My Approach
Arranged roughly in order of importance, the following terms should help you gain a better understanding of my own particular approach to counselling. It is also my hope that these explanations will to some extent demystify the counselling process, and offer people some tools with which they might help themselves.
For a full description of each term, please click on the links below:
Client-Directed Outcome-Informed
Person-Centred
Relationship
Humanistic
Solution-focused, Strength-based
Existential
Spiritual
Holistic
Ethical
Constructivist
Multicultural
Systems and Family Perspective
Attachment Theory
Narrative Therapy
Somatic Experiencing
Cognitive-Behavioural Therapy
Emotional co-regulation
Stages of Change Model
Motivational Interviewing
Response-Based Interviewing
Client-Directed Outcome-Informed
Extensive research has shown that no one type of counselling is any more effective than any other. The single greatest predictor of therapeutic success – besides what the client brings to the table – is the degree to which the counsellor’s strategies and interventions match the preferences, values, beliefs and goals of the client. Therefore, instead of embracing a single preferred ‘approach’ to counselling, I draw on numerous different strategies and disciplines, deliberately and painstakingly tailoring my work to fit the individual needs of the person in front of me. I work hard to foster a culture of feedback, consistently encouraging my clients to teach me how I could serve them better. I also use a brief but powerful tool that enables me to measure a client’s ‘level of functioning’. I want to be sure that progress is being made, as reflected in a rising ‘score’. If clear progress has not been achieved by the end of three sessions, I will either try something new, or help my client to find a practitioner whose skills are better suited to their specific needs.
My practice begins and ends with respect for the individual, not as a ‘patient’ to be ‘fixed’, but as a unique individual who is the true expert on their own life. Doctors do not mend broken bones: they apply casts to provide a safe space in which the bones can mend themselves. Similarly, counsellors do not ‘fix’ clients: we provide a safe, supportive environment and all the tools necessary for the psyche to heal itself.
Carl Rogers maintained that the relationship between counsellor and client is central to this healing process. We are social animals. Most of our ‘issues’ and problems take shape through relationships, and it is through relationship that they must be addressed. My job is to be utterly authentic, present, grounded and supportive, demonstrating a heightened degree of empathy and unconditional positive regard, devoid of value judgements, prejudice, assumptions and expectations. When a person feels heard, understood, and accepted for who they really are, the path to healing tends to open up naturally.
Psychology has a tendency to focus on pathology, on what is ‘wrong’ with people. Abraham Maslow argued that psychologists and therapists should also aim high, turning our attention to what is most successful, powerful, beautiful and healthy in each individual. I wholeheartedly agree. The part of us that grows is that part to which we give our attention. My focus is to help you recognize and build on your strengths; to boost your sense of empowerment, self-confidence, and self-esteem; and ultimately to help you work toward the realization of your full potential as an extraordinary individual.
Solution-focused, Strength-based
In the past, counsellors have tended to focus on their client’s problems and issues, encouraging problem-saturated talk, and often making the individual feel worse as a result. I believe that you do not even need to know what a problem is in order to find a solution to it, and for many people (not everyone) this is the most efficient way to work. Actively seeking solutions, identifying what’s already working (or has worked in the past), and focusing on strengths not only boosts a person’s sense of self-esteem, empowerment, internal locus of control, optimism and joy, it can also yield tangible results very quickly, making therapy much more affordable.
At bottom, we all struggle with the same existential givens of life: the inevitability of pain, uncertainty, constant change, disease, old age, and death; the fact that we are, in many ways, fundamentally alone; the necessity of living with other people who have their own needs and agendas, and who will also inevitably get sick and die; and the lack of clear answers concerning our complex human souls, and our place in the universe. We all yearn for meaning, purpose and hope. I consider my greatest strength as a counsellor to be my willingness to go deep with people: I will walk with you, unflinching, through the valley of death, always encouraging you to go deeper, to become more authentic, to see the larger perspective, to face up to your responsibilities, and to work toward the realization of your full potential.
I am a deeply spiritual person. I hardly ever mention spirituality in my work, unless the client goes there first, and I would never foist my own beliefs or feelings on others, but I do believe that a deep spiritual strength and understanding underlies everything that I do. I believe that the spiritual dimension is a necessary component of a healthy existence, and can be satisfied in numerous ways that have no connection to religion, such as contact with nature, listening to music, contemplating beauty, doing yoga or physical exercise, or cultivating mindfulness. Ultimately, I believe that the spiritual life is the highest, truest answer to all of life’s problems, though it is not an answer everyone is ready to embrace.
Counselling is not just about the mind. My goal is to help the individual achieve full health, which depends upon the development and interaction of all aspects of our life: physical, mental, social, emotional, and spiritual. In my practice, I am always looking for ways in which each of these five domains can be enriched, and can enrich one another.
My ethical prerogative is to put the client’s needs before my own. This means: helping them to the full extent of my abilities; taking all possible precautions to do no harm; staying well within the boundaries of my professional competence, and referring clients elsewhere if it is in their best interest; persistently ensuring that clients understand what each therapeutic intervention entails, offering choices, and eliciting full informed consent; and respecting a client’s right to privacy and confidentiality.
A constructivist (or postmodern) perspective acknowledges that there is no one objective truth or reality, indeed that we each inhabit a separate universe. I can never fully grasp what it feels like to be you. As such, prejudices, assumptions and judgements are not only ethically wrong, they are absurd. Opinions and advice are not only pointless – given that my perspective and solutions work for me but might not work for you – they are also insulting and dis-empowering. A counsellor should never pose as a guide or guru. I would rather be seen as a strong, supportive and loyal companion, who will stay with you wherever your journey may lead; a facilitator with a helpful box of tools; and perhaps a beacon of hope and optimism.
Differences in race, culture, religious belief and sexual orientation are only the most obvious examples of obstacles to communication and mutual understanding. In a sense, all counselling is multicultural, as we can never completely place ourselves in another person’s shoes. As such, my role is to maintain an attitude of respectful and playful curiosity, inviting my clients to explain their world to me, so that I can help them to achieve clarity, formulate goals, and generate solutions.
Systems and Family Perspective
An individual can never be fully understood separate from the many systems in which they are embedded, like layers of nested dolls. These layers include family, social institutions such as schools, clubs and churches, socioeconomic background, and the broader community, society, culture and nation in which the person lives. Of these, the family of origin is invariably of crucial importance, so I often spend time drawing up a person’s family tree, exploring inter-generational trends, and examining the family’s spoken and unspoken rules, roles, norms and values.
During the first few years of life, infants naturally attach to their primary caregivers. When secure attachment is not achieved – maybe because a parent is abusive, chronically inconsistent, physically or emotionally absent, or in some way damaged themselves – the repercussions for the infant can persist across the lifespan, often emerging as social or psychological problems or issues. Those first, crucial relationships create a blueprint for future relationships, such that a person becomes entrenched in recurring dysfunctional patterns without understanding why. Frequently, a counsellor is the first person to accept the client unconditionally as the person they truly are. As such, this powerful relationship can often supersede the dysfunctional attachment relationship, and forge a new, healthy blueprint, built on trust, openness, mutual respect, and clear, consistent boundaries.
We humans are natural story-tellers. We weave a story to make sense of the events of our lives, then we live according to that story. Problems begin when the story is a dysfunctional or limiting one. We easily forget that the story is not real: it is an interpretation of events, but one of many possible interpretations. The trouble is, these limiting stories can become self-fulfilling prophecies: they can become real, and then we entirely identify with them. I usually begin narrative work by finding appropriate externalizing language, describing my client’s situation in such a way that challenges their complete identification with a problem behaviour. Once it is clear that they themselves are not the problem – that the problem is the problem – then that problem can be looked at objectively and addressed. For example, the client is not an alcoholic: he is a person who has succumbed to alcoholism (and needs to fight back!) I might then go back over the client’s relevant history, looking for discrepancies, instances where the evidence contradicts the accepted story line. The client is not a failure: actually she succeeded again and again and again; she simply overlooked those successes because they did not fit in with her dominant narrative (‘I’m such a failure!’). Thus, together, we build up an alternative, more healthy narrative, initiating an upward spiral.
This perspective suggests that we have five key modes for processing information, summarized by the acronym SIBAM. These are: Somatic (body sensations); Imagery (including imagination and memory); Behaviour; Affect (emotions); and Meaning making (mental or cognitive). Most people tend to get stuck in one or two modes, which will only get them so far. A skilled counsellor helps their client to access the information to be gained by exploring all modes, moving from one to another in a manner that can become intuitive and revelatory, never lingering in one mode long enough to become saturated. Shift, inevitably, always happens. The emphasis in this practice is on the Somatic element. Trauma gets lodged in the body, often resulting in a perpetual low-level activation of the fight-flight or freeze response, a state of hyper-vigilance that can easily be triggered into a panic, rage, shutdown, or dissociation response. By assisting the client to become increasingly aware of body sensations, paying attention to the quality and movement of those sensations, and encouraging these sensations to trigger revealing information from the other modes (mind, emotions, images and actions), the counsellor helps the client’s body to follow its own wisdom and dislodge the blockage.
This orientation focuses on the cognitive and behavioural modes. This is the approach of choice in many cases, because our incredibly powerful minds are the root of many of our problems, generating thousands of thoughts per hour, most of which are ‘automatic’ thoughts that remain just below the level of consciousness, yet affect our emotions, behaviour, and physical health. I draw upon many strategies to help people turn the mind into an ally: problem solving; the identification and challenging of ‘cognitive distortions’; the identification of undermining automatic thoughts, and their replacement with more positive affirmations; the excavation, exposure and unpacking of deep-seated core values and beliefs that underlie the automatic thoughts; numerous grounding exercises and visualizations; progressive muscle relaxation; manipulation of the antecedents and consequences of behaviours; the role playing of alternative behaviours; progressive desensitization; anger management; and so on.
As well as being aware of the power of relationship and attachment theory, a good counsellor helps their client emotionally through co-regulation. I often encourage my clients to depict their emotional life on a simple graph, as a wave that oscillates between two lines which represent the upper and lower limit of what they can handle emotionally without losing control (corresponding to the fight-flight response) or shutting down (the freeze response). This becomes more meaningful with comparison to similar graphs of their significant others. Being comfortable with a broad range of emotions is a skill learned in early life, and an important indicator of healthy function. Modern research suggests that when we are within six feet of another person, their nervous system interacts and resonates with our own. By remaining calm, grounded and unconditionally supportive, a counsellor can co-regulate their client’s emotions, allowing them to handle uncomfortable emotions that lie outside their normal range. Like a muscle that expands through exercise, the emotional range broadens, and this alone can lead to a dramatic improvement in functioning and relationships.
Counselling invariably involves making changes. Research suggests that lasting change usually involves five stages, which overlap and frequently have to be revisited. In the Precontemplation stage, the individual denies having a problem, believing that nothing needs to be changed. In Contemplation, he admits that there is a problem, but is not yet committed to changing it. The behaviour in question has pros as well as cons, and all of these must be explored and discussed before a wholehearted commitment to change is possible. Most change projects fail because this stage is skipped or rushed through. There follows Preparation, Action, and Maintenance. Different stages require different therapeutic strategies.
This strategy is very effective at the Precontemplative or Contemplative stage of the above model. No change will occur until the client is motivated. So the counsellor elicits change talk, seeks out the leverage – the forces driving the client to change – and develops any discrepancy between the client’s values or desires and their actual reality or behaviour.
This narrative strategy is often used with survivors of abuse. Frequently, such clients are saturated with feelings of shame, guilt, despair, or self-loathing, often because they feel that they did nothing to defend themselves. But they did do something, which allowed them to survive. With skillful questioning, they often come to recognize their own strength, and the life-skills they acquired through adversity, finding renewed self-esteem, confidence, joy, and frequently a desire to help others.