How long does counselling or psychotherapy go on for?
I have a brief answer to this question. In my experience about 75% of the clients I work with have between 5 and 15 sessions, on average. This can be regarded as short to medium term therapy.
About 25% of the people I work with will have upwards of 20 sessions, sometimes working for over a year or more, which can be regarded as long-term therapy.
In addition to regular feedback in each session, periodic reviews take place every 5-6 sessions to assess progress. This allows the course of therapy to be checked and discussed openly so that both the client and counsellor know where the therapy is going and what the goals are in the process.
The Process of Psychotherapy (May 2015)
I'm often asked how counselling and psychotherapy works. There are many ways in which it facilitates change, and it varies from person to person. But there's one things that nearly all clients I work with recognise as helpful. The increased understanding and awareness that results from therapy can give us choices about how we react, respond or behave.
Where self-awareness remains limited, we're more likely to fall into old patterns of feeling and behaving. It's rather like falling into familiar and outworn ruts. Even though these habitual ways may not serve us well, we fall back into them because they're all we know.
Exploring and understanding aspects of ourselves can create new perspectives, resulting in new ways of being with ourselves and others. Choosing to respond differently can begin to feel empowering.
It's good to talk (January 2015)
Did you know that talking about problems is more acceptable now? A research project showed that 95% of respondents agreed that ‘it is a good idea to seek counselling or psychotherapy for a problem before it gets out of hand’ (BACP, 2013).
As a counsellor I often hear clients say after a few sessions, “I wish I’d done this before”. Having overcome initial concerns or scepticism about counselling, people are surprised at the benefits of talking through their problems.
They see that, even in the very act of describing their difficulties, a sense of clarity and reason can emerge. Frequently people feel relieved of a burden of worries that have been circulating in their minds for months or even years. Working hard to put certain thoughts or feelings away can feel like they’re working at their problems. But in counselling, they soon begin to see that this only fuels such thoughts and feelings with greater weight, thereby increasing levels of anxiety or low-mood.
Talking to someone is a way of climbing out of feeling immersed in feelings or situations that seem to have power over us. By gaining a wider perspective, of seeing other ways of reacting and relating, we can choose alternatives to the familiar and outworn perceptions that no longer seem to serve us.
Finding a Counsellor (Autumn 2014)
Finding the right counsellor or psychotherapist is about finding someone you feel you could work closely with in a trusting and professional relationship. The idea of disclosing our personal difficulties to someone we have never met inevitably raises some anxiety—perhaps the very thing we wish to be free of! We may feel that our problems aren’t serious enough to warrant this kind of help, or that they’re too much for the counsellor. It is therefore not surprising that many people find it daunting, not to say nerve-wracking, to take those first few steps.
It may help to meet with a few therapists in order to assess for yourself which one feels right for you. You have every right to ask them about their experience and qualifications, and whether they think they’re competent to work with the issues you bring. Having met with a counsellor, do you think that they would be sufficiently understanding, genuine and challenging in a supportive way? What does your ‘gut feel’ say to you about the therapist?
On a practical level some counsellors offer an initial meeting, either free or at a reduced rate, in order to explore how you both might engage in the issues you wish to work on. Others may offer such a consultation, but charge for their time. Either way it can give you a sense of assurance to make your own assessment of such a professional.
What is Mindfulness? (December 2013)
Mindfulness is fast becoming used in all kinds of ways to enhance mental, emotional and physical well-being.
Mindfulness practice is an activity that can be done at home or in organised groups. It is informed by different theories, religions and philosophies.
But what is it, exactly? It involves paying attention—as far as possible without judgement—to what is happening within us and around us. It’s about developing a very particular way of observing experience, whether it’s a feeling that emerges or a thought that arises, for example.
You might just catch a thought, for instance, as it leads to a memory that then triggers a shift in mood. Or you might tune-into the sensation of your breathing. It’s the careful observing and being ‘with yourself’ that counts in mindfulness.
How is it done? It’s simply a case of sitting (or lying) quietly, either on a chair or on a cushion, in order to focus on the mind. A very common technique in mindfulness is to observe our breathing. It’s a bodily experience that can allow us to be mindful of ourselves in the moment.
Many people find that joining a class or group helps them build mindfulness practice into their lives. At first, sitting for 5-10 minutes is enough. Later, people sit for 45 mins or an hour.
You may ask “Why do it? How can it help?”
This practice, that looks deceptively simple at first, effectively takes the mind ‘out-of-gear’. No longer is it beavering away at to-do lists and plans. No longer is it immersed in an endless stream of thinking mixed with anxiety and edgy feelings (you might say this is a mindless state!).
Mindfulness practice has a profound effect on the brain and body. It rests the whole system in a supportive yet attentive way. Free from side effects, it is proving beneficial to health in numerous ways.
Sources and further information:
Resistance (March 2013)
In times of turmoil or disquiet in our lives we often find ourselves resisting everything that we see as ‘trouble’. Dissatisfied with the past, we try to change it, becoming wary of a future that could repeat past mistakes. In the tangle of thoughts, feelings and negative urges, we try all kinds of ways of avoiding the reality of our situation. From fantasising to gambling, from excessive exercise to over-drinking, from self-downing to changing others—we make huge efforts to try and bring back a sense of order and normality to our lives.
It seems to me that, while there can be some benefit from getting respite from this inner battleground, it is ultimately a losing battle. The more I try to resist a feeling or pattern of thoughts, the more power it seems to gain. I might benefit from short-term relief that I have rationised a thought away, but sooner or later it re-emerges, often with more bite.
The alternative—to face it—seems counter-intuitive. Why would I want to feel more pain by going into it? However, by carefully looking over unturned stones, or opening doors in our minds we’d rather not look behind, we can, with the support of a friend or counsellor, begin to see that the problem is not what quite as we imagined it to be. A feeling might not be as catastrophic as we assumed. Even small discoveries can come as a revelation, giving us hope that things can be different. Soon the tensions from those massive efforts to resist what exists in us begin to subside. We see that our initial resistance stemmed from judgements we made that set the issue in stone. At last, we might see that there is a way through without things being so fraught with inner conflict.
What Keeps Us Well? (November 2012)
Wellbeing has seeped into public awareness, reflecting a more positive and useful way of thinking about our physical and mental health.
Emerging from many research studies into wellbeing, seven ways (or ‘pillars’) of maintaining and improving our health are now widely agreed upon. They are:
• Managing stress
Each of these will mean different things to different people. If you were to draw each of these as circles on a piece of paper, how large or small would they appear on a scale of importance? For example, your ‘exercise’ circle may appear very small compared to your ‘connectedness’ circle. What’s this really about? Perhaps talk to friends or partners as a way of understanding your relationships with these aspects of wellbeing. This might throw up things you could do to enhance an area that needs attention. It might reveal ways of making your life and outlook more whole and complete.