So here’s my answer.
I practice as an “integrative” therapist which, for me, means I integrate theories from different schools of psychotherapy in order to offer the therapy best suited to your needs. I use not just my awareness of which theory sounds as best fit to address the situation, but also my felt experience (i.e. what I feel emotionally) within the therapeutic relationship as a continuing guide amongst those theories, helping me navigate which theory or theories will likely prove as best use in our therapy.
Predominantly I draw upon four psychotherapy schools of theory: cognitive-behavioural, psychodynamic, existential and person-centred.
Cognitive-Behavioural Therapy (often referred to as CBT) is useful in understanding the interrelationship between our thoughts, behaviours and feelings. Sometimes a faulty belief, such as “I am unworthy”, informs our decision making and/or behaviours in such a way that it means we (unwittingly) reinforce that first thought of not being worthy enough. Practical tasks which challenge these assumptions and attempt to break those unhelpful patterns of behaviour can unseat that negative self-belief and release us to a new perspective on ourselves.
Psychodynamic theory gives us means to understand the impact of formative events in our lives and how the emotional wounds dealt us in the past have caused us to erect emotional “defences” which can also steer our decision making, thoughts and feelings. Here we talk of the unconscious element, which might be considered as a silent partner wishing to aid our survival; difficult emotions which have proven too painful to be fully experienced get buried there and inspire the construction of those defences. A simple example of such a defence would be avoidance; we might avoid a certain place because it too closely resembles the site of a childhood trauma, and we’re fearful of re-experiencing those painful feelings.
Existential psychotherapy utilises the vocabulary and tenets of existential philosophy to permit a conversation on a topic which I find to be on my mind frequently, and certainly on the minds of those who seek me out for therapy: “what does it all mean?” Frequently I hear from people who feel they lack a sense of purpose but haven’t yet found the words with which to say this or, frustratingly, found anyone in whom they can trust to safely have such a difficult conversation.
And lastly, person-centred therapy is founded upon belief that the Core Conditions of empathy, congruence and unconditional positive regard are essential in facilitating our growth towards the person we are capable of becoming. A therapy can offer those conditions.
Since the inception of psychotherapy over a century ago, traditional theories have been challenged by later revisions and the advent of new therapies. I expect that anyone who has even loose knowledge of some of the above might challenge my too brief descriptions and certainly those that hold strictly to one school above any other will have ready argument as to the incompatibility of the four theories I lay out above. For instance, psychodynamic theory relies on its assertion that there is such a thing as the unconscious, where instincts drive us and which may require another’s intervention to uncover and explain; person-centred therapy doesn’t speak so definitively of an unconscious and posits that therapy is best found in a more egalitarian meeting between two people.
However, I say that there are significant compatibilities in practice. Drawing a CBT diagram to show the interrelationship of thought, feeling and action may be enough for some to inspire change; for others a deeper inspection of the unconscious dynamics which guide those same thoughts, feelings, and actions may be warranted. Increasingly, I find, those unconscious dynamics are a reaction to being exposed to tricky existential questions and so, an existential conversation first and foremost gives us the words to begin describing those unconscious dynamics.
It is my person-centred approach which I believe underpins the reason why a therapy I offer can help. Whilst we might need the language and explanation lent us by the other three theories, it is the therapist’s willingness to listen empathically, with congruence and unconditional positive regard that brings greatest and lasting change. Your experience of yourself is unique and yours alone, but that doesn’t mean I can’t approximate what it must be like to have your experience by referencing within myself how I’ve felt at similar times of angst, anger, depression etc. In our conversations I can demonstrate that your experience is understandable and relatable. I try hard not to let the emotions by which I can reference your experience get in the way of our conversation but, at the same time, I don’t fight to keep them away; I try and maintain a position of congruence, or as much awareness of my feelings and deportment as possible, so that I can stay as emotionally engaged with you as possible. And whilst engaged I offer no judgement on you; we are all human and subject to the shortcomings of being human. Be clear, this isn’t to say that I can always approve but it is understood that as a flawed human you will make the poor choice sometimes, you will lash out and cause damage; we’re not perfect, and I accept that.
I believe in an existential tenet that we always have a choice; it may be a choice we’re not happy to make, and none of the options seem favourable, but that we have a choice is immutable. We are better informed in our choices if we understand ourselves and have navigated past our defences, and bad habits, and unhelpful thinking patterns, and deep seated traumas. It is the goal of a therapy to get you to that place and, happily, I can say that I have aided others find such a place. This is how I believe therapy helps.