Many people wonder which psychotherapy approach will work best for them. At Psychotherapy Berlin we use many different psychotherapy methods because psychotherapy works best if it is tailored to each individual. Which psychotherapy method works best is largely determined by the underlying causes of the problems and presenting symptoms.
What are the causes of psychological distress and how can it be alleviated?
Physical malfunctions can lead to psychological symptoms. Most of us know that our genes have a role to play in our psychological well-being and that chemical imbalances in the brain can lead to symptoms such as depression or anxiety. What is less known is that our experiences also shape our brain and influence its chemicals. Just as muscle growth requires exercise, genetic predispositions will only result in symptoms if we get exposed to certain life experiences. The exciting news is that psychotherapy can actually change our brain! Nevertheless, it is important to first rule out physiological causes like thyroid malfunctions before focusing therapy exclusively on the psychological domain. In some cases it might be very useful to complement psychotherapy with psycho-pharmacology medication. In the case of a severe depression, for example, anti-depressants might give an individual a jump-start, i.e., they might give him/her the necessary energy to make life changes that will further brighten his/her mood, until the anti-depressants are no longer required. But in many cases good psychotherapy will do. And in many cases a psycho-physiological jump-start can also be initiated by regular aerobic exercise.
Unmet emotional needs
The more we learn about the brain, the more we come to understand that human beings are wired to connect. We have a inborn need for nurturing emotional connection with at least one significant other in our lives. Experiences of emotional disconnection, rejection and loneliness makes us feel deflated, depressed and anxious. Feeling loved, supported and secure on the other hand, energizes us and fills us with vitality and joy. Having a lot of friends does not necessarily mean that our emotional needs are met. Even when we are in a relationship, we can feel emotionally disconnected and alone. For our emotional needs to be meet, we require certain types of experiences with others. We require moments in which we don’t have to present a certain image of ourselves, moments in which we can feel loved for who we really are. We need moments in which we feel held, seen and understood in our deepest vulnerability. We need loving and attentive eyes that smile at us and a tender touch that makes us feel nurtured. Because our emotional needs have such a powerful impact on our happiness, psychotherapy often needs to be focused on finding effective ways to meeting those needs.
Click here for an interesting TED Talk about our emotional needs.
Click here for a video demonstrating the power of connection to alleviate our anxiety and pain.
Bad life situations
It is common sense. But often we underestimate the degree to which our life situation impacts us. Our life situation is determined by our own choices and by factors that are beyond our control. Making bad choices or having bad luck can lead us into stressful life situations in which we develop psychological symptoms. So sometimes the first focal point in psychotherapy becomes examining what aspects of one’s life situations can actually be changed – and making these changes. Bad life situations can come to feel so natural that we often overlook existing possibilities for change.
Unconscious emotional learnings
Many of our unwanted feelings, thoughts and
behaviors are governed by emotional learnings from our pasts. Today we know
that we have at least two brain systems in our skulls which are responsible for
different kinds of learning and knowing: We have a rational-reflective brain
(the neo-cortex) and an emotional-reactive brain (the limbic system). This fact
is responsible for the common experience of “I know I shouldn’t be feeling that way, but I just can’t help it.” In this situation our
rational-reflective brain tells us what would be best for us – but our emotional
brain pulls us in a different direction. If we really want to change unwanted
feelings, thought and behaviors, we need to access and transform the underlying
emotional learnings that are stored in our emotional brain. We cannot change
these unwanted feelings, thoughts and behaviors by rational thought and intellectual insight alone. Emotional memories can be accessed and transformed by
particular experiential psychotherapeutic techniques, by gaining healing
emotional experiences in the conversations with a psychotherapist, and by
facilitating new and transformative life experiences. Psychotherapy often does
not work too well because many psychotherapists have not learned how to access
and transform emotional learnings. Unfortunately many psychotherapists have not yet had exposure to
the latest discoveries in neuroscience (on memory re-consolidation) and the experiential techniques to bring
about deep and lasting emotional change. Because many psychotherapists focus on insight or
behavioral change, many clients report that their previous therapy experience
has helped them better understand the reasons behind their behaviors and what
they should do differently, without helping them make real emotional shifts.
Click here for a concise presentation on the neurological process called memory "re-consolidation" that transforms emotional learnings which drive unwanted thoughts feelings and behaviors.
Our relationship with ourselves
Most of us are familiar with talking to
ourselves in our heads. This self-talk is an aspect of our relationship with
ourselves. The relationship we have with ourselves often reflects how we were
treated by our parents or other significant others in our lives. We often
internalize these people’s feelings about us and the messages they gave us.
When we have internalized negative feelings and critical messages, we often
feel bad about ourselves and treat ourselves in critical ways. Even good and
loving parents can send us critical messages that can give birth to an inner
critic. We internalize these messages because criticism hurts. Self-criticism
starts out as a preemptive strike as in “I rather criticize myself, before you
will criticize me, because being criticized by you hurts too much.” When he had
abusive parents, it might be even harder to relate to ourselves in loving ways.
Significant others also teach us how to relate to our own experience. When
significant others react to our pain in carrying and comforting ways, we learn
to relate to our own pain in carrying and comforting ways. When significant
others ignore our pain, we either learn to ignore our pain as well, or we
become hyper-focused on it and make it bigger, in the hope that it might be
noticed. When significant others react to our pain with overwhelm and panic, we
learn to be overwhelmed and panicky whenever we experience pain. Painful
ways of relating to ourselves and our own experience can be changed with the
help of certain experiential psychotherapeutic techniques and by gaining new
experiences with a caring therapist or a caring friend or partner.
Click here for a great TED Talk on our relationship with ourselves.
Click here for yet another TED Talk on the connection between relationships, our brain and our relationship with ourselves.
Fighting futile battles
Actually, it is common sense: We all know that there are some things in life that we simply cannot influence or change. At least not today. And we also all know that struggling against the unchangeable will drain our energy and amplify our psychological pain and suffering. But it is part of human nature that we get caught in trying to change the unchangeable time and time again. Often the problem is that in practice it can be hard to determine whether or not we do have the power to change a given situation. (Or whether our influence is so limited that we are better advised to invest our precious energy in other areas of our lives.) Sometimes we need to spend some time in psychotherapy separating out the things that can be changed from the things that can’t be changed and then learning ways of accepting that which can’t be changed. Acceptance is not the same as resignation. Acceptance is (a) finding peace with what is, (b) investing our energy in areas in which we can be more successful, and (c) staying open to emerging possibilities for change. Acceptance is the peaceful middle zone between an obsessive clinging-on and a depressive giving-up. In psychotherapy it is important to first invest a good amount of time in changing what can be changed. And there is a lot that can be changed. The more we know about how our brain works, the better we become at targeting therapeutic interventions and affecting change in even tenacious patterns of thought, feeling and behavior. But there will always remain some limits. Although our neuro-architecture is very plastic and malleable, our genes do set some limits on what we can feel, think and do.
Interaction of factors
In reality all the above mentioned factors all interact. For
example: My life situation is going to determine how much time I have to
nurture relationships and to have my emotional needs met. Having my emotional
needs met will give me more energy to change my life situation. Unconscious
emotional learnings may cause me to make bad life decisions or to stay in life
situations that are harmful for myself. Unconscious emotional learnings may also
determine how I interact with others and whether or not my emotional needs will
be met. Further, having my emotional needs met will help me relate to myself in
more loving ways. And bad life situations, unmet emotional needs, and painful ways of
relating to oneself can all lead to muscle tension, the release of stress
hormones, a weakened immune system, chemical imbalances in the brain and
Click here for a great TED Talk on how stress, our body, our beliefs and our ability to relate to others interact to influence our health and well-being.
Methods of psychotherapy used in our practice for psychotherapy in Berlin
At Psychotherapy Berlin we don’t believe in limiting ourselves to only one method of psychotherapy. The choice of the therapy methods we use with a particular client depends on the following questions: What seems to be the main cause for the client’s psychological distress? What methods are most likely to facilitate desirable changes most quickly? What methods are most suited for the particular individual in his particular life situation?
Depending on the answers to these questions, we use or draw on any of the following psychotherapy models and methods:
Models of psychotherapy used in my practice in Berlin
- Accelerated Experiential Dynamic Psychotherapy (AEDP)
- Acceptance and Commitment Therapy (ACT)
- Attachment-based Psychotherapy
- Cognitive-Behavioral Therapy (CBT)
- Coherence Therapy
- Emotionally Focused Couple Therapy (EFT-C)
- Emotion Focused Psychotherapy (EFT)
- Interpersonal Therapy
- Mindfulness-based Cognitive Psychotherapy (MBCP)
- Mindfulness-based Stress Reduction (MBSR)
- Schema Therapy
- Time-limited Dynamic Psychotherapy (TLDP)
Methods of psychotherapy used in my practice in Berlin
- Attachment-based interventions
- Behavioral activation
- Behavioral monitoring
- Coaching interventions
- Couples therapy/involving partner or significant other
- Dyadic regulation of emotions
- Empty chair dialogues
- Experiential imagery exercises
- Experientially accessing and transforming emotional learnings
- Exploring the historical origins of patterns of feeling, thinking and behaving
- Functional analysis of behavior therapy
- Limited Re-parenting
- Physical exercise
- Role plays
- Systemic interventions
- Treating affect phobia
Please don’t hesitate to contact me if you have any questions about us me or our practice for psychotherapy here in Berlin.