People seek counselling for a number of reasons, yet what unites these is a desire for something to change.
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Why do we do what we do, think what we think? What keeps us behaving in a certain way, keeps us locked in the shadow of anxiety or depression, keeps us repeating the same mistakes within relationships or keeps us isolated and alone? And equally what stops us moving forward, overcoming failure or fear, and embracing the positive and the future?
Whereas some approaches, and indeed some therapists, focus exclusively on feelings, my view is that for therapy to be considered successful, it must result in some change. That change can be behavioural or cognitive, it can be a major life change or just a tweak in how you view things, but it has to be something.
However, change requires work. It can be difficult and painful and it takes time. Occasionally clients arrived wanting a ‘quick fix’, perhaps advice for a specific issue or dilemma, such as whether to stay in job or to leave a relationship. Although as a therapist I can sympathise and offer some guidance on these issues, it is important to recognise that the therapeutic process (as opposed to say life coaching) involves looking deeper, looking beyond the surface.
It believes fear or despair result from aspects of yourself which have been blocked or thwarted due to past experiences, and that through connecting and accepting these hidden aspects, we can exert more control over their influence. Consequently, therapy is a process, normally lasting between two and six months, of making you aware of, or making you listen to what you already know.
How it works
If you have never attended therapy before, or even if you had, it can be useful to reflect on what actually is therapy and how does it work. How does sitting down in a chair and talking to a relative stranger about your problems help, or how is it different from talking to a friend or even talking to yourself. The truth is that, is that an all honesty we don’t know how it works, and equally there are times it doesn’t. Not everyone has a positive experience of counselling with some find it frustrating, confusing and a waste of both time and money.
Often the relationship is cited as the key factor in successful outcomes but this relationship is also a consequence of the style of the therapist. For although there are a wide number of therapeutic approaches and theoretical models, therapists themselves tend to fall into two camps: therapist as witness versus therapist as detective.
The former tends to lean heavily on exploring emotions, you will hear the phrase ‘tell me how that makes you feel’ a lot, and although the therapist may offer the odd observation, this approach is strictly non-directional. It is defined by giving you the space to talk about whatever you want and even giving you the space not to talk, to sit there in silence if you chose. Theoretically this position can be classified as humanistic and stems from a therapeutic belief that clients have the strength and knowledge to essentially ‘heal themselves’ and the therapist role is simply to give them that space, to essentially be a mirror to the client.
A difficulty for some is that individuals often seek counselling in moments of chaos or confusion, which in truth, can be compounded by a non-directional approach and perceived therapist passivity. Those who lean toward the detective style argue that without some guidance sessions may meander or become repetitive. and therefore, part of their role as professional psychotherapists is to shape or direct the session. This approach will often be characterised by more challenge, more questions, and particularly with an approach such as CBT, less interest in past events or how you feel, and more focus on the mal-adaptive thoughts or behaviours in the present. It may involve the setting of goals, and requires you have a clear sense from of what you wish to get out of therapy.
The danger is that the very act of shaping or directing of sessions becomes a reflection of the therapist’s agenda, which may overtime lead to a direction of travel that is at best parallel, at worst counter to the client’s wishes.
Of course, many therapists employ a mixture of both these styles and integrate a number of theoretical models. Both approaches have their strengths and weaknesses; some feel the detective approach can at times be too prescriptive, too superficial; it can focus on thoughts without any real exploration of the history of such thinking. But equally the danger with a humanistic approach is that it gets bogged down, lost in the emotions, without offering a path or framework out of unhappiness or confusion.
How I work
As with all therapists, I have to chose between directing and following, between asking questions and saying nothing. Like most therapists my approach is an integration of a number of theoretical models, however, by instinct I lean towards a more structured approach and a more problem solving dynamic.
Central to how I work are the concepts of awareness, adaptation and acceptance; and although typically awareness is the first challenge, I tend not to view these steps as sequential.
Often times we have only a hazy understanding of why an exchange or situation makes us so emotional, or why we just can’t seem to get past some obstacle that is making us unhappy. It is my view such blocks are often located in the past, whether it is childhood relationships with our parents or previous friendships, and that these exchanges result in beliefs we hold about ourselves that still impact on our daily life. With awareness we start to examine the source and challenge the nature of such beliefs, particularly any deeply self-critical thoughts and feelings of being worthless or a failure.
Adaptation tends, at least for me, to be more behavioural then cognitive, although many practitioners view it the other way round. How are you going to change how you behave as a result of therapy? The challenge facing all talk therapy is that it may alleviate the symptoms without targeting the cause. For example, if you are lonely, we can explore patterns of relating, history of social anxiety or low-self-worth, automatic negative and critical thoughts, or even unconscious defence mechanisms carried over from childhood. However ultimately you will continue to feel lonely until you meet someone with whom you can connect. So for me, part of this process is recognising sometimes talking will only get us so far.
Whereas adaptation looks at what we can change, to some extent acceptance is a reflection on what we can’t. Not everything about ourselves, whether that is our personality or how we see the world, can be altered. Nor necessarily should it. Indeed, individuals who are engaged in a programme of constant self-improvement can themselves be blinded by some deeper, critical drive, a fear to accept who we truly are, faults and failings.
While, as a therapist, I understand the importance of self-improvement and of working on oneself it important to balance this with accepting our true selves. Indeed, it can be helpful to view therapeutic process in terms of balance: between what we can change and what we can’t, between ignoring the past and being defined by it, between denying emotions and being overwhelmed by them. And through striking a balance, moving forward.
Please contact me if you have any questions or would like to arrange an initial consultation.
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It's difficult to control what we don't understand. The following articles and videos aim to give you some insight in how therapy works, and how it can work for you.
They don't provide all the answers however they can be a useful starting point.
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