The Origin of Constructed Awareness

In my counseling graduate program, I learned what all young therapists learn—cognitive behavioral therapy (CBT). CBT has been around forever. It’s been researched extensively, and the research has shown it time and time again to be effective (or so I was taught). In school, I learned how to develop treatment plans and set goals. I learned techniques like thought-stopping, cognitive reframing, and reflecting feelings. I gained the tools I needed to help people (or so I thought). All my hard work and preparation came crashing down the first time I sat in front of a real client. As the person told me their story of why they came into therapy, a sense of dread washed over me, and I was faced with a realization that I knew nothing and had nothing of value that could actually help the person. 

But I tried anyway. I did the things I learned in school. The client and I worked on a treatment plan and set goals. I had hope, and so did the client. Unfortunately, the client returned week after week in worse shape each time. Why? Because they failed to meet the goals and expectations of the treatment plan. It wasn’t for lack of trying. The client made a good effort, but their symptoms persisted. Only now, things were worse than before because of added thoughts like, “What’s wrong with me? Why can’t I follow the plan? I must really be a terrible person.” And I, too, felt like a failure and thought, “I must be a terrible therapist.” 

But I kept trying. Surely, the stuff I learned in school would work if I kept using it. My teachers told me CBT techniques were the way to go because they were empirically proven to work. But they weren’t working, so the only logical explanation was that I was doing something wrong. However, my supervisors maintained that I was performing well based on their observations. So why was it not translating into my counseling sessions? After repeatedly feeling inept, I decided that goal-oriented and solution-focused approaches were not for me, and I began looking for a different way of doing therapy. 

Along the way, I became interested in the emerging mindfulness-based approaches, which were cutting-edge at the time. They even had an exciting nickname—the “third wave” of CBT. These mindfulness-based methods piqued my curiosity, which led me to adopt a personal mindfulness and meditation practice. For the next few years, I took a deep dive into mindfully observing the parts of my experience. My interest in Eastern philosophy and spirituality grew (i.e., Buddhism, Taoism, Advaita Vedānta Hinduism, and Christian mysticism). I also found myself drawn to therapeutic techniques on the fringes of the counseling field (i.e., transpersonal psychology, somatic therapy, hypnotherapy, etc.). Through mindfulness and meditation, I learned about the nature of my mind, sensations, the external world, and the self. These practices changed my life significantly. My body felt calmer and less reactive. My thoughts were clearer and quieter. I felt connected to the world around me for the first time. These changes and the practices I used to attain them naturally flowed into my work. I started incorporating this new way into my counseling practice.

Around this period, I also discovered Ron Kurtz, a pioneer of somatic therapy, founder of a brilliant type of psychotherapy called the Hakomi Method, and a major influence on the development of CA. In his book Body-Centered Psychotherapy, Kurtz talks about “violence” and “nonviolence.” One line in particular struck me. He said, “When someone simply assumes they know what is best for others, you have violence.” At first, I resisted this sentence. It seemed too extreme. But as I read on, I understood what he was saying. If I, as a counselor, decide what’s best for the client, and I begin imposing my will about what I think is best, I’m behaving in an oppressive and violent way. This is true even if I assume that the client should feel better. Therefore, nonviolence in therapy is a commitment to not imposing personal values or opinions about what is good or bad, right or wrong, what a client should or shouldn’t feel, and, instead, trusting in clients’ natural ability to heal themselves. 

All these insights about mindfulness and nonviolence led to profound personal growth. I had tried lots of different things. I pondered: What was the key to my development? My answer to that question led to the first principle of CA: Bringing awareness to the client’s experience changes their experience. I realized my transformation wasn’t due to mindfulness practices or my ability to do them well. The change was the result of the awareness that the practices inspired. Over and over, I mindfully observed my thoughts and feelings, and over and over, they changed. My enhanced awareness changed my life. My habits, my way of thinking, and my connection to my body, the people around me, and my higher self were drastically different. I felt new. My marriage, my relationship with my kids, and my role as a counselor, all of it felt renewed, and I attributed the change solely to the awareness I brought to each area of my life.

When I realized the potential power of awareness, I dropped all goal-setting and solution-seeking in counseling sessions; instead, I began leaning solely on awareness as the agent of change. Instead of forcing change upon the client’s experience, I devoted myself to helping them improve their awareness of their experience and trusting awareness to bring about change. 

Finally, my clients began reporting transformations in their lives, but neither I, their therapist, nor a treatment plan dictated the change. The change arose from their own inner wisdom. 

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CA’s second and third principles were inspired during my time as an Eye Movement Desensitization and Reprocessing (EMDR) therapist and trainer. I received my initial training in EMDR in 2016, and within the next year, I was certified and on my way to becoming an EMDRIA-approved consultant, which meant I helped other therapists become certified in EMDR. Once I completed my consultant training, I became an EMDR trainer, leading basic and advanced trainings, as well as presenting at professional conferences. 

The idea to develop CA into a training was conceived during the last hour of the very first EMDR training I taught by myself. It was the end of the last day of the event. I had dutifully taught the eight phases of EMDR. Phase 1 is the “history-taking” phase, where the therapist gathers information about the client’s life and how they respond to stress. Phase 2 is the “preparation phase” or “resourcing phase,” where the therapist practices resources designed to prepare clients for processing in phases 3-8, which are the ones everyone knows as EMDR. Phases 3-8 are where the processing of traumatic memories happens using eye movements. I had spent hours, over six days of training, teaching participants EMDR resources. So when, during the Q&A portion at the end of the day, a participant asked, “What’s a resource?” I realized she lacked an understanding of the entire phase 2 of EMDR. I was determined to do better next training. But no matter how hard I stressed history taking and resourcing in future events, I received the same questions: “What is history taking?” “What is resourcing?” “How do we do history taking?” “How do we do resourcing?”

People were much more confident performing Phases 3-8 but struggled immensely with Phases 1 and 2, and I wondered why this was happening. I concluded the problem was an inconsistent structure within the EMDR phases. For phases 3-8, a clear structure was provided for the clinician by the EMDR script. Therefore, there was less confusion. Trainees could confidently follow the script with little guidance, and their assurance was reflected in the questions they asked during training about Phases 3-8. But when it came to Phases 1 and 2, there was no structure or script to guide trainees. There was no direction regarding when and why to do certain resources, leading participants to ask questions that reflected their insecurity and self-doubt. On the other hand, I was having success in Phases 1 and 2 because I had unwittingly developed a structure. This structure, the model that would become CA, was revealed by a simple question that I asked clients over and over: What are you noticing now? During EMDR processing, this is the most common question therapists ask. While working with nearly 200 clients in my private practice from 2016-2020, I witnessed patterns emerging from their responses to that question. These observations led me to a new understanding of how clients orient their awareness. 

Mental Orientation: When asked what they noticed, some clients answered primarily with thoughts. I could tell they naturally relied on logic and reason to understand what they were processing. Outside of sessions, they did the same. I realized these individuals typically relied on their minds to regulate themselves, and they preferred to connect with people, including me, more intellectually. I thought of these individuals as “Mentally Oriented.” 

Sensation Orientation: Other clients expressed themselves more physically during EMDR sessions and responded to the question primarily with what they felt in their bodies. While processing memories with EMDR, they cried, shook, twitched, vocalized, and moved cathartically in various ways. Outside of sessions, they reported stronger sensitivity and emotional reactions than other clients, put a lot of energy into ensuring their physical bodies were as comfortable as possible, and connected with others more physically, enjoying touch and sharing space. These clients were all about their feelings, so I considered them “Sensation Oriented.” 

External Orientation: Finally, I observed that other clients relied on their external environment during EMDR processing. When asked, “What are you noticing now?” they hid their pain from me and edited their responses to ensure that I was not uncomfortable. They often answered by asking if I was okay, or they would become easily distracted by things in the office and even things they heard in the lobby or saw outside the window. It was clear they were using things in their external environment, including me, to regulate themselves, and they did this outside of sessions, too. These individuals were prone to manage their environment and people in their environment to regulate their emotions. Basically, their approach was, “If you’re okay, then I’m okay.” When stressed, these individuals cleaned and organized their spaces and/or took care of other people. I identified these clients as “Externally Oriented.”

This insight led to CA’s Second Principle, which states that the human experience is made up of three building blocks: thoughts, sensations, and external senses. Everything ever experienced is only made of those three things. It’s pretty wild to think our entire conscious experience can be boiled down to such a simple arrangement of parts. 

This organization of experience was enhanced when a friend directed me to Lisa Feldman Barrett’s theory of constructed emotion, which breaks away from classical theories that view emotions as innate, predetermined responses. Instead, her theory suggests that instances of emotion are constructed by the brain as needed in the moment based on internal and external stimuli and past experiences. Barrett’s book How Emotions Are Made provided an empirical framework for what I saw regarding client orientation and provided a scientific theory to support CA’s three-factor construction. 

CA therapists understand that thought + sensation + external stimuli = emotion. We consider “emotions” simply as concepts, words that describe the collection of the parts that comprise them. And rather than working with “emotions,” CA therapists work with the building blocks that construct them. In fact, I named CA “Constructed Awareness” because practitioners bring awareness, the agent of change, to the building blocks that construct their emotions. For more information about CA’s construction of emotion, check out my blog entitled, “What are emotions?” 

This realization about the three building blocks led to the Third Principle of CA, which states that most people naturally orient their awareness more strongly to one of the three building blocks. Some clients are Mentally Oriented. Some are Sensation Oriented, and others are Externally Oriented. I defined orientation as how someone uses their building blocks to regulate themselves, connect with others, and meet their needs. As previously noted, clients tended to rely on one part of their experience, or building block, to regulate themselves and make sense of their experience in and out of session. 

Armed with this knowledge, I wondered what would happen if I returned to the drawing board. What if I could determine the client’s orientation in Phase 1 of EMDR and develop resources in Phase 2 to enhance the client’s awareness of the less-developed building blocks? 

Would this enhance the processing? 

As you probably guessed, it did. 

I officially decided to turn the CA structure and theory into a training while teaching an event on the West Coast. The group, like all the training groups before them, was struggling with questions about EMDR Phases 1 and 2. I had a method that could help with that, so I asked them, “Would anyone be interested in an advanced EMDR training that focused on putting structure around Phases 1 and 2?” The room buzzed with excitement. Their reaction confirmed there was a need that I could fill. 

Originally, the CA training was intended to be an advanced EMDR training, but as it came together, I couldn’t justify the new model with the tenets and definition of EMDR. It was an entirely new approach. In 2020, I stopped teaching EMDR and focused solely on developing, teaching, and researching CA. The material from the original CA training became Constructed Awareness, Level One: Resourcing Trauma Through Deeper Awareness. Later, I developed a new way to process traumatic memories, which is what trainees learn in Constructed Awareness, Level Two: Reconstructing Traumatic Memories.

Well, there you have it. That’s the story of how CA came into the world. If you feel connected to my story or theory, check out the CA website at constructedawareness.com. We’d love to see you at a future training. CA is new and emerging. I’d like to invite you to be a part of the story as it continues to unfold.