Counselling and psychotherapy are professional services. They are helping services.
What do they help with?
Like a mechanic helps with vehicle difficulties, a psychotherapist helps with difficulties in one or more of three areas of experience illustrated in the diagram below:
Notice the arrows in the diagram. Our thoughts, feelings and behaviour all interact and influence each other. In my opinion, good counselling and psychotherapy work with all three, and are able to shift focus and priority to suit individual and situational differences.
For example, you might come to therapy because of worries, which are keeping you awake at night, and making it hard to concentrate at work. Worries are thoughts. However, feelings and behaviour are also at play when these thoughts happen.
Worried thoughts are often fueled by feelings in our body, like the icy fingers of dread squeezing our stomach, or the so-called “butterflies in the stomach” (which seem too gentle and cute to describe what happens in many stomachs). In the behaviour department, worry can be kept alive and healthy by specific behaviours, like sitting home alone. That behaviour provides plenty of time to think and think and think. If worries were flowers, this behaviour would be like water. Also, sitting at home alone does not provide much fun and activity, which help to chase away worried thoughts.
The feelings and behaviour need to be tackled, as well as the thoughts, for the best results.
Different models of psychotherapy tend to prioritize one or two of the three areas of experience. Cognitive Behavioual Therapy (CBT) and Emotion-Focused Therapy (EFT) are pretty obvious about it; it’s built-in to their names. While a particular form of therapy may focus more on thoughts, or feelings, or behaviour; most forms of therapy do address all three to some extent.
For more information about different types of therapy which I make use of, click here.
Each form of therapy uses various methods of intervention to help. This might involve specific kinds of questions, designed to help people realize and understand new and helpful information. Teaching specific skills might happen; skills to more effectively tackle stubborn problems. Some therapies use technical procedures designed to help change thoughts, feelings and/or behaviour without directly talking about them as much, or even at all.
For me, a couple of considerations are important here:
- explaining the interventions I recommend doing, before doing them;
- asking if you actually think that’s a good idea, and want to go ahead.
Going back to mechanics and vehicles, I try not to replace the engine without asking if you are having any problems with it, first. Then, if you are, we can talk about what you do and do not want to do about it.