Process versus Content In Therapy

Process

• What happens between/within the therapeutic relationship (experiences)

• Questions are not used to gather information, but instead to generate experience

  • Feelings

  • Beliefs

  • Experiences

  • Patterns

  • Dynamics

• When a client feels sad and you can see their tears welling up in the corners of their eyes

• When a client feels angry and you can see their hands clench

• When you hear emotional material from the client and it elicits feelings of sadness and pain inside of you

Content

• Words and stories

  • The who, what, when, where, and why

• When clients talk about their life (the data)

• When clients vent about their life

Process In Therapy

• Trust

  • Who do you trust?

  • How do you trust others? Do you?

• Boundaries

  • What are your limits?

  • How do you say no? Do you?

• Support

  • How do you ask for help? Do you?

• Endings

  • How do relationships end for you?

  • Who leaves whom?

• Love

  • How do you receive love? Do you?

  • How do you give love? Do you?

• Communication

  • How do you ask for help? Do you?

Sample Process Interventions/Skills

Describe how you will likely interrupt at times

• “I can see things can go off the rails between you quickly, so I’m going to be interrupting you at times to slow us down, and help you get further in this conversation ...is that OK with you?”

Be in charge of who speaks, when

• “Thank you for sharing your experience, now I would like to hear from your partner how they  feel about the relationship.” 

• “I’m going to stop you there, you said something really important that I want to understand better...”

Focus on the experience of the one who is speaking

• “And what goes on for you when they do that thing you dislike so much?” 

•  “I hear you saying this is very difficult for you. What happens inside when you look down as you say, ‘He works all the time?’”

Listen to one person’s story first

• “Frequently people have slightly different or even very different perspectives about the relationship, so it’s very important that I get to hear from both of you. Who would like to start?”

Reflect, Validate, Explore

• I heard you say….that makes sense…tell me more. (explore)

• So after one of these fights, it’s like you lose him. And you feel desperate and afraid, like he is gone forever? (empathic reflection)

• It makes sense to me how scary it gets for you if he doesn’t talk with you. (validation) – He is so very precious to you, right? 

Tracking The Client

• I saw you move your hands just now

• You took a big deep breath

• What just happened there when you clenched your hands?

• Your shoulders just went up…

• I see tears in your eyes

• A big sigh

• Your voice got soft

Slowing Down

• Take your time

• Let’s slow down

• We don’t need to rush through it

• Let’s sit with this

• Stay with this

• Can we go back to the feeling of sadness? We can make space for the story about X later

Elicit Emotions

• Stay with that feeling

• Where do you feel that sadness right now inside?

• Where do you feel that sensation in your body?

• What would you call this sensation?

• Emotions List: https://www.cnvc.org/sites/default/files/2018-10/CNVC-feelings-inventory.pdf 

Metaprocessing

• What’s it like to share that with me?

• What was today’s session like for you?