How to find the right counseling strategy for our patients

The human mind can focus in two direction, the external and internal. Extroversion and introversion if you like.

We can use our five senses to ground us in the external world of the here and now or...

We can go inside our heads and use our memory to access past data or use our imagination to anticipate the possible futures.

Each has its pros and cons of course. Too much introversion is an issue. Too much extroversion can also be an issue.

When someone is more focused, zoomed in, or “fused” with the past memory or the imagined future, and these are “negative in nature”, it may then manifest as an anxious or flat mood. If excessive, it can lead to a “mood disorder”.

So what are our options?

1. Go back in time and change the event. Of course this is not possible although it would be nice to do so.

2. Try to understand it and reframe it. We cannot change the event but we can certainly change the meaning of it.

3. Try to understand it, defuse from it and accept it.

4. Try to take a drug or chemical of some sort to numb it or detach from it. There are illegal and legal types with illegal not recommended.

5. We simply ignore the inside head experience and ground ourselves to live in the 5senses present moment experience or value based living. Think Zen Master.

6. We can do a combination of the above.

So often, I will ask patients regarding what strategies resonate with them the most and go from there.

Defusion and detaching from thoughts or feelings, and creating a new experience are more towards Mindfulness, DBT and ACT in my opinion.

Understanding, and reframing our story may be more in line with Psychoanalysis, CBT and Schema Therapy perhaps.

Medications are a good option too especially if the condition is too severe for the person to engage in new skill learning and training. With this in mind, I see medication as an adjunct to counseling rather than the other way round.

Simply living life in the present moment like a Zen Master is nice but not practical for most of us.

Often, we end up taking a combination approach.....