The guide to Therapeutic Modalities: What do all those acronyms mean anyway?

IFS, EMDR, AEDP, what do all these letters actually mean?!?

It can be frustrating as you’re looking through the Good Therapy website, trying to find a good therapist, when all these acronyms, or different treatment types are thrown around. This post will help you understand the different modalities of therapy that we use at the Phoenix Counseling Collective, as well as which therapists use the different modalities- so if you do have experience with a therapy that worked well for you before, you can choose a therapist that uses that method, or if you’ve heard of good things about a particular type of therapy, you can select a therapist who uses it to see for yourself.

IFS/Parts Work:

IFS stands for “Internal Family Systems” and was developed by Richard Schwartz. In this therapy rather than fighting the different parts of ourselves (and especially those parts of us that we don’t like) we actually get curious about them and their roles within the internal system. When we do this, we often find that in fact, these parts of us play significant roles and they actually are helping us function, even if the way they are going about it might not be the best.

If you have ever heard yourself say “A part of me really wants this but another part of me isn’t so sure” then you likely understand what it feels like to have parts of ourselves in conflict with each other. Together we break down the various parts of yourself to understand our Exiles (the parts of us that are self-conscious, cautious from past woundings, and often prefer to go unnoticed), our Managers (the parts of us who are image-focused, performative, and ensure the world sees us as good enough/worthy), and our Firefighters (the parts of us who become defensive/reactive to the presence of our Exiles). With an improved insight into how these different parts of you fight to run the show we can help them to be less reactive and instead operate authentically. By joining with these parts we can learn to integrate and allow our true Self to live fully and well. The belief that the human mind is made up of enumerable parts is a big part of IFS. We have a self that is the essence of who we are, but we are multifaceted and multidimensional. We are capable as humans of holding great hostility toward someone or something and at the same time holding great affinity and love for that same thing. How is that? Well, we hold those feelings in different parts of ourselves. For example, we might be perfectionist and driven one moment, and also find ourselves procrastinating and avoidant. On deeper levels, we might hold deep sadness and pain, but find ourselves acting out in anger or rage unable to experience more painful emotions. In IFS therapy, we get to know our “parts” and how they function. With clearer awareness of our parts we are able to heal wounded parts, help sad or anxious parts find relief and ultimately work to establish healthy ways for our parts to “coexist”. If you have watched the movie “Inside Out”, you’ve seen a glimpse of how IFS views our inner worlds. In therapy, we patiently and gently explore that inner world working towards greater awareness and healing. Eventually, we can acknowledge these parts but can still be available to lead ourselves instead of being taken over by any certain “part”.

Pros:

This therapy is easy to conceptualize.

One of the greatest benefits to this model is deeply painful memories do not need to be accessed to find healing.

EMDR – Eye Movement Desensitization and Reprocessing:

EMDR is a specific modality that helps people more readily access their unconscious and process painful and or traumatic events. This is modality that uses bilateral stimulation (in essence pinging between the right and left hemisphere of your brain with the use of eye movement or tactile stimulation) to help you access the deeper (and often past) emotional and cognitive messages that you are responding to in the present. In this therapy, there is a specific protocol that is observed that allows the brain to begin to heal itself. This modality can help us come to some peace with past trauma so that the energy of the event or the fear of it happening again is not experienced in the present.  In this type of therapy, you can share very little details with your therapist, and still get very good results. If we experience our emotion at a 7, 8, 9 or 10 when we experience anxiety, fear, or anger/rage, we are probably re-experiencing something from the past. This can give us a clue that the negative beliefs about ourselves (such as “I am not good enough”, “I cannot handle this”, “It is my job to fix it”, etc) rooted in our past, are being activated. EMDR helps our mind to store these formative experiences in a more adaptive way which helps with current triggers, having a more positive self-image, while improving insight into how we became who we are today.

Pros:

Helps those with “simple” (meaning one) and “complex” (meaning more than one, or even layered) trauma

It is especially helpful with PTSD symptoms, like flashbacks and extreme responses to triggers

Narrative Therapy:

This modality has a lot to do with the way we understand things, which is altered by our definitions, stories, and experiences. It is based on the our experience and our reality in our language. Externalization- which is separating the person from the problem- is extremely helpful. It helps to put a name/image to the problem and it starts to separate our own voice from the problem’s voice. In this model, we externalize our problems or traumas from ourselves. The stories that we tell ourselves matter. Our stories not only tell us where we’ve been, but also who we are and where we are going. It is in these stories that we have experienced both great joys and great losses, and have learned how to relate to others and our world around us. How we live in our relationships is core to who we are and how our story continues to unfold. Together we can walk through the stories and relationships of the past in order to illuminate the true self and help you live more freely in your world today. For instance, What is anxiety telling you? How is that different from your own voice? How do you picture anxiety? etc.

You may have seen the quote “You are not what happened to you.” This is the essence of narrative therapy. Often, especially as young people, we tend to conceptualize our treatment/mistreatment as being central to who we are. This can create anxiety, depression, self-image/esteem issues among many other things. A narrative approach separates the story from the person. This model helps you discover your own strength, resilience and make sense of difficult or confusing experiences. It helps you to rewrite your story, and make the parts of your story rich that ought to be rich. For example, if the theme of your life seems to be “I am worthless,” but you’d like it to be “I am an individual worthy of love” then we would look at times that this theme has been true in your life, and work to turn that story into a saga. This therapy is often used in conjunction with other types of therapy. Part of being aware of ourselves requires that we know our history and what stories we may be “re-living” on a daily basis. By knowing what stories we may be attempting to avoid or repair, we can begin to decide how we want to write the story differently and hope for something new vs just trying to “fix” their past in the present.

Rogerian:

This theory was developed by Carl Rogers. He believed in unconditional positive regard toward the client because he believed that the ability to grow comes when one accepts themselves. Often clients come in wanting to be a different person, but invariably it is this energy spent on “cutting out” or “killing” their very selves that is causing them so much distress. When they can come to some peace with themselves then change comes as they look to further their own good. It is like the football player who tries hard to win vs the one who is merely trying to not lose.

AEDP – Accelerated Experiential Dynamic Psychotherapy:

AEDP is a therapy that starts with the foundation that every person has an innate healing capacity and that we just need the right environment to unlock the healing capacities. One way to foster and tap into this innate healing capacity is through what AEDP calls “undoing aloneness.” One way to undo aloneness is by establishing a relationship between client and therapist that is both a safe haven and secure base. AEDP therapists are affirming and supportive. AEDP works deeply with the emotional experience. It focuses on building moment to moment awareness to the client’s emotional, relational and physical experiences as they are unfolding in the therapy session. We are interested in “what is happening for you right now/what are you feeling right now as you talk about____?” AEDP therapists believe that core emotions like sadness, fear, disgust, anger, grief, excitement, joy and sexual excitement are there as an amazing compass to help us navigate through life. These core emotions help us to know what we like, what’s important to us, what hurts us. Denying or ignoring these emotions can lead to a loss of sense of self, anxiety, depression, difficulty finding joy and peace in life. But it doesn’t have to end there! An AEDP therapist can help you get to know your emotions and feel more of your true Self.

Relational Psychotherapy/Relational Psychodynamic:

All theories start with the basis of change, and relational psychotherapy believes that it is in the midst of relationships that we change. The relationship between the therapist and the client is unique in that it is primarily for the client and the work we do is to help the client know himself or herself more clearly. When he or she is more aware of how they are in the room, then they can be more aware of how they present themselves in the outside world and begin to make decisions about how they want to be.

Clients often tell us with their words and actions who they are, what they struggle with, and what they hope for. From a relational psychodynamic orientation, we also look at the relational components between the therapist and clients. What’s going on in the in between? A good bit of information lies in the in between, and if we allow ourselves to slow down, feel the feelings, experience the sensations, and be present then we can dip into the unconscious & subconscious and bring it into awareness. And in this awareness we begin to find that we have choices that we didn’t use to think we had.

Systems:

As marriage and family therapists, we were trained in systems work. This means that rather than view clients in isolation, we do our best to understand the entire system that they are a part of. “Everything makes sense in context” is a quote that speaks to systems theory. By working to understand the context, and particularly the feedback that clients are receiving, helps the therapist to see their system. Then we can slowly and sustainably make changes to that system, rather than changing everything at once. People affect each other, especially within families. It is necessary to explore family of origin because what happened there still affects us, and requires us to work through those impacts.

Systems theory is often the underpinning of all of the other modalities of therapy that are used. “The whole is greater than the sum of its parts” is a concept of systems therapy that comes into play in the therapy room often.

Mindfulness:

So often we as humans act on auto-pilot. We respond to stimuli in our day and can wonder, “Why did I get so mad about that?” or “Why am so scared to do this right now?” Becoming more mindful of ourselves and our surroundings can offer us the space we need to try and make a different choice than what would be our normal mode of operating. Therapy is much about slowing down our process and getting some of the space.

Gottman:

John and Julie Gottman’s work and research is an incredible resource to the world of systems. Their work puts numbers to the concept of “Systems.” Whether it be their 5 to 1 ratio, the concept of Negative Sentiment Override, bids for connection, or any other number of their contributions, their work is often running through the minds of these therapists. It is very helpful to have research that demonstrates with numbers what we see clinically, and the concepts they use can be very helpful to couples starting out in the world of therapy. The language they use is so helpful and clear. This aides couples in sorting through the feedback and communication they are receiving from each other. Couples who function effectively treat each other with respect, consideration, and act as a place of refuge for one another. The Gottman approach helps couples to identify which areas of their relationship are currently not effectively functioning (some of these pillars include finances, sexually, spirituality, having shared meaning, approach to and repair from conflict, raising children, understanding how your partner thinks about and approaches their world). We help approach these fundamental aspects of our relationships without the Four Horseman present (Criticism, Defensiveness, Stonewalling, and Contempt) building trust, accountability, and fondness in your relationship.

SE – Somatic Experiencing

Our emotions begin in our bodies. We have a somatic or physical response before we ever cognitively realize we are experiencing an emotion. More and more science is showing us that our bodies are central to healing trauma and central to being able to regulate our emotions and heal our emotions. The concepts behind SE foocus on your felt experience in the body and aim to relieve the effects of trauma and stress on the body. Often people who have experienced stress and trauma may find their bodies get “stuck” in fight, flight or freeze. This therapist uses concepts from SE in connection with IFS in a “bottom-up” approach – the body will lead us to what needs to be addressed.

Pros:

One of the greatest benefits to this model is deeply painful memories do not need to be accessed to find healing.

Experiential Therapy:

At its base, experiential therapy means to experience something differently. That’s a big goal of this therapist. Something isn’t working so let’s work on doing something differently. Specifically, this modality focuses on experiencing differently, which is a step beyond thinking differently. We cannot know what we haven’t experienced. This means that we will bring emotions into session so we can work on them right there- that way the groundwork is being laid for you to continue the work outside of therapy. Experiencing differently is important for couples, families, and individuals. With particular clients, this also means bringing things into session that can help us experience differently like art, breathing, etc.

CBT/DBT:

Some of the techniques of these therapies have been very helpful to this therapist. Slowing down our cognitive processes, and using skills like a behavior chain analysis (where you are looking for patterns in behavior and linking them to your thought patterns) can be helpful when we feel like we “can’t stop” doing something. Or using mindfulness or radical acceptance strategies from DBT to help slow us down, so we can then connect with ourselves can also be useful tools in therapy.

Attachment and Reparenting:

Attachment to the most influential people in our lives is a normal and fundamental aspect of our humanity. Unfortunately, as children and into adulthood we often do not experience our needs being met in the way that we would like in order to feel unconditionally loved, accepted, and secure. This approach in therapy helps you to build first a safe attachment with yourself to feel confident that you will never leave, abandon, or choose something harmful for yourself, then expand that confidence into safe attachments with the important people in your life.

Attachment Theory:

While attachment theory isn’t an official modality, it influences how this therapist sees most of the therapeutic orientations. Attachment theory looks at ways of relating to others (via thoughts, feelings, behaviors, patterns, and interpersonal exchanges) based on how we implicitly and explicitly learned how to navigate life from our primary caregivers and early relationships. Usually these patterns are so ingrained in our ways of relating that if we continue to go through life without awareness, we just keep repeating the same patterns over again. But by taking into account how our primary relationships left an imprint, we can then have more choice in our present day relationships.

Interpersonal Neurobiology:

This is a cross disciplinary look at how the mind, body, and relationships all impact one another. In a well integrated mind and body, we can find more peace and freedom anxiety and depression, while when we are functioning from an non-integrated or threatened mind, we respond out of our primal brain and can get stuck in our stress cycles. Our minds, of course, are extremely complex, and so this approach takes into consideration how our early attachment affects the development of our brains, how our nervous system responds to threats and stress, and how all this impacts our daily lives and relationships.

EFT – Emotion Focused Therapy:

This is therapy that includes work with emotions, first formulated by Les Greenberg and Sue Johnson. You might think that all therapy focuses on emotion, but in fact, much of therapy is “talk therapy” where sometimes what’s going on beneath the surface can be ignored. In Emotion Focused Therapy, what is going on in the body is paid attention to, and listened to. “Emotions are the language of the body” and by working to learn that language, we also learn the wisdom of the body. This helps us to make the unconscious (or subconscious) conscious. When we do this, we have choice about what we do with our emotions. Much like IFS, emotions are not viewed as “bad”, but rather having good intentions. Once we drill down to those, we can understand our emotions better, and what the intention is behind the behaviors. When working with couples, the core emotions are accessed, shared, and needs are expressed not only to self, but also to your partner.

Grief Therapy:

Most people may assume you go to grief therapy to help grieve the death of someone in your life. While that can be true, this therapist also uses grief work with almost all clients. When there is loss, we mourn and remember what is no longer with us, and are challenged with facing decisions about life and what’s ahead. This can provide a fertile – deep, aching, longing, rich, and vacant – soil for growth and hope. We face loss all throughout our lives; loss of relationships, loss of jobs, loss of neighbors & communities, loss of dreams. And with each of these losses, we must consider the impact of that loss on our life.

SP – Sensorimotor Psychotherapy:

SP is a somatic (body-centered) approach to working with trauma and attachment issues. SP believes that the body has innate wisdom that often cannot be known or discovered through talk therapy alone. With SP there is no need to retell your trauma story, in fact, that can often be retraumatizing. SP uses a body-centered approach that does not necessitate the retelling of details in order to heal from traumatic experiences. SP therapists encourage curiosity and awareness to allow the wisdom of the body to guide the natural drive towards healing. During traumatic situations our bodies automatically respond with the fight-flight-freeze-fawn response in order to help us survive. However, sometimes in a traumatic event these responses may not have been completed or attempted at all. When these responses are not completed or attempted, they can get stuck in the nervous system and one might feel like the traumatic event is still happening versus knowing that one is safe, and the traumatic event is in the past. Other symptoms that can come after a traumatic event and as a result of these traumatic responses being stuck in the nervous system are depression, anxiety, hypervigilance (increased alertness to potential danger) bodily shaking, changes in posture, emotional overwhelm, little or no memories, chronic pain, nightmares or flashbacks, and loss of a sense of future. Instead of just talking (although there still is a lot of talking involved in SP), an SP therapist will use emotions and the wisdom of the body as a guide to help move through some of these stuck responses in the body. This may look like having someone who experienced a violent attack to push back or run away (we get creative on how to do this in session like pushing against a pillow, etc.) in order to complete this response in the body and help to return the nervous system back to normal. It’s truly incredible all the information our body and emotions hold when given the space and attention.

Pros:

With SP there is no need to retell your trauma story.

Trying to nail down a therapist about what modality they use is sort of like trying to nail down the Beetles as to the specific genre of music they made. They were always in flux as they practiced their art. Therapy is a science-based activity that, when practiced well, flows like an art. It is as varied as there are therapists.

There are many, many types of therapy that have been proven to be effective. Feel free to explore to find the right fit for you.

If you are interested in starting your therapy journey, please reach out to us and we can help connect you to a therapist.

Take Care,

The Phoenix Counseling Collective