The Carlton Vale Psychotherapy Practice

Frequently Asked Questions

WHAT SORT OF THERAPIST ARE YOU?
I am registered with the United Kingdom Council for Psychotherapy as an 'Integrative Psychotherapist’. While this can be understood in different ways, I consider that this reflects the reality that every therapist, whatever their training, has to explore both clinical and theoretical work and has to come to a personal distillation of this. In clinical practice this is a constantly evolving process. The work of any therapist is an amalgam of her or his own personal therapy experiences, clinical training, development and theoretical studies and explorations, areas of interest and, of course, personal traits. Most therapists will have areas of particular interest which they pursue. I have explored and studied humanistic, interpersonal, psychoanalytic and attachment theories and have a particular interest in time limited work, traumatic processes and the therapeutic relationship (which is shown by research to be a key element in therapeutic success).


WHAT IS INVOLVED IN PSYCHOTHERAPY WORK?
This is not a straightforward question. It is not necessarily easy to know what will make a difference. Many people can use therapy well. Their coping capacities may have been overwhelmed but may become reactivated and possibly enhanced in the course of a short term therapeutic intervention.

However, this cannot be taken for granted. If a person’s coping capacities are impaired, undeveloped or damaged, after repeated disappointments, challenging and difficult events and circumstances in life which have impacted on personal development and from which little or no recovery has been possible then something more fundamental is likely to be involved.

Many people tell of a difficult reality in which they are able to function well in some areas of their life – their work and professional life, for instance – while other areas of their life remain a struggle. In these other area, they may have experienced repeated disappointments.

The issue of repeated disappointment is an important element in psychotherapy. Over the years many ‘new’ therapies have been introduced. All claim to have discovered the secret of success within a time limit. However, many people’s experience of time limited therapies is that symptoms may be relieved for a period of time, but return at some point. A strong commitment from both client and therapist may be required if this tendency to lose progress is to be overcome. Freud was among the first to discover this. Although – perhaps thanks to Woody Allen – there is the belief that psychoanalysis is interminably long Freud’s early treatments were short. It was some time before he began to understand that this was often not going to be enough.

I undertake both time limited and open ended therapeutic work and am constantly coming up against this boundary, the question of what will be enough, or enough for now. For people who can ‘never get enough’ the question of how they might come to feel that it is possible to have ‘enough’ or come to find that not having ‘enough’ is not necessarily the end of the world, may become important therapeutic questions.

For some people a history of deprivation and repeated disappointments sours life and can undermine therapeutic effort, particularly if the therapist is not aware of this issue and is unable to help the client/patient to grasp this point. I have come to think that this is reflective of the developmental experience of repeated disappointment for people who were unable to find the support, strength and inner resources to overcome obstacles to development.


WHAT DOES ASSESSMENT MEAN?
There are significant differences between a person who is in the middle of a crisis who needs a space in which to think and a person facing a psychological difficulty within themselves which stops them from thinking and living constructively. The purpose of the initial assessment is to explore the nature and the degree of difficulty you bring. I work with people in short term crisis as well as with people who are facing significant psychological and emotional difficulties and with people who are using or have used NHS and other mental health services. Any initial assessment is also based on initial impressions and may be reviewed in time.


HOW DO I CHOOSE A THERAPIST?
The choice of a counsellor or psychotherapist must be yours. To repeat what I have said elsewhere, if you are consulting a practitioner you need to be as sure as you can be that the person you are seeing can:
1) work with the difficulty that you bring
and
2) that you feel sufficiently comfortable with that person to begin the work.
You need to approach your first meeting holding in mind that you will need to make as clear a choice as possible to proceed or not and be prepared to walk away if you are not satisfied. You may agree to continue to meet while still feeling unsure. This would not be unusual. You can search for a therapist by post code using the links on the ‘contacts’ page of this website.


HOW LONG WILL I NEED TO SEE A THERAPIST FOR?
I will only be able to express a view on what you present after I have talked this through with you.

You decide how long and how often you wish to see a therapist. I will need to make an initial assessment of the degree of difficulty you bring and will discuss this with you. I will, of course, be making a professional judgement as to how to work with you and the framework within which to work.
However, this will be discussed with you and your views will be taken account of. Initial assessments are often subject to revision as the process continues. We may agree a time limit or to review the process after a period of time or you may choose to work without any time limit.