The quick answer is pretty much everyone. Of course children under the age of twelve, in general, are somewhat limited in their capacity to engage in 'talk therapy' as a vehicle for change and would benefit more from some form of expressive therapy such as sand-tray, art, or play therapy as a conduit for exploring feelings and resolving trauma. I have a sand tray in my office for this purpose so that the child can engage in a sensory experience which can 'unlock' unconscious thoughts and suppressed feelings and minimize resistance, fear, and discomfort; allowing for greater communication and a more satisfying and enjoyable experience. The adolescent equivalent of the sand tray is the pool table which I also have in my office and serves a similar function; primarily because it acts as a distraction from the subject at hand being the primary focus and allows for the dialogue to be a 'sidebar' resulting in a less anxiety-provoking and more fruitful interaction. It's amazing how much insight and awareness can pour out of the mind of a competitive teenager when they're focused on 'annihilating' their therapist in a 'friendly' game of pool. In the absence of a pool table, a deck of cards or a game of chess can be an effective substitute.
Usually, if there is a need to work with young children, there exists some significant dysfunctional patterns within the family system and, in this case, it would be more effective to work with the whole family while placing much of the focus on the parents/primary caregivers. Exceptions to this would include adoption in which the child is currently living in a stable family environment but is still dealing with the effects of trauma imprinting from when they were with their family of origin or some type of physical, emotional, or cognitive disability that is limiting the child’s ability to function. But even in these two scenarios it is always best to include the family whenever possible since this is the environment that has the greatest influence on the child's development . In future articles, we will address adolescence and emerging meta-cognition which increases the individual’s capacity to participate in a process of self-reflection, allowing for a more dynamic therapeutic experience.
In exploring the question, Who Can Benefit from Therapy?, there are a few consistent and fairly common presentations that I have experienced over the years in my practice.
The first one represents the largest demographic that I work with and occurs when the parent(s) identifies, often with help from school administrators, that something is wrong with their child and they would like my help in ‘fixing’ whatever that might be. The assumption on the parent’s part is that if I do my job well and ‘fix’ their problem child, then the family as a whole can get back to the business of functioning in a healthier and more balanced way. What I’ve learned over the years is that nothing could be further from the truth and even more intriguing, the identified ‘problem’ child always ends up being the healthiest member of the family. Future articles focused on parenting the child and adolescent will address this common misconception, why it is a misconception, and how to change it.
The second presentation that I see often in my practice is when a spouse has identified that their marriage or partnership has become a source of great pain and suffering and is looking for my help in trying to either ‘fix’ the relationship or decide once and for all to dissolve it. In order for there to be even a glimmer of hope in salvaging the relationship; both partners need to be equally motivated and committed to doing so. Personally, I’ve never experienced this. Without exception, in the past ten years, one partner usually has one foot out the door long before they or their partner contacts me for assistance. My role as I see it is to help them achieve clarity around what they truly desire and to help them achieve it as gently and lovingly as possible while ensuring that I never have an agenda or attachment to any particular outcome. Future articles on the dynamics of relationship will identify why this process is rarely, if ever, gentle or loving.
The third presentation that makes up a significant part of my clientele is the twenty-something year old who has achieved some degree of personal and professional independence for the first time in their lives and is beginning to notice that they have some unresolved ‘stuff’ from childhood that seems to be distorting their continued identity-formation which would include their ability to form healthy and satisfying relationships. What I love about working with this demographic is that they are, without exception, incredibly ‘hungry’ to learn and understand how they can achieve mental, emotional, and spiritual well-being in an effort to experience greater meaning and purpose in their lives. It takes very little time or effort to achieve significant changes with these individuals due to the absence of any resistance on their part as evidenced by how 'hungry' they are for the therapeutic experience.
The fourth and final presentation is the smallest demographic that I've worked with but undoubtedly deserves a big mention considering that the most challenging transitions one will ever have to navigate occur at this stage of one's life. Sexagenarians, Septuagenarians, and Octogenarians represent individuals between the ages of 60 and 89. I like to think of an individual lifespan occurring in three trimesters, with each trimester spanning approximately 30 years.
The first trimester is all about identity formation and depending on how secure and healthy your attachments were to your primary caregivers, you should be well centered and balanced in the knowledge of who you are by the time you reach your second trimester which is all about settling into your life plan in regards to career and family which is informed by how you see yourself and what makes sense for you. So your life plan could involve you being a stockbroker, married to an ex-Dallas Cowboys cheerleader who gives you three 'perfect' kids while living in Westchester, NY or it could be backpacking indefinitely around the world with your current girlfriend or boyfriend while taking odd jobs when necessary to finance the trek and looking forward to the ceaseless unknowns that will continue to reveal themselves around every corner and over every mountain range. It doesn't matter what your life plan is or how safe and predictable it is. It just needs to make sense to you.
By the time you reach the third trimester, you've begun your life review and are experiencing the impermanence of life in general as the concept of retirement begins to loom large on the horizon; health and well-being becomes a greater concern and priority because the body is now more vulnerable to manifest some type of disease expression; children who had been a primary focus during the second trimester have launched themselves and are beginning to formulate their own life plan while friends, colleagues and relatives you've known and loved for some time, including your own parents, are starting to deal with significant health issues and transition beyond this lifetime.
Two years ago, I had a client come to me who had been referred by a former client. She was in her early sixties and wanted my help and support with resolving some recent traumatic events in her life as well as assist her in creating a plan for moving forward. It turns out that in the past twelve months she had knee surgery to replace both knees, was being forced into retirement by the agency she had worked for after twenty-five years, discovered that her husband of thirty years had been having an affair with her best friend and then had to have brain surgery to repair an aneurysm. Imagine having to recover from any of these events; but in combination over a period of twelve months is almost incomprehensible. And a quick note to my twenty-something year old readers: Over time, life in general, has a way of working its 'magic' on you. I feel it myself as well as see it and hear it in the faces and stories of my clients. There is an accumulative fatigue that occurs over a lifetime that I refer to as 'soul weariness'. In Traditional Chinese Medicine (TCM) there is a concept referred to as Natal Chi. Chi (Chee) is understood to be the 'life force energy' that moves through all living things. Natal Chi is the understanding that you are born with a finite amount of your own personal reserve and depending on how challenging your life is, there is the possibility that yours might be depleted sooner than later. Regardless of how you conceptualize the process of aging, it is a fact that as one ages, the physical body's ability to recover from stressful and unexpected events becomes more and more limited. So a primary focus in therapy when working with this demographic is to help increase the individual's ability to navigate loss, increase their comfort level around the impermanence of all things physical and restore their sense of emotional, physical, and spiritual equilibrium.
Regardless of which demographic we’re speaking of, they all have one thing in common. When it comes to beginning the therapeutic process, no one seeks out a therapist because they’re feeling really good about themselves. On the contrary, everyone who comes to therapy does so because they’re experiencing a significant amount of emotional pain and suffering that even well-honed coping mechanism can no longer alleviate. Even with the understanding now that therapy is not exclusive to the severely mentally ill and emotionally disturbed; there still lingers a stigma amongst the collective perception from when this was actually true. This could explain why the majority of people do not allow themselves to seek out this venue of support until after experiencing many years of suffering.
The most important thing to remember is that no matter what your age or identified problem, therapy can be the beginning of a dynamic journey into the self as a means to identify and achieve what your heart truly desires. Finding the right therapist to act as your co-pilot and effectively facilitate this journey for you will be the next subject we explore.
Usually, if there is a need to work with young children, there exists some significant dysfunctional patterns within the family system and, in this case, it would be more effective to work with the whole family while placing much of the focus on the parents/primary caregivers. Exceptions to this would include adoption in which the child is currently living in a stable family environment but is still dealing with the effects of trauma imprinting from when they were with their family of origin or some type of physical, emotional, or cognitive disability that is limiting the child’s ability to function. But even in these two scenarios it is always best to include the family whenever possible since this is the environment that has the greatest influence on the child's development . In future articles, we will address adolescence and emerging meta-cognition which increases the individual’s capacity to participate in a process of self-reflection, allowing for a more dynamic therapeutic experience.
In exploring the question, Who Can Benefit from Therapy?, there are a few consistent and fairly common presentations that I have experienced over the years in my practice.
The first one represents the largest demographic that I work with and occurs when the parent(s) identifies, often with help from school administrators, that something is wrong with their child and they would like my help in ‘fixing’ whatever that might be. The assumption on the parent’s part is that if I do my job well and ‘fix’ their problem child, then the family as a whole can get back to the business of functioning in a healthier and more balanced way. What I’ve learned over the years is that nothing could be further from the truth and even more intriguing, the identified ‘problem’ child always ends up being the healthiest member of the family. Future articles focused on parenting the child and adolescent will address this common misconception, why it is a misconception, and how to change it.
The second presentation that I see often in my practice is when a spouse has identified that their marriage or partnership has become a source of great pain and suffering and is looking for my help in trying to either ‘fix’ the relationship or decide once and for all to dissolve it. In order for there to be even a glimmer of hope in salvaging the relationship; both partners need to be equally motivated and committed to doing so. Personally, I’ve never experienced this. Without exception, in the past ten years, one partner usually has one foot out the door long before they or their partner contacts me for assistance. My role as I see it is to help them achieve clarity around what they truly desire and to help them achieve it as gently and lovingly as possible while ensuring that I never have an agenda or attachment to any particular outcome. Future articles on the dynamics of relationship will identify why this process is rarely, if ever, gentle or loving.
The third presentation that makes up a significant part of my clientele is the twenty-something year old who has achieved some degree of personal and professional independence for the first time in their lives and is beginning to notice that they have some unresolved ‘stuff’ from childhood that seems to be distorting their continued identity-formation which would include their ability to form healthy and satisfying relationships. What I love about working with this demographic is that they are, without exception, incredibly ‘hungry’ to learn and understand how they can achieve mental, emotional, and spiritual well-being in an effort to experience greater meaning and purpose in their lives. It takes very little time or effort to achieve significant changes with these individuals due to the absence of any resistance on their part as evidenced by how 'hungry' they are for the therapeutic experience.
The fourth and final presentation is the smallest demographic that I've worked with but undoubtedly deserves a big mention considering that the most challenging transitions one will ever have to navigate occur at this stage of one's life. Sexagenarians, Septuagenarians, and Octogenarians represent individuals between the ages of 60 and 89. I like to think of an individual lifespan occurring in three trimesters, with each trimester spanning approximately 30 years.
The first trimester is all about identity formation and depending on how secure and healthy your attachments were to your primary caregivers, you should be well centered and balanced in the knowledge of who you are by the time you reach your second trimester which is all about settling into your life plan in regards to career and family which is informed by how you see yourself and what makes sense for you. So your life plan could involve you being a stockbroker, married to an ex-Dallas Cowboys cheerleader who gives you three 'perfect' kids while living in Westchester, NY or it could be backpacking indefinitely around the world with your current girlfriend or boyfriend while taking odd jobs when necessary to finance the trek and looking forward to the ceaseless unknowns that will continue to reveal themselves around every corner and over every mountain range. It doesn't matter what your life plan is or how safe and predictable it is. It just needs to make sense to you.
By the time you reach the third trimester, you've begun your life review and are experiencing the impermanence of life in general as the concept of retirement begins to loom large on the horizon; health and well-being becomes a greater concern and priority because the body is now more vulnerable to manifest some type of disease expression; children who had been a primary focus during the second trimester have launched themselves and are beginning to formulate their own life plan while friends, colleagues and relatives you've known and loved for some time, including your own parents, are starting to deal with significant health issues and transition beyond this lifetime.
Two years ago, I had a client come to me who had been referred by a former client. She was in her early sixties and wanted my help and support with resolving some recent traumatic events in her life as well as assist her in creating a plan for moving forward. It turns out that in the past twelve months she had knee surgery to replace both knees, was being forced into retirement by the agency she had worked for after twenty-five years, discovered that her husband of thirty years had been having an affair with her best friend and then had to have brain surgery to repair an aneurysm. Imagine having to recover from any of these events; but in combination over a period of twelve months is almost incomprehensible. And a quick note to my twenty-something year old readers: Over time, life in general, has a way of working its 'magic' on you. I feel it myself as well as see it and hear it in the faces and stories of my clients. There is an accumulative fatigue that occurs over a lifetime that I refer to as 'soul weariness'. In Traditional Chinese Medicine (TCM) there is a concept referred to as Natal Chi. Chi (Chee) is understood to be the 'life force energy' that moves through all living things. Natal Chi is the understanding that you are born with a finite amount of your own personal reserve and depending on how challenging your life is, there is the possibility that yours might be depleted sooner than later. Regardless of how you conceptualize the process of aging, it is a fact that as one ages, the physical body's ability to recover from stressful and unexpected events becomes more and more limited. So a primary focus in therapy when working with this demographic is to help increase the individual's ability to navigate loss, increase their comfort level around the impermanence of all things physical and restore their sense of emotional, physical, and spiritual equilibrium.
Regardless of which demographic we’re speaking of, they all have one thing in common. When it comes to beginning the therapeutic process, no one seeks out a therapist because they’re feeling really good about themselves. On the contrary, everyone who comes to therapy does so because they’re experiencing a significant amount of emotional pain and suffering that even well-honed coping mechanism can no longer alleviate. Even with the understanding now that therapy is not exclusive to the severely mentally ill and emotionally disturbed; there still lingers a stigma amongst the collective perception from when this was actually true. This could explain why the majority of people do not allow themselves to seek out this venue of support until after experiencing many years of suffering.
The most important thing to remember is that no matter what your age or identified problem, therapy can be the beginning of a dynamic journey into the self as a means to identify and achieve what your heart truly desires. Finding the right therapist to act as your co-pilot and effectively facilitate this journey for you will be the next subject we explore.
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