Psychotherapy

On this page I explore the idea of psychotherapy and my approach to working with clients.

What Psychotherapy May Be

Psychotherapy is actually an umbrella term for what may be thought of as a spectrum of different ways of doing therapy. At one end of the spectrum is the medical model, where mental distress and impairment, and dysfunctional behaviour, are thought of as illnesses that can be diagnosed and treated in a similar way to physical illnesses. In this case, successful treatment returns the patient to a state of normality.

At the other end of the spectrum is a more holistic way of viewing psychotherapy. This sees mental ill health as being an adaptation to a set of highly difficult or abnormal circumstances – circumstances which push our adaptive ability to an extreme, resulting in distress and, sometimes, dysfunction. This state of extreme adaptation is, of course, a highly individual thing because the history and resilience of each person are unique to them. As we go through life, our psyche collects adaptations to different things, and these may interact with each other. As we work through the issues underlying these psychological and behavioural adaptations, we move towards a new position of homeostasis, and this is often a process of personal growth and development.

Probably, neither view is totally right nor totally wrong.

Psychotherapy

On this page I explore the idea of psychotherapy and my approach to working with clients.

What Psychotherapy May Be

Psychotherapy is actually an umbrella term for what may be thought of as a spectrum of different ways of doing therapy. At one end of the spectrum is the medical model, where mental distress and impairment, and dysfunctional behaviour, are thought of as illnesses that can be diagnosed and treated in a similar way to physical illnesses. In this case, successful treatment returns the patient to a state of normality.

At the other end of the spectrum is a more holistic way of viewing psychotherapy. This sees mental ill health as being an adaptation to a set of highly difficult or abnormal circumstances – circumstances which push our adaptive ability to an extreme, resulting in distress and, sometimes, dysfunction. This state of extreme adaptation is, of course, a highly individual thing because the history and resilience of each person are unique to them. As we go through life, our psyche collects adaptations to different things, and these may interact with each other. As we work through the issues underlying these psychological and behavioural adaptations, we move towards a new position of homeostasis, and this is often a process of personal growth and development.

Probably, neither view is totally right nor totally wrong.

Transpersonal Psychotherapy

At the holistic end of the spectrum there is also a recognition that, in a psychological and emotional sense, people can grow and develop beyond the average ego state. This is the transpersonal view. Transpersonal therapy is interested in the meaning of things – how a client experiences the meaning of their life and all the different aspects of that. Being holistic, transpersonal psychotherapy understands that physical and mental/emotional health are intimately connected. It seeks to increase insight and facilitate the client in moving from a state of dis-ease to one that is more balanced. Dis-ease can arrive in the form of mental ill-health whether diagnosed or not, dysfunctional behaviours, patterns of issues, difficult life circumstances, or loss of meaning in life. Sometimes, physical illness may also have a psychological or emotional component. The goal of psychotherapy may be resolution of the difficulties, or an improvement in how the client is able to understand and manage them.

Transpersonal psychotherapy is also about facilitating a person to grow and develop to their best potential as a human being, which may be conceptualised in secular and/or spiritual terms. The American psychologists Abraham Maslow and Carl Rogers, who were at the heart of the humanistic approach to psychology, called this self-actualisation. A generation before them, the Swiss psychiatrist, Carl Jung, called it individuation. It’s a process of working towards becoming one’s most authentic and whole self. This may be a side-effect of working on the presenting issues but it can also be an important focus of therapy in its own right.

Transpersonal Psychotherapy

At the holistic end of the spectrum there is also a recognition that, in a psychological and emotional sense, people can grow and develop beyond the average ego state. This is the transpersonal view. Transpersonal therapy is interested in the meaning of things – how a client experiences the meaning of their life and all the different aspects of that. Being holistic, transpersonal psychotherapy understands that physical and mental/emotional health are intimately connected. It seeks to increase insight and facilitate the client in moving from a state of dis-ease to one that is more balanced. Dis-ease can arrive in the form of mental ill-health whether diagnosed or not, dysfunctional behaviours, patterns of issues, difficult life circumstances, or loss of meaning in life. Sometimes, physical illness may also have a psychological or emotional component. The goal of psychotherapy may be resolution of the difficulties, or an improvement in how the client is able to understand and manage them.

Transpersonal psychotherapy is also about facilitating a person to grow and develop to their best potential as a human being, which may be conceptualised in secular and/or spiritual terms. The American psychologists Abraham Maslow and Carl Rogers, who were at the heart of the humanistic approach to psychology, called this self-actualisation. A generation before them, the Swiss psychiatrist, Carl Jung, called it individuation. It’s a process of working towards becoming one’s most authentic and whole self. This may be a side-effect of working on the presenting issues but it can also be an important focus of therapy in its own right.

What Psychotherapy Might Not Be

So what is the difference between counselling and psychotherapy? Historically, these were two distinct modalities with different theoretical bases and ways of working with clients. These days the boundaries between them are increasingly fuzzy and many people would not recognise a difference between them. What we can say, however, is that counselling tends to be more short-term than psychotherapy and is directed towards addressing a particular problem or issue the person wants help with. It works mainly at the conscious level to find practical solutions and offer support along the way. Psychotherapy, on the other hand, can include these things too, but in addition it pays attention to the unconscious dynamics of a situation. It is also interested in how experiences in childhood may have set the patterns that are now playing out in adulthood. It aims therefore to work at a deeper level and offer the potential for longer-lasting healing and change, rather than being focused on a particular manifestation of a problem in the short-term, which might be part of a larger but unrecognised pattern.

What Psychotherapy Might Not Be

So what is the difference between counselling and psychotherapy? Historically, these were two distinct modalities with different theoretical bases and ways of working with clients. These days the boundaries between them are increasingly fuzzy and many people would not recognise a difference between them. What we can say, however, is that counselling tends to be more short-term than psychotherapy and is directed towards addressing a particular problem or issue the person wants help with. It works mainly at the conscious level to find practical solutions and offer support along the way. Psychotherapy, on the other hand, can include these things too, but in addition it pays attention to the unconscious dynamics of a situation. It is also interested in how experiences in childhood may have set the patterns that are now playing out in adulthood. It aims therefore to work at a deeper level and offer the potential for longer-lasting healing and change, rather than being focused on a particular manifestation of a problem in the short-term, which might be part of a larger but unrecognised pattern.

Psychotherapy or Self-Help?

There are many thousands of books, videos, websites and workshops which cater to the continuing demand for help in helping oneself. Self-help products and activities can be wonderfully supportive. They motivate, educate and inspire us to know we are not alone in our difficulties, and that there are solutions. They also provide role models – if he or she has managed it (whatever “it” might be), then so can we! Why, then, would anyone invest time and money in therapy when you can go it alone?

Many clients arrive in therapy after periods of working with self-help materials, and they have all done an amazing job. It takes guts and determination to work this way. Therapy offers some additional resources that can help you towards success.

The need for connection

It has been demonstrated time and again in research studies that the single most important aspect of what therapists do is to meet the need for human connectedness (Norcross, 2011; Wampold & Imel, 2015). The therapeutic relationship is real. Exploring aspects of one’s life with another person, in confidence, may be an essential step in addressing your concerns. To be heard, understood, witnessed and mirrored are healing and reparative.

The need for safety

It is often a lack of psychological safety, and sometimes physical safety too, which has led to a person’s difficulties to begin with. Psychotherapy sessions offer an oasis, a safe space in which to rest and recuperate. Sometimes, that is all that’s needed. When the right conditions are provided, healing can often take place naturally. The experience of safety at a physiological level is an essential pre-requisite for deep psychotherapeutic work to be effective (Porges, 2017; Schwarz, 2017).

Working on unconscious material

Your psychological defences, which by definition are unconscious, will neatly work around almost anything you might try to do which would disturb them. That is their job, after all! Psychotherapy works to build a person’s natural strength and resilience, and to heal the need for problematic or dysfunctional defences. It is also important to take into account the systems of relationships that the client is part of because it is often the case that defences develop in response to what’s happening in those relationships. So an important aspect of working with a therapist is that they facilitate a client in increasing their awareness of such things.

Resourcing the client

In addition, a therapist functions as a resource for the client – one which is attuned to their situation, personality, needs and background in a way that no mass media product could ever be.

Psychotherapy or Self-Help?

There are many thousands of books, videos, websites and workshops which cater to the continuing demand for help in helping oneself. Self-help products and activities can be wonderfully supportive. They motivate, educate and inspire us to know we are not alone in our difficulties, and that there are solutions. They also provide role models – if he or she has managed it (whatever “it” might be), then so can we! Why, then, would anyone invest time and money in therapy when you can go it alone?

Many clients arrive in therapy after periods of working with self-help materials, and they have all done an amazing job. It takes guts and determination to work this way. Therapy offers some additional resources that can help you towards success.

The need for connection

It has been demonstrated time and again in research studies that the single most important aspect of what therapists do is to meet the need for human connectedness (Norcross, 2011; Wampold & Imel, 2015). The therapeutic relationship is real. Exploring aspects of one’s life with another person, in confidence, may be an essential step in addressing your concerns. To be heard, understood, witnessed and mirrored are healing and reparative.

The need for safety

It is often a lack of psychological safety, and sometimes physical safety too, which has led to a person’s difficulties to begin with. Psychotherapy sessions offer an oasis, a safe space in which to rest and recuperate. Sometimes, that is all that’s needed. When the right conditions are provided, healing can often take place naturally. The experience of safety at a physiological level is an essential pre-requisite for deep psychotherapeutic work to be effective (Porges, 2017; Schwarz, 2017).

Working on unconscious material

Your psychological defences, which by definition are unconscious, will neatly work around almost anything you might try to do which would disturb them. That is their job, after all! Psychotherapy works to build a person’s natural strength and resilience, and to heal the need for problematic or dysfunctional defences. It is also important to take into account the systems of relationships that the client is part of because it is often the case that defences develop in response to what’s happening in those relationships. So an important aspect of working with a therapist is that they facilitate a client in increasing their awareness of such things.

Resourcing the client

In addition, a therapist functions as a resource for the client – one which is attuned to their situation, personality, needs and background in a way that no mass media product could ever be.

Integrative Psychotherapy

Some schools of counselling and psychotherapy are aligned with a founding figure(s) and their theories, and practise their way of doing therapy. Examples include psychoanalysis (Freud and followers), Jungian analysis (Jung and followers), person-centred counselling (Rogers and followers), and CBT (Beck and followers). In contrast, integrative therapy recognises the contributions of the great founding figures, philosophical movements, and scientific discoveries which have contributed to understanding and healing human distress. Integrative work with clients can therefore include understandings and techniques drawn from any tradition that is appropriate, but all crafted together within a coherent theoretical and clinical framework.

Integrative Psychotherapy

Some schools of counselling and psychotherapy are aligned with a founding figure(s) and their theories, and practise their way of doing therapy. Examples include psychoanalysis (Freud and followers), Jungian analysis (Jung and followers), person-centred counselling (Rogers and followers), and CBT (Beck and followers). In contrast, integrative therapy recognises the contributions of the great founding figures, philosophical movements, and scientific discoveries which have contributed to understanding and healing human distress. Integrative work with clients can therefore include understandings and techniques drawn from any tradition that is appropriate, but all crafted together within a coherent theoretical and clinical framework.

So integrative psychotherapy might be thought of as that which recognises the accumulated wisdom of what works in therapy and of how we can understand the human condition. The additional benefit is that it is informed by modern scientific research.

So integrative psychotherapy might be thought of as that which recognises the accumulated wisdom of what works in therapy and of how we can understand the human condition. The additional benefit is that it is informed by modern scientific research.

References

Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15(3), 199–208.

Norcross, J. C. (Ed.). (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York, NY: Oxford University Press.

Porges, S. W. (2017). Vagal pathways: Portals to compassion. In E. M. Seppala, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron, & J. R. Doty (Eds.), The Oxford handbook of compassion science (pp. 189-202). New York, NY: Oxford University Press.

Schwarz, L., Corrigan, F., Hull, A., & Raju, R. (2017). The comprehensive resource model: Effective therapeutic techniques for the healing of complex trauma. Abingdon, United Kingdom: Routledge.

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). New York, NY: Routledge.

References

Gilbert, P. (2009). Introducing compassion-focused therapy. Advances in Psychiatric Treatment, 15(3), 199–208.

Norcross, J. C. (Ed.). (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). New York, NY: Oxford University Press.

Porges, S. W. (2017). Vagal pathways: Portals to compassion. In E. M. Seppala, E. Simon-Thomas, S. L. Brown, M. C. Worline, C. D. Cameron, & J. R. Doty (Eds.), The Oxford handbook of compassion science (pp. 189-202). New York, NY: Oxford University Press.

Schwarz, L., Corrigan, F., Hull, A., & Raju, R. (2017). The comprehensive resource model: Effective therapeutic techniques for the healing of complex trauma. Abingdon, United Kingdom: Routledge.

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). New York, NY: Routledge.