Psychodynamic - is the theorectical base that nearly all counselling approaches have been influenced by. Freud is seen as the founder of the psychodynamic approach, although modern psychodynamic therapy has changed and developed drastically since classic psychoanalysis.
Central to the psychodynamic approach is the process of bringing into awareness the unconscious feelings, beliefs and memories which may be negatively influencing our behaviour and psychological health. Usually these are from childhood, because negative experiences and relationships during early development which our undeveloped ego could not cope with, have the potential to affect us on a deep level. Unfortunately the way that our unconscious mind tries to protect the ego from negative experiences also creates problems. Denial, repression, regression and projection are defensive strategies that keep us from accepting and processing the impact of those difficult experiences and feelings. Another defensive pattern is 'splitting' - which is a pattern of relating to experiences or relationships as either 'good' or 'bad' only - no shades of grey. This pattern is thought to come from extremely primitive early childhood experiences.
The psychodynamic concept of 'transference' is very helpful in using the counselling relationship as a space where these developmental traumas, patterns, experiences and the problematic defences against them, can be approached. Transference is the way in which we transfer ways of being/relating and feelings from our previous relationships to each new relationship. Our most significant primary relationships with parents or care-givers form the basis of most of our transferences. Although this is sometimes described as a natural process, the obvious disadvantage is that we are not in the relationship as it actually is.
Often the patterns of relating and feelings we transfer into the new relationship are affected by our developmental issues and unconscious defences. This can then lead us to have repeating experiences in relationships, which reinforce our unconscious transference. 'Counter-transference' is the term used to refer to the patterns of relating and feelings that the counsellor transfers into the counselling relationship (but is trained to be aware of).
The counselling relationship is therapeutic because through trust, authenticity and empathy, it aims to increase awareness of the transference that is present in it. This then allows us to approach the underlying unconscious feelings, beliefs or memories that the transference is defending and experience 'catharsis' - the release of the emotional tension that binds our energy and disrupts us from engaging with life open-heartedly.
Motivational Interviewing - This is a type of person-centred/humanistic approach that is very common in helping with addiction. It can be said to be more directive than some person-centred approaches as it seeks to focus the therapy on motivating change. One of the key theories behind MI is that acknowledging and resolving ambivalence is a key to making a decision to change. Despite the damage that our patterns of behaviour (e.g. addiction) may be having in our lives, there may be hidden motives or reasons not to change. Unless these are made concious and accepted they have the power to unconciously impact any attempt at recovery. MI also focusses on promoting self-efficacy - belief in the ability to change. Although MI is more directive it isn't about convincing or coercing change, it upholds the humanistic perspective that our natural capacity is to become more actualised, the fullest version of ourself. By fully feeling and recognising the motivations and beliefs around our negative patterns of behaviour, we realise how they compare to our core values. And in connecting to our core values, find the energy and resolve to change.
Person Centred/Humanistic - This approach was founded by the psychotherapist Carl Rogers. It is based around the concept that it is the qualities of the client-counsellor relationship, that is the most important factor in therapy. Rogers desribed these qualities by referring to the 'core-conditions' - empathy, congruence and unconditional positive regard. Rogers believed that a counsellor able to offer these conditions in the therapeutic relationship would promote healing and growth. This was based on years of practice and evidence. Rogers developed a theory of the self which explained why this worked. Every living being is influenced by the general actualising principle - which is a natural tendency to grow into the most complete, healthiest potential of ourself. However this can get blocked if we experience a lot of conditional love, judgements or shaming. We can develop 'conditions of worth' where we end up repressing or
denying any aspects of ourself which we experience
as not worthy, not wanted - effectively trying to be
someone we are not. We are then actively working
against the actualising principle, this takes up a lot
of energy and creates anxiety, and this is what leads
to repetitive problems in our lives. An experience of
a relationship where we are able to re-experience
and re-connect with those denied or forgotten
aspects of our true self, will liberate the creative
energy of the actualising principle to promote healing.
Compassion - This is not a counselling approach but I believe it is an essential part of why counselling works. Compassion is an emotion that can accompany empathy. It is empathy for another's suffering. The feelings of warmth and kindness, a desire to help, and a recognition of the shared nature of the experience of suffering and imperfection - "There but for the grace of God go I." Compassion definitely isn't about just being all fluffy and nice. Encouraging someone to be accountable for their actions can be a compassionate thing to do, like the idea of 'tough love'.
Buddhism teaches that because we are conscious beings with the capacity to think and feel, we are all of value and all deserving of compassion. The Dalai Llama says; "Human beings by nature want happiness and do not want suffering. With that feeling everyone tries to achieve happiness and tries to get rid of suffering, and everyone has the basic right to do this..." But the universal human experience is that some suffering is unavoidable and we are all imperfect. The feeling of compassion connects us to this shared experience, and our desire to want happiness and not suffer. It connects us to the grief of the world, which we are all able to carry a part of. One would think this would be a bad thing, but actually connecting to our heart's capacity to hold grief, allows us to accept the compassion and love that rises to meet it.
Self-compassion, is about connecting to the feeling of compassion by having empathy with one's own suffering. This can be an extremely powerful way to help with shame, self-criticism and self-directed anger because it can help access our warmth, kindness and caring towards our own experience, rather than foster feelings of isolation, fear and anger. Self-compassion is different from self esteem in that it doesn't depend on how well you are doing. High self-esteem is often gained by comparing oneself to others, but self-compassion is not a measure of worth at all - it's a way of relating to our experience of ourself. When we experience shame, anger, depression, fear - we can also experience warmth, understanding, acceptance, kindness. This subtlely changes our feelings, so we can be more present, have more perspective, connect to others rather than isolate, not get out of control, and find more useful meaning in our experience.
Stafford Wilson MBACP
PG Dip Counselling
University of the West of England
What is this self inside us, this silent observer, severe and speechless critic, who can terrorise us and urge us on to futile activity and in the end judge us still more severely for the errors into which his own reproaches drove us? -T.S.Elliot
Tel: 07970 421016
Self-Psychology/Heinz Kohut - This approach, first developed by Heinz Kohut, is based on the concept that in order for our 'self' to develop fully - we need certain conditions. He called these; Mirroring, Idealising and Twinship. Mirroring (also called the grandiose/exhibitionist need) is the developmental need to be fully appreciated and prized. Idealising is the need to be able to idealise or look-up to a strong, dependable other. And Twinship is the need to be able to recognise in yourself qualities which are similar to those around you, giving a sense of belonging.
In childhood, hopefully it is our parents or care-givers that can provide these conditions - however this will always be imperfect. No-one is able to provide these things 100% of the time for their child, but this fact is actually necessary for the self to develop. We learn to fulfil these needs ourself, using the memory and experiences already gained, providing we have experienced enough of them. In adulthood a developed self allows us to tolerate difficult emotions, have the confidence to develop competence, have a grounded sense of self-esteem, and have a sense of direction through connection to our values and ideals.
The development of the self is a life-long process, so we can experience problems if we are not continuing to get these needs met to some extent in our adult lives. However, if there was a significant lack in our childhood of these conditions, not only do we suffer the effects of the under-developed parts of ourself, but these needs remain in their most primitive form, making them difficult to acknowledge, let alone get met. For example, if our grandiose/exhibitionist need was not met as a child, as an adult we can experience intense feelings that alternate between worthlessness and dangerous grandiosity.
If counselling is empathetic and has a focus on the relationship, it can be possible to identify and fully acknowledge these unmet needs. Although it may not be possible for the counselling relationship to replace what was not received in childhood - in recognising and fully accepting the need, the primal intensity can be reduced and the capability to nurture the self and honour self-needs in relationships, is increased.
My Counselling Approach
In counselling, it is through a therapeutic relationship that healing happens. The foundation of my approach therefore is to focus on forming a relationship characterised by empathy, congruence and unconditional positive regard.
Empathy means that I try to understand your feelings and thoughts from your perspective, and reflect this back. Congruence means that I am as genuinely and honestly myself as I can be, and unconditional positive regard means that I recognise your inherent worth both exactly as you are, and in your potential to grow and heal. I have also found the feeling of compassion to add to and fit in with these core conditions.
Below is a range of counselling/psychotherapy theories and approaches that inform my practice. If you are thinking about counselling, you may be inspired by one or more of the approaches below.