Some years ago my wife began experiencing vague abdominal pain. We went to a chiropractor who diagnosed her with subluxation. Since we were not sure, we also went to a specialist who diagnosed her with candida. Finally, we went to an internist who diagnosed her with appendicitis. As the pain was increasing, we went with the surgeon. When he operated, he learned that he was also wrong. There was nothing wrong with her appendix (though he removed it anyway). On the other side of her abdomen, however, he discovered a ruptured ovarian cyst.
I learned two important lessons from this experience.
(1) People in the helping fields tend to diagnose to their specialty. There can be, in my opinion, both good and not-so-good reasons for this.
(2) Diagnosis is the most crucial aspect of treatment. Treating a condition that is not present can be time-consuming, expensive, and even dangerous. And it never resolves the symptoms.
Consider Attention Deficit Hyperactivity Disorder as an example. This disorder is the most misdiagnosed of all mental health conditions. When a person has ADHD, the symptoms often look identical to anxiety. The most common treatment in the US for ADHD is amphetamines. However, amphetamines, rather than being helpful to someone who is anxious, are often deleterious.
Consequently, it is always time well spent on the front end of treatment to understand the situation.
While I do not prescribe medication, I have suggested to some few clients that they might benefit. In such cases, these people were so burdened by the symptoms that they had difficulty attending their sessions consistently. In most cases, once they completed therapy and were symptom-free, they no longer needed medication.
Clients sometimes come in over medicated. I have even seen clients who, once they stopped taking their medication, didn’t need therapy any longer. The medication was the problem. However, determining whether or not to stop taking anti-depressants and some other psychotropic drugs, should be done with the help of a psychiatrist, as dangerous side effects can occur, especially in adolescents.
The basis for my approach to helping is Attachment Theory. Folk wisdom tells us, “As the twig is bent, so grows the tree.” Now it’s no longer observation and conjecture — it’s hard science. Brain scanning is proving that the Attachment Theorists of the ’50s and ’60s were right on the mark. They taught us that our earliest relationships form a style of relating that usually is a part of us all our lives. If our early life was secure, life is more likely to go relatively well. If not, a host of issues can emerge, including PTSD, depression, anxiety, personality issues, as well as emotional regulation difficulties.
If you want to know more about Attachment Theory, YouTube offers any number of videos that explain how it works. Just enter “Attachment Theory.”
There is also an excellent book on the subject. The Amazon website gives a synopsis and makes it easy to order, if interested: Becoming Attached, by Robert Karen.
I use EMDR most often to treat PTSD, anxiety, and, depression. I call this a “bottom-up” treatment because it goes down to the cause of the issue and work’s it’s way up to behavior and symptoms. It’s so helpful to get to the root of a problem, rather than merely treating symptoms. I explain how this therapy works in the first session, but if you want more now, you can go to the EMDR website, or we have written about the results of it and how it works in some of the issues covered on the Services page.
Sometimes, after the root of an issue has been addressed, habitual negative thought patterns and behaviors hang around.
To eradicate these pesky hangers-on, I use a form of cognitive behavioral therapy to do the “top-down” work. I call it CEBS — the Cognitive, Emotional, Behavioral, Spiritual modality. You won’t find the acronym if you Google it because I developed this acronym for my personal use — to remind me to help the whole person, rather than isolating aspects of a person’s being, or focusing solely on symptoms or diagnoses.
With this modality, I work on the remaining habits and behaviors (or top) down. I work to help and to strengthen the entire person, rather than dealing with these issues in isolation.
Regarding the spirituality aspect mentioned above, while I consider myself to be a spiritual person, I do not try to impose my spirituality on others. Instead, I find that bolstering the client’s spirituality helps more.
I do everything I can to educate clients about their condition and involve them in treatment planning. In other words, I engage them as partners. This inclusive approach helps because, while I often know more about how to treat a given condition, only they know how they are feeling and what has happened to them in the past. It works best when we work as a team.
It satisfies to help clients feel better a soon as possible and then go live their happier lives. While the kind of treatment offered promotes rapid healing, treatment alone is not all required for successful therapy. Clients must contribute as well. They need to attend regular sessions and give honest feedback about their experience in therapy. They need to be courageous enough to face the negative feelings that may come up. They need to believe that they, more than I, will resolve their symptoms, and therefore need to work hard to achieve desired goals.
Underlying everything explained so far, is my effort to form a non-judgmental, supportive, therapeutic alliance with clients. Nothing works well if trust is not a part of the process. I find this kind of connection especially beneficial to adolescents.
Here is a link to some reviews clients have left on Yelp after completing therapy.