The Secret of Good Therapy
“The fool doth think he is wise, but the wise man knows himself to be a fool.”
William Shakespeare – As You Like It.
Which just about sums up the entire underlying principle of all of the talking therapies. It’s just as Carl Rogers said – the client must decide there’s something wrong in the first place and then decide something must be done about it. What exactly should be done about it – is also entirely up to the client. The therapist acts only as a guide, someone to bounce ideas off.
So much to choose from… so much on offer… how can one possibly decide which kind of therapy to go for? Hopefully, this article may throw some light on your choices…
Psychotherapy literally means ‘mind-healing.’ Whatever your preconceptions of the plethora of modern therapies, they’ve got to be better than the pills and potions dished out by overworked, overstretched GPs, bribed with free trips to conferences, free dinners and free samples by the pharmaceutical companies.
So forget the chemical cures. Instead, read Irving Kirsch’s excellent book, The Emperor’s New Drugs. In the meantime, let’s spend some time looking at the tried and tested, non-physically invasive therapies that are gaining not only in effectiveness, but also in respectability.
As with psychology genius Carl Rogers, the best kind of counseling is non-directive, non-judgmental, and client-centred – the client’s wellbeing and welfare being the main objective.
There are lots of different types of psychotherapy/counseling, and that’s what we are going to look at. Usually, the first step taken by the patient is to consult their own GP. The GP may then refer the patient to a psychotherapist or counselor.
In the latter half of the 20th century, the conventional wisdom (or assumption) was that the cause of the majority of psychosomatic problems was a chemical imbalance in the brain. This is no longer the current wisdom. This sea change in medical opinion has spawned a whole new industry in human ‘well-being.’ I touched on some of the more bizarre, not to mention extreme examples of this new thinking in the article Neuro-Linguistic Poppycock; looking in particular at things such as Eye Movement Desensitization and Reprocessing (EMDR) the fully ludicrous crystal therapy, and er… Neuro-linguistic poppycock.
All the non-doctor therapies (if you will pardon the pun) are HUMANISTIC, COGNITIVE and BEHAVIOURAL.
Psychodynamic Therapy is based on psychoanalysis; endless sessions where clients pay their money (usually in cash) so that they can come back at the same time next week to hand over even more. I’m sorry, where the client ‘talks out’ their problems to a fully qualified therapist, usually a psychologist or psychiatrist.
Then there’s Behaviour Therapy, based on learning theories (we will explore this in more detail later on.)
Cognitive Therapy helps clients to identify their own personal goals and get them to think of positively about ways of achieving them, while Group Therapy gets people with similar difficulties, like alcoholism, get through their shit lives so that they can offer help, support and advice to each other
Psychotherapists are not to be confused with psychiatrists, who are medically qualified and regulated by genuine professional bodies like the British Medical Association (BMA) or psychologists, who have at least got some kind of degree from a recognized academic institution like a University. Believe it or not, anyone can call themselves a ‘psychotherapist.’ There are no real rules and regulations or indeed any recognized qualifications, although there are some professional bodies that recognize certain courses and teaching institutions and supposedly regulate member’s conduct and set ethical standards. Right! So just like the hypnotherapists then!
Aromatherapy and the placebo-based therapies such as herbalism and Prince Charles’ favourite, homeopathy (and I do wish he’d stop going on about it, the right royal twerp) are not going to be explored in this article. Sure, they can make you feel better, but then so can a number of other things, like getting out of your own personal rut and getting a decent social life.
Most people seek out the help of therapists because they are experiencing problems associated with depression, anxiety, phobias, obsessive compulsions, eating disorders such as anorexia and bulimia, but in the main, the real problem is that they simply need to improve their confidence or social skills. Therapists who are not qualified psychologists or psychiatrists should not attempt to deal with people who show symptoms of schizophrenia, bi-polar disorder, or who self-harm. Believe me – leave that stuff to the professionals!
People who suffer from depression experience symptoms of feeling sad, hopeless, that nothing ever goes right, and that they are useless. Physical signs include lethargy, constant tiredness, loss of appetite or at the other end of the scale, over-eating and poor sleeping patterns.
Depression however, should not be confused with grief, which is a perfectly normal and natural reaction to say, the loss of a loved one, or when Manchester United loses against Portsmouth. Only when sadness is disproportionately prolonged does it become depression. Manic depression, sometimes called bi-polar depression, is a different thing altogether. In these cases, the individual experiences extreme mood changes – swinging from extreme sadness to extreme feelings of elation for no apparent reason.
The truth is that a lot of people get depressed at some time in their lives. The down times make one appreciate the up times so much more! However, some people seem to be on a permanent poor-me party!
Depression brought on by a certain event or events is known as Reactive depression. If, on the other hand, there seems to be no discernible cause for the depression, then it is known as Endogenous Depression. To complicate matters further, some people find that their depression can come and go, often descending without warning. About 10% of the population find themselves subject to depression at least once in their lives, although women seem to be more prone to it, especially between the ages of 35 to 45. Creative types seem more prone than others to depression – Robbie Williams, for example, seems to be in and out of The Priory for no discernible reason. A lot of the great composers and artists suffered interminable bouts of chronic depression; Van Gogh even cut his own ear off!
Anxiety is typified by unusually debilitating apprehension or continuous dread, most often about imagined problems, again most often about imaginary events. General Anxiety Disorder is a recognized mental illness and is more than just an overreaction to normal life and events. People can easily become continually overanxious because they are unable to cope with excessive stress, especially stress caused by job-loss, financial worries, kids on drugs, wife having an affair with the milkman. The therapist can’t solve your financial predicament, get you your job back, get your teenage daughter off heroin or stop your wife shagging everything in sight every time she has more than three cans of Stella Artois. But the therapist can give the client the tools to cope better.
Anxiety is quite common, and it can be dealt with. Where the cause of the anxiety can be traced to a specific real cause, it can be successfully treated the same ways as any phobia using, amongst other things, hypnotherapy. What actually happens is that the therapist teaches the client the exercises that will help them regulate their own anxiety.
Anxiety is a subjective experience. We all get anxious at some times in our lives – anxious when the kids are late getting home, anxious when you suddenly get a bigger than expected bill from the lawyers, that sort of thing. Everyone gets anxious on occasion, and again, this is normal and natural in most circumstances. But constant excessive or unreasonable anxiety with no reasonable cause has to be treated. Some people find anxiety unbearable.
A Phobia is an irrational and uncontrollable fear of something specific. Most phobias are animal phobias, especially a fear of things like spiders, snakes, rats, etc. because these animals are associated with unclean, slimy things or rotten food. Of course, a healthy respect for things which can do us harm is a good thing! No one in their right mind is going to mess about with a rattlesnake or jump in the sea when the sharks are circling. Other phobias, for example, fear of flying or a fear of bananas (a real client of mine had that one) are learned and can be unlearned equally quickly and easily. In All In The Mind, we looked at how people become conditioned to their Phobias. Hypnotherapy has a fantastic cure for phobias that normally takes less than twenty minutes!
Obsessions and Compulsions
Obsessions and Compulsions are recurrent and persistent ideas that affect not only the behaviour of the individual, but those around them. Obsession easily leads to compulsive behaviours – there is an emotional component to obsessional ideas – think Howard Hughes; people who wash their hands twenty-seven times a day, people who can’t get through life without indulging in pointless and bizarre rituals etc. The good news is that compulsions can be treated.
Over-eating is the most common eating disorder, which might go some way to explaining why there are so many fat people around. That, and the ready availability of cheap, offal-based, animal waste products masquerading as fast food. This 21st century deluge of salty, sugary, lardy, crap gives people instant access to the type of short-term gratification known as comfort eating. The obvious health problems are obesity, heart disease, diabetes, and not being able to find anyone willing to be seen in public with you.
Bulimia and Anorexia are both ways of binge eating (or troughing as I like to call it) followed by vomiting or abusing laxatives so you can eat what and as much as you want and lose weight at the same time. Anorexia Nervosa is now an enormously popular disease, thanks to the popular media and most especially teen magazines, and is often linked to Bulimia. It occurs when young girls erroneously think they are fat, or when they find themselves marrying into Royalty. It is really a form of self-harm, and is considered as such by many health professionals.
The tragedy of self-harm, or self-inflicted injury, is prevalent mostly amongst teenage girls. Again, these vulnerable youngsters are far too easily persuaded by the girlie magazines they are encouraged to buy and subsequently find themselves subject to the ghastly delusion that supermodel posh spice stick figures are the norm. Self-mutilation goes hand in hand with feelings of extremely low self-esteem. The symptoms are immediately apparent –becauseself-inflicted injuries are easy to spot. The current and conventional wisdom is that self-inflicted injuries are ways of relieving anger, frustration. The physical damage reinforces the individual’s feelings of low self-worth. Other forms of self-harm are more mundane and yet more familiar; alcohol abuse, excessive smoking, or drug use. Self-harmers are often in denial; they nearly always claim they know what they are doing and somewhat laughably, they also claim they are in control. Although I can find no reliable research on this, tattoos and body piercings surely must fall into the same category. Fashion is one thing, but a fashion statement that stays with you forever is a rather different matter.
Schizophrenics have had a bad press over the years. The fact is that you are much less likely to be attacked by someone suffering from schizophrenia than you are by a ‘normal’ person from an inner city sink estate.
If you think that schizophrenia means split personality, like some sort of Jekyll and Hyde character, you would be wrong. Schizophrenics are mainly harmless, although they plagued by disorganized thoughts and emotions. They can become increasingly detached from reality, especially in their teens or early adulthood. One telltale sign is that they are often careless about their appearance. So that’s most Americans and Australians then…
Another telltale sign to look out for is repetitive rocking back and forth (Hitler at the 1936 Olympics) and an inability or unwillingness to communicate properly with others. Schizophrenics sometimes hallucinate and have visions and/or hear voices. Schizophrenia is easily confused with madness, although these days we prefer to call it distraction. Either way, they need urgent help. If left untreated, schizophrenics can even wreck other people’s lives.
The diagnosis of schizophrenia depends to a very large extent on observing the individual’s behaviour. About 1/3 of sufferers recover on their own; about 1/3 experience only intermittent episodes; about 1/3 remain locked in chronic mental illness. Hypnotherapy cannot and should notbe used to cure schizophrenia. This is the domain of the psychiatrist, for reasons already covered inAll In The Mind. However, a better understanding and tolerance from the rest of society is helpful. The Diagnostic Statistic Manual (DSM) gives useful information on schizophrenia. The DSM is also useful because it encourages us to disregard the term ‘mental Illness’ and instead refer to abnormal behavior as Psychopathology, or the even the more mundane term ‘disorders.’
From All In The Mind:
The two most common forms of mental disorder are: Neurosis and Psychosis. Neurosis and psychosis are very distinct. With a neurotic person, only a part of the personality is affected – the person is aware that there is something wrong, that they are not thinking straight or that they have some form of ‘mental block’ and they are able to recognise that they have to take steps to address it. Examples of Neuroses are phobias, obsessions or anxieties where the patient is aware that they have a problem or awareness that their behaviour is abnormal.
With a psychotic person however, the whole personality is affected and the person is not aware. “If I was mad, how would I know?” An example of psychosis is schizophrenia.
Mood Affective Disorders on the other hand are a different kettle of fish altogether. Examples of these disorders are antisocial behaviour (this comes under the heading of psychopathology) and dependency, that is, dependency on anything from alcohol or drugs, to dependency on one’s own emotions to dependency on another specific person. (If you are a therapist, make sure that person is not you!)
People who are depressed or who are unable to let go of their own emotional baggage are often addicted to their negative emotions in the same way that someone who cannot stop drinking is addicted to alcohol. They are comfortable in the world of their own depression and use it as a refuge or a barrier against the real world. They lack the confidence to enter into social interaction and have an affinity for self-absorption. They can be difficult customers and would probably get more out of a visit to the Comedy Store than they would out of an hour’s consultation with a trained therapist. Depression is anger without enthusiasm.
What the Talking Therapies Try to Achieve:
Psychologists and most Therapists have recently abandoned the notion of a ‘cure.’ Trying to cure psychopathology is like trying to cure a rainy day – it can’t be done! It is far better to focus on what are called Coping Strategies. These encourage the individual to achieve realistic goals and make the most of everyday life. Mindfulness is also useful. Just take a moment to think about what the word actually means –the patient is reminded to be mindful, to watch out for, or be aware of their own behaviour. Often they are given a key word to remember, the mention of which will restore calm and reasonable behaviour, rather like the character Mad Margaret in W.S. Gilbert’s Ruddigore; “Basingstoke… Basingstoke!”
Being able to cope with the downside of life on planet earth, with all its setbacks, disappointments and general shit, is something we all have to come to terms with, deal with, and ultimately survive, like it or not. Either get with it, or become extinct – which means you are less likely to pass on your genes to the next generation! I have lost count of the number of people who have come to me moaning that they can’t cope anymore, or that life is just getting them down to the point of depression. Some of them have very real and immediate problems, while others are just wasting may time and their own. How many times have you, as a therapist/counselor encountered someone who needs a good kick in the pants, to put it politely? Improving an individual’s quality of life requires a very different approach according to each individual’s needs and expectations. The concept of Care in the Community is all very well and good, but more often than not, it means that individuals are released back into the wild where nobody gives a damn.
There is no doubt that in the West at least, society as a whole has become more tolerant – no one gets called a ‘mong’ anymore, unless its by Ricky Jervais. With the right care and supervision, individuals can be part of society rather than shut away in the asylums or workhouses of the Victorian era, and like they still are in Rumania and parts of Africa and the Middle East. Psychologists and psychotherapists have come to the realization that re-structuring behaviour is what it’s actually all about, rather than the more traditional notion that the unfortunate individual has been possessed by demons, as is still the case in some parts of Southern Africa, Alabama and Mississippi.
The practice of psychotherapy is all about improving the practicalities of the lives of the less fortunate. In short, it’s all about helping others to help themselves.
As early as the mid 17th century, Rene Descartes advocated “the control of the passions through reason and the will.” This was because Descartes was a genius. However, Descartes believed in the ‘separateness’ of body and mind. The current, and in my opinion, more correct view, is that the individual is a mind with a body, not a body with a mind – the body and mind are inseparable, which is why more and more mind-therapists take a holistic (wholeness) approach to psychotherapy.
I have heard it said that in modern society there is a greater need for psychotherapy than ever before. I do not subscribe to this theory: in the West, we are much more comfortable today than we were say, half a century ago. Before the Second World War, most people didn’t have inside toilets; homes were nowhere near as warm or well appointed as they are today, something which today, we take for granted. Nor are the Luftwaffe trying to bomb us on a night after night. What has actually happened is that psychotherapy is now much more available. That, and the fact that more and more disorders are recognized as, er… disorders.
Now for a shocking statistic: In Britain, approximately 25% of all prescription drugs are for psychotherapeutic use. The real shock is that some observers, such as Dr. Irving Kirsch, an expert in the use of anti-depressants, believe the effect of these drugs to be largely a placebo effect.
Freud, the famous inventor of psychoanalysis and serial cocaine addict, claimed that mental disorders were the result of conflicts between the different parts of the mind – the id, the ego and the superego – and that these conflicts are repressed in the unconscious. At the beginning of the 20th century psychoanalysis was the only available form of psychotherapy. Shame then that Freud was talking bollocks.
Freudian Psychoanalysis basically means that you visit your analyst once a week for however long it takes, sometimes months or even years, until you finally realize that you could have worked all this stuff out for yourself and saved a small fortune into the bargain, whilst the psychoanalyst sits out of sight, so as not inhibit or distract the client, and tries his best to stay awake, when in reality, his thoughts are on the golf course.
Psychoanalysis makes use of free association (saying whatever comes into your head) the idea being to get the client to open up – to get the client to talk openly and freely without the censorship of the ego interfering. It often takes several sessions for the client to get used to this and start to spill the beans, as it were.
Now I’m not trying to punt my own profession here, but the great advantage of hypnotherapy, which relies on getting the client to relax and find a comfortable ‘space’ to discuss things which would otherwise be difficult, is that it provides a comfort zone that allows the client to do just this. Therefore, it is quicker and cheaper than hours and hours of psychoanalysis. Freud abandoned hypnosis because like many others of his time, he was still searching for the ‘trance’ – the elusive, magical state of mind that only the very suggestible can achieve. In modern hypnotherapy, we don’t worry about trances and ‘altered states of consciousness,’ we just get the client to focus their attention on what they already know deep down to be the truth, and then take it from there.
At the same time as getting the client, or patient if you like, to ‘freewheel,’ analysts concern themselves with trying to spot any ‘resistance’ such as a reluctance on behalf of the client to talk about certain things or the client trying to change the subject, or the client cracking jokes (I’d be a terrible patient!) The general idea being that resistance is the client’s way of stopping painful thoughts coming to the surface.
Unfortunately, this is actually bollocks. Any hypnotherapist knows that clients are perfectly willing to open up about their innermost thoughts and problems to a perceived professional. My experience, and that of most of the therapists I have spoken to, don’t worry about this. The clientknows what the problem is, and even if they don’t want to talk about it (which sometimes they don’t) it makes no difference to the positive outcome of the session: so long as the client knows what it is, I don’t necessarily have to know – so long as they know. I have conducted entire sessions where I have absolutely no idea what the client’s problem is, but by the end of the session, they feel a lot better about it and are visibly relieved, expressing their thanks by means of a cash payment. So… Freud had it all wrong. Not all his fault of course, after all, he was a pioneer in an as yet not nearly understood field, but maybe he should have laid off the coke a bit.
It was Carl Jung who introduced the technique of Word Association. As with Freud’s free association, the general idea is to say out loud the first word that comes into your head, the theory being that from your random words, the analyst can work out what is troubling you. This is worse than some sort of ridiculous guessing game, it’s complete and utter folly.
Another beardy-weirdy way of doing it is by looking for Psychological Cues – blushing, turning pale, sweating, changes in breathing or changes in voice pitch. Fortunately, this method has already been exposed as being worse than useless, not only because environmental influences can affect a client’s physical responses, but because it really is no more revealing that Darth Vader’s truth ray.
The theory is that once the data has been conscientiously written down; once the unconscious conflict has been made conscious, the analyst can then go on to the business of interpreting what has been made apparent. The client then transfers (through a process not surprisingly called Transference) their feelings of frustration, jealousy, hostility or hatred, or love and affection, onto the analyst. Freud believed that by doing this, even disorders such as schizophrenia and depression could be cured. He really was nuts, you know. Shouldn’t have done all that coke. The only real way to cure these kind of issues, is by getting the client to understand or accept that they are distressed (easy) and then show them how to create emotional distance from all the negative thoughts, feeling and emotions that have been holding them back (takes about 10 minutes on a bad day!)
Nonetheless, what the analyst is doing is getting the client to gain Insight into their own particular bugbear and be mindful of it’s emotional content, thereby gaining the ability to control it. Or perhaps re-taking control of their lives would be a better way of putting it. Or maybe, re-taking OWNERSHIP of their lives…
Dream interpretation (another Freudian pseudo-psychobabble) is supposed to indicate a client’s Wish Fulfillment. Freud believed that dreams were symbolic and reveal what the client really wants. For example, a dream about eating a giant marshmallow could be the mind’s symbolic way of saying ‘I want to have sex with a very large woman.’ Or maybe not.
The truth of the matter is that any symbolism in dreams means whatever the client wants them to mean. Symbolism is unique only to that one client and is of no use whatsoever to anyone else. Again, that is all that is necessary for both client and therapist to move swiftly on.
True, hypnosis is no better at revealing information. But that is not what hypnosis is there for. Hypnosis is about the solution to the problem and getting the client to effect change, not picking over the debris of some repressed (or false!) memory. (See related articles.) But, the main problem I (and most others in the know) have with Freud is his obsession with aggressive and sexual impulses, characteristic of the Id, if indeed the Id exists in the first place – we only have Freud’s word for it.
So, how many psychotherapists does it take to change a light bulb? Answer: Only one, and only if the light bulb wants to change. And therein lies the weakness of this whole business. You can take the horse to water, but you can’t make it drink. ALL psychotherapy is dependent on the client’s willingness to identify and face up to their shortcomings, and take steps to effect change. Today, most therapists are dismissive of Freud’s psychodynamic therapies, if only because things have moved on considerably: there are now faster, more efficient, more targeted therapies on offer. Freud, I’m afraid, has passed his sell-by date.
Behaviour Therapy aims to literally change a person’s behaviour. No big surprise there! Gone is the time-wasting process of delving into a client’s unconscious. Instead, Behaviour Therapy means what is says on the tin: Bad or undesirable behaviour is unlearned and new, good behaviour is learned – just like the naughty pre-schooler in kindergarten, but more expensive.
The techniques of behaviour therapy were covered in detail in the chapter ‘A Quick Psychology Lesson’ in All In The Mind. I do not propose to regurgitate the whole thing here – suffice it to say that the psychology lesson isn’t really that quick and it was considerably more detailed than can adequately be reproduced on a web page. Still worth a look though.
Cognitive Therapy, or Cognitive Behaviour Therapy (CBT) is based on the premise that mental disorders are the result of faulty thinking. It is useful for dealing with a variety of disorders, including, but not limited to, phobias bulimia, anorexia, depression, to name but a few. Some say it can also be effective in dealing with chronic fatigue, but I’d watch out for that one if I were you – how would you know that the chronic fatigue you are trying to cure is not caused by chronic heart disease…eh?
Anyway, the basic premise is that the individual is not disturbed by actual things or events, but by their perception of things or events. In other words, the way they view things or events. Albert Ellis put the process into three easy stages:
A) Activating event: example: I was expecting a phone call from my friend – she always calls on Friday, but she hasn’t called in two weeks!
B) Consequence: I’m very worried that I have said or done something that has upset her and she’s fallen out with me.
C) Belief system: I’m a useless person – no one likes me!
In reverse, the theory is that by changing the belief system, we can go on to deal with the emotional problem tied to it, and thereby dismiss as irrelevant or inconsequential the activating event, after all the friend might be away on business or visiting her parents! This sort of rationalization with clients is easy once you know how!
Many people hold onto irrational beliefs, and again, this is a subjective experience and is nearly always the result of negative attitudes toward oneself. Some of these negative beliefs are extreme enough to be considered Paranoia. This is a difficult rut to get out of. Nonetheless, there is an answer.
Try asking the client to imagine that they can have a conversation with someone they either like, admire, or respect. It doesn’t matter whether or not the client knows them or whether or not they have even met them, because what we are about to do is play a game of ‘make-believe.’ The person the client chooses could be anyone – maybe a loved and respected great-aunt, or a film star, or sporting star – it could be a best friend or a family member, even someone they haven’t seen for years.
Now, I don’t need to know who that person is, I really don’t. But what the client can now ‘make-believe’ is this: if you were somehow able to have a conversation with that person, what advice do you think they would give you? This is a way of getting the client to do the work for you – the client is able to give themselves the advice that suits them best – the advice that deep down they always knew to be the truth! (Barrie St. John showed me this one and it’s brilliant in its simplicity. I use it a lot with clients now and it’s really effective.)
This technique covers a multitude of problems. Above all, it encourages the client to take a more realistic approach, even if the advice is not always what they want to hear! Like the rest of us, clients need to face up to some of the harsh realities of life. The secret lies in our ability to beobjective rather than subjective. We have all had friends who have had problems, and it’s always so easy to see the solutions to those problems when you’re looking at the problem from outside the bubble. Not so easy though to see the solutions to our own problems – because we are too close to them, trapped inside the goldfish bowl – a classic case of not being able to see the wood for the trees really.
Cognitive Restructuring Therapy is another variation on the theme. Developed by Aaron Beck, it encourages clients to think of alternative explanations to perceived problems or threats, thereby regaining control of their emotions. For example:
Interpretation 1: the cat has not returned home; maybe it’s been run over;
Interpretation 2: the cat has not returned home; maybe it has found a mouse-hole to play with.
Beck says that excessive criticism from parents or teachers during childhood and adolescence can lead to depression later on, through a triad of inter-related negative beliefs:
· The self-view feels worthless, undeserving of love, helpless and unable to ever be happy;
· The world-view is that life is always too demanding with too many obstacles;
· The future view confirms these negative feelings – that there is no likelihood of improvement and no hope…
This is obviously a distorted and unrealistic outlook. Nonetheless, once these feelings take a hold, they are almost impossible to shake off. Almost impossible…
Cognitive Restructuring teaches the client how to think about their thinking (this is also known as mindfulness) and encourages them to correct the faulty thinking that created the problem in the first place. It’s simple enough to do. First, the client learns to monitor his or her own negative thoughts. Next, they rationally and logically examine the probabilities (the cat has disappeared before, but always comes back in the end.) Finally, the client substitutes the more realistic explanation, In this way, the client learns to first identify, and then alter the negative beliefs that lead to the distortion of reasonable expectation.
There is one small flaw in this plan and that is that the therapist is often tempted to offer guidance to the client. According to the rules, this is something the therapist should not allow themselves to do (reference Carl Rogers.) But using this particular technique, there is always the danger… Which brings me to my actual point, which is that some of the therapists I have met are actually bonkers – stark staring mad some of them! I don’t know why it is, but the alternative therapy business seems to attract some very odd types. It’s a shame there isn’t more regulation.
There is a common theme running through all these therapeutic techniques, and that is; Attributional Bias, which is all to do with how the client attributes the problem. Most people feel that any successes in their lives are mainly due to their own efforts (with maybe a sprinkling of good fortune, such as being in the right place at the right time.) Failures however tend to be attributed to outside influences; other people’s faults or unexpected environmental influences such as earthquakes or getting mugged on the way home from the railway station.
People in depression don’t see it like that. Depressives see it in quite the opposite way; they attribute their failures to their own shortcomings and successes caused by factors beyond their control.
What the therapist has to work out are ways of changing this mindset. I have found lists, tables, diagrams, charts, all very helpful. Clients make these themselves with no assistance or interference from me, laying out in a legible manner their successes and failures, and what they were all down to. I have found this to be an extremely useful exercise because it gives the client something tangible to look at – a pictorial representation of their beliefs – and is a brilliant way of helping them to decide what needs to be done! Once that part of the therapy is accomplished, we can then move forward, getting the client to use their own logic and intelligence to improve their self-esteem, confidence and of course their overall performance. It takes a little time and some patience, but it can be done. I have found that the client starts to see it soon after they start the exercise.
In the end, it all comes down to the power of positive thinking! As Carl Rogers said, the individuals have within them vast resources of self-understanding that can alter their self-concept, attitude, and self-directing behaviour. These resources can be tapped if a definable set of goals can be presented to, and agreed on, by the client.
OK, so if you have read some of these articles already, you will by now realize that Carl Rogers is a something of a hero of mine, and I admit it. I have found that his idea of Person-Centred Therapy is simply the best approach. It’s non-directive and non-judgmental; it makes perfect sense and seems to work every time. Maybe it is because it forces the client to most of the work! At the very least, it certainly encourages the client to face reality, something they have been putting off for too long! The other point to bear in mind is that although the therapist must never give advice, it’s OK for the therapist to agree with and support the client when the client gets it right.
I can throw out a list of words and phrases like unconditional positive regard, genuineness, empathy, authenticity, realness, transparency, congruence, honesty, openness, acceptance, respect, understanding,but I’m not going to, although all those terms precisely describe what the relationship between therapist and client should be like. You must always care about your client; if you don’t, you will fail, because the client always picks up on it. Lets face it; you know when someone is trying their best for you the same as you can tell when someone doesn’t give two hoots. It’s all about building a trusting relationship. Furthermore, we have two ears and only one mouth, so we should listen twice as much as we talk. So what are we really there for? We simply help the client make their own decisions about their present and future situation.
Now the Gestalt Therapists might want to start throwing in their ten-pence worth at this point. Gestalt simply means ‘wholeness’ and as far as the people in therapy are concerned, it can include factors like diet, social life, who your friends are, the sort of entertainment you prefer, even the amount of natural light you are exposed to – anything in fact that might have a bearing on your general well-being.
Psychologist Fritz Perls used all sorts of role playing (acting out) games to help clients deal with ‘unfinished business.’ These amateur dramatics are sometimes useful in that they attempt to put the client in someone else’s shoes. It’s always healthy when individuals can see someone else’s point of view. If a client’s behaviour is irresponsible, it might be possible to Amplify that behaviour to such an extent that the client starts to see how ridiculous, childish or harmful it really is.
Perls also stressed the usefulness of concentrating on the present and the future rather than what is in the past, getting them to focus on what they have rather than what is absent. Do I need to flog this point? Last but not least, clients shouldn’t try to be someone else – bad news for the NLP enthusiast. All this modeling and mirroring does no good; pretending to be someone or something you’re not is more stressful that it’s worth. And a bit sad… Just be yourself. Honestly, it’s a lot easier.
So, to sum up, here is a quick summary of 10 things we need to get the client to do:
1. take responsibility for their own self, their actions and thoughts;
2. become independent and self governing;
3. exercise their own conscious intention;
4. make ethical and moral choices;
5. confront the anxieties and disappointments that are part of everyday life;
6. move beyond their isolated, lonely, self and seek the company of others; in other words, make some friends;
7. engage in loving relationships (not you, Oedipus!)
8. get involved in some creative activity – there are plenty of opportunities to do this; dance classes, art classes, film clubs, musical and dramatic societies etc; above all, don’t just sit at home in front of the idiot lantern all the time!
9. Get together with someone else, or better still, a group of people and invite them to go rock-climbing or paintball shooting or something.
10. Read Dale Carnegie’s books How to Win Friends and Influence People and How to Stop Worrying and Start Living. Honestly, it’s all in there!
Throughout all this therapy stuff, Visualization is the most powerful tool. It helps people enhance their performance in sport, music, in the workplace, in relationships… need I go on? And in case you didn’t realize it, Just being able to talk to someone is HUGELY therapeutic… and beneficial.
For more information on hypnotherapy, read All in the Mind – Hypnosis, Suggestion and the New Mesmerists. Available from this website.