Podcast Summary: The Leading Edge in Emotionally Focused Therapy Episode 20: When Things Go "Bad" Pt1 of 2 Release Date: November 14, 2021

In Episode 20 of The Leading Edge in Emotionally Focused Therapy (EFT), hosts Dr. James Hawkins and Dr. Ryan Raina delve into the inevitable setbacks that occur during the therapeutic process. This episode focuses on understanding and managing moments when therapy sessions do not unfold as intended, introducing the concept of "ditch enactments" as a strategic response within EFT.

1. Embracing Setbacks in the Therapeutic Process

Dr. Ryan Raina opens the discussion by highlighting that setbacks are a natural component of meaningful change and growth in therapy. He states, “In any meaningful change process or growth process, there are inevitable setbacks. It's a part of the process. If you're not having setbacks, you're probably not doing something worthwhile.” [00:01]

Dr. James Hawkins echoes this sentiment, emphasizing EFT as a dynamic and humbling model that continuously pushes therapists to advance their understanding and application of EFT principles. The hosts set the stage for the episode by acknowledging that not all therapy sessions progress smoothly, and addressing these challenges is crucial for effective therapeutic outcomes.

2. Introducing Ditch Enactments

The core of the episode revolves around the concept of "ditch enactments," a term coined by the hosts to describe situations where a therapy session hits unexpected turbulence. Dr. Ryan Raina elaborates on this metaphor:

“It's like a plane that you're flying smoothly, you're going along, and then boom, it's just turbulence and it's just shaking. And it just feels like this person put this big thing out there and you... just feels like it's not going to happen.” [01:20]

A ditch enactment occurs when a client's attempt to engage vulnerably in therapy is met with an unexpected block or withdrawal from the partner, akin to a pilot facing an emergency landing. This scenario presents a significant challenge: how can therapists navigate these moments without inadvertently discouraging clients from taking future emotional risks?

3. The Aviation Metaphor: Navigating Therapeutic Turbulence

To elucidate the concept, Dr. Ryan Raina employs an aviation metaphor, comparing therapy sessions to flight operations. He explains:

“Most important part about being a pilot, James, is to not die. If you want to write that down. Extra note there.” [02:50]

He continues to describe how pilots are trained for emergencies, not for smooth flights:

“They train for things to go wrong. And so if they're in a plane and they run out of fuel or lose an engine... they start checking down. It's like, okay, well let's do what we can here.” [03:30]

Similarly, therapists must be prepared for sessions where clients cannot engage as expected. The ditch enactment metaphor serves as a guide for therapists to manage these challenging moments skillfully, ensuring that even when things go awry, the therapeutic process remains respectful and constructive.

4. Strategies for Managing Ditch Enactments

Dr. Ryan Raina and Dr. James Hawkins discuss practical strategies for handling ditch enactments within EFT:

• Expect Blocks: Therapists should anticipate that not all attempts to engage will be successful. Raina mentions, “Don't be surprised when it doesn't work. Don't be surprised when you get a block.” [06:32]

• Utilize EFT Techniques: Employing methods like CPR (Catch, Permission, Reset), parts work, and slicing moves can help navigate blocks. For instance, Raina describes parting out a client’s conflicting emotions to facilitate a response:

  “Hey, a part of you would love to believe you matter that much... This is really hard to hear right here.” [07:00]

• Implementing the Ditch Enactment: When traditional EFT techniques are exhausted, the ditch enactment offers an alternative approach. Raina explains:

  “Instead of no response when I can't get a good response, let's get an okay response and let's give a little bit of explanation for why I can't respond.” [07:45]

This involves acknowledging the difficulty of the moment and providing a compassionate explanation for the lack of response, thereby maintaining therapeutic integrity and keeping the door open for future emotional engagement.

5. Personal Insights and Reflections

The hosts share their personal experiences and reflections on managing difficult therapy sessions. Dr. Ryan Raina recounts his own challenges as a less experienced therapist, illustrating the emotional toll and the learning curve associated with handling setbacks:

“I've been knocked off the horse and just feel terrible about ourselves. It's still a pretty good session.” [07:10]

Dr. James Hawkins adds depth to the discussion by highlighting the importance of remaining present and compassionate, even when clients struggle to respond. He emphasizes that ditch enactments, while not ideal, provide a crucial opportunity for clients to feel heard and understood, preventing retraumatization through neglect.

6. The Impact of Therapist Confidence

A significant takeaway from the episode is the vital role of therapist confidence in fostering a safe therapeutic environment. Dr. Ryan Raina notes:

“The more relaxed or confident the therapist is, the more safe your clients feel. The more safe your clients feel, the more risk they're likely to take.” [26:14]

By preparing for ditch enactments and having a plan to manage them, therapists can maintain their composure, which in turn enhances clients' sense of safety and willingness to engage deeply in therapy.

7. Moving Forward

As the episode concludes, the hosts hint at further exploration of the ditch enactment concept in the next installment (Episode 21), where they will discuss how to summarize sessions that did not go as planned and outline strategies for moving forward constructively.

Notable Quotes

• Dr. Ryan Raina: “In any meaningful change process or growth process, there are inevitable setbacks. It's a part of the process. If you're not having setbacks, you're probably not doing something worthwhile.” [00:01]

• Dr. James Hawkins: “EFT is a dynamic model that humbles even the most seasoned therapists.” [00:26]

• Dr. Ryan Raina: “They train for things to go wrong. And so... we got to stay there. In a way, what we're kind of calling it here is a ditch enactment.” [03:30]

• Dr. Ryan Raina: “We don't mean like necessarily something bad. It's actually a skillful maneuver on the part of the pilot to put the plane down in a way with as less damage as possible and less loss of life as possible.” [08:02]

• Dr. Ryan Raina: “The more relaxed or confident the therapist is, the more safe your clients feel. The more safe your clients feel, the more risk they're likely to take.” [26:14]

Conclusion

Episode 20 of The Leading Edge in Emotionally Focused Therapy provides invaluable insights into handling the challenging moments that inevitably arise in therapy sessions. By introducing the concept of ditch enactments and equating them with emergency landings in aviation, Dr. James Hawkins and Dr. Ryan Raina offer therapists practical strategies to navigate setbacks effectively. This approach not only preserves the therapeutic alliance but also fosters an environment where clients feel safe to take emotional risks, even when initial responses are not as expected.

For therapists seeking to enhance their skills in managing difficult therapeutic moments, this episode serves as a crucial resource, laying the groundwork for deeper exploration in the subsequent episode.