My Approach to Psychotherapy

My academic background is in the social sciences and, as a psychologist and a psychotherapist, I take a pragmatic approach to the different schools of psychotherapy. I am happy to discuss theory with clients and make reference to it in sessions. I have studied three schools of psychotherapy in depth at a master’s or postgraduate level: psychodynamic, constructivist, and Gestalt therapy. Below I briefly outline these theories of psychotherapy. For info on Mindfulness see the next page. 

As a psychotherapist, I base my practice on psychodynamic psychotherapy which is also known as psychoanalytic psychotherapy. This is one of the most widely practised forms of psychotherapy in the world and is used in public and private healthcare systems across Europe and the Americas. From my point of view, it’s the most elaborate and complete school of psychotherapy. According to psychodynamic theory, psychological ‘conflict’ is an unavoidable part of daily life for all of us. We judge how we act and feel, how others appear to act and feel, we have parallel contradictory feelings towards ourselves and others and situations... and so on. These tensions are not always fully apparent to us, and can result in anguish and other uncomfortable emotional states. Our natural inclination is to avoid discomfort, so we develop ‘defence mechanisms’ which sometimes actually serve to exacerbate the problem. We can end up feeling stuck in the same emotional patterns...

In this form of therapy, the person is aided in accurately identifying and exploring the dynamics which cause them difficulty. As these are recognised consciously, the way the person relates to the difficulty changes along with the negative knock on effects of attempts to avoid the original unwanted feelings. The result is an increased sense of freedom from the initial concern and a enhanced capacity to process and change or accept these situations. In this way emotional patterns which cause difficulty can transform and dissipate. Read a little more on some core concepts in psychodynamic therapy here.

 

Psychoanalytic or psychodynamic psychotherapy has its origins in the work of Sigmund Freud (1856-1939). However, psychoanalytic psychotherapy as practised in public health systems and private practices across the world today, has evolved significantly since its roots in Freudian psychoanalysis. It has become a thoroughly contemporary, pragmatic, and versatile approach to therapy. Psychoanalytic psychotherapy is now adapted to many settings and is used in brief-focused and longer term therapy.

 

There are many well-known theorists associated with the psychoanalytic or psychodynamic approach to therapy. One of the most important figures for me is Donald Winnicott (England 1896-1971). Winnicott argued that the nature of anguish without words is an experience of general and unbounded suffering. By adequately putting words to our difficulties, he argued, that we transform these and effectively limit or 'contain' them so that they no longer overwhelm us. The analogy he used is of the parent reassuring the small child - the child experiences total anguish and cries uncertain what is wrong or if the discomfort will ever end or even get worse and worse until it is intolerable. The carer comes to help the child and checks what the problem is and accurately identifies the source of the suffering e.g. 'don't worry, you're just hungry' etc. For an adult then, Winnicott would suggest that when we are able to accurately identify and elaborate our fear or worry through language, we are able to transform it and make it less threatening. Essentially, we are acting as our own carer by limiting our own anguish through words. This principal serves as a general metaphor for the purpose of talking based psychotherapy: a fear or a need with a name is already far better than nameless, nebulous uncertainty. And from this transformative first step we can then work towards satisfying the need or seeking appropriate comfort.

Constructivist therapy starts from the idea that each of us has a unique and highly personalised set of beliefs or ‘constructs’ about self, others; and reality. When we encounter difficulty, constructivist therapy aims to help by facilitating a detailed examination of the beliefs or ‘constructs’ surrounding the problematic aspect of our experience. Through close attention to the content of our beliefs we become aware that we had taken many things for granted and that there are other ways to see and experience the same situations. This insight leads to a more flexible and adaptive way of relating to difficulty. The constructivist approach emphasises that we are not passive to the messages and roles assigned to us by society and our upbringing. We are, instead, active agents in constructing our own identity and our own sense of reality. It is not only psychologists and psychotherapists who have used this approach to the social world but also theorists outside of psychology - across the social sciences and beyond in education and politics. George Kelly (USA 1905-1967) is probably the best known psychologist and psychotherapist associated with the constructivist approach to therapy. Read a little more on Constructivist therapy here. 

 

Gestalt therapy is one of several psychotherapies from the Humanist perspective. Humanist therapies share the idea that the person already possesses all of the innate capacities to lead a fulfilling life. The work of therapy is to accompany the person in (re)connecting with these deeper personal resources. From this base the person can live a life which is more congruent with his or her own values and needs, rather than those which may have been imposed from the outside over the course of their life. Gestalt therapy particularly emphasises responsibility to self and others i.e. connecting with ones own needs and values is not a path to self-centred living, but rather a base from which we can better negotiate our own needs along with those of others. Sometimes this will involve compromise, but from a position of conscious awareness and positive choice, rather than a position of submission or dominance. Another key concept in Gestalt theory is about perspective: through focus and attention pre-existing answers, resources, and alternative ways of being will emerge and become apparent to us. This approach is especially relevant for those who feel that they have somehow lost their way, as it suggests a path towards re-discovering our own motivations and needs so that these may act as a trustworthy guide. Fritz Perls, a psychiatrist and psychotherapist (Germany, South Africa, USA 1893-1970), is the founder of Gestalt therapy. Read a little more on core concepts in Gestalt therapy here. 

 

To conclude, the three approaches to therapy described here are based on different models of the person and resultant different methods to aid with life difficulties. Nevertheless, it will also be clear that they also share a lot of basic assumptions, as do all of the other major approaches to psychotherapy. After all, these are all attempts to approach the same subject: people and their difficulties. What is universal to talking-based psychotherapies is the principal that exploring personal concerns through language in a structured and consistent manner is therapeutic and leads to change and acceptance.

Below are photos of the theorists mentioned here, hover over the photos to see who's who...

Sean Cockburn English Speaking Psychotherapist in Barcelona
Freud | Psychologist Barcelona | Sean BCN Therapy
Winnicott | Therapy Barcelona | Sean BCN Therapy
Kelly | Constructivist Psychologist Barcelona | Sean BCN Therapy
Perls | English Speaking Therapist Barcelona | Sean BCN Therapy