Counsellor: one who gives counsel or advice
Psychotherapist: one who attends to the soul
In this paper, I am using the words “therapy” and “therapist” rather than “counselling” and “counsellor” to raise awareness of the difference between the practice of longer-term, deep psychotherapeutic work (practiced at SCC) and the cognitively-based, manualised, brief counselling largely in use through the NHS.
Psychotherapy–What’s It Good For?
People enter therapy for dozens of different reasons, each as individual as that person’s history, outlook and current situation. But the overarching reason is usually the same: there’s a problem that’s become too painful to ignore, and nothing else has worked.
Psychotherapy solves problems we haven’t managed to solve on our own. These problems can be as simple as finding a better-fitting job, or as difficult as dealing with war-related post-traumatic stress. Therapy is where we turn when we’re stuck and, miserable, and can’t find a way out. In therapy, we come to identify what we need and how to get those needs met; how to relate better to other people, even how to lay down inner burdens carried since childhood.
Examples of what people work on in therapy.
1. Changing habits such as nail-biting, smoking, being late, procrastination etc.
2. Mending or improving partnerships/marriages, relationships with family members
3. Finding healthy ways to handle physical illness or aging
4. Making big life decisions, or being supported through experiencing difficult life events
5. Grieving all kinds of losses
6. Finding ways to be happier, reaching personal goals and dreams
7. Finding the roots of and remedies for depression and anxiety
8. Rediscovering feelings of purpose and meaning
9, Dealing with post-traumatic stress reactions
10. Becoming kinder, more supportive and happier parents
What Do Therapists Do?
Really listening to someone, fully and consciously, is serious work. It takes energy, patience and practical skills. Therapists study and practice different types of listening, including listening for what hasn’t been said, how things are being said (more than the actual words) and body language that often speaks louder than words. As science discovers more about how our brains, minds and bodies interact, we update our understanding by taking courses, attending seminars and reading, as well as working with more experienced mentors and supervisors. Therapists in training attend therapy sessions as clients, and many continue to use their own therapy to increase their self-knowledge and capacity to help others.
Getting to Know You…
How often have you felt someone really understood, really wanted to know you? Feeling understood is pretty rare in a busy world where people don’t have time to listen to each other, and it’s crucial for our sense of belonging and our psychological and even physical wellness. (A future column will discuss the mind-brain-body connection.)
Knowing how important it is for healing, therapists put energy into understanding their clients. Your therapist might invite you to talk in ways you haven’t done before; might recommend resources and educational materials; might ask about your dreams; might even challenge ideas you’ve always believed in, perhaps without questioning them. Therapy combines detective work and philosophy, ideally held with a mixture of fierce compassion, warmth and strength.
We study the varieties of troubles people have and the best ways to help. We learn how babies grow into adults and how a complicated childhood can follow us into adulthood. We learn and talk about dark things most people don’t like to think about but all experience–illness, fear, deep sadness, loss, death. People bring us the range of human experiences, and we try to be there for them, as solid and clear as possible, in the toughest times.
Why Not Just Go to the NHS?
At SCC, we often see people who have been through NHS talking therapies, and oftentimes, the clients say these therapies didn’t work for them. Most NHS therapies are short-term–6, 8, maybe 12 sessions. Clients don’t have time to get to know and trust their therapists, and therapists are often limited to working “by-the-book”, without considering individual clients’ needs. With mental health funding so restricted, people don’t get enough time to feel safe with the therapist, to understand the process of therapy and to work deeply or creatively on their unique problems.
There’s no one-size-fits-all approach to therapy because we’re all so different. A problem that might seem a minor hassle to one person may pose serious life issues to another. Therapists have to be flexible, to see what’s happening for each individual they work with.
When we see clients, we have the possibility of seeing them for as long as it takes to help them. (As we’re not an NHS service. We’re not open 24/7 and can’t help in crises. People in crisis must call their GP or go to the nearby A&E for help.)
Which Type of Therapy Works Best?
The myriad types of therapy (person-centred, psychodynamic, gestalt, cognitive-behavioral, to name but a few) may feature different techniques, but research shows that the therapist’s training background doesn’t determine the outcome of therapy: the main factor in successful therapy lies in the quality of the relationship between client and therapist. The medium in which problem-solving can take place is the human connection.
When Strangers Meet
In the therapy room, two strangers meet to talk—generally a nerve-wracking experience most of us would prefer to avoid! There’s a simple goal: one comes to the other, who tries to help. Along the way, they get to know each other, but in a way quite different to being friends, family, co-workers or lovers.
There is something in this unique relationship, with its boundaries of time and place, confidentiality and privacy that’s paradoxically freeing. We can be more honest, share our secrets, practice new ideas and explore. Things we can’t tell our families, partners and friends, things that are hard, embarrassing, distressing, are the things we tell our therapists. There is something in the telling and truly being heard that heals. But, why? Even therapists with 40+ years’ experience call it a mystery.
In getting comfortable with the often uncomfortable process of sharing thoughts and feelings in the session, even problems such as long-standing depression and paralysing anxiety can be addressed. “Just” talking can transform feelings of hopelessness and despair, bringing ease and a sense of hope. People who come in feeling utterly lost, even suicidal can find their way out of that dark and frightening place, through the seemingly simple, incredibly complicated act of talking to someone who really wants to know.
That’s what psychotherapy is good for.
Lori Covington, MA, MBACP
Somerset Counselling Centre
