How I work as a therapist

There are many many theoretical books written by great and valued people, from Freud,Carl Jung, Carl Rodgers, George Kelly, Melanie Klein, Eric Berne and many more, all of them explaining their theory as they see it. Each author seen as distinguished in their own circles and in some cases like Freud world wide.

I am not conceited enough to argue with any of their therapeutic approaches as being totally right or totally wrong. I see them more as an aide in my tool box of bits and bobs that will help the individual.

This of course from a purists point of view is sacrilege, as they would argue how could I be an effective therapist if I don't follow the rules of their particular training. Each psychological approach  having it's own set of criteria on how to be effective as a therapist. I wouldn't argue with this if the clients that go for treatment feel that they have come away from any one therapeutic approach feeling better.

Each form of therapy, such as Freudian Psychoanalysis, Transactional Analysis, Person Centred Therapy, Personal Construct Psychology, Gestalt or many other approaches have  much to offer. They are a  disciplined and serious form of training that can take many years to master, if ever, as we never stop learning.

All therapies have their own set of rules as to how it should work, all with different labels; transference, constructs, unconditional positive regard, boundaries, parent/adult/child, for example, to describe human behaviour or as techniques used to help facilitate understanding human nature.

And to the follower of each discipline they make perfect sense in their ability to explain the human condition and to work with clients to help them overcome whatever issue they have bought to therapy in the first place.

However, it is with the client that I start to identify that these approaches can cause conflict for me. Now I am trained in a psychological therapy, it took me four years of hard graft on top of two nursing qualifications in general and psychiatric nursing and years working as a counsellor and psychotherapist it get to where I am today. I have worked with the health service my entire working life, since I started as a Cadet nurse when I was 16 years old, over forty years ago.

What I feel with a grand passion is that not one approach works for all. That the therapy needs to fit the client  and NOT the client fitting into the therapy. At the end of the day the client group bring the same old problems to therapy, every day to every therapist. They come because the current experience of their lives is making them feel stuck and they are reacting to this 'stuckness' in a way that causes them pain and difficulty.Whether that is a  here and now issue, or because of the current situation  has bought up conscious or unconscious issues from the past that are now getting in the way of them functioning normally within the parameters of their own daily lives

All clients without fail come to therapy with the same issues, their individual stories are different, some definitely more harrowing than others, but their need to deal with their feelings is what brings anyone into therapy. Pain is pain, loneliness is loneliness, sadness is sadness, fear is fear. We all feel these things, we have our feelings in common. Although every persons psychological pain threshold may be different. So my ability, say to be happy alone, may not be the same for someone else. My barmy fear of spiders is someone else's love of spiders. But my ability to be frightened and to experience fear when I see spiders is someone elses fear of the cliff edge or men with red beards or whatever. Our subject matter makes no sense, our feelings of fear are the same.

What I believe is that when someone comes to me for therapy it is my job to delve into my tool box of therapeutic techniques and find whatever is in there to use for the individual person to facilitate change in them. So that the quality of their life is improved for them, by them, with my assistance walking alongside them. And that using a mixture of therapeutic mediums to put their needs first is going to be how I work with the personal needs of the indivdual, rather than getting them to fit into my prescriptive box of therapy

Therefore in my knowledge of therapeutic approaches I do feel that there are some that work really well to help explain to a client what is making them tick at any one time. So with any one course of therapy I would the parent/adult /child model from Transactional Analysis to explain how they are working in conjunction with their closest family members. I might move on to Personal Construct Psychology to get them to look at their constructs/characteristics and how those effect how they personally see the world. I could use CBT to help establish healthier patterns of behaviour in relation to dealing with their anxiety. Mindfulness would be included to get people to learn to live in the here and now, rather than remembering the past and dreaming about the future in a way that hooks them into anxiety. I would also be using Gestalt techniques to teach people really good and safe ways to let of their anger and sadness without them taking out their feeling at the wrong place and time on other people.

All in all I work with people to teach them to empower themselves to know that they have a psychology and that they can choose how to use it to either harm or help themselves. Which of course it goes without saying so are all therapists! But I want to demystify the process, I want my clients to have their own tool box to use in the middle of the night when the 3am gremlins are clutching at them and I believe that having a variety of therapeutic process to call upon allows each person to become their own facilitator and be healthy, rather than be dependent on the  powerful  but mysterious ways of some therapies. Cause one thing is for sure, when my clients wish I was around at 3am to help sort them out, chances are I'll be dealing with my own little gremlins with as powerful an exercise I can find in my own arsenal of techniques to get to grips with my own middle of the night terrors!