[Review] Co-Creating Change

co-creating-change-effective-dynamic-therapy-techniques-jon-frederickson-paperback-cover-artCo-Creating Change: Effective Dynamic Therapy Techniques. Jon Frederickson, 2013. 532 pages. Seven Leaves Press. ISBN 978-0-9883788-4-1.

Two things immediately stood out to me about this book. The first was the title. “Co-creating Change” underlines the importance of the alliance between counselor and client. From the get-go, Jon Frederickson sets the stage for a partnership conducive to assisting clients with emotional difficulties.

The second thing that grabbed my attention was the bulk of the work. At over 500 pages, it was a little daunting to pick up and dive into. Fortunately, Frederickson has divided the chapters into sub-topics and the text flows so smoothly that before you know it, you’ve read 50 pages and are hungry for more.

Frederickson, an MSW and founder of The Intensive Short-Term Dynamic Psychotherapy Institute, centers the work around the triangle of conflict: feelings trigger anxiety → anxiety triggers defenses → defenses create problems. In order to work through this triangle, the therapist uses three principles:

(1) If the patient responds with feeling, explore feeling

(2) If the patient responds with excessive anxiety, regulate the anxiety and then explore feeling

(3) If the patient responds with a defense, help them see and let go of the defense and then explore feeling

Co-Creating Change is divided into three parts: an outline of the basic principles; working with fragile patients; and working with highly resistant patients. In the first part the reader is introduced to the triangle of conflict with an in-depth look at each “angle.” Feelings is first on the agenda where the reader learns how to help a client identify and pay attention to feelings, experience feeling in the body, and maintain the focus on feeling. Frederickson notes the importance of recognizing feelings do not hurt the patient; defenses hurt the patient. Feelings do not cause the patient’s suffering; defenses do. Feelings do not make the patient fall apart, anxiety and defenses do.

A great deal of part one is spent on identifying anxiety. Frederickson lists several ways of identifying bodily symptoms of anxiety, which include somatic symptoms: tension headaches; tension in arms, shoulders, and neck; sighing; and clenched fists; sympathetic symptoms: dry mouth and eyes; dilated pupils; blushing; and shivering; and parasympathetic symptoms: salivation; teary eyes; dizziness; and foggy thinking. Once anxiety is identified, Frederickson includes ways of assessing and regulating the anxiety by inviting the client to observe and pay attention to the signs.

Next the subject turns to defenses. Many defenses are identified and discussed such as avoidance, denial, distancing, and evasiveness. Vignettes provide sample scripts for clinicians to use but unlike most scripts found in counseling related books, Frederickson includes what I like to call “real world” scenarios. These vignettes are not from a model client (i.e. a client who says all the right things) but rather from a realistic client, full of unknowns. Frederickson also provides treatment strategies for depression, somatization, acting out (anger/rage), defiance, rapid and/or loud speech, impulsivity, and others.

Parts two and three provide numerous tips and vignettes in how to effectively work with fragile and resistant clients. Part two addresses how to build a capacity in a client to observe feelings and how to identify and work with regressive defenses. Part three deals with the Superego and covers character defenses, transference, and the unconscious.

At the end of each chapter Frederickson provides a list of recommended readings separate from the bibliography. Additionally, there is a list of recommended materials that include links to online video presentations by the author and others on the chapter’s topic. Viewing the videos at the completion of a chapter is an excellent way to ensure the desired message of the chapter is received. Frederickson also includes helpful charts that diagram, in an easy visual form, content from the chapters. 

There simply is no way this small review can cover the tremendous amount of information contained in Frederickson’s work. Along those same lines, I found it impossible to take in everything in just one reading. Even with the helpful online video links, this is a book that needs to be read and then re-read in order to get the most bang for your buck.

Recommended 

Note about ratings:

 Rate  Meaning
 Highly Recommended  Seriously check this out!
 Recommended  I liked it and you might, too.
 Meh  Not bad but not good either
 Yawn  Need something to help you sleep?
 Seriously?  Someone actually wrote this?
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