[Note: I use ‘counselling’ and ‘psychotherapy’ more or less interchangeably here. Just worth mentioning to avoid any confusion]

In this series of posts, I’m going to outline three of the main therapeutic approaches: Psychodynamic Therapy, Person-Centred Therapy, and Cognitive-Behavioural Therapy (CBT). There are many more approaches and I’ll touch briefly on some others, but I’ve chosen these because they are amongst the most influential. This post is shorter one which just covers the fundamental basics.

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Everyone could do with some counselling, in my opinion.

I’m not saying everyone really needs to go and see a counsellor. Just that everyone could benefit from it.

Some people are lucky enough to have people in their life that they can talk to about anything, and that’s awesome. Thing is though, these people care about you. What I mean by that is that it’s possible that they are so invested that before long, they’ll probably have had enough of you not having a solution to your situation – it might even make them uncomfortable – and they will want to put you out of your misery by giving you all the answers to your problems. Some people will listen to you first and then advise, and others will just jump in with the answer to your problem when you’re just wanting to vent.

I know this from experience. I’ve tried to go properly into ‘counsellor mode’ when friends have come to me with a problem, and it’s extremely difficult to do properly when it’s with someone I know and care about. I can’t personally detach myself enough to do it; there’ll usually be a point where I just have to butt in (for their own good, obviously) with my own perspective on it and tell them what I think they should do. And there’s nothing wrong with that; it’s what friends are there for. But it’s different from a counselling session.

I know the benefits of counselling from personal experience. I’ve seen someone in the past when I’ve been having a really shit time of things and the one thing that struck me was how different it really was from any normal relationship. First of all, it was purely one way traffic: it was all about me. There was no asking the counsellor lady how her day was or anything like that – I did it initially and she answered briefly and then directed the conversation right back at me and my feelings.

It’s not the kind of thing you can do in social situations without seeming like a bit of a freak and making people uncomfortable, and so it’s not something I’d ever quite experienced before. In an hour of that kind of attention though, you can get a lot done. You can get exploring and figure out – with the counsellor’s help – how you really feel about all kinds of things that are on your mind, and get insights into things that you never recognised before. Sometimes (often, I’d say) part of the problem is that you don’t really know how you genuinely feel about something (or why you feel that way), and counselling can give you the time and freedom to work that out. You really can talk about anything, too. The counsellor won’t be someone you know and they’re bound by confidentiality agreements so they’ll never pass anything on unless there are extremely serious and immediate concerns about yours or someone else’s safety.

Seeing a therapist can be confusing though, not least because there are so many different approaches out there (I count 155 on this Wikipedia page). What’s more, the principles of each approach can vary widely and are often not made explicit beforehand. Even when they are though, it’s difficult to know what to think about them if you don’t know much about them in the first place.

There have been recent studies which suggest that the most important factor in a positive experience in therapy is less to do with the approach chosen and more to do with the relationship between the therapist and the client. This suggests that the approach someone chooses isn’t particularly important in the grand scheme of things. I’m hesitant to jump on-board this idea though, and would counter the point by saying that the strength of the relationship itself can depend on how well-suited the client might be to the approach being offered. In any case, some of the major approaches are very different from each other and it’s worth people knowing the basics of what they are all about so that they can make an informed decision on what they would prefer.

I started out writing this with the intention of writing a dinky little guide for people, but it’s expanded to become a lot longer than I’d planned, so I’m writing it and putting it up in parts to make it more palatable. This is just the introductory post.

First of all: Childhood

Before we look at the differences I want to explore what the approaches have in common and what general psychological principles are agreed across all of them. The main thing common to all these approaches (and most others for that matter) is that childhood experiences have an important impact on a person’s development.

This is probably pretty obvious to most people. It’s still worth exploring properly though, because it’s fundamental to a lot of psychology.

Obviously not everyone talks about their childhood in therapy and sometimes it’s not particularly relevant to the issue at hand. If someone has just been through a messy relationship break-up or they’re recovering from some other traumatic event in their life, the relevance of their childhood doesn’t seem obvious and might never get mentioned – though this depends on the type of therapy you’re getting. In any case, it’s one of those things that has a massive impact on who we are and how we deal with stresses and obstacles in life, so it’s worth looking at.

An Evolutionary Context

The crucial thing to recognise here is that as mammals, we are a species in which our young children are completely dependent on their parents for a very long time after their birth. We’re not like spiders, that lay a thousand or so eggs, protect the eggs and then give the individual baby spiders relatively little attention once they’re hatched.

I’m not having a dig at spiders here. They can get away with not being so bothered about their kids because they have a thousand of them. Even when they go off and leave them to it, they can be pretty safe that at least a few of them survive and that their genes will continue. The name of the evolutionary game is survival, and if a spider cared about each their kids in the same way that humans do it’d probably die of stress within a few seconds of them all being born, which wouldn’t be good for survival.

Humans are in a different predicament though. Human babies have a nine-month incubation period and you usually can only have one at a time. This makes the stakes a lot higher. The name of the game is still survival, just like it is with the spider, but we’ve got a totally different way of playing it. In this case, it’s in our best interests to really care about the kid that we’ve created.

Babies themselves have adapted to this situation too though, and human babies have an overwhelmingly strong tendency to become attached to their primary caregiver because it makes them more likely to survive. Furthermore because they rely so heavily on their parents, they’ve adapted to look out for clues as to what behaviours are most likely to ensure their parents’ love (and hence their own survival), and what is likely to upset their parents. So certain behaviours, feelings, inclinations in themselves will naturally become prominent as a result of the clues they get, while others will be buried.

This is all well and good, but the thing is that parents aren’t robots. All people (parents or otherwise) have certain idiosyncrasies – certain behaviours or emotions which they don’t like, and others that they’re more comfortable with – which make up who they are. It’s not always rational or even particularly sensible, but it’s there nevertheless. The sources of these idiosyncrasies could be from their own upbringing, their genes, or a mixture of both. The name of the game is still survival though, and the kid will pick up on clues for survival which arise purely from their parent’s idiosyncrasies.

These clues are picked up on and these lessons are learned without the kid being aware of most of it. If they were aware though, this is an example of how they almost certainly wouldn’t think:

“My parents are really strange about anger. I better not express my anger around them in order to survive living here, but there are other people in this world who are cool with anger and who I can express it with when the time comes.”

That’s not how it works. Kids aren’t aware of the world at large in that way; they have no frame of reference for these lessons that they’re learning. As a result, they tend to generalise the lessons they learn from their parents. So the lesson is more like:

“Anger gets me into trouble. I better not show my anger.”

Or even:

“Anger causes pain. Anger is a bad emotion. Therefore I should never feel angry, ever.”

So these aren’t just lessons that apply when dealing with their parents. As far as the kid is concerned, this is reality. The kid doesn’t know any different, and so they will generally just adapt to these clues and live by them thinking that this is just how the world is in general. So kids become cut off from certain areas of themselves in order to survive.

The lesson might not necessarily be that anger is bad, either. Maybe it’s sadness that shouldn’t be felt. Maybe it’s assertiveness that’s so terrible. Maybe it’s happiness. Maybe sexuality, or thinking that you’re a good person, or whatever. There is no end to it. There is also no end to the number of different lessons different children could learn from the same circumstances too, as people can interpret things in different ways. One of the most fascinating things I find about psychology is the infinite number of ways people can react to their circumstances.

Back to Therapy

Literally everyone has gone through this process, and remember that kids aren’t aware that it’s happening – it’s unconscious. There’s nothing wrong with it either – it’s just the natural course of life. For most people it never really becomes an issue – their past has an impact on who they are, sure, but they like who they are and they’re happy enough, so it’s no big deal. Some people can run into issues though when the lessons learned stick with us long after they have become out of date. When sadness, or anger, for example, isn’t acknowledged, it can cause issues because sadness and anger are both extremely useful tools for dealing with certain things; there is a good reason for us having them in our repertoire. See the movie ‘Inside Out’ and all the shit that happens because sadness is seen as a ‘bad’ thing to feel, for example. When certain feelings aren’t acknowledged, it can sometimes begin to have a negative impact on how well we cope with the stresses of life.

The general process set out above is almost universally recognised, although different approaches place a different emphasis on it. For example, some approaches focus almost solely on making conscious some of the lessons learned in childhood and see that as the way to treat people (Psychodynamic), while other approaches see the past as little more than background noise; something that gives context to one’s current issues but which there is no point in focusing on for its own sake (CBT). Different approaches also use different frames of reference and terminology to describe this process, but as far as I can see the basic premise described above isn’t really contended by any of the approaches.

With the groundwork sorted, I’ll get on with looking at each individual approach and how they different from each other. In the next post(s) I’ll be exploring how Psychodynamic, Client-Centred and Cognitive-Behavioural therapies all developed, how they view the therapeutic process and what therapy in each of these approaches is likely to be like.