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Therapy Lingo

Titration

Boost Your Results: Work with Shorter List

Counseling Tip

Some clients arrive at the therapist's office anxious to discuss a long list of topics. If this describes you, I'd encourage you to consider a smaller list.

counseling list

It's usually far more effective to explore one topic than it is to rush through many. The value of therapy is less in making sure your therapist knows all the details than it is in experiencing parts of your story with your therapist.

Give yourself plenty of time to process what happens--as it happens--in the session as you talk about your concerns and as your therapist responds.

Allow yourself to settle in at the beginning, during and at the end of any subject. In other words, let your body catch up to your words.

My Private Practice Changed Overnight

The process of titration completely transformed my practice when I came upon it several years ago in my training as a body psychotherapist. My clients enjoyed faster results and the work got easier for both them and me.

What happened?

By working with smaller amounts of fear in the body - what's called titrating - clients reported faster changes. By reducing the amount of emotional material we worked on (i.e. chunking the work in smaller bits), paradoxically it had the effect of creating a better healing environment.

We accomplished more with less!

Titration is a process for managing energy.

Non-cathartic and holistic treatments such as homeopathy, craniosacral therapy and body psychotherapy are based on the practice of titration.

In actual fact, titration is a term from chemistry. When two opposing chemicals are put together quickly there is an explosion.

titration in counseling

However when the chemicals are mixed slowly over time, drop by drop, the explosion is avoided.  That's titration!

 

So, it's a gradual adjustment of energy, small enough that it's easy to absorb and accommodate to. What is potentially oppositional is transformed into something that is complementary.

Titration in psychotherapy

In the therapeutic process, titration refers to easing the amount of material you are working on e.g. activation/arousal, emotions etc. so it's easier for your nervous system to handle. For example, a psychotherapist would help you to move away from material that he or she felt could trigger too much activation. "Too much" would be anything that moves you outside the window of your body's capacity to cope and into fight, flight or freeze.

Here's what I mean...

In the second session with my new therapist, I am tempted to talk about my abuse history in detail. However, she suggests we wait until I have established a stronger connection with her. She knows that, at this point in the work, the activation associated with my history would likely be too much for my nervous system to deal with.

Not to mention, it would be a lot easier for me to process a small piece of material distantly related to the abuse. In guiding me in this way, my therapist is working with the principle of titration.

Titration is a relatively new concept that derives its importance from the shift away from cathartic methods in therapy (both psychotherapy and body work) towards an emphasis on "containment".

Unfortunately, too few health professionals use titration to advantage, as the technique is still so very new.

My Personal Musings

In order to recognize that a client is within their capacity, it is necessary that the therapist be attuned. And, the more a therapist is self-regulated (in the body) the easier it is to be attuned to clients. 

Reviewed by: Psychologist Dr. Carole Gaato

Related Topics

Containment

Here's an article from the NewYorker Magazine that explains how Toyota's small steps enabled it to beat General Motors, one step at a time:

http://www.newyorker.com/talk/financial/2008/05/12/080512ta_talk_surowiecki

Here's another article from the New York Times. Janet Rae-Dupree explains how any change potentially triggers the fear response. Yet, by working in small, incremental steps we can achieve more and keep our creative juices flowing:

Unboxed: Can You Become a Creature of New Habits?

Overcoming Phobias with Brief Therapy

By reducing the charge in the nervous system around a fear a spiders, these clients were able to hold a tarantula!

The more newsy part to me however...was how this experience changed not only their fear associated with spiders - it lowered their overall fear state in the brain.

Now that's news!

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Reader Comments

Julie (UK)

I have stumbled across your website but I am so glad I have. Your very knowledgeable and inspirational. Just to say...Thank you.


Dude

Intersting article. How does this play out in 'every day' life though?

Dude

So glad you asked Dude. You can use titration for anything you want to exceed at and especially those tasks or challenges that are overwhelming when approached head on. For instance, titration is at the heart of "chunking" a process for breaking down a task into manageable chunks. This is especially useful if you find yourself avoiding certain tasks.

Some everyday examples are explained in the links at the bottom of this article. One concept, the Japanese notion of kaizen entails making incremental changes. It was responsible, in part, for Toyota's rise to the top of the car industry.

What's important to understand is that each person has a different capacity to tolerate challenge. This capacity is based on the size and health of the nervous system. When we approach a task that we feel is too much, it potentially moves us into fight, flight or freeze. However, by making the task smaller, it keeps us within our window of tolerance. In other words, we've reduced the task into bite sized bits so we don't feel so stressed about it.

When you approach a difficult task a little at a time, you make it far easier for the nervous system to handle. This is especially useful for folks who have a hard time taking initiative or are so maxed out, everything feels unmanageable.

However, no matter where you start, due to brain plasticity, it is possible to expand the capacity of the nervous system. So, each time you reduce a task into manageable pieces, you are also training your nervous system to manage more. This is particularly so when you are in the company of another nervous system, as you are with a therapist (especially one who is adept at helping you manage activation).

I could write much more on titration as it's really exciting news for how we approach our goals. For instance, I think there are reasons for "laziness". In other words, it's very likely that "laziness" is not a flaw of character...but that's another story.

Hope that gives more depth to the topic,

Shrinklady



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Gee, do ah' need t'make notes? I'll neva' rememba' all dis.