The Puzzle of Progress- Avantika Malhautra

Avantika Malhautra

Psychologist/ Expressive Arts Therapist

Founder – Soul Canvas – Art for Wellness

 

Movement in Therapy

What qualifies as movement in therapy? This has been my personal research question since I began practicing as an Expressive Arts therapist and this article is an interaction between my personal experiences so far and theories or models that are in alignment.

I am deeply inspired by the works of psychologists such as Carl Rogers, Carl Jung, Sigmund Freud, Donald Winicott, John Bowlby, Erick Erickson and Eugene Gendlin, to name a few. I find my own insights as a practitioner validated by masters in the field, and in parallel, I am on an exploration to find my independent understanding through direct experience of my practice of expressive arts psychotherapy with individuals and groups.

My exploration began a few years ago with questions like 1) Does therapy require a leap of faith or can it be defined and measured in outcomes?

2) What makes therapy work? 3) How long does therapy take?

These questions came from personal and professional inquiry in the hope for answers for myself and other practitioners. As I started to explore further I came across multiple paradigms, many of which were talking about similar key aspects regardless of the form or approach to therapy.

I began to view the therapy process as a function of 3 core interactional elements – the inner world of the client, the inner world of the therapist and the relational field between them. This made me curious about the movement that takes place within each of these elements and how that contributes to the overall growth for the client. I discuss this further through the following themes:

  • Movement in the client
  • Movement in the therapeutic relationship
  • Movement in the therapist

Movement in the client – I experience this movement as a process of lightness of being, of changing body symptoms. New thoughts, beliefs, perspectives or behaviours start to appear as the client moves towards health by navigating through the inner friction, stuck-ness, conflict and resistance. And what really begins to then change is a relationship with the self. The self, which comprises of body and mind – physical form, sensations, feelings, thoughts, perception and consciousness – are all constantly in a state of flux. Thus, providing a facilitative, supportive and safe environment in psychotherapy allows for an emergence of unconscious parts of self to be acknowledged, expressed, met with, as and when the client is ready to unfold, unmask, submerge to emerge and perhaps take action.

“There is a change in the individual’s manner of relating

The self becomes increasingly simply the subjective and reflexive awareness of experiencing. The person has changed, but what seems most significant, is that s(he) has become an integrated process of changing-ness.” ~   Carl Rogers ~

Movement in the therapeutic relationship – The relationship between the therapist and client is central to the effectiveness of therapy – The relationship is an invitation for a secure attachment experience, moving from a place of mistrust, avoidance, suspicion, anxiousness or fear to experiencing a safe, trusting and close relationship where one can truly be themselves. The transference and counter-transference, the merging and separation that is experienced as the client attaches with the therapist provides potent information about the client’s relational self and past experiences. The projections, defense mechanisms, free association, Freudian slips, dreams, stories, metaphors, body movement and art are all windows and sometimes doors to the unconscious. There is an immense power in being witnessed and seen by another in exactly the way the client wants to be seen. It can be an empowering experience and become a playground for practice of new skills or ways of being within the client-therapist dynamic that can then be taken outside the therapy room into daily life.

Movement in the therapist – My own growth and process of self-inquiry through personal therapy, self-work, supervision, academic reading and personal practices of the arts and spirituality has benefited me deeply while providing support and knowledge. It has enhanced my confidence, trust, intuition and competence as a therapist and I see the impact of it in the ‘holding space’ and ‘grounded-ness’ of my presence that can truly become an offering for clients to move towards their personal health. I acknowledge that this professional path is first a personal commitment to one’s own continuous growth and then a facilitation of any kind.

The ‘movement of the therapist’ is of utmost importance in the overall process for movement to occur in therapy. I would like to elaborate this further by Virginia Satir’s work highlighting the use of the self as therapist that I find extremely valuable and relevant to my work. The development of the self of the therapist is a significant aspect of becoming an effective therapist.

The Satir model (Banmen, 1997) promotes four goals of therapy for the training therapist: to increase self-esteem, to foster better choice making, to increase responsibility, and to develop congruence. These four goals are not only applicable to clients, but are important for the development of the self of the therapist.

The Satir model encourages that therapists and clients to become fully human and congruent. It is not possible to be congruent at all times, yet it is important that therapists strive to be congruent at all times within their therapy sessions. Therapists will not become congruent if they neglect to work through their own personal issues because of discomfort, avoidance, resistance, or denial. Satir believed that if therapists were congruent, there would be no need for transference or counter transference, rather that therapists would model the possibility of how to stay more connected with themselves.

  • Increase Self-Esteem
  • “How do I feel about who I am?”
  • “What do I think about my own worthiness?”
  • “What would help me feel better about my own competence?”

High self-esteem leads to trusting intuition, therapeutic process interventions, ability and flexibility to make choices. Both clients and therapists have unresolved issues from their family of origin, which have an impact on their level of self-esteem. Therapists’ professional esteem could suffer if they are not able to be accepting or understanding of their clients’ responses and growth. Therapists using the Satir model are encouraged to increase their self-esteem by being gentle and kind to themselves, not judging themselves, accepting who they are, and acknowledging their intuition and abilities. As therapists increase their self-esteem, they are more likely to believe in their own therapeutic capabilities.

a. Self-care & Acknowledging feelings

Therapists could ask, “How am I maintaining balance in my personal and professional life?” “How can I take better care of myself?” “How have I been ignoring my spiritual life?” “When I only focus on a few areas in my life, what is happening in the other areas that I have overlooked?” Since Satir’s death in 1998, the self-mandala has continued to be an important tool for self-care and for creating and maintaining inner harmony by therapists.

 

b. Self-care & Resilience

As therapists take better care of themselves, they are more able to remain resilient in spite of professional stressors.

“I’m exhausted after seeing so many clients today who were in pain, so I’m going to stroll by the ocean in order to clear my mind.” Satir recognised that as therapists accepted and acknowledged their feelings, then life energy would be able to flow more readily, which means they would be more able to connect with self (Satir & Banmen, 1983).

c. Strengths & Resources

Just as clients are not always aware of their strengths and resources, therapists are not always aware of their own strengths and resources. “What strengths and resources have I gained from my own family?” As therapists are better able to gain access to their own strengths and resources, their sense of self-esteem will grow. They will have a greater access to their own innate qualities that can support healthy therapeutic relationships. “How can I focus on my client’s strengths and not on their regrets?” Satir model therapists are encouraged to accept, acknowledge, “own,” and access their strengths and resources (Lum, 2000).

  • Foster better choice-making
    1. Awareness of the therapist – promoting the internal monitoring of therapists’ inner worlds, which can increase access to crucial therapeutic information and experiences (Lum, 2000).
    2. Therapists’ perceptions of the world – Satir explored four areas of perceiving the world: how we define a relationship, a person, an event, and attitudes toward change (Satir et al., 1991).

When the therapist is aware of his/her emotions, values and beliefs, he/she is more capable of stepping out of these frames of reference to be fully present to the reality of the client.

  • Increase Responsibility
    1. Training the self of the therapist
    2. Competence of the therapist
    3. Ethics of the therapist
    4. Supervision of the self of the therapist

Therapists have a responsibility to respond to their clients compassionately, non-judgmentally, and transparently. To truly hear what is behind the words and interactions of clients will take therapeutic artistry on the part of the therapist.

Clients can be very sensitive to the therapeutic relationship and may sense if there are any biases, resistance, discomfort, unresponsiveness, or disrespect coming from therapists. “If I’m still reacting, I wonder if there is something that I haven’t yet healed?” Satir model therapists are encouraged to resolve hurts from their family of origin, which may still be having a negative impact on their present life.

  • Develop Congruence – Satir recognized that combining one’s intuition and groundedness would facilitate a sense of connectedness to others (Banmen & Banmen, 1991; Satir & Banmen, 1983). Satir saw therapy as a spiritual experience between herself and her client. Now the therapy world is acknowledging the interconnection of therapy and spirituality (Miller, 1999). “How can I honour the essence of my clients?” “How can I facilitate a sense of inner peace right now in this moment?” “What do I know about the sense of divine within my own life?” Therapists are encouraged to explore their own connection to their spirituality in order to be able to process clients’ spiritual exploration (Lum, 2000). 

A question that is almost always asked – How long does psychotherapy take?

This can be answered based on several indicators, however, often we may not be able to put a time frame to it due to the emergent nature of the work, the relationship and the client’s level of readiness.

A few questions we can ask ourselves as a therapist –

  • What did the client come for? Is the goal achieved, specific problem resolved, fresh perspective or hope found, new ways of being or coping or relating with others found that enhance daily living
  • Life as a mirror – Is there a feedback from life and people around
  • External support and resources – What is going on outside therapy?
  • Individual Factors – Some can experience a stir after a single session and others can continue therapy for 1-2 years before they feel the benefit
  • Mental Condition – Ongoing therapy for some may be to maintain day-to-day functioning and for others it may be for improved well-being.

In conclusion, movement is a process of changing position or perspective is not limited to the client and is far more important to be witnessed by the therapist in the self, in order to be fully present, spontaneous and attentive to the unfolding of every moment that arises in therapy with the other. Therefore, honouring and building capacity to hold dual awareness to be present within and without is the ongoing practice of an effective therapist.

References –

  • The Arts in Psychotherapy, Vol. 15 pp. 71-77 Pergamon Press plc, 1988. Printed in the U.S.A
  • Expressive Therapies – History, Theories and Practice – Cathy A. Malchiodi
  • Assessments and Outcomes in the Arts Therapies – A Person Centered Approach – Edited by Caroline Miller
  • DeBerry, S. and Baskin, D. (1989) Termination criteria in psychotherapy: a comparison of private and public practice. American Journal of Psychotherapy, 43, 43-53.
  • Fortune, A.E., Pearling, B. and Rochelle, C.D. (1992) Reactions to termination of individual treatment. Social Work, 37(2), 171-8.
  • Hunsley, J., Aubry, T.D., Verservelt, C.M. and Vito, D. (1999) Comparing therapist and client perspectives on reasons for psychotherapy termination. Psychotherapy, 36, 380-8.
  • Mindfulness & Psychotherapy – by Christopher K. Germer , Ronald D. Siegel, Paul R. Fulton
  • http://www.apa.org/helpcenter/understanding-aspx
  • https://link.springer.com/referenceworkentry/10.1007%2F978-3-319-15877-8_544-1

Avantika is a practising Psychologist and Expressive Arts Therapist who works with individuals and groups using the body-mind approach to counselling and psychotherapy through her private practice in Bandra, Mumbai. She specialises in working with youth and adults experiencing depression, anxiety, stress, grief, relationship, self-esteem, abuse, identity and adjustment concerns.Avantika has gained her training and experience within the Indian cultural context and has worked across Delhi-NCR, Bangalore, Mysore, Pune and Mumbai. This has been in settings such as corporates, hospitals, schools and therapy centers. She founded Soul Canvas – Art for Wellness in 2014 to spread awareness about the power of expressive arts in individual/group therapy and training. As Director of Therapy Services at Artsphere she led several corporate workshops and expressive arts therapy modules in training at Dance & Psychology Departments of Pune University and the CYDA-TISS Counselling Diploma in Pune. Currently, she is a faculty member with Creative Movement Therapy Association of India, teaching and supervising on the Dance Movement Therapy training courses in Delhi and Pune.

 

 

 

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