4 Foundations

Consciousness and four foundations of effective psychotherapy

I believe everything has consciousness, from cosmic strings to matter, to life, to our cells and organs, to the most complex phenomena in the known universe: human intimacy. Human consciousness can observe itself observing itself in relationship with other people—a staggering evolutionary achievement.

A particular form of human intimacy is the therapeutic relationship. Therapists can self-observe and attune to their clients and focus on constructing energetic containers in which clients feel known and cherished. In these relationships healthy thoughts, beliefs, and actions are considered beautiful, good, and true. 

How do you construct and maintain such intersubjective containers? One effective method is to embody four foundations of effective psychotherapy. 

Four foundations of psychotherapy:

1. Boundaries: Be clear about your boundaries. What are the agreements? In all change work you need sets of agreements. Psychotherapy usually needs clear black-and-white boundaries on time, money, duration of treatment, and dealing with crises. 
2. Do you feel understood by me? “This is a grounding orientation of all change work. When clients are dysregulated or when there is confusion or ambiguity, therapists can shift to understanding their client until he or she feels understood 
3. Observations and connections: Gestalt therapy is making the implicit explicit and pointing out the obvious. I like Greggory Lester’s formulation that psychotherapy makes cause-and-effect connections and observations of what the therapist sees and the client doesn’t. This activates new neuronetworks of understanding and self-observation which get more heavily mylenated with repeated activation. Effective therapists make observations and connections with their clients about past and current experiences and patterns. “When you___, then___happens,” is a connection statement (designed to teach cause-and-effect and encourage productive self-awareness of patterns of thought and behavior). “I notice you just looked automatically for what might be harmful to you when I mentioned your husband.” Is an observation in the present moment (designed to activate and strengthen the observing ego). 
4. Notice drama and shift to problems solving: Notice your client and/or yourself being persecutor/victim/rescuer (the Karpman drama triangle) and don’t indulge the drama. Interrupt drama and advocate problem solving. When you’re problem-solving you are rarely in drama.

For more on the Karpman drama triangle check out this excerpt from a Witt and Wisdom Corey and I did a few months ago— https://integrallife.com/breaking-the-cycle-drama-problem-solving-and-relational-mastery/