The simplest way to describe my job is to say the following: that counselling and psychotherapy are types of talking therapies to help people improve their mental health. But ‘simple’ doesn’t always accurately reflect the difficulties people bring, nor what needs to be done to help people feel more well and functional in their everyday lives.
Layers and Facets to the Self
Humans are multi-faceted, and this translates into the many layers of a problem a person can bring to their Psychotherapist. What is being experienced as anxiety can point to any number of things such as: uncertainty, a fear of something in particular, or difficulties in having a solid sense of self. It’s my job to pay attention to all of this, at all times, and work with whatever is emerging at each moment.
Using a trauma-informed relational model that integrates psychodynamic, attachment, and intersubjectivity theories means that I have the theoretical framework to achieve this whilst honouring each person’s unique self and personalised journey of recovery.
So how do I become aware of all these facets and layers, in order to fully know the person and their problem so that I can help? A large part involves creating an awareness of what is being communicated not only in words but also in a person’s body, what is being said, and what has yet to be expressed. I think that ‘talking therapy’ can be a misnomer given that communication does not always mean verbalisation.
Trying to Communicate
Very often the hardest part of psychotherapy and counselling is saying out loud the things we have kept in our minds, whether it be because of the emotions that come with them and/or because we haven’t felt comfortable enough to let someone else know what we’ve been thinking. It’s normal to not feel able to verbalise or communicate what’s going on.
Therefore, feeling safe and comfortable is a key aspect that underpins my approach. This is partly because safety engages the parts of the brain and parasympathetic nervous system that allow us to be comfortably connected with ourselves and others. Once we feel safe, we feel more able to freely explore what the problem is and feel more enabled to change it.
What happens sometimes is that starting to open up to someone can make us feel vulnerable or nervous, and this can tap into emotions that stop us from being able to connect and communicate. These emotions are often (but not limited to) shame, fear, and guilt. At this point one facet or layer of the person’s self has emerged, and it is telling us something even if there are no words to it yet.
I often refer to mental health as a ‘full body experience’ as my clients usually have not just a cognitive (thought/mind) response to their problems, but a somatic (physical/body) response too. For example, depression can mean a heavy feeling in the legs or anxiety can mean tension in the chest. When it comes to communication, my work has taught me that we must listen to what the mind is saying and what the body is saying too. Often one part can communicate something the other can’t, or one stops the other from expressing something difficult.
How Can Counselling and Psychotherapy Help?
At all times my role is to help a person better understand themselves so that they know what is already helping them manage their mental health and wellbeing, in order to build on or adapt these to further them along this very personal process.
When words fail in psychotherapy and counselling we can wonder about the silence, think about which part of your self is at the forefront of our attention, listen to what your body is saying, or even get creative in a way that feels right for you. This can include using pens and paper, pictures, or metaphors to give shape to what’s difficult to express.
Above all, when words fail it doesn’t mean that you’ve failed at talking therapy. The whole experience should be tailored to you, and whatever you need in that moment depending on what part of you needs paying attention to the most. The practice of this over time can lead to a more integrated sense of self, and ability to better manage our mental health and wellbeing.
If you have any questions, or want to explore how counselling and psychotherapy could help you, please get in touch.