Types of therapy and how it helps you

I’ve been going to therapy my whole life because my first year was in a Romanian orphanage, As a child, I was disowned by my adoptive family, abused in a foster home, and I have chronic illness. I thought it would be interesting to take a look at the types of therapy there are, and how each type could be beneficial for those of us with chronic illness.

Holistic Therapy

Holistic therapy focuses on the mind, body, and soul. It Incorporates spiritual healing and energy medicine. The first session is to establish goals for the treatment. Clients express themselves through art therapy, meditation, breathing techniques, rebirthing and/or guided imagery. Clients participate in specific exercises to work through unhealthy emotions and guide them towards control of these emotions. The benefits include improving self-esteem and reducing stress, anxiety, depression and past trauma.

Meditation, other mindfulness practices, and breathwork

Meditation therapy consists of relaxation and consciousness expansion by focusing on a mantra, keyword, sound, or image while eliminating outside stimuli. Practitioners believe that negative emotional experiences manifest physical illness and emotional pain that includes anger and frustration, which is a part of life with chronic illness. The client relives negative emotions by looking back at specific memories and learning to be intentionally mindful of their emotions and thoughts. Clients begin to see them more clearly and recognize how they have impacted them and learn to accept how their life is changed forever by being diagnosed with chronic illness. Mindfulness is adapted to fit the particular needs of clients.

How to practise mindfulness during a session or privately

1. Start by sitting comfortably, with your back straight and eyes either softly open or closed.

2. Notice that you are breathing and feel the sensations of the breath

3. If your mind wanders, no problem; just gently bring your attention back to the breath. After following the breath for a few minutes, see if you can locate any discomfort, such as an itch or an ache.

4. Instead of automatically shifting to relieve your discomfort, bring your full attention to that feeling. Notice its texture, and how it changes from moment to moment.

5. Stay with the sensations of discomfort as long as you can. Experiment with staying with them for a while.

6. After attending to the discomfort for several minutes, return your attention to the sensations of the breath.

Narrative Therapy

Narrative therapy allows the client to explore other storylines, problems, and actions to find an alternative meaning to their life and their narrative of chronic illness, separating the client from the cause and negative feelings.

The client tells their story in their own words to find meaning and purpose. By the client telling their story they'll discover meaning, find healing and establish or reestablish and identify the most important factors for their success in therapy. Narrative therapy helps those who have anxiety, attachment issues, ADHD, depression, eating disorders, grief and PTSD, and supports the client to become aware of themselves processing their habits, strengths, and weaknesses. The main principle is not to diagnose the type of illness the client has but to help them develop a narrative of how they got to where they are.

Storytelling therapy and chronic illness

Narrative therapy is to help a client find their voice and tell their story in their own words. As clients explore their experiences they try to find alternatives to their feelings and action points of their story. The same events can tell a hundred different stories since we all interpret experiences differently and find different senses of meaning. Telling the story of having chronic illness redefines causality and self-perception. Storytelling encourages knowledge exchange, collaborative learning, reflection, and making meaning of one's disease. The goal is for the client to build a sense of community through facilitating peer support, empowerment, and active engagement in disease self-management.

Behavioural Therapy

Behavioural Therapy identifies and changes self-destructive or unhealthy behaviours. Behavioural therapy treats anxiety disorders, stress, bulimia and anger-related disorders, depression, addiction and those who are struggling to accept life with chronic illness.

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy encourages the client to build thinking and behavioural patterns helping them achieve a better quality of life. This is by creating an illness management plan and learning to improve and maintain their quality of life over time. CBT encourages an individual's thoughts, feelings, and behaviours toward lasting growth. CBT for Chronic Illness includes learning self-advocacy skills, problem-solving, relaxation training, and other lifestyle self-management skills.

Person-Centred Therapy

Person-Centred therapy is described as the notion of self-awareness and working through recognising their needs, worries, and grieving the losses that come with chronic illness. Person-Centred therapy is non-judgemental listening and expressing unconditional positive regard, empathy and agreement with the client. The client should feel supported in a non-judgmental way, and the therapist should provide the client with hope, empathy, and respect for themself.

Microskills of Person-Centred therapy

• Be Non-Directive; The therapist lets the client lead. The therapist is seen as an equal collaborator however it is important that the client is taking responsibility for their own life.

• Unconditional Positive Regard; The therapist must exhibit unconditional positive regard for the client, which, means that they accept and care for the client as they are. The therapist doesn’t have to agree with the client but must refrain from judgment. It is essential that the client feels valued by the therapist.

• Congruence; The client learns to develop their own identity with validation from the therapist. Congruence is necessary to become a highly functioning person and achieve life goals. The therapist must be genuine towards the client which enables both client and therapist to have a trusting relationship.

• Empathy; Empathy is showing understanding for a person. Without empathy, the client will not feel safe with the therapist and will be unable to be genuine and exhibit their true self.

• Accept Negative Emotions; An example of a safe environment for a client is where they feel they can share information without negativity and judgment. There are times when a client is going to express negative emotions that elicit a reaction. At times a client may even direct negative emotions toward the therapist. A therapist needs to learn to not take words personally, especially from a client that is experiencing personal issues.

• Active Listening: Active listening is not just listening. It is listening in such a way as to let the client know that they have an understanding of what is being said. Some critical aspects of active listening are; body language by maintaining eye contact, leaning slightly forward, and keeping an open style of communication (e.g., arms and legs uncrossed). Reflection is verbally responding to what is being said. In many therapies, the therapist tries to interpret what the client means and see through their own perspective. The therapist should not try and change the client's meaning, but rather simply reflect on the client in an effort to further understanding. Paraphrasing is a type of reflection to ensure there is an understanding of what the client is meaning. Your tone of voice should remain even and supportive. Large inflections may be interpreted by the client as a judgment or a lack of empathy. Using open-ended questions allows the client to remain in control of their session. Open-ended questions tend to draw out more information. Affirmations can be both verbal and non-verbal. “I appreciate what you are telling me” is an example of a verbal affirmation. Even a small phrase like “go on” tells a client you are interested in what they have to say. A non-verbal affirmation can be something as simple as a head nod.

I feel most comfortable during person-centred therapy because it provides constructive feedback in an affirming way. I hope you are able to find the type of therapy for you.