Larry Alan Nadig, Ph.D. Clinical Psychologsit, Marriage & Family Therapist

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About Dr. Nadig

Treatment Philosophy

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© copyright 1999
by Larry Nadig,
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Last updated:
July 19, 2010

 

Dr. Nadig's Treatment Philosophy

 

I prefer to view my professional role as that of a "life coach" rather than the traditional view of doctor and patient. I do not like the medical model because it focuses so much on giving a pathological label to what is being treated. I use a learning and systems model. My client's problems and struggles are not due to abnormal psychopathology, but are normal reactions to living in this stressful, complex, changing and sometime contradictory world.  I want to understand each of my client's issues and struggles in the context of their real lives rather than in reference to a theoretical model that focuses on pathology.    

We are guided and limited by our learning. People don't usually receive formal education and training about human behavior, handling feelings, listening and communicating with others, or the various ways of productively resolving conflict. We initially learn how to get along with others, how to relate to the opposite sex, how to handle anger and conflict and other problems by what we were taught, experienced and observed in our family as we were growing up.  The learning broadens as we observe and learn from others outside our family, but it is always limited and incomplete. If a person is lucky and is raised in a healthy, well-balanced, high functioning family, the person learns effective skills for living in a harmonious environment. If a person is unlucky and is raised in a broken or dysfunctional family, the person will likely either learn to be similarly dysfunctional or will learn how not to handle things. Knowing what doesn't work and what not to do is useful, but not as useful as knowing what does work. Even a person raised in a high functioning environment does not necessarily have the skills to function effectively in a hostile dysfunctional environment. Humans are too complex and there are so many different ways of being, relating, believing and doing things that we cannot learn it all. By far, the vast majority of people who come to me for help have not learned how to effectively deal with or make sense of and understand the issues and dynamics causing their problems.  

I always strive to understand my clients from the perspective of their life, based on who they are, their values and the unique pressures and stresses they experience. Basically my task as a therapist is to accurately understand what the person wants, what is interfering or preventing the person (or couple) from accomplishing it themselves, what they need to do differently in order to achieve or resolve it, and to coach and guide them in their efforts. 

There are 5 interrelated dimensions that I use to help me understand my clients and the situations and issues they want help with.  

  • Cognitive.  I want to know how the person understands, makes sense of or interprets the problem or event. People generally feel and behave in a way that is consistent with the way they are thinking, believing and anticipating. The more accurate and clear a person is in his/here understanding the more appropriate and effective the person is able to be.
  • Affective. How does the person feel? What does the person do with their feelings? How does the person use their feelings? How aware and skilful is the person with his/her feelings? What feelings are difficult for the person? How does the person react to and handle someone else's feelings.
  • Behavior. What do they actually do behaviorally? What skills do they have for handling the event, and what might they need to learn? What impact does their behavior have on others? How deliberate and conscious is their behavior, and how automatic and unconscious is it.
  • Social. I want to understand the social context of the event or problem. The climate of the social/family system, the pressures and supports.
  • Biochemical. I keep this in mind because I do not want to make the mistake of thinking everything is psychological and overlook the possibility of an underlying medical problem or drug and alcohol abuse.

There are only a few general reasons people seek counseling and psychotherapy.

  • Discomfort. The person is significantly bothered by something, is experiencing significant discomfort and wants relief or help to overcome it. Typical examples include grief, depression, anxieties, guilt, worry, anger, or bother about a habit or behavior of their own or a behavior of someone else.
  • Dysfunction. The person is having difficulties in their life as a result of a dysfunction, limited ability or simply lack of learning. They have become aware of it and want help overcoming it, or accepting it and living more effectively with it.
  • Growth. There are those who are not having any particular difficulties in their life but value learning and growth.  They want to broaden their awareness and/or get another perspective on something.
  • Requirement. Some people are forced or pressured to receive treatment. The pressure could come from their family, employer, the legal system, etc. or therapy might be required in order to be eligible for something else.
  • Desperate.  The person or couple has been having difficulties for a long time and has avoided getting help from a therapist. Things have gotten so bad and there is a realization that things are about to get even worse, they seek therapy as a desperate last resort.

When there is dysfunction or discomfort one or more of the following concepts will usually be out of balance, lacking or inappropriately applied. 

  • Awareness and Seeing Clearly.  If something is occurring and we have no awareness of it, we can't do anything about it. We are not in control of it, and it might be in control of us. Once we become consciously aware of it, we can than start to do something about it.  Of course the awareness should be clear and comprehensive. The more clearly we see others, the situation, and ourselves, the more effective we can be.
  • Direct. In the general American culture, being direct with others and with self usually helps the communication be more effective by improving the clarity of the message. Hinting is too subtle and is easily dismissed, and the message could be missed altogether.
  • Honest. Lying usually eventually makes things worse. Don't say it is "ok" when it is not ok. Don't tell the other person you would like to, and you would if you could but you can't, when the truth is you don't want to.
  • Respectful.  Be direct and honest with others with tact and respect. Don't be a jerk by being direct and honest without tact and respect, which comes across as blunt, demanding or insensitive and may trigger resistance or resentment.  Be respectful to others and to yourself. Be just as respectful of your own needs, wants, beliefs and values as you are of others.
  • Responsibility. Be clear of what you are responsible for, as well as the limits of your responsibility. What are the other person's responsibility and the boundaries of their responsibility? What about shared responsibility. People have a lot more trouble and difficulties when they don't accept responsibility for their choices and behavior or for the consequences of their choices and actions.
  • Acceptance. There are some things that bother us that we can do something about, and there are things we cannot do anything about. It makes no sense to get stuck on and waste time and energy on something we cannot do anything about.

Some therapists have a basic assumption that people (especially clients) are weak and fragile and need to be protected from upset and pain, or that clients are so limited, incapable and powerless that they need to be saved and rescued. I think such assumptions are insulting and disrespectful. I assume that people are generally capable, adaptable and durable. We may not currently know how to do something, but we might be able to learn. We don't have to avoid something because it is uncomfortable, frightening or upsetting, we can tolerate and handle a lot. Upset and pain is a part of life and we need to be able to face and effectively handle upsetting and painful events and feelings when necessary. We also don't have to make ourselves powerless or helpless and just tolerate and endure painful or upsetting things when we could do something to make things better. I want my clients to see themselves and others clearly and accurately. We should be aware of our weaknesses and limitation and our abilities, strengths and capabilities. 

Some therapists believe that they know what is best for their clients, and tend to impose their own values and agenda on their clients. I do not believe that there is one best set of values or one best way of life. My values and beliefs work for me, but they may not work for someone else. I do not have any need or desire to impose my beliefs or values on others, especially in my professional life.  If I accept someone as a client, I will respect his or her values and belief systems.  I stay oriented and relevant to what my clients want from therapy. During the first or second meeting we will identify the goals of treatment. Once the goals have been achieved therapy will end. 

 

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Contents: .
Home 

How to Express

Difficult Feelings 

Tips on Listening 

Conflict: Healthy

or Unhealthy

Stress: Health &
Relationship Killer

Selecting a Mate

Weight Control

Holiday Blues

How to Get the Most From Therapy 

Psychological Tests

About Dr. Nadig

Treatment Philosophy

Professional Services and Fees