What is Counselling
There are times in life when it is difficult to cope; counselling is the process of talking through personal problems with a professional in a confidential setting in order to understand the difficulties and the feelings they create within us. The process of counselling offers insight into how we deal with these feelings and how we express them. In so doing it can free us from self-defeating patterns of behaviour.
In the counselling room a safe, non-judgemental space is available to begin to make sense of problems. As a trusting relationship is built with the counsellor, certain ways of relating to important people in our life become apparent. As we become more aware both of ourselves and how we relate to others, so we can begin to understand how key events and people in our lives shape how we are today. We become aware of what is helpful and what is not helpful for future healthy relationships and gain in confidence by knowing our own feelings enabling us to differentiate between anxiety, anger and grief for example. By getting to know our own emotions and genuinely experiencing them, we are no longer trapped by them but free to make thoughtful decisions for our future.
What is ISTDP (Intensive Short Term Dynamic Psychotherapy)?
ISTDP is an accelerated and powerful form of psychotherapy which is backed up by research that demonstrates it to be a uniquely effective treatment for symptoms of anxiety and depression and other emotionally based problems.
What makes ISTDP different from other therapies?
In ISTDP the therapist takes an active stance and is not a passive listener. The first session is typically 90 minutes and the client and therapist work together to establish a set of goals for the treatment. The clear focus is derived by a detailed inquiry as to the specific nature of the emotional problem/s that the client is experiencing at present. At the same time in the initial session the therapist and the client work closely to monitor and regulate anxiety so that these unpleasant symptoms are kept at a manageable level. Techniques to regulate anxiety are taught for use within and outside sessions. During the initial session the therapist also draws attention to automatic defences that hinder the client in their emotional life and bay be preventing them from accessing and fully experiencing all their emotions and may form a barrier to intimacy in relationships.
What are automatic defences?
Everyone uses psychological barriers or defences in order to protect themselves on an emotional level. This can also be a way of hiding feelings both from ourselves and from others - we might withdraw rather than engage therefore becoming lonely and possibly depressed. When feelings make us anxious we may find relief from the anxiety by using an escape or avoidance tactic which offers temporary relief. In our early years defences can be helpful as a way of dealing with traumatic experiences and it would make sense to withdraw and hide feelings from a volatile parent/carer. As a vulnerable child if there is no-one to help manage emotions then, in order to keep parents/carers close and happy, the child may go for covering up feelings and burying them. What was once a helpful defence may in later life become an automatic way of dealing with feelings evoked by certain stimuli and situations. The defences function as invisible barriers that no longer serve their original purpose of protection but hinder relationships by cutting off from one's own feelings (often pain, anger, guilt, love and grief) and cutting off from another person. The aim of the therapy is to access the buried feelings which once threatened key relationships and to allow them to be experienced with the therapist without debilitating anxiety or the need for outdated defences.
How can defences by so unhelpful?
Well, ignoring and neglecting for example are both defences that one can deploy unconsciously in order to keep feelings out of the way and buried. If one ignores and neglects symptoms of anxiety for example this can lead to physical symptoms like digestive problems, headaches, chronic pain or other health problems.
In therapy the client will learn how to become good at noticing and paying attention to the specific time when defences are employed to cover over emotions that push up from deep within. It is these unprocessed emotions that cause the danger cue and we experience anxiety - often crippling - and when attended to and processed and separated from unconscious anxiety they can be processed together with the therapist. How much more pleasant to experience an emotion without anxiety or the need to hide it away.
The goal of psychotherapy
The ultimate goal of psychotherapy is to reach the unconscious buried feelings which relate to a singe trauma or traumatic experiences and to face them honestly. These buried emotions will surface along with longing, memories and feelings that can be worked through together with the therapist. Old patterns of self-destructive behaviours will be relinquished and replaced with compassion. Finishing therapy is worked on in the final stages one the presenting symptoms are significantly lessened or gone.
This particular form of psychotherapy is embedded in attachment theory. Dr Robert Neborsky based in USA has developed Attachment Based ISTDP (www.istdp.com) and has taught with Josette ten Have-de Labije in Europe and I have had the privilege to be trained by them both in Core Training and Advanced Training. The training is overseen by the International Experiential Dynamic Therapy Association.
The first meeting
The therapist will be active in defining therapy goals with the client for a structured therapy. The therapist uses video tape to look over what has possibly been missed in sessions with the client's permission and to gain a deeper understanding. ISTDP can be 90 minutes or block sessions may be booked of 3 hours and follow up rather than weekly sessions depending on need or logistics. Management of future sessions will be discussed and if this therapy is not deemed appropriate then a different model of therapy could be suitable and can be thought about together.
Information about current fees are given at the first telephone conversation/email following an initial referral. Major credit/debit cards are accepted.
- What are the typical emotional problems?
- Anxiety, Depression, Stress, Anger, Life crisis, Relationship problems, Bereavement, Loss, Low self-esteem, Inner conflicts.
This is not an exhaustive list, but some examples of common problems . If your problem is not mentioned here, please do not hesitate to talk to me on the phone or e-mail me to discuss whether counselling may be appropriate for you.
- Will it be confidential?
Confidentiality is very important and I abide by the BACP code of ethics. Sessions are confidential. If there is serious concern for your safety or another person, then this would be discussed with you and possibly with your GP.
- How often will I see the counsellor?
This depends on our discussion at the initial meeting and your personal needs and circumstances.
- How long will it take?
This will become evident as we work. I am able to work in a short-term focused way as well as in a more open-ended longer term way. We will discuss your needs and come to a mutual decision that best suits you.
- How will I know when to end the counselling?
You will know when life is becoming more manageable for you and that the original problems you came to work on are no longer causing you emotional distress. It is always important to think about the ending of the counselling a number of sessions before the actual end.