How can psychotherapy help?

Psychotherapy is usually about dealing with deeper issues than counselling. If you can’t quite put your finger on the problem, but somehow your life seems to be a mess, or you don’t feel good about yourself, or you keep having problems with relationships, then you may find psychotherapy helpful.

For many people the word “psychotherapy” conjures up an image of lying on a couch talking about your childhood. What I mean by psychotherapy is something different, more like a normal friendly conversation; we will talk about things you remember from the past, but we’ll also talk about what’s happening in the present and also what you want for the future. Two approaches to psychotherapy that I find particularly helpful (and very compatible with each other) are attachment theory and self-relations therapy.

Attachment theory

Attachment theory was developed by John Bowlby in the 1970s on the basis of his observations of how babies and young children “attach” themselves to their mother (or main carer), trying to keep close to her and becoming upset when she is not around. He noted that children who were secure in their relationship with their main carer grew up to be more confident and better adjusted than those who were insecure or anxious.

Subsequent research has largely confirmed Bowlby’s observations that early attachment patterns have a big influence on our relationships later in life. And recent advances in neuroscience have also demonstrated that our early attachment experiences are where we learn how to regulate our feelings and emotions.

What all this means for psychotherapy is that there are often patterns of relationships and emotions that run very deep in our lives, and attachment theory can help identify these patterns and so start to change them.

Self-relations therapy

“To have good self-esteem is to have internalised a two-person relationship in which one bit of the self feels good about another” (Jeremy Holmes). Self-relations psychotherapy, developed by Stephen Gilligan in the 1990s, is based on the concept that relationship is the basic psychological unit, and that each of us has a “cognitive self” and a “somatic self” which are in relationship with each other.

In order for this relationship to work well, the somatic self needs to have received “positive sponsorship” (commonly known as love!) from parents, teachers and others. This positive sponsorship is then internalised in the relationship between the cognitive self and the somatic self (as described in the quote above). Unfortunately many of us receive “negative sponsorship” (blame and criticism) which leads to disconnection from our somatic self.

The role of psychotherapy is then to identify neglected and disconnected parts of ourselves, and to help develop positive sponsorship for these neglected parts, so re-connecting the cognitive and somatic self. And if this sounds rather technical, it’s all summed up in the title of Stephen Gilligan’s book, “The Courage to Love”.

What does this mean in practice?

Counselling and psychotherapy aren’t mutually exclusive; you may come for counselling about a specific issue, and then find there are also some deeper problems that you want to work on. Or you may come for psychotherapy with some problems which seem quite deep, and decide after a couple of sessions that in fact you have a specific goal related to just one issue.

Working with deeper problems tends to take longer, and to involve working more with the emotions, but you can still expect to start seeing some improvements after just a few sessions. And eventually this kind of work can enable you to experience a whole new quality of life.

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