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.It was also interesting to sit with how I felt about those in the group who didn’t participate in the group’s discussions.
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.