INTRODUCTION.
I thought it might be useful to offer prospective clients and supervisees
more information about what individual psychotherapy is, the work we may do
together and myself. It’s also a chance for me to write some of what could later, time (and enthusiasm!)
permitting, be expanded into articles. I’ve divided it into sections so
you can go directly to what you think is relevant to you. You might want
to skip the lot and arrange a free no obligation half hour meeting with me
to explore whether you reckon I can be of any help to you and if it is relevant
that we work together.
THE DIFFERENCE BETWEEN COUNSELLING
AND PSYCHOTHERAPY.
I offer both counselling and psychotherapy. In practice, I find it difficult
to draw a clear distinction between these two forms of therapy. How any practitioner
can claim to offer one without straying into the realms of the other I find
nonsensical. In fact the similarities are so great the layperson might be
forgiven for wondering why the different names. They both involve addressing
psychological issues on a one to one basis through talking, usually for an
hour at a time, on a regular basis and in the same place.
At the risk of offending some practitioners I will stick my head above the parapet and offer the following statement of difference. Counselling tends to be more short term in nature; with the emphasis more on addressing a particular problem in the client’s life, dealing with the Ego and its agenda alone. Psychotherapy tends to take place over a longer period of time and whilst there may well be a particular issue affecting the client in their life, there is usually recognition of the need to address the clients past and the changes being demanded for the future.
When asked to define the difference
I often use the analogy that Counselling is about getting the dragon back
in the cave, whereas Psychotherapy is about taking dragon-riding lessons.
From my woodworking days we used to use the phrase “making a feature
out of a fuck up”. It came from making what could be seen as an error,
for instance chipping a piece out of a table leg, and then turning this into
a feature, in this case making it into a carving that was then repeated on
the other legs. People viewing the finished table or chair would admire the
fine carving not knowing that its root came from the fuck up. This too forms
an apt metaphor for psychotherapy. Instead of learning how to live with some
form of perceived error or disadvantage, which may be more of a counselling
approach (I said this might offend some people... most probably those who
call themselves counsellors), psychotherapy can turn that fuck up into the
centre of one’s life. As Carl Jung put it “the Gods are in our
diseases”.
Practically the work may result in a major shift in one’s life perspective,
a shift from an ego centred life to a soul centred life, the classic example
being the mid life crisis/transition. By this shift I mean a more whole life,
one including parts that may have been excluded, ignored or unconscious previously but
are now demanding attention and requiring integration. This kind of work is
sometimes described as transpersonal psychotherapy or even psycho-spiritual
psychotherapy as the context for the work is wider than the needs and wants
of the Ego, or the personal. Whilst the Ego has to be allied to the work for
it to succeed, and definitely does not need to be cast as the villan of the
piece, the Ego is often the last part of the person that wants to make the
necessary changes.
SOUL AND PSYCHOTHERAPY.
It is the discord between the Ego’s wants and the Soul’s demands
that brings about the variety of diseases, difficulties, problems etc. that
bring a person to therapy... after all who would go to therapy unless they
have realised that they can’t resolve the problem themselves and need help from
beyond themselves? In fact the greater the resistance of the Ego, the more
distorted and grotesque the symptoms may become. Reading these signs from
an Ego perspective is bound to be tricky for the individual as they are the
last person who wants to see them. Similarly, in dreams, it is the dreamer
who is likely to be the last to get the message of the dream, their ego is
literally asleep and their soul (or whatever you want to call the dream maker)
is given free range to express itself.
This is where a psychotherapist can help. Trained to pay attention to the unconscious or Soul, a psychotherapist hopefully has this dual vision - the ability to see from both Ego and Soul perspectives. The root of the word Psychotherapy means to pay attention to the Soul, Psyche – “Soul”, and therapy – “to pay attention to”. Personally I prefer to describe myself as a psychotherapist. The nomenclature psychotherapist is sufficient in itself without additional prefixes. Actually the pre-fixes “Transpersonal” and “Psycho-spiritual” only serve to make an unnecessary distinction between the other psychotherapies that may be better and more accurately described as counselling i.e. NLP (Neuro Linguistic Programming), Gestalt, Psychodynamic. I suspect the inappropriate adoption of the term psychotherapy by particular therapy training schools comes from a perceived superiority, professionalism or scientific rigour associated to psychotherapy. There is no denying these therapies pay attention to something, but whether that something is Soul or Psyche I doubt. From this you may gleam my scepticism behind the Government’s promoting and funding of psychotherapy in the NHS through the use of NLP. The Government has picked this particular therapy because it is short-term work, measurable and gets results (short-term). I’m not knocking it, NLP has its place, but it, or its practitioners need to recognise its limits and the damage that may be caused by its inappropriate use. Anyway the use of the word psychotherapy may well have changed over the years and there is little use me ranting about it. Hopefully from this you’ve got a better sense of what I mean by psychotherapy.
INDIVIDUAL PSYCHOTHERAPY.
This said, I do use a prefix to describe my work, that prefix being “Individual”.
The more obvious implication is that the work is for individuals as opposed
to groups. I have done some group psychotherapy work but it is not where my
interest lies at least for now (I do have my doubts about it’s effectiveness
and concerns about its potential for harm). Beyond this though I think it
is useful to emphasise the individual nature of the work we would do together.
Jung coined the term “individuation” to describe the process of
becoming more whole, more ourselves. In this sense our work is about helping
you become more you. It is easy to see such work as selfish or egocentric, however
this would be a mistake. I believe it is impossible to become more oneself
without recognising what I would call “otherness”, be that otherness
in oneself or of others.
The form of the work is going
depend on you and what you bring. There is no set formula that I apply to
you, or process for you to go through. It’s about you becoming you,
not conforming to some school of therapy. Of course there are patterns that
the work may take and similarities that do occur from one client to another
but the very essence of the work is to honour your uniqueness. This is what
keeps me interested in the work, i.e. that with each client I get the privilege
of meeting another unique individual and helping him or her further their
uniqueness.
The process however is not necessarily experienced as one of growth or expansion;
sometimes it is more an experience of contraction or shrinkage. It is no coincidence
that psychoanalysts are colloquially known as Shrinks. Therapists of all kinds – psychological and physical, often overlook that there are two directions
of change possible. Recognising whether the question is one of growth or shrinkage
for a particular client is one of the most subtle (and perhaps the most
ethical) dilemmas faced by the psychotherapist. Ideally my job is nothing
more than to present both sides of the dilemma and allow the client to decide.
DREAMWORK.
As alluded to earlier, I find the client’s dreams to be of particular
use in informing us about the whole of our work. What you say about your particular
issue and how it develops fills out part of the picture, dreams help to complete it.
Often clients will talk for most of the session and between us useful work
is done, only for the client to mention a dream close to the end of the session
that not only affirms the work already done but also offers neat twists, further
insights and a sense of wholeness. So valuable do I believe dreams are in
living a Soulful life I offer "one-off" sessions for people not
in on-going therapy to explore a particular dream.
THE RELATIONSHIP.
The “relationship” rather than the form of therapy is often cited
these days as being the most important factor in effective therapy (interestingly
independent studies have shown that minimal therapeutic training can be the
most important factor in effective therapy). When analysed the importance of the relationship is
obvious... if the client does not feel safe or able to relate to the therapist
then how can they bare themselves. Of course therapists are trained in ways
to foster a healthy working relationship however ultimately I believe there
is no faking it. The advice I give to those seeking a therapist is to walk
out if it does not feel right in the first sessions, however if something
crops up later in the work then that could be worth investigating, especially
if it bears any resemblance to the problem that took you into therapy. If
the therapist is unwilling to explore the relationship between the two of
you this sets up an unhealthy one-sided power dynamic. Unlike some therapists,
notably those of the Psychodynamic approach, I am open about my responses,
thoughts and feelings in relation to you whilst also elucidating and making
use of what you imagine my response may be. In this way both the inequity
of withholding and the “knowing better” attitude of the therapist
is avoided without denying the client the benefit of the therapists thoughts,
insights, reflections, and feelings.
TRANSFERENCE AND COUNTER TRANSFERENCE.
This leads me on to a rather technical matter, that of the use of Transference
and Counter Transference. Put simply, the classical or more psychoanalytic
definition of Transference is the unconscious redirection of emotions from
the client’s past onto the therapist. Under such circumstances the client
comes to see or treat the therapist as their Mother or Father. However the
range of projections may be wider than this i.e. the Mother and Father the
client never had, the ideal partner or lover, the Wise Man etc. Counter-transference
is seen as the therapist’s unconscious reaction to how the client behaves towards them under the influence of transference. If you have got lost by this point and don’t
understand what I am taking about, don’t worry, because that is an appropriate
feeling at this stage in relation to the subject matter and if a few therapists
could grasp that too, there wouldn’t be such a problem. You may have
noticed in my description that the term “unconscious” was used
and wherever that term is employed there is licence for all kinds of trouble
and abuse of power.
As part of my exploration of the various Psychotherapy professional bodies, I became aware of, and engaged with, the Clients Voice movement. One of the major concerns of some clients (and therapists) was the use of approaches focussing on Transference and Counter Transference. Having become dependent on their therapists some clients felt abused by them referring all of their feelings back to their past. Unable to change things in the present relationship and unable change the therapist’s entrenched fixed position the clients languished in a therapy they were unable to leave despite the emotional and financial cost.
I don’t deny that the feelings that arise in therapy are strong and that this kind of abuse has happened to some clients. I have heard an analyst talk at a lecture about a client of 17 years standing, five sessions a week initially down to three a week later in the analysis, with her boasting how she could tell exactly how he was feeling when he entered the room. This reeks of ineffective, perhaps exploitative and quite possibly abusive therapy. It raises questions of Counter Transference issues, as to who the younger male client was to her... her son possibly and was she an over intrusive Mother? I have also been on the wrong end of such an experience myself within my Psychosynthesis training and it was this that spurred me on to research and understand this process more thoroughly.
What is apparent to me is that there are two fundamental errors involved. Firstly, there is a complete misunderstanding by the therapist of the process of transference and counter transference at the theoretical level and secondly there are the errors relating to particular clients due to the unconsciousness of the therapist, or more precisely how the therapist handles that unconsciousness.
With respect to the process itself, Carl Jung wrote what must be the seminal text on transference and counter-transference in his work “The Psychology of the Transference”. Like most of his writings its tough going but there are some pictures! The pictures are taken from an alchemical text, The Rosarium Philosophorum, and depict (part of) the alchemical process. The underlying message is that whilst the process can to some extent be mapped out, the form will be unknowable and both the therapist and the client get lost in it, and are eventually transformed by it. This is the crux of the matter i.e. that the therapist gets lost also, that the therapist has an unconscious. The criticism often levelled against analysts who mishandle a transference situation is that they are “insufficiently analysed”, as if the unconscious can be analysed away, which only goes to show the endemic nature of the problem in the profession. It is this arrogance, this lack of humility, this hubris of the therapist being perfect that is the real problem. In the therapeutic relationship such an attitude places the client in the position of always being wrong. The only way out of such an impasse is to take on the truth of the therapist and give up one’s autonomy... hardly the goal of psychotherapy!
In practice the risk of an unhealthy transference is avoided firstly by the attitude of the therapist. The power invested in the therapist by the client has to be handled carefully. This comes down to a matter of morals or ethics, something that is largely untrainable and to who the person fundamentally is. Secondly the effects can be minimised by effective supervision – a topic of such importance that it deserves it’s own section.
SUPERVISION.
Supervision is where a therapist discussed their client work with another,
usually more experienced, therapist. The “more experienced” is
not essential it’s the outside perspective that is important. The supervisor
stands outside of the dynamic and can hopefully see what the therapist and
client may be caught in. What surprises me from the upheld complaints published
in Professional Body’s journals is that the recommendation of the Complaints
Committee is that the errant Therapist is required to undertake a period of
supervision. Undertake a period of supervision! As I see it, supervision not
only increases the efficacy of the work done but also stands as the best safeguard
for the client against the development of unhealthy transference situations
and the elimination of abusive practice..
GOVERNING BODIES. ACCREDITATION,
COMPLAINTS AND HEALTHY PRACTICE.
The above section on supervision has brought up the subject of the Profession’s
governing bodies. My experience of the Profession’s Governing Bodies
has lead me to choosing to be a member of none, whilst recognising more fully
my anarchic tendencies. Please be clear that by “anarchic” I mean
self governing in a responsible way and hopefully from this writing you can
see how this applies. Part of this aversion comes from
the Government’s drive towards the “professionalisation” and
registration of psychotherapy. I won’t go on about this here but for
further information please see my article in “Ethically Challenged Professions” edited by House and Bates or (the full version) on this website “The
Fallacy of Accreditation”. I have all the relevant training, experience
etc. to become accredited but have chosen not to be. I believe in being open
and transparent about my working practice, of which this article is an example.
If you have any further questions I would be willing to answer them in person.
Generally my experience of the major professional bodies, the BACP, UKCP etc is that they are large, remote, impersonal, and assume an authority they have never been granted. They seek to monopolise the psychotherapeutic field, rarely collaborate with one another and are there to protect their own interests and members (the therapists) and not those of the client (you can probably see from this where the Client’s Voice Movement started). One consequence of this is that these organisations are not the best place for a client to make a complaint about one of their member’s work. They have a vested interest in their organisation not being seen by its current and prospective members and the public, to be populated by poor quality practitioners. A friend (and therapist colleague!) who did raise a complaint against a practitioner found the experience thoroughly dissatisfying. The process re-traumatised her and resulted in little more than a slapped wrist for the therapist involved.
My advice to anyone I know who is in therapy and is considering making a complaint against their therapist is to first try your utmost to resolve the issue with the therapist yourself, if necessary with the help of a third party/advocate of your choice. If this proves unsuccessful I would say to walk away and move on, unless there are sufficient grounds to bring a civil case in which case the advice of a solicitor should be sought.
I did have a more significant interaction with another organisation, The Independent Practitioners Network (IPN) and their underlying principles appear to be quite sound. It is based on a network of small groups within one wider network. This face-to-face peer based system has great merits in terms of support and accountability. The small scale of IPN means overheads are kept to a minimum - so no large membership and accreditation fees are involved as with the larger organisations. Such large fees discourage part time practice as they make it uneconomic (I heard the field of acupuncture suffers from this to a greater degree with the closed shop of the governing body being tied into insurance provision). For me, I see part time practice as essential to my well-being and hence the effectiveness of the work. Part time working helps me avoid burn-out and maintain a soulful life independent of therapy. To be emotionally and financially dependent on the work risks introducing an unhealthy dependency of the therapist on the client. IPN does have its faults though, most notably where it tries to act as a whole on the wider stage and it’s “accreditation” system has some fundamental flaws.
I have had my fill of Psychotherapy politics. I no longer want to put effort into trying to change others and simply prefer to get on with the work in an ethical way based on my own hard won experience and understanding of the practice of psychotherapy. Unlike most other practitioners I do not blindly submit to others assumed authority over me, my work or my clients. If you are uncomfortable about my approach I suggest you look elsewhere for a therapist. I'm sorry to be so blunt, but life is too short.
TRAINING.
Training to be a psychotherapist is becoming an increasingly academic and
impersonal exercise with more and more University’s offering courses.
If we go back to the route of the word psychotherapy - to attend to soul,
how would you train do that? What did people do before psychotherapy was invented,
was the soul ignored? In fact, Jung was against the formation of a training
school in his name, possibly due to the inherent contradiction between being
trained to do something and the honouring of individual uniqueness. Originally
there was not the plethora of training schools or even forms of therapy there
are today. Prospective therapists would undertake a training analysis, wherein
they would enter therapy with a training analyst until such time that they
both felt the trainee was ready to work with clients under the supervision
of the training analyst. Large lectures were available to attend but the individual
development of the therapist was self-directed under the guidance of the training
analyst. The work is carried out one to one, and, as I see it, so too should
most of the training be. Learning should largely be self-directed where the
individual recognises their own weaknesses and specialties and seeks to rectify,
or further them respectively. This would set the therapist on an ongoing path
of individual development independent of any one narrow (by definition) training
school rather than the artificial delimitation of qualified/not qualified.
It would also avoid the churning out of therapists who can only qualify if
they conform to and adopt the methods of their particular training school.
Finding your own way inevitably sets the student in conflict with the training
school who can only graduate the student if they conform. If the training
schools let go of their possessive grip on “their” students and opened
their doors to all, there would still be a place for them in the provision
of lectures and perhaps basic courses in listening skills. The dynamics of
the training scenario can unconsciously transfer into the therapeutic relationship
bringing in attitudes of superiority, arrogance, authority, power-over, possessiveness,
conformity etc.
(Return to Menu)
MY BACKGROUND AND EXPERIENCE.
I started my therapy training with a postgraduate three-year course (over
four years) in Integrative Psychosynthesis at Revision in 1990, starting work with clients
in 1993. I attended various weekend workshops and retreats to compliment this
work. The founder of Psychosynthesis was Roberto Assagioli. Like Jung, he
was a student of Freud’s, who saw that Freud was not seeing that we
are more than just a result of our past. Assagioli building on his study of
the Western Mystery Traditions developed Psychosynthesis to redress this imbalance.
Assagioli’s work and Psychosynthesis are often taken out of context
as he wrote little about what Freud had already covered. That Revision addressed
this omission and kept training groups small in number was what attracted
me to their course.
My graduation though was delayed by my refusal to practice transference and
counter-transference in the way prescribed by the course directors. Only when
I was prepared to walk away from the training and chose to seek the help of
an Analytic Psychologist who could see the mis-use of transference I was expected
to employ, did things change. The Psychologist was known to the Directors
at Revision and they agreed to accept his assessment. This supervisory relationship
continued for many years and helped me form the core of my working style.
It was here that my Jungian influences were furthered and my use of dreams
cultivated. In some ways, the training only really begins after graduating.
Recognising that my work lacked some kind of centre or embodiment I undertook the nine-month introductory course to Core Process Psychotherapy at the Karuna Institute. Core Process Psychotherapy is underpinned by Buddhist psychology and having attended several Vipassanna meditation retreats I felt attracted by the link between meditation and psychotherapy. I did not realise at the time just how much I stood to gain from this course. The struggle I had in marrying my Western psychology based Psychosynthesis training with the Eastern psychology based Core Process psychotherapy proved very fruitful. It gave me another perspective, unifying elements of experience and psychology previously disparate and isolated. My training at Revision was based on an attempt to integrate several of the modern psychotherapies under the umbrella of Psychosynthesis. Whilst this had its advantages, overall it actually lacked integration. The Core Process training gave me an anchor point from which to integrate the parts.
I gained five years experience working as a volunteer in the Art Therapy department of a Psychiatric hospital. Helping co-facilitate an in-patient Art therapy group and assisting in the drop in facility the department offered. This work gave me experience of working with clients with psychotic symptoms and under medication. This has helped me be with clients in distress and read the movements of the soul at a deeper level.
In Bristol I ran a private psychotherapy practice for fourteen years working with many individuals over both the long and short term. Presenting issues have been wide and varied including addictions, bereavement, depression, physical illness, relationship difficulties, with my speciality appearing to be in people's experience of lacking purpose and meaning, or the midlife crisis. I have provided supervision to managers and counsellors of an Inner City Drugs Project and the Dementia Care Trust, as well as to psychotherapists and alternative practitioners from the fields of acupuncture, homeopathy, massage, nutritional therapy and shiatsu. I have helped train volunteer counsellors/carers in Listening Skills and lead group courses and workshops in Here and Now therapy. Over the years I have undergone sixteen years of personal psychotherapy including Psychoynthesis and Jungian approaches.
Other than attending the occasional Jung lecture in Bristol, I am not undergoing any formal training at the moment and keep this situation under review. I am presently establishing a small-private practice in Frome and engage supervision at a level suitable to my client load. I have recently (April 2007) become a Father, so along with family life, part-time work for a local traditional restoration company and work on my own home I feel I am living a soulful life.
Gary Tomkins BA Hons., Dip.