“The facts are always friendly, every bit of evidence one can acquire, in any area, leads one that much closer to what is true.Carl Rogers
Are you struggling?
Are you struggling with life at the moment, and feel a need to speak to someone independent? Have you experienced poor mental health for a long time but can’t quite get to the bottom of why? Do your relationships and friendships feel like an uphill struggle?
There are many reasons why someone may seek therapy – from experiences of grief and loss, to traumatic experiences, to just feeling ‘not OK’ but not being able to put a finger on why. Psychotherapy can help us to heal after difficult events, help us to make sense of what is happening in our lives, and empower us to make changes if this is what we want or need. Sometimes, we might just need help with figuring out how to adapt to a change in our circumstances.
What does counselling/
Counselling/psychotherapy is a conversation, but not just any kind of conversation. It is uniquely focused on you. It is one where the subject is your thoughts, your feelings, your issues, and your psychology. The psychotherapist/counsellor helps you to explore these and make sense of them, by making focusing comments on what you have said. This helps you to reach new insights, and feeling understood in this way can be a huge relief that can take the intensity away from a problem.
Will therapy help?
Therapy helps with around 79% of cases. This is quite a high success rate, when you consider that many medical and surgical procedures have a success rate of around 50% (see Cooper, 2008, for more). Therefore, there is a good chance therapy will help. However, it is worth being prepared that sometimes, particularly at the beginning, you can feel a bit worse before you start to feel better. This is because therapy can put you in touch with things that you were previously denying to your awareness. Grief is a good example of this. Grief hurts, and it has to, if the person that died meant something to you. Sometimes people can get blocked in their grief when they over-use the strategy of distraction or constantly push their feelings away. Sometimes it has to hurt before it heals, as they say, and this can be true for psychotherapy.
Cooper, M. (2008). Essential research findings in counselling and psychotherapy: The facts are friendly. Sage; London.
Here are a few examples of some presenting problems I have worked with:
- Depression and feeling low
- Problematic eating
- Relationship difficulties
- Hearing voices
- Problems at school or work
- Post-natal depression and anxiety
- The emotional impact of Covid-19.
However presenting issues are usually not the whole story, and may be covering up other difficulties, that you might need help to get to the bottom of.
Choosing a Psychotherapist
Does my therapist need to be older than me in order to help?
No, they do not. Speaking personally, I have worked effectively with people of all ages, including those a generation older than me. However, for some people it is important to them to see a therapist who is older than them, perhaps because they have a belief that wisdom only comes with age or that they wish for their therapist to have experienced the same life stages as they are going through. This is often down to matters of personal preference, so it’s worth thinking about whether you have any strong preferences in this area when you’re making your choice.
Therapist’s Life Experience
Does my therapist need to have experienced the same life events as me in order to help?
No. It’s not possible to have experienced everything all clients bring and part of training as a relational therapist is to be able to work with a variety of experiences and to increase our knowledge and understanding of such experiences. Our training focuses on understanding what emotional consequences different experiences might have for people.
For example, your therapist does not need to have the same sexuality as you in order to help you. However, you might decide for particular issues that you really want to speak to a male/female therapist or one who is quite public about their sexuality, and this is fine too.
Having said all this, many relational therapists train in the profession because they have been helped themselves by psychotherapy after challenging, difficult or traumatic life experiences – they may not be exactly the same ones as the clients they help but they have usually experienced their own suffering and healing processes, what Jung termed, ‘the wounded healer’.
Emotion Focused Therapy
I have trained with Les Greenberg, a Canadian-based clinical psychologist, who was one of the founders of Emotion-focused therapy.
Introduction to EFT
This is a recent humanistic psychotherapy that developed from combining the principles of person-centred therapy with techniques from Gestalt therapy.
This type of therapy emphasises the role of emotions in both the development of problems and as catalysts for the process of change within therapy. At the heart of this approach is the belief that emotions are vital in alerting us to our needs, but that these signals can become ignored or distorted by ourselves (and others) by the messages we pick up as we are growing up.
According to the theory, psychological problems can arise when emotions are very under-regulated (that is, are felt as completely overwhelming) or very over-regulated (where a person represses their emotions considerably). There are often also particular emotions that a person can struggle with. A common example is when a client cannot feel or express anger this can lead to an inability to protect oneself in situations and relationships with others, and sometimes result in depression (which can be understood in some cases as a form of anger turned in on oneself). The therapy helps clients to achieve more balance in accessing and regulating their emotions. This is often through the use of particular techniques that are designed to temporarily intensify emotion in order that it can be explored together, and made sense of, in the safety of the therapy room.
Person Centred Psychotherapy
Person Centred Theory
The Person-Centred Approach is a type of relational psychotherapy that was originally developed by the influential American Psychologist Carl Rogers in the 1950s, and has been widely used ever since, both in the UK and internationally. According to the theory of the person-centred approach, psychological distress is caused by incongruence. This is when our experiences do not match with our self-awareness. Some of the experiences we are having – whether these are emotions, dynamics in relationships, or thoughts about a situation – are out of our awareness and therefore denied or distorted. This results in what Rogers termed a “basic psychological tension” – which can manifest as anxiety, depression, or dissociation. I have also seen this lead to other problems, such as problematic eating patterns, or hearing voices, as a person tries to cope with overwhelming feelings that they cannot quite describe or put their finger on. The therapist, through offering an empathic, accepting, and congruent relationship, can help the client to reach a state of greater congruence and psychological adjustment.
Person Centred Approach in Practice
Practitioners of the Person-Centred Approach were among the first therapists to do systematic research into psychotherapy. Therefore since the 1950s the ‘necessary and sufficient conditions’ (see box below) of therapy have been grounded in research evidence (see Cooper, Watson and Holldampf, 2010; Pybis et al., 2017). In fact, the presence of high levels of empathy has been consistently identified as one of the most important factors in effective therapy, for both adults (Bohart et al, 2002) and children and young people (Hayes, 2017).
- Bohart, A., et al (2002). Empathy. In J.C. Norcross (Ed), Psychotherapy Relationships that Work. Oxford University Press, pp. 89-108.
- Cooper, M, Watson, J C & Holldampf, D. (2010) Person-Centred and Experiential Therapies Work. PCCS Books.
- Hayes, J. (2017). What leads to change?: Common factors across the therapies. In, Midgley, N, Hayes, J and Cooper, M (eds) Essential research findings in child and adolescent therapy: The facts are friendly too. Sage; London.
- Pybis et al. (2017) The comparative effectiveness and efficiency of cognitive behaviour therapy and generic counselling in the treatment of depression: evidence from the 2nd UK National Audit of psychological therapies. BMC Psychiatry, 17, 215.
[Jac to suggest heading]
The necessary and sufficient conditions of constructive personality change
- Two persons are in psychological contact;
- The first, whom we shall term the client, is in a state of incongruence, being vulnerable or anxious;
- The second person, whom we shall term the therapist, is congruent or integrated in the relationship;
- The therapist experiences unconditional positive regard for the client;
- The therapist experiences an empathic understanding of the client’s internal frame of reference and endeavours to communicate this experience to the client;
- The communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree received.