Experiential Therapy: Symbolic-Experiential, Human Validation Process, Emotion-Focused Couples Therapy, Internal Family Systems

Question 1

Experiential Models

Answer 1

◦ Some Psychology Experiential Models
- Gestalt therapy
- Psychodrama
- Roger’s client centered therapy
- Encounter group movement
◦ Humanistic, existential view of humankind
◦ Emphasis on emotional experience vs. intellectual reasoning
◦ Psychological health= individual growth, freedom of action, and
open expression
◦ Problems exist when emotional expression is blocked so people
cannot authentically be themselves
◦ Goal: “unblock honest emotional expression in families…and to open
individuals to their inner experience…helping them be more fully
human”
- Develop a heightened sense of competence, well-being, and self
esteem

Question 2

CFT Experiential Models

Answer 2

◦ Symbolic Experiential
◦ Satir Human Validation Model
◦ Emotionally Focused Therapy
◦ Internal Family Systems

Question 3

Stance of the therapist

Answer 3

◦ Foster open communication and spontaneity
◦ Self-disclosure and authenticity
- Accessibility as regular people
◦ Emphasize here-and-now experiences
◦ Address unfinished business
◦ Existential encounters: therapist willing to both receive and disclose
reactions in session with family
- Model non-avoidance
- Provocatively increase stress and emotional intensity to push for
breakthrough of affect
- Serves as model for here-and-now (alternately supporting and
challenging family members)

Question 4

Treatment Interventions

Answer 4

◦ Guided by belief that people are naturally creative, loving, and
productive if free from constraint
◦ Full participation from therapist
- Focus on here-and-now
- Alternating challenge and support for family members
◦ Interventions aimed at increasing ability to experience emotions and
encourage more genuine interactions
- Ex: family sculpting, family drawings, symbolic drawing of life space,
role-playing

Question 5

Symbolic-Experiential Therapy

Answer 5

Carl Whitaker
◦ Psychiatrist at Emory University
◦ Provocative interventions
◦ Existential themes: freedom, choice, self-responsibility, anxiety, and
awareness of death
◦ Interactional metaphor: therapist-client symbolic relationship
- Parent imago: therapist’s role to client
- Goal to terminate therapy in adult-to-adult relationship

Question 6

Normal Development in Symbolic-Experiential means…

Answer 6

◦ Flexible, integrated family
◦ Interactions across generations maintain sense of history
- Generational roles are separate
- “As if structure”: can experiment in different roles as long as there
is understanding of symbolism
* Metacommunication: communication about communication
◦ Raised in atmosphere that supports feelings, natural creativity, and
individual growth and choice
◦ Assimilation and accommodation – regression and reintegration
- Normal processes of change
- Negotiation of life tasks (coupling, etc)

Question 7

Dysfunction in Symbolic-Experiential means…

Answer 7

Several circumstances:
◦ Spouses struggle over whose FOO culture will dominate
◦ Unable to accommodate to developmental changes
◦ Degree of craziness:
- Driven crazy
- Going crazy
- Acting crazy
◦ Fixation of triangles (clash of FOO cultures)
◦ Teaming roles (self-sacrifice)

Question 8

More Symbolic-Experiential info

Answer 8

Interactional metaphor: therapist-client symbolic relationship
◦ Parent imago: therapist’s role to client
◦ Goal to terminate therapy in adult-to-adult relationship

Use of therapist’s personality and spontaneous reactions prioritized over technique

Co-therapists
◦ Counterbalancing countertransference
◦ Expert/coach, not a teammate

Sometimes required 2-3 generations to be seen in therapy

Question 9

Symbolic-Experiential - Battle for structure

Answer 9

◦ Therapist decides who should attend and assumes the position as
leader
◦ Blocks family members from typical patterns of behavior
◦ Therapist must win the battle for structure

Question 10

Symbolic-Experiential - Battle for initiative

Answer 10

◦ Therapist communicates responsibility for treatment belongs to the
family
◦ Family must win the battle for initiative

Question 11

Symbolic-Experiential - Assessment

Answer 11

First interview
◦ Entire family 2-3 generations; whole system must participate
◦ Gains sense of whole system/patterns/roles/dynamics
◦ Makes assumptions about family roles re: power, distance, alliances,
etc.
Therapist implicates the whole family in the problem
◦ Raising anxiety for suprasystem
◦ Causes are circular and so are changes
Avoids diagnosing
◦ Therapeutic double-bind

Question 12

Symbolic-Experiential - Goals & Treatment

Answer 12

Goal: Establish family members’ sense of belongingness and provide
freedom to individuate
1. Increase stress level
2. Development of family nationalism
3. Expand relationships with extended family
4. Expand relationships to culture and community
5. Develop sense of family boundaries
6. Separate generations
7. Family learns to play
8. Develop a we-they, therapist-family split
9. Explode the myth of individuality
10. Each member should be more of him/herself

Question 13

Human Validation Process Model

Answer 13

Virginia Satir
Training director at MRI: 1950s
Added humanistic element to MRI emphasis on communication
Satir Growth Model:
◦ Enhancing awareness and understanding of communication
patterns
◦ Building self-esteem
◦ Enhancing congruence and tapping internal resources for external
change
Emphasis on communication, inter-connectedness, and healing power
of love and touch
The more self-aware, the more able to communicate honestly

Question 14

Human Validation Process Model - The Primary Triad

Answer 14

◦ Self
◦ Context
◦ Other
Within the Primary Triad, children learn family rules about:
- Safety
- Their bodies
- Their lovability
- Their ability to love
Children’s identities are the outcome of the Primary Triad
- Self-esteem
◦ Positive: foundation of individual and family mental health
◦ Low: contributes to many family problems
- Coping mechanisms
- Stress patterns
- Feelings of inclusion and exclusion

Question 15

Normal development in the Human Validation Process Model means…

Answer 15

◦ Nurture and open communication in healthy families
◦ Give affection freely
◦ Genuine care for one another

Question 16

Dysfunction in the Human Validation Process Model means…

Answer 16

◦ Symptoms = result of blockage
◦ Avoidance of feelings
◦ Alienation from experience
◦ Seek safety rather than growth
◦ Oriented toward past and future, rather than present
◦ Low self -esteem
◦ Destructive communication

Question 17

Human Validation Process Model - Congruence & Communication

Answer 17

“Choosing congruence means choosing to be ourselves, to relate to and contact others, and to connect with people directly.”
Low self -esteem leads to incongruent communication

Question 18

Human Validation Process Model - Sculpting and the Survival Stances

Answer 18

◦ To demonstrate (in an exaggerated way) people’s internal feelings of
self-worth Satir developed four incongruent communication
stances:
1. Placating
2. Avoiding
3. Blaming
4. Computing
5. Leveling
◦ Originate from low self-esteem and imbalance
◦ Adopt stances to protect their self-worth against threats
◦ Family rules

Question 19

Human Validation Process Model - The Stances

Answer 19

◦ Placator:
Hides vulnerability by attempting to please others. Feels they are no
good, but by doing what is expected of them, they will not be
rejected
◦ Blamer:
Hides vulnerability by attempting to control others and by
disagreeing indiscriminately, thus giving themselves a sense of
importance despite inner feelings of loneliness and failure
◦ Super-reasonable:
Every aspect of living becomes intellectual experience that bypasses
inner self and ensures anesthesia of feelings. Uninvolvement and
control -> internal feeling is vulnerability
◦ Irrelevant stance:
Handles stress by pretending it’s not there. Focuses elsewhere, away
from present context and away from feelings. Internally, uncared for
and alienated

Question 20

Emotionally Focused Couples Therapy
(EFT)

Answer 20

Greenberg & Johnson
◦ Brief (8-20 sessions), structured approach to
couples therapy
◦ 1980s: Sue Johnson & Les Greenberg
◦ Draws on Attachment Theory (Bowlby)
◦ Examines process of partners’ emotional constructions of
experience and how partners engage with one another

Question 21

Goal of EFT

Answer 21

◦ Expand and re-organize key emotional responses between partners
- Identification of primary and secondary emotions
◦ Create secure bond between partners
◦ Shift interactions between partners

Question 22

Normal development in EFT means…

Answer 22

Attachment theory
◦ Sense of connection with intimates offers a safe haven and secure
base
◦ Definition of self in relation to others, rather than self-sufficiency
and separateness

Question 23

Dysfunction in EFT means…

Answer 23

◦ Partners process and enact attachment needs in a context of
perceived danger and insecurity that primes their distress
◦ Fear and uncertainty activate attachment needs
◦ Symptoms are a result of insecure attachment

Question 24

EFT - Assessment & Treatment

Answer 24

Therapist= process consultant
◦ Therapist engagement in alliance with each client is successful
predictor in positive outcomes of therapy (safe haven)

Assessment: First 2 sessions conjoint & 2 individual sessions

Nine steps:
◦ Steps 1-4: Assessment & de-escalation of problematic interactional
cycles
◦ Steps 5-7: Creation of specific change events where interactional
positions shift and new bonding experiences occur
◦ Steps 8-9: Consolidation of change and integration of changes into
everyday life

Question 25

EFT: Contraindication

Answer 25

◦ On-going abuse
◦ Couples who are separating (only used in abbreviated form)

Question 26

Internal Family Systems
(IFS)

Answer 26

Richard Schwartz
◦ Synthesis of systems thinking and intrapsychic processes
◦ Influenced by Structural, Strategic, Satir, and Bowen
- Collaborative in nature (co-creation of client stories)
◦ University of Chicago
- Institute for Juvenile Research
- Client references to competing inner voices: “parts”

Question 27

Basic Tenants of IFS

Answer 27

◦ Discrete “parts” of clients form coalitions and alliances and
sometimes engage in combative behaviors, much like a
dysfunctional family system
◦ Internal system functions like a family system
- Feedback loops, etc
◦ There are no “bad” parts of a person
◦ Each person has a core Self that has “clarity of perspective and other
qualities needed to lead effectively”
- Role: generate a degree of trust so the parts will provide input to
Self, but will respect the leadership and ultimate decision-making of
the Self

Question 28

Goal of IFS Therapy

Answer 28

◦ Help client differentiate his/her core Self and heal the subparts
- Goal is not to eliminate the parts, but to understand/listen to them
- Help them to become non-extreme in their behaviors
◦ Family members can have Self to Self interactions and begin to see
each other as people, rather than their problems

Question 29

IFS - Parts

Answer 29

◦ Therapist needs to be careful to determine if he/she is working with
client’s Self vs. part
◦ Resistance = activation of sub-roles/parts
1. Exiles: contain pain, fear, and sadness from past hurtful feelings
2. Managers: try to keep the exiles, and the feelings they contain, out
of consciousness.
- They might tend to avoid relationships or become perfectionistic
in order to avoid being hurt further
3. Firefighters: Used when managers fail
- Douse painful emotions with substances such as food, drugs, or
alcohol, or distract with sex, self-mutilation, or obsessive activity