¶ Normalization in Therapy
Hi there , everyone , and welcome to our licensure exam podcast . I'm your host , dr Linton Hutchinson , down here in hot and sunny Florida , and this is my co-host , stacey Frost . How you holding up there , stacey , in that frozen northern thunder of yours ?
Well , not as cold as you might think . This week , linton , I think I actually stepped through a portal into your Florida jungle , but without the excitement of seeing those beautiful butterflies and dragonflies and the occasional fairy , my office here in Michigan feels like it's a sweat lodge .
I've actually had to jump in the shower a couple of times today just to cool off . I do not know how you do this day in and day out , linton .
Well , it's really easy , Stacey . It's something called air conditioning Touche . It's something that you northerners have yet to discover , you know . But on a side note , how's that crappy situation up there in your new homes ?
Oh , you're talking about the sewer backup in the basement Right exactly .
Oh my gosh .
Well , it was not what I expected to wake up to , you know , in the middle of the week , but there you go . It's always something to keep you on your toes . We've got it sorted out , though for now we rented one of those long snakes , you know and kind of got out the tree roots and crap that we're backing it up .
So everything's okay , at least for the moment .
Yeah , but you know the thing ? Still , it stinks , doesn't it .
Oh , it does . The disinfection process right now .
Oh my gosh . Well , stacey , what's on the agenda today ?
Well , one of my favorite topics microskills and specifically normalization . So in therapy , normalizing is the process of reframing a client's experiences and feelings to help them understand that what they're going through is quote unquote normal or typical , and doing this reduces feelings of isolation and stigma and helps build trust .
Right . So normalization is based on the idea that all humans have shared experiences , such as pain , joy , love and fear all of them , everybody . So those feelings have a tendency to unite everyone , no matter what their circumstances are . So in moments of crisis or emotional distress , you , as a therapist , can use normalization that offers compassion and understanding .
Those are the two essential ingredients that you need to build a therapeutic and trusting relationship .
Exactly .
So let's have some examples . Okay , let's say that you've got a client named Cindy if that's her real name who is dealing with intense grief after the loss of her mother .
You see that she's just consumed with sadness and she thinks about her mother all the time and she's got this intense longing for her mother and at one point she actually says to you I don't know what's wrong with me .
It's been over a year since my mother passed . I should be over this by now .
Well , to normalize Cindy's reactions to the loss of her mother , you might explain to her that grief doesn't have a timeline and her feelings are just absolutely normal and it's really just part of the morning process . And , by the way , stacey , would your diagnosis be PTSD or persistent complex bereavement disorder ?
Don't you mean prolonged grief disorder Linton ?
It doesn't sound like I can pull a wall over your eyes . Looks like someone's been using that DSM-5TR Absolutely .
And you therapists out there should also be using the DSM-5TR if you're studying for your licensure exam . All right , here's another one . David is struggling with test anxiety .
I don't know , Stacy . I don't think anyone listening out here can really relate to that at all .
No , no , not at all . No one out there struggling with testing anxiety .
No no .
Well , david feels paralyzed every day and continues to put off studying for his licensure exam . And he says to you I'm not usually this way .
I can't seem to make myself study . What's wrong with me ?
Well , to normalize David's feelings , you might tell him that anxiety manifests in different ways and feeling overwhelmed by decisions , even the seemingly small ones , is a common experience for people struggling with anxiety .
You could also throw in some psychoeducation and explain that feeling anxious can be an adaptive response when you're confronted with stressful situations or uncertain outcomes . You could let him know that , paradoxically , a bit of anxiety can actually be a good thing .
It seems kind of counterintuitive , but moderate anxiety can be beneficial in situations like taking an exam . It's been linked to increased focus , improved recall and overall improved performance . Ever heard of the Yurkis Dodson Law there , linton ? That's the magic behind it . We can look that up one day .
I'm going to have to . So why are we normalizing Cindy's and David's experiences again ? What's the point ?
Well , we're giving the client permission to express their feelings without judgment , which helps create a compassionate space where they can feel comfortable and safe to express themselves .
Yeah , and by normalizing your client's feelings , you help them see that they are not alone or strange Not that there's anything wrong with that which ultimately helps them to feel heard , accepted and free to process their emotions in a more healthy way .
Gotcha . So , Linton , it sounds like you're saying normalization is a good thing . Is this always a good answer option when you're practicing for an ?
exam . That's a great question , stacey , and the answer is absolutely Definitely , you guessed it , no .
Oh .
I know that sounds wrong , but normalization isn't always the best or most appropriate response . It's essential to be mindful of when and how you use it , especially if your client describes a behavior that could harm themselves or harm others .
Yes , In those situations , it's really important to focus on safety first Right , Assess the risk , provide support , implement crisis intervention techniques if necessary and take whatever action is required to ensure that everyone is safe .
Exactly Now . Here's another example of when normalization is not the best response when a client is using unhealthy coping mechanisms like substance abuse or self-harm to cope with their issues , If you attempt to normalize that behavior , you could give them the impression that it's okay to continue down those paths , which is not exactly what you want them to do .
Right . So normalizing dangerous or destructive behavior might unintentionally condone or encourage it and set your client up for further trouble .
Exactly so . In cases where the client is engaging in dangerous or destructive behavior , instead of normalizing , what do you do ?
Okay , well , you might consider validating and empathizing with their experience . So , for example , saying something like I understand why you might feel like drinking is the only way to cope with your pain , or it makes sense to me that you want to numb the pain that you're feeling .
So , with these responses , you're acknowledging what they're going through , providing empathy and compassion rather than judgment or criticism .
Right In that judgment and criticism . They're probably getting enough of that from their family and friends to begin with . So part of your job as a therapist is to provide a supportive and non-judgmental environment for the client to be able to safely explore their feelings .
Very well said . So now a quick recap of what we have talked about today .
¶ Validation and Normalization in Counseling
Validation is about recognizing someone's experience , their emotions and reactions and responding empathically with understanding and support . It doesn't necessarily mean that you agree with their behavior , but you understand where they're coming from . So that's validation .
Normalization , on the other hand , is about reframing a client's experiences and feelings to make them understand that what they're going through is normal given the circumstances , or that it's a common reaction . And this really reduces feelings of isolation and stigma and can help build trust .
And also , it's important to note here that sometimes normalizing your client's experience , those feelings and behaviors , is not the best response on a practice exam . An example is when your client engages in destructive or dangerous behavior . Well , there you've got it Stacey .
You can check normalization of your list of skills to reveal off the chart . So until next time , happy studying and remember it's in there .