People often present for therapy when they can’t achieve something which they should be able to achieve. This may be delivering a presentation with confidence; having the confidence to say no; being confident in social situations; establishing boundaries; and so on. The client’s goal is tangible and practical.
The therapist obviously can’t directly help the client to achieve a practical goal. The client doesn’t need practical help. She knows intuitively that there’s something in herself that is stopping her from achieving her goal. She needs the therapist’s help to identify and resolve something internal – the therapeutic problem.
Sometimes, where the emotion is part-and-parcel of the practical problem, the therapeutic problem seems more readily identifiable. For example, if someone is suffering from presentation anxiety the emotional aspect of the therapeutic problem, anxiety, is readily identifiable. Why is the person not able to deliver his presentation confidently to an audience? Because he feels extremely anxious.
Very often, however, the emotional aspect of the therapeutic problem is not at all clear. For example, a person may have no idea why he manifests addictive behaviour, or has obsessional thoughts, or can’t bring himself to make decisions. The emotion may not be apparent. Even when the emotion is obvious, the therapeutic problem may be far from being understood – a person may feel sad, upset or angry for no reason he can fathom.
The uncomfortable emotion (such as anxiety, anger, upset) is one aspect of the therapeutic problem. The primary aspect is a negative and limiting belief. This belief is unconscious, and was formed by experience in the past.
Examples of a limiting belief are: I must not make a mistake (or I will be ridiculed); I am unlovable (so I will cut myself off from others to guard against disappointment); I must be approved of by everyone (so I must not speak out); I am of very little significance (so my viewpoint is worthless); I am powerless in the face of others’ anger (so I must avoid conflict); I am a sexual target (so I will make myself fat and ugly); and so on.
Having established the therapeutic problem, the therapeutic task (more properly, my task as therapist, since this is a unique approach) is to uncover the experiences that created it and help the client to navigate these experiences successfully, enabling her to achieve her practical goal in the present.