Page 16 - EMCAPP-Journal No. 17
P. 16

In  the  interchange  above  the  therapist  is   they are learning about their approach to,
             curious about the thematic presentation of        and perspective on life, and assists them in
             disappointing events, the client’s response       finding value-aligning alternatives. This can
             of  shrugging,  and  how  the  client  may  be    provoke great ambivalence between safety,
             using  these  behaviors  to  cope  and  com-      pain reduction, and an orientation to thri-
             municate. The effectiveness of the client’s       ving within the kingdom.
             strategies is explored to generate client in-     C: I just want to feel better, to feel ok about
             sight, which leads to the client’s schema of      all these things I get distressed about.
             the  world.  The  therapist  investigates  this   T: How do you feel right now as you name
             schema by asking about the client’s contra-       that you  want relief from distress and
             sting desires. In this short exchange, explo-     shrugging?
             ring  ‘stuck  disappointment’  moves  to  the     C:  I’m  just  so  frustrated  that  everything
             client’s perceptions and desires.                 goes wrong so much!
                                                               T: You want relief from disappointment but
             Process 2: Emotion and Response Focus             you also see how this world has so many
             A second process the therapist can engage         losses.
             is a focus on the client’s emotions and re-       C: yes… exactly. It just keeps coming—one
             sponses, which helps illuminate unacknow-         thing, then the next. I just hate it, it’s so de-
             ledged grief/loss and how the client copes        pressing.
             with these feelings. To engage this work, the     T: Depressing. It really weighs on you.
             therapist can invite further exploration of       C:  well…  I  feel  really  stupid...  I  mean  I
             the most salient feelings. This requires hel-     know  things  go  wrong!?  But  I  just  want
             ping the client to express the full meaning of    something… to have something go right for
             the feelings as they experience them in the       me… to enjoy it!
             present. Teyber and McClure (2011) make           T: You feel stupid—like there is something
             clear, “Simply allowing clients to be able to     wrong with  you  that you  long  for good
             have  the  feelings  that  are  commensurate      things and to enjoy something going right.
             with what actually happened to them is a          I  can  really  appreciate  wanting  things  to
             lifelong gift to many” (p. 197). As client’s      go well, to be joyful, to be OK. I can see
             become honest with life in the Kingdom of         why  you  would  shrug and  tell me  about
             God, loss is experienced more fully, and the      it—wanting relief, even while knowing life
             meaning the client associates with the loss       keeps going like this.
             is available for exploration. This work usual-    C: yeah… I hate that I end up just talking
             ly  adds  to  the  illumination  of  the  client’s   about  it  over  and  over,  I  know  shrugging
             primary Horizons. Building on awareness of        doesn’t really do anything—But what else
             the salient emotion, the therapist explores       can I do!?
             the full constellation of associated feelings.    T: That’s a great question. You seem to want
             For example, anger and shame commonly             something  other  than  how  you  currently
             occur around sadness. When the therapist          see and respond to this cycle of disappoint-
             helps the client tolerate and acknowledge         ments, shrugging, wanting comfort. Can we
             each important emotion the client can of-         explore that together?
             ten  then  explore  the  actions  and  choices    C: sure, I guess…
             they make in the light of the emotion (Tey-       T: I notice that you long for good things to
             ber & McClure, 2011). This further illumi-        go as you hoped—things to work out well,
             nates Horizons and coping strategies. The         to be pleasurable, even though the world
             therapist can assist the client to notice and     has shown you its far more unpredictable…
             examine  their  responses,  and  the  under-      there is a tension between your hopes and
             lying values and heart orientation. The the-      the realities of life… what do you notice?
             rapist supports the client to consider what       The prior exchange provides an example of

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