What happens in counselling sessions
The counselling process is not pre-set; it depends largely on each individual client’s goals and preferences and the issues they bring to counselling. This means that no two experiences of counselling are the same.
In general, though, we often begin by talking about whatever it is that has brought the individual to counselling, exploring their various thoughts and feelings, and identifying how they would like things to be different.
At some point, we will probably also try to understand what seems to contribute to any difficulties or issues they bring. This may include examining any patterns or connections between their thoughts, feelings, physiological responses and behaviours. It may also include looking at the ongoing effects of past experiences as well as the impact of their current interactions with others.
Depending on clients’ preferences and the particular issues they want to work on, I may also suggest that in addition to talking, we use other therapeutic techniques such as mindfulness practice, Eye Movement Desensitization and Reprocessing (EMDR) or Neurofeedback. You can read about some of these therapeutic approaches using the tabs on the right..
A key aim of psychodynamic counselling is to help the client become more aware of their patterns of thinking, feeling and behaving that may be causing them inner conflict or uneasiness, or difficulties in their external interactions and relationships. These patterns may have usefully been set up in the past as strategies for dealing with overwhelming experiences and feelings, but may be maintained longer than necessary or helpful. Psychodynamic counselling provides an opportunity to explore these less conscious aspects of one's experience and to consider which are still relevant or useful to us, and which we might want to let go of in order to open up our lives to new possibilities.
Systemic therapy focuses on how difficulties arise, and are maintained, in the interactions between people. It focuses less on the complexities of each person’s internal experience, and more on how they experience the dynamics within their families, communities and society as a whole. A systemic perspective is particualrly helpful in therapy involving couples or family members, but can also be useful in individual counselling, particulcarly when working with difficulties that are relational in nature.
Cognitive Behavioural Therapy (CBT)
CBT is based on the idea that our thoughts, feelings, behaviours and physiology are all linked and affect one another. So we can make changes to how we feel, by examining and reality-testing the thoughts that are contributing to that feeling or by using certain behavioural strategies. The change process requires the active involvement of the client to do things like keep a diary of their thoughts and feelings or conduct some behavioural experiments and notice how certain things affect them.
Eye Movement Desensitization and Reprocesssing (EMDR)
EMDR is an innovative therapeutic treatment method that has been found to be particularly effective in helping individuals deal with the distressing or problematic effects of a traumatic experience. This may be an assault, an accident, a natural disaster, sexual abuse, childhood neglect, or any other traumatic experience.
This treatment method involves the client attending to their emotionally disturbing material a little bit at a time while simultaneously focusing on an external stimulus such as the therapist’s finger moving from side to side, or alternately vibrating discs held in their hands. These forms of bilateral (left-right) stimulation appear to facilitate the accessing of the traumatic memory network that is stored in the brain and the processing of this information. People report that after EMDR, although they still have the memories, they are not accompanied by the same level of emotional and physiological distress.
EMDR is also increasingly being used to treat complaints which are not obviously or directly related to a major trauma. This includes panic attacks, phobias, performance anxiety, self-esteem issues and other anxiety-related difficulties.
To practice mindfulness means to pay deliberate attention to your present experience, observing it non-judgementally as it unfolds.
In therapy, as well as in daily life, mindfulness practice can help us to develop a new way of relating to our experience by encouraging us to temporarily suspend our usual tendencies to problem-solve or to avoid and shut out unwanted thoughts, feelings and body sensations. Instead of getting swept up and carried away by these thoughts and feelings, we try to notice and acknowledge them through a lens of acceptance and non-reactivity, even if only for a few moments at a time, and then to let them go.
Mindfulness can help anyone who chooses to practice it feel more grounded and peaceful in their lives, but it has been found to be particularly helpful to people dealing with stress, depression or anxiety. Like anything new and unfamiliar, it can take a little practice to really feel like you’re getting the hang of it, but clients often report positive effects fairly early on.
Neurofeedback can be a valuable adjunct to talking therapy. It involves placing sensors at particular points on the scalp to gather information about brain activity that is then displayed to the client on a screen, thus allowing their brain to subconsciously adjust its patterns of activity and achieve more regulated states. It can be helpful for a wide range of presenting concerns but I have found it to be particularly effective in relieving anxiety