On Psychotherapy

Reflections on Psychotherapy

The Texas State Board of Examiners of Professional Counselors requires that clients be provided with written information concerning the purpose of counseling sessions and the techniques to be employed by the counselor. Let me share a few of my thoughts about that.

The purpose of counseling is fairly simple and straight forward. Individuals seek professional help because of pain, which arises because of conflict in the clients’ world. The client (individual, couple, family) joins in a relationship with a professional to explore their crises, and to attempt to achieve resolution. The basic “technique” of counseling is sharing, which primarily refers to the client sharing their inner process and the counselor sharing their training and experience.

That is counseling in a very small nutshell. Let me expand on what is really being said. It is vital that the exploration of a clients’ problem be understood to be a collaborative venture. Both counselor and client have work to do. It is the responsibility of the client to bring their conflict and pain to awareness, and to open up to the counselor with honesty and vulnerability. That entails not letting fear, self reproach, shame, embarrassment, stop them from opening up and sharing as completely as possible what they are thinking and feeling, etc. It is the responsibility of the counselor to meet the client with reciprocal honesty and trustworthiness. That means suspending judgment, being compassionate, and maintaining their objectivity outside of the frame of reference of the client. Further, the counselor is also responsible to bring all of their education, training, professional experience, and their own personal growth to the process.

In regard to the actual counseling process, I think that it is important to recognize that in some ways, the process is unique to each individual. Everyone comes in with a unique way in which they have learned to process life. Some people more easily talk than others. Some are more in touch with themselves and their inner worlds than others. Some more easily or readily catch onto the nature of the counseling process. Some have previous counseling experience or personal growth work upon which they can build. This in no way implies that there are good clients and bad clients. It does mean that the process varies. Coupled with this, you also have important factors such as the nature of the problem itself, the severity and duration of the problem, and the inclusion of others who might be involved in the process. All of these factors greatly influence how each individual experiences the counseling process.

These same factors also greatly influence and account for change in the counseling process. Everyone wants change to occur instantly. Everyone also wants to know, “How long will this take?” It is a fair question. There is just not an easy answer. In some cases, change can occur rapidly, but that is generally the exception to the rule. In most cases, change involves some time. Counseling is not a hard science or a linear process. We are not dealing with hard, cold facts or an objective client world or situation. As we really begin to get into a client’s crises or concerns, what we have done is move into the clients’ unique world, a world based upon individual interpretation, history and a very personal point of view. There, we are apt to uncover long term and much more deep-seated, unresolved issues. We also find patterns of thinking and behavior which we discover have repeated themselves throughout the clients’ life. Bottom line, the clients’ initial reason for seeking help, the presenting problem that made them initiate counseling, is usually just one, current expression of larger life issues. There are usually multiple layers of issues involved. That does not mean that the client has to address them all. It does mean that all of those things are part of the process and also influence change.

Finally, let me attend to the question of “technique” in counseling. Technique is always secondary to, and led by, the goal in counseling. It is the responsibility of the counselor to employ whatever means available to help the client become more conscious of themselves and the issues that are creating a problem or crises in their life. Once again, that will differ from individual to individual and from situation to situation. Counseling may look like just talking things out. The counselor has a perspective that is not trapped within the client’s frame of reference. New thoughts from this outside source may be enough to raise consciousness and elicit change.

Sometimes, simple talking is not enough. There may be unconscious resistance that is blocking the individual from becoming more conscious of what is going on. In those cases, the counselor might employ some techniques such as role playing, to help someone more clearly see what they or someone else is doing. Exaggerating aspects of the situation might have someone see the humor in the situation or the absurdity of what they have been doing. Counseling may include teaching specific skills such as learning to communicate, how to deal with anger, overcoming fear. Homework, such as writing in a journal and/or reading assignments might be given to the client to work on in between sessions, which can greatly speed up the process. What is important about all techniques is that they are used to raise awareness. There is no magic. The counselor should work to see what might be effective with any given client at any particular time, but the clients’ willingness and commitment are the most powerful determinants of how effective the process will be.

In conclusion, counseling can be an extremely powerful process and a deeply rewarding experience. Getting help from someone outside of your world and outside of your personal frame of reference is very revealing, and can be very liberating. It really can literally change your life. It is not a quick fix and is not a substitute for your having to address your life and make the changes that will make your life better. The worst that can be said about counseling is that it can be painful and confusing at times. What is much more the case is that it is an exciting journey with rich possibilities, the greatest of which is your discovering yourself.