Who Are the Homeless?

Looking at the bag lady, it’s easy to jump to conclusions or make snap judgments – many of which turn out to be false. This person must be lazy, a bum, mentally ill, a criminal – the list goes on. The fact is that the homeless population in America includes individuals from all backgrounds. They include entire families, elderly individuals, youth, single adults, and veterans. Among all homeless adults, an estimated 23 to 40 percent are veterans. Homelessness is not confined to the big cities, but occurs in small towns, suburbs and rural areas as well.

Besides being homeless, these individuals often suffer from substance abuse and/or mental health disorders, or have a disability or are in poor physical health. According to the National Coalition for the Homeless (NCH), 20 to 25 percent of the homeless population in the U.S. suffers from some form of severe mental illness. This compares to only 6 percent of Americans with a severe mental illness (National Institute of Mental Health, 2009). In fact, mental illness, says the NCH, is the third largest cause of homelessness for single adults.

Homeless individuals may have lost their job, home, car, experienced bankruptcy, or had a severe trauma. Domestic violence is often an immediate cause of homelessness for women and children. Chronic homelessness, although representing a small percentage of the total homeless population, nevertheless consumes more than 50 percent of the available services. About 9 percent of the homeless live in rural areas. There is no single “face” of the homeless, and addressing the problem of what to do for the homeless requires understanding the complexity of the problem.

Risk Factors for Family Homelessness

Research has identified the lack of affordable housing as the primary cause of homelessness among families. The threat of homelessness is a constant pressure among poor families who are struggling to meet monthly mortgage payments or to pay the rent. According to the National Alliance to End Homelessness, there are other factors or predictors, characteristics that homeless families tend to share. These include:

• Extremely low incomes
• Tend to have young children
• Headed by a younger parent
• Homeless children have high rates of anxiety, depression, behavioral problems and poor school performance
• Homeless poor families have high incidences of domestic violence and mental illness

What is Motivational Interviewing?

Motivational interviewing (MI) is a person-centered, empathic guiding approach that can lead people to make significant changes in their lives. This is the definition of MI used by Ken Kraybill and Steven Samra in a recent webcast, Guiding People toward Change: the Spirit of Motivational Interviewing, available through the Homelessness Resource Center, part of the Substance Abuse and Mental Health Services Administration (SAMHSA).

The practice of MI involves a unique and creative approach of combining spirit and technique. Some have referred to it as a means of practicing “kindness with skill.” During the webcast, the presenters explored what is meant by MI, why it’s essential, and how it can be more useful in providing care for people who are experiencing homelessness. In other words, MI is an approach utilized to reach and draw out the homeless, to get them ready to accept change and to become motivated to change their circumstances.

The presenters know what they’re talking about, having had a great deal of experience in the field. Kraybill, who works as a technical assistance specialist for the Homelessness Resource Center, has worked in the behavioral health, health, and homelessness arena for the past 27 years. He has developed curricula, research guides and workshops to help inform others and equip them to work in the field. He currently provides training nationally on topics that include motivational interviewing, outreach and engagement, supervision, and personal and organizational wellness.

Samra recently joined the HRC as a recovery specialist and is also a veteran’s service coordinator with Operation Stand-Down in Nashville, Tennessee. After spending more than 30 years in and out of homelessness and battling addictions, Samra pulled himself together and received his BA and MPA at Cal State in Chico (in 2000). His life since then has been dedicated to helping pull others out of the street. He currently assists homeless veterans in and around Nashville.

How MI Works

In essence, MI works because it is a collaborative relationship between the counselor (provider) and the homeless individual. To be most effective, trust must first be established. Kraybill and Samra describe the relationship as being more like a partnership than being in an expert or recipient role.

The spirit of MI involves a counselor showing genuine interest in the homeless individual, believing in him, encouraging him to think creatively, and thus making learning interesting and fun for the homeless individual.

It is important to note at this point that motivation is elicited from the client (the homeless person), and not imposed upon him by the counselor. The chief task of the counselor, then, is to help facilitate expression (verbalization) by the client and guide him towards a resolution that triggers change. This often takes a non-linear approach, as direct persuasion is not an effective tool to resolving ambivalence. You can see this at work by thinking how trying to talk people into change rarely works. While it may be seen as helpful, it is just as likely to backfire as you meet resistance from the person you’re trying to persuade to change. In contrast, the counselor in MI quietly helps the person to examine the source of his ambivalence, and directive in the sense that he guides the client.

An individual’s readiness to change, then, is not a trait. It comes about as a direct result of interpersonal interaction. Denial is feedback regarding the counselor’s behavior. It is resistance. You cannot overcome resistance by bulldozing through it. A more empathic approach is needed.

Many homeless individuals have lost hope – hope in the system that has failed them, hope in themselves, hope that there’ll ever be a more promising future. Experts in treatment know that without hope, there can be no lasting change. There is no motivation without hope for the future. The spirit of MI is such that the counselor infuses hope to the client. By refusing to give up on the client and by providing a lifeline of hope, spirit, and belief that things can be changed, the counselor carries hope for the client. Kraybill and Samra liken it to being a “hope lender” for the client. The counselor believes in the client even when the client can’t believe in himself. One of the beautiful aspects of MI is that when clients do change, they will often make statements like, “I was only able to do this because someone believed in me.”

• Each partner has expertise – An interesting way of looking at MI is that each person in the partnership has some type of expertise and/or wisdom. A collaborative partnership or relationship is side-by-side, not face-to-face. Side-by-side implies collaboration, whereas face-to-face is confrontational.

• Goals are set collaboratively – Instead of a top-down approach, in MI, goals are set collaboratively. Once mutually agreed-upon, the client is given a menu of options as to how to achieve those goals.

• Approach matches readiness with personal choice – The type of approach takes into consideration the client’s readiness to change and emphasizes personal choice and autonomy. Ambivalence is seen as a normal part of change. It just means that a slightly different approach may be needed to counter the ambivalence and help the client to soften his resistance to change.

• MI requires responsiveness – In order to draw out the homeless, the counselor needs to come from a place of quiet and reflection. He needs to be responsive, mindful of the present, grounded and centered. He cannot be reactive. Reaction is fear-based and all about defense.

• Two main areas to eliciting change – One of the key elements in MI is to use skills to elicit change. Two main areas to helping people change is to establish a strong relationship of trust and safety, and to get the client to talk about change.
Talking about their lives, telling their “stories” is often very difficult and painful for the homeless individual. Mental illness, intoxication, neurological and developmental disorders, and brain injuries can often deprive the individual of the capacity to relate their stories or to locate themselves in the real world. Their narrative, thus, may take on bizarre or extreme dimensions. In order to get the client to a place where a coherent story can be shared, especially if the homeless person also has a disability or illness, may involve exercising great patience and a careful approach on the part of the counselor.

When the counselor invites the client to share his story, it’s a non-threatening way to gain the person’s trust and to form a picture of the individual’s life. Sharing a little of the counselor’s own story builds confidence and common ground. The shared “humanness” helps solidify the trust and encourages the client to proceed further toward goals.

Living on the street often builds estrangement. The individuals are literally alone and to themselves, being estranged from society, separated from ordinary activities, relationships, and a sense of place and purpose in the world. The longer homelessness persists, the deeper this sense of isolation and estrangement becomes. Reaching out to the client with MI allows hospitality – an invitation to relationship.

Hospitality implies no strings attached. There are no rules to follow, no judgment and no demands. The counselor is giving of his heart in order to help the client. Within this spirit of hospitality, the trust that builds allows the client to freely tell his story. Once the story is shared – past, present, and future – self-reflection and restoration can begin. The fertile ground for hope and change to sprout and take form can follow.

How does hospitality work? Imagine the first encounter by a counselor with a homeless individual. This may have been a referral or a chance meeting. The variations are endless, but the specifics are simple. Hospitality could be sharing a cup of coffee, a smile, acknowledgement, listening without interruption, offering a word of encouragement, or just being with the person in silence. To be effective, the counselor has to see the big picture, and not an instant fix. In MI, there is no quick fix. It is all about the big picture, the long-term desired results, always emphasizing the client’s personal choice and autonomy.

• Reflective listening is important – The counselor using MI needs to listen reflectively. This means eliciting and selectively reinforcing the client’s self-motivational expressions of problem recognition, concern, desire and intention to change, and ability to change.

• No jumping ahead – Gauging the client’s ability to change in MI means the counselor cannot jump ahead. If the client is not yet ready to change, jumping ahead of his ability to do so will only bring about resistance.

Future for MI in Drawing Out the Homeless

As for the future use of MI in drawing out the homeless, it would seem that the effectiveness of the technique to-date bodes very well for its continuation. As many MI proponents have contended, there is no win-win in a confrontational approach. Thus, the use of the collaborative, empathic MI approach is more effective in helping to build trust and guide the homeless client toward a willingness to change. MI is grounded in mutual trust, and an emphasis on the client’s personal choice and autonomy.

MI works not only with homeless individuals, but also with those who may be concurrently suffering from alcohol or other substance abuse, mental disorder, and disabilities. It is a more human technique, the so-called means of “practicing kindness with skill.”

As more MI counselors are trained, perhaps the great isolation and walls of resistance of thousands more of the currently homeless can be bridged and removed. This will allow an open pathway upon which to build and create a blueprint of change for the future.

So, you’ve gotten this far – made it through detoxification and started treatment. Congratulations! This is a big step for any individual trying to overcome addictions. But this is also where the hard work begins.

Naturally, some problems are bound to occur. And they’re likely to happen during discussions with your counselor or therapist. Why is that? Your therapist or counselor is the person who, in the treatment process, sees you the most often and begins to know you as a person. Depending on your mindset and readiness to move forward, you may be resistant so some of what the therapist has to say.

Goal of Therapy

It’s important to remember that drug or alcohol therapy has two goals. The primary goal is to help you achieve and maintain abstinence from addictive drugs and alcohol. The secondary goal is to help you recover from the damage that addiction has done to your life and that of your family.

Role of the Therapist

The therapist is here to provide support and education – and to hold you accountable through nonjudgmental confrontation. Ideally, you should see the counselor as an ally in your goal to achieve sobriety.

Recovery is ultimately your responsibility. The job of the counselor/therapist is to encourage your self-developed movement toward recovery.

What Happens During Therapy

Denial is part of the recovery process and is expected. You are most likely in denial of some aspect of your addictive lifestyle, and that may be causing the friction you feel with your therapist.

Think about how honest and forthright you have been with your therapist in discussing your drug and/or alcohol abuse. How truthful have you been about what it has done to your own life and that of your family? In fact, alcoholics and drug addicts are rarely upfront about these issues. The first thing your therapist does is to deal with your resistance.

Let’s face it. People don’t like change. Just being in drug or alcohol treatment is a big change for you – as it is for every client.

You may block or deny how negative the impact of drugs or alcohol have been in your life. As long as any traces of drugs or alcohol remain in the bloodstream, your thought processes are somewhat distorted. The process of complete detoxification may have only taken days, or it could have lasted weeks. If your thinking continued to remain clouded, a psychiatric evaluation may have been necessary. But the fact that you are now in therapy with a primary therapist assigned to you, attempting to address some painful issues, confronting them instead of denying them, means that you’re vulnerable – and you don’t like it.

One way to deal with that discomfort is to say you’ve got a problem with your therapist. Ask yourself honestly if you’ve given it enough time? Did you take an instant dislike to the therapist and subconsciously worked up a barrier – just so you can avoid taking responsibility?

The therapist will do the following:

• Help you to break through denial
• Help you to create strategies to stay away from negative people, places and things instrumental in your addiction
• Help you to take a personal inventory
• Help you to work on character development
• Help you achieve an inner strength
• Help you to address issues that continue to present themselves each day

What to Look For in a Therapist

Therapists in your treatment facility are licensed and trained to deal with substance abuse and addiction. What you need in your therapist is someone with whom you are able to establish a rapport, someone who is a good listener and who accepts you for who you are – no negatve attitude about why you are here or whatever you have done. There should be no blaming on the part of the therapist for your actions, even if it is a relapse. Your therapist should encourage you to speak honestly about your drug and/or alcohol addictive behaviors, accept your story, and, above all, be respectful of you as a person.

What You Need to Do in Therapy

It’s not easy. Coming to grips with what you’ve allowed your life to become will surface intense feelings of guilt and shame. You may feel unloved, abandoned, worthless, unworthy of a better life. Your number one obstacle to overcome at first is to realize and admit that you have a problem with addiction – and that you need to deal with it.

You will need to continue to meet with your counselor or therapist on a regular basis – whether this is through a residential or outpatient treatment program.

You have to give it time to work. Breakthroughs don’t happen overnight. Just as your addiction took some time to develop, learning to overcome those self-destructive behaviors will take some time as well.

Working with your therapist, various therapeutic techniques may be employed. Some are time-limited approaches based on focused cognitive behavioral therapy (CBT) and the 12-step recovery programs. CBT helps you recognize, adapt and cope with situations where you’d most likely resort to drugs and/or alcohol. You’ll learn to develop skills and strategies to deal with cravings for drugs and/or alcohol, how to avoid people, places and things that cause triggers to use, and how to regain your self-esteem, confidence and inner strength. You will, in effect, learn the tools to help you continue your lifelong recovery.

Can’t You Just Leave?
People do leave treatment before completion. But it’s always at a huge cost to their recovery. If you decide that you can’t work with a particular therapist and can’t or won’t give it additional time, before you walk out of treatment, ask to speak with the therapist’s supervisor or the director of the facility. It’s critical that you remain in treatment, for your own sake, and the facility will do what it takes to ensure that your needs are met, within the bounds of protocol.

Perhaps another therapist can be assigned to you, or through discussion, there may be some accommodation that can be reached between you and your original therapist that will be acceptable. Don’t lose sight of the ultimate goal: to achieve and remain abstinent in lifelong recovery. You owe it to yourself to give treatment the chance to work. You are your own worst enemy, after all. Instead of walking away – and having to repeat the whole process again at a later time – push through your barriers to change.

Look To Your Future

Keep in mind your future – one that’s drug- and alcohol-free. The goal is attainable. Through counseling, individual and group therapy, education, and motivation, you can and will achieve it. Don’t put off your better tomorrow. Stay in therapy, remain in treatment, and envision the life you can and will have in recovery.
 

If only it were true.

There’s good news and bad news when it comes to how much help hypnosis can provide to individuals genuinely trying to overcome their addiction to alcohol and/or drugs.

The good news is that hypnosis may help temporarily overcome some destructive behaviors. The bad news is that it doesn’t get at the underlying physical and/or psychological causes that drive the addict to use.

What Is Addiction?

In the case of alcohol and drug addiction, according to the National Institute on Drug Abuse (NIDA), the essence of addiction is “uncontrollable, compulsive drug-seeking and use even in the face of negative health and social consequences.”

Addiction has both physical and psychological roots. It is an illness, and addicts have usually experienced several failed attempts or relapses trying to overcome their addictions. Their hurt is always equated with rejection and depression. They resist change, because to them, it’s better to assuage the hurt with something they believe they can control – such as drinking and doing drugs – than to try to overcome the addiction.

Why Do Addictions Occur?

Addictions occur for three main reasons.

• The individual uses the alcohol or drug to relieve pain and stress, whether that may be emotional and or physical.

• By drinking or doing drugs, the individual obtains instant gratification – an immediate high which, in itself, becomes a psychological craving for more.

• Repetition of the behavior (drinking, doing drugs) moves the person into addiction through classical conditioning response. The addict sees people he or she associates with drinking or doing drugs, or goes to a certain location where this activity occurs. It could even be a certain time of day (“happy hour”), or a sound of glasses tinkling. When the addict drinks and uses drugs, this conditions them to do it again.

Underlying Causes of Addiction

According to experts in the field of psychology, underlying pre-cursors to addiction include low self-esteem. This may include repeated rejection, abuse, child abuse, neglect, and feelings of inferiority and inadequacy. Such harsh and destructive experiences lead addicts to seek refuge in alcohol and drugs. In effect, they’re compensating and masking deeper personal underlying causes that may have occurred long ago and have been repressed.

What Hypnosis Can Do

Hypnosis can give some kind of post-hypnotic suggestion to create a distraction or diversion when the addict feels compelled to engage in his or her addiction. But hypnosis cannot get at the underlying causes of the addiction.

Some of the behavioral triggers (emotional/psychological) can be helped through hypnosis. But digging deeper into personality problems during hypnosis veers past true hypnosis into regression hypnosis. Experts recommend that the addict may be better off with long-term therapy or counseling.

Hypnosis can help the addict relax and be more receptive to the message of recovery. Along with other alternative treatments, Cognitive-Behavioral Therapy (CBT), individual and group counseling, hypnosis can give the addict better tools with which to combat addiction.

As the NIDA counsels, addiction can be treated behaviorally and, in some cases, with medications. But it is not simple. While a range of effective addiction treatments exist, they are not enough. The NIDA continues to invest in research, to improve existing treatments, and develop new approaches to help addicted individuals deal with their compulsions.

Bottom line: hypnosis is a very good therapy. But it is not the best for treating addictions – at least, not by itself.

The terms “downward facing dog” or “pigeon pose” may not a ring a bell to you, but for a large number of yoga enthusiasts, these terms are commonplace and elicit a calm and meditative reaction. There are a lot of misconceptions and preconceived notions about the practice, but what every yogi knows are the benefits yoga has on the body.

For individuals recovering from alcohol or drug addiction, transforming the body and the mind is essential in order to overcome an addiction. As more and more recovering addicts look for ways to change their past destructive lifestyles and look for alternative approaches to cope with life’s stresses, yoga may be the perfect complement to one’s more traditional therapy.

Yoga is the ancient discipline of joining the physical self with the spiritual self. Originating approximately 5,000 years ago in India, the term “yoga” is Sanskrit for “yoke” or “to unite.” As the meaning suggests, the practice of yoga includes two distinct elements that unite as one: the physical element and the mental element. By engaging in postures, or “asanas,” with varying degrees of difficulty, yoga helps you strengthen, align, and tone your body. By adding breathing techniques and meditation, yoga becomes more than just an exercise—it becomes a way of life. And for more than 6 million Americans, yoga is a regularly performed practice.

One of the main hurdles recovering addicts face is their physical dependency on drugs or alcohol. Due to the painful and sometimes severe withdrawal period, a recovering addict should detox under the supervision of a physician. In addition to the physician’s recommendations, the implementation of yoga into an individual’s daily or weekly regiment will change the body for the better; one will become leaner and stronger, in turn helping the individual defeat physical cravings.

Yoga is a great form of detoxing because the practice helps flush out toxins from the body due to increased blood flow. Yoga is also practiced in a non-competitive environment where the results noticed are directly related to how much energy the participant puts forth. This allows for a relaxed atmosphere, free from judgment and pressure.

The physical benefits of yoga are only part of what makes this discipline a good treatment choice for recovering addicts. The meditative element helps bring an emotional balance to the body. Along with the meditation, the deep breathing involved in yoga brings a calmness that many recovering addicts haven’t experienced in years. By having to concentrate so intently on a specific pose or on a breathing pattern, personal troubles seem to disappear during the practice. It is also suggested that yoga produces an increased ability to concentrate and to focus, characteristics important for recovering addicts to maintain.

Individuals seeking to break an addiction are faced with an uphill battle, one that may seem impossible to overcome. Yoga is there to help as an alternative approach to the traditional treatment options. In a world of ups and downs, yoga emphasizes a balanced approach to life that everyone can benefit from.

Transactional analysis, commonly referred to as TA, is based on these primary concepts:

1. People have three parts (or ego-states) to their personalities.
2. These ego-states converse with each other in transactions.

Transactional analysis is a theory that promotes personal growth, development, and change. To begin this explanation, part of transactional analysis is a theory of personality, which is based on the study of the ego-states. It helps people gain a better understanding of why they behave the way they do and helps them better express themselves.

Transactional analysis is also a theory of communication, which makes it a system for in-depth analysis. Because of the versatility of transactional analysis, it can be used to diagnose and treat a wide variety of psychological disorders. Its therapy applications can be utilized in individual, group, family, or couples sessions.

The primary purpose of transactional analysis is to help patients realize their own self-worth. TA strives to teach people that they do not have to be slaves to the behaviors and thought processes that they learned as children. One of the core beliefs of TA is that we all learn certain behaviors and ways of thinking as young children. These thought processes continue to shape our behaviors into adulthood, and sometimes this leads to the development of personality traits that people would like to change.

An interesting aspect to traditional TA therapy is that therapists are supposed to commit to attempting to “cure” their patients instead of simply being there to listen to them during sessions. Any changes that a patient would like to see within themselves should be openly addressed at the very beginning of therapy so that both patient and therapist are on the same page regarding treatment goals. This type of action serves to make patients feel more valued as individuals, and instills within them a belief that their therapist has a true interest in helping them achieve their long-term goals.

Patients who are beginning TA therapy can generally expect to undergo at least several sessions with their therapist. The overall length of treatment, however, is something that the patient and therapist determine together, and can vary quite a bit among patients. It is certainly not a quick-fix type of treatment, but it is one that can offer lifelong changes to individuals who devote themselves to the treatment process.

There are a variety of different types of events that can lead a person to experience traumatic stress:

• Abuse
• Assault
• Car accidents
• Disaster
• Rape
• Serious medical procedures

Depending on the severity of the trauma, it may or may not become a chronic problem. If the event does lead a person to develop chronic traumatic stress issues, there are generally both physical and psychological symptoms that result. Some of the physical symptoms that may manifest themselves include the following:

• Cold sweats
• Difficulty concentrating
• Being easily startled
• Extreme energy
• Irregular or rapid heartbeat
• Panic attacks
• Sleep problems
• Unusual exhaustion

Some of the most common psychological symptoms include:

• Anxiety
• Avoiding social situations
• Feeling of being detached from oneself and others
• Flashbacks

With somatic therapy, patients do not necessarily have to force themselves to go back over traumatic events and unhappy memories. This type of treatment can be quite effective if patients are simply willing to allow themselves to honestly complete the therapy process.

In order for somatic therapy to truly work, patients must realize that they are capable of taking control over their own symptoms, which will then allow them to create a sense of comfort and safety that will empower them to get past their previous traumatic events. Other important components to somatic therapy include tapping into emotional resources, balancing the nervous system, and evaluating physical reflexes.

The treatment period for somatic therapy can range from a few sessions to several years. The length of treatment that is necessary for a patient largely depends on the type of trauma that was suffered, whether the trauma is related to other traumatic events, the patient’s age, and the patient’s current inner strength and determination.

Many professionals believe that somatic therapy can provide people with the tools they need to lead healthier, more productive lives because they will be better equipped to deal with unpleasant events and leave them in the past where they belong.

Dr. Albert Ellis, the creator of rational emotive therapy, determined that there is an ABC format that can teach people exactly how their belief systems lead to their emotional reactions:

A. Something happens.
B. You have a certain belief about the event or situation that has occurred.
C. You have some type of emotional reaction to whatever your belief happens to be.

This system seems to explain why people may have different reactions to the same situation. For example, if two different people are accused of stealing something at work, both of those individuals can have completely different reactions. One person might become infuriated at being falsely accused of a crime, while the other person might become anxious and be more concerned about losing his or her job. The reasons for the different reactions are based entirely on each individual’s beliefs about the upsetting event that just happened to them.

When patients begin rational emotive therapy, they generally complete an initial assessment with their therapist that usually involves a question and answer session. Some of the topics covered include medical and psychological history, family background, employment and education history, and the disclosure of any type of drug use or criminal background. All of these things help the therapist chart the best course of action for a patient’s treatment.

Therapists who use rational emotive therapy in the treatment of their patients have complete faith that the sessions will enable those patients to change their pre-programmed ways of thinking so that they will be better able to develop a tolerance for frustration or anger when faced with obstacles in life. Because of the close interaction between therapist and patient during rational emotive therapy, it is extremely important for a patient to choose a therapist with whom he or she feels entirely comfortable. Challenges will undoubtedly be faced during treatment, and the types of honest exchanges that will result are best handled when there is trust between therapist and patient.

From a clinical standpoint, rational emotive therapy has proven to be very effective and efficient at helping patients gain ownership over their emotions. In addition to its uses as an individual type of treatment, it has also proven to be quite effective when used in conjunction with other types of therapeutic practices.

Psychoanalytic therapy, or psychoanalysis, is very intensive and time consuming, so patients should be aware going in that this type of therapy is not a quick fix for their problems.

There are actually a number of techniques that therapists utilize during the process that can help patients open up more about their past and current problems. For example, free association is a process where the patient talks about whatever comes to his or her mind. Dream analysis is another popular technique, and it allows the therapist to find some common ground within the patient’s thoughts and actions that may help to resolve some issues for the individual.

Psychoanalytic therapy consists of three different applications:

1. A method of treatment of emotional or psychological illness.
2. A systemized set of theories relating to human behavior.
3. A method of investigating how the human mind works.

There are also more than 20 different approaches to treatment that all revolve around deciphering the complexities of human development. Attempting to uncover the deeper meaning behind our unconscious thoughts and how they affect our behaviors is a central goal of psychoanalytic therapy.

For patients who feel that talking to an objective professional might help them, psychoanalytic therapy may be an ideal course of treatment. Regardless of whether an individual is experiencing problems at home, work, or school, this type of therapy can help people work through their problems and perhaps even discover the root cause of them.

Psychoanalytic therapy is also widely believed to be very beneficial for children who are experiencing social problems. While many children will not discuss their thoughts or feelings with their parents, particularly if they believe that they will be viewed harshly, they are often more likely to open up to a therapist in a private setting. Parents are encouraged to explore the benefits of psychoanalytic therapy if they have a child who is acting out at school, or who simply becomes uninterested in participating in family or other social activities.

Even with children, however, the length of treatment with psychoanalytic therapy can be extensive. It is always best to approach this type of therapy with the expectation of devoting a healthy amount of time to the process in order to see it through properly.

The length of time that family therapy sessions take largely depends on the extent of work that needs to be done to strengthen or repair relationships. In some cases, couples or families might only need five or six therapy sessions. In others, it might take as many as 20. This is a decision that patients and therapists make together as the treatment sessions progress.

In general, family therapy is considered to be a short-term treatment. Some of the typical problems that might be resolved during family therapy include school problems, eating disorders, problems adjusting to new locations or situations, and communication breakdowns.
The theories behind family therapy systems include the following:

• Differentiation
• Balance
• The Identified Patient
• Triangular Relationships
• Extended Family

Differentiation simply means that each family member should be allowed to maintain their own identities without feeling that they have to conform to the expectations of other people in the household. Balance refers to the stability and organization that a family tends to take on naturally over time. The natural family balance is likely to be resistant to change, so a qualified therapist can help family members embrace change rather than being sent into upheaval when one family member brings change into the home.

The identified patient is the particular family member who prompted the family as a whole to seek some assistance and guidance. This concept does not in any way attempt to label the identified patient as a problem person or instigator.

Triangular relationships refers to the fact that most families have at least three members that at some point become actively involved in any type of dispute. These involved family members can not only include immediate family members, but extended family members as well.

Of course, the extended family is the immediate household members plus grandparents, aunts, or uncles that may contribute to the family dynamic. When patients choose family therapy, they are committing themselves to a thoughtful process that will allow each family member to express themselves in a structured environment where everyone’s individual opinions are heard. Family therapy is grounded in the belief that individuals can actually be best understood when the entire family is evaluated in therapy.

Essentially, EMDR works by helping patients to completely deal with their memories by fully processing them. Part of the treatment for EMDR involves bilateral stimulation of the brain. Bilateral sound, eye movements, or bilateral tactile stimulation are combined with visualized images and various types of body sensation to produce the most effective results. Many clinicians believe that this type of therapy is quite valid for desensitizing patients to their traumatic memories.

The basic belief behind EMDR is that eye movements help to reduce the acuteness of traumatic memories. During the treatment process, patients are asked to focus on a traumatic event in their lives so that their memories can be reprogrammed to be more positive. The utilization of eye movement is thought to aid in this process.

During treatment through the use of EMDR, patients experience a dual awareness that allows them to alternate between visualizing their traumatic memories and being aware of their present surroundings. The use of eye movement in this type of treatment helps to reduce the negative emotions and sharpness of the memories that are associated with past traumas. It also helps to induce some physiological changes that aid in the treatment process.

Therapists who use EMDR treatment help patients to create a link between a past traumatic episode and the use of rapid directional eye movement. One of the keys to the success of this treatment is for patients to allow themselves to consciously think about a traumatic event while also placing themselves in the present to focus on the therapy at hand. If this treatment is given a fair amount of time, the traumatic memories will eventually become desensitized and may actually be replaced with more positive thoughts.

Some professionals believe that EMDR is quite similar to REM sleep (Rapid Eye Movement). Rapid eye movements can not only help relieve anxiety, but can also put events into a different perspective, allowing patients to view past traumas from a healthier point of view that is much easier for them to live with.

EMDR therapy is generally broken down into the following phases:

1. Client history and treatment planning
2. Preparation for therapy sessions
3. Assessment
4. Reprocessing, desensitization, and installation
5. Body scan
6. Closure
7. Reevaluation

EMDR was developed 22 years ago, so it is still a relatively new type of treatment. It is important that patients seek assistance only from those therapists who have been specially trained in the use of EMDR.