The Role of Hope in Healing

During a workshop I attended on trauma the lecturer related the story of a client who said they felt without any glimmer of hope. This resonated with me and is something I have heard many times over the years. So what is hope? How can we define it? Hope is the essence that provides our lives with trajectory, a sense that we are generally moving in the right direction, no matter how faint the light that guides us. The desire to feel hope is hard wired into our being.

Without those messages that tell us life can change for the better, we fail to thrive, we collapse inwards, our nervous systems shutdown. Ultimately our spirit dies and our bodies follow.

Viktor Frankl, a Holocaust survivor, renowned psychotherapist and author, believed that man needs a sense of hope in order to survive. He wrote that someone could endure any amount of pain, anguish and darkness provided that he or she could hold onto a vestige of hope that things would one day change.

Let us imagine that I am sitting with a client, either in person or using our computer screens to create a connection between us. The client is on edge, perhaps it is their first session with me. They do not know what to expect, or how I can help them. They know only that they feel unable to cope alone with the issue they are experiencing. They describe their life, their sleep patterns, the feelings manifesting in their body, they may tentatively describe their fear, sadness or anger. They may tell me that “things feel hopeless”. And that is the point that I will tentatively challenge their perspective. I will tell them that their hope brought them into counselling. It is their sense of hope that guided their hand to write the email or dial the phone to contact me.

Together, that client and I can nurture their faint glimmer of hope. We can gently breathe on its dying embers and celebrate each small triumph that encourages the warming flame. That flame will ultimately cast light into the shadows.

When we listen to our hopes, no matter how quietly they whisper, we can be guided towards a better way to exist. We can be piloted towards a place of safety, where we can heal. Hope will show us how to find meaning in life. Hope will ultimately guide us to a place of wholeness, where we can each thrive. Hope is inherent in the act of being alive and no matter how dark the place which you currently inhabit, the future is abundant with possibility.

And the message to take away? A full life is not suddenly going to spring into existence with the wave of a wand, no matter how much that myth may tempt and beguile. When all hope feels lost, it is possible to find some meaning, if only in the recognition of the smallest things. Perhaps noticing a flower forcing it’s way out of the frozen winter soil, or enjoying the warmth of a hot drink. Not only can you thrive in the future, you can begin to live now.

As Frankl so inspiringly wrote:                

“…it is possible to practice the art of living even in a concentration camp” (Frankl, p55)

References

Frankl, V. (2004) Man’s Search for Meaning, London: Rider

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness.

Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk

Follow @sussexcounsell1 on Twitter

A new day brings hope

Aftermath of loss – Numbness

My personal perspective

I was a full-grown adult when my Dad died. He was in his seventies, mid-way through plastering a wall at home, when he collapsed. He took his last natural breath as I hurtled up the M1. A doctor switched off his breathing apparatus 25 minutes before I completed the 4-hour journey to his side. That night I lay awake in my former bedroom, still painted the pale, dusky pink I had chosen as a teenager. One word repeated in my head. “Daddy, Daddy, Daddy…..”

During the following days the routine of death took over. Obtaining the death certificate, speaking to dozens of relatives and friends to break the news, arranging the funeral. I was numb. It took several months before my body felt safe enough to feel the extent of my pain and then release it. Intellectually I was aware that numbness is common after experiencing a loved one’s death. At an emotional level I longed for a sense of my own body and of feeling something, anything. At a visceral level I was in a state of high protection.

Numbness as a defence

So how does numbness after loss serve us? Numbness is a defence mechanism. It is one way our bodies guard us from the overwhelming swell of feelings that would otherwise threaten our lives. I am not making an overstatement of the facts here. When something distressing happens our bodies operate at a primal level. Emotional pain is a trigger which elevates the body’s stress response. Our heart rate increases, the body enters the early evolutionary state of fight or flight, caustic cortisol floods our organs and our blood pressure sky rockets. But our bodies are sophisticated, they can protect their existence by entering a state of numbness where we cannot be overwhelmed.

Some people feel guilt about emotional numbness. They wonder if it means they loved less. This is simply not so.

Some people experience numbness as an out of body experience. Some do not feel in full control of their limbs. For some individuals food is tasteless or an insidious chill fills their veins. Maybe they cannot hear properly or their vision is distorted; they long to feel something and can enter a phase of behavioural risk taking or might embark on a passionate affair.

In some cases, numbness after loss will last for hours. In other cases years.  Reframing numbness as a healthy response to a shocking event can help. Your body is protecting you. Your feelings (or lack thereof) are natural. Grief is a natural process. If numbness persists, talking therapy may help. Other methods include the use of binaural soundwaves; bilateral body movement (running or dance, for example); breathing exercises that engage the body’s parasympathetic nervous system. 

The aftermath of loss can feel like a state of limbo. In my case, recovery began the moment I acknowledged out loud that I simply wanted to feel normal again.

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness. Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk& follow @sussexcounsell1 on Twitter

“I didn’t leave him on a train”

Exploring the language of loss

On the bottom shelf of my book case sits my dictionary. The edges of each page are sandy coloured with age. As I open this heavy tome, I bow my face and breathe in the unmistakable fragrance of old book, transporting me to my Nan’s spare room, though she has been dead for 20 years and her house has long been sold.  This is the power of smell. It is an instance passageway through time. This form of transportation is a common thread with my clients, many of whom describe how a particular smell blurs the edges of time and brings a deceased loved one into momentary re-existence.

In my role as a counsellor, I accompany grieving clients daily. Each experience they relate to me is as unique as the relationship they had with the person who is no longer alive. And also, I hear a familiar refrain in the words they use. They speak of their sense of loss, literally of being lost in unfamiliar terrain. Loss is such a small word to encompass what is often a monumental event.

The Definition of Loss

The Oxford Advanced Learners Dictionary, 1989, defines loss as

“act, instance or process of losing: Loss of blood, health, prestige, money. The loss (ie death) of his wife was a great blow to him. Without (any) loss of time. A temporary loss of power.”

Death of someone we love is a great blow (even when we think we are prepared, for example, after a long illness). Time warps and twists, minutes can be endlessly static and infinitely long whilst days pass in a hurried blur. Loss of our own sense of empowerment or control is common as are the accompanying waves of fear (How will I continue without them?) or anger (How could life do this to me? How could my loved one do this to me? How did the doctors allow this to happen?)

Yet the word we use to encompass the complexity, depth and breadth of death is ambiguous and minimises the very experience of grief. Loss. As so many of my clients have said, “ I didn’t lose my (brother/mother/husband/child…), I didn’t leave them on a (insert mode of public transport of your choosing)”. The language of loss is inadequate and misleading.

Terms that have seeped into our communal understanding of death encompass the theatrical (curtains), the soporific (rest, sleep), the transitional (passing, passage, exit) and the irrevocable (final dissolution, end, demise). All of them spectacularly fail to express the physical impact and emotional turmoil of someone we love dying.

I am familiar with the sense of alternative reality that often engulfs those still living after a death. The sense that this is not really life, this can’t be real. The sense some people have of being displaced, dislocated from their own bodies, unable to think, barely able to breathe and yet continuing to exist.

“Feathers In the Kitchen”

I also recognise the cautious look a client gives me, a momentary hesitation, before they disclose something that they would have found unthinkable to say ‘before’.

“I get messages”

“There are feathers in the kitchen and I know she has been there”

“I still speak to him about my day” 

“She hides things, like my glasses”

And then another pause. My client waits for my reaction, my judgment. The truth is these experiences are normal. Yes, normal. I know they are normal because I hear these admissions repeatedly. I have yet to hear a disclosure so fantastical that I fail to trust my client is telling their truth. We have become bound up by logic and the need for empirical evidence. We have lost touch with the knowledge that death often feels the same as shared life and is different. We are scared of sharing the new relationship we have with someone who has died. We fear being judged. The phrases I hear simply express one of the languages of grief, the continuing bond (Klass, Silverman & Nickman, 1996).

A Continuing Bond

The continuing bond is found in the widow who glimpses her dead husband in the garden as she prunes the roses. It is found in the joyous dreams of a mother who wakes to the painful knowledge that her child no longer sleeps in the room next door. It is found in the tears of a son who sits on the bench where his Dad once sat to throw crusts to the birds.

Our stunted spoken language around death is also exemplified by the phrases “get over” and “move on”, which suggest rejection and dissociation from the past. Rather we can use the phrase “move forward”, which accepts and respects both past and future. There is no timeline for grief either, no sell by date on the love we still feel.

Think of language as a way to communicate. Sometimes we use words, yes, but not exclusively. We communicate with our eyes, our bodies, our energy, sometimes through art, sometimes through dance. Even our dreams are forms of communication. The ways to communicate are infinite.

We can learn the language of loss, of being lost, of grief. We can learn to appreciate the bittersweet scent of a nostalgic memory. Eventually we can find the language of a new normal too. Human beings are resilient, it is possible to move forward, to grow, to find joy and hold that joy in the same space as our more painful experience. The initial step is to honour our grief and pay attention to it. The language of death can heal, first we need to expand our vocabulary.

References:

Klass, D., Silverman, P.R., & Nickman, S. (1996) Continuing Bonds: New Understandings of Grief. London: Taylor & Francis

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness.

Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk

Follow @sussexcounsell1 on Twitter

A Tale of Hope

Self-disclosure is the act of revealing something about oneself to another person. From a therapeutic perspective, it is telling a client something personal about myself. It was drummed into me during my counsellor training that revealing anything about my life, family, history, personal philosophies or any other factor must only be done if, and only if, it is of benefit to the client. I was emphatically told the words “Me Too” must never pass my lips. However, I believe that acknowledging I have lived experience of psychological distress may benefit others. My acknowledgment has the potential to normalise human experience. It breaks down the cycle of secrecy and demonstrates that moving forward is possible.

A history

My father was the first in his family with an education and a profession. We lived in the prosperous Southern Counties.  In contrast, my father’s family were from a small industrial town in the Midlands. It was a town with narrow streets, rows of red brick terraced houses and a canal which was once used to transport clay, cloth and coal. In my grandmother’s front parlour stood never used furniture with lace antimacassars. When we made the trip north from my home in rural Hampshire, the family gathered to gossip in my grandmother’s small sitting room overlooking the back yard. Too many bodies squeezed in, children on the floor, horse brasses gleamed from the fireplace, the smell of homemade gravy, tobacco, lily-of-the-valley and Jeyes fluid permeated the air.

My aunts and uncles shared rumour and hearsay about friends and neighbours. When it was bad news, I perceived the mixture of pity and relish that my loved ones heaped into the telling of the tale. As a result I became fearful of telling anyone my problems. I thought that people lived in shame, in a place where there are no secrets. I learned later that shame and psychological pain thrive in secrecy.

A story

When I was a child I read a comic strip. A beautiful girl lived in a house with only one mirror. She believes she is disfigured because the mirror is warped. Her mother (jealous of her daughter’s youth) reinforces the girl’s belief with unkind words. A warped mirror is an excellent metaphor for the view we can develop of ourselves and our lives as we struggle to survive the psychological pain that life can inflict. Those self beliefs are sometimes reinforced by others. I reached out for help when my embodied feelings became too heavy a burden and my body said “enough”. The right therapist came along at the right time. I finally learned to live healthily with the numerous losses I had experienced. Eventually I began to thrive.

Fast forward

Here I am, a human being who is not defined by my past. Yet I acknowledge that my past is a part of my reality. There is a chance that potential clients may read this blog and back away. They may believe that I am flawed because I have alluded to a less than rosy history. To them I say, I am flawed but that has nothing to do with the experiences I have had. It is simply a universal truth that humanity is not a state of perfection. If that means you do not want to use my services, then I am not the right therapist for you.

I am not going to share my story here because I do not believe it would be of sufficient therapeutic benefit for my clients to know it. There is also a risk that a client might hold something back because they want to protect me. To them I say, therapy without truth is not therapy.

A message of hope

I did not write this blog entry to disclose my lived experience of loss or of psychological pain, but to share my experience of hope. Please hear me if you have remained silent. I speak now to the person who fears being judged; who fears not being accepted; who thinks they may not be believed; to the person who feels anxiety writhing in their body; who hears a critical internal voice saying “I’m not good enough” or “there must be something wrong with me”. I know my clients have the potential to move forward with their lives, because I did. That is a more important disclosure than any other I can offer.

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness. Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk & follow @sussexcounsell1 on Twitter

One size does not fit all: A brief look at the therapeutic relationship

“It is amazing how much people will tell you if you listen in the right way” (Pratchett,T 2015 P37)

For many years I have possessed a beautifully bound but well-worn notebook that is never far from me when I read. The notebook contains all the sentences that jump out at me, those rare moments when something in me connects and aligns with the author. I wrote down the Terry Pratchett quote when I was reading his small and perfectly formed account of Alzheimer’s and his own mortality, ‘Shaking Hands With Death’. I read this particular volume when I was a Counsellor in training and this quote seemed to capture the very essence of communication between a therapist and their client, and yet…. What is the right way to listen? How can I, as a counsellor, listen so intently that my clients will connect with me and begin to share their inner lives?

I am a humanistic practitioner, so the theory suggests that three core factors need to be in place (Rogers, 1961). Firstly, I must be empathic, whereby I enter the client’s experience and journey with them as they explore. I must be congruent, meaning that I can be authentic with my client and show them my true self. Finally, Rogers writes, a therapist must be non-judgemental. I habitually ask my clients what they get from therapy that they do not experience in their normal lives. The response is often that other people will judge them. So, is that at the heart of listening the right way?

As counsellors we receive a great deal of training in how to listen. I have known clients for whom listening is all that is required. To know that in the noise and hubbub of their everyday existence there is one person in their life who will listen to them, intently, with respect and without judgment. There are other clients who require something else; something more; someone who is active and on their team; someone with that x-factor that connects with them and their idiosyncratic life experience and thus enables change. The recognition that each client is utterly unique and requires from the therapeutic encounter something utterly unique in return.

Theories abound as to the reason the therapeutic relationship is central to the process of change. For example, attachment theory suggests that a strong therapeutic bond is essential because it provides a healthy experience of relationship which heals ancient wounds. I believe this can be the case, and there are other factors at play. In his acclaimed book, Lost Connections, Johann Hari considers the numerous ways that modern life has fractured our connections with each other, our own bodies and nature, resulting in huge rises in depression and anxiety diagnoses. Connection alone can make the difference.

I have heard all sorts of negative feedback about counselling over the years and have come to the conclusion that often the central issue is that the person speaking has not found the right therapist for them. One size does not fit all.

For this reason, I encourage potential clients to shop around because the relationship a person builds with their therapist is central to the work they do together. When I am contacted by someone seeking a counsellor, I suggest that we have an initial (free of charge) conversation. We can have a chat about what brings them to therapy, why they contacted me in particular and what their expectations are. During the course of the conversation they will be able to gauge if I have the x-factor they need, if we can build rapport, if they have a sense that I am the right fit for them at this particular time.

I often flick through that beautiful notebook of quotes and read the sentences within. After all these years, they still connect with something inside me, just as I still feel allied to past clients with whom I experienced a genuine rapport. The clients for whom I listen in the right way.

References

Hari, J (2018) Lost Connections, London: Bloomsbury

Pratchett,T (2015) Shaking Hands with Death, London: Corgi Books

Rogers, C (1961) On Becoming a Person, London: Constable

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness. Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk& follow @sussexcounsell1 on Twitter

In A Nutshell – Transactional Analysis

Welcome to my “In a Nutshell” series. When you are looking for a therapist the terminology can be baffling. There is so much theory, so many different fields of study and dozens (literally dozens) of different therapeutic modalities. How do you know if what I offer matches what you want from therapy? This limited series of blogs will explain the three core theories I use in my practice and I will attempt to show how they may be useful for you.

The underlying principles of Transactional Analysis (TA)

I’m OK – You’re OK

“I’m OK – You’re OK” is at the heart of TA’s philosophy. It is a term used to express the belief that we are all of value. Our “OK position” influences how we view our place in the world and impacts our relationships.

Strokes 

The founder of TA, Eric Berne, observed that people need “strokes” to survive. A “stroke” is a unit of interpersonal recognition. There are two types of stroke: positive and negative. Berne observed that positive strokes are preferable and encourage individuals to thrive. An example of this would be smiling at a stranger and receiving a smile back. Immediately the day feels brighter. Positive strokes encourage us, boost our self esteem and enhance our self-image. However, when positive strokes are unavailable any stroke is better than none at all. This can be exemplified by a child who acts out at school. When a child is neglected at home they will often be “naughty” because their organismic self requires some form of recognition, even if it results in being told off. A stroke can be understood as a means to satisfy our biological need for recognition and avoidance of sensory deprivation.

Ego States 

Berne postulated that the human personality is made up of three “ego states”. Each ego state is an entire system of thoughts, feelings, and behaviours via which we have interactions with each other.

Transactions 

A transaction is a basic communication unit between people. In everyday language we call a series of transactions between people “a conversation” (or sometimes an argument).

Life Script 

Berne proposed that dysfunctional behaviour is the result of self-limiting decisions made in childhood. These decisions would have been made by the child to ensure survival in their home environment and they form a sort of life plan called the “life script”. For example, people who made the childhood decision that they are stupid (based upon what they were programmed to believe by their primary care takers) will follow a life pattern that reflects their belief. Tell a child often enough that they are naughty and eventually this will become part of their life script.

Games

Berne noticed that many people enter into repetitive dysfunctional behavioural patterns. He called the behavioural patterns “Games.” The purpose of a Game is to get the stroke we want to receive from others but can’t ask for in healthy ways. Games reinforce our negative feelings and self-concepts. Games are always played out of the awareness of the people in the game, therefore the purpose of recognising Games is not to apportion blame. What the people playing actually want is the familiar feeling of knowing “I knew it, this always happens to me!” Games follow a pattern during which the players move positions on the following chart (The Drama Triangle):

Games are recognisable, once you know what you are looking for. For example, Bob complains he is struggling to write an important presentation, Ann offers advice. Bob replies, “yes , but….” Ann offers more advice, and gets the same response several times. Bob becomes annoyed and tells Ann “You have been no help at all!” See if you can follow this set of transactions on the diagram, work out what position Bob and Ann were in when they entered the game and compare it with where they ended up.

Contracts

In a counselling practice, Transactional Analysis requires a mutual contract for a defined change. TA counsellors consider that people are capable of deciding what they want their lives to be. As a result, in my practice I help my clients to define what they want to change and how they will recognise when they have what they want. Afterall, if you don’t know where you are heading, how will you know when you get there?

Helen Clarke - West Sussex Counsellor

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness.

Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk

Follow @sussexcounsell1 on Twitter

In A Nutshell – Gestalt Therapy

Welcome to my “In a Nutshell” series. When you are looking for a therapist the terminology can be baffling. We counsellors are keen to tell you what model of counselling we are trained in and it is confusing because there is so much theory, so many different fields of study and dozens (literally dozens) of different therapeutic modalities. How do you know if what I offer matches what you want from therapy? This limited series of blogs will explain the three core theories I use in my practice and I will attempt to show how they may be useful for you.

The first in the series can be found here https://safespacesussex.co.uk/in-a-nutshell-person-centred-therapy/

The Underlying Principles of Gestalt Counselling

“There is only you to discover and you are a friend.” (Houston,1995, p. 6)

The Gestalt model was founded on a holistic approach, akin to the eastern philosophy of Zen. The approach was spearheaded by Fritz and Laura Perls and examined the human as a complete and whole being consisting of mind, emotion and body, each facet intertwined and meeting the environment in which each person exists. It goes further, asserting the premise that each person is part of his/her own environment and cannot be understood separately from it. The ensuing process of existence is dynamic and creative, it determines how we experience the world in which we live and Gestalt theory acknowledges that as human beings we not only influence our environment but vice versa, because we are part of that environment and not distinct from it.

The model also asserts that each human is proactive and is fully capable of being sentient of his own sensations, thoughts, emotions and perceptions, each of which is a component of the whole being. From a holistic viewpoint change in one area will result in changes to the whole and this can be achieved when the individual brings any or all of these factors into their awareness.

Each client is viewed as a distinct being, with unique insight to their own existence and behaviour. The purpose of therapy within this model is to provide the client with an environment in which they can explore their unfinished business from the past, their perceptions and their feelings, in the here and now, taking on responsibility for the way in which they react. According to Gaie Houston:

              “Gestalt is not concerned with blame…It is interested in helping you notice your                  response-ability at this moment” (Houston, 1995, p. 36)

By increasing self-awareness and taking ownership of feelings and actions the client is encouraged to accept greater responsibility for himself and be aware of the repertoire of responses available to them, thus moving towards a state of autonomy.

We each experience our world from a unique perspective and the term Figure and Ground is used to determine that perspective. Gestalt therapy encourages the client to re-evaluate their perspective by challenging the client to look again at themselves, their actions, thoughts and feelings. This process is cyclic, each healthy cycle providing an opportunity to increase awareness and culminate in “final contact” at which point the need has been satisfied. (See figure 2. below).

However, the client may experience blocks to the emergence of new perception and of greater self-awareness, resulting in an unhealthy cycle where final contact is prevented.  In Gestalt terms any prevention in final contact (completion of a gestalt) is unfinished business which leaves the client with a feeling that the cycle is incomplete, although even this may be out of their awareness. Unfinished business is known as a fixed gestalt.

A fixed gestalt will prevent the client from a move towards autonomy. The diagram below demonstrates the factors at play in a fixed gestalt, where the creative and dynamic process required to achieve a healthy cycle stalls.

Figure 1 – What is a fixed Gestalt?

It is the counsellors aim to assist the client to recognise the block/s causing the fixed gestalt, bringing this into the client’s awareness by inviting the client to assess what they are experiencing “here and now”. The client holds the keys to his own state of autonomy and can free himself from the fixed position he is experiencing by recognising how he is reacting, how appropriate that response really is and how he could react instead; the counsellor provides a safe space for him to test the alternative.

The Gestalt Cycle  

The Gestalt Cycle demonstrates the framework in which a person becomes aware of a need and follows through to complete the satisfaction of that need. The cycle follows seven steps.

Figure 2 – The Gestalt Cycle

A complete cycle is called a gestalt.    

  “The completion of a gestalt with good form and vibrant shape is a thing of beauty formed in        relation to the environment.” (Mann, 2010, p. 38)

A complete gestalt gives satisfaction of the need, a block at any point during the cycle will prevent satisfaction being met.

Interruptions to contact

Interruptions or blocks to the Gestalt Cycle of Awareness (contact) have been identified as:

  • Desensitisation – when a person’s emotional responsiveness to negative stimuli from the environment becomes diminished e.g. a person has repeatedly been undermined intellectually so they no longer feel an emotional response to the words “You are stupid”.
  • Deflection – a person uses avoiding behaviours e.g. changes the subject during a conversation they don’t like.
  • Introjection – This relates to ‘swallowing messages whole’. e.g the message a child hears from a caregiver may be ” You’re stupid”, they swallow this message whole and do not attempt to fulfill their potential as an adult because they do not believe themselves to be capable.
  • Projection – This relates to when a person confuses “Other” for the “Self“. e.g. A person may believe all other people are liars because he is a liar.
  • Retroflection – This is when a person withholds emotions or responses which they feel towards others e.g. if I am angry with someone and I don’t express the emotion, it will build up inside and have later consequences that may be disproportionate to my initial anger.
  • Egotism – This is when there is no attempt to interact between one person and another, the exchange will only be one way e.g. a person who talks about himself without listening to or engaging with the other person.
  • Confluence – This is where there is no boundary between self and other, the person will feel merged with someone else. e.g. a woman who can’t decide what colour jumper to buy for herself without the input and approval of her partner.

Figure and Ground

Figure and ground relates to the way in which we make sense of our environment, the figure being interpreted by the brain as being the most vital information to process, and the ground being secondary in our perception, providing context. In Gestalt terms figure and ground applies to all perception, examples include:

  • Visual perception The black and white curves of Rubins vase (Rubin 1915) (a monochrome depiction of two faces mirroring each other, forming a vase shape between them)
Rubins Vase.png
Figure 3 – Rubin’s Vase (1915)
  • Music Notes form the figure against a ground of silence (e.g. piano keys being struck, guitar strings being strummed)
  • Movement The human brain will perceive the sudden unexpected movement of a snake nearby when walking in a forest but will barely register the gentle sway of the trees.

Accordingly, in the Gestalt model, the client’s perception of self and environment is viewed in terms of figure and ground. As the client’s level of self-awareness affects their perception of their emotions and actions, their perception of figure and ground also changes. As a client’s perception changes they have a greater scope to react in a new and often healthier way to their feelings, their situation and to the people around them.

References

Houston, G. (1995). The Now Red Book of Gestalt (7th Revised edition ed.). London, : Rochester Foundation.

Mann, D. (2010). Gestalt Therapy – 100 Key Points and Techniques. Hove, East Sussex: Routledge.

Rubin, E. (1915) Rubin’s Vase. Synsoplevede Figurer. Denmark.

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness.

Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk

Follow @sussexcounsell1 on Twitter

In A Nutshell – Person-Centred Counselling

Welcome to my “In a Nutshell” series. When you are looking for a therapist the terminology used can be baffling. We counsellors are keen to tell you what model of counselling we are trained in and this can be bewildering. There is so much theory, so many different fields of study and dozens (literally dozens) of different therapeutic modalities. How do you know if what I offer matches what you want from therapy? This limited series of blogs will explain the three core theories I use in my practice and I will attempt to show how they may be useful for you.

See the second in my “In A Nutshell” series here https://safespacesussex.co.uk/in-a-nutshell-gestalt-therapy/

The person-centred approach developed in the 1950’s and 60’s. It was very different from the type of therapy previously available. It was radical in that it placed the client as the expert in their own life, with specialist knowledge of their own emotions and drives. The focus of this developing theory placed new emphasis on the client as a unique human in every sense, rather than as a biological unit programmed with a set of behaviours which would be analysed by the expert therapist, who back in those days would have been a medical doctor. The lead proponent of the new model was Carl Rogers, who is described by many as the “Father of person-centred therapy”.

The model promoted the idea that the relationship between counsellor and client was at the heart of successful therapy. Experts were out, teamwork was in and this approach has stayed at the heart of person-centred therapy. In person centred therapy the person is the priority, not their “symptoms”.

The Potential For Growth

Rogers and his cohort believed that each person, given the right set of circumstances in a collaborative relationship, would find the tools within him or herself to grow, to become more complete, to be themselves. The primary focal point was no longer on the past life of the client, as in Psychoanalytic therapy, but on the potential for growth now and in the future. This potential and innate desire became known as the “actualising tendency”.

   “At the deepest level there is in all of us a yearning and the wherewithal to become more than we are” (Mearns and Thorne, 1999, p6)

A commonly used analogy which demonstrates the actualising tendency is that of Rogers childhood potato story. He noticed that the white shoots grew steadily towards the light in the darkness of his parents’ cellar. (Rogers, 1980). In other words, people can send out their own shoots of personal growth to the light.

Conditions of Worth and Self Concept

However, along the way we are each diverted from actualisation (from being our true selves) and are influenced by outside factors. For example, by the rules of a teacher, the messages given to us by our parents or the influence of the society in which we must survive. Often, we will not even be aware of these influences, which can be insidious, and yet we react to them by modifying our internal voice to produce the “right” behaviour. Ultimately these become our conditions of worth.

“Influence is a process which works chiefly in the unconscious.” (May, 1992, p.75)

A person develops a self-concept based upon their experience of being either accepted or more worryingly, rejected. Where a person has been criticised, their feelings trampled upon and their views scoffed, they modify not only their behaviour but their self-image. Consider the child that can’t do their times tables and is told, “you’re stupid”. This becomes part of their understanding of themselves, they absorb the voice that says they are stupid and this influences their self-concept going forward.

The Therapeutic Alliance

The development of an authentic relationship between client and therapist was seen as key to successful therapy. Rogers developed what would come to be known as the “core conditions” which he felt were ideal and crucial in the development of such a relationship and would result in change for the client.

The Core Conditions – Congruence

Rogers affirmed that to give truly effective counselling the therapist must be a congruent person. In other words, the counsellor must be true to him or herself,

  “..not a facade, or a role, or a pretense.” (Rogers, 1961, p282)

In other words, Rogers believed that clients instinctively know when their counsellor is being incongruent and that this limits the client’s growth. Not only will the client fail to trust the therapist but when the counsellor is transparent and open within the therapeutic relationship this sends the message to the client that it is OK to be oneself. As Rogers put it,

   “…if I can transparently be what I am and what I feel in relationship to him. Perhaps he can be what he is, openly and without fear.” (Rogers, 1961, p67)

The Core Conditions – Empathy

Rogers also stated that empathic understanding was an essential element of successful counselling. Empathy can be described as a deep state of identification with another and of profound emotional understanding. However, for the therapeutic relationship it goes beyond the counsellor understanding her client. This is insufficient. Above all, what truly matters is that the client perceives that another person, in this case the counsellor, is trying to understand completely by journeying into their emotions as a companion.

  “success depends upon their ability to accomplish this walking with another person into the deepest chambers of his soul. Empathy is experienced…” (May, 1992, p.64).

Therefore, for empathy to be effective a strong rapport between the parties is essential. Without this connection the client is alone with his or her confusion, doubts, fears, conflicts and the sound of critical voices from their past, the strongest of all being their own voice. Ultimately, to be a good person-centred counsellor the model requires that the therapist

   “…be the kind of companion who is capable of encouraging a relationship where the client can begin, however tentatively, to feel safe and to experience the first intimations of self acceptance” (Mearns and Thorne, 1999, p6)

The Core Conditions – Unconditional Positive Regard

Person Centred therapists believe that it is only through being accepted by the counsellor that a person becomes able to adjust their view of self and learn to accept himself. This condition is known as Unconditional Positive Regard (UPR). It is central to effective person-centred counselling in that this condition of complete acceptance purportedly allows the client to revisit their self-concept and make changes to that perception from within. Literally the client will see that “if you think I’m OK then maybe I am”. The outcome of this assessment is entirely in the hands of the client and the counsellor is there to help in the exploration by creating a safe environment and only going into territory that the client is ready to visit in that moment. In this regard the client dictates the pace and direction.

Change

Some have argued that the core conditions are insufficient to assist the client in making substantive change. Some would say that by employing empathy, UPR and congruence the counsellor is simply being the right type of person to fulfil a helping role, but that these conditions alone will not necessarily produce change.

Egan, for example, believed that change was an active process requiring specific input from the counsellor and the client in collaboration with each other. (Egan, 2002). He proposed that the core conditions were essential in the forming of the working alliance between counsellor and client, but that change would be achieved by setting defined goals and working towards them.

Ultimately change can only occur when the client is ready. This involves developing such concepts as self-awareness, self-acceptance and ultimately making a choice to be true to himself with others.  

How person-centred therapy works

Change can be a daunting experience. This is because becoming more “yourself” will mean travelling in territory which you have not previously explored. Ultimately, the purpose of person-centred therapy is to create an environment that is conducive to you tentatively testing your new found self within the safety of the therapeutic alliance. As you learn that disaster does not strike, that you are still accepted, then your confidence will grow. Ultimately, Rogers believed, that we may ask:

“Do  you suppose I could be my feelings with other people also? Perhaps that wouldn’t be too dangerous either…I get defeated sometimes, I get hurt sometimes, but I’m learning that those experiences are not fatal… could I be myself this way outside of this relationship? I wonder… Perhaps I could. ” (Rogers, 1961, p68)

This can be seen to occur in a cycle:

Rogers felt that the therapeutic relationship is ultimately a fertile ground for you to explore your emotions, make discoveries, begin to trust the voice of your true self and practice being yourself. Above all, the role of person-centred therapy is to create a space, in the here and now, which is conducive to the change you require.

My Practice

My practice has, at its heart, the understanding that you are the expert in your life and your experience. I believe it is essential for you to be heard without judgement, for us to collaborate as I work to understand your life and your feelings and, ultimately, it is vital for our relationship to be genuine.

During my work with clients I integrate the models of Gestalt and Transactional Analysis. You can learn more about these fields in my “In A Nutshell” series. Look out for them in the coming weeks.

References

Egan, Gerard (2002) The Skilled Helper: A Problem-Management Approach to Helping (7th ed) Brooks/Cole,  Pacific Grove, Calif

May, Rollo  (1992), The Art Of Counselling, Souvenir Press, London

Mearns, D and Thorne, B (1999), Person-Centred Counselling in Action, Sage, London

Rogers, C (1961) On Becoming a Person , Constable, London

Rogers, C (1980) A Way of Being, Houghton Mifflin Harcourt, Boston

Helen Clarke - West Sussex Counsellor

Helen Clarke is a qualified Humanistic Integrative Counsellor based in Coastal West Sussex. She specialises in loss and the associated physical signs of profound, traumatic loss, such as palpitations, sleep issues, panic attacks, vivid and recurrent dreams, unexplained aches & pains, a sense of immediate and physical fear or overwhelming sadness. Follow this link for more information on Helen’s private practice. https://safespacesussex.co.uk& follow @sussexcounsell1 on Twitter