Many folks come to therapy to learn coping strategies, tips, and tricks, concrete techniques that will help them feel grounded and at peace.
Anxiety traps you inside the house. Depression tells you it will never get better. You feel it down to your marrow: you’ve gotten what you deserve, and you don’t deserve to live a full life. But a part of you knows you don’t have to live like this. So you (eventually) find a therapist.
That first appointment is difficult, but you are hopeful, a bit nervous. It may have taken you years to get there. You’ve made the decision to start therapy, found someone potentially compatible, with openings. If you’ve really been blessed, maybe your therapy will be covered by insurance (!). It’s amazing that you’ve made it to this point. Here you are, in a therapist’s office. Or, if you’re meeting remotely, there they are, smiling from your computer screen.
You are ready for solutions. Understandably, you want them fast. Let the healing begin! After all, television shows, movies, websites, apps, and social media show that solutions, strategies, and skills are what therapy is about, unless it involves lying on a couch talking about your mother. Sweet relief is only a few guided mindfulness practices plus one daily gratitude journal entry away.
The desire to be free from emotional pain
I’ve had clients express their wish for Instagram-worthy epiphanies, for tips and tricks, for simple, concrete coping strategies. They are searching for the thing that will release their motivation, create a sense of self-love, banish anxiety, and dampen down emotional pain. Similarly, many parents want to know techniques for keeping their kids on an even keel, getting them to tolerate school or calm their inner fires from total self-immolation to a low, manageable burn.
I understand the need to feel better fast. The idea that a few insider tips will overhaul our thinking and bring sunshine and always-present coping skills is appealing. I have my own fantasies about this, particularly when I am in the weeds with a client, both of us slogging through, seemingly stuck in place.
In these dark afternoons of the soul, I wish I was some other kind of therapist. I browse cognitive behavioral therapy (CBT) trainings and consult my bible of dialectical behavior therapy (DBT) techniques (dialectal means the integration of opposites, the ability to accept and cope with the complicated, sometimes contradictory nature of reality). I wonder why I am not more perky, better able to convincingly direct my clients to fill out thought logs. The acronyms of DBT (DEAR MAN; ACCEPTS ) taunt me with their deceptive simplicity. Frustrated, I wonder why I can’t fully accept the theory that the secret to changing how we feel is changing how we think.
Structured therapeutic approaches can be useful
Let me be clear: CBT, DBT, and their relatives are life-changing for many, particularly folks who prefer a structured approach to therapy. Not everyone wants or needs to deeply explore their inner world. For some, this type of exploration can be overwhelming or feel unnecessary. Or perhaps it is not the right time to go beneath the surface. There are real benefits to learning concrete techniques to cope or sit with difficult feelings, to gently push through tough situations, to separate out who we are from how we feel. But these paths to change do not work for everyone and every situation—and they are not generally how I approach therapy. If you are looking for this sort of approach, I am not the therapist for you.
Positive, lasting change through the therapeutic connection
I work relationally, with a focus on understanding and changing unhealthy attachment patterns that affect how we connect with others and ourselves. Using the safety and trust of the therapeutic relationship, my clients and I create room to explore and make sense of the past. By sitting with folks, listening deeply, and thinking together, we also make sense of difficult emotions and experiences. This atmosphere of shared acceptance and meaning-making provides the space and perspective to heal and grow.
We are social creatures, learning who we are, our value, and our strengths and weaknesses through our interactions with others. While our struggles have roots in our relationships, so does our recovery. When we feel connected and safe, we are able to face our difficulties with purpose and resolve.
Relational therapy not only focuses on connection, it also attends to things going on beneath the surface. Uncovering hidden or disavowed emotions and experiences helps us understand what affects how we see ourselves and the world. What feelings or beliefs lie beneath that anxiety or depression, that pallid sense of self? How have our experiences affected our expectations and self-image? How can we be as free as possible in our lives, while also acknowledging the inevitable pains of being human?
Working relationally does not preclude identifying concrete coping strategies. But it does mean that these strategies are only part of the process of change. When we attend to other aspects of a person’s experience, the need for these concrete approaches is often lessened.
Relational therapy works!
In the past, I have found it difficult to clearly describe how I work and its benefits. This is particularly true when clients come to therapy actively seeking solutions and strategies. Similar to my early attempts to explain the benefits of nondirective play therapy, it can feel as though I am describing a magical, inscrutable process. Over time and with experience, I have gotten better at making my case. It helps that I’ve seen the benefits of my approach, with my clients, from kids to teens to young adults, and in my own therapy.
Working relationally takes time. The therapeutic relationship and sense of trust is something my clients and I build together. It also takes flexibility, open communication, and playfulness. But the results are sturdy–and exciting! In general, I have found my long-term clients are more grounded and better able to cope with difficult circumstances. They have positive and realistic views of themselves and their capacity to change and grow.
The appeal of coping strategies
When people are hungry for relief, worksheets, breathing exercises, and checklists can offer structure and apparent surety. CBT and DBT get good press. They’re well-studied and have been found to be effective, though there is some debate in the psychotherapy research community about these results. Physicians have heard of their effectiveness and make therapy referrals. News articles tout their benefits. Insurers sometimes require their use.
I incorporate these techniques when warranted. Sometimes I may refer a client to a specialist if I believe they would benefit. But before I do this, I think carefully about the hopes and projections we might have around these techniques. Is it more comfortable to consider changing coping skills, to imagine the apparent simplicity of learning concrete steps to change, versus to deal with sticky, painful emotions? Could there be a fantasy about the problem at hand, easier to identify as a lack of coping skills, because the emotions underlying it are scary and unknown? Are folks hoping that I will hold them accountable and keep them on track, looking to me as a more of a coach than a therapist? Or perhaps I am feeling stuck and searching for a way out, wanting that illusion of surety myself?
Coping strategies: Self-help resources
Psychotherapy that is structured and concrete can be useful. Here are some self-help websites if you are looking for quick tips and tricks or want to supplement your less tippy and tricky psychotherapy.
In general, these techniques are often used to cope with symptoms of anxiety and depression. They can also help you better regulate difficult emotions.
- CBT Techniques: 25 Cognitive Behavioral Therapy Worksheets from PositivePsychology.com
- Cognitive Behavioural Therapy Worksheets and Exercises from ThinkCBT
- 20 DBT Worksheets and Dialectical Behavior Skills from PositivePsychology.com
- DBT Self Help
If you are looking for a certified CBT or DBT therapist, check out these directories. You can also search any major online therapy directory and specify therapists who specialize in these techniques.
- Find a CBT Therapist from the Association for Behavioral and Cognitive Therapists
- Find a Certified DBT Clinician from DBT-Lineham Board of Certification
Contact me
Interested in learning more or want to schedule an initial consultation? Use my secure contact form or email me directly. My online portal shows my current openings, most of which are before 3pm. You can also schedule an appointment via the portal.