A Primer on Educative-Experiential Psychotherapy

The Educative Aspect of the Educative-Experiential Model

The educative-experiential (EE) model is educative in that the knowledge of human behavior embedded in the fundamental disciplines of this approach is thoughtfully and thoroughly explained to clients within an experiential framework. For instance, to normalize teen behaviors, clinicians might introduce the work of Erikson (1950), Marcia (1966), Elkind (1967), or Elkind and Bowen (1979) to parents and teens to provide insight into the developmental demands that may be influencing the teen’s behavior and clinical presentation. The goal is to arrive at an adaptive and functional level of individuation that aligns with parental boundaries and aims to avoid power struggles that can breed feelings of resentment and erode emotional connections between parent and child.

When working with a client who has been ostracized by their family unit, it can be a validating experience to identify and explore possible explanations as to why their family has seemingly excluded them (Bowen, 1978; Minuchin, 1974). The idea is that each family member takes on an assigned role so as not to expose the familial dysfunction to members outside the family unit. Individuation can feel threatening to the family unit and may leave some members feeling exposed or vulnerable to their own faults once the individual who previously received the displaced blame has recognized this tendency. The end result, especially for more rigid family structures, is to ostracize this family member.

The concept of the introject can be introduced to individuals who have been told statements like, “You act just like your aggressive father.” The introject refers to the incorporation of the most powerful aspects of the primary caregiver’s personality into the child’s developing psyche (Henry et al., 1990). Conversely, the maladaptive part or parts of the primary caregivers typically play out under high levels of distress in their lived experience. Therefore, it is crucial to emphasize to the client that although he may behave similarly to his father when he is feeling distressed, this does not make him “just like” his father. The manifestation of the introject demonstrates the pervasive impact of his father’s behaviors on his current functioning and points to the presence of an unconscious introject created in childhood.

Education on character structure as espoused by McWilliams (1994) and restorative fragmentation might be used when working with family members of someone with disruptive personality features. In this example, the family may be able to see a narcissist’s behavior in light of a psychologically fragile individual who is married to one’s self-preservation, making it difficult (if not impossible at times) to self-reflect and take ownership for their behavior. This might help the family members anticipate the harmful behaviors instead of being surprised by both the behaviors and the reflective limitations of these behaviors on others.

Other significant concepts that can be timely employed to facilitate knowledge, understanding, and/or validation include areas related to accommodation (Piaget, 1954), adult lifespan development (Levinson, 1978), influence of preverbal development on styles of attachment (Mate, 2018), upward and downward comparisons (Festinger, 1954), fundamental attributional errors (Weiner, 1985), and emotionally focused ideology (Greenberg & Johnson, 1988). How these are used in treatment will be explored in the case study that follows.

Lastly, educative feedback based on the mastery of core psychological principles is likely under-utilized when implementing treatment interventions. When used effectively, this can allow the client to move beyond initial defensiveness and resistance, and can create a shift in perspective on why and how one impresses upon and is being treated by others. It can also reveal core defense mechanisms, tendencies toward emotional projection, and the behavioral and emotional patterns causing the client (and others in their life) significant distress. This can provide clients with insight and guidance on how to navigate relationships by reflecting on the disruptive patterns they engage in while interacting with others. Additionally, clients may have increased awareness and understanding of how their behaviors can influence and impact the way others interact with and respond to them. When timed and delivered to maximize effect, this educative knowledge has the effect of being held firmly in their mind, which clients often report utilizing to reframe their thinking and protect against engaging in harmful relational patterns and styles of interacting. Therefore, educative feedback can promote a deeper integration of the psychological strategies and practices learned, leaving the individual with a sense of control over their choices and their path toward growth.

The Experiential Aspect of the Educative-Experiential Model

The EE model is experiential in nature, however, this is not always as simple as it seems. The experiential aspect rests on the idea that each individual has a unique way of perceiving one’s lived experiences and will attach meaning to them based on their mental and emotional state in that moment and based on their perceptual background (Merleau-Ponty, 1945/2002). From this perspective, therapy is maximized when it is delivered in a reciprocally lived-experiential-flow that promotes peak therapeutic experiences. In using this approach, a skilled therapist will assess the client’s ego strength and specific areas of focus to learn the level of pressure applied when certain doors open (therapeutically), with the goal of minimizing distress to the client.

The delivery of educative knowledge is done, more operationally speaking, by suspending presuppositions (Giorgi, 1991), staying in the client’s experience, and tracking the client’s word use, tone, and subtle behavioral nuances (which can be done by mirroring the behaviors back to the client). Progressive muscle relaxation, for example, is delivered within the context of arriving to the lived-moment and entering into the space by the therapist and client together. The following example demonstrates mirroring and reflecting back to the client what they are doing and saying with the intention of imparting educative knowledge.

Consider the following example. A restless client abruptly stands up in the therapy room and begins pacing around. The client states, “I’m sorry” in response to noticing her reaction and the therapist reflects back, “…sorry.” The client sits down and silence fills the room. The therapist observes the client and states, “Your shoulders look tight.” This prompts the therapist to lead tense-and-release exercises that are practiced together with the client, who quietly responds, “I’m just so tired of myself.” The therapist softly reflects, “…tired.” The client begins to describe a profound fear that she will never be able to find stability in her life independently and will continue to depend on her parents. The reflections made by the therapist subtly and impactfully encouraged the client to self-reflect in a safe, supportive space and in a meaningful way. This unlocked a discussion about vulnerable, deep-rooted feelings that led to the introduction of emotionally-focused concepts (i.e., core feelings of inadequacy, inferiority, and shame) that were then intentionally and consistently reframed both in and out of session. The lived-experiential-flow, as described earlier, led to an impactful moment that allowed more easily integrated educative feedback to be absorbed and discussed without defensiveness highlighting the efficacy of this model.

Case Example Utilizing the Educative-Experiential Model

The following is a case example of a therapeutic experience utilizing the EE model.

Dee identifies as a woman in her mid-forties whose father (that she described as narcissistic) left the family unit when she was an infant. She was raised by a mother who was described as having features resembling those in people who live with borderline personality and/or histrionic personality structures. Dee’s mother reportedly left her for extended periods of time during her preverbal development to be cared for by her grandmother.

Dee presented to therapy with high levels of persistent anxiety, recurrent episodes of panic, and continuous feelings of hopelessness and low self-efficacy. She was struggling with a potential divorce from her husband of 23 years, who was reported to be significantly older than her and who was described as “narcissistic.” A reciprocally lived-experiential-flow was accomplished, in part, by allowing Dee to choose whether she was wanted to scream, lay on the floor, cry, use expressive language, or restore her breath through grounding practices.

Concepts derived from a preverbal developmental perspective (see Erikson, 1950; Marcia, 1966) were used to illuminate the early dynamics surrounding her birth and how the absence of her father and inconsistent presence of her mother may have disrupted the consolidation of self. This left her to enter into post-verbal development with an anxious attachment style, a sense of mistrust, and a fleeting ego strength. Similarly, these concepts were utilized to illuminate a foreclosure of her adolescent self, deferring to the kind of identity her mother imposed on her. This left her without having explored who she was and who she wanted to be; learning to consistently put her individual needs aside to prioritize the needs of others. She entered early adulthood as an anxious and unsure individual searching for connection and intimacy, but she continued to feel isolated, alone, and riddled with self-doubt. Dee compensated for these feelings by sexualizing herself and eventually meeting an individual described as emotionally unavailable, narcissistic, and much older (similar traits to her father), initiating the start of two decades without sufficient emotional intimacy and intra- and inter-personal growth.

From a psychodynamic perspective, Dee relied on the use of intellectualization as her primary defense mechanism. She presented with a neurotic character structure, which she was amused to learn is considered an adaptive style of character structure. This suggested she had a relatively functional ego strength with an ability to remain emotionally regulated when navigating challenging interpretations in treatment. These explorations and subsequent interpretations included unconscious choices and relational repetitions that have presented across many areas and in many relationships throughout her life. This was exemplified when she chose to be in a partnership with a man who resembled many of the challenging aspects about her father. This explanation and connection resonated deeply with Dee’s lived experience, leaving a significant impact on her shift in perspective.

Educative interventions were used along with psychodynamic interpretations, skill building, and cognitive restructuring within the EE model. The impact of the therapy across 18 sessions was significant. By the end of treatment, Dee was able to sit still in session and her tearful outbursts were no longer present. Likewise, she reported a significant reduction in panic symptoms, which decreased in intensity and duration as treatment progressed. Dee’s symptoms of depression began to alleviate as she started to let go of the many harmful messages conveyed to her throughout her life. She made intentional choices to establish more concrete and consistent boundaries with her sister and her mother. She reported more positive self-talk, reduced self-doubt, and, of significant importance, she stopped worrying about her ex-husband’s children and what they thought of her. This eventually led her to challenge her fear of being alone and by the end of treatment sessions, Dee made the decision to finally file for divorce. At the last check-in with Dee, she had recently moved into her own home and established a positive and supportive group of friends.

Summary and Conclusion on the Educative-Experiential Model

The educative-experiential model derived from the author’s ever-evolving theoretical style focuses on the use of important educative concepts and is delivered within a reciprocally lived-experiential-flow between the client and therapist. When implemented as intended, theoretical and clinical considerations derived from foundational psychological domains (i.e., developmental, social, biological, psychological) are used selectively and with intention in a specific moment to maximize the effect of this experiential model. Moreover, therapists must be skilled enough to enter this experiential flow with clients to maximize peak therapeutic opportunities while maintaining an awareness of the client’s ego strength and their present ability to remain regulated. This combined approach can establish new paradigms for a client’s self-understanding and allow them to continuously re-root themselves in their identity and lived experience.