Therapeutic Approaches

The Rogerian or person-centered approach

The Rogerian or person-centered approach is an approach that, as its name suggests, is centered on the individual and accepts the individual as a whole. 

This approach is based on the fact that every human being has a natural tendency to develop and realize himself or herself as a person. 

In order to create a therapeutic relationship that is conducive to change, evolution and self-actualization, three fundamental attitudes are necessary :  

The congruence or authenticity of the counselor or coach who is true, authentic with himself/herself and the people he/she accompanies. That is, the inner experience of the therapist corresponds to the outer expression of it. Their beliefs and values are in alignment with their actions. By being authentic, they show that they are trustworthy, which helps to build a good therapeutic relationship. Congruence also serves as a model because it encourages individuals to be themselves, to develop healthy boundaries, and to express their thoughts and feelings without any kind of façade.

Unconditional positive regard means that the counselor is genuinely interested in the people he or she is accompanying and does not evaluate or judge their thoughts, feelings or behaviors as good or bad. Each person is accepted and valued for who they are, as they are, without any conditions or judgments on the part of the counselor. 

Empathic understanding means that the counselor or coach understand the experience and feelings of the person being supported in a compassionate and meaningful way. They recognize that each person’s experience is subjective and therefore strives to see things from each person’s unique perspective.

“Treat people as if they were what they should be,

and you will thus help them to become what they can be.”

(Johann Wolfgang von Goethe)

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) is an approach that focuses on cognition and behavior. It aims to positively modify the negative beliefs and thoughts that people have about themselves and the world. 

It is based on the principle that the problems encountered are not the main cause of unhappiness but that it is the thoughts associated with these situations that generate emotional distress. By modifying our thoughts, we can automatically act on our emotions and therefore, at the same time, on our behaviors. 

CBT focuses its attention on the here and now. It helps people observe and evaluate their own interpretation of what is happening around them and the impact their perception has on their emotional experience. 

CBT does not focus on childhood experiences and events, but these can be explored to help clients understand and process emotional disturbances that occur early in life and to understand the impact these experiences may have on their responses to present events. 

During CBT, individuals learn to identify, challenge and change their automatic thoughts, attitudes, beliefs and cognitive biases. 

By noting our thoughts in situations that are emotionally charged, we will learn that our thinking can make our emotional charge worse or better. 

CBT shows us how to reduce our emotional load by : 

• Identifying the distortions, the errors in our thinking
• Considering our thoughts as just thoughts but not as established facts
• Helping us to step back from our thoughts in order to observe situations from other possible angles

What disorders can CBT treat ?

CBT is effective in treating a variety of psychological disorders, including : 

• Mood disorders, such as depression and bipolar disorder 
• Anxiety disorders, including some phobias, panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder 
• Relationship difficulties 

Why does CBT work ? 

CBT is an effective treatment approach because it is : 

• Organized 
• Short (6 to 20 sessions) 
• Problem-solving oriented
• Goal-oriented
• Teaches new strategies and develops life and life skills
• Rests on the importance of a healthy therapeutic alliance based on trust and respect 
• Based on scientific studies and clinical experience

« A belief is nothing more than a thought that you have thought́ over and over again».

(Wayne W. Dyer)

Neuro linguistic programming (NLP)

The map is not the territo

The presuppositions of NLP 

1. The map is not the territory

What we perceive of a situation is NOT the situation itself but our interpretation of it.

People react and respond to an event based on their past experiences and interpretation of that event and not directly to the reality itself. 

In fact, we never have access to reality as it is. Our experience of reality is made through our five senses, our filtering systems, our cognitive biases, our beliefs, and our past experiences; in other words, through our own “personal mental map” of reality. There are as many mental maps as there are individuals and no mental map is better than another. 

2. All behavior is underpinned by a positive intention

All behavior is generated by a positive intention. Each person does the best they can, with the resources they have.

No one decides to fail intentionally. 

Although we never have full access to the intentions of others, one of the principles of NLP is to respond to the positive intention rather than the problematic behavior. 

The question we might ask is, “what might be the positive intent behind this behavior?”

3. We can’t not communicate

Whether we express ourselves verbally or non-verbally, we are always communicating. Even silences or lack of response is information. 

Communication involves more than just the words we use (the verbal), which is only a small part of the message we want to convey.  The tone, rhythm and intonation of the message (the paraverbal) as well as the body language (the non-verbal) are the largest part of our communication.

4. We are not our behaviors

This principle teaches us to unconditionally accept people as they are. People are not their behaviors. The idea is to accompany any behavior that is causing a problem towards a change while respecting the nature of the person. 

This philosophy teaches us that habits and self-destructive behaviors are not immutable, but rather choices that can be changed at any time.

5. Body and mind interact with each other

Our thought system is closely linked to our body, and vice versa. Changes in the body cause changes in the mind and vice versa. Each affects the other. 

6. It is possible to reproduce the performance of others

If something is possible for others, then that means it is also possible for us.

In NLP, we can use the process of modeling, to replicate the effective behaviors and strategies that another person has used to achieve the desired life results. 

7. The meaning of communication is the reaction you get 

It is not what we say that is important, but rather what the other person understood. Their reaction and response inform us about the outcome of our communication. 

Even if we are not always aware of what we are communicating, what matters is how it is perceived and understood. 

8. The more choices we have, the better

People who have the most options are the most likely to deal with emergencies and problems. It is the variety of options that makes it possible to deal with complex situations, and when that doesn’t work, they can change their ways and try other approaches.

9. Each person has all the resources necessary to get what they want

Each individual has all the resources he or she needs to succeed.

The objective of coaches is to help people become more aware of their own power and potential so that they can achieve the desired results. Indeed, a person’s limitations are only the representation they have of them.

10. There is no such thing as failure, only feedback

In NLP, there is no such thing as failure, only feedback. Mistakes are part of learning, of taking responsibility for our actions and give us the opportunity to act. Indeed, a result different from the desired one is additional information to help us modify our way of doing things and thus bring us closer to our objectives. 

11. If you do not achieve your goal with a behavior, change that behavior.

One of the principles of NLP is to learn to “think outside the box” and therefore to remain open and flexible to alternative approaches. So, when we fail to achieve a goal, try another approach.

12. Appreciate the other person’s model of the world

To communicate well, it is important to appreciate and respect the unique mental map of the world of the person we are talking to. All people interpret the world they live in according to their beliefs, values, filters and experiences. By understanding and respecting these differences instead of judging or jumping to conclusions, we will become better communicators and naturally have better relationships based on trust. 

13. Behaviors and changes must be evaluated in the context and ecology.

The interpretation of a behavior depends on the context in which that behavior takes place. It is very easy to take something that has been said out of context and interpret it differently from its original meaning.

In NLP, it is crucial to evaluate the behavior and change in terms of the individual’s abilities, as well as the impact it might have on the person’s life in general.

14. A person’s behavior is the most important information you can have about them 

In NLP, it is important to be able to measure people’s behavior without trying to read their minds because the only visible information we have about another person is their behavior. Anything else would just be speculation, influenced by our biases. Since it is impossible for us to physically enter another person’s mind, it is essential that we become skilled at assessing behavior.

15. We are responsible for our minds so we are also responsible for our results

Each of us own our minds; therefore, we must own our life results as well.

Thought precedes each of our actions, behaviors, reactions and responses. It is important that we understand that before we commit to a course of action, the course of action has first been considered in our thoughts.

If we can become more aware of our thought patterns and internal processes, we can therefore become more effective in managing our responses and behaviors.

16. Empowerment is about responsibility.

Maturity is more a reflection of people’s willingness to take full responsibility for their lives than their age. When a person takes responsibility for their thoughts, emotions, and behaviors, and does their best, their feelings of autonomy, confidence, and accomplishment will grow. 

“My beliefs create my world and my world is what I am.”

(Thierry Zibi)

EMDR therapy (Eye Movement Desensitization and Reprocessing)

EMDR is used to treat painful and traumatic events: 

According to this theory, many emotional and/or physical disturbances are the result of experiences that have not been properly encoded and stored in the memory.

The bilateral ocular, tactile or auditory stimulation used in EMDR will contribute to releasing the emotional charge associated with painful events by allowing the creation of new neuronal connections that favor the reprocessing of information in the prefrontal cortex, thus calming the limbic system, the part of the brain involved in emotions. 

How does EMDR therapy work?

The way our brains store information is not based on the facts themselves but on how we emotionally experience the events we have experienced.

For example, my best friend and I could be in the same car accident and experience the exact same event. Yet my brain might store the event as something traumatic while for my friend, it might not be traumatic at all. 

If the brain chooses to store the event as traumatic, the hippocampus – which is supposed to store memories in the right places – will not do its job properly. 

As a result, because the information will not have been processed in the same way as non-traumatic information, all of the thoughts, images, cognitions, emotions and bodily sensations that were associated with the traumatic event will continue to manifest themselves in the present and often in unexpected ways (e.g., a screeching brake at a stop sign might cause me to jump and panic because it reminds me of the car accident). 

Since the memory could not be processed properly, certain events in the present can take us directly back to our traumatic past. This is why certain responses or behaviors in the face of events can be disproportionate. 

To describe how EMDR therapy works, let’s imagine that our brain is a filing cabinet and that our memory corresponds to the files and documents that need to be organized. 

When we live our lives without traumatic events, the documents are stored in the files that are filed in a structured and orderly fashion.

But when we experience an event that has been identified as painful, the document cannot be stored methodically in the appropriate folder. It will just be ‘thrown’ on top of the other files and every time we open the compartment where all the files are stored, the document will be there in front of us and therefore it will be difficult to ignore it or not think about it since every time we open the drawer, it will be there in front of us. 

EMDR therapy takes care of ‘putting away’ the information in the right folders so that it is no longer activated at the slightest opportunity. 

To do this, EMDR will reproduce what the brain does naturally and unconsciously during our sleep: rapid eye movements from left to right!

That’s right! During REM sleep (also known as rapid eye movement sleep) the processing of information seen during the day takes place, and in parallel, behind our closed eyelids, our eyes move rapidly from left to right. 

These bilateral stimulations can be done using different senses: sight, hearing or touch. 

The treatment of the traumatic memory is completed when the subject no longer experiences or experiences very little emotional charge in relation to the event (desensitization phase) and when the subject has created new, more positive and realistic cognitions in relation to the event (reprocessing phase). 

What disorders can EMDR treat? 

EMDR is effective in the treatment of a variety of psychological disorders, including :
o Generalized anxiety disorder 
o Social anxiety disorder
o Obsessive-compulsive disorder
o Post-traumatic stress disorder 
o Certain phobias
o Relationship difficulties 
o Depression
o Chronic pain
o Grief
o Separations, divorces, infidelities
o Self-esteem, difficulty in asserting oneself
o Physical and psychological violence
o Professional or relational difficulties

Why does EMDR work?

EMDR is an effective treatment approach because it is : 
o Structured (8-phase protocol) 
o Shorter than traditional therapy (approximately 8-12 sessions for a simple trauma) 
o Organized around problem solving
o Goal-oriented
o Rests on the importance of a healthy therapeutic alliance based on trust and respect 
o Based on scientific studies and clinical experience

Les 8 phases of EMDR therapy

“I learned long ago that in order to heal my wounds, I must have the courage to face up with them.“

(Paulo Coelho)

IFS (Internal Family System)

IFS therapy is a psychotherapeutic approach founded in the 90’s by Dr. Richard Schwartz that builds on universal human qualities such as curiosity and caring to reach out to one’s inner self in order to heal emotional wounds and live a more harmonious life with oneself and others.

This model considers that each individual is composed of several sub-personalities (called in IFS ‘parts’) and that these parts, which are all endowed with qualities, have the role of protecting us from suffering. In order to do this, they may embody extreme roles that will ultimately harm us even if their intentions are always positive and good. 

Objectives of IFS therapy :

o To help the parts to free themselves from the extreme roles they take on and help them choose more positive and realistic tasks to restore harmony within the system. 

o Restore a harmonious balance between the parts and the Self in order to allow the Self to rise up and fully live its 8 main qualities which are: curiosity, calmness, compassion, clarity, trust, creativity, connection and courage. 

Although we have many sub-personalities, the three main parts seen in IFS are: firefighters, managers and exiles. 

Firefighters protect us in a reactive way when faced with a situation. An example could be the recall of a painful memory where the firefighter would use substances to put out the “fire” of pain.

Managers protect us in a proactive way by managing situations through intense planning and work to prevent something from causing deep pain.

According to the IFS theory, firefighters and managers do this to protect exiles from coming forward and flooding us with painful and traumatic memories.

For which problems should IFS be used? 

IFS therapy can help with everyday problems such as low self-esteem, relationship and work problems, or difficulties adjusting to different life transitions.

Although the approach is not pathologizing (it does not reduce a client to his or her diagnosis), it can address many mental health issues such as 

o Anxiety
o Obsessive-compulsive disorder
o Major depressive disorder
o Bipolar disorder
o Dissociative Identity Disorder

What are the benefits of IFS therapy?

o Empowerment and a greater sense of accomplishment 
o Promotes self-compassion 
o Allows for greater self-awareness
o Prepares for future emotional difficulties
o Improves symptoms of generalized anxiety
o Improves symptoms of depression 
o Improves physical health problems
o Builds resilience 
o Is based on scientific studies and clinical experience

The Self : The natural, deep essence of each person. When the protective parts are not in control of our lives, the Self feels: curious, calm, compassionate, clear, confident, creative, connected, and courageous. The Self is perfect as it is and does not need to be improved, it just needs to be discovered to express itself and shine

Managers: proactive protectors who control and direct daily life.  They judge and criticize easily; they are well seen by society because they are responsible and ambitious. They prevent suffering from arising by oppressing the exiled.

Examples of managerial behavior: too nice to forget, perfectionist, self-sabotaging behavior, procrastinator, anxious, over-achiever…

The exiles: parts that carry and hide the suffering, trauma, shame and injustices of the past. Want to be seen, heard and listened to but fear exposing their vulnerability.

Protectors believe that if exiles expose themselves, they will destabilize the entire system. Examples of exile behavior: feels inferior, not good enough, worthless, bad, too much, abandoned, dependent, and ashamed

Firemen : reactive protectors who have automatic and impulsive responses; they are responsible for putting out the fire (pain) felt by the exiles and do so by distraction, escape, or anesthesia.

Examples of firefighter behaviors: addictions, obsessions, eating disorders, threats, anger, risky behaviors…

Sources: 

Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.

Presuppositions of NLP. The Association for Neuro Linguistic Programming. (n.d.). Retrieved June 30, 2022, from https://anlp.org/knowledge-base/presuppositions-of-nlp

Rector, N. A., & Centre for Addiction and Mental Health. (2010). Cognitive-behavioural therapy: An information guide. Toronto: Centre for Addiction and Mental Health

Schwartz, R.C. & Sweezy, M. (2020). Internal Family Systems Therapy (2nd ed.). New York NY : Guilford Press.

Shapiro, F. (2001). Eye movement desensitization and reprocessing (EMDR): Basic principles, protocols, and procedures. New York: Guilford Press.

Watson, J. C. (2002). Re-visioning empathy. In D. J. Cain (Ed.), Humanistic psychotherapies: Handbook of research and practice (pp. 445-471). American Psychological Association, Washington, DC.