I offer a number of therapeutic strategies to assist you. Depending on what it is you want from counselling, I can simply listen to you, or we can problem solve together and find strategies which work for you to change problematic situations into empowered ones, such as Cognitive Behavioural Therapy (CBT). If you have experienced trauma then I can offer trauma informed therapies which include calming of body and mind with a strong emphasis on emotional safety before any strategies are discussed to treat any traumatic memories. Some of these therapies include talk therapy, Eye Movement Desensitisation and Reprocessing (EMDR) and Breathwork.
So what is 'Counselling' really? It can be many things, which is why it is so important to have some idea of what you want to get from going to a Counsellor. As I have a Person Centred philosophy, counselling means sitting with someone without judgement; with as much understanding and empathy as possible, and having an open and honest therapeutic relationship together. Here's what a Counselling journey with me may look like, based on a series of counselling sessions of 1 hour duration each:
Initial session: Getting to know each other, sorting out preliminary details and counselling agreement. Finding out the main issue or issues which have brought you into the session, and also what the aims of Counselling are for you.
Subsequent sessions: Listening to you, asking pertinent questions regarding the past, the present and future possibilities. Regular check-ins occur which checks if the Counselling is reaching your expectations and we are on the right track. If not, changes are made to make sure you are satisfied. This is one of the most crucial aspects of our therapeutic relationship and involves openness, transparency and honesty from both parties. Also asking what may be uncomfortable questions to assist reflection on your or other's behaviour. When clarity is achieved around the issue(s), what can be done to change things, if this is what you wish.
Final session: Working towards cessation of counselling is part of the counselling process, and does not happen until you feel ready. This session will recap on what has been worked through and what realisations and insights may have occurred. Any action plans will be recapped, and the invitation to return for a refresher as necessary will be extended.
Cognitive Behavioural Therapy
Cognitive behavioural therapy (CBT) is a form of psychological treatment that is effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness. Research has shown that CBT can lead to significant improvement in functioning and quality of life, as it targets people changing their behaviour instead of continuing on in the same old (unhelpful) ways.
CBT has an emphasis on helping you to become you own therapist, as this structured treatment uses exercises in the session as well as “homework” exercises outside of sessions. This process experiments with and tests what behaviours work for you or not, in addition to your coping skills and how your thinking, emotions and behaviour affect each situation you find yourself in.
In a 1 hour CBT therapy session, we emphasise what is going on in your current life, rather than what has led up to your difficulties. A certain amount of information about your history is needed, but the focus is primarily on moving forward in time to develop more effective ways of coping with life.
Each subsequent 1 hour of CBT treatment usually involves strategies to change habitual thinking patterns. These strategies might include:
- Learning to recognise any distortions in thinking that are creating problems, and then to re-evaluate them in light of reality. This involves me questioning habitual thinking such as "I am no good at relationships" and getting you to look at what relationships you have which work for you, and then we investigate together to find out how and why they work.
- Gaining a better understanding of the behaviour and motivation of others.
- Using new problem solving skills to cope with difficult situations.
- Facing your fears instead of avoiding them.
- Using role play to prepare for potentially problematic situations.
- Learning to calm your mind and relax your body.
- Developing a sense of confidence in your abilities by trying out new ways of behaving in between sessions.
Eye Movement Desensitisation and Reprocessing (EMDR) therapy is another psychotherapy technique also used to relieve psychological stress. It is an effective treatment for trauma and Post Traumatic Stress Disorder (PTSD). During EMDR therapy sessions, you process past traumatic events in brief doses whilst the therapist directs your eye movements. Interestingly, the distressing emotions usually triggered by recalling these events do not occur during EMDR due to your attention being diverted. This allows you to be exposed to the memories or thoughts without having a strong psychological or physical response.
Over time, this technique is believed to lessen the impact that the memories or thoughts have on you. People who are dealing with traumatic memories and those who have PTSD are thought to benefit the most from EMDR therapy.
It’s thought to be particularly effective for those who struggle to talk about their past experiences.
EMDR therapy can be used to treat:
- Panic attacks
- Eating disorders
EMDR therapy is broken down into eight different phases, so you will need to attend multiple sessions. Treatment usually takes up to or more than 12 separate 1.5 hour sessions.
Phase 1: History and treatment planning
I would commence a typical initial counselling session to review your history and decide where you are in the treatment process. This evaluation phase can include talking about your trauma and identifying potential traumatic memories to treat specifically, or if you are not ready for this we would commence with Phase 2 and then discuss your trauma story when you feel safe enough to do so.
Phase 2: Preparation
I will work with you so you learn several different ways to cope with the emotional or psychological stress you’re experiencing. Stress management techniques such as deep breathing, mindfulness and grounding techniques if dissociation occurs may be used. When you have a number of strategies you are happy with which you can use at home we move into the third phase.
Phase 3: Assessment
During the third phase of EMDR treatment, we will discuss your trauma story and you will identify the specific memories that will be targeted to commence the EMDR treatment.
Phases 4-7: Treatment
I will then begin using EMDR therapy techniques to treat your targeted memories. During these sessions, you will be asked to focus on a negative thought, memory, or image whilst you are guided to do specific eye movements. After each bilateral eye stimulation I will ask you to identify the word which you have in your mind and to hold on to this word or concept as we begin again. This continues until there are no more identifiable word associated memories for this story. We then reframe the memory to a preferred positive cognition (thought) and finally you scan your body to see if there are any residual stressors left with this positive cognition. If so we continue. If we run out of time, containment strategies, which have been taught at the beginning, are used to hold you safe until the next session when we recommence the story until there is no longer any residual stress held over this story.
Usually, in a remarkably short space of time, the distress over particular thoughts, images, and memories start to fade.
Phase 8: Evaluation
In the final phase, we will evaluate your progress after these sessions.
EMDR therapy is considered to be a safe and effective therapy for clients who have experienced trauma. There is however the possibility of some side effects with this therapy which you would need to consider prior to treatment.
EMDR therapy can cause a heightened awareness of thinking which does not end immediately when a session does. This may cause light-headedness, or vivid, realistic dreams. It often takes several sessions to treat PTSD with EMDR therapy. This means that it doesn’t work overnight. Therefore the beginning of therapy may be triggering to people starting to deal with traumatic events specifically because of the heightened focus. This is why I spend time at the beginning on grounding and containment strategies which are necessary should you become triggered whilst not in therapy and need to practice self containment.
Breathwork is a body focussed treatment which is simple in its essence. Usually you are lying down (on my massage table for instance) or you could sit on the couch, and commence what is known as continuous connected breathing. This is simply repeatedly taking relaxed deep breaths which reach your stomach and sternum. Because we hold emotions and stress in our tissues this breathing helps us process these feelings and let them out. Getting these feelings out of our bodies helps us to also get them out of our minds. Typically after a cathartic breathwork session you will feel calm and emptied of emotion, similar to after having a good cry. Because the breathing is slow and I coach you as you go, hyperventilation should never be a problem. As in talk therapy Counselling, I am by your side at all times partnering you in your breathwork journey so that you are safe and supported. A typical breathwork session lasts 1.5 - 2 hours and looks like this:
- We discuss any subject which is causing you concern and what you would like to focus on in your breathwork session. A bond of trust and empathy is made before you start as this is essential to you feeling safe enough to breathe and let go.
- The breathwork session begins and you may experience a variety of emotions as you journey through your breath. I stay with you every moment and check in with you regularly as I coach you to continue your continuous connected breathing. We journey together until your body has done its work and you reach a place of serenity.
- We finish our session by sitting with a drink of water or hot drink while you debrief your feelings and breathwork journey.
I feel this is an effective way to process stress and assist in longer term relaxation. Additional interventions to augment breathwork are mindfulness and meditation to gain feelings of calm and peace when you are at home. Group breathwork sessions may be facilitated if you have enough people who are interested in trying this therapy.
Because I have been an Occupational Therapist for more than 20 years, I have a functional solution focussed and goal oriented philosophy underpinning my counselling work. To switch from Counselling to Coaching requires a slight change of perspective to an action oriented approach. Coaching may be used to assist with everything in life from bringing up babies, workplace assertiveness or career planning, managing relationships or older adult lifestyle planning. The list is endless. In essence, coaching is joining with someone to guide you to become more empowered and improve your current situation by working together on your identified goals. Coaching is a step by step process and includes the following:
- Identify, clarify and create a vision for what it is you wish to do
- This is a journey of self-discovery and growth
- Collaborate on a plan of action based on what fits best with your goals, lifestyle, budget, personality and vision
- You are made accountable due to the deadlines and timelines you set for creating change.
- Follow up sessions are scheduled periodically to check in, ensuring that plans are effective and if anything has changed. If so, plans can be tweaked or new plans made.