4. Guide - Educator - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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The therapist may also act as a guide to effective communication and intimacy interactions.  As the knowledgeable guide in the "wilderness" of healthy living, processing, or relationships, the therapist may lead individuals, couples, or families through the challenging psycho-emotional and social terrain.  The therapist would be assumed to have explored or journeyed through life and relationships already and have significant training and professional experience.  Thus, the therapist is assumed to be very familiar with potential difficulties the individual, couple, family are facing.  However, that may not be always true.  Some therapists for example, may have expansive personal experience with successful intimate relationships but minimal professional experiences with couple therapy to draw upon.  Others may have professional experiences as a couple therapist, but have personal failures being part of a couple.  A psychotherapist who has been in a long term successful relationship, but with minimal experience doing couple therapy may successfully work with a couple by drawing upon his or her personal experiences more than from his or her professional training.  On the other hand, a psychotherapist who has been married and divorced three or four times may have questionable credibility for couples, especially if his or her theoretical orientation is has the unsuccessful guide for his or her relationships.  Successful couples functioning and relationships or any professional expertise can come from a variety of important elements: expectations, values, experience, awareness, and knowledge.  The expert therapist may be seen as the holder of all these and other elements, and are expected to have the ability to integrate them and apply them in for the particular task arising in therapy.  Therapy becomes the classroom for learning from a master teacher how to be a healthy person or in successful relationships as a couple or family.  Guanipa et al (2000) differentiated expert therapists from novices.  "In general, experienced professionals differ from beginners in their use of theory and principles to integrate apparently disparate features of the problem… In other words, experts tend to reason about the problem, while novices remain tied to the surface features of the data.  Experts perceive large meaningful patterns in their area of specialty…. This ability reflects an organization of the knowledge base.  The most evident reason for experts to excel is that they have an extensive domain of knowledge… Experts appear to be faster than novices at using their specific skills, and they seem to solve problems quicker and with fewer errors.  By the same token, experts see a problem in their domain at a deeper level than novices, and they seem to expend more time analyzing the problem in a qualitative way.  Experts' conceptualizations go beyond the application of techniques or equations, and reflect deeper levels of understanding.  In general, this conceptualization process is a movement toward integrated knowledge and leads to a more accurate understanding of the situation" (page 182).

The individual or members of any couple or family presenting for therapy often have limited experience and knowledge from their current and previous relationships of what makes life and relationships functional.  As such, the therapist who has been trained, educated, and practiced in areas of specialty including couple and family therapy often hold roles of being an expert and an educator.  As the therapist may see underlying patterns in client, couple, or family's behavior, he or she can introduce the patterns for examination in the therapy, or can use it to guide other interventions.  Many theoretical orientations have significant psycho-educational bases.  A psycho-educational approach assumes that ignorance of one sort or another causes or contributes to dysfunction or poor choices.  Therefore, if individuals or the couple or family collectively gain appropriate or essential knowledge from the therapist, they will (hopefully) readily utilize the knowledge to make necessary adaptations in their behaviors.  For example, individuals or the couple or family collectively may be under significant stress in many different realms: work, home, school, finances, health, and so forth.  They may not understand its effect on them intrapsychically and interpersonally.  Thus, understanding the effects of stress upon emotions, health, thinking, and relationships can be very therapeutic.  "It is only when the individual is confronted with stressful situations that demand too much of him or her that the lifestyle dynamics can become rigid and problematic (from overuse or underuse).  Hence, the goal of therapy is not to change the lifestyle dynamics of the couple per se, but rather to provide insight into these dynamics and have the clients choose more useful expressions of these dynamics when they are under stress.  Therefore, focusing the couple on their particular stress level may help to release some of the tension and tendency for destructive behavior" (P, 1999, page 261).

The comparable premise of awareness-oriented theories is that if an individual, a couple, or family gains self-awareness through a therapeutic process, they will readily utilize the self-awareness to make necessary adaptations in their behaviors.  Awareness of physiological cues in one's body may be distinguished from knowledge or cognitive insight.  Education about the "why" and awareness as the "what" of stress, are mutually and reciprocally beneficial.  Education about stress would include its effects on health, the flight or fight response and so forth.  Helping individuals become aware of physiological indicators of stress in one's body promotes their purposely activating behavior change based on psycho-education on how to relieve stress.  This includes how to avoid stress buildup.  Mirroring for example is an awareness strategy.  Therapists can "effectively increase awareness in their clients through using process questions.  Initiating and guiding effective therapy is an intentional and consciousness raising process.  Therapists share observations in order to heighten their client's awareness of themselves within their situation" (Lum, 2002, page 186).  The therapist can reflect to the individual that he or she seems stressed from his or her observations of body, facial, movement, and tonal cues. This aids individual's self-awareness.  "Carson, notice how you're holding your breath."  "What do you feel in your body right now?"  "Vee, you just stiffened up right now.  What's that about?"  Prompting the individual about feelings in their body, face, forehead, neck, chest, and so forth when stressed or upset enhances self-awareness.  Sometimes stress in life such as school or work, moving, getting married, or illness challenges functioning and relationships.  As the therapist recognizes and understands how these stresses, individuals, couples, and families become educated of the effects they have on their interactions.  Often, individuals, couples, and families feel that they are handling stress fine without awareness of how they may be acting out and harming their relationships.  

While education, knowledge, or awareness may be sufficient for some people, sometimes clients will still be unable to activate healthy change.  There are often deeper levels of knowledge that affect current feelings, thoughts, and relationships.  Edward had always worked hard as a police officer.  He dedicated to making himself serve his department, the city, and his wife and kids.  When he suffered a career ending disability, he was forced to retire.  He shifted to a business career.  He made more income than he did as a policeman.  From other people's observations he seemed to excel at it.  However, the loss of his identity as a cop was emotionally devastating.  Although he thought he hid it well, he was short-tempered with his wife and kids.  He lost his sex drive as well.  Niki, his wife initiated couples therapy because of the conflicts between them.  It took the therapist educating him about how profound the loss of identity can be for someone, for Edward to put together how losing his career had affected him. And, then to mourn his loss.

Scheinkman (2008) says the therapist needs to take "an 'inside' look at the individuals and considers how assumptions, beliefs, expectations, feelings, and meanings about the self and the relationship may be working to maintain the couple in impasse.  This level, influenced by psychodynamic ideas… is here primarily based on the construct of the vulnerability cycle" (page 206).  Individuals, couples, and families often need to be educated about the transmission of vulnerabilities from various experiences, including experiences deep in childhood and the family-of-origin.  New or current stress may have historical antecedents.  "Our vulnerabilities are usually a result of experiences in our families of origin where we may have felt hurt, criticized, yelled at, neglected, rejected, or abandoned.  Alternately vulnerabilities may be related to extra-familial experiences such as bullying in school, rape, war, or poverty.  They may emanate from hurts perpetrated in the history of the couple's relationship itself, such as recurrent disappointments or an affair.  Or they may be the result of a current stressful situation such as being exhausted by 12-hour workdays, dealing with a loss, or an illness. Individuals also feel vulnerable about physical characteristics such as being short, overweight, having an unusual learning style, or having a mental or physical illness" (page 207).  "Sometimes, even after the couple has gained a solid grasp of their positions in the vulnerability cycle, and worked to transform it, one or both partners may still feel stuck in some aspect of their lives.  It is useful at this point to refocus the therapy from the couple's ongoing dynamics to an exploration of unfinished business each may have with his or her family of origin.  The therapist considers if ongoing family tensions, cut-offs, hidden loyalties, legacies, or secrets might be contributing to the individual or the couple's current problems" (page 210).

Simple or small things and activity often ignite individuals, although they intellectually know such things should not be especially threatening.  Individuals such as Carson and Vee often have a laundry list of little triggers that ignite their battles.  As a result, they feel shame, which intensifies their negative reactions.  Essentially, individuals, couples, and families often need to be educated about how current triggers symbolic of old experiences and traumas activate old emotions such as anxiety, fear, depression, and loss.  Since clients may not recognize or acknowledge these associations to even look for them, the therapist may first need to be family history researchers to access client's emotional and psychological archives.  

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
office: (510) 582-5788
fax: (510) 889-6553
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