Please note: This post should not be considered an exhaustive list of all of the theories and methods I use in therapy sessions.
You've completed the first two or three sessions with me where you've filled-out all of the questionnaires and you've answered all of my questions about any symptoms you're experiencing. Then we get down to the "real therapy."
My approach is derived a great deal from studying Irvin Yalom, M.D., a master therapist who is an existentialist and believes that human beings basically have "four ultimate concerns, four fundamental facts of existence --- death, isolation, meaninglessness, (and) freedom --- which, when confronted, evoke deep anxiety." In The Gift of Therapy Yalom goes on to write that freedom includes responsibility and having to make decisions.
Through an existentialist approach, we can take a deep dive into the emotional conflicts you're feeling internally now that one of the existential issues mentioned in the previous paragraph is confronting you. For example: Imagine a client has moved to Seattle because she and her parents always imagined her working in the tech industry and making a great deal of money. But after she got here, she perceives her job as meaningless. She spends weekends cooking amazing meals for friends. Her heart knows her deepest desire is to become a chef, though the pay is horrible early on. She comes to see me to wrestle with this freedom of choice and the anxiety over possibly disappointing her parents.
By talking every week, we begin to uncover her values --- apart from her parents' values --- as well as her internal strengths. She may decide that downsizing her apartment and living paycheck to paycheck for the first few years would be so anxiety-provoking for her that she'd be better off somehow marrying her tech know-how with the food industry rather than becoming a chef. But at least when she's done with therapy she'll have a much clearer idea of who she is and will be much more likely to choose a life partner who honors her true self, just as she now does.
Also important to this process, as Yalom points out, is the relationship between the client and therapist. Something you say or do during a session will probably match how you react to a situation in "real life." Our relationship should be strong enough that we can talk about these moments.
Meanwhile, for some clients I will use cognitive-behavior therapy techniques in an effort to decrease symptoms so that they can better participate in therapy with me. For clients suffering from PTSD, I often recommend EMDR therapy, which you can read about here.
~ Matthew Nordin, MSW, LSWAIC, MHP