About person-centred therapy
I'd like to share some of the ideas that guide my work.
My approach is primarily person-centred, whilst also drawing on elments of other major therapeutic approaches, including existenital, gestalt, psychoanlytic and CBT.
Therapy is not primarily an intellectual exercise, or a set of theories and techniques to be 'applied', but a conversation guided by the unique personality, priorities and needs of each client.
Therapy involves a lot of reflection, and can at times be heavy, at others light. It can involve a complex of emotions, including anger, sadness, and helplessness. At times it can be disappointing and messy. At other times it is illuminating. It can involve tears, humour and laughter. It can bring a sense of being compassionately seen and understood. It can bring hope and increased contentment and strength.
The curious paradox is that when I accept myself just as I am, then I can change (Carl Rogers)
Person-centred therapy is humanistic form of therapy and first emerged within the 1940s. This was in response to the perception and critique of psychoanalysis, as it was back then, as being overly negative and domineering of the client, and of behavioural therapy as being too mechanistic and inhuman.
Person-centred therapy views people as naturally tending towards growth and places an emphasis on people having the capacity to find optimal ways forward for themselves when another person is sufficiently attuned and accepting of them.
The central conditions that the therapist provides are acceptance, empathy (understanding the client and their world from the client's own point of view), and authenticity (being 'real') with the client.
When these conditions are provided for us, we tend to become more aware and accepting of parts of ourselves that we have rejected or struggle to accept, and thereby become more integrated, agentic and energised. Acceptance can include acknowledging and becoming more aware of aspects of ourselves we tend to value and prize in others. Acceptance can also include acknowledging aspects of ourselves we don't like, and this can make this available to understanding and change.
As with psychoanalysis, and cognitive and behavioural therapies (CBT), there is a tendency to regard psychological distress as arising from some kind of incongruence within the individual between one or more of the coordinates of desire, belief, and behaviour. In essence, tension between contradictory aspects of ourselves, or between ourselves and others, can become difficult for us to bear. These tensions can arise in our development. They can also be created suddenly by a disturbing or traumatic event, which can severely strain or shatter our assumptions about ourselves and the world.
It is not neurotic to have conflict.... Conflicts within ourselves are an integral part of human life (Karen Horney)
In my view the purpose of therapy isn't to bring an end to all inner conflict or struggle, but to enhance creative and constructive engagement in our struggles, and to enable us to be freer in ourselves.
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About my style of working
In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth? (Carl Rogers)
As already metnioned above, I generally see therapy as a process of empathic understanding and a meaningful and open-ended conversation, rather than a set of techniques or theories to be 'applied' to a client. I work hard to hold theory carefully and lightly so that I can learn alongside each of my clients and their uniqueness, rather than impose preconceived ideas on them.
However, there are a number of conversational habits or strategies I tend to practice that may be seen as akin to techniques. These tend to help create what is sometimes referred to as 'relational depth' between the client and therapist, and which can facilitate client growth:
Techniques
Empathetic reflection: This involves compassionate and active listening. This includes engagement with the content of what clients say. It also includes making observations about how the client says things. The latter can include tone of voice, and body movements and posture. We're not always aware of all of these aspects of our communication. When our attention is ocassionally and gently drawn to them, it can help open us more fully to our own experience.
Immanence and self-disclosure: I do sometimes share how I am feeling in the moment, as this often (though not always) connects in some way to how the client is feeling, and can assist the client to better to get in touch with their own feelings. Occasionally I may share information about myself where this seems to be in the therapeutic interest of the client. This can help for example address and ease a client's sense of shame about an aspect of themselves that is in fact a commonly shared feature of being human.
'I-thou, here now' This is a mantra drawn from gestalt therapy (another humanistic kind of therapy), and refers to being attuned to the ways the client and therapist relate to each other and how this can helpfully highlight patterns in how the client relates to other people in their lives. Quite often these patterns emerge within the therapeutic relationship, and the therapeutic space makes it possible to bring these into greater awareness and bring the possibility of change.
Problems develop when people internalize conversations that restrain them to a narrow description of self.
These stories are experienced as oppressive because they limit the perception of available choices
(Kathleen S.G. Skott'Myhre).
Supportively challenge restrictive narratives: I believe ourselves to be fundamentally social in the sense that we are shaped by narratives and stories we tell about ourselves and which are drawn from family and broader cultural narratives available to us. At times I tentatively facilitate exploration and critical reflection upon narratives which seem in the client's experience to be detrimental to their well-being. Restrictive narratives (where they are present) tend to emerge spontaneously within the conversation of therapy, rather than through a concerted or highly conscious search for them.
Psycho-education/instruction: I draw on elements of psycho-education where it seems relevant and potentially helpful. This for example includes mindful breathing and grounding techniques to help address acute forms of anxiety. Worksheets as homework between sessions, and therapeutic writing and art exercises can also be incorporated into the work where it may be beneficial, and if a client wishes to work in this way. More often than formal homework, I make suggestions to clients where in their inner experience it may be helpful for them to focus their attention.
