Page 15 - EMCAPP-Journal No. 17

Clinical Application
We transition to apply the preceding
discussion to clinical practice. In particu- daily losses and grief. The therapist notices
lar we present ways to clinically address
the two problems discussed earlier; that
many clients desire for pleasure is regularly
thwarted by life’s small and continual chal-
lenges, and second, they are sad to lose
a genuine good and suffer real loss. This
approach rests upon Horizon 3 (a biblical
worldview and Christian Psychology), and
incorporates what is coherent from Inter-
personal Process Therapy (Teyber & McClu-
re, 2011), Horizons of Significance, Prophe-
tic Imagination, and the Christian tradition.
The ‘vehicle’ for this integrated strategy is
the person of the therapist, who provides
compassion, attunement, and intervention
as conceptualized and organized by Hori-
zons 1 through 3. Such therapists take se-
riously; the body, its experiences, trials and
temptations; social and cultural factors and
formation; and life in redemptive historical
time. This orientation allows the therapist
to remember the following in their work:
There is real comfort in the loss of all things
for the sake of Christ’s name; the privilege
of providing acceptance to one another de-
spite shame and sorrow; we must gently
name (discover) what is true in the life of
a client, including the harm done to them
and by them, the self-defeating strategies
they use to cope, and the orientation of
their hearts (Day, 2006).
Four processes within this clinical approach
to loss and joy are outlined below. We in-
clude details of specific interventions, and
sections of therapist-client dialogue that
are based on real client interactions. The
four stages include: exploring the clients
personal dynamics; utilizing key emotions
and responses; assisting in meaning ma-
king; and utilizing prophetic imagination
and exploration.
Process 1: Exploring Personal Dynamics
Exploring personal dynamics includes a
number of therapist foci and actions desi-
gned to illuminate a client’s experiential re-
18
lationship to the phenomenon of ongoing
and name’s themes, patterns, and rigidity
in the client’s relationship with grief. This
is made possible by tracking and validating
salient emotions, asking about desires, and
discerning the self-protective function of
the client’s intra and interpersonal strate-
gies. Attending to these features enables
the therapist to experience and explore a
client’s interpersonal resistance, learned
behaviors, schemas, and worldview (Teyber
& McClure, 2011). The cumulative picture
constructed by a client’s personal dyna-
mics begins to reveal the guiding Horizons
of Significance in their life. The following
therapist-client example is based upon a
real case, and models an exploration of a
client’s lack of awareness and resistance
surrounding a perpetual state of dissatisf-
action:
Therapist (T): I have noticed you often re-
peat stories of disappointing experiences
when we talk… like that dinner party that
was canceled…, and you usually shrug them
off each time. I’m wondering what it would
be like for you if you shared them more ful-
ly with me, or if you stopped sharing them?
Client (C): I’m not sure, I guess you can’t
just dwell on things – life is hard and you’ve
just got to deal with it.
T: Shrugging helps you deal with the hard
parts of life. What is your experience of ha-
ving shrugged a lot over time, yet repeating
disappointing stories?
C: Well… it hasn’t changed anything, but I
can’t just stop and be sad.
T: You can’t just be sad — something feels
wrong, unsafe, or uncomfortable about
that…
C: It wouldn’t do anything. You can’t fix
everything.
T: Aah, I see… You have sadness about all
these broken things, and you can’t just fix
them—so you shrug. I am curious why you
might still repeat the disappointments with
me. What do you long for here with me?