How do Counsellors Help? Part II – Therapeutic Experience

In our last post in this series, we introduced the concept of the Counsellor’s ability to “target and titrate.” But what exactly does that mean, and how does it create a healing experience? And even before that, what does it mean to have an “experience” in the first place?

Typically we think of counselling therapy as “talk therapy,” and that’s what it looks like when we watch it on TV or in the movies. Two people talking about things that happened elsewhere. Talking about things can help make important changes to the way we think and the way we behave, but as we have learned from modern neurobiology, we aren’t consciously thinking about a lot of our most ordinary responses to things. When the lessons we received from our parents about tolerating stress get hard-wired into our brain, they become part of a dynamic that happens outside of our awareness. To heal and change things that were first learned experientially, our best bet is to create new experiences leading to an alternate lesson and outcome.

The trick of it is that this new experience must be “just right,” a kind of Goldilocks challenge that is neither too easy nor too hard. If it’s too easy it won’t activate the old repertoires at all, and there will be no new lesson available. If it’s too hard, these responses will be over-activated and protective, and the experience can become just another frightening addition to the already full Stress Container. This is why therapists use both targeting and titration. Targeting ensures that the experience is directed at something important: it means that the challenge will activate the precise feelings which are important. And titration means that the intensity—or the “dosage”—of the challenge is appropriate, depending upon where the client is in their therapy as well as where the counsellor and client are in their relationship. To begin with the dosage will be quite low, but as the client gets used to their own reactivity and as the feelings of trust grow in the therapeutic relationship, the dosage can be increased.  To do this, therapists stay completely engaged so they can constantly measure and balance the amount of challenge.