Hear an interview of Dr. Durana by Karen Copeland. He describes his philosophy and integrative approach to therapy.
Dr. Carlos Durana offers individual,relationship, and couples counseling as well as telephone consultations. His approach is based on a resource model ofgrowth and healing.
Effective counseling/therapy provides a safe and supportiveworkspace where you, the client, can experience and think through problems,experiment with potential solutions and gain information and skills within thecontext of a helpful and caring relationship. Dr. Durana’s model:
· Utilizes your strengths and resources to generate solutions and growth.
· Is based on self acceptance and positive regard for self and others.
· Assumes that we can change most easily from aposition of strength.
· Is practical and educational, emphasizing ways to help oneself in everyday life
· Uses research evidence to guide effective practice.
· Is flexible in choosing the therapeutic method that best fits you.
· Is holistic in nature by acknowledging the importance of the connection between body, mind and emotions
To read more about Dr. Durana’s views on therapy anddifferent approaches used by him:
SUCCESSFUL THERAPY: YOUR ROLEAS A CLIENT
Research hasshown that there are four factors indetermining success in counseling/therapy. The most important element determining about forty percent of theoverall success in the client is the client’scapacity for growth and self-healing. Every person has strengths and resources;these may include beliefs, values, feelings, skills, knowledge, experience,abilities, relational capacity, and so on. Effective therapy helps clients marshal their resources. Dr. Durana emphasizes what has worked ratherthan what has failed it, elicits strengths, competencies, and resources. By assuming that we can change most easilyfrom a position of strength, not failure, problem solving is facilitated andself-esteem enhanced. By looking at what is right with people, what works or has worked for them inthe past and by identifying assetsin what people say and do, peoples’ capacity for healing and change can bepromoted.
Some forms ofcounseling and learning place emphasis on what is wrong with the person(pathologizing), on what is the hidden cause of the problem and what can bedone to fix it. Although sometimeshelpful, Dr. Durana has found that this approach has many drawbacks. For example, when a person is called phobicabout relationships, this label and the associated lack of competencies can actas barriers that may prevent fully understanding the person; the label maythreaten and cause defenses. Dr. Duranabelieves that a person is much more than a label. It is much more useful, in this example, tosay that the person has forgotten how to relate because of pastdisappointments. Thinking this way aboutoneself can then facilitate self-understanding, self-acceptance andself-love. As a therapist, Dr. Duranabelieves that thinking in this fashion about the client may assist one inavoiding getting into a rut, trying to “fix” the person. How we think about what goes on withourselves and with another person is of utmost importance.
It is valuableto find out what has not worked, but it is more valuable to find out what hasworked so that it can be enhanced and used; for example, in what periods of ourlives were we most ourselves, when and how did we make the best decisions, andso on. Dr. Durana’s approach facilitatesself-discovery, personal responsibility, personal control and problemsolving. It is based on the premisethat people possess the ability to uncover resources and directions for growthin life, and it is founded upon a faith and an interest in everyone’s personal worth, competence and lovability.
Dr. Duranabelieves that it is the job of the therapist to help the client uncover theirresources and potential for growth, and to provide the conditions under whichsuccessful counseling can take place, but it is the client that makes therapywork, not the therapist or the technique.
The Client-Therapist Relationship
The second mostimportant factor in successful therapy is the working alliance developed by the client and the therapist. This relationship is another resource thatyou, the client, can mobilize for healing and growth. A few of the essential qualities displayed byan effective counselor are warmth, empathy, caring, interest in and respect foryou as a person (your ideas and feelings), genuineness, and encouragement intrying out new solutions. Therelationship can provide a safe and supportivespace where you, the client, can take the time to experience and think throughproblems, generate new perspectives, experiment with potential solutions, gaininformation and skills, receive feedback and experience mastery over yourproblems.
In a collaborative and caring relationship, through the meeting of minds and hearts, Dr.Durana listens and engages rather than “treating” or “fixing”. Gradually, a confiding relationship developswhere you can feel safer in exploring deeper areas of concern. Even those who may not be ready or evenwilling to engage in deeper self-exploration, will nonetheless benefit fromthis caring relationship and may discover new resources, gain skills andknowledge.
Dr. Durana is effectivebecause he understands and empathizes with what is most important for you, andhow much you are willing to engage and to learn; in this regard, you set theagenda. Counselor and client agreement of goals and tasks to beperformed is a good predictor of successfuloutcome. In the end, if you, theclient, see the product of the therapy as a result of your own best efforts andhave accepted responsibility for the changes, then the results are more likelyto endure.
Client Expectancy and Hope
Most peopleseeking therapy are not “sick” in the medical sense but they may beexperiencing mental and emotional pain, they may be frustrated and discouragedabout not reaching their life goals or they may not be functioning optimally. Dr. Durana has found that often peoplepersevere in using old strategies even when those are not working, or avoidingand denying the problem; sometimes they may not have someone to listen in acaring way so that they can take the time to stand back from the problem andcontemplate solutions. People often seekhelp after feeling demoralized in their own problem solving efforts or mighteven feel stuck and powerless about changing things. However, the act of doing therapy shows a new determination to get better, the “I can do it” sense; this is an act of hope.
Good therapyfosters this type of thinking. Effectivetherapy offers hope that something can be done to improve one’s condition. The techniques and methods of Dr. Durana’scounseling enhance pathways forexperiencing and thinking about problems. A client’s perception of the problem and their hope about how toameliorate it is the third important factor in determining the success ofcounseling. A belief in the restorativepower of the therapy helps facilitate progress. Attending to what is functional in the client’s life, and enhancing theclient’s strengths, resources and capacities to cope effectively within acontext of care and respect helps generate optimistic expectations that changewill occur and that the client hasthe competency and power to promote recovery and change.
Change isusually a step by step process of trying out new thingsover successive times. In every daylife, people change through normal processes of thinking about a problem,exploring and experimenting with solutions and receiving feedback from theenvironment; out of this come new perspectives and experiences which then leadto new solutions and explorations. Theseare natural self-righting mechanisms,that when promoted, generate hopefulness in the pursuit of goals.
Therapy can be helpful for mostindividuals. Therapy research findingssuggest that beneficial effects can be achieved in 5-10 sessions with at leastfifty percent of clients. For twenty tothirty percent, more than 25 sessions may be required. Clients who are very hostile, poorlymotivated, have a history of poor relationships or expect to be passiverecipients of a medical procedure are more likely not to benefit.
Methods or Models of Therapy
The last factorof therapeutic success contributing about fifteen percent of the total benefitrefers to the methods or techniques used in therapy. The client factor described earliercontributes about forty percent, client/therapist relationship about thirtypercent and hopeful expectancy about fifteen percent. More important than the technique or methodis how you, the client, use the approach. You are the primary healing factor. Healing and growth occurs through theclient’s self-healing or self-actualizing potential. The techniques and methods of therapy can help mobilize it, along with hope, andthe therapist’s supportive contributions. The magic is in you, the client.
Dr. Durana makesuse of several therapeutic methods. These approaches can be thought of asdifferent ways of learning. Some of us are best in utilizing thoughtprocesses, others work best through experiencing feelings and emotions, othersbenefit more by focusing on behavioral changes and action (communicationskills, learning new behaviors, etc.); some benefit greatly by focusing on bodyawareness and the relationship between body signals and personal concerns. There are individuals who gain deeper accessto themselves through mindfulness. Thereis not one best approach, it is best to use the method most suitable for you, the client. More than oneapproach can be used and different methods can be used at different stages oftherapy. I will briefly describe a few:
Cognitive behavioral therapy. As human beings we have beliefs abouteverything. Beliefs are part of ourself-image, sense of self, philosophy of life, our way of relating, etc. We interpret reality through ourbeliefs. Many of life’s problems ariseout of faulty or limiting beliefs, for example, “I am unworthy”, “I amunlovable”, “people are untrustworthy”, etc. If I believe that I am inferiorand people are hostile, I may not strive towards solving my problems (faultybeliefs and a generalization) and instead develop compensatory ways of coping(avoiding, withdrawing, etc.). Beliefscan be noticed in our inner self-talk and in our evaluations of ourselves andothers; they become automatic thought patterns that distort ourexperience. If I believe that I aminadequate and I get a good grade, I may discount it; instead of valuing myefforts, I may dismiss my achievement by saying to myself, “well, that comeseasy anyway” or “I should be doing better”. Cognitive behavioral approaches help clients identify and transform problematic beliefs into adaptive and healthy ones. Theseapproaches are very helpful with depression, anxiety, health related concerns,coping with illnesses, personality disorders, addictions, etc.
Emotionallybased approaches: Acommon problem is the avoidance or denial of certain emotions andfeelings. We may make excessive use ofcertain emotions and suppress others, thus creating inner conflicts. This can be problematic in our personal lifeas well as in our relationships. Dr.Durana believes that all emotions have a purpose and a role in life. The ability to be emotionally open to anotherhuman being is essential in the development of intimate relationships. Emotions can open us to our needs, affirm our worth, facilitate communication and problem solving, andpromote maritalsatisfaction and love. Information processing seems to occur through the interaction of arational system and an experiential (emotionally driven) system. The rational system uses logic and causalconnections; the experiential system works more through metaphors, images,holism and pleasure-pain considerations. Our deeper core beliefs about ourselves are emotionally encoded. Techniques that evoke our experience ofemotions are also particularly helpful in effectively enhancing motivation, commitment and determination inthe effort to achieve our goals and resolve our problems. Emotionally based approaches also helpclients enhance awareness of emotions and appraisals, and gain acceptance ofexperience, as well as facilitating the integration of emotion and action;commonly used in both individual and couples therapy.
CouplesTherapy, Marriage Counseling or Relationship Therapy: Relationship or couples therapy helps clients understand and resolve conflicts, communicateeffectively, and problem solve in a healthier way in order to improverelationships. Couples therapy can be short term to help youmove through a crisis or it may last for several months or more if therelationship has greatly deteriorated. In the event of separation or divorce, couples therapy can ease thisvery difficult process. Couples therapyfocuses on problems between individuals, but these problems also involveindividual problems which may need to be addressed along with relationshipconflicts. For example, someone who maybe depressed may also have difficulties in handling conflict. Beyond helping couples break out of negativecycles, the ultimate aim of relationship counseling is to enhanceintimacy, love and develop a way of relating that supports each other’s core identities and life purposes.
Dr. Durana’s resource based approach incouples therapy emphasizes what has worked, doing more behaviors that createsuccess, discovering strengths and resources beneath the relationship symptoms,redirecting attention to the couples’ hopes and aspirations and developing behaviors that increase relationshipsatisfaction and happiness.
Mindfulnesstherapy: Mindfulness refers to being conscious oraware of something; thus, doing something mindfully entails doing it withawareness. More broadly, mindfulness isa quality of attention characterized by curiosity, openness, non-judgment and acceptance. Itis an open and receptive attention to what is happening in the present asopposed to our habitual and automatic ways of mental processing that attend tothe past or the future, missing important aspects of our experience. Dr. Durana’s mindfulness practices teachclients to understand themselves in anon-judgmental way, and to develop an innerstillness that is essential as a way of standing back from a problem to get awider and deeper perspective. Through mindfulness, we can develop a healthier relationship to ourproblems or illnesses. This meditativeapproach is excellent for dealing with anxiety, depression, pain, illnesses andother disorders. Mindfulness can alsohelp a client connect with deeper dimensions of being, what some may describe as soul, spirit –our core awareness.
Body-centeredapproaches to therapy and Holism: Common to body-centered approaches to therapyis the assumption that change is possible by working through the body. Italso involves the idea that there is a unity betweenbody and mind (holism). Dr. Durana’s experience is that itis impossible to separate the mind and body. Instead of viewing the mind in a hierarchical position above the body,they are both interactive aspects of the whole person. By becoming more in touch with how we areorganized in our bodies, we can learn about our limited beliefs andcounterproductive ways of being. Inaddition, Dr. Durana’s body-centered approach can illuminate the connectionsthat exist between stress, coping style and physical symptoms or illnesses. Traumas can also be addressed with these methods. Dr. Durana’s body-centered approaches makeuse of sensation-based awareness to support change. Finally, an increase in vitality, wholeness and enlivened waysof being may also be a by-product.
