"Not a coping skills kinda therapist"

Recently, I've been hearing more than ever before the phrase, "coping skills" as it relates to therapy. And each time, I have the same basic response, which is, "I'm not a coping skills kinda therapist." And of course I explain what I mean by that, but I thought I'd comment on it here too.

Of course, to a certain extent, "coping skills" can just be a buzz word (phrase?) that takes off, which I assume has happened lately. And, of course, all therapy does include increasing coping skills in one way or another. But, when I say, "I'm not a coping skills kinda therapist," I mean that I'm not a therapist whose focus is teaching this or that coping skill. I guess my thought process is that, essentially, one can read a book and be taught coping skills, so why would I be charging people to do the same?

That probably means I should find some really good coping skills books, but, I promise, I tried for years to read self-help books so I could recommend them, and I just cannot. I mean, do you want to read about your work during your free time? No, me neither...

So, if I'm not a coping skills kinda therapist, what kinda therapist am I? Well, in graduate school, we had to "defend" our therapeutic approach prior to them letting us go out on internship. I had a firmly held belief that Interpersonal Therapy and Cognitive Behavioral Therapy worked together in eating disorder treatment. Now, I was warned to never try to defend this at the time. Butttttt, I'm stubborn, and it genuinely was my approach to therapy, so I did exactly that. And, against all odds, I passed. Shortly thereafter, it became more mainstream to see these two approaches, previously seen as somewhat opposite, as blending well. Whew!

It's been a long time since graduate school, and I work very hard to not speak in psychobabble, so here's a very short blurb of how I see IPT and CBT going hand in hand in ED treatment: Interpersonal therapy basically looks had how relationships have impacted a person (the very, very short version) and sees healing as existing in relationship. CBT challenges your thoughts and behaviors (pretty obvious how that applies to EDs). I believe that our experiences in our relationships impact our thoughts and behaviors. (Believe me, I had to say more than that perfectly clear sentence to defend it a the time!!) And, I believe relationships are what have the power to provide healing.

So, early in treatment, I am more CBT. The behaviors must change for reasons thoroughly discussed in other posts. But, the other focus is building a relationship where what I say matters, and a relationship in which healing can occur. And that is anything but "coping skills kinda therapy." I can teach a coping skill without any real relationship; again, a book can teach a coping skill. But, what I hope to be able to do is understand someone on a deep enough level that I can help them to make lasting change.

(On that note, if you ever want what I believe to be a massive challenge....try writing what you hope to accomplish as a therapist without sounding like a fluffy...well...ball of fluff. It's not easy to put into words.) 

I will tack on...I do also believe both IPT and CBT help someone work through PTSD also, though believe it is MUCH MORE about the IPT and also body-focused therapies advocated for by Bessel van der Kolk and Peter Levine.