Counsellor and psychotherapist Johanna Sartori
Counsellor and psychotherapist Johanna Sartori is our regular columnist. This week she lifts the lid of the types of therapy that exist.
THE British Association of Counselling and Psychotherapy (BACP) this week suspended the Senior Accredited Status of Lesley Pilkington, a psychotherapist who professed to offer a cure to gay men and women who do not want to experience same sex attraction.
Ms Pilkington works from a Christian perspective and I have written here about why I believe her approach is wrong and unethical, but it got me thinking about the different types of therapy on offer. If you are feeling like you want to explore counselling or therapy, it can seem a large and confusing profession to chose one person from, especially if you have no knowledge of what is on offer. In which case, I thought a quick guide (as I see it) might be useful.
Psychoanalysis is where it all began, Freud’s “talking cure” at the beginning of the century was ground breaking and is still the basis for how therapy works today. If you are looking for a psychoanalyst you may find they describe themselves as a Freudian, Jungian, Kleinian or “an otherian” Analyst based on the particular school of learning they reflect in their practice. All however, will focus on childhood development, along with innate shared drives as a way of understanding how you as the client, learnt to operate in the world and in relationships. The role of the sub-conscious is also a very important concept and making meaning of what may appear to be everyday events in light of hidden thoughts, desires and needs. Reflecting the old school nature of this way of working your analyst may well have a couch for you to lie on, and is likely to say very little themselves, as they focus on entirely on your process.
Psychoanalysis rarely comes cheap and it is often recommended that clients attend more than once a week, over a long period of time (think Woody Allen’s commitment to therapy). It is an opportunity for in-depth work and an interpretation of what may appear to be even the most mundane of events at an unconscious level.
Behavioural Therapy grew out of behavioural psychology, and is most recognised in its form as Cognitive Behavioural Therapy (CBT) which has received lots of publicity in recent years, and is generally what is offered on the NHS via a GP referral. CBT looks to address the negative thoughts that make life difficult, things like finding it very hard to talk in groups, believing that people generally don’t like you, worrying that you are not good at your job etc, anxiety attacks, phobias, are also suitable for CBT. The idea is that by and recognising the negative thought patterns, and understanding how this then affects your behaviour and emotions, you can begin to rationalise the negative thoughts and replace them with more positive ones. It is generally a short term form of therapy, and as such is quite strategic and focused on the problem in hand, often there will be “homework” set to continue the work between sessions.
Another variant of behavioural therapy is Solution Focused Therapy which aims to increase a client’s ability to find solutions and overcome barriers to their current sate of mind through envisaging a problem free scenario.
Counselling and Psychotherapy, or “The Rest”. Firstly, what is the difference between counselling and psychotherapy? Well, the short answer is, that there is no universally acknowledged or defined difference, and in practice, the experience should be broadly the same in either case. Generally, I see it as an issue of terminology rather than anything else.
That said, within the field of counselling and psychotherapy you will find a wide variety of different types of therapy on offer; you might hear therapists describe themselves in many different ways, eg, Person Centred, Gestalt, Humanistic, etc, essentially reflecting their theoretical training, or as an Integrative Therapist, indicating they have a wide knowledge base rather than specialising in one distinct area. Therapy can be offered from many different perspectives, Feminist, Christian, BLGT and of course unlike the previous categories also includes couples counselling.
Where I think “The Rest” differs from psychoanalysis and behavioural therapy is recognition that the relationship between the therapist and the client is the most important aspect of the work, as this is the conduit through which the benefit will come.
General Rules. Whatever form of therapy you opt for, there are a couple of things you are entitled to receive from your therapist, respect, confidentiality, non-judgemental acceptance and to be heard. For good measure I would check that they are a member of a professional body and that they have regular supervision with another, more experienced therapist.
Feel free to “try out” a few therapists if you can afford to, and don’t assume you are obliged to return to the first one you visit if you do not feel comfortable. Therapy is about you, it is not done to you; it is a journey you take with your therapist and as such you have to say if and when it does not feel right. Your therapist can look after themselves, and they can handle it if you disagree with them or are annoyed by them, so tell them!
So, if you are contemplating therapy, I hope that helps with the decision making.