• Richard Hughes

Questions And Answers

Updated: 5 days ago

Everyone has a few questions as they start psychotherapy or counselling. Here are just a few of them:


LONG TERM? SHORT TERM? OR A QUICK FIX?

A question many people ask is if they should do open-ended/long term therapy or could they do something shorter?

The decision is usually based on several factors, including your prior experience of therapy. If you are considering longer term therapy, it might be that you have done some workshops, or short-term counselling or CBT in the past and now you want to go deeper. Or it may be that you are ready to explore your sense of self or relationship patterns in greater depth.

Open-ended or long-term psychotherapy is both a time and financial commitment, and only you will know if and when it is right to take that step. The process of open-ended work will not be linear, it may be challenging or even frustrating at times, but it can be extremely powerful and life-changing.


My approach is to take our sessions one step at a time. I always do a couple of initial sessions and then we will contract for a time frame, which can be rolling. We will check in with each other regularly to see how we are getting on.

Short term work may give you a taste of all of this and it can also be impactful in its own way. Sometimes we need a 'witness' to our experience, or support at a stressful time such as a career change or a big life decision.

Of course, a 'magic wand' is always appealing and sometimes we may need a few techniques to cope with a difficult situation but I am not sure about the long-term benefit of a 'tips and tricks' approach.


Good therapy is about working at depth with the 'whole of you', taking into account the stories, complexity and nuance that may emerge over time. There is no quick fix, and I would be mindful of anyone who promises that.


At the writer Anais Nin reminds us:


'There are very few human beings who receive the truth, complete and staggering, by instant illumination. Most of them acquire it fragment by fragment, on a small scale, by successive developments, cellularly, like a laborious mosaic.' - The Diaries of Anais Nin

WITH SO MANY DIFFERENT TYPES OF THERAPY, HOW DO I CHOOSE BETWEEN THEM?

Just some of the modalities of psychotherapy include classical psychoanalysis, relational psychoanalysis, integrative, Jungian, existential, Gestalt, humanistic and person-centered, or a combination of these. Then there is art therapy, drama therapy, CBT, body work and eco-psychotherapy, and that is just the start.

Empirical research has shown that the 'therapeutic relationship' is key to the effectiveness of psychotherapy and counselling, the type of therapy is rather less important. These days most modalities value the therapeutic relationship.

I practice 'relational integrative psychotherapy' which is a popular way of working. I have a relational and reflective focus, with five years of training at a MSc level, plus on-going annual CPD which is accredited by the UKCP.


Integrative psychotherapy considers the relationship with 'self' and 'other', and is about the 'integration' of all those different parts of your 'self' which make you the embodied, unique human being that you are.

As a process, relational integrative psychotherapy is not about me telling you what to do, rather together we are curious and reflective together, as we begin to explore some of the issues that have brought you here.



IS IT CONFIDENTIAL?

As an accredited member of the United Kingdom Council for Psychotherapy, I respect, protect and preserve the confidentiality of everyone I see in practice.

It is also important to understand that there are legal and ethical limits to this confidentiality.

In rare circumstances, I might need to disclose confidential information to a third party. However, if this should happen, we will always discuss this, if possible. For example:

* If there is a possibility of harm to yourself or others or in cases of crime.

* Due to a request by a court of law, a child protection agency or the terrorism act.

* If a referring agency require a report.

All psychotherapists have supervision. I will therefore share some of the content of our sessions with my clinical supervisor, though your full name and personal details will not be shared.

I may keep notes and records, and these are kept securely locked away at my place of work, in accordance with the Data Protection Act (2018). You have the right to inspect your notes and records should you so wish, and this request will be fulfilled during a therapy session.


WHY WEEKLY THERAPY?

I offer weekly psychotherapy. There are many reasons why I believe this is preferable. It establishes a clear parameter which creates a more 'holding' and 'containing' environment.

If sessions are done twice monthly or once a month there can be a sense that they become 'catch up'.

Sometimes when people have been doing long term psychotherapy, less frequent sessions can be part of the ending process.

IS IT ALL ABOUT THE PAST AND MY CHILDHOOD?

Psychotherapy has always been interested in childhood and family dynamics, and for good reason: we are formed in part by our childhood experiences. Our past is alive now; it impacts how we experience life today.


There is a huge amount of empirical evidence that developmental inconsistencies and deprivation can have adverse consequences on a child's emotional, psychological and physical development, resulting in difficulties in adulthood.

But of course, there is more to it than just that, we are also formed by our culture, societal structure and biology.


I also hold a neuroscientific perspective that trauma works at a cellular level. We hold the trauma of past generations.

With this in mind, we may explore how old narratives get replayed in current relationships, including in the therapy room, and how our experiences of gender, race, sexuality and class interact with our developmental and relational history.




WILL THERAPY FIX ME?

Many people embarking on therapy ask if it will fix them. It is a good question. After all, the anticipation of change is at the heart of the psychotherapeutic process. Anticipation of change presents itself as hope. But of course, as we all know, there is no 'magic wand'.

There is plenty of empirical evidence that some therapeutic techniques can help people reframe their issues, giving them space to be more flexible and self-reflective.


I also believe that being met in relationship is transformative for both parties involved. As human beings we are hardwired for connection; and that change and healing comes through the co-created relationship.

I also hold this observation from psychotherapist Thomas Moore, in his book, The Care Of The Soul:

'The trouble with some of our modern therapies and psychologies is that they aim at goals that are known, fantasies or normality or unquestioned values ... but there are times when we may need to be weak and powerless, vulnerable and open to experience ... in relation to the symptom itself, observance means first of all listening and looking carefully at what is being revealed in the suffering. An intent to heal can get in the way of seeing. By doing less, more is accomplished.’



WHAT IF THERAPY GOES WRONG?

We have all heard stories of people who have fallen out with their therapist. Sometimes an off-hand remark can cause a breakdown in trust, other times there is a serious breach of the ethical frame.


One of the most difficult things to do in therapy is to share with your therapist the misattunement or rupture, and to stay open to the possibility of talking about it. We are all human, mistakes happen, but when they are shared, and explored, it can be transformative. I would really encourage you to do that. There is even a theory, that we have to work through at least three misattunements for the therapy to get into its stride!


HOW DOES THERAPY END?

Usually by agreement between us.


Endings can bring up all sorts of thoughts and feelings and it is important to acknowledge and explore these as part of our time together.


For this reason, I always suggest that we take at least 4 sessions to process the ending.


I hope you have found these Q&As useful. If you have any more questions, please do not hesitate to contact me on 07970 245 899.

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