Personal Theory as a Therapist,

¶ … Personal Theory

As a therapist, my basic approach is to view the person in therapy as taking responsibility for his or her own life and problems. I believe that all human beings have a basis of good, and that it is my job as a therapist to help my patients find this seed of good inside themselves, however small. In order to do this however, I cannot try to force the process by attempting to force my view of human nature into the therapy session. Instead, it is my job to unconditionally accept my clients and their views as a basis for future therapy towards healing.

As such, I need to accept that all my clients come to therapy with a certain past, containing events that they will not necessarily want to share. In this, I believe that it is important to help clients understand that their therapy is their own responsibility. This is also an important part of acceptance. Human existence is filled with difficulty, flaws, and depression. These things are helpful clues towards the subconscious processes that will eventually help me to help my clients take responsibility for their lives.

Problem Identification

My goals for meetings with clients include first forming a friendly and open relationship with them by everyday conversational dialogue. I will ask the client leading questions regarding his or her life, goals and ideals, as well as deeper questions relating to how he or she feels about life and existence in general. The focus throughout the conversation will be complete and unconditional acceptance of the client and his or her views.

To identify the problem, I will listen carefully for clues in the responses of the client. This will then provide material for further conversation and the possibility of excavating possible hidden and more subconscious issues that the client might be struggling with. I will then use the issues raised during the conversation to plan my intervention in further sessions. It is important that the client plays an active role in these decisions. The closure of each session will then be a focus on dialogue regarding the specific issues raised during the session, and planning for future sessions. I will encourage the client to make suggestions for the therapy, and explain my premise for the therapy. The client should also feel sufficiently confident to criticize any of my approaches, upon which I will make modifications accordingly. The premise is to let the client not only take responsibility for his or her life, but also for the course of the therapy.

In terms of outcome assessment, I will use a combination of my own observations and the client's feelings to determine whether to terminate therapy. Of course it is possible that the client might feel he or she is ready to terminate when my estimation is that this is not the case. In such a case I would suggest a trial period and keep regular contact with the client.

Key Concepts and Therapeutic Approach

In my therapeutic practice, I specifically draw from four therapeutic theories in order to integrate my own approach. These include the Psychoanalytic, Person-Centered, Existential, and Gestalt Therapies. Each theory has valuable aspects upon which I draw to form an integrated approach to be of optimal help to my clients.

In psychoanalysis, I am not a very big adherent to Freud's analytic theory in terms of human sexuality. Indeed, his tendency to see sexuality as the basis of all human behavior appears somewhat narrow, particularly in the complexities of the mind. Furthermore, I cannot reconcile myself with the idea that all women envy men for their sexual organs, or that all boys want their mothers as lovers. What I do gain from this is however that the therapist can never approach a case from a basis of a single viewpoint. Instead, the whole of human experience - both psychological and physical - and furthermore the way in which these interact to form the particular individual of each particular case. The point of therapy is not to impose generalized theories upon individual cases, but to use relevant aspects in order to reach the core of each individual problem.

My problem with Freudian psychoanalysis is then basically that the sexual aspect encompasses everything. Sexuality is part of humanity, but does not dictate the whole of human life and behavior. Furthermore, I find the idea of the id, ego, and superego as delineated by Freud somewhat simplistic. I am more in agreement with Carl Jung, who places greater emphasis on the subconscious and its impact upon human behavior, including sexuality. While Psychoanalysis is therefore a good starting point for a therapeutic approach, my personal approach is to use it as a springboard for further ideas.

The theory that I feel most comfortable with is Person-Centered therapy. Its simplicity and focus on the client are the elements that make me most comfortable with this theory, and I therefore also use it to the greatest degree in my approach. In my view, Person-Centered therapy, in my view is most relevant to therapy and the theory of humanity today. Particularly, I am attracted by the fact that therapy is the responsibility of the client rather than the therapist, and also the fact that the therapist builds an open and honest relationship with the client. I like the idea that the therapist is an instrument in the pathway towards healing, rather than the "oracle" from which the client is somehow to receive healing like a holy grail. In person-centered therapy, the focus is on a more equal relationship between the client and the therapist.

In terminology, I also like the idea of "clients" rather than "patients," although this is not imperative for me. In particular, I feel that the point is to let the patient or client decide for him- or herself which terminology and method is most comfortable on the way towards healing.

A more important point is the emphasis on attitude. Whereas Freudian therapy strikes me as somewhat biased, particularly against the female paradigm, I feel that the positive and open attitude of the person-centered therapist is much more conducive to honesty. Honesty is for me at the basis of an effective therapist-client relationship.

In Gestalt therapy, the most important element for me is dialogue, which combines well with the attitude aspect of the person-centered paradigm. Effective dialogue is based on a positive and honest attitude.

Finally, the main element of existential therapy that I use in my integrated approach is its honesty regarding the human condition. While some of its aspects are decidedly negative, particularly in terms of the meaninglessness of a life that ends in a mysterious death, I do find that this very negativity provides a valuable balance and honesty from which to view the condition of the patient.

In integrating the above four theories, I will then use person-centered therapy as my point of departure, and combine it with what I view as the most important aspects of the other three. In starting my session with a client, I would therefore begin by a simple conversation. I approach such a session as forming a new friendship, and try to connect with the client on a personal level. I will determine what is interesting about the client, and what is important to him or her. During this session, I will then listen carefully for clues regarding issues that the client would like to address during future sessions. I will end the session by explaining to the client what I have observed, and asking whether they agree or disagree.

While the above is basically a client-centered approach, I will integrate the idea of the subconscious in psychoanalysis, the dialogue of gestalt therapy - particularly at the end of the session - and the basic honesty of existentialism. In this, I will focus upon accepting the person in an all-inclusive and honest manner in order to promote honesty from the client during the sessions as well.

In terms of informed consent, I will explain my basic approach to the client only at the end of the first session in order to encourage spontaneity during the session. I believe that therapy will be most effective only if I can encourage my clients to spontaneous during our initial conversation. At the end of the session I will inform the client of my intention for future sessions. I will also encourage further dialogue relating to what the client believes should be the focus of further therapy.

Therapist-Client Relationship

As I gain insight into the client and his or her problems, my therapeutic goal will be to help the client gain insight into his or her own situation. In this, it is important to share a collaborative relationship, as my focus is mainly person-centered. It is therefore my goal to establish a friendship-type relationship with my clients, helping them to open up in an open and honest way. This is particularly vital during the first sessions.

In order to gain focus on the client's particular problems, I need to apply considerable listening skills. From the basis of psychoanalysis and existential therapy, I will then listen for any problems relating to attitudes that can be driven by repressed emotions. I will use dialogue in order to gain an understanding of how the clients see their problems, and what they think is needed to help.

In the dialogue session, I will provide the client with my own insight on how I believe the best progress will be made in future therapy, and also on how long I estimate such therapy to take. I will however emphasize that I will not terminate therapy if the clients feel in any way that they will not benefit from such termination. Dialogue and collaboration means that I should be able to modify my approach according to input from my clients. If a client for example disagrees with an approach I am using, we will discuss various options of changing this and come to an agreement on a new approach to use. Such an approach will then form the focus of future therapy sessions.

In order to maintain focus on the problems at hand and therapeutic techniques to handle these, it is important to continuously monitor the client's view of his or her therapeutic progress. As problems emerge, I will also continually steer our conversations towards accepting and finding eventual solutions to these problems. Acceptance not only of the client, but also the specific manifestations of his or her problems, is a vital part of targeted and effective therapy.

Therapeutic Goals

As mentioned above, my main focus is person centered, and therefore a large amount of therapeutic responsibility will be that of the client. As therapist, I will however not completely relinquish responsibility for the therapeutic process, and I therefore believe that goal determination should be a collaborative process between myself and the client.

At the end of each session, the goals for future sessions will be determined, while those from previous sessions will be evaluated and revised, if necessary. The client will have a large amount of control, in that he or she has to be in complete agreement with the goals in order for therapy to continue effectively. The client will also have complete freedom to change or add to the goals as necessary.

Goal determination in my approach is a very good way to help the client assume responsibility for therapy and eventual healing. In order to facilitate goal directed behavior, I will then help the client by strategies such as naming and writing down goals for use in everyday life. Together, we will determine goals to reach outside of therapy. These do not necessarily relate to therapeutic goals. The ideal is to help the client become aware of the necessity of setting and reaching goals; in effect, to help him or her form the habit of reaching goals.

Central Techniques and Methods

My techniques and methods are based upon the client centered approach, while using gestalt dialogue for problem diagnosis and goal setting. Rather than setting myself apart from the client as therapist, it will be my goal to create for the client a basis of friendship from which to approach and solve problems. It will therefore not be a basis of therapy for its own sake, but rather of an honest relationship to use as a springboard for problem solving and goal oriented behavior.

Conversational techniques are used to determine the way forward for further therapy. The client is given full power to determine the course of therapy throughout each session. The therapeutic process is therefore determined by the client. The relationship is also collaborative, however, and as therapist I provide the client with input on how I believe the therapeutic goals can best be achieved. This is however not done in an authoritarian way and the client is at all times welcome to provide criticism and suggest modifications to my input.