WHATSUPDOC.US

Julie Evans Bingham, Ph.D.

home

 

What is it like to be treated here?

Although I have a foundation in the psychodynamic theories, with much training in Cognitive and Behavioral therapies, I am firmly resolved to follow the "science" to provide the most "evidence-based-practice" for my patients and families.  This means that I try to utilize an intervention that has the most scientific research basis for its effectiveness with a particular problem.  However, I never forget the 'human-ness' and uniqueness of each person and situation.  I believe in the collaborative process and try to make decisions WITH rather than FOR others.  I believe in empowering others with the knowledge of what we are doing and why so that each person's needs and wishes is respected and so that what is 'learned' or 'accomplished' is understandable and do-able by themselves later on.  This means that I am big on psycho-education (getting to be an expert on your disorder or issues) and on biblio-therapy (using books outside of therapy to maximize what you learn in therapy). 

We start with the basics: 

  1. Empathy:  any good therapist should not have to ask the stupid question "how did that make you feel?"  They should be able to understand how you feel without asking most of the time.  They might ask for a clarification if needed; and they should always make sure they've got it right.
  2. Genuineness:  the therapist acts like a real person, not a "blank screen" saying "uh-huh" or "hmm..."   The therapist is "congruent", meaning that what they think or feel while sitting with you is not hidden or disguised.  
  3.  "Positive Regard":  this means assuming that you are a good person with some bad symptoms, perhaps, or even bad behaviors; but there are probably explanations for those symptoms and behaviors, as well as ways to help you change them.  

You might recognize these as "Rogerian", if you know the history of psychology a bit.  In fact, Dr. Rogers' research team showed many years ago that these three characteristics of  therapy strongly affect how well treatment works.   Every good therapy should have them. You can sometimes get these basics from a friend, family, or within your church/synagogue/mosque. 

A good therapist should be able to add specific techniques like "behavioral" or "interpersonal" therapy to these basics.   The most common additional techniques are cognitive, behavioral, interpersonal, and psychodynamic.   I do not use Freudian analytic stuff (the couch, the silence -- like the stereotypes). 

Medications and psychotherapy are routinely combined, because research often shows--at least for moderate to severe problems--that a combination works best.  In this case, I work collaboratively with primary care providers or psychiatrists who can provide medications to add to the psychotherapy.  However, I am happy--in many cases--to work on maximizing treatment effectiveness without the use of medications if that is a preference (remember, this is collaborative). 

In any case, there is some examination of how your life is going in the "big picture", with attention to your way of seeing it that might be moved a little (the "cognitive" part, in which a new way of looking at something is offered).  This sometimes means getting some perspective on things or seeing a pattern in your life that you've never noticed before.  Or there is attention to your relationships and your satisfaction in them (the core of "interpersonal therapy").  Medications are supposed to have some impact on these kinds of things, so we track the medication usage, as well. 

Finally, there is something called "transference", a term originally from Freud's work.  This describes what happens to a person in the "patient" position.  In most cases something happens over time that adds to the power of what we do:  the "patient" comes to trust the therapist, and talk about things it's hard to talk about elsewhere.  This creates a special connection, an often intense emotional connection, that must be respected by the "therapist".  In fact, this connection can be used to help make the therapy more effective.  It can also be very badly managed, leaving the "patient" feeling strangely violated, such as when the therapist blames the patient for something beyond her/his control, or worse, when the error was partly the therapist's.  Therefore in my work the "transference" is always being attended to, even with multiple family members sometimes.  This is one of the trickiest skills I've learned over the years (and there's always room to be better at it).  

So, you may still wonder what it will "feel" like to come see me.  This is a big step for some people.  It's like admitting there might be something wrong with your head.  But in reality, I hope it won't end up feeing like such a big step.  For starters, I won't assume there is something wrong with your head -- we'll try to decide about that together and what to do about whatever the problem is.  Being seen here should be like reading these web pages: 

For a nice description of serious therapy, in case you have no idea what that looks or feels like, here's a very detailed site About Psychotherapy.   He is basically talking about "psychodynamic" psychotherapy.  The sections on how therapy works, and what it isn't, are particularly good (see the navigation bar to read those; there's quite a bit to explore.  He's got a good sense of humor, and just plain good sense about the whole thing.  He hasn't adopted he/she yet, though; too bad.)