IIGP

Institute for Individual and Group Psychotherapy

Institute for Individual and Group Psychotherapy
29600 Northwestern Hwy, Ste 100A
Southfield, MI 48034
(248) 353-5333

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Animals in Psychotherapy: Clinical & Ethical Considerations

October 4, 11 & 18, 2016

29600 NORTHWESTERN HWY., STE 100A
SOUTHFIELD, MI 48034

This seminar will discuss the role animals play both in the lives of therapists and their patients. Attitudes about companion animals will be surveyed and analyzed for clinical consideration. The ethics of prescribing therapy animals will also be covered.

Paul Shultz, ACSW has been a practicing psychotherapist for 31 years. He is a faculty supervisor of IIGP and holds the position of Past President. He is past president of the Michigan Group Psychotherapy Society. Mr. Shultz has presented on many workshops at the local and national levels. He is in a unique position to understand the powers of behavior change in a therapeutic setting, he has published professional papers in the area of Patient change.

To register for upcoming seminars, please email or call Deborah@iigp.org or 248.353.5333

CHOOSING A PSYCHOTHERAPIST BY HOW MUCH IT COSTS?

blog-iigp-choosing-psychotherapistPicture this scenario:  You are in the market for a car, and you know that you’ll need to finance it somehow. You go to your bank, tell them you need their help with buying a car, and in response the loan specialist at the bank hands you a booklet entitled: “These are the cars we’re willing to help you finance. Otherwise, you’ll have to pay for the whole thing yourself.” Catchy title, isn’t it?  So you go home, sit down and read through the booklet and pick one of the ten cars listed so that you can receive financing from the bank.  It’s not the car you had in mind, it’s the wrong size and color and it doesn’t have a roof rack for your canoe. But it’s on the list so you have no choice but to buy it. Right?

I don’t think so.  We all know that this is a messed up way to go about getting a car. Yet this is how many people end up with the psychotherapist they go to.

Many psychotherapists sign a contract with an insurance company in which they promise to adjust their charges according to what the insurance company thinks is “reasonable.” In return, the insurance company puts them on their list of “providers” who “provide” the service of psychotherapy. (And what is that, anyway? Read the blog “What a Good Psychotherapist Does.”) What many people then do is find the “provider” who is most conveniently located, and make an appointment.

What most people don’t know is that being included on an insurance company’s list of “providers” says nothing at all about how well the psychotherapists on that list are trained, or the quality of treatment they “provide.” The only guaranteed detail is that the psychotherapist holds a valid license in your state. Furthermore, many insurance programs put strict limits on how long a session will be and how many sessions you can have before the insurance runs out. For example, in some programs you find yourself covered for only twenty sessions.

Those of us at IIGP, most having practiced in this field for 35-40 years, know that the best that the patient can receive in twenty sessions is temporary relief from anxiety or some advice. After their insurance limit runs out, many people then leave “psychotherapy,” believing that it can’t help much, and end up relying on medication. Sometimes people are even told that they have a “chemical imbalance” like diabetes and will need to be medicated for life. This is true for only a small handful of disorders. The rest of the time this claim is pseudo-science that has no research to back it up.

So here’s the straight talk. If you want to get good psychotherapy, talk to as many people as you dare to talk to about your search for a good therapist. DON’T bring money into it, because you’ll pre-reject some of the best therapists in town. Find the therapist you hear has really helped people change their lives. If a therapist can help someone actually change his or her life, rather than just learn how to get over the current crisis, then chances are s/he’s at least a pretty good therapist. I would suggest making an appointment with someone like that, rather than someone on a list.

Don’t ask about the fee. If he begins by telling you his fee and asks you if you can pay it, you got a bum steer. A good therapist is willing to consider a temporary fee reduction so you can at the very least get to know what quality psychotherapy is like. Go at least three times, even if it costs a fortune. We’re talking about the quality of the rest of your life here, not buying a luxury car.

Good therapy can be like paying to get through a university degree program, but it’s even more important because it will affect how happy and satisfied you’ll be in the years you yet have to live. A good therapist will understand your financial difficulties and help you find a way to do it.

Group Therapy vs. Individual Therapy

IIGP_Blog 12a_No 202722442What advantage does group therapy have over only individual therapy? Using an analogy, let’s say therapy is akin to going clothes shopping. Often, when one goes clothes shopping they have only a single mirror in front of them, reflecting back what they look like. You might turn to one side or the other, trying to see if your belly is protruding, or gauging whether how tight or ill-fitting a garment might be on your posterior. However, if you’re lucky, you’ll come across a dressing room that comes well equipped with a three-sided mirror that gives you multiple vantage points from all sides. Following those shopping excursions, you may tend to get a more accurate view of your outfit, which also may translate into better eating habits and more exercise (should your clothes not fit so well, etc.) Sticking with the analogy, the reasons for making some lifestyle choices seem obvious: multiple perspectives allow you to see all your profiles at once.

Hopefully, the clothes shopping metaphor puts into focus what advantages group therapy can have over only individual therapy. No person can really see how they look, behave and interact with others unless multiple mirrors are held up for viewing. With several angles provided simultaneously, there is the opportunity to have accurate reflections of how we interact, behave and respond, all in ways that we can’t see by ourselves.

IIGP_Blog 12b_No 138711317But a therapeutic group has other advantages over an individual setting as well. The group setting is a closer match to real life. Ideally, the group is a healthy mix of people: young and old, men and women, varied ethic/racial groups, differing economic and educational backgrounds, etc.

Group involvement is not a perfect system, of course. We don’t have the luxury of choosing participants that are all pre-vetted to raise just the right issues in everyone else, but when does that happen in real life, either?

Still, the odds that troubling or hindering behavior patterns will show in a group are much more likely than in a one-on-one session. Both individual and groups sessions, combined, are useful, but the group setting, for most people, is indispensible.

Besides, when trying to change lifelong behavior patterns, a key therapeutic goal, it’s reassuring to have comrades by your side. Walking together helps when the path to better living gets rough.

‘DAMAGE’ That a Psychotherapist Treats

IIGP_Blog 11_ID No 365561933

As small children we can’t “think,” at least in the critical sense, so how do we learn things, in the classical sense, when we can barely say ‘‘dada’’ or ‘‘mama’’? A lot of what we learn, especially early on, we learn the same way a puppy learns. Psychologists refer to this as ‘‘conditioned’’ learning.

For example, we get “potty-trained”; we get positive reinforcement or praise when we do something ‘‘right’’ and hear ‘‘no-no’’ when we mess up. We also learn how to react to people and events around us by feeling emotions — emotions we likely can’t even define or call out by name. Yet, we learn to avoid Uncle Al, but run up to hug Daddy. And all of this is conditioned learning — learning that is stored in our emotional “gut,” not in our thinking “mind.”

The problem arises as we grow older, since then we may react emotionally to someone who is much nicer than Uncle Al, but react to him as if he actually was Uncle Al! Or, to someone who is pretty nasty, as if she actually is Mommy. The point is, even though our word-thinking mind knows better, our emotional gut still reacts the same way.

As these misplaced emotional reactions replay themselves again and again, we can go through a lot of needless suffering. That is, unless we get the right kinds of “new” experiences to retrain our emotional gut and break those old patterns. That’s what psychotherapy, at its most effective, does for its patients

A psychotherapist’s job is to use the individual therapy setting (ideally, combined with group therapy) to help people experiment in a safe setting with behavior that runs counter to what their misplaced emotional reactions otherwise lead them to do.

When it works, people change in their emotional gut, not just in their word-thinking mind. Yet, just like in physical therapy, both therapist and patient must work hard and in concert. It isn’t easy and it can be painful, but this process provides more than temporary relief of symptoms.

Many people find that their whole life has been changed. Is it worth seven or eight years — and a financial investment — to live life freed from personal ‘‘demons’’ from the past? You’ll have to decide on that one.

 

 

 

The Central Place of the “Body” in Psychotherapy

Blog 9It is widely understood that the body is the subconscious mind.  Whether you are a budding psychotherapist or a veteran in the field, your own body is really the instrument of your work.

“How” you are (physically and in touch with your physiology) is likely more important than how “smart” you are.  Remember, as a therapist, you are still a bundle of energy approaching another — vulnerable — bundle of energy.  Thus, if you are not comfortable in your body, or if you are inflexible in your range of motion or manner, it has an impact on your client or patient.

In our training group we aim to be body-oriented psychotherapists.  We try to measure change by shifts in the physiology.  Even in group and individual psychotherapy where talk is the medium, we are always paying attention to whether the body is managing emotion in healthy or unhealthy ways.

Our interventions have attention to the physical woven into them.  We attend to their breathing.  We attend to eye contact — especially when the patient is trying to communicate emotion.  We pay attention to voice quality and other metrics of physiology where emotion is bound up.  In this way, we use the group as a laboratory for embodied relationships where we have an opportunity to do repair work as transferences emerge around the group.  In the process we cultivate a new capacity for expression, thus often lifting depression and freeing energy for other purposes.

We think that each therapist should have at least some experience with direct body approaches such as bioenergetics, craniosacral therapy and more.  The reason that we believe this is necessary in a training program is because by going through these programs, one can get a sense for how emotions play out in their own body.  This gives them a baseline from which to identify with the patient, to empathize accurately.  It also provides a conceptual framework for interventions. Since we now know there is no true separation of body and mind, this is the way we approach the mind inside the body.

Our program was infused with body consciousness over the course of a 20-year relationship with Dr. Charles Kelley, a student of Wilhelm Reich and trainer of hundreds of body workers worldwide.  In the course of his working with us, individually and collectively, we learned about the physical segments of one’s “character armor” in preparation for our style of intervention.

Thinking and Feeling

As small children we live mostly based on our feelings — not our thinking. When something scares us, we avoid it or fight it, since we are unable to judge whether it might be dangerous or something totally harmless.

If we like something, we tend to go toward it, regardless of whether it’s good or bad for us, because we can’t evaluate reality very well yet. We reflexively learn how to fit into our environment primarily based on our feelings. This is how our basic patterns of personality get laid down, patterns that tend to repeat themselves again and again throughout life, often without us even knowing it. This can present a problem because those automatic feeling-based patterns often don’t work well in adulthood.

We may find ourselves, as adults, scared of things we know shouldn’t scare us. We may find ourselves hurt by things we know shouldn’t hurt us. We also may make repeated bad decisions and wonder why we don’t learn from the experience and do things differently. If the problem is bad enough, we might decide to seek psychotherapy.

Does psychotherapy help?

It depends on what you mean by “psychotherapy,” because there is no general definition of what psychotherapy is. Many people think of psychotherapy as a way of figuring out “why we do what we do” or “why I am the way I am.” However, even if one figures out “why I do what I do,” it doesn’t do a lot to help break the pattern. Negative or destructive behaviors often continue to repeat themselves.

For psychotherapy to work it has to affect much more than how we understand ourselves. It also has to affect us on an emotional level. In order to change these patterns we developed as children, we have to experience the childhood feelings again, but this time in a safe and therapeutic setting. In other words, we need corrective emotional experiences.

At IIGP, we teach a form of therapy using corrective emotional experiences, experiences that affect feeling and not just thinking. When it works, harmless things that used to scare us no longer affect us the same way. Our decision-making improves, our quality of life is considerably better, and our relationships are enriched.

The Value of Co-Therapy

Working in tandem as co-therapists has multiple benefits for both the patients and for the group therapists charged with patient care.

When clinicians work together, they learn from each other, watching each other work in the group and gaining valuable skills. The value brought to a therapist’s skill set by way of co-therapy can be as important as coursework. Therapists just beginning their practice have the opportunity to gain practical, hands-on training from a senior peer. Two experienced therapists can benefit from each others’ strengths. Your colleague will inevitably be better at certain aspects of therapy than you. In a co-therapy setting, this can be a valuable opportunity for you to learn “in the trenches,” and broaden your ability to help patients.

Co-therapy also benefits the patients with two trained clinicians working on their behalf. It’s common for one therapist to hear and see things that their peer may have inadvertently missed. It’s that old adage: two heads are better than one. While one therapist is interacting with one patient, the other therapist can observe what is happening with the group and pick up on things that otherwise would be missed.

Furthermore, co-therapists can “tag team” with a patient. For example, if a patient seems to be stuck or having difficulty with one therapist, the co-therapist can step in and help facilitate dialogue — asking the patient how they feel, how they react to the other therapist — and it actually may be easier for the patient to open up to the second therapist.

In our experience, we sometimes see a patient divulge to the co-therapist thoughts and feelings that the primary therapist hadn’t previously discussed with the patient. The patient may feel safer with the co-therapist or perhaps the co-therapist asked a question that the primary therapist hadn’t thought to address. That’s not to say that the patient was trying to hide anything per se, but sometimes a co-therapist is able to illicit responses due to their particular personality and techniques, or because they have a different relationship with a patient.

Altogether, co-therapy offers rewards for the therapy team as well invaluable opportunities for the patients in the group.

 

To learn more about co-therapy, click here.

The Process of Change in Psychotherapy

How to determine a candidate for successful in-office treatment

At the IIGP, we attempt to help patients change in fundamental ways by working with their underlying illnesses. The relationship between patient and therapist is critical; we have to get them involved with us — similar to their experience with their original caretakers. It isn’t just one “thinking brain” to another “thinking brain.”

The therapy must be able to stimulate all types of old feelings (fear, pain, sadness, love) that we experienced — and became recorded — in our “emotional” brains early in life. But it’s not enough to just trigger a lot of these old reactions because that would simply be like salt in the wound.

Something has to go beyond that. There must be a corrective emotional experience that occurs. When a person’s strong intense emotional reactions are juxtaposed with their knowledge of reality, the feelings start to lose their grip on a person’s life. This requires that a person be able to see the reality in the midst of strong feelings: “I feel scared, yet I know there is no danger here.” Then the person has to be willing to take a step forward in spite of the irrational fear.

Because the patient needs to commit to not acting out when the feelings get strong, there are certain disorders that are not conducive to in-office therapy. For example, people with psychotic disorders and sociopathic disorders, and people with poor impulse control would be hard to treat in the office.

In-office treatment can help with issues including anxiety disorders, panic disorders, depression, relationship problems and eating disorders, as long as the patient has enough health to not live impulsively and can develop a trusting relationship with their therapist.

For more information on this subject, click here. To contact IIGP, please call (248) 353-5333 or contact us online, here.

A Conversation on Working with the Body in Psychotherapy

April 12, 19 & 26, 2016  ~ 12:15pm to 1:30pm

3.5 Continuing Education Credits Available (2.5 Regular and 1 Ethics) – $50.00

Registration Deadline:  Tuesday, April 12, 2016 (12:00pm)

To Register for Upcoming Seminars Please Call 248.353.5333 or email Deborah@iigp.org

 

Course Description

Neuroscientists now insist that one must work with the physical body in psychotherapy.  Less than 1% of psychotherapists have training, much less any idea, how to do this.  Indeed, physical touch is prohibited by some ethical codes.  In truth, not only is physical touch inherently confusing, but working with the body on any level also tests the appropriate boundaries of the majority of therapists.  How do we solve this dilemma?

Goals and Objectives

Participants will:

  1. Witness levels on which the body can be addressed in psychotherapy. Ethical considerations.
  2. Bring in their own cases of body level interventions, if any. Some cases will be reviewed for learning purposes.
  3. Make critical self-evaluations regarding their status and relative need for further training.

The IIGP Faculty, CME committee members and the presenters receive no commercial support.

Ronald J. Hook, LMSW, CGP:  Faculty, Institute for Individual and Group Psychotherapy. Mr. Hook completed his Bachelor of Arts in Psychology and English at Hope College, his Master of Social Work at Wayne State University and also studied at New Brunswich Seminary and Rutgers University. Included among his many certifications is his certification by the Radix Institute as a Radix Practitioner and as a Certified Kelly/Radix Trainer.

Mr. Hook’s 30 plus years of experience includes expertise in: My thirty years of experience includes expertise in: individual and group psychotherapy, body psychotherapy, psychotherapy training and supervision, neo-Reichian bodywork training and supervision, and consultation with various business and religious leaders.

 

Why Change is Difficult

“I know I need to lose weight, but I can’t bring myself to go to the gym.”

“I know smoking is bad for me, yet I continue to smoke.”

“I think I understand why I get so angry, but I can’t stop myself from letting the little things bother me.”

The following examples are a fraction of the myriad thoughts people have on a daily basis, yet the underlying fact preventing people from making good choices and altering their behavior in a positive way is quite simple: change is difficult.

As very small children, we learn all kinds of things without even knowing that we’re learning them. We learn what we like and don’t like, what we’re supposed to do and what not to do; what’s good, what’s bad; what’s scary and what’s safe.

We learn so much innocently because we’re just children; we learn how to act accordingly and develop an entire set of behaviors. It’s mostly automatic. The old adage that children are sponges is true. We absorb what is presented to us as children and then act out those behaviors accordingly.

The problem occurs when we become older and find that we still react in ways we learned as children. We might be scared of something even though we know, logically, that something isn’t scary. We find ourselves angry at things we know, intellectually, shouldn’t make us upset. We act in ways we know aren’t good for us, yet we keep repeating them. Here we are, scared, angry and destructive. But how do we change these patterns?

If things become bad enough, debilitating or inhibiting our ability to be happy, we might seek help, such as psychotherapy.

Does psychotherapy help?

Most people think of psychotherapy as a way to gain understanding of how we got to be the way we are. That is a component of its ultimate goal, but understanding our motivations — why we do the things we do — doesn’t help much if we want to change. Understanding can be interesting, but changing means getting out of our comfort zone.

Psychotherapy only helps if the therapist walks with us through the discomfort that comes when we take steps to change. Eventually this discomfort eases up as the changes become more part of us. With time, persistence, and good therapy, we really can change those childhood patterns for good.