William L. Mulligan, Ph.D.

The Art and Science of Psychotherapy

There are many schools of psychotherapy and, most of us have some preconceived ideas about therapy and how it should work. I have prepared this page to give you a clearer picture of the type of therapy I provide and what you might expect as a prospective client working with me.

"The Therapist" by Rene Magritte (1937)

Basic Ingredients

First and foremost, your therapist has to be someone you can trust, someone who understands you, who genuinely cares about you and provides you with the kinds of information, guidance and feedback that makes sense and produces results. In a nutshell, you should feel comfortable with your therapist, have confidence in him or her and you should see some results within the first few sessions.

As Magrite portrays in the painting to the left, therapists offer clients the opportunity to escape their own personal cages.

"The Beginning" by Cecilia Betancourt www.betancourt-art.ch

Psychotherapy, like good medical care, is both art and science. It is a collaborative effort between professional and patient. I believe everyone needs a flexible PLAN to guide them toward their goals. In therapy, I help my clients clarify what their primary problems are and what specific results they want to achieve. Then, we identify specific action steps that will enable them to reach their goals. 

We all want many of the same things in life: health, loving relationships, confidence, peace of mind, financial security, success, happiness, etc. How successful we are in reaching our goals depends upon having the necessary (1) will or motivation, (2) the knowledge or skills and (3) a well-conceived action plan. My job is much like a coach, to inspire and motivate you, while giving you the necessary tools. Your job is to do the necessary work to implement your plan, and to persevere despite expected obstacles. The results you seek are generally possible and worthwhile, but they will not occur overnight or without sustained effort.

Increasingly, research shows that a combination of medication and cognitive behavior therapy produces the best treatment results for many conditions. I work closely with a number of primary care physicians and psychiatrists who can provide medication management, if this is needed.

Multimodal - Cognitive Behavior Therapy 

I trained extensively with Dr. Arnold Lazarus, the founder of Multimodal Therapy. This approach is a comprehensive form of Cognitive Behavior Therapy and can be described as generally:

• Shorter-term (average of 12 sessions, with a wide range; some clients, who should be seen much longer, drop out after 1 or 2 sessions, while others continue therapy for well over a year; the number of sessions a client is seen depends on many factors, principly the client's motivation and the severity and duration of the presenting problems)
• Holistic (concerned with the whole person; recognizing the important  interactions of biological, psychological and cultural factors),
• Eclectic (using a variety of treatment methods),
• Pragmatic (designed to get specific results)
• Humanistic (emphasizing conscious awareness and efforts to cope with the real world), and
• Educational (providing information and teaching clients more effective coping skills).

The Seven Primary Modalities

In providing a thorough Initial Evaluation and comprehensive treatment, multimodal therapists systematically address problems in each of the following modalities:

• Behavior (progress is usually limited without changes in action)
• Emotions (anxiety, anger, guilt and depression)
• Physical Sensations (stress-related, psychosomatic symptoms)
• Imagery (visual pictures)
• Thoughts (success at just about anything requires positive, rational thinking)
• Relationships (social skills, communication and conflict-resolution skills)
• Health (nutrition, exercise, possible need for medications)

"Female Torso" bronze by William Mulligan

The General Objectives

At a more abstract level, and in keeping with the spirit of the Serenity Prayer, you could say I help clients:

1. take constructive action to change those things they can change,

2. become more accepting of the things they cannot change, and

3. learn how to more skillfully distinguish those things they can change from those they cannot change.

"Duo" by Cecilia Betancourt www.betancourt-art.ch

Life Transitions

I help clients navigate through predictable and challenging Transitions in Life, such as the following:

Childhood (building self-esteem, family relationships and school performance)

Adolescence (peers and social skills, independence struggles with parents, self-esteem and identity)

Young Adult (transition to greater independence, dating, sex, college and career)

Marriage (Mars and Venus themes, communication and conflict-resolution skills, satisfying individual needs while working as a team to manage family life. 

Separation and Divorce (learning and growing from one of life’s most painful crises, while minimizing hostilities...primarily for the children's welfare)

Mid-Life Crazies (change is unavoidable and can be positive, more opportunities to learn and grow)

Retirement (are you prepared for your "golden years"?)

Older Age (caring for elderly parents and aging gracefully as we come to terms with the fact that none of us live forever).

"Attached" by Siri Dehipitiya www.siridehipitiya.com

A Case Illustration

Mrs. Smith, a 34 year old mother of three children requested therapy, complaining of anxiety and bouts of depression. Once rapport had been established, Mrs. Smith's vague, global states of dissatisfaction (e.g., fear and unhappiness) were broken down into:

specific and discrete problems, such as depressed mood; negative thoughts about herself, her husband and her future prospects; inability to communicate or assert herself effectively; self-destructive, addictive behavior (overeating and excessive drinking); headaches and muscular pains; and insufficient exercise, which in turn were addressed with:

specific interventions that were largely

educational in nature, such as the following:

Cognitive restructuring and rational-emotive therapy. Mrs. S. was taught how to replace negative, irrational thinking with more positive, realistic thoughts about herself, the significant people in her life, her future prospects and the world in general;

Referrals to her physician and a psychiatrist for medical and psychiatric evaluations to rule out any medical basis for her presenting complaints and to determine if medications might be a beneficial treatment for her anxiety; depressed mood and headaches;

Assertion training and Communication Skills Training;

Marital therapy for conflict resolution, parenting and sexual complaints;

Physical exercise, nutritional counseling and relaxation training (with guided imagery) for physical and stress-related complaints;

Referral to a community support group and to other community resources (e.g., a parenting group, couples support group and Weight Watchers) provided specialized help and support from others with similar problems.