Approaches to counselling and psychotherapy

Different theories provide a framework for understanding and exploring issues that bring you to therapy, but the most important part of the work is building a trusting relationship in which you feel safe to include all of who you are and explore anything you wish to in the sessions.

Integrative therapy

Draws on many sources, believing no one approach has all the truth. The therapeutic relationship provides the means for exploring experience, growth and change. It aims to provide a holding environment in which things can be undone and redone, leading to a greater tolerance of life’s experiences and an increase in creativity and a sense of purpose.

Transpersonal psychotherapy

Acknowledges and includes the spiritual dimension to life and being human. This is not attached to any particular religion. It views the human psyche as having a central, timeless core (for some described as ‘Self’ or soul, for others, ‘essence’ or values and beliefs), as well as personality based in the everyday. It includes work on uncovering the past and revealing future potential through an ongoing relationship between the individual and their connection to this core.

Art therapy

Art therapy is not about producing a good piece of art, it is about using creativity to express something you know on some level but cannot put into words. It can provide a safe way to express feelings that may otherwise seem unmanageable.

Different art forms offer different means of expressing experience, through different senses, for example: sand play, clay, painting or drawing, music, movement, puppetry or drama, poetry.

If you choose to use art we will explore it to discover what it means to you and what issues, conflicts, thoughts, feelings and aspirations it is communicating. It is hoped that this process will enable you to gain insight into yourself, your relationships and concerns. The art form can be a means of exploring new choices, and support you in resolving conflicts and formulating new perceptions that lead to growth and change.

This approach is based on the belief that the arts and active use of creative imagination enable us to grow and make sense of the world in profound ways, so they support us in fulfilling our potential, not just in repairing the past.

Attachment theory

Attachment theory was developed by John Bowlby in the 1950s and 60s. He higlighted the importance of a secure parent – child bond in the first years of life for later healthy emotional and psychological development. The difficulty in forming a secure bond may be the result of a parent being absent or struggling to manage their own issues such as depression, a bereavement or financial worries, and therefore find it difficult to care for, calm and be fully with the child.

The impact of this can be repaired later within the parent – child relationship or through therapy.

Lack of a secure bond can affect individuals’ behaviour in school and later, making it difficult to form mutually healthy and supportive relationships, so that individuals cling, live in fear of forming a close bond or find it difficult to be consistent in relationships and suffer with low self-esteem or depression. It might be the longing to be able to form better relationships that draws you to therapy.

Within therapy, the reliability of a fixed time and place help provide security, to enable a sense of safety and trust. This, as well as the building of a reliable relationship, can help support new patterns of relating and behaving.

Object relations

Refers to the way we relate to other ‘objects’ in the world – people or things. Patterns for our behaviour and relating are often set up in our early childhood, particularly through our relationships with parents and siblings. Therapy can be a place where we can explore, renegotiate and transform these patterns through the process of relating in therapy.

Gestalt

‘Gestalt’ comes from the German, meaning ‘form’, ‘shape’ or ‘figure’ and has come to mean ‘holistic’, or a ‘meaningful organised whole’. Gestalt theory was developed by Frederick and Laura Perls and the idea of making ‘Gestalten’ is about finding meaning in our experience.

Difficulties in the present can be the result of responding to situations in ways that are based on past experience and no longer useful. This “unfinished business” is like an incomplete form and tends to keep us stuck, unable to make new meanings, leading to low energy.

So in therapy you will be supported to become more aware of how you are functioning as a person in relation to others by concentrating on your experience in the present moment, your physical and emotional responses. You will also be encouraged to experiment and explore new possibilities, to extend your choices.

This could mean using the ‘open chair’ technique, which is when a person sits opposite an empty chair and then mentally places into that chair someone significant, who has caused them pain or trouble and tells them what they were unable to say at the time.

Jung

Jung built on the work Freud started and emphasised the importance of the spiritual aspect of life to psychological health.

He saw human beings as dual and in conflict, with symptoms making sense in the light of each individual’s story. So the task in therapy can be the balancing of opposites – who we think we are (our ego) and aspects we deny (our shadow).

He introduced the idea of a ‘collective unconscious’ – a knowledge we all have and share, through all time, which is communicated in images, symbols, metaphors, dreams, fantasies and creative play. He described these types of communal experience and knowledge as ‘archetypal’.

He saw what goes on in our inner world as equally important as what goes on in the outer world. So finding a balance between the personal & communal can be important for our wellbeing.

For him, the unconscious is not just repressed parts where we shut away unacceptable ideas, but the true basis of the human psyche, from where consciousness arises. He saw libido as a psychic, creative energy rather than just a sexual or agressive drive.

He emphasised psychological development occurs through relationship, and believed we all have capacity within to heal ourselves.

He advocated the use of different art forms and creative play to discover what we know, but are unconscious to, and these two elements combined form the basis of art therapy.

So in therapy, we may explore your images together to connect to your own inner wisdom.

Neuroscience

New developments in the understanding of how the brain developed and works provide evidence to support the effectiveness of counselling and psychotherapy. There are 3 parts to the brain: a survival, emotional and thinking part. They develop in sequence: a baby is born with a ‘survival’ part, which responds to need and threat, the emotional brain is developed through secure, empathic relationships and finally, the thinking or rational part develops, which allows us to reflect on our experience. Any trauma can block the development of the next part, and trauma in the present can automatically trigger the ancient responses of ‘fight, flight or freeze’.

A relationship with an emotionally reflective adult can help build new neural pathways. (It takes 7 minute for one new pathway to form.) This can help create connections between the different parts of the brain. It builds the capacity to think about feelings and impulses and make choices based on the present, rather than respond in a fixed way, out of fear and anger to any perceived threat, which may be more connected with the memory of a past experience.

Children’s thinking brains are often not developed enough to calm overwhelming emotions. They need an empathic adult to help manage these and support them in finding ways of understanding and working with their experience, so that their behaviour is not the only language for their feelings.

Art can help access what is buried in unconscious, emotional brain and defies words. It provides a different way of thinking, linking the left and right (emotional and rational) brains and offers the opportunity to undo and repair experiences, putting them in new scenario symbolically and then practically.

So in therapy we pay attention to building an empathic relationship, notice sensations in the body that might indicate panic or trauma, and sometimes use art or images to find new ways of exploring and thinking about experiences.

Play therapy

Play is a child’s natural way of communicating, making sense of the the world and exploring possibilities. It can help him or her say the unsayable and explore relationships. The symbols and metaphors can help provide a way in the child’s world, but they do not need to be interpreted for its healing potential to be realised. The play therapist may guide the child to a particular type of play or give the child complete freedom in their choice, depending on his or her needs.

Psychosynthesis

is a holistic approach to counselling and psychotherapy which recognises that just as past suffering can prevent us from living fully in the present, so can suppression of our unique potential, which brings the capacity for healing and change. It combines exploring the past and painful experiences, with working with hopes, dreams and aspirations.

Establishing a safe and trusting relationship between client and therapist, where you feel free to bring whatever you wish, is an
important part of that work – and is more important than the use of any particular techniques. The work may involve just talking. It can also include the use of images or art forms, visualisations, working with dreams, subpersonalities and paying attention to the feelings in the body, depending what seems appropriate or feels right to you.

It can be helpful in dealing with unexpected life events, crises, dilemmas or a deeper exploration of how past events may be causing suffering in your present life, or blocks which prevent you from living to your potential.

It is also helpful in dealing with specific issues such as: depression, anxiety, stress, personality issues, mid-life crisis, transitions, redundancy, loss, grief and bereavement, spiritual awakening or crisis, loss of meaning, crisis of identity, addictions, abuse, childhood or current trauma, relationship difficulties.

Psychosynthesis offers a framework for personal growth as well as a model for understanding suffering. It can help guide a person to understand the meaning of their human life within the broader context of synthesis – the drive towards the harmonisation of all relationships, whether with one’s own self, others or between individuals and groups. A belief central to Psychosynthesis is that we are whole and that as we grow we become more truly who we are. It is a holistic approach, which includes paying attention to what is happening in our body,
feelings, mind and spirit. It is about including all parts of ourselves, rather than ‘getting rid of’ bits.

It was developed by Roberto Assagioli, a pioneer of psychoanalysis in Italy, who began developing the insight that even as the psychological past exists in the present, so too does the psychological future.

Assagioli maintained that just as there is a lower unconscious, there is also a superconscious. He describes this as a realm of the psyche that contains our highest potential – the Self, the source of our unique human path of development. This is the realm of values and
of peak experiences, later to be studied by Abraham Maslow, which gave birth to the field of Humanistic and Transpersonal Psychology.

Assagioli formulated his discoveries into an approach he named psychosynthesis, to distinguish it from psychoanalysis. However, he did not mean to replace the insights of psychoanalysis, but rather to build on the work of Freud and Jung, and include the past within the context of the awakening of the Self.

Somatic work

Our body (soma) provides a container for our experience and it can become the place where past emotional or physical trauma is stored in the form of tensions, lack of movement, and pain. ‘The body keeps the score’ – trauma expert Bessell Van der Kolk. Simply paying attention to the body and feelings held in it can help develop an awareness of both trapped pain, and an increasing ability to manage troubling sensations and emotions. Gradually building a sense of safety in the body can allow incomplete experiences to be processed and blocked energy released, so that it becomes available for living.

Links to professional organisations

www.psychosynthesis.org

www.terapia.org.uk

www.artspsychotherapy.org

www.childmentalhealthcentre.org