What is counselling and what are the different approaches?
Let's be clear that going to a counsellor does not mean you're mentally ill, though counselling is often used within psychiatric treatments. Nor does it imply that there is 'something wrong with you', though there may be something amiss with the way you are living your life.
The essence of Counselling is to help you develop your self awareness, to know yourself, to see what makes you tick. Self knowledge reveals answers to your problems and what to change in your life and especially in yourself; your behaviours, attitudes, perceptions, modes of thought and world view. You cannot change other people, and generally can do little to modify the world, but you can transform yourself. Counselling helps you do this by revealing your attitudes, fears, old habits and ways of being. It puts them on the table, so you and your Counsellor can look at them, see where they might have come from and which of them to change and how, (and which to retain). You may discover hidden talents. Many habits of thought and action may have been necessary defences in childhood, but are no longer appropriate in you as an adult, and probably no longer work!
Counsellors bring about change in numerous ways, not just with the 'talking cure', some use Voice, Gesture, Posture, Role play, Writing, Art materials, etc. Many work on your dreams. However, this abundance of different styles, orientations, or models of counselling largely fit in the following broad groupings.
Psychoanalytic and Psychodynamic
These approaches particularly look at the role of past upbringing and how it, together with unconscious drives and instincts, manifest in your relationships. The way in which and your Counsellor work together is given special attention as a representation of your interactions with others. A psychodynamic perspective is incorporated into many other styles of counselling.
Cognitive and Behavioural
These therapies are much more focussed on here and now solutions, giving far less attention to the past. Attention is on what you're going to do, rather than how did you get here. Your Counsellor may act more like a trainer in new ways of being, working in a structured way over a limited period, and are likely to set exercises as homework.
Here the approach is to move towards individuation and self-hood, becoming a person and develop present awareness; to become more healthy rather than less sick. The past is important in the ways in which it manifests in the present. Such as when do you feel childlike? The counselling relationship is more one of dialogue and active engagement.
Here the concern is of our being in the world and finding meaning within the givens of death, isolation and one's freedom to act. You and your counsellor are both on a journey of exploration to find "What's it all about?". Existential Counsellors keep focussed on the meaning you put upon your feelings and actions.
This engages more on the spiritual aspects of life and what lies behind reality. It doesn't imply that you or the counsellor have strong religious beliefs, but have a sense of the 'otherness' behind reality.
Nearly all approaches draw upon others while having their own emphasis; for example, Jungian analysis and Adlerian therapy have both psychodynamic and humanistic elements. Jungians often work particularly with your dreams; Adlerians look at your social and family context. There are also different styles of counselling within each approach. In the 'humanistic group', Person Centred counsellors tend to be reflective, holding up a mirror to yourself. Gestalt therapists engage move actively with you and Transactional Analysis is more systemised. Apart from some specific issues, such as behavioural therapy for phobias, it is as pointless to ask "Which is the best therapy?", as to ask "Which is the better art form, oils, watercolour, acrylic or pastels?" All artists do much the same sort of thing, with very similar tools and materials. Hence today many counsellors are 'Integrative' rather than belonging to one school, just as artists mix their media, and similarly every counsellor works in a different way. Nor do the terms "counsellor" and "psychotherapist" imply a particular style of therapy.
The essential point is that, for you, these terms and models are far less important than how you and your counsellor relate together, for it's the relationship itself that heals. To choose a counsellor shop around, have introductory or assessment sessions with two or three (remember you are assessing them as well as they you; and you're the 'customer'). Ask them how they would work with you. Some counsellors also run therapy groups and these can be very beneficial, especially for relationship problems, or specific issues like addiction. Even on the basis of one meeting, do you feel (rather than think) you can be open with them, allow them to respectfully challenge you, and in due course be vulnerable in their presence? If "Yes" then give them a try, you'll soon know if it's working. The style a counsellor adopts will generally reflect their own world view and if that's similar to your own, then you're likely to feel comfortable with them. But the relationship mustn't become too cosy; else no work will be done. Expect to have your own world view changed.
As to the difference between counsellors, psychotherapist and analysts, some are very insistent on their title, as psychotherapists and analysts will normally have had a longer training. A distinction between the practice of counselling and psychotherapy is more fluid, in that psychotherapy goes deeper and lasts longer. Clients will often shift from counselling into psychotherapy in the same course of therapy, such as moving from "Help me get over my broken relationship." into "Help me understand my role in how my relationships keep breaking up, and how I need to change.". So counsellors do psychotherapy and psychotherapists do counselling. But you do the work.
By Tony Morris
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