“I keep giving up on therapy because I am so sick and my brain can’t process or remember anything they say.”
Someone said this in a social media group for people with Chronic Fatigue Syndrome (CFS).
It’s a reminder of why having several tools in your therapy toolbox is important if you are a therapist.
If you work with carpentry or gardening, you have several tools for different situations and purposes. So why not also if you work as a therapist?
For instance, if I worked with someone with relatively severe CFS, I would not do talk therapy. I may talk a bit with the person initially to get an idea of where they are at and what their needs are, and then I would choose an approach that’s more process or somatic-oriented.
For instance, I may try Tension and Trauma-Release Exercises (TRE). If the person has severe enough CFS, I may just go directly to the last position and see if tremoring is happening and how the system responds in general. If there is tremoring, it can help the person release tension and frozen patterns in the system, which can help with well-being and it may even help with the CFS. (Releasing frozen patterns can help the system get more access to its energy.)
I may also guide the person through a process, similar to what we do in Process Work (Process Oriented Psychology). I did that myself a few days ago when I woke up with strong brain fog and fatigue. See Exploring brain fog and disorganization where I recorded a few things from this process.
Depending on what the person feels she or he is able to do, another option may be to do a Big Mind dialog where the person gets to explore different parts of themselves and their relationships.
Another option is heart-centered explorations like ho’oponopno and tonglen. As part of that, I would have the person visualize herself or himself in front of them, and doing ho’o or tonglen with themselves. This can help with self-compassion. In general, these practices help with well-being and shifting one’s relationship with oneself, others, situations, and life in general.
All of these are more visceral processes and it’s not so important if the person remembers anything or not.
On a personal note: A part of me gets a bit upset when I read what this person said. As a therapist, it’s your responsibility to have a wide range of tools in your toolbox. Talk therapy is useful in some situations and with some people, or as an intro to a more visceral approach, and it’s far from the best tool in all situations. It’s irresponsible and unprofessional to use it if the person is unable to benefit from it.