Modality and Personality: Does Modality Matter?

Deena was interested in therapy, but she didn’t know where to begin. “I keep reading articles and hearing about different kinds of therapy: DBT, CBT, EMDR, IFS, and more! How can I figure out what type of therapy would work best for me?”

I can certainly understand why Deena felt overwhelmed; there are so many different therapeutic modalities and more information than ever before. While this can be empowering, it can also make one feel vulnerable and uncertain about their choice.

Knowing the relationship and communication style you tend to gravitate towards, or that ‘speaks’ to you, can be helpful and give some direction as well. Some therapies are based on a more practical and cognitive style and others conceptualize and operate more relationally and emotionally. There are many types of therapy available and it’s not uncommon for therapists to blend therapeutic approaches, although there are therapists that are firmly committed to a specific modality.

I once met with a representative of a referral agency, who put emphasis on modality. When I shared that I prefer to customize a counseling approach for each client, she shared her perspective that training in specific modalities is important. I do agree that modality training in general is very important, both to keep up with current practices as well as to have clarity in the way to guide treatment. Some clinicians take a highly focused approach that is very specific to one modality, while others (like me) prefer to train in a variety of modalities and integrate techniques and approaches most appropriately. Often I find there to be a fair amount of overlap in which modalities serve to enhance each other (for example, Emotion Focused Therapy [EFT] and Internal Family Systems [IFS]).

Two of the most popular forms of therapy practiced today include (among many others):

• Cognitive Behavioral Therapy (CBT): This approach focuses on the connection between thoughts, feelings, and behaviors, and the impact that each of these have on oneself.
• Internal Family Systems (IFS): This modality is a more recent and popular one. This modality encourages the idea of ‘multiplicity of self’ and is helpful in guiding one to tap into the complex thought processes that go on within. A word often associated with IFS is ‘parts’, with the client connecting with different parts of the self and exploring the function or purpose that these parts serve. IFS allows for a deep inner connection which is incredibly powerful and healing.

Internal Family Systems takes a deeper look at the complex system of interactions among the parts, and encourages connection. Cognitive Behavioral Therapy helps adapt and change your mindset and behaviors by reassessing unhelpful thought patterns.The similarity between these modalities is that once a person is able to recognize their different thought patterns and emotions, it allows for access to more authentic joy, peace, and connection.

These modalities can be used in couples counseling as well. Other popular couples counseling modalities include Emotion Focused Therapy (EFT), Imago Therapy, and the Gottman method. While each of these approaches might have specific techniques and focus, the underlying premise is that each person has emotional needs, often based on their attachment or childhood/life experiences, which drives their behavior. The ability to recognize this, be vulnerable with oneself and with one’s partner, and to be able to share childhood experiences and resulting needs, allows for an incredibly deep understanding and connection.

“I never realized what Tehila needed from me until we were in counseling together. When she shared how important it was for me to show up physically, especially because she had been so parentified as a child, I stopped being so resistant to her requests. I realized she wasn’t trying to limit my freedom or be demanding,” Nate shared. “I also realized where my resistance to showing up stemmed from, and we were able to figure out what my needs are and how Tehila can show up for me, too.”

In my opinion, as important as an appropriate modality is, I believe it can be even more useful to assess the following 2 points:

1. Readiness for therapy
2. The connection between oneself and the therapist.

Are you ready for therapy?

Therapy involves honesty, and may challenge you to examine deeply rooted perspectives and thoughts. In addition to the vulnerability of self-disclosure, the willingness to receive feedback can sometimes be difficult. Honest self reflection is a key component of therapy, no matter what modality the therapist is trained in.

Gita recognized that her neighbor, Shuli, had been acting differently lately. Shuli seemed so much more self confident and comfortable in her own skin. Gita approached Shuli, who shared that she was in therapy and was gaining so much insight and self awareness. Gita felt motivated and excited to feel more positively about herself and her connection with others around her, and decided to create space for therapy in her own life as well. However, Gita struggled to accept that in order for things to change in her life, she had to do things differently. She spent her time in therapy sessions listing the faults of those around her, and how she had been wronged in so many ways. When her therapist tried to redirect Gita to reflect or consider her patterns, parts, or explore the connection between thoughts, feelings, and behaviors, Gita got frustrated.

Gita was seeking validation without expecting herself to self-reflect or change anything. True readiness for therapy is reflected in readiness not just for ‘things to change’, but to make change- to be a part of creating new, different, more helpful thought and behavior patterns.

You don’t need to walk into a therapist's office and immediately feel a deep connection and trust. You do need to feel comfortable, with the perspective of being able to come to trust this person. It may take several sessions to build a really comfortable rapport, and that is normal. It can be really challenging to meet a therapist, who is essentially a total stranger, and consider baring vulnerability right away. To get more of a feel for the potential of developing a relationship, it can be helpful to find the person on media, get a reference from someone you trust, and even have a short phone call with the therapist first.

There are many therapeutic modalities available, and it can be easier to learn about what type of modalities are out there than it is to choose which is best suited for you. The bottom line is that modality and personality are both important: you want to vibe not only with the technique, but also with the person you will be working with. Most importantly, the readiness to approach this space of self awareness and growth, combined with your own commitment and effort is what can get you to your goal.

This first appeared as a column in the Five Towns Jewish Times