peers. Special attention is paid to group dynamics (what is going on in the room between peers) and how this relates to the clients in their lives, past and present, with friends, family members, romantic partners, and colleagues. Clients are able to work together to process their emotions and experiences both inside and outside the group dynamic.
At PCH, neurofeedback is used as a self-regulation program. During neurofeedback, brainwaves that are efficient for you will be reinforced/rewarded with positive sounds and sights (feedback). The brainwaves that are inefficient for you will be punished with harsher sounds and less appealing sights. The program is essentially retraining your brainwaves while you engage in certain activities (relaxing/focusing). It is helpful in practicing skills from yoga, mindfulness meditation, DBT, breathing exercises, visualizations, etc. Neurofeedback offers a place to apply and practice the various skills that are learned in other treatment modalities at PCH. You will gain awareness of your body, while retraining your brain to become more regulated, alert, calm and focused.
This class uses a therapeutic style of yoga, which engages muscle, mind, body, and spirit. Therapeutic yoga assists in coping with stress by calming the nervous system, allowing the body to heal and recalibrate. The practice of yoga is not about getting a foot behind your head! Yoga at PCH is specifically designed to support emotional regulation, reduce stress and anxiety, while developing powerful self-soothing practices to quiet and calm both mind and body. Our focus is on finding safety in your body and building skills to ease the nervous system. Clients are introduced to different yoga postures that can be therapeutic in coping with depression, anxiety, trauma, and panic. Each class is meant to provide a safe space to get out of your head, recover from your day, and release tension. All students are fully supported in honoring their needs, and beginners are welcome.
Clients are given a short writing assignment, typically 10 minutes in length, which is then presented and shared with the group. These assignments may involve writing a short poem, narrative, letter, or diary entry. For example, “If my life were a fairy tale, it would be . . .” or “Write a letter of anger, gratitude or apology to a significant person in your life”. The facilitator and peers make observations about the client’s writing and assist the client in recognizing themes and issues, both past and present.
This group provides support, education and guidance for those who have been through any type of trauma, either as a child, adult or throughout life. We discuss what trauma is and how it affects one’s view of the world, their relationships and sense of safety, while providing techniques for coping through times of crisis. It is through this understanding that healing and hope is possible.
Food and Feelings Group
This group provides clients with a space to explore the thoughts and emotions that underlie obsessions with food, weight and body imagine. Individuals that are concerned or obsess over controlling their food intake, the shape of their body, the amount of calories consumed each day or how much exercise one participates in, tend to find this group beneficial. The unpleasant symptoms that get expressed through the body or the obsession to achieve an “ideal” body are often the manifestation of extreme pain and feelings of being out of control. Together we will address the deeper roots of these obsessive thoughts and the compulsions that accompany them.
This group allows an opportunity for clients to explore issues relating to their addiction in a safe non-judgmental environment. Clients that are in recovery from compulsive substance abuse and/or alcoholism are able to work through their issues of addiction, while the facilitator and other clients provide guidance and support. The format of these session will reflect some of these principles of the 12-Step program, however, clients are not required to attend meetings outside of PCH.
Family Systems Group
In Family Systems Group we explore the client’s family of origin and the components of that family system from the point of view and remembered experience of the client. The group helps to identify and articulate roles that were played by all the family members and patterns that developed over time. By bringing these into awareness, the client begins to see how those roles and patterns may continue to play out in the issues they are working on while in treatment.
The timelines group is an opportunity for community members to gather together and bear witness to the life history of another community member. In a wholly supportive atmosphere clients can, if they choose, relay to the rest of the group a chronological account of their lives, describing significant events and relationships in their life journey up until joining us at PCH. Clients are welcome to bring along pictures, symbols or play music that was significant to them at particular times. Each week a new member shares their history and then can move on to alternative groups in the program. Participation is encouraged but not required. However experience suggests that this can be a very healing part of the program, now running for a fifth year at PCH.
Coping with Anger and Shame Group
The objective of this group is to increase emotional intelligence surrounding two distressing emotions; shame and anger. Through group process, participants will learn to identify these emotions and create a language for how they experience shame and anger. In addition, participants learn to recognize their defensive reactions when triggered and develop new strategies for coping.
This group provides members with the most recent research on the cause, diagnosis, and treatment of bipolar disorder. Group members will also learn how to effectively cope with their diagnosis, how to accurately identify the symptoms of bipolar disorder, ways to manage and stabilize their mood, and methods to prevent the escalation into mania and the spiral into depression. This group provides mood management strategies that fit the unique psychological and biological needs of each member, allowing them to successfully pursue their life goals and ambitions.
Members begin to identify negative patterns of thought, emotion, and behavior through the use of written and experiential exercises. Through this identification, clients’ work together to establish ways in which they are able to diminish these habitual patterns by means of support and guidance from the facilitator. This is an important step on the road to personal transformation. Common patterns addressed include shame, low self-esteem, displaced anger, aggression, people-pleasing, caretaking, complaining, blaming, anxiety, depression, and many more.
Identity & Self Group
The Identity and Self Group is a semi-structured group in which clients are welcomed to explore topics that are involved in the exploration and development of one’s sense of self and identity. Topics include, but are not limited to: definition and development of self identity, as well as in their relation to others; distinguish their self boundaries, image, love, and the impact of their trauma on the sense of self. Clients are encouraged to share personally relevant examples of their experience with defining and discovering a true sense of self and identity. Group facilitation is conducted in an open-ended and process-oriented manner.
Clients learn about and practice “mindfulness”, which is loosely defined as “paying attention on purpose, moment-by-moment and non-judgmentally”. Using various mindfulness meditation techniques, guided visualization exercises and psycho-education, clients learn to identify a “triangle of awareness” which includes their thoughts, emotions and body sensations. This can enhance the ability to self-regulate feelings, increase frustration tolerance, and manage anxiety by learning how to be with one’s actual lived experience. Clients learn to identify repetitive and habitual thought patterns (such as comparing, judging, negative self-criticism, anxious anticipation of the future or regretful rumination on the past) in order to gain greater agency over where their minds go. In addition, many find “relief” from overactive and often cruel thoughts with calming techniques and specific meditations that foster compassion and acceptance.
Seeking Safety Group
This group is an evidenced-based treatment for PTSD, substance abuse, and other problem behaviors that stem from emotional dysregulation. With a primary emphasis on establishing safety, each week the group covers one of several topics that address coping skills relevant to these disorders. Some topics include Grounding, Asking For Help, Compassion, Honesty, and Healing From Anger. Through this skill training, clients are able to better regulate and control their emotions and subsequent actions.
Sleep and Anxiety Group
This group provides members with the most recent and important research on sleep and reviews in a step-by-step manner the findings of major sleep centers across the United States. This group offers practical advice about sleep fitness and designs sleep hygiene protocols that meet the unique needs of each member, thereby providing the support to the elimination of insomnia and sleep related anxiety.
Coping with Grief and Loss
The Grief and Loss Group gives clients the opportunity to explore and process feelings related to the loss of a significant person in their lives, through death, break up, abandonment or traumatic circumstances. For some, the loss of a job, educational opportunity or even a beloved pet can be very difficult to process. The focus of the group is to help identify key losses and to put words to these experiences.