How I work
I have trained in a number of different approaches to counselling – Existential, Psychodynamic, Cognitive Behavioural Therapy and EMDR. And the breadth of my training means that I use a range of different techniques in my counselling work. Having said that there are several fundamental approaches to counselling that I tend to use.
Cognitive Behavioural Therapy
Many of the difficulties that clients face can be very effectively dealt with by using a strategy based approach like CBT. This is often very good, for example, for issues like stress and anxiety.
CBT suggests that there are a number of key factors that contribute to our problems. First there are the triggers and pressures that we are facing – things like having a huge workload or very stressful responsibilities in your job. The first step in this approach is looking at whether these pressures can be reduced in any way
The second focus in CBT is to look at how we think. A key argument in CBT is that it is not the trigger, but how you think about the trigger, that is what really causes the problems and so we devote a lot of attention to identifying negative thought patterns and helping you to change them.
Another important area is how your body is reacting. When we are stressed and anxious our bodies tense up, making the anxiety worse. So another important focus is on how to de-stress your body, which will de-stress your mind in turn.
The final element to look at is how we behave. People with stress and anxiety often do things that they think will ease their situation – working very long hours or drinking too much are two, very different, examples of this. But the strategies we adopt are often dysfunctional and just make things worse. CBT helps you to look at your behaviour patterns and to adopt ones that are helpful and healthy, reducing your stress and anxiety in the process.
Longer term therapy
Although for some problems an approach that just focuses on the present is all that is needed, other people recognize that their issues are much deeper rooted and stretch back into childhood experiences. A typical example of this would be someone who has low self-esteem. This kind of person never thinks that they are good enough, however successful and able they might be. And they always expect other people to think the same about them as they think about themselves, meaning that their moods are often very negative and even depressed.
Very often, when someone experiences their life in this way, the roots of the problem go back to early life. Children who have harshly critical parents or teachers for example will often absorb the adults’ way of looking at them and it becomes their way of looking at themselves. A dysfunctional set of beliefs and feelings about yourself becomes embedded in your mind and conditions how you experience much of your adult life.
In depth therapy, which typically would take rather longer than a CBT approach, looks at the disabling ways of experiencing life in the present, and then traces them back to painful past experiences. We can then use an approach like EMDR (Eye Movement Desensitization and Reprocessing) to target the damaging early experiences and properly process them, so that they no longer dominate how you experience your adult life. The objective is not to eliminate the early experiences. That can’t be done. But to get you to a place where you remember them simply as facts, things that happened once but which no longer have any influence on your life.
One more key area in my counselling work is trauma therapy. People who have experienced intensely frightening situations such as accidents, assaults and abuse, will often develop distressing post traumatic reactions. The key to this is the nature of the memory you form. With normal, non-traumatic, experiences our memories are often limited to a few images and facts, and the event will feel finished and in the past. Traumatised people from very different memories. The events feel vividly alive in their minds (people will often have flashbacks, intrusive thoughts and terrible nightmares of what happened) and you are always fearful that something similar is going to happen again. This often leads to behaviour patterns in which people become very avoidant, which in turn leads to huge limitations on how you can lead your life.
In my trauma work I always use a carefully targeted EMDR (Eye Movement Desensitization and Reprocessing) approach. We begin with a range of EMDR based strategies to help you to manage any distressing feelings that come up when we begin to focus on the trauma. And we then work carefully through the traumatic event or events using eye movements to change the nature of the memories so that they begin to feel much less emotionally vivid and firmly in the past. EMDR is a powerfully effective therapy and the majority of clients find that they are able to put their trauma behind them and move on when they have had EMDR treatment.