Sunday, January 2, 2011

A Recipe for Wellness

Clients come for counseling to talk about what's wrong.  It really throws them when I ask, "What's right?  What's going well in your life that you wouldn't want the counseling process to change?"

It's one thing to assess and diagnose problems.  Understanding of what the problems are and how they became problems is a necessary first step in the treatment process.  But things only get better when solutions to the problems are discovered and applied.  It's what I call "A Recipe for Wellness" 

Think about the essential ingredients for your favorite recipe.  Perhaps it's pizza, or lasagna, apple pie or homemade ice cream (am I having some cravings?).  There are very specific ingredients in very specific quantities, combined in order through a process that will render a tasty product...if you follow the recipe.  The counseling process can work in a similar way, though it might take a bit longer than preparing your favorite meal.

Research has demonstrated that there are three basic categories of variables that can cause, sustain and potentially cure mental and emotional disorders: 1. Biological (the physical component), 2. Psychological (what you think about and how you think about things), and 3. Social (relationships).

Biological includes genetic heritage, illness or enduring conditions.  Predisposition to mood disorders, anxiety, addictions are real.  But one's genetics isn't destiny.  Our biological blueprint isn't always what will be seen in reality because other variables are powerful enough to produce different results.

Psychological includes our characteristic way of thinking about ourselves, others and the world in general.  It is shaped by a variety of factors including formative relationships (with parents, siblings and other influential family members), life experiences (losses, traumas and successes).  Cognitive Behavioral treatment approaches target this area by altering what we think about and HOW we think about things.  Such changes result in changes in emotions and perspective.

Social is our relationships.  Are they life-giving or stressful: a source of pain or pleasure; helpful or harmful?  How do the most important people in our lives view us? 

This is a quick over-simplification of the basic categories of life that contribute to overall mental health (or can erode it). Why have I written about this?  Grace and Truth values a collaborative relationship with our clients.  The more you understand about how we think, the more you will be prepared to participate in the process, and the quicker you will get the results that you want.  And whether you get counseling at Grace and Truth or elsewhere, you can begin now to identify the factors that contribute to or detract from your mental and emotional health.

Let me give a quick illustration about how this works in diagnosis and treatment planning:

A 40 year old woman* comes complaining of episodes of tightness in her chest, shortness of breath, perspiration, racing heartbeat.  These began after a particularly stressful season at work where she is responsible to produce a quota of time-sensitive reviews of client applications.  She grew up with parents who didn't have a very happy marriage, and who talked out loud about their unhappiness with each other and their children.  Admittedly, she has never felt very good about herself.  To top it all off, her best friend recently began acting squirrely, like something is wrong between them, but won't tell her what it is.  Her husband might be having an affair, and her once obedient children have hit the teen years and their personalities have changed.  They are not as pleasant as they used to be. And she feels like her relationship with God is strained.

What's wrong?
  • Panic disorder (anxiety symptoms) or heart problems?
  • Negative self-worth and self-image based on how she thinks about herself?
  • Grief and loss in significant relationships? 
Again, this is over-simplification, to make a point.  It is clear that there are plenty of factors in the bio-psycho-social model to produce a painful experience.  After a thorough assessment of all of the contributing variables (ingredients) is completed, it is possible to begin working cooperatively with this client to make adjustments.  A medical physical would be in order to rule out other physical factors producing or mimicking the anxiety symptoms.  If panic disorder, medication might be indicated.  A clear understanding about how she thinks about herself and others (self-talk) would be needed before adjustments could be recommended.  And boundaries and other decisions about how to handle relationships would be part of the therapy.

I'm sure you get this breakdown of factors intuitively.  When things go awry in life most of us "assess" what it wrong and why it is wrong.  I just wanted to give you and model to break down your understanding of the key areas that counselors are looking at in assessment.

We see good outcomes at Grace and Truth when clients fully engage the assessment and treatment process.  We help this along by providing education about variables that contribute to and erode mental and emotional health, and then ask our clients to examine their lives and share with us about the balance of these factors in their life.  The overall goal is to reduce or eliminate the ingredients of pain and displeasure, and to increase the ones that contribute to a sense of physical, emotional and relational well-being.  It's a process of identifying and combining ingredients, just like a recipe.

We hope this helps.  If you or someone you love could use some help to sort this out, please call. We'd love to try to be helpful.

Blessings,

Jeff Williams
Professional Clinical Counselor - Supervising Counselor
State of Ohio, #E-3098
937-717-5591
*This is a fictional scenario.  Any resemblance to any person living or dead is entirely coincidental.

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