Counselling and its limitations
The British Association for Counselling and Psychotherapy (BACP) defines counselling as “helping you explore your thoughts, feelings and behaviours so you can develop a better understanding of yourself and of others. A counsellor will not give you their opinions or advice or prescribe medication. They will help you find your own solutions – whether that’s making effective changes in your life or finding ways of coping with your problems.”
The BACP doesn’t mention how you might actually achieve change through therapy, so what happens once counselling has helped you to understand yourself better? Does insight in itself bring about change in your problems? Is insight enough to ensure that your life improves? Counsellors are specifically trained not to give you their opinions about what you should do, not to give you advice and not to suggest solutions, so what needs to happen if you get stuck? How are you going to bridge the gap between insight and taking action to make things better, without professional advice or guidance?
The purpose of therapy is change
No kind of therapy can turn you into a different person but it can help you to be happier as the person you are. That is not a message of despair, it’s simply that you cannot undo your own history. You will always be the child of your parents, always have had the past experiences you have lived through, always have spent part of your life thinking and believing the things which may have led you into difficulty and shaping the person you are.
None of that background can be wished away, forgotten or undone. You cannot make your past disappear but counselling can help you find better ways of thinking and feeling about it. That may be enough for you, but finding better ways of understanding your past may not be enough if more than insight is needed to improve your life in the future. It may not be enough to simply understand yourself better. You may need something more to help you find ways that work better for you and that will mean something more than counselling.
How you can change through therapy
Counselling assumes that you will be able to use the insights from therapy to find your own solutions to your difficulties, rather than having your counsellor’s ideas imposed on you. It’s a laudable principle because, after all, your counsellor may have unhelpful or even crazy ideas about what would be best for you and push them at you. You don’t want to adopt your counsellor’s crazy ideas.
Deliberately avoiding giving you guidance to achieve change through therapy is a also fundamental weakness in traditional psychotherapy as well as in counselling. For those whose circumstances are such that they can find solutions for themselves, it’s great to be given the control and autonomy that counselling and traditional psychotherapy offer. Many people, though, can find themselves stuck, either because their circumstances make change seem overwhelmingly difficult, or because they don’t have a clear idea about how things can be better, what changes would help, what might suit them or how they might do things differently.
The failure of many his patients, and those of his colleagues, to achieve change through psychotherapy is exactly what inspired Aaron Beck to invent cognitive behaviour therapy (CBT). Professor Beck was originally a traditional psychotherapist, wedded to the idea of therapy being undirected. However, after many years he realised that many of his patients got stuck. He saw patients of colleagues who had had years of therapy and gained much insight but were not making progress to actually change. They often became therapy addicts, attending regularly for years and repeatedly going over the same ground in discussing their past, but not making the changes through therapy that would have enabled them to be discharged.
Cognitive behaviour therapy
His solution was to agree goals with his patients, towards which change through therapy was then aimed. He realised that insight, rather than being simply enough and a ‘good thing’ whatever it related to, needed to be targeted at the thoughts and beliefs that blocked patients’ progress towards change through therapy. The focus of CBT is on the problems that obstruct progress to solutions so that patients are helped to make the changes that will improve their lives. The CBT therapist doesn’t tell you what change you should make but does help you to achieve the changes you want to make.
An example
To take a specific and narrow example, simply to illustrate what this means, let’s imagine a patient who has a tendency to be excessively keen to please others. Counselling would help them to understand the origins of this tendency but won’t teach the patient how to stop their people-pleasing.
A CBT therapist would start demonstrating and teaching the patient the skills and techniques that would help them to change, instead leaving it to the patient to discover how to do it for themselves. CBT has well established and proven methods for overcoming such problems and making successful change. The CBT therapist would invite the patient to set their goals for change and then teach techniques for achieving them.
CBT has been shown to be very effective in helping to bring about change
Part of CBT, as with counselling or traditional psychotherapy, involves exploration and understanding of childhood experiences or other life events that have shaped the patient’s behaviour but the focus will be on identifying the pattern of thoughts and beliefs that cause the problems the patient actually has. Unlike a counsellor or traditional psychotherapist the CBT therapist will suggest and teach skills and methods which test and change those thoughts and beliefs, leading to a more balanced and satisfying pattern of relationships.
Although insight is still important, CBT, unlike counselling, is focused on change through therapy and its development has revolutionised the effectiveness of psychological treatment.
How Become Yourself will help you to change
We will always adapt our approach to suit the unique needs of each client, couple or family, whether it is counselling, CBT or some other approach. We will start by helping you to clarify, for us and for yourself, what you are seeking and what you need to change in your life. Insight and understanding of the problem are a prelude to deciding the goals of therapy, the changes that will be the focus and how best to achieve them.
Once our discussion makes it clear to you what you want your goals to be, we will help you to explore in practical terms the best solutions and explain how to get there. We will support you to work towards those solutions using whatever skills are needed.
Having a therapist who is focused on helping you to find solutions and change through therapy, rather than simply explore and revisit your difficulties, is crucial to bringing about actual improvement in your life.
