50) Top Down or Bottom Up

Which type of therapist are you? Are you more the ‘expert’ therapist that guides your client in a ‘top down’ approach to behave in an appropriate manner, think more rational, or see things in a more realistic way. Or are you more the ‘explorer’ type who works from the ‘bottom up’ to help realign blocked emotions, ‘parts’, or thoughts to encourage internal integration and growth. Either way the therapist comes with a ‘helping agenda’ designed to move the client forward to achieve the end goal of being more ‘functional’. The problem, of course, is that even the most motivated of clients’ are not always ready to keep up with their therapist’s well-meaning ‘helping agenda’. This leads us to suggest a third possible option that is beyond ‘top down’ or ‘bottom up’; what might be called a ‘Here & Now’ approach. Here, in a paradoxical manner, the therapist is willing to let go of his personal agenda to change the client. In so doing, the focus of treatment is to simply strengthen the alliance based on enhancing a trusting relationship that is not dependent on changing behavior, emotions, or thoughts. The focus is to simply accept the client ‘as he is in this moment’. Instead of trying to encourage the client to be or do more of ‘who he is not’, - in the ‘here & now’ we offer empathy, humor, and genuineness to relieve the client’s underlying experience of abandonment, isolation, and feeling stuck. This unconditional acceptance results in feeling a profound sense of internal relief. When done correctly, this instigates an organic, unplanned, and unexpected level of change that is not subject to a linear or logical agenda.