Category Archives: Learning About Therapy

What is Family Constellations Therapy?

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Family Constellation work in the tradition of Bert Hellinger posits the larger system, or energy field, of each person. This encompasses all the members related to and influencing the well-being of that person. The larger, whole system can be accessed in this model through a process of representation. Within a workshop setting, the client (the person presenting a problem to the facilitator) chooses representatives for significant members (mom, dad, siblings, for example) and places the reps in a contained space. Often this workspace is an open area. The reps then focus on their experience in that grouping (or constellation) and speak of the experience felt at that moment. Much information emerges from the constellation experience that relates to the client’s situation, even though the reps know little of the persons being represented.

The facilitator listens carefully and suggests options for healing the distress/discomfort felt by each. The goal is to provide a flow of Love or enlivening energy which, until this moment, has been blocked by subconscious entanglements from the past. Options for change might include moving, speaking, repositioning, testing for missing or shunned members. Often spontaneous rituals of inclusion, connection, and clarification will be created and tested for their impact on the individual or the system.  The client mostly observes until the constellation work is ready for his/her direct involvement in the dynamic of the working group.

Basic tenants of the constellation theory are called Orders of Love. These include but are not limited to:

  1.  the need to belong (bonding, similar to the focus of attachment theory by John Bowlby)
  2. the need to maintain a balance of giving and taking (in other words–equilibrium, as well as the importance of hidden bonds and loyalties described by Ivan Boszormenyi-Nagy)
  3. the need for the safety of social convention and predictability (order)

These three needs emerge differently in each person’s life and can be known through experience of guilt and/or innocence enticing and driving choices in service of, or opposition to, these needs.

In my work with clients I screen for disruptions in each of these three Orders:

For instance, each person needs a strong sense of belonging and sense of place in the system in order to thrive. Without these, anxiety takes over.

Each person needs clear permission to make personal choices in support of well-being. Often parents have been unable to generously give love and attention but have rather required the child to care for the parent’s sense of worthiness. This might emerge as guilt and confusion while making personal choices.

Too often unpredictability or disruption in the family system will reveal itself as depression in the individual. Or “too much or too little giving” indicates imbalance in the sense of order experienced by the client within the family system.

Clients can change by modifying the life circumstances experienced in any one of these orders.

A client might reconnect with those who have been separated from contact or enhance a connection that is too “thin.” In session, we might create rituals of healing that can improve the energy felt by system members either in imagination, role play, or using figurines to reimagine relationships. Sometimes just talking about experiences of belonging, giving-taking, or sense of order can initiate changes in a client’s experience.

This modality has been very useful in launching young adults from family of origin, healing wounds from early childhood, honoring lost relationships (first loves, adopted children, early deaths, injustices), managing illness, and ancestral entanglements. The introduction to Bert Hellinger’s book, Love’s Hidden Symmetry by Gunthard Weber states, “Bert Hellinger’s spirituality is close to the earth, embodied, passionate, life-affirming. It embraces the everyday lives of average people struggling with their suffering and with their greatness. It draws us into life rather than seeking to lift us above it. It celebrates the simple and ordinary, speaking to everyone who is wrestling with whatever limits the soul’s longing to reach its potential in the world. This book is about remembering how to listen to your soul and the to the Soul of the Greater Whole.”

A Kid’s Guide to Play Therapy

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(Ok, so this is really a guide for grown-ups. Perhaps this can help you understand and talk with children about child-directed, psychoanalytic play therapy.)

Yes, it’s really true. All you’re asked to do is show up and PLAY. You can show me how to play with me if you want. There are no rules, except that we are safe.

This is really important for us, because I know that you can’t be expected to open up and play if you don’t feel safe. Because you’re a kid, I know that thinking and talking can be hard. We know that play is another good way of expressing yourself, and it can be safe and more fun than talking at your age. Don’t worry – I speak this “play language” too. When we play, you can act things out, explore feelings, and feel understood, and the cool thing is that this is happening in the background while we play. We have lots of great toys.

To me, they each mean something and help me understand what you’re working on in your life. But we can talk about those things when you’re older, when you’re expected to talk. For now, let’s stick to the toys. At the start, it is important that I get to really learn who you are, and where you come from, so that I can know how to be helpful. It is also super-important for you and your family to decide if I might be a good fit for you. I’ll meet with your parents for a long, boring interview and ask them lots of questions about you and the family. When you and I first meet, I’ll explain the rule (about safety) and I’ll try and get to know you a bit. I’ll ask questions about what you like to do for fun, what you like to eat, and other things. I’ll also ask you some funny questions that help me know how you think and feel. Then I’ll show you all of our toys. They’re all organized in bins so we know where to find things; everything will be in it’s right place each time. In the first session, we might even have time to start playing some!

When we play, a lot is going on, but most of it is behind-the-scenes. You’re choosing what we play with and how we play. I join in, and follow your lead. Because I’ve learned about you, the things I say and do in the play are chosen carefully. I’m always thinking about what might be going on, and what might help. Sometimes my play character, for example, will say just the right thing that your character needs to hear and learn words for, such as, “Ugh, I feel so tired of getting beat up. I don’t like feeling this weak and helpless!!!” Or, maybe I say the wrong thing and our characters battle it out. I might then say, “Oh, boy- I really messed up and said the wrong thing and you really let me know it. I’m so sorry.” There is no script, but it does help that I have done an assessment of you at the start.

If you’re wondering why you’d come to a place like this, maybe I can help. Kids ages 3 to teenager come here for lots of reasons. As is usually the case, it seems that you could use some special time in a safe place with a person who understands some things about what would help you feel better and keep doing your job (to grow!). It can be really nice to have this special relationship – different from that with parents or teacher – in an ongoing way. I’m sure you’re working on things, and we can work on these together, with play. We all want to feel better, and to do our job – which is, to GROW. Play therapy can help you do that.

It is also best when I can work with your parents on the side to help them be the best parents for you that they can be. Rest assured – we won’t ever use your time for that. When I meet with them, it also helps me know how things are going for you at home and at school. The more the grown-ups talk, the more you and I can focus on playing. By the way – I’ll let you know when the grown-ups meet.

So, don’t worry – you still have lots of time before you’re able to really talk about the hard things going on in your life, your big feelings, and your developmental drives. Your language right now is PLAY, and I speak it, too.

Dr. Matt Percy is a licensed clinical psychologist at Samaritan Center. He sees children ages 3 and older for play therapy and conducts psychological evaluations. He can be contacted at (206) 527-2266 x347 or mpercy@samaritanps.org.

Can We Help Each Other Change?

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Couples who are coming into counseling to deal with anger in their relationship often wonder:  Is this really going to help?   Will the therapist be able to help my partner see things differently?  Will this be worth the time and effort?

To me, it seems to be a question of hope.  Is there hope?  Yes, there is.  Hope does not disappoint (Romans 5:5) but the answers to our questions might be disappointing. We can’t change our loved ones and they can’t change us. The hope lies in learning that we can help each other change by changing ourselves.

For example, asking ourselves questions like this: What was I doing right before the temper flare?  Was I pushing buttons?  Was I criticizing or yelling?  Was I stonewalling?   Realizing that tempers are not lost in a “vacuum,” we look for the extenuating circumstances.

When we start to look at the big picture and at our part in the big picture, we begin to understand what we can do to help our loved one solve what we’ve been thinking of as “their” problem.  It begins to become an “our” problem.

Taking this position of helping each other change is one sure way to make therapy worth the time and effort. If we can recognize the triggers that lead to our partner’s losing their temper, we can learn ways of coping that will be more effective.  An equally important piece of the puzzle is learning their buttons, choosing not to push them, and letting the other person walk away when they need to.  When we learn more effective ways of communicating, we’ll be more successful  when we sit down and try to solve a problem.

If we think that we’re just an innocent bystander and the conflict is all about our partner, we might want to spend some time asking God to show us our blind spots. Or we could even ask our partner what they think we contribute to their temper flare ups. When we are able to control our anxiety and consider another person’s point of view, we can learn something  important about our relationship journey.  Controlling our anxiety and agreeing to hear constructive criticism isn’t easy but it can be done, especially when our partner is willing to offer their thoughts in a kind and gentle way.

John Gottman, in his work at the University of Washington, says that if you can allow your partner to influence you and if your partner can gently share their opinions, you’re well on your way to a healthy relationship. And a healthy relationship can tackle many mountains, including the anger mountain–when you’re doing it together.

Understanding Childhood Grief

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Loss affects all people – children and adults – in profound and unique ways. One interesting and often challenging feature of grief is that it is a personal, subjective experience – no two people’s experiences of grief, even over the same loss, are the same. It is, therefore, important that parents and caregivers work to understand their children’s possible grieving. Then can a child receive the support they might not know how to ask for, and feel understood when they are in an emotional state that can feel foreign, confusing and uncomfortable.

In anticipation of or following a loss, the following guidelines can help facilitate a child’s grieving in a way that promotes healthy development. Symptoms can vary in children, from sadness to anger and irritability, loss of appetite, and difficulty sleeping. Understand that no loss is too great or too small to grieve. The experience of loss is relative to the person, so the death of a pet can be as painful as the death of a loved family member. What causes grief can be different for every child.

Answer all questions and tell the truth. When a child is curious, give him or her answers in ways that are clear and easy to understand. The less a child has to wonder, the less he or she is likely to rely on fantasy or imagination, which often can cause anxiety. Difficult feelings are actually opportunities. While it can be difficult to see a child feeling sad or in pain, resist the urge to “make it better.” Instead, join in the sharing of their hard feelings, helping to name the feelings when that is possible.

Remember, the goal is not to “get over” a loss, but rather to learn how to live with the reality of it in healthy ways. There is no timeline. Understand that grief is a personal process that requires working through very difficult feelings. Rushing this process can get in the way, unintentionally drawing the grief out longer than it needs to be.

What Brings Men to Counseling?

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Samaritan’s Men Counselors Reflect on the Question

It may happen in their 30s, 40s, 50s or later.  Men who have dealt with everything life has handed them – those whom Michael Rogers, a therapist and formerly the clinical director at Samaritan Center of Puget Sound, describes as “testosterone-driven fixers”– find that their defenses are wearing thin.  The pressures come at them from all sides.  Frustration, depression and anxiety threaten to overwhelm them and their relationships.  “At the point when they can’t outrun their fear,” Michael said, “it’s usually through someone close to them who sees or feels their distress – a doctor, wife, employer, or friend – that they come to counseling.”

“In fact,” said Rob Erickson, one of the 12 men who provide counseling at Samaritan, “it’s often the women in their lives who ask them (either lovingly or with some level of hostility) to come to counseling.”

Gary Steeves, Samaritan’s coordinator in South King County, noted that he eventually had to admit that he couldn’t fix himself in the aftermath of an auto accident several years ago.  Physical therapy and “dealing with it myself” was only helpful up to a point, he said.  “It was as if I was carrying that traumatic experience around in my body.  I was like a block of concrete.”  When he finally went to a movement therapist, he said it was transformative.  “First of all, the roles were reversed.  Someone was working with me—not ‘fixing’ me but, rather, helping me manage those forces within me.  I think it is incredibly powerful when we face our limitations and our vulnerability.  We can stop carrying the mantle of having to do everything by ourselves.”

Mar Houglum, a pastoral counselor as well as marriage and family therapist, said that he thinks it is “a huge step for men to seek help.  They resist the notion that talking with someone who listens in a safe, affirming, empathic way could be helpful.  I find that when they take that risk, they find a sense of greater ease with themselves—a generosity with themselves.”

Michael Rogers notes that there are a number of men’s groups in the area.  “I’ve been part of a small men’s group for years,” Michael said, “and I have to tell you that we aren’t nearly as good at self-disclosure as women are.  It takes us a long time to get to an authentic level of sharing.”

“Coming into therapy seems to give men ‘a Walden Pond’,” said Bill Collins, who has been with Samaritan as a therapist and supervisor for many years.  “It provides a reflective space where they can take stock of themselves and consider healing possibilities.  In The Way of Man, Martin Buber notes that Yahweh asks Adam in the garden, ‘Where are you, Adam?’ not because Yahweh does not know the answer, but because Adam doesn’t know the answer.”