My Approach To Counseling

There are many theoretical models of psychology and counseling.  Some are best utilized for particular situations and needs.  Often, an eclectic approach, or the utilization of several approaches is best for the resolution of problems.  I do utilize several schools of psychological theories and methods in my work.  However, it is the Cognitive-Behavioral Model that anchors my orientation to counseling.

The pure cognitive therapies—such as Aaron Beck’s Cognitive Therapy, focus on changing certain thought patterns.  The premise, in Beck’s words, is that “the way we perceive situations influences how we feel emotionally,” and so by changing thoughts, then behaviors will also change. The pure behavioral therapies, such as classical conditioning or operant conditioning, focus on changing behaviors.  Behavioral therapy, in its pure form—such as conditioning—is really not much different from animal training. You can teach an animal to respond to behavioral or verbal commands, but the animal doesn’t have to understand a thing about it’s own behavior.

Cognitive-Behavioral therapies are a blend of higher level, "humanized" behavioral techniques and cognitive techniques—hence the name Cognitive-Behavioral—and so they do involve some amount of thoughtful awareness.   And some forms of treatment such as Rational Emotive Behavior Therapy (REBT)—developed by Albert Ellis—mix cognitive AND behavioral elements. The name reflects the understanding that rational beliefs, emotions, and behaviors are all interdependent and that therapy should involve understanding on all these levels. 

However, throughout the process,  I also tend to embrace the foundational beliefs and core conditions of Carl Rodgers' Client-Centered Therapy, which states that people tend to move toward growth and healing on their own, especially if the therapist:

For a somewhat better understanding of Cognitive-Behavioral Psychology, please feel free to read the following excerpts of an article I originally wrote for Heart2Heart, a newsletter for Cystic Fibrosis patients and families in and around Alabama and was later published in Viewpoint, the Quarterly newsletter of the Alabama Mental Health Counselor Association....

How can I find hope when my situation is hopeless?

A ship should not ride on a single anchor, nor life on a single hope.

Epictetus, Greek Philosopher

Nearly 2000 years ago, Epictetus recognized the physical danger risked by traveling on a ship unprepared for all the various challenges and possibilities of a long journey at sea.  He used that example as a metaphor to make his main point…it is psychologically and spiritually dangerous to travel through ones life without being able to recognize that there are many possibilities! 

If ones focus is too microscopic and based upon only one hope, one desire, one dream, one expectation…it is likely one will miss all the other wonderful opportunities life offers.  There is the chance all the other hopes and desires we might have had for our lives are ignored because we are consumed by just one goal or expectation.  What is even more likely is we dismiss possibilities, though recognized, because we believe they are pointless (or even impossible) if we cannot be assured of obtaining our primary goal.  To use the Epictetus metaphor, one might get “shipwrecked” along the way! 

Often, it is our interpretation of circumstances, and not necessarily the circumstances themselves, that cause us to get shipwrecked - stuck, depressed and convinced that our situation is hopeless.  I often will use the following story (or a similar scenario) to illustrate the basic principles of Cognitive Behavioral Therapy (CBT). 

Take the following event as an example (Bush, 2002).  A friend is due to meet you for dinner at your house at 7:30. But it's now past 8:00, and there's been no sign of her - not even a phone call.  What will you think, feel and do about this?  Remember, there is only one event!

As this table of responses clearly illustrates, there is more than one possible belief, feeling and response to the situation.  These differences are based upon perceptions and beliefs that are not necessarily accurate - we still do not know why our friend is late. 

It is important to note the relationship among events, thinking, feeling and doing.  The way we feel (both physically and emotionally) can affect what we think and what we do, and what we do affects how we think and feel.  It is equally important to appreciate the relationships between events and feelings (which we can’t directly control) and thoughts and behaviors (which we can control).  Thus the name – Cognitive Behavioral Therapy! 

                                   Thoughts

      Events                 Feelings

  Behaviors

**thoughts and feelings  = "can control"

**events and feelings = "can't directly control"

The following are some suggestions, mostly based on CBT, for when you get stuck:

1.       (Thinking)  Be careful that your interpretation of events is completely accurate.  *Note- If your thinking could be described as “all or nothing”, you are probably not being objective or completely honest with yourself.

2.       (Thinking)  Think outside the box!  Look at other possibilities.  Do not allow one central idea corrupt all other ideas. Use the example and diagram above to help you.

3.       (Feeling)  Give yourself permission to feel awful sometimes.  It is perfectly normal and even healthy to feel bad when bad things are happening.  However, at some point, remember that the way you feel may actually cause you to misinterpret some things.  Re-evaluate!  

4.       (Doing)  If you are not doing anything….DO SOMETHING!!  If what you are doing is not working for you….DO SOMETHING ELSE!!  Believe that doing can affect feeling which affects thinking and so on.

5.       (Doing)  Ask for help if you get stuck.  It is wise and appropriate (and a sure sign of personal strength) to seek help when we get so stuck we cannot be proactive.  Seeking help IS proactive!  Utilize positive support systems found in religious faith, friends, peers, family, counselors and medical professionals.

6.       (Thinking, Feeling, Doing)  Remember that it can be difficult to overcome inflexible thinking, overwhelming emotion and unhealthy behaviors.  Take it slow.  Utilize your strengths and minimize any weaknesses.  Mostly….  THINK – FEEL – DO!!!

The original question was – “How can I find hope when my situation is hopeless?”  I’ll tell you what - Let’s rephrase the question in a cognitive behavioral way: 

What can I DO to FEEL hopeful when I THINK my situation is hopeless? 

Finally, I opened with a quote, so I will close with another 2000-year-old quote from our old friend Epictetus: 

"The thing that upsets people is not what happens but what they think it means." 

Think about “what it means”!

Gary Williams, Ed.S., LPC, CRC