6 自我认知

第六章

了解自己

要完全与他人建立联系，首先必须与自己建立联系。 ——欧文·亚隆

为什么你成为了一名治疗师？让我们来看看一些参与在线FAP社区的治疗师们怎么说。

• 我知道什么是痛苦。我希望别人在痛苦中不再孤单。
• 在别人想要逃跑时，在即使你也想逃跑的时候，我愿意在那里。
• 在我生命中的某个时刻，当我强烈需要更多地了解自己时，我爱上了心理学这门科学。然后，在见证了心理治疗对改善人们生活潜力之后，我决定将它作为我的职业。
• 我想把另一个人从我曾经陷入的那个困境中拉出来。
• 最初是为了帮助那些受苦的人。而现在，原因变得有些自私；我成为一名心理治疗师是因为这让我成为一个更好的人。
• 其中一个原因是学习如何治愈，并将这种治愈带回到我的家庭中。
• 因为帮助他人也帮助了我自己，我想把我经历的事情转化为好的东西。
• 当我还是个青少年时，经历了一些失去和痛苦，在面对这些时，我意识到与他人建立充满爱、有意义且深刻的联系对于治愈心中的创伤有多么重要。
• 对于我们自身以及周围世界的知识形成与消逝有着无法抑制的好奇心。看到通过简单地做自己就能服务于他人的机会。
• 起初我想拯救世界。后来我意识到我几乎救不了自己。现在如果我的来访能够静下心来面对自己，我就感到满足了。
• 我想理解自己童年时期反复经历的存在危机，直到今天我仍在体验这些。
• 我想理解并支持自己的迷失感和其他脆弱性，并将这种支持扩展到周围的其他人——最终让自己感觉不那么孤单。
• 我有一位非常棒的心理治疗师，他真的改变了我的生活。我也想为其他人做同样的事情。
• 我想理解人，理解生活。
• 我对人生轨迹背后的原因、（我自己的）痛苦背后的原因——以及关于生命意义的大问题——所有这些都是一个寻求灵魂的年轻人的思考……后来，这变成了一种帮助他人的愿望。
• 更深入地理解我为什么做我做的事情，以及为什么其他人做他们做的事情，并通过这种理解减少我们的共同痛苦。
• 理解为什么人们（有些人）如此痛苦。
• 我想帮助自己和他人感觉到他们在生活中有真正的选择。过上他们真正渴望的生活。并且知道那是什么。
• 从小我就被教导情感并不重要。作为一个年轻人，我因为重度抑郁症接受了治疗，并不得不重新调整我对情绪的态度。经历了这一切后，我对那些正在经历情感痛苦的人感到极大的同情。我想做一些事情来帮助他们感觉更好。
• 对人类的工作方式、痛苦的工作方式、胜利的工作方式、家庭破裂的方式的好奇心。对故事的热爱。
• 感觉到我真的“看见”了某人，这对我来说是非常有强化作用的。当有人“看见”我——好的、坏的、丑陋的——时，我也会感到被强化。
• 我曾长时间处于危险和破坏性的状态。通过进行治疗，我看到了一种有用的方式。这对我来说意义重大。
• 因为我真心喜欢看到人们“觉醒、变得生动、开始生活”，并照顾好自己。我当时不会用这样的词来形容，但现在我依然有同样的眼神，当我在见证“觉醒”时。我在25岁时觉醒并开始照顾自己，而我现在仍在学习如何生活。
• 我想帮助人们，更好地理解我的家庭。幸运的是，我发现了通过连接带来的治愈，现在我想向我的来访展示同样的道路。
• 自我认知一直是我感兴趣的一个领域。受到苏格拉底和斯科特·派克的影响，我决定深入探索自我意识，并鼓励他人也做出这样的飞跃。
• 我喜欢关于苦难和救赎的想法和故事，但认为自己太笨拙和不足，永远无法帮助他人。在某个时刻，因为一些关键人物相信我，我决定接受挑战，成为我认为自己不能成为的人，并帮助他人面对他们的恐惧和羞耻。
• 一个愤世嫉俗的人可能会说：“治疗师都是为了自己——他们只是在解决自己的问题。” 这是贬低治疗师的说法，但愤世嫉俗者误解了我们的目的和目标。我们对工作的个人承诺——为什么我们要这样做——是我们力量、洞察力和同理心的最大来源之一。就像任何需要智力和情感劳动、创造力、在起伏中坚持、独立思考和专注研究的职业一样，最令人信服的理由总是深深个人化的。如果我们想在所选领域有效工作，至关重要的是我们扎根于一种让奋斗变得有意义的生命目的感。
• 除了目的之外，你在提供的治疗过程中还以其他方式存在。最具体地说，在任何一次会话的任何一个时刻，你并不是站在过程之外旁观。你是过程的核心，你的反应是治疗的媒介。我们不仅仅在谈论你的技术和理论掌握，还有你的情绪、你的回避、你感受的意愿，以及你的个人经历是如何塑造你带到治疗关系中的内容。你的世界观。你的信念。这就是作为一名治疗师的工作景观（Alves de Oliveira & Vandenberghe, 2009; Vandenberghe & Silvestre, 2014）。

FAP要求你通过与自己和他人建立良好的关系，有意识且有效地跨越各种社会关系、角色和情境，来奠定你的实践基础。

FAP与其他多种治疗方法一样，都强调个人实践：

• 精神分析训练 涉及完成你自己的分析。
• 辩证行为疗法 要求治疗师发展个人的正念和技能实践。
• 接纳与承诺疗法 要求治疗师使用六边形模型中的过程来练习心理灵活性。
• 慈悲聚焦疗法 要求治疗师发展慈悲实践。

在上述所有方法中，治疗师的自我发展不仅是为了确保治疗师的问题与来访的问题保持分离，也是为了鼓励治疗师以一种更自我披露、更自我参与的方式参与其中。例如，当一个来访对你生气并且你感到“被不尊重”时，你会保持灵活并保持治疗性吗？还是你会冲动地反应？你会超越自己的反应去倾听来访的问题，而不是仅仅关注它对你意味着什么吗？

你注意到并调节自己反应的能力影响着你在来访身上唤起（或避免唤起）以及强化（或未能强化）的内容。例如，如果当来访反馈她不明白你刚刚解释的内容时，你感到愤怒或羞愧，你可能会无意中惩罚或抑制这种反馈——即使这绝对不是你想做的事情。如果你对“冲突”感到厌恶或避免让他人“感觉不好”，你可能不会处理来访对他人的负面影响——而这些是你在治疗关系中亲身经历的——从而错过了来访呈现问题的一个关键维度。

细致的自我意识让你能够从这些模式中抽身而出。通过清晰地看到它们并评估其成本——对你和你的来访——你可以找到机会，以勇气和同情的灵活平衡来与来访互动。治疗师的自我发展是一个持续的反思过程，也是一个自我发现和技能发展的过程。功能思维对此提供了良好的支持。

治疗师的自我发展过程（或斗争）不仅仅反映在治疗关系中的临床相关时刻。在我们与临床医生的咨询中，我们一次又一次地看到，治疗过程本身——特别是挑战性案例所需的试错和坚持——使治疗师直面他们在坚持、信仰、信任、控制等方面的脆弱性。

例如，一位咨询者描述了当她的来访没有对她的初步干预做出反应时，她感到无能和不确定。作为回应，她感到了很大的压力——基于真正的同理心——去帮助或解决来访的问题。换句话说，她的同理心的功能是增加了她的痛苦和无效！经过咨询后，她意识到她的压力和焦虑导致了来访不需要的东西：改变的期望、迫切需要解决问题的感觉，以及问题无法忍受的感觉。甚至像“你现在感觉怎么样？”这样的无害问题也传达了这种急迫感。

这种解决不确定性和痛苦的紧迫感对治疗师来说有着深远的历史。通过练习接受自己对不确定性的不适（并意识到过去是如何塑造它的），她逐渐建立了一个更加灵活的立场，从这个立场出发，她可以同情来访的痛苦，同时作为治疗师保持信任和同情的视角。反过来，她能够更有效地邀请来访放下“控制”，转而找到并拥抱他们确实拥有的选择。

当你掌握了自己恐惧和脆弱时，你不仅仅是解决了那些特定的问题——你对不确定性的挣扎、批评或其他什么；你以一种深刻的方式学习了只有真正扩展边界的发展才能教会你的东西。你学会了面对看似不可能或压倒性的情况，并通过这一过程成长。我们经常要求我们的来访这样做，因此亲自了解这一领域是无价的。

在本章中，我们将引导你完成一系列旨在指导你进行个人自我发展的练习：

• 生命史练习 要求你回顾你最具形成性的学习经历——无论是负面的还是正面的——以便你能清楚地看到当前的脆弱性和优势所在，以及你的经历是如何塑造它们的。
• 来访历史审计 与生命史类似，要求你审视整个职业生涯中与来访的经验如何塑造了你是谁以及你作为治疗师的脆弱之处。
• 反馈访谈 是超越自我反思的过程，从你信任的人的角度看待你的优点和缺点。
• 冒险实践 是审视生活中或治疗工作中因某种对不适或不确定性的厌恶而回避的重要事情，并有意识地挑战自己向前迈进。
• 最后，治疗目的声明 邀请你定义你作为治疗师的身份，你希望为来访成为什么样的人，以及你希望提供哪种类型的治疗关系。

生命史

我们是被我们的历史所定义的生物。我们根据自己的经历来思考自己是谁。我们对他人的期望很大程度上是由我们的历史塑造的。我们学会了什么是痛苦的，什么是安全的。由于这种学习，我们很容易错过当下的时刻，而停留在我们认为安全的范围内。 生命史练习旨在从你的生活故事中找到洞察：你的历史如何塑造了你，以及它在哪些方面创造了脆弱性和优势。这个练习的目标是帮助你在治疗关系中有效地存在。讲述你的故事对于这一目标是有效的，因为它让你通过识别之前的具体事件来理解当前时刻的意义。讲述你的故事并不在于细节，而在于叙事——历史如何使这一刻变得有意义？就像如果你没有看过《星球大战》和《帝国反击战》，你就无法理解《绝地归来》一样，不了解过去，你就无法理解你生活中这一段落的背景。

考虑以下问题：

• 为什么愤怒的来访会让你特别焦虑？在你的历史中，你是否学到了愤怒是危险的？
• 你的历史如何使你未能准备好去同情那些在学校挣扎的人？你是否总是觉得努力相对轻松？
• 对犯错的恐惧如何导致你避免某些类型的脆弱性？你是否学到了犯错误意味着你是无能或不值得爱的？

清晰地看到你的故事可以创造理解其他视角的可能性。例如，它可能让你意识到愤怒并没有感觉上的那么危险，或者错误是学习的道路。深刻了解我们的故事，甚至是那些最羞耻的部分——并与之紧密生活，并与对我们重要的人分享——也往往会让我们与更广泛的人类共通感联系起来。弗雷德里克·布赫纳在他的回忆录《讲述秘密》（1991）中很好地阐述了这一点和其他几点： 我开始相信，人类大家庭都有同样的秘密，这些秘密既非常有启示性也非常需要被讲述。它们之所以有启示性，是因为它们揭示了我们状况的核心矛盾——我们或许比任何事情都更渴望的是以我们完整的本真被认识，但这也是我们常常最害怕的事情。至少偶尔说出我们真正完整自我的秘密是很重要的——即使只是对自己说——否则我们就有可能失去对真实自我的追踪，逐渐接受一个经过高度编辑的版本，希望世界会发现它比真实的东西更可接受。说出我们的秘密也很重要，因为这样更容易看清我们在生活中走过的路和将要走的路。这也让其他人更容易向我们透露一两个他们自己的秘密，这样的交流对于家庭和作为人类的意义至关重要（第2-3页）。

步骤1

第一步是用某种方式来呈现你的故事，无论是视觉的还是叙述的。 选项1：创建视觉时间线 在一张纸上，画一条垂直线贯穿页面中央。在顶部标记“现在”，底部标记“出生”。在线右侧记录积极的生活事件，使用距离线的水平距离来表示积极程度；换句话说，离中心线越远的事件越积极。在线左侧以相同的方式记录消极的生活事件。不需要详细描述每个事件；简短的标签就足够了。当然，有些事件可能既有消极又有积极的方面。在这种情况下，可以自由地将事件记录在线的两侧。 选项2：写一篇叙述文 以叙述的形式写下你的历史。这种格式允许更深入地描述各种事件的情况及其影响，但也可能会让人感到不知所措。我们鼓励你以一种适合你的方式自由写作。花尽可能多或少的时间，只要感觉合适就行。以对你来说是2的方式进行这个练习。

步骤2

现在退一步反思你的故事以及它是如何塑造你的。你可以在完成步骤1后立即这样做，但根据我们的经验，在至少间隔24小时后再进行这第二步反思往往更有成效。 当你准备好反思时，阅读以下问题并选择几个你觉得相关的问题。如果你不能选择，按顺序完成所有问题。 意识

• 哪些关键事件最塑造了今天的你？
• 从这些事件中你学到了关于自己的什么教训？
• 从这些事件中你学到了关于他人的什么教训？
• 从这些事件中你学到了关于世界的什么教训？
• 这些教训在你的生活中产生了什么影响？它们如何塑造你看待生活中特定人物的方式？
• 你如何与这些教训关联？例如，你是接受它们还是抗拒它们？你主要是将它们排除在意识之外，还是它们经常是你心理景观的一部分？ 勇气
• 当你回顾你的生命史时，你在哪里感到不适，这可能表现为恐惧、焦虑或羞愧等情绪？
• 哪些部分是最难以停留的？
• 你在哪里感到想要加快速度继续前进的冲动？如果你放慢速度，你会注意到什么？
• 通过向他人展示你的情感或脆弱性，你学到了关于冒险的什么？ 爱
• 在你的故事中，你在哪里感受到最多的爱或同情？
• 你能对故事中的某些方面，尤其是那些最难同情的部分，带来更多的爱或同情吗？

步骤3

从前述的生命史反思中选择一个似乎与你目前生活特别相关的主题。然后在该主题的背景下回答以下问题。

• 你做了哪些适得其反的事情？你的1是什么？
• 在发生1的情况下，对你来说最重要的是什么？
• 相对于你的1，哪些行为可能代表改进？你的2是什么？
• 展望即将到来的一周，或任何你觉得相关的时间框架，找出几个可能发生1和2的情况。在这些情况下，你的2会是什么样子？

治疗师回避问题

回避常常发生在我们关系中最困难或最僵持的部分；对脆弱性的回避限制了我们与他人的亲近，并影响我们的治疗关系。作为对你的一般1s和2s思考的补充，具体考虑一下回避在你生活中的功能。以下问题探讨了你在日常生活中所回避的事物与作为治疗师时所回避的事物之间的相似之处。对每个问题简要回答：

• 你倾向于避免与来访讨论哪些问题？对于本周见过或将要见到的来访，你在回避什么？
• 这种回避如何影响你与这些来访的工作？
• 你在生活中倾向于避免处理哪些事情？请具体说明，包括任务、人、记忆、需求以及情绪（如渴望、悲伤、愤怒、忧郁和恐惧）。这周你在回避什么？这个月呢？这一年呢？
• 你在日常生活中的回避如何影响你与来访的工作？

一旦确定了特定的回避领域，你可以开始探索在这些情况下你的2s会是什么。随着时间的推移重新审视这些问题是有用的，因为回避是会变化的。

可选练习：与伴侣分享生命史

处理生命史练习的最后一个选项是与他人分享你的故事。分享你的故事提供了一个自然的机会，让你可以进行脆弱的披露，并从倾听者那里获得响应。在FAP培训中，我们将口头叙述限制在五分钟内，不仅是为了让每个人都有时间分享，还因为简洁迫使我们更快地触及故事中的脆弱核心，而不是花费大量时间讲述细节。 以一种感觉脆弱的方式分享，这意味着走出你的舒适区进入一个脆弱的地方。这可以是一个小步骤或大步骤；选择权在于你。无论你使用哪种生命史方法，在每个人分享完他们的故事后，花时间以脆弱和同情的态度回应。

来访历史审计

作为治疗师的历史也塑造了你在治疗中的身份。一方面，我们许多人记得那个让我们感到挫败的来访，那个超越我们所有极限的来访，以及那些让我们感到无力的来访。另一方面，我们也可能记得那些最激励我们的来访，或是教给我们最多东西的来访。 在这个练习中，你将对自己的临床历史做一个详细的审计。目的是把所有的来访都摆到桌面上，清晰地反思他们是如何影响你的。

步骤1

按年份列出你见过的所有来访。查阅旧的会谈记录等。如果你从业多年，这项任务可能会相当困难。无论如何都要做，也许可以把审计范围限制在你能记住的来访；然而，如果你有记录，请尽可能制作一个详尽的列表。你也可以将督导或咨询顾问加入这个列表。

步骤2

浏览列表，挑选出一两个或几个对你影响最大的来访，然后回答以下问题：

• 你从这些来访那里学到了什么？
• 你发现了自己什么？
• 你开始害怕什么？
• 由于与这位来访的经历，你现在倾向于避免什么？

根据你的审计列表，重复此步骤，尽可能多地针对不同的来访。注意从来访那里学到的经验教训中出现的任何主题。

可选步骤3

最后一步是从视角转换的角度进行练习。从那些你最难理解或有效工作的来访的视角出发，试着回答以下问题：

• 我作为一个孩子经历了什么并学到了什么？
• 我是如何学会应对的？
• 我最大的恐惧是什么？

反馈访谈

我们并不总是能够清晰地看到自己。有时候，在重要的方面，别人比我们更清楚地看到我们。在这个练习中，你将利用这种可能性。反馈访谈是强烈的，因为你邀请了了解你并关心你的人来提供关于你的行为的见解——包括优点和缺点。你通过一个结构化的访谈来获取这些反馈，在此过程中，你尽可能地暂停自己的反应，而是专注于引出并理解对方的观点。你可能会更清晰地认识自己，同时扩展对1s和2s的理解。

步骤1

选择一个了解你并且有你最佳利益考虑的人。你可以只为自己进行这次访谈。或者，如果合适且双方同意，你们可以轮流进行访谈。选择一个你信任的人，他们能给予关怀的反馈；或者，如果你愿意接受挑战，也可以选择一个可能大胆或直言不讳的人。无论如何，请明确邀请对方诚实而富有同情心地提供反馈。

步骤2

心理准备：

• 你害怕什么？
• 你可能会听到什么？
• 在最好的状态下你会如何反应？

步骤3

进行访谈。我们强烈建议使用脚本来结构化对话。这可以促进更大的勇气，而模糊或缺乏结构则可能导致回避。以下是一些你可以考虑使用的问题。请根据需要自由调整。

• 你最欣赏我的哪些方面？
• 你希望我更多地欣赏自己的哪些方面？
• 你看到我在生活中积极努力的是什么？
• 你看到我做了哪些自毁的行为？
• 我做了什么让别人更接近我？
• 我做了什么在自己与他人之间设置了障碍？
• 当我处于最佳状态时，我做了什么？
• 当我不处于最佳状态时，我做了什么？ 只需倾听，并澄清。 感谢对方的见解。

步骤4

现在是时候反思了：

• 反馈是否符合你的预期？
• 反馈是否与你现有的自我评估一致？
• 提供反馈的人有哪些偏见？
• 提供反馈的人在哪方面比你更准确（也许比你愿意承认的还要准确）？

风险承担

风险承担是FAP社区成员的核心个人实践之一。《每周工作四小时》的作者蒂姆·费里斯在2008年获得《连线》杂志的自我推广奖后写道：“一个人的成功通常可以通过他/她愿意进行多少不舒服的对话来衡量”（2007年，第47页）。FAP版本的理念看起来像这样：FAP治疗师的成功往往可以通过他/她愿意进行多少不舒服的对话来衡量。本质上，采取有意义的个人风险可以培养转化为治疗室中的技能。 风险承担关乎勇气——一种带着脆弱、痛苦、不确定性或失败的可能性或其他任何事情向前迈进的意愿。下面我们将提供一些你可以遵循的实践方法，以培养你的风险承担能力，从而服务于你作为FAP治疗师的发展。从选项1开始，然后考虑选项2和选项3。

选项1

退一步，从高处审视你在生活中所回避的事物。考虑你的职业生活、人际关系、健康、财务、家庭维护、家庭、精神、社区、创造力——任何对你有意义的事情。对于许多人来说，有一些长时间未被正视的大问题。你知道它们是什么（或谁）。深呼吸，说出它们的名字。把它们写在一张纸上或在这里写下： 现在考虑这些问题并写下你的答案：

• 你现在最重要的是开始做什么？在未来的一年里呢？
• 你必须面对的内部或外部障碍是什么？
• 你是否愿意克服这个障碍——或者找出绕过它的方法——以便前进？
• 你需要做些什么来开始？

选项2

每天都要冒险。记住，“风险”并不等同于“鲁莽”。它是有策略的。 有意义的日常风险可能看起来相当平凡。例如，在餐厅点餐时更坚定地表达你想要的菜肴。承诺每周发送账单。放慢脚步，关掉手机，花时间陪孩子（是的，这对某些人来说也是一种风险）。相比之下，有些风险可能是改变人生的。联系疏远的兄弟并道歉。给高中老师写一封感谢信。报名参加铁人三项赛。在日记或其他类型的文档中记录你的每日风险。如果你想的话，可以给风险打分。

选项3

找一个同事、朋友或家人，他们也想练习有意的风险承担，并定期分享彼此的风险日志。面对面喝咖啡或啤酒，或在线上交流，互相反馈各自所承担的风险。给予并让自己接受赞赏。 本书作者之一加雷斯与他的密友克里斯·霍尔交换了一年的风险日志。克里斯正在从不快乐的就业状态过渡到自雇再到快乐的就业状态——一系列重大的职业风险——而加雷斯也在经历自己职业生涯早期的一些发展。这些谈话对他们两人来说每月都是深刻的激励和满足的亮点。

治疗目的声明

我们将通过一个练习来结束本章，这个练习旨在让你清楚地了解你是谁以及在与来访的关系中和作为治疗师的整体工作中对你来说重要的事情。虽然这里我们专注于你作为治疗师的价值观，但我们强烈建议你在更广泛的范围内持续进行价值观工作和目标设定。接受与承诺疗法的文献中充满了这类工作的优秀资源（特别是可以参考Dahl, Plumb-Vilardaga, Stewart, & Lundgren, 2009）。 在开始之前需要注意的是：虽然“目的声明”意味着一个完成且精炼的文档，请不要以这样的目标来进行这项练习。撰写目的声明是一个你将从不完美开始并不断稳步进行的过程——或者有时是断断续续的——就像从一块粘土中塑造和重塑雕塑一样。

步骤1

反思在你的职业生涯中那些最激励你的时刻、信息、想法或人；例如，某个特定来访的反馈、某位督导的意见、你觉得非常强大的治疗关系，或是你发现有效的某种治疗方法。现在不必担心要使这些内容连贯起来。只需要把所有让你感到兴奋的事情列出来。把它们写成一个列表，或者用其他方式记录在纸上或屏幕上。

步骤2

在对你有意义的事物中，你看到了哪些主题、模式或统一的想法？你看到哪些矛盾不需要解决，因为实际上你致力于矛盾的两面？是否有某些东西是因为“你应该”而列出的，但实际上你并不真正关心？什么对你来说最重要？

步骤3

基于上述反思，起草一份声明（或两到三份），捕捉你今天希望成为什么样的临床医生，以及你今天和未来九十天内希望集中精力和注意力的地方。放弃制作一个永远正确且完美的东西的需求。今天感觉对的是什么？

步骤4

这一步至关重要。把你的目的声明放在一边至少四十八小时。然后重新审视它，并问自己它是否仍然合适。你会做出什么改变使其更适合今天的情况？重复这个过程，每周、每月、每季度或每年继续这样做。

关于大胆的个人使命：

不要让领域沉默了你 我们是专业人士。进入这一领域的第一步开始了专业化的进程，在这个过程中，我们学习遵循有效的方法。我们指的是维持职业运作的方法，遵守规则并尊重我们没有亲身经历的风险——但我们的职业已经学会尊重这些风险。作为学生和专业人士，我们从这种学习中受益匪浅。我们同意遵守职业道德的法律和原则。我们同意服务于来访的需求，并基于有效性的基础行动，而不是基于我们个人的信念。

然而，除了专业化之外，我们的工作也极其个人化——并且艰难，有时孤独——部分原因是由于我们在其中工作的专业结构（保密性、个体治疗）。在专业环境中也可能存在一种保守主义，这种保守主义会悄悄地让我们远离更个人化的体验和价值观。例如，学术环境和专业组织经常告诉临床医生，他们不应该公开自己的心理痛苦挣扎（以及由此产生的使命感）。幸运的是，这种趋势正在改变。 如果你在这个领域持有个人使命，请不要因为专业规则和专业背景中缺乏个人元素而让自己疏远它。坚持你的使命。这不是错的。周围的人可能不会说出这一点，但它至关重要且充满活力。坚持住那些至关重要的东西。

总结

• 发展自我意识并在治疗关系中实践勇气和目的，以便有效地导航。
• 保持持续的自我反思和勇敢的风险承担实践，以朝着你所关心的方向前进。
• 在不同的背景下评估和塑造你自己的1s和2s。

知识点阐述

1. 治疗师的动机与自我反思

   • 定义：治疗师选择这个职业的原因多种多样，包括个人经历、对他人的同情、对心理学的兴趣等。
   • 重要性：理解自己的动机有助于治疗师更好地认识自己，从而更有效地帮助他人。自我反思是治疗师成长和发展的重要部分。
   • 具体实践：
     • 个人经历：许多治疗师因为自身的经历或遭遇，如痛苦、失落、精神疾病等，选择了这个职业。这些经历使他们更加理解和同情来访。
     • 利他主义：治疗师通常希望帮助他人减轻痛苦，提供支持和指导。
     • 个人成长：治疗师希望通过帮助他人来实现自我成长，提升个人品质。

2. 治疗师的个人素质与专业发展

   • 定义：治疗师不仅需要具备专业知识和技术，还需要具备一系列个人素质，如同理心、自我意识、情绪调节能力等。
   • 重要性：这些个人素质直接影响治疗效果。治疗师需要不断自我反省和提升，以保持专业性和有效性。
   • 具体实践：
     • 自我意识：治疗师需要对自己有深刻的认识，包括自己的情绪、价值观和偏见。
     • 同理心：能够设身处地地理解来访的感受和经历，提供支持和安慰。
     • 情绪调节：学会管理自己的情绪，保持冷静和专注，以便更好地服务来访。
     • 持续学习：通过阅读、培训和督导等方式，不断提升自己的专业技能和知识。

3. 治疗师与来访的关系

   • 定义：治疗关系是一种特殊的互动模式，强调治疗师与来访之间的亲密、勇气和连接。
   • 重要性：良好的治疗关系是治疗成功的关键因素之一。它为来访提供了一个安全和支持的环境，促进其情感和行为的变化。
   • 具体实践：
     • 建立信任：通过倾听、理解和尊重来访，逐步建立起信任感。
     • 共情：展示深刻的理解和共情，让来访感受到被理解和接纳。
     • 透明度：保持开放的态度，必要时向来访道歉并接受反馈，增强治疗关系的透明度。

4. 功能性分析心理治疗（FAP）的基本原则

   • 定义：FAP是一种基于功能性分析的心理治疗方法，旨在通过治疗关系中的互动来促进来访的改变。
   • 重要性：FAP提供了一套实用的原则和方法，帮助治疗师更好地理解来访的行为模式，并通过具体的互动来促进积极的变化。
   • 具体实践：
     • 关注当下：重视治疗过程中每一刻的发生，及时识别和处理来访的临床相关行为（CRB）。
     • 强化有效行为：通过积极的反馈和支持，强化来访的有效行为（CRB2），促进行为的泛化。
     • 功能性分析：运用功能性分析的方法，理解来访行为背后的功能和意义，从而制定更有效的干预措施。

通过这些知识点，我们可以更好地理解治疗师选择这个职业的动机、所需具备的个人素质以及如何通过良好的治疗关系促进来访的改变。这些内容不仅有助于治疗师提高治疗效果，也有助于他们在实践中不断成长和发展。

知识点阐述

1. 治疗师自我发展的必要性

   • 定义：治疗师的自我发展是指治疗师通过各种方式提升自身的专业素养和个人品质，以更好地服务来访。
   • 重要性：治疗师的自我发展有助于区分治疗师自身的问题与来访的问题，同时促进治疗师以更开放和参与的方式工作。这有助于提高治疗效果，增强治疗关系。
   • 具体实践：
     • 个人分析：如精神分析训练中的自我分析，帮助治疗师理解自己的内心世界。
     • 技能练习：如辩证行为疗法中的正念练习，帮助治疗师提升个人技能。
     • 心理灵活性：如接纳与承诺疗法中的六边形模型练习，帮助治疗师提高心理灵活性。
     • 慈悲实践：如慈悲聚焦疗法中的慈悲练习，帮助治疗师培养慈悲心。

2. 自我意识与情绪调节

   • 定义：自我意识是指治疗师对自己情绪、反应和行为模式的深刻认识。情绪调节是指治疗师管理自己情绪的能力。
   • 重要性：良好的自我意识和情绪调节能力有助于治疗师更好地理解和处理来访的反馈，避免无意中惩罚或抑制来访的积极行为。
   • 具体实践：
     • 反思：定期进行自我反思，识别自己的情绪和反应模式。
     • 接受不确定性：学会接受不确定性，减少因不确定性带来的压力和焦虑。
     • 情绪管理：通过正念、冥想等方法管理自己的情绪，保持冷静和专注。

3. 治疗师与来访之间的互动

   • 定义：治疗师与来访之间的互动是指治疗过程中双方的情感和行为交流。
   • 重要性：治疗师的情绪和反应直接影响到来访的行为和感受。良好的互动有助于建立信任和支持的治疗关系。
   • 具体实践：
     • 倾听：认真倾听来访的问题和感受，超越自己的反应。
     • 共情：展示深刻的共情，但避免过度投入而导致无效。
     • 灵活应对：根据来访的具体情况灵活调整自己的态度和方法。

4. 治疗师自我发展的具体步骤

   • 定义：治疗师自我发展的具体步骤包括一系列练习和活动，旨在帮助治疗师更好地了解自己，提升专业能力和个人品质。
   • 重要性：通过这些步骤，治疗师可以更好地理解自己的优势和脆弱性，从而更有效地帮助来访。
   • 具体实践：
     • 生命史练习：回顾自己的重要经历，了解这些经历如何塑造了自己的脆弱性和优势。
     • 来访历史审计：审视与来访互动的经验，了解这些经验如何影响自己作为治疗师的角色。
     • 反馈访谈：从信任的人那里获取关于自己优点和缺点的反馈。
     • 冒险实践：面对生活或工作中的挑战，有意识地挑战自己，克服对不适或不确定性的恐惧。
     • 治疗目的声明：明确自己作为治疗师的目标和愿景，以及希望提供的治疗关系类型。

通过这些知识点，我们可以更好地理解治疗师自我发展的重要性及其具体实践方法。这些内容不仅有助于治疗师提高治疗效果，也有助于他们在实践中不断成长和发展。

知识点阐述

1. 生命史的重要性

   • 定义：生命史是指个人经历的总和，包括正面和负面的事件，这些经历塑造了个人的身份、信念和行为模式。
   • 重要性：了解自己的生命史有助于个人更好地理解自己，识别自己的优势和脆弱性，从而在面对新情况时做出更明智的选择。
   • 具体实践：
     • 自我反思：定期回顾自己的经历，识别关键事件及其对自己的影响。
     • 情感连接：通过情感连接来处理过去的经历，特别是那些具有挑战性的经历。
     • 故事叙述：通过讲述自己的故事，理解事件之间的联系和意义。

2. 自我意识与成长

   • 定义：自我意识是指个体对自己内心状态、情绪和行为的认识。成长是指通过自我反思和实践，不断改进和发展自己的过程。
   • 重要性：自我意识和成长有助于个体更好地应对生活中的挑战，提高适应能力和幸福感。
   • 具体实践：
     • 识别模式：识别自己在不同情境下的行为模式，理解这些模式背后的原因。
     • 接受反馈：开放地接受来自他人的反馈，将其作为自我改进的机会。
     • 持续学习：通过阅读、培训和实践，不断学习新的知识和技能。

3. 情感与人际关系

   • 定义：情感是指个体在面对不同情境时的感受和反应。人际关系是指个体与他人之间的互动和联系。
   • 重要性：良好的情感管理和人际关系有助于个体建立支持性的社会网络，提高生活质量。
   • 具体实践：
     • 表达情感：学会健康地表达自己的情感，而不是压抑或逃避。
     • 倾听他人：认真倾听他人的感受和需求，建立深层次的理解和共鸣。
     • 培养同情心：对他人展现出同情和支持，特别是在他们遇到困难时。

4. 勇气与脆弱性

   • 定义：勇气是指面对恐惧和不确定性时仍然坚持行动的能力。脆弱性是指个体在面对挑战时可能感到的不安和不确定。
   • 重要性：勇气和脆弱性是个人成长的重要组成部分。勇敢面对自己的脆弱性可以帮助个体克服恐惧，实现更大的成长。
   • 具体实践：
     • 面对恐惧：识别并面对自己的恐惧，逐步克服它们。
     • 接受脆弱：接受自己的脆弱性，并将其视为成长的机会。
     • 寻求支持：在需要时寻求他人的支持和帮助，共同面对挑战。

5. 行为改变与改进

   • 定义：行为改变是指个体通过自我反思和实践，调整自己的行为以达到更好的结果。改进是指通过具体的行动来提升自己的表现。
   • 重要性：行为改变和改进有助于个体实现个人目标，提高生活质量和工作效率。
   • 具体实践：
     • 设定目标：明确自己的目标，并制定具体的行动计划。
     • 识别障碍：识别阻碍自己达成目标的行为和思维模式。
     • 实施改进：采取具体的行动来改进自己的行为，逐步实现目标。

通过这些知识点，我们可以更好地理解生命史的重要性及其在个人成长和发展中的作用。这些内容不仅有助于个人更好地理解自己，也有助于他们在实践中不断成长和发展。

知识点阐述

1. 治疗师的回避行为

   • 定义：治疗师的回避行为是指治疗师在面对某些情境、话题或情绪时，有意无意地避免直接处理的行为。
   • 重要性：回避行为可能会影响治疗效果，因为它可能导致关键问题未被充分探讨，从而阻碍了治疗进程。此外，治疗师的回避也可能导致来访感受到不被理解和接纳。
   • 具体实践：
     • 识别回避：定期自我反思，识别自己在治疗过程中回避的问题或情绪。
     • 探索原因：探究回避背后的原因，例如个人经历、情感反应或职业压力。
     • 逐步面对：通过逐步暴露和处理回避的情境，增强自己的心理灵活性和应对能力。

2. 脆弱性与治疗关系

   • 定义：脆弱性是指个体在面对不确定性、挑战或情感暴露时的感受。在治疗关系中，治疗师的脆弱性表现为能够真实地表达自己的感受和体验。
   • 重要性：治疗师的脆弱性能促进治疗关系的真实性，帮助建立信任和共情。当治疗师能够展示自己的脆弱性时，来访更有可能开放自己，分享更多的信息。
   • 具体实践：
     • 自我披露：在适当的情况下，适度地自我披露，以示真诚和开放。
     • 倾听与共鸣：认真倾听来访的情感和需求，展现出深刻的共情。
     • 保持界限：在展示脆弱性的同时，保持专业界限，确保治疗关系的安全性和有效性。

3. 治疗师的职业发展

   • 定义：治疗师的职业发展是指治疗师通过不断学习、反思和实践，提升自己的专业技能和个人品质的过程。
   • 重要性：职业发展有助于治疗师更好地应对复杂的治疗情境，提高治疗效果，并保持对职业的热情和动力。
   • 具体实践：
     • 持续教育：参加专业培训和继续教育课程，不断提升自己的专业知识和技能。
     • 案例反思：定期回顾和反思自己的治疗案例，从中学习经验教训。
     • 寻求反馈：向同事、督导或来访寻求反馈，了解自己的优势和改进空间。

4. 来访对治疗师的影响

   • 定义：来访对治疗师的影响是指治疗过程中，来访的行为、情感和反馈对治疗师的认知、情感和行为产生的影响。
   • 重要性：了解来访对治疗师的影响有助于治疗师更好地调整自己的态度和方法，从而更有效地支持来访。
   • 具体实践：
     • 自我反思：定期反思来访对自己产生的影响，识别自己的情绪反应和行为模式。
     • 情感调节：学习管理自己的情绪，避免因来访的情绪而过度投入或退缩。
     • 灵活应对：根据来访的具体情况灵活调整自己的治疗策略，以满足来访的需求。

5. 视角转换与共情

   • 定义：视角转换是指治疗师尝试从来访的角度理解其经历和感受。共情是指治疗师能够感同身受地理解来访的情感状态。
   • 重要性：视角转换和共情有助于治疗师更好地理解来访，建立深层次的治疗关系，并提供更有效的支持。
   • 具体实践：
     • 换位思考：设身处地地想象来访的情境，理解他们的感受和需求。
     • 情感共鸣：通过语言和非语言方式表达对来访情感的理解和支持。
     • 文化敏感性：尊重和理解不同文化的背景和价值观，避免文化偏见。

通过这些知识点，我们可以更好地理解治疗师在治疗过程中的角色和责任，以及如何通过自我反思和实践来提升自己的专业能力和治疗效果。这些内容不仅有助于治疗师更好地理解自己，也有助于他们在实践中不断成长和发展。

知识点阐述

1. 反馈访谈的重要性

   • 定义：反馈访谈是一种通过他人提供的意见和观察来更好地了解自己的一种方法。它可以帮助个体识别自身的优势和劣势。
   • 重要性：通过他人的视角，我们可以发现自身的盲点，更好地理解自己的行为模式和情感反应。这对于个人成长和专业发展至关重要。
   • 具体实践：
     • 选择合适的反馈者：选择那些了解你且关心你的人，确保他们的反馈是真诚且有价值的。
     • 准备心态：在访谈前做好心理准备，思考可能的反馈内容以及如何应对。
     • 倾听与澄清：在访谈过程中，保持开放的心态，认真倾听对方的意见，并适时澄清以确保理解正确。

2. 风险承担的意义

   • 定义：风险承担是指个体在面对不确定性和潜在不利后果的情况下，依然选择行动的过程。
   • 重要性：风险承担有助于个人突破舒适区，实现个人和职业上的成长。它不仅增强了个人的适应能力和解决问题的能力，还能提高自信和韧性。
   • 具体实践：
     • 设定目标：明确你要承担的风险是为了达成什么目标。
     • 逐步推进：从小的风险开始，逐渐增加难度，逐步提升自己的承受能力。
     • 寻求支持：与他人分享你的计划和进展，获得他们的支持和鼓励。

3. 勇气与脆弱性的平衡

   • 定义：勇气是在面对困难和不确定性时依然坚持行动的能力，而脆弱性则是面对这些情况时感到不安和恐惧的状态。
   • 重要性：勇气和脆弱性是相辅相成的。勇气帮助我们面对挑战，而承认和接纳脆弱性则使我们更加真实和完整。
   • 具体实践：
     • 自我反思：定期反思自己的情绪和感受，识别何时感到脆弱。
     • 表达情感：学会健康地表达自己的情感，而不是压抑或逃避。
     • 建立支持系统：寻找可以信赖的朋友或导师，与他们分享你的感受和经历。

4. 持续改进与自我成长

   • 定义：持续改进是指不断学习和改进自己的过程，自我成长是指个人在知识、技能和情感层面的全面发展。
   • 重要性：持续改进和自我成长是个人成功的关键因素。它们帮助个体不断提升自己，适应变化，实现更高的目标。
   • 具体实践：
     • 设定短期和长期目标：明确你要达到的具体目标，并制定实现这些目标的计划。
     • 定期反思：定期回顾自己的进步和不足，从中吸取经验教训。
     • 终身学习：通过阅读、培训和实践，不断学习新的知识和技能。

5. 团队合作与相互支持

   • 定义：团队合作是指多个个体共同努力实现共同目标的过程，相互支持则是指在这一过程中彼此提供帮助和鼓励。
   • 重要性：团队合作和相互支持能够增强团队的凝聚力和效率，帮助个体在面对挑战时更有信心和动力。
   • 具体实践：
     • 建立信任：通过坦诚沟通和相互尊重，建立团队成员之间的信任。
     • 共享信息：及时分享信息和资源，确保团队成员都能获得所需的支持。
     • 庆祝成就：认可和庆祝团队和个人的成就，增强团队的士气和凝聚力。

通过这些知识点，我们可以更好地理解反馈访谈和风险承担在个人成长和发展中的作用。这些内容不仅有助于个人更好地认识自己，也有助于他们在实践中不断进步和提升。

知识点阐述

1. 治疗目的声明的重要性

   • 定义：治疗目的声明是一种明确表达治疗师个人价值观、目标和愿景的陈述。它帮助治疗师清晰地认识到自己的职业方向和意义。
   • 重要性：通过撰写治疗目的声明，治疗师可以更好地理解自己的职业动机和目标，从而在实践中更加专注和有动力。这有助于提高治疗效果和职业满意度。
   • 具体实践：
     • 反思与收集：回顾职业生涯中的重要时刻和经验，收集对自己有启发的内容。
     • 识别主题：找出这些内容中的共同主题和模式，明确自己真正关心的方面。
     • 撰写声明：基于反思结果，撰写简明扼要的目的声明，反映当前的职业目标和愿景。
     • 定期更新：随着时间的推移，定期回顾和更新目的声明，确保其始终符合个人的发展和变化。

2. 个人使命与专业规范的平衡

   • 定义：个人使命是指治疗师在职业生涯中追求的个人价值和目标。专业规范则是指行业内的标准和规则。
   • 重要性：个人使命为治疗师提供了内在的动力和方向，而专业规范则确保了行业的标准和伦理。两者之间的平衡对于治疗师的职业发展至关重要。
   • 具体实践：
     • 坚守个人使命：即使在专业环境中，也要坚持自己的个人使命，不让外部因素削弱其重要性。
     • 遵守专业规范：在日常工作中严格遵守职业道德和规范，确保提供高质量的服务。
     • 寻求支持：与同事、督导或其他专业人士交流，寻求支持和建议，帮助平衡个人使命与专业规范。

3. 自我意识与勇气的培养

   • 定义：自我意识是指对自己的情感、行为和动机的深刻理解。勇气是在面对困难和不确定性时依然坚持行动的能力。
   • 重要性：自我意识和勇气是治疗师成功的关键因素。它们帮助治疗师更好地理解自己，处理复杂的情感问题，并在治疗关系中保持真实和开放。
   • 具体实践：
     • 自我反思：定期进行自我反思，识别自己的情绪反应和行为模式。
     • 勇敢面对：勇于面对自己的弱点和挑战，不断提升自己的能力和应对策略。
     • 建立支持系统：寻找可以信赖的朋友、同事或导师，与他们分享自己的感受和经历，获得支持和鼓励。

4. 持续的自我反思与风险管理

   • 定义：持续的自我反思是指定期回顾和评估自己的行为和决策。风险管理则是指识别和应对潜在的风险，以实现个人和职业目标。
   • 重要性：持续的自我反思和风险管理有助于治疗师不断改进和成长，避免职业倦怠和道德困境。
   • 具体实践：
     • 定期反思：定期回顾自己的工作和生活，识别成功经验和需要改进的地方。
     • 制定计划：根据反思结果，制定具体的行动计划，逐步实现个人和职业目标。
     • 风险管理：识别潜在的风险和挑战，制定应对策略，确保职业发展的顺利进行。

5. 多情境下的自我评估与调整

   • 定义：多情境下的自我评估是指在不同的情境下对自己的表现和行为进行评估。调整则是根据评估结果进行相应的改变。
   • 重要性：在不同的情境下进行自我评估和调整有助于治疗师适应各种情况，提高灵活性和适应能力。
   • 具体实践：
     • 情境分析：识别不同情境的特点和要求，了解自己在这些情境中的表现。
     • 评估与反馈：通过自我评估和他人反馈，了解自己的优势和不足。
     • 灵活调整：根据评估结果，灵活调整自己的行为和策略，以适应不同的情境需求。

通过这些知识点，我们可以更好地理解如何通过撰写治疗目的声明来明确自己的职业方向，同时在个人使命与专业规范之间找到平衡。这些内容不仅有助于治疗师更好地认识自己，也有助于他们在实践中不断进步和发展。

CHAPTER 6 Know Yourself To fully relate to another, one must first relate to oneself. —­Irvin Yalom W hy did you become a therapist? Let’s look at what some therapists participating in the online FAP community have to say. I knew what it was to suffer. I wanted others not to be alone in that suffering. To be there when others want to run, when even you want to run. I fell in love with the science of psychology at a time in my life when I felt a strong need to learn more about myself. Then, after witnessing the great potential psychotherapy had for bettering the lives of people, I decided that practicing it was what I wanted to do with mine. I wanted to pull one other person out of the hole I had been in. At the beginning, to help people suffering. Right now, it is a selfish reason; I am a psychotherapist because it makes me a better person. One of the reasons was to learn how to heal, and to bring that back to my family. Because helping others helps me, and I wanted to turn what happened to me into something good. When I was a teenager I experienced some losses and some pain, and in facing them I recognized the importance of having loving, meaningful, and deep connection with others as a way to heal the wounds I have in my heart. Unquenchable curiosity about the formation and the falling away of knowledge about ourselves and the world around us. Seeing the opportunity to be of service to another person by simply being myself. First I wanted to save the world. Then I realized I can barely save myself. Now I am content if my clients can just sit with themselves. I wanted to make sense of repeated existential crises I experienced as a child, which I continue to experience to this day. I wanted to understand and support my own sense of lostness and other vulnerability and extend my support to others around me—­ultimately to feel less alone. I had a wonderful psychotherapist that made an actual difference in my life. I wanted to do the same for other people. I wanted to understand people, and life. I was deeply curious about the whys behind life trajectories, the whys behind (my own) suffering—­and the big question about the meaning of life—­all the ponderings of a soul-­searching teenager… Only later on it turned into a wish to help others. To understand more deeply why I do the things I do, and why others do the things they do, and with that understanding decrease our mutual suffering. To understand why people (some people) are so miserable. I wanted to help myself and others feel they had real choices in their lives. To have the life they really yearned for. And to know what that was. I was taught from a young age that feelings don’t matter. I got therapy for major depressive disorder as a young adult and had to reorient my approach to emotions. After what I’ve been through, I feel so much empathy for people who are suffering emotionally. I wanted to do something to help others feel better. Curiosity about how people work, how misery works, how triumph works. How families fall apart. A love of story. It is very reinforcing to perceive that I truly “see” someone. I feel reinforced when someone “sees” me—­the good, bad, and ugly. I spent a long time dangerous and destructive. In doing therapy, I could see a way to be useful. That has meant a lot to me. Because I genuinely enjoy seeing people “waking up, becoming alive, and starting to live” this life and taking care of themselves. I wouldn’t put this into words then, like now, but I have the same look in the eyes when I am witnessing “waking up” as then. I woke up and started to take care of myself at the age of twenty-­five, and I am still learning how to live this life. I wanted to help people and better understand my family. And luckily I found the healing through connection, and now I want to show the same path to my clients. Self-­knowledge has always been a fascinating field for me. Being influenced as an adolescent by Socrates and Scott Peck, I took the decision to dive into the exploration of self-­awareness and to encourage others to do this leap as well. I loved ideas and stories of suffering and redemption but believed I was too awkward and deficient to ever help people. At a certain point, because some key people believed in me, I decided to take on the challenge of becoming what I thought I could not be, and of helping others enter their fear and shame as well. In a moment of cynicism an armchair critic might say, “Therapists are in it for themselves—­ they’re all just working out their own issues.” This is meant to disparage therapists, but the cynic misunderstands our purpose and goals. Our personal commitment to our work—­why we do it—­is one of our greatest sources of strength, insight, and empathy. As in any profession that demands intellectual and emotional labor, creativity, persistence through ups and downs, independent thought, and dedicated study, the most compel- ling whys are always deeply personal. If we are to be effective in our chosen field, it is crucial that we are grounded in a living sense of purpose that makes the struggle meaningful. Besides purpose, you are present in the therapy you offer in other ways. Most concretely, in any given moment of any given session, you are not outside the process looking in. You are as central to the process as the client; your reactions are the medium of therapy. We’re not just talking about your techniques and grasp of theory, but also your emotions, your avoidances, your willingness to feel, and your personal experiences and how they shape what you bring to the therapeutic relation- ship. Your worldview. Your convictions. This is the landscape of working as a therapist (Alves de Oliveira & Vandenberghe, 2009; Vandenberghe & Silvestre, 2014). FAP asks you to ground your practice by relating well, to yourself and others, deliberately and effectively across a whole range of social relationships, roles, and situations. FAP shares this focus on personal practice with numerous other therapy approaches: • Psychoanalytic training involves completing your own analysis. • Dialectical behavior therapy asks therapists to develop a personal mindfulness and skills practice. • Acceptance and commitment therapy asks therapists to practice psychological flexibil- ity using the processes in the hexaflex. • Compassion-­focused therapy asks therapists to develop a compassion practice. Across all of the approaches listed above, therapist self-­development is as much about ensuring that therapist issues remain distinct from client issues as it is about inviting the therapist to partici- pate in a more self-­disclosing, self-­involving way. For example, when a client becomes angry at you and you “feel disrespected,” will you remain flexible and therapeutic? Or will you react impul- sively? Will you listen beyond your own reaction to hear what the issue is for your client, distinct from what it is for you? Your ability to notice and modulate your own reactions contributes to what you will tend to evoke (or avoid evoking) and reinforce (or fail to reinforce) in your clients. For example, if you feel angry or ashamed when a client gives you the feedback that she didn’t understand what you just explained, you may subtly punish or extinguish such feedback—­even if that’s the last thing you would want to do. If you are averse to “conflict” or avoid making others “feel bad,” you may not address the negative impact a client has on other people—­and which you experience firsthand in the therapy relationship—­thereby missing a crucial dimension of the client’s presenting issues. Nuanced self-­awareness allows you to step back from such patterns. By seeing them clearly and appraising their costs—­to you and to your clients—­you can instead find opportunities to engage your clients with a flexible balance of courage and compassion. Therapist self-­development is an ongoing reflective process, a self-­discovery process, as well as a skill-­development process. It is well supported by functional thinking. The therapist self-­development process (or struggle) is not just reflected in clinically relevant moments in the therapeutic relationship. Again and again in our consultation with clinicians, we see how the extended process of therapy itself—­especially the trial and error and persistence demanded by challenging cases—­brings therapists face-­to-­face with their own vulnerabilities around persis- tence, faith, trust, control, and so on. One consultee, for example, described feeling a sense of incompetence and uncertainty when her client did not respond to her initial interventions. In response she felt a great deal of pressure—­ grounded in a genuine empathy—­to help or solve her client’s issues. In other words, the function of her empathy was to increase her distress and ineffectiveness! With consultation, she came to realize that her pressure and anxiety led to more of exactly what the client didn’t need: an expecta- tion of changing, an urgent need to solve “the problem,” and a sense that the problem was intoler- able. And this intention came across to the client even with innocuous questions like “What are you feeling right now?” This urgency to resolve uncertainty and pain had a deep history for the therapist. By practicing acceptance of her own discomfort with uncertainty (and with awareness of how her past had shaped it), she gradually built a more flexible stance from which to empathize with the client’s pain, while remaining grounded in her own perspective, as a therapist, of trust and compassion. In turn she was able to more effectively invite her client to let go of “control” and instead find and embrace the choices he did have. When you master your own fears and vulnerabilities, you don’t just solve those particular issues—­your struggle with uncertainty, or criticism, or whatever; you learn, in a visceral way, what only genuine, boundary-­expanding self-­development can teach you. You learn what it means to face what seems impossible or overwhelming and to grow through the process. So often this is what we ask our clients to do, so knowing the territory personally is invaluable. In this chapter, we will walk you through a series of exercises designed to guide you in your personal practice of self-­development: • The life history exercise asks you to look at your most formative learning experiences—­ both negative and positive—­so you can see clearly where your current vulnerabilities and strengths lie and how your experiences shaped them. • The client history audit, paralleling the life history, asks you to look at how your experi- ences with clients—­throughout your career—­have shaped who you are and where you are vulnerable as a therapist. • The feedback interview is about stepping beyond self-­reflection and looking at your strengths and weaknesses from the perspective of someone you trust. • Risk-­taking is the practice of looking at the important things in your life or therapeutic work that you are avoiding, out of some aversion to discomfort or uncertainty, and deliberately challenging yourself to step forward. • Finally, the therapeutic purpose statement invites you to define who you are as a thera- pist, who you want to be for your clients, and what type of therapeutic relationships you wish to provide.

LIFE HISTORY We are creatures defined by our history. We think of who we are based on what we’ve done. Our expectations of how others will treat us are largely shaped by our history. We learn what will be painful and what will be safe. Because of this learning we are susceptible to missing the present moment and instead staying within the confines of what is safe. The life history exercise is about finding insight from your life story: how your history has shaped you, and in what ways it has created vulnerabilities and strengths. The goal of this exercise is to help you be effectively present in the therapeutic relationship. Telling your story is effective for this goal because it allows you to see the meaning of this moment by recognizing the specific episodes that preceded it. Telling your story is not about the details, rather it’s about the narrative—­how does the history make this moment meaningful? Just as you wouldn’t understand Return of the Jedi if you haven’t seen Star Wars and The Empire Strikes Back, you can’t understand the context of this episode of your life without knowing the past. Consider the following: •Why do angry clients make you especially anxious? Did you learn that anger is dangerous in your history? •How has your history left you unprepared to empathize with those who struggle at school? Did you always find effort relatively effortless? •How does the fear of making a mistake lead you to avoid certain types of vulnerability? Did you learn that making mistakes means you are incompetent or unlovable? Seeing clearly your story creates the possibility of understanding other perspectives. For instance, it may allow you to see that anger is not as dangerous as it feels, or that mistakes are a road to learning. Knowing our story well, even the most shameful chapters—­and living closely with it and sharing it with those who matter to us—­also tends to connect us with a broader sense of common humanity. In his memoir Telling Secrets (1991), Frederick Buechner makes this point and several others well: I have come to believe that by and large the human family all has the same secrets, which are both very telling and very important to tell. They are telling in the sense that they tell what is perhaps the central paradox of our condition—­that what we hunger for perhaps more than anything else is to be known in our full humanness, and yet that is often just what we also fear more than anything else. It is important to tell at least from time to time the secret of who we truly and fully are—­even if we tell it only to ourselves—­because otherwise we run the risk of losing track of who we truly and fully are and little by little come to accept instead the highly edited version which we put forth in hope that the world will find it more acceptable than the real thing. It is important to tell our secrets too because it makes it easier that way to see where we have been in our lives and where we are going. It also makes it easier for other people to tell us a secret or two of their own, and exchanges like that have a lot to do with what being a family is all about and what being human is all about (p. 2–3). Step 1 The first step is to make some kind of representation of your story, either visual or narrative. Option 1: Creating a Visual Timeline On a piece of paper, draw a vertical line down the middle of the page. Label the top of the line “now” and the bottom “birth.” To the right of the line, record positive life events, using the horizontal distance from the line to represent the degree of positivity; in other words, events farther away from the center line are more positive. To the left of the line, record negative life events in the same way. You need not write a detailed description of each event; a brief label is sufficient. Of course, some events may have both negative and positive aspects. In such cases, feel free to record the event on both sides of the line. Option 2: Writing a Narrative Write your history in narrative form. This format allows for more in-­depth description of the cir- cumstances and impacts of various events, but it can also be overwhelming. We encourage you to write freely in a way that works for you. Take as much or as little time as feels right. Do this exercise in a way that is a 2 for you. Step 2 Now step back and reflect on your story and how it has shaped you. You can do this immediately after completing step 1, but in our experience this second reflective step is often more productive after a pause of at least twenty-­four hours. When you’re ready to reflect, read through the following questions and pick a handful that seem relevant to you. If you can’t choose, work through all the questions in order. Awareness •Which key events most shaped who you are today? •What lessons did you learn about yourself from these events? •What lessons did you learn about others from these events? •What lessons did you learn about the world? •What effects have these lessons had in your life? How do they shape how you see specific people in your life? •How do you relate to these lessons? For example, do you accept them or resist them? Do you mostly keep them out of awareness, or do they often make up part of your mental landscape? Courage •As you reflect on your life history, where do you feel discomfort, which may be reflected by emotions such as fear, anxiety, or shame? •Which parts are the most painful to linger with? •Where do you feel urges to speed up and move on? If you slowed down, what would you notice? •What did you learn about taking risks by showing your emotions or vulnerability with others? Love •Where do you feel the most love or compassion in your story? •Can you bring more love or compassion to aspects of your story, perhaps those that are the most difficult to see compassionately? Step 3 Pick one theme from the preceding reflections on your life history that seems particularly relevant to your life at the moment. Then answer the following questions in the context of that theme. •What do you do that is counterproductive? What are your 1s? •In situations in which your 1s happen, what matters most to you? •Relative to your 1s, what sorts of behaviors might represent improvements? What are your 2s? •Look ahead to the coming week, or whatever time frame seems relevant, and identify a few sit- uations in which these 1s and 2s might happen. What would your 2s look like in these situations? Therapist Avoidance Questions Avoidance often occurs in the most difficult or stuck part of our relationships; avoidance of vulnerability limits our closeness with others and impacts our therapeutic relationships. As a supplement to thinking about your 1s and 2s in general, then, think specifically about the function of avoidance in your life. The questions below explore parallels that may exist between what you avoid in your daily life and what you avoid as a therapist. Write brief responses to each of the following question: 106 •What do you tend to avoid addressing with your clients? With the clients you have seen or will see this week, what are you avoiding? •How does this avoidance impact the work you do with these clients? •What do you tend to avoid dealing with in your life? Be specific, and consider tasks, people, memories, needs, and emotions (including longing, grief, anger, sadness, and fear). What are you avoiding this week? This month? This year? • How does your avoidance in daily life impact the work you do with your clients? Once you’ve identified particular areas of avoidance, you can begin to explore what your 2s would be in those situations. It can be useful to revisit these questions over time because avoidance evolves. Optional Exercise: Share the Life History with a Partner One final option for working with the life history exercise is to share your story with others. Sharing your story provides a natural opportunity for vulnerable disclosure and responsiveness from your lis- tener. In FAP trainings, we confine the verbal story to five minutes, not only for the sake of giving every- one time to share but also because brevity compels us to get to the essence of the vulnerability in the story sooner, rather than spending a lot of time on the details of storytelling. Share in a way that feels vulnerable, by which we mean taking a workable step beyond your normal comfort zone into a place of vulnerability. This can be either a small step or a large step; the choice is yours. Whichever life history method you use, take time to respond vulnerably and compassionately after each person shares his or her story. CLIENT HISTORY AUDIT Your history as a therapist also shapes who you are in therapy. On the one hand, many of us remember the client who got away, the client who pushed past all our limits, and the clients with whom we felt powerless. On the other hand, we may also remember the clients who most inspired us or taught us the most about something. In this exercise, you will make a detailed audit of your clinical history. The aim is to put all your clients on the table and, with clear eyes, reflect on how they’ve influenced you. Step 1 Make a list, by year, of all the clients you’ve seen. Consult old session notes, records, and so forth. If you’ve been in practice for more than a handful of years, this task may be quite difficult. Do it anyway, perhaps limiting your audit to the clients you can remember; however, if you have the records, by all means make an exhaustive list. You may add supervisors or consultants to this list as well. Step 2 Survey the list and pick out one client, or a handful, who shaped you the most, then answer the following: •What did you learn from these clients? •What did you discover about yourself? •What did you come to fear? • What do you tend to avoid now because of your experience with this client? Repeat this step with as many clients from your audit list as you wish. Notice any themes that develop in the lessons you learned from clients. Optional Step 3 The final step is an exercise in perspective taking. From the perspective of the clients you most strug- gled to understand or work effectively with, try to answer the following questions: •What did I experience and learn as a child? •How did I learn to cope? •What is my biggest fear? FEEDBACK INTERVIEWS We don’t always see ourselves clearly. And sometimes, in important ways, other people see us more clearly than we see ourselves. In this exercise, you will take advantage of this possibility. The feedback interview is intense because you invite others who know you and care about you to offer insights about your behavior—­both strengths and weaknesses. You elicit this feedback via a structured interview, during which you suspend your reactions (to the extent possible) and instead focus on drawing out and understanding the perspective of the other person. You may come to see yourself more clearly while expanding your grasp of your 1s and 2s. Step 1 Pick someone who knows you and has your best interests in mind. You can conduct the interview solely for yourself. Or, if appropriate and both parties agree, you can take turns conducting the interview. Pick someone you trust to give caring feedback; or, if you’re up for the challenge, you can certainly choose someone who might be bold or confrontational. Either way, be sure to explicitly invite the other person to be honest and compassionate. Step 2 Mentally prepare yourself: 108 •What are you afraid of? •What might you hear? •How would you react at your best? Step 3 Do the interview. We highly recommend using a script to structure the conversation. This can facilitate greater courage, whereas ambiguity or lack of structure can lead to avoidance. Here are some ques- tions you might consider using. Feel free to adapt them as you see fit. •What do you most appreciate about me? •What do you wish I would appreciate more about myself? •What do you see me actively working on in my life? •What do you see me doing that’s self-­defeating? •What do I do that brings others close to me? •What do I do that can put up barriers between me and others? •When I’m at my best, what do I do? •When I’m not at my best, what do I do? Just listen, and clarify. Thank the person for his or her insight. Step 4 Now it’s time to debrief: •Did the feedback fulfill your expectations? •Did the feedback match up with your existing self-­assessment? •How is the feedback-­giver biased? •How is the feedback giver more accurate than you (perhaps more than you’d like to admit)? RISK-­TAKING Risk-­taking is a central personal practice among members of the FAP community. Tim Ferriss, author of The Four-­Hour Workweek and winner of Wired magazine’s self-­promotion prize in 2008, writes that “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have” (2007, p. 47). The FAP version of this idea looks something like this: a FAP therapist’s success can often be measured by the number of uncomfortable conversations he or she is willing to have. In essence, the practice of taking meaningful personal risks builds skills that translate to the therapy room. Risk-­taking is about courage—­a willingness to move forward toward what matters while carrying your vulnerability or pain or uncertainty or the reality of failure or whatever comes. Below we offer some examples of practices you might follow to cultivate your risk-­taking in ways that will serve your development as a FAP therapist. Start with option 1 below and then consider options 2 and 3. Option 1 Step back and take a ten-­thousand-­foot view of what you are avoiding in life. Consider your profes- sional life, personal relationships, health, finances, home maintenance, family, spirituality, community, creativity—­anything and everything that is meaningful to you. For many people, there are a few linger- ing elephants that have not been squarely looked at for some time. You know what (or who) they are. Take a deep breath and name them. Write them down on a piece of paper or right here: Now consider these questions and write down your answers: What is most important for you to begin moving on now? And over the coming year? What is the internal or external obstacle you must face to begin moving? oasis-ebl|Rsalles|1490374138 Are you willing to move through that obstacle—­or figure out how to get around it—­in order to move forward? What do you need to do to get started?

Option 2 Every day, take a risk. Remember, “risk” is not the same as “reckless.” It is strategic. A meaningful daily risk may seem quite pedestrian. For example, be more assertive about how you want your meal prepared when ordering at a restaurant. Commit to send out invoices every week. Slow down, turn off your phone, and spend time with your kids (yes, that can be a risk for some). In contrast, a risk can be life changing. Reach out to your estranged brother and apologize. Send a thank-­ you note to your high school teacher. Sign up for a triathlon. Track your daily risks in a diary or some other kind of document. Rate the risk in intensity if you wish. Option 3 Find a colleague or friend or family member who wants to practice deliberate risk-­taking and share your risk logs with each other periodically. Meet over coffee or beer or online and give each other feedback about the risks you’ve taken. Give and let yourself receive appreciation. Gareth, one of the authors, exchanged risk logs with his close friend Chris Hall for a year. Chris was transitioning from unhappily employed to self-­employed to happily employed—­a major set of profes- sional risks—­and Gareth was moving through some of his own early career developments. Those talks were deeply motivating and satisfying highlights every month for both of them. THERAPEUTIC PURPOSE STATEMENT We’ll wrap up this chapter with an exercise in getting clear on who you are and what matters to you in your relationships with your clients and in your work as a therapist in general. While here we focus on your values as a therapist, we highly recommend that you commit to ongoing values work and goal setting more broadly. The acceptance and commitment therapy literature is full of great resources for these types of work (in particular, check out Dahl, Plumb-­Vilardaga, Stewart, & Lundgren, 2009). A note before we get started: While “purpose statement” connotes a finished, polished document, please do not approach this exercise with that goal in mind. Crafting a purpose statement is a practice that you will start imperfectly and then continue steadily—or sometimes in fits and starts—like shaping and reshaping a sculpture from a block of clay. Step 1 Reflect on the moments or messages or ideas or people that have been most inspiring to you in the course of your career; for example, the feedback of a specific client or supervisor, a therapeutic rela- tionship you thought was strong, or a type of therapy you found effective. Don’t worry yet about making anything coherent. Just assemble all the things that made you light you up in some way. Put them in a list or otherwise lay them out on paper or a screen. Step 2 What themes or patterns or unifying ideas do you see in the things that are meaningful to you? What tensions do you see that don’t need to be resolved because, in fact, you are committed to both sides of the tension? Is there anything you put down because “you should,” but in fact you don’t really care for that thing? What seems most important to you? Step 3 Given your reflections above, draft a single statement (or two or three) that captures who you want to be as a clinician today and where you want to focus your intention and energy today and in the coming ninety days. Let go of the need to make something that will last forever and be perfectly right. What feels right today? Step 4 This step is critical. Put your purpose statement aside for at least forty-­eight hours. Then revisit it and ask yourself if it’s still right. What would you change to make it more right for today? Rinse and repeat, continuing weekly or monthly or quarterly or annually forever.

A NOTE ON BOLD PERSONAL MISSIONS: DO NOT LET THE FIELD SILENCE YOU We are professionals. Our first steps into the field begin a process of professionalization, through which we learn to follow the path of what works. We mean this in the sense of what maintains the working of the profession, what obeys the rules and respects the risks that we have not personally experienced—­but that our profession has learned to respect. As students and professionals we benefit immensely from that learning. We agree to follow the laws and principles of professional ethics. We agree to serve our client’s needs and to act on the basis of what is effective rather than what we idiosyncratically believe. And yet beyond professionalism, our work is also intensely personal—­and difficult, and some- times lonely—­because, in part, of the professional structures (confidentiality, individual therapy) in which we work. There can also be a conservatism in professional contexts that insidiously dis- tances us from our more personal experience and values. For example, academic settings and pro- fessional organizations often communicate to clinicians that they should not be open about their own struggles with psychological suffering (and the sense of purpose that can arise from that suf- fering). Thankfully that trend is changing. If you hold a personal mission in this field, do not let the absence of that personal thing in the articulation of the professional rules and the professional context alienate you from it. Cling to your mission. It is not wrong. It may not be spoken by those around you. But it is vital and life giving. Hold on to what is vital. SUMMARY • Develop self-­awareness and practice courage and purpose in order to effectively navi- gate therapeutic relationships. • Maintain an ongoing practice of self-­reflection and courageous risk-­taking to move yourself toward what you care about. • Assess and shape your own 1s and 2s across diverse contexts.