Case Study


Case Study

When Actions Speak Louder than Words: Creating Change Through Therapeutic Rituals

By Paul Leslie

May/June 2022


When therapists work with clients who don’t seem to respond to ordinary cognitive therapeutic approaches, it’s easy to feel stuck and frustrated. I know I’ve felt that way. After years of attempting to use talk therapy to help these clients alter their entrenched beliefs, I’ve discovered a more effective way to help them connect with their deepest experience—through the use of therapeutic rituals.

The hallmarks of talk therapy—insight, cognitive restructuring, and exploration of etiology—may not create change in clients who can’t seem to override their ingrained, unconscious patterns. In those cases, the amygdala, or emotional brain, may be running the show.

Since the emotional brain is nonverbal, sensory based, and symbolic, it’s not surprising that verbal, cognitive approaches aren’t always sufficient to create change. Because our emotional brain is geared to detect threats that are associated with past experiences, similar situations trigger involuntary responses. Although these responses may appear to be intractable, they can change in response to new, intense experiences that alter previous associations.

Healing rituals to alleviate emotional distress occur in many cultures. I first came across the use of therapeutic rituals early in my therapy career, when I was introduced to the work of Milton H. Erickson, the renowned psychiatrist and hypnotherapist, who sometimes designed unusual procedures and rituals for his clients to perform. Therapeutic…

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