THEORETICAL ORIENTATIONS

Intergrative Psychotherapy

This approach most represents my overall approach and really intergrates some of the main approaches that I have mentioned below. Integrative Psychotherapy takes into account many views of human functioning. The psychodynamic, client-centered, behaviorist, cognitive, family therapy, Gestalt therapy, body-psychotherapies, object relations theories, psychoanalytic self psychology, and transactional analysis approaches are all considered within a dynamic systems perspective. Each provides a partial explanation of behavior and each is enhanced when selectively integrated with other aspects of the therapist's approach. The psychotherapy interventions used in Integrative Psychotherapy are based on developmental research and theories describing the self-protective defenses used when there are interruptions in normal development. The skills of attunement, and inquiry are central to this approach. The development of the relationship between client and therapist is of utmost importance in this approach.

The aim of an integrative psychotherapy is to facilitate wholeness such that the quality of the person's being and functioning in the intrapsychic, interpersonal and sociopolitical space is maximized with due regard for each individual's own personal limits and external constraints.

Within this framework it is recognized that integration is a process to which therapists also need to commit themselves. Thus, there is a focus on the personal integration of therapists. However, although a focus on personal growth in the therapist is essential, there needs also to be a commitment to the pursuit of knowledge in the area of psychotherapy and its related fields. There is a particular ethical obligation on integrative psychotherapists to dialogue with colleagues of diverse orientations and to remain informed of developments in the field.

Gestalt

I was first trained as a Gestalt psychotherapist and this approach forms the basis of my practice. Gestalt psychotherapy highlights self- awareness, personal responsibility, and genuine contact. Unfinished business is a concept in Gestalt that refers to those things that linger unexpressed in our present experience. These are feelings such as resentment, rage, pain, shame and abandonment that are linked to past situations. From this perspective, I bring attention to how the person is experiencing himself or herself in the present moment, and often exaggerate the experience to enable people to become more aware of their experience.

Unfinished business interferes with a person's present experience in a number of ways, such as, over-thinking, projecting their experience on to others, operating from shoulds, merging with other people's experience, and turning against themselves. These interruptions get in the way of genuine connection with others, and are the kind of personal processes that lead us to feeling alienated.

The focus of therapy is firstly to explore and become aware of the ways we interrupt our experience. As we gain awareness we will encounter our unfinished business that needs to be expressed. Often this will lead us to deal with past issues that are still affecting us.

It is through our senses that we experience the world, but people often try and make sense of their experience by analyzing, intellectualizing, and justifying their experience. This will lead to self-doubt. This is not to say that thinking is wrong, there is a place in therapy to think about the experience and integrate that into our self knowledge, but 'how' we think about things is part of the focus of therapy. With greater awareness a person will have greater choice and responsibility over their lives. As we reclaim aspects of our self that we had disowned due to shame we can experience more freedom to be who we are.

Psychodynamic

I have been influenced by the theory known as object-relations. From this perspective the transference issues that emerge in the relationship between therapist and client are an important aspect to the therapy. Paying attention to how a person may be recreating early experiences in therapy and in their life, gives valuable information on what unfinished business needs to be worked through. It is from this perspective I will often give interpretations and provide understanding of early experiences as they emerge in a person's process.

This approach identifies the relationship between our thoughts and behavior, and focuses on our thoughts as the object of change. The idea being if we can change our thinking the way we feel and react will change. I certainly believe there is some merit to this and work with people at various times on addressing the way they perceive themselves or a situation. This can be particularly evident with people struggling with depression, self-esteem, anxiety and perfectionism.

However, I tend to use this approach in conjunction with other frameworks. Especially where in depth work is required, for eg when working through trauma, grief, and unfinished business, attention to the emotional aspects of an experience and developing self-awareness are just as important.

EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is an information processing therapy. It has been found to be helpful for people who are dealing with trauma, as a way of processing upsetting material.

EMDR is not for everyone. The therapist first has to do an assessment to make sure that the client has good coping skills to deal with the emotionnal distress that can arise in the process. If they need to develop these skills then therapy would initially focus on stabalization.

The process involves the client focusing on a mental picture representing the distressing memory. At the same time identifying cognitions and emotions associated with the memory. As he/she gives attention to these different aspects they will be instructed to also give attention to outside stimulation in the form of eye movements, tapping or auditory sounds. This is repeated many times with the client noticing what emerges each time, until the client reports no distress associated with the memory.

I usually use this approach as part of in depth psychotherapy as a way of processing traumatic material, in addition to the other approaches outlined above. There have been a number of occassions where I have used EMDR for specific sessions on a short term basis with issues such as being afraid to drive after an accident, other specific phobias and single incident trauma.