Over the past few weeks we’ve been learning about three very different counselling theories – Person-centred counselling, Psychodynamic counselling and Cognitive Behavioural Therapy (CBT) – with very different methods, glossaries and philosophies that ultimately all work towards the same goal, which is helping people. They each offer a different language, and a different way of understanding our personality or self, our personal history, and our patterns of relating to others.
Person-centred sees the self as an abstract concept made up of two parts: how a person sees themselves in their mind, and how they actually exist in the physical world. A big difference in the two can result in incongruence, which can lead to a person behaving in problematic ways. Psychodynamic theory sees our personality being developed through the different psycho-sexual stages. Examining whether we are stuck in a particular stage can explain problematic aspects of our behaviour. CBT suggests that our personality is not set in stone, and that our “self” can be whatever we want it to be. We are in charge of how we react to situations, and have the power to acknowledge and overcome emotional outbursts. This would actually be quite useful in the Person-centred concept of incongruence – as learning CBT techniques to change negative thought patterns can result in a matching of a person’s inner world and outer reality, which would result in a more congruent way of being.
In terms of personal history, Person-centred theory explains that conditions of worth are formed in the past, as people repeat things that make them feel secure. Sometimes these things that make them feel secure and happy go against their own personal values, but they continue with the learned behaviours to continue feeling happy. This then becomes a condition of worth, of the client being dependent on someone else, essentially saying that “this person will only provide me with that happiness when I do this thing that I don’t really agree with, but I’ll do it because I want to stay happy”, which results in incongruence. The Psychodynamic approach places great importance on a person’s childhood, and that their personal history formed them as a person. It states that when this history is gently unpicked and examined, it can result in great personal change. In CBT, a person’s personal history is not looked into in great detail as it is very much based on changing the behaviours of the present and the future. The past can be looked into if only to explain why cognitive distortions manifested in the first place.
With regards to patterns of relating, Person-centred theory has a concept called the “locus of evaluation”. If a person has an external locus of evaluation, it means that they place more value in what others think of them than themselves. This could cause a person not feel courageous enough to be who they truly are. In Psychodynamic theory, a common pattern of relating is based around a person’s childhood and how they related to their parents. If a negative pattern was formed, it could be repeated later on in life when the impulses manifest in unwanted behaviours or fixations on certain activities, such as addiction or stealing things. In CBT, people can be seen as obstacles to tackle or challenges to overcome, but it’s important to note that CBT informs the client that not all people are the same. A common cognitive distortion is that because some people treated you in a particular way, everyone will – But in reality, not all people will treat you in the same manner.
I love how, in terms of language, I can really get a feel for each theory by the style of words they use. Person-centred theory uses words that evoke feelings, such as empathy, conditions of worth, and organismic. Psychodynamic theory on the other hand, uses exotic words like sublimation, introjection and regression, some of which may require a dictionary for the uninitiated. CBT uses scientific, modern sounding words like polarised, restructuring, and cognitive, which is quite fitting, as it is a modern interpretation of several older theories.
It’s interesting to compare the style of relationships between the counsellor and client in the three theories we have studied, as they are all wildly different. In a Person-centred relationship, the counsellor believes that the client is the expert on the subject of the client, and that they, the counsellor, are there as a catalyst for change. They are a self-improvement tool to be wielded by the client that facilitates personal growth. I feel that in Psychodynamic theory, the counsellor is the expert in interpreting what the client says and then relaying that back to them. The counsellor is a blank canvas for the client to reflect things off, or to project things onto – transference is an important part of the relationship in the Psychodynamic theory. The relationship in CBT is more akin to that of teacher and student than the other theories, with the counsellor setting homework, and quizzing the client every week on how they rate their feelings.
The overarching goals of each theory are essentially the same, but subtle in their nuances. The ultimate goal for all of them is for the client to feel better about themselves and for them to eliminate unwanted behaviours. The goal when it comes to Person-centred counselling is for self-actualisation. This is when the client truly knows who they are, they trust in themselves and their own judgement, and have a more congruent outlook on life. The goals for the Psychodynamic theory are to uncover the past, determine what psycho-sexual stage the client may be stuck on, and bring the unconscious processes and patterns into the conscious mind to be unravelled, explored and resolved. The goal in CBT is for the client to think in more productive and positive ways, and not to react so wildly to each emotion that comes along. The goal is for them to know that whatever situation they find themselves in, they can handle it.
From my own personal experience with CBT, I found it to be quite clinical and it revolved around measurable results. My CBT therapist was not a counsellor, and she made the distinction that what she was doing was not counselling several times – she was a Cognitive Behavioural Therapy practitioner – and she made sure I knew the distinction. It was a professional relationship, and she was friendly enough, but she was often cold and distant, and there were times I made a big disclosure that felt really hard to say, and a massive relief that I’d put them into words and got them out of my head, but she was writing notes and missed them – she was not present.
I found several of the exercises useful, but they were often forgotten in the heat of the moment. This has got better for me over time, I think because I’ve reflected on the times things did go wrong, even though I knew the “correct” way to approach the situation. A person-centred counsellor would not have missed my disclosures because they would have been present in the room and not making notes, and I think they would have made me feel more “acknowledged”, through their use of empathy and unconditional positive regard.
I’ve never had Psychodynamic counselling or Person-centred counselling, but I am thinking of having some soon. It is a requirement as I progress through my training to have regular counselling, and I am quite looking forward to it to be honest. I may start it sooner rather than later. I would like to experience a lot of different styles and theories of counselling from a wide range of counsellors – I think it would help greatly in relating what I am learning to my own self, more so than roleplays or just applying the theory to my own self-awareness.
