Here I’m going to talk to you about therapy generally but also about my specific approach. The truth about therapy is that; even though we all draw from particular schools of thought or areas of specialist training and experience; just as you are unique, each therapist is also unique. So if you are reading this and trying to choose a therapist, you’re in the right place, although eventually, the best way to choose a therapist is to meet them for an introductory session.
What’s the difference between psychotherapy and counselling? Which do I need to help me?
Generally, and simply, the difference between counselling and psychotherapy is a matter of time and depth. Counselling is usually fairly short in duration (6-12 sessions for example), whereas psychotherapy is usually longer term and can often take place in weekly sessions over many months.
The depth of work is more difficult to define because the experience of what feels ‘deep’ is very personal. But, usually, there will be more space to explore deeper, older issues in psychotherapy such as patterns and beliefs learned in childhood and early relationships that continue to repeat in problematic ways in your present life. Counselling is work aimed to support you through a short period of stress or transition, or it can be used preemptively to address a very specific issue such as anxiety about an upcoming event.
If you like to be imaginative, try this:
Think about a house. Counselling would be the equivalent of having a good deep clean of the house, tidying up, organising and putting things straight. The house will be fresher and easier to use afterwards, and you might have found treasured possessions that you thought were lost!
Psychotherapy on the other hand could be thought to be the equivalent of having the house, or part of the house, thoroughly renovated. Perhaps walls will move, floors might be dug up, windows changed. That takes more effort, more disruption, and usually more time. At the end of a sympathetic and caring renovation the house is still itself, it still has the same soul. But inside, radical change has taken place: walls have come down; new views opened up; the flow of movement has changed. But most importantly the house now fits the needs of the people who live in it and they are comfortable.
This is a guide for your expectations rather than a clear and definite road map. There are always exceptions about how long something takes or how deep change can be. Therapy is a very personal process!
Luckily, with me, if you’re not sure, you do not have to choose whether you want to receive counselling or psychotherapy at the outset. That’s partly why I use the term “therapy” to cover both types of work. When we first meet we will discuss your hopes and aims for therapy and formulate a suitable plan. As our relationship develops so will our focus, goals and aims often shift and change as therapy develops. We will revisit your hopes and goals for therapy, sometimes in a structured way, but also as I check in with you each session. And of course, ultimately, you are in charge so you may set the agenda for each session as you see fit.
How do I work? What kind of therapy do I provide?
I work relationally. What that means is that I work guided by the belief that the single most important thing that achieves change is the relationship between me and you. This isn’t blind faith though: scientific study after study, across all types of therapy, and across decades has found that the single most important factor is the relationship between the two (or three in couples counselling) people in the therapy room.
What exactly is it about the relationship that facilitates change?
Connection, acceptance, and understanding. Somebody listening without judgement and striving to feel what it’s like in your world, from your point of view. These things create a safe space where new possibilities can open up, new ideas can be tried out. Painful experiences can be understood and their power to hurt us is defused. Difficulties can be explored. Maybe you will experience safety and security with another human for the very first time and feel how transformative that can be.
Existential ideas also influence my work. In practice this is about concepts that are familiar and important to all of us. Big ideas such as: What brings meaning to life? What causes us emotional pain? What is freedom and what restricts it? How do we cope with death and suffering and find a way to live a good life, even in difficult circumstances? For some clients these ideas are directly relevant, especially if you are living with bereavement, or going through a period of change and upheaval. Other times the ideas are hidden beneath the main issue of therapy and less clearly obvious in what we talk about.
And what actually happens in a therapy session?
In practice we have a conversation. You will share your concerns and I will listen. I will offer thoughts and reflections where I judge it will be helpful, but I am not the expert on your issues, you are. My job is to reflect and notice what you are saying and how you are saying it. Then I can bring that into your awareness and together we can feel and make sense of your experiences in new ways. A trusting relationship allows us to be open minded about where that takes us. We progress like this, step-by-step along the way.
I have a favourite metaphor: “You can drive successfully across a whole country in the dark as long as you have the headlights on”. What this means for therapy is that we don’t need to be able to see everything all the time (or even any of the time!). We just look at what is happening right here and now, in front of us, and use that to think about what that means for success in our overall journey.
On occasion I also use creative materials and methods such as drawing, looking at photographs, mindfulness, image association, storytelling. These come into play in a unique way with each client, and I’m always led by what you do or don’t want to do. But if I suggest something creative or different in a session it’s often to help if we feel stuck in a rut or perhaps to open up difficult issues in a less threatening way.
Most importantly therapy with me is always lead by you. In technical terms it’s an approach called ‘person-centred’. What it means in practice is that you are at the centre of everything that happens in therapy, and the pace, content and structure of sessions are unique to your needs. For some people that will be specific requirements that they can and do state clearly. For other people it can be more subtle and quiet. Often it’s a mix of both. Again it’s all unique and personal to each client. We’ll find out together what works for our therapeutic relationship.