Holiday time finds me reading books which I had failed to read throughout the year, such as I’m OK you’re OK as well as books which I want to read out of pure interest. I also find myself reflecting on the last two years as I pass the mid point in my training. I recall what tutors said on the opening evening of the course. They said that we as students would develop as counsellors in our own unique way throughout our time at the Centre. There was not a CCPE way to developing as a therapist but that we would grow in our own individual way and find our own truth. I am reminded of this as I write.
As a result I find that I ask myself what is my way? Have I read enough? What is my approach to counselling and psychotherapy? What does it mean for me to be an integrative psychotherapist? These are questions that will be perhaps a constant line of questioning throughout my journey as a therapist.
My second year at CCPE has been a time when I have revisited early life issues and experiences. Indeed, Rosemary Cowan [1] points out that the developmental model that CCPE suggested was very helpful to her. She notes that trainees in the first year were likened to wide-eyed, enthusiastic primary school children; in the second year, like pre-teens, they gain confidence and independence but may also be ‘know-alls’ who overstretch themselves; in the third year they reach the rebellious, argumentative, difficult teenager stage; in the fourth year, with increased maturity and stability, they become more rounded, finished characters. I am not sure where I fit in with this model but it is an interesting theory.
I became more conscious of the emotional effects of group-work
I learned a lot about my early childhood experiences and how I act in groups following 16 weeks of group process. Families are, after all, our first blueprint for how we act in groups. It became evident to me that my early experiences were constellating in my life as an adult. I like what Bion [2] said about experiential groups. When under attack it is far more beneficial to one’s own learning process to try to observe that one is being attacked, and take in what that experience really feels like, rather than reacting to the source of the attack.
I took greater insights into the consulting room as I became more conscious of the emotional effects of group-work. My clients often tell me about their difficulties in communicating in one way or another with people in their life.
I find myself wondering about the current debates in the transpersonal movement specifically when pertaining to participatory consciousness to do with the whole. Some in the community are asking, for instance, if psychotherapy can create a narcissistic split. Sometimes I find that I can be concentrating on my own individual experience at the expense of the group experience. I like what my group process facilitator said: that it is sometimes better to engage with our own material in groups and see where that takes us. I believe I can be ‘psychotherapeutically correct’ a lot of the time whereas I could be more willing to share my shadow material and see what transpires. Maybe it would be more fruitful if we explored our shadow material more often in groups instead of saying “oh sorry that is my stuff” when we have encounters with others. Is it my stuff? How do I know? Maybe a good confrontation would be more healthy and perhaps more authentic than the polite approach of excusing one’s strong feelings.
The group might be jumping to conclusions
I have found supervision invaluable by providing a steer to my client work. I believe that it is important that one is challenged by the supervisor so that I am always striving to think creatively about seeking solution for the client.
In supervision I also need to be mindful that I might sometimes need to challenge the supervisor and other members of the group and to stand up for my client. The group might be jumping to conclusions. Or, I might need to fight for attention and time when seeking to present my clients. Group dynamics can also be challenging but perhaps everything is a learning opportunity in that I need to check myself, my motives, my defences and my fears.
My placement gave me an insight into the limitations of psychotherapy.
I had been fortunate to secure a psychiatric observational placement at an NHS Mental Health Trust where medical students were also on placement. It proved to be an amazing experience from a learning point of view as there were many specialist services in the Trust.
I had been familiar with Cognitive Behavioural Therapy (CBT) before the start of my placement through my lectures and my own prior knowledge. However, I attended a team meeting in a sexual behaviour unit in a forensics unit and learned about the Dialectical behaviour therapy treatment programme. It was welcome to see that Zen techniques have been incorporated into the treatment models, even in the NHS.
My placement gave me an insight into the limitations of psychotherapy. Some patients are so ill they lack the capacity for insight and a pharmacological treatment plan is critical for their recovery. I believe we need to proceed with great caution when working with clients with psychotic conditions as there is often an absence of a healthy ego.
Gestalt Psychotherapy proved to be one of the most powerful components of the course so far
I have enjoyed the second year lectures starting off with short term therapy. I found the lecture on short term therapy to be very helpful from a practical point of view given that I see clients for an initial period of six weeks at Help Counselling. One or two lectures (though thankfully the minority) were uninspiring and at times I wondered whether we were really on a postgraduate level course given the poor quality of discourse in the room.
We had a three day weekend on Gestalt Psychotherapy, which for me, proved to be one of the most powerful components of the course so far. The word gestalt is used to describe a phenomenon/concept in which the ‘whole’ is considered as greater than the sum total of all its parts. I found the empty chair technique to be a good technique for dialoguing with absent parents, friends or colleague, dealing with unfinished business.
I believe that in psychotherapy clients make theory rather than theory making therapy. I need, therefore, to remain open-minded and use early life theory as a map which might be helpful in the navigation rather than as a set of rules. Pattern recognition is essential to good therapy. The primary difference between talking to our friends or Aunt Dorris is that counsellors are trained to look for patterns.
As an integrative therapist I am carrying a basic toolkit of theory and methods from which I can produce an approach that is appropriate to the client. With some clients I will get nowhere unless I work cognitively, with others who have a healthy ego and are full of their insight into their own problems I might explore more transpersonal techniques.[3] This is what it means to be truly integrative, for me. In this I like what Erikson [4] (Erikson 1987) said about a new psychology that emerges every time we close the door and sit down with a new client. This presupposes that we are open minded, congruent, and receptive and that we avoid the temptation to make judgments about the client. I see my job as building a solid containing space for the client to explore their particular issues.
I am looking forward to the third year when we start with two lectures on existential psychotherapy. As I progress as a therapist, particularly into longer term work with clients, I am reminded what one of my tutors said in the early days of my training. He used a helpful metaphor. When out in the Atlantic rowing towards America, when land has disappeared from the point of departure and land from the destination venue is not yet evident, the key is to keep rowing.
what is my way?
Perhaps I will have a better understanding of my particular development as a therapist when I tackle the third year essay which asks us to consider a holistic approach to psychotherapy and a review of four approaches: one humanistic, one transpersonal, one existential and one psychodynamic approach. So far I am intrigued with the psychodynamic tradition such as TA, Gestalt and the Rogerian school. I want to read more Freud, Klein and Winnicott as well as embracing the existential school. Where I end the year is open to question.
