Michael - Individual Work

What is counselling?

Counselling is a “talking therapy”.   It can be useful when you are worried or upset by your feelings, your thoughts, or the way you are behaving.  Such things can affect us very powerfully and leave us feeling out of control and unable to understand ourselves.

In the counselling I encourage you to talk openly about yourself and your difficulties.   I reflect with you on what you share, and help you to explore what is causing your problems and how you might be able to resolve them. It can feel very supportive to have someone working with you in this way.  However, at times it can also be challenging, as I may be inviting you to look at yourself in quite a different way.   

Where counselling is successful, it can help you to gain new insights into your emotional difficulties and to find new ways of dealing with them.  I do not offer you advice, such as favouring one course of action above another.   One of the aims of counselling is to help you make your own decisions about your life.   What counselling cannot do is to take away the “ordinary unhappiness” of life. Some life events are very distressing and unsettling.  However, given time and support people come to terms with what has happened and move on with their lives.    It is when we become stuck in some way, and cannot recover and move on that counselling is most helpful.

What is psychotherapy?

Psychotherapy is essentially the same activity as counselling, and the comments above apply equally to psychotherapy. The different terms are sometimes used to distinguish between more brief work focused in the present, often with a  problem-solving orientation, and an aim to restore normal functioning (counselling) and longer term work, examining the impact of the past and unconscious motivations and aimed at changing deeply rooted patterns of thinking, behaviour or relating, with an aim to help people live richer more free and more fulfilled lives than had been possible for them in the past (psychotherapy). In practice the two are often indistinguishable and I would normally use the word "counselling" to cover both approaches.

Is counselling (or psychotherapy) for me?

One of the most important factors in whether counselling will be effective is whether you want to undertake it.  If you are doing it to please someone else or because someone is pressurising you into it, it is unlikely to be helpful.  

Counselling is very different from going to see your doctor.   We tend to expect that once we have explained what the matter is to our doctor, he or she will give us something that will remove the problem.    Counselling however, is not something that is done to you, or given to you, like medicine or advice.   It is “emotional work” and it is important that you see it as your work, with your counsellor thinking alongside you.  If you want someone to take away your emotional distress without you having to do anything yourself, it is unlikely that you will find counselling helpful.

 

If you are unsure whether counselling is the right thing for you at present, you could ask yourself two useful questions. 

1)   Do I want to make changes to myself, rather than just wanting my situation or the people around me to change? 

2)   Am I prepared to consider the contribution I make to my difficulties?

If you can answer yes to these, it is likely that you will benefit from counselling.

 

One further thing to consider is that you need to feel strong enough to bear the difficult emotions that may be touched on in the course of the counselling.  In order to move forward you may have to go through a period of feeling worse than you are at present, before you can start to feel better.  You need to be aware of this before agreeing to undertake counselling.  

 

Psychodynamic therapy

My work is informed by my initial psychodynamic training, though this no longer the primary model that I use. Psychodynamic thinking is based on the theory that we are often powerfully motivated by things which are beyond our understanding or awareness, and we end up feeling and behaving in ways that we might find worrying or distressing.

A part of my task may be to help you to explore these aspects of yourself, which may be "unconscious", and to try to put you in touch with your underlying feelings in a way that lessens their power over you. I may also focus on what happens between you and me in the counselling, as a means of enabling you to gain a clearer insight into your patterns of behaviour and ways of relating to others.

 

Exploratory Goal-Corrected Psychotherapy - an attachment based approach.

This is now my main way of working, and the thinking behind it is as follows:

The experience of wellbeing is closely connected to our sense of self.  When we have a strong sense of self (good self-esteem), we can ask others for the help and support we need, we can give care to others without it wearing us out, we can make and maintain affectionate intimate relationships, and we have the energy and vitality to pursue our interests and share them with friends.

When our sense of self is fragile, we tend not to seek help from others, we tend to be more responsive to what others want than what we want, we have difficulties with close relationships, and lose touch with our own interests and hobbies, feeling flat and drained of energy. 

The key difference between the two ways of being depends on how strong, or resilient our sense of self is, and that in turn is dependent on how effective our system for “self-defence” is – how well we are able to protect the self from the blows that life deals us, and how quickly we can recover. These “blows” or threats to the self can be real, such as an assault, a bereavement or being treated unfairly, but they can also be imagined - thinking that others are thinking of us in a negative way.

The self-defence system has two key elements, the “danger-fear system” and the “care-seeking system”.  Both of these are instinctive biological systems.   The danger fear system, the oldest in evolutionary terms, helps us survive threats by instantly altering our physical state to allow us to fight, run away, or freeze in the face of danger.   

The  care-seeking system, a later development in evolutionary terms, prompts us to seek help, support, and reassurance from others in the face of a threat.  This system is vitally important in humans as so much of the development of our brains happens after birth.  As infants and children, our minds are formed and “connected up” by means of our interactions with adult carers. 

Being on the receiving end of good care-giving leads to a strong sense of self and a sense of wellbeing.  Failures in care-giving lead to a fragile sense of self, anxiety and depression.   Failures in care-giving also wire our brains to distrust seeking care, and for self-protection we only have the danger-fear system to fall back on.   Where we are over-reliant on the danger-fear system, we survive, but we feel isolated, and are prone to anxiety and depression.

This therapeutic approach, which aims to replicate the kind of caregiving which builds a strong sense of self, is more active and responsive than psychodynamic work and aims to help clients regulate their fear system responses in order to become more exploratory.   

I find that this approach helps my clients to be less self-critical and more compassionate and understanding of the way they have been affected by past experience.   I also find that clients become better at asking for the support and help that they need, and better at working out who can give this support to them and who can not.   This work also helps clients to improve the quality of their intimate relationships and to rekindle lost interests and enthusiasms.  Click here for a full article on this approach.


Trauma therapy - EMDR (Eye Movement Desensitization & Reprocessing)

This is a relatively new but highly effective therapy which uses eye movements as as part of a process to treat the psychological effects of trauma (such as car / train accidents, industrial accidents, rape, physical assault, war, explosion etc.).  The eye movements are prompted by the therapist moving his fingers in front of the clients eyes, though other methods such as an LED light-bar can be used instead.

Distressing symptoms of Post Traumatic Stress Disorder such as flashbacks, intrusive thoughts and hyper-vigilance can often be alleviated within a few sessions, (6-12 sessions - often arranged in double-sessions, i.e. 2 x 50 mins). This approach can be used for both past and more recent physical trauma but can work equally as well with emotional trauma, though, as it can activate past repressed memory, in some cases it is best used within the context of a longer-term therapy.

You can find out more about this way of working by visiting the EMDR website: www.emdr.com

 

How do we decide whether to work together and for how long?


Our first meeting would be for an assessment, which would either last up to 1½ hours, or could be spread over two or more 50 minute sessions.   This would allow me to consider whether I 
thought I could help you with the issues you were bringing, and would give you the chance to decide whether you felt you could work with me.

 If we agreed to work together, I would normally see you once a week, at a regular time for a 50 minute session, and give you the opportunity to talk about yourself and your difficulties. You would be encouraged to speak as freely as you were able about your thoughts, feelings and concerns.  

 At our first session we would consider together what might be the appropriate number of sessions and way of working. Short term work (6-10 sessions) can be very effective where it is possible to focus clearly on one or two issues, but longer term work, (perhaps on an "open-ended" basis), may be needed for less clear or more complex problems of long standing.

 

The counselling relationship is quite different from other relationships - I have no contact with clients outside of our agreed time, and, unlike sharing with a friend, I do not tell you about myself or my problems.