Stages Of Therapy

2024 Author: Harry Day | [email protected]. Last modified: 2023-08-08 14:21

Stages of therapy

What can be the stages in psychotherapy? Are they accompanied by difficulties? What are the most difficult stages?

There are several categories according to which the stages of therapy are classified:

1. By time (start, middle and end)

2. By contact cycle (pre-contact, contact, full-contact and post-contact). On the curve, full contact is considered a peak, post contact is responsible for processing and integration

3. According to age crises (there may be a reverse sequence of processing, there may be inconsistency, a long delay in the crisis in which there was the most significant and painful injury, periodic resumption of work with the problem area after working through other crises)

This category, in turn, is divided into additional subcategories:

The crisis of 1 year is the main task to form a circle of trust. If a person in this period had a violation and significant trauma, a long study will be required. Trust in a psychotherapist will take a long time to develop. In general, the earlier the trauma was received, the earlier the crisis was not resolved, and the longer the therapy should be

Crisis 2-4 years - development of recognition. This time is considered a natural narcissistic period (the whole world is spinning around me). If the baby gets the expected recognition, there will be no injury

Crisis 5-6 years - development of an initiative

Crisis 6-12 years - development of independence, independence and freedom from external influences and coercion

Crisis 12-18 years old - elaboration of identification

Crisis 18-25 years - working out relationships (whether a person will need interaction and interconnection with people or in isolation from society)

Crisis 25-45 years - realization of creative potential and development

The crisis for 60 years has been characterized by integrity and wisdom

These figures are rather arbitrary and are taken from the research works of Eric Erickson. According to Freud, the indicators differ and have different designations (for example, anal and oral periods). If crisis management has not been successful, a return to therapy is recommended

1. By stages of elaboration of a certain difficulty or injury. First, you need to see the problem (complexity) and its essence, hear the therapist ("Look, there was a trauma here"), realize the problem, accept it, experience it, transform it (after working through the trauma, react differently to people, change values in life or leave it as it is). In the last stage, one must also remember that not everything in the psyche lends itself to transformation, some moments cannot be changed, they can only be accepted

2. By the cycle of attachment:

Trust / merger

Addiction / counterdependence (guilt, shame, fear, rebellion)

Separation (The client can independently regulate the distance in the relationship with the therapist, relying on his sensitivity, and not on projections, fears, shame and guilt. At this stage, breaks are possible to determine the level of a person's readiness to live without a therapist)

Healthy, adult, mature attachment (the therapist is important for the client, but there is no painful need)

At the beginning of therapy, trust is formed between therapist and client. During this period, the crisis of one year is being worked out more or less. However, if the person has had a severe impairment, the trauma will be worked through repeatedly, and during the psychotherapy sessions there will be returns to the problem. With each session, the relationship with the therapist becomes more trusting and deeper

In any case, in the initial stages of therapy, the basis of a strong union between the therapist and the client is formed so that the latter can open up and tell quite intimate things

If the client has had an infant crisis with an anxious, depressed, or emotionally unattached mother, it will be difficult for him to open up to the therapist and discuss rather personal issues. In this case, almost all therapy will be aimed at building trust. The deeper the client can open up, the longer the therapy will take

At this stage, it all depends on the relationship with the therapist - the better it is, the deeper the study will be. After all, this is not just a story about how a person spent the summer, not about events and facts, but deep experiences and states that are possibly associated with shame, fear, pain. That is, it is important here whether the client can show shame, pain, fear, difficult experiences and experience them in the presence of his therapist. Accordingly, in time it may take not a session and not 10 sessions. On average, it takes a year to build trust. To understand the depth of this question, one can draw an analogy with the formation of friendships (How long does it take to call a person a real friend? That's about the same amount it will take to build trust.)

In fact, this stage is considered very intimate and deep. However, it depends solely on the client and on how much he wants to tell any things. Everyone has their own possibilities in the psyche, so no one will condemn

The next part of psychotherapy is the middle one. This is where all the most difficult and interesting begins. The client is immersed in the process of suffering, torment, lives through the whole spectrum of pain, working with the therapist all the traumatized zones of the psyche. Depressed mood, vivid but painful childhood episodes may occur between therapy sessions. The process itself can be compared to the experience of grief: shock, anger, powerlessness, suffering and, at the very end, integration (acceptance)

At the same time, there is an intensified elaboration of attachment violations, if any (In which zone were the violations? In merger, dependence or separation?). These problematic moments are worked out with the therapist using transference, countertransference, work with projections

Also, at the middle stage of psychotherapy, age crises are worked out (the first 3 crises of our life are largely associated with the formation of attachment). For example, a 3-year crisis could be related to unsafe primary separation. A person could not be let go a step, not giving the opportunity to show initiative, independence, satisfy their childish curiosity, but they could, on the contrary, separate early, so he had to become an adult and “leave the mother's paradise” long before he was ready for this

Working out is not just a conversation, it is living through all the problematic moments in a relationship. For example, on a subconscious level, it may seem to the client that the person with whom the trauma is directly related is nearby and the situation is repeated. There are several examples of affection to consider

Example # 1: The child was sent to kindergarten, and the mother ceased to be interested in his life. Or, on the contrary, she did not allow one to step freely: “Where did you go? What are you doing? Why are you here?"

In this case, during the study, the client will feel that the mother is nearby and still does not allow him to live an independent life, clinging to him

Example # 2: The mother (father, grandmother, grandfather) rejected the child

In this situation, the person will see rejection in their therapist. If the mother was angry with him, he will see anger in the therapist as well

The period is quite difficult, but it has an undoubted advantage - after such a deep analysis of his personality, a person will never again set goals that do not correspond to his soul, will not try to please someone, live according to the rules of social networks (if everyone around is successful, so I need to buy a car and a bigger house). A person will begin to do such things for his own sake, and not for someone else

In addition, in the middle therapy there is a goal - the formation of understanding and awareness that each of us is responsible for our lives, and no one will solve someone else's problems. In order to come to this opinion, you need to grow up in therapy, while going through age-related crises (basically, these are crises up to 7 years old - they are the strongest and leave an indelible imprint on the client's psyche). Thus, you will have to make a lot of efforts to make life real and you could manage it yourself, so that a person understands what his life consists of, adapts as much as possible to himself and his character traits, but does not fall from the burden of responsibility

Conditional example. At the age of 3-5, the child had to become an adult beyond his years - an infantile mother, alcoholic parents or constant family scandals. From this period, the child does not move on, he lingered at the level of a three-year-old baby, on whom the reinforced concrete responsibility called "life" was piled. Hence the constant feeling of fatigue, haste and anxiety, incessant depression

The stage is really difficult, but in the end the client will receive tremendous moral satisfaction and will be grateful to himself because of the incredible growth. For him, these reinforced concrete piles of life will turn out to be a feasible burden that can be easily dealt with. You can always find ways to alleviate it

The last stage of psychotherapy is completion. This is the period of integration of parts of the personality into an integral mental structure, into an integral personality

At this stage, new adaptive defense mechanisms are developed, relatively speaking, a person learns to live in a new way, taking into account all the acquired experience and knowledge about himself in the process of therapy. Definitely, the help and support of the therapist is needed here, but the sessions can be reduced to a supportive option (once every two weeks) or take breaks