counselling practice

defence mechanisms

unconscious psychological strategies that the ego uses to manage internal conflict and reduce anxiety

what do defence mechanisms protect the individual from

emotional impact of:

unacceptable thoughts/desires

guilt or shame imposed by the superego

stressful realities in the external world

Unconscious

dreams of symbolic representation of unconscious needs, inner conflicts, unfulfilled wishes

Id-superego conflicts

slips of tongue, free association material, symbolic content of psychotic material. repressed material

preconscious

habits, denials, habitual repetitive patterns we are semi aware of

eros/libido- life instrinct

drive towards love, growth, survival, creativity

• seeks connection, meaning and bonding

• powered by libido- energy of vitality

• encourages unity, healing, transformation

thanatos- death instinct

• pull towards destruction, aggression, return to stillness/nonbieng

• seeks release from tension through return to nonbeing

• manifests in self sabotage, violence, apathy

  • opposes eros yet balances in psyche

structural model- 3 parts of personality

id

superego

ego

ID

ruled by pleasure principle. orignial system of personality at birth.

what does the id seek

seeks to reduce tension, avoid pain, gain pleasure. largely unconscious/ out of awarenss

Superego

ruled by moral principle- judicial part of personality

what does the suepr ego seek

aims to inhibit the id. idealistic and moral intentions. internalisation of parental and societal aism and values

ego

the reality principle. executive part of personality, regultes and governs personality. controls consciousness, checks and controls impulses from id. seat of rational intelligence. distinguishes between inner and outer reality of experience

pscyhsexual development

stages focus on satisfaction of sexual drives through erotogenic zones of body

fixation psychsexual stage caused by

deprivation/overindulgence

ego defence mechanisms purpose

normal behaviours to cope with anxeity.

help person moderate anxiety, adapt to feedback, learning, to develop

prevent ego from being overwhelmed by guilty, shame, anxiety

protect ego

prokection

attributing unacceptable behaviour to others

reaction formation

expressing the opposite

sublimation

diverting psychic energies into more acceptable channels

introjection

positive/negative: internalising values from parents/teachers/therapists

compensation

masking perceived weakness, making up for limitations in other areas ( focus on accomplishments)

denial

denial/distortion of reality, fear of ego overwhelm

repression

exclusion from awareness

rationalisation

finding reasons for explaining bruised ego

identificaiton

loss of personality identity

regression

reverting to an earlier life stage

displacement

shifting to a safer target

resistance

corner stone of psychoanalysis. uncomfortable feelings and thoughts rise to the surface/become conscious. resist self exploration because intensity is too great- therefore, use defences to avoid emotional intensity

what does resistance signal?

possibility that patient is unconsciously truing to avoid threatening thoughts and feelings. resistance signals the presence of buried material ( idea that early experiences shape later things)

goal of psychoanalysis therapy

• bring unconscious into conscious awarensss

• aim to recover repressed/unconscious thoughts, feelings and memories that influence present behaviour and emotional distress ( result of unresolved conflicts from early life experience)

  • facilitate emotional release ( catharsis)

goal of psychoanalysis therapy continued

• encourages the release of pent-up or repressed emotions to enable healing or psychological release

• promote insight and understanding

  • gaining self awareness about internal conflicts and defence mechanisms

insight for psychoanalysis

considered key for long term changes

• understand how past expereinces shape current struggles

• healing– increased insight into unconscious processes, weakening or transformation of defence mechanisms, emotions once avoided– acknowledged, tolerated, expressed etc.

• less burdened by shame or inner conflicts

role of therapist psychoanalysis

1. interpreter of unconscious

2. recogniser of defence mechanisms and patterns

3. helping client move from hidden plain—> conscious understanding—>emotional acceptance—>real life change—→ transforming client from inside out

therapeutic techniques psychoanalysis

• free association

• dream analysis

• transference

• counter-transference

• resistance

• interpretation

free association

facilitation of uncensored revelations of client’s thoughts and feelings

dream analysis

exploring the latent content of clients’ dreams

transference

working through of the clients’ personal reactions to the therapist

counter-transference

therapist’s processing of his/her reactions to the client

resistance

evidence of clients’ avoidance to develop

interpretation

therapist offering of deeper meanings and explanations to client revelations

transference

what is transferred to new situations from previous situations.

• the tendency for a person to base some perceptions and expectations in present day relationships on their earlier attachments, especially to parents, significant others, siblings.

what does transference mean for us?

we do not see others entirely objectively, but rather ‘transfer’ onto them qualities of other important figures from our earlier life

transference in therapy

therapeutic process magnifies transference phenomena to examine. psychoanalyst and patent create a relationship where all the patient’s transference experiences are brought into the psychoanalytic setting and can be understood

psychoanalysis diversified approaches

• object relations therapy

• attachment based psychotherapy

• inner child work

• adlerian therapy

• relational psychoanalysis

• neuropsychoanalysis

what does behaviourism say about people

1. strong emphasis on learning- everything you are and know is a resultof an experience

2. what matters to you is what you learn and how you are treated

3. sciencee

4. no clear differnece between species

5. all behaviour can be reduced to a simple stimulus response association

cognitive behavioural therapies

how we think (cognition), how we feel (emotion) and how we act (behaviour) all interact together

• our thoughts determine our behaviour

where do problems come from (CBT)?

• maladaptive or irrational beliefs

• cognitive distortions (thinking errors)

• negative core beleifs and schema

• avoidance and safety behaviours

• unhelpful behaviour patterns

rational emotive behavioural therapy

• developed by AlberT Ellis mid 1950s

what does REBT emphasise?

people’s emotional and behavioural problems stem from rigid, illogical and self-defeating beleifs, called irrational beleifs.

what do irrational beleifs arise from

a mix of biological, experiential and cultural factors and are maintained through habitual thinking and lack of critical examniation

rebt USES the ?

ABC

activating events

beleif

consequence

to explain how these beleifs lead to emotional disturbances

irrational beliefs .2

they constitute the major causes of emotional problems and maladaptive behaviours

main irrational beleifs

• need for approval

  • beleif: if i am not liked and approved by others, that is awful, im no good

  • impact: this belief can lead to anxiety ( maybe explanation for social anxiety)

• perfectionism

  • belief: if i dont always do good jobs, then i am worthless

  • impact: this belief often results in chronic stress, burnout, fear of failure

schemas

the unspoken rules or underlying core beliefs often learned through childhood experienes.

can be adaptive or maladaptive

what do schemas act as

filters: they filter out unwanted information so we can attend to that which we consider important

unhealthy schemas

prone to negative automatic thoughts or irrational beliefs

negative cognitive triad

biological and evolutionary perspectives- genetic predisposition and stress responses. these beliefs heighten impact of stressful/negative life events

negative thoughts—>trigger corresponding emotions—>behavioural response

ABC model

A: activating event

B: perception of the event guided by our rational/irrational beliefs

C: our belief determines the consequences

A does not cause C but is influenced by B

role of counsellor CBT

• educator: teach clients how thoughts/emotions/behaviours are connected

• collaborative empiricist:work with clients to test beliefs and assumptions–client becomes own therapist over time

• coach and skill trainer:develop coping strat

• structured facilitator:keeps sessions goal focused and time managed

• supportive and empathetic:recognises the importance of therapeutic relationship

how does cbt support change

• focus on present, not past

• therapist established link between maladaptive behaviour and client’s thoughts

• identify specific goals for change

• assist clients to restructure thoughts/schemas

• clients learn new functional self-statements, alternative interpretations, different perspectives

• emphasise the importance of therapist-client parternships–they work together to investigate the client’s thoughts and behaviours— new opportunities for diff types of interventions

therapeutic techniques cbt

• cognitive restructuring

• psychoeducation

• establish link between maladaptive behaviours and client’s automatic thought

  • thought monitoring:trace the stream of thought to identify core belief

• use socratic questioning to chllange and restructure thoughts and core beliefs

• exposure and response preventoin

• use of homework to apply learnings to real life

• client learns new self statement, alt interpretations, different perspectives

overarching hopes of CBT

• empowerment: gain insight into unhelpful behaviour adn behavioural pattners. become own therapist- independent, resilient, more in control of mental wellbeing

  • mental housekeeping: Sort through messy/unhelpful thoughts using CBT. Clear out mental junk draws– automatic beliefs that no longer serve us, so ppl can live and think more clearly

  • gardening: Identify and pull out weeds [ negative thoughts and behaviour] and nurturing healthy plants [ positive thoughts and adaptive behaviours]

wave 3: behaviourisms

• acceptance and commitment therapy

• dialectical behaviour therapy

• mindfulness-based cognitive therapy

• functional analytical therapy

• more

what does 3rd wave behaviourism question?

Questions The Assumption of Healthy Normality

• High rates of divorce, sexual concerns, abuse, violence, bullying, prejudice, loneliness

• Psychological problems are maintained by excessive avoidance of painful experiences (thoughts, feelings, memories, etc)

how do problems arise 3rd wave behaviourism?

 Difficulties occur due to a “narrowing behavioural repertoire” that is gradually created due to unhelpful strategies to cope with thoughts and emotions.

• Lack of Psychological Flexibility

• Cognitive Fusion – being ‘tangled’ in our thoughts and beliefs, and responding to the world according to these.

• The thought and the person thinking the thought become one, so the situation feels real, rather than being based in language.

• Experiential Avoidance – when the pain brought on by thinking is avoided or suppressed.

• Escaping private events, feelings, and sensations.

how does 3rd behaviourism support change

goal of ACT is to increase psychological flexibility

how does ACT increase psychlogical flexibility

• Using acceptance & mindfulness processes to develop more flexible patterns of responding to psychological problems

• Reduce the impact of thoughts and self stories on behaviour

• Help the client be in contact with their actual experiences

• Increase the frequency of value-based behaviour

In ACT, there is no goal of symptom reduction. Symptom reduction frequently happens, but it is simply a fortuitous by- product, not a goal. (Boorman, Morries & Oliver, 2017)

 

psychological flexibility/therpeutic process of ACT

• attention to the present moment

• acceptance

• values

• committed action

• self-as-context

• defusion

defusion

create distance from thoughts to help shape and guide behaviour

acceptance

accept what is there without defence or judgement

contacting the present moment

use of mindfulness and other techniques

values

clarifying with clients what is really important for them- then evaluate if behaviours align

committed action

engage in behaviour change strategies to support them to take value based action

therapeutic techniques cont

• psychoeducation

• mindfulness

• cogntive defuion (leaves on stream, cloud in sky)

• defusion techniques ( notice im having the thought)

• values exercises

• contact with present moment (grounding activities)

• journalling

• struggle switch

negative automatic thoughts

• selective abstraction

• magnification and minimisation

• labelling and mislabelling

• dichotomous or black/white thinking

• emotional reasoning

• arbitrary inferences

• mental filtering/focusing on the negative

• catastrophising

• overgeneralisation

• personalisation

• mind-reading

• fortune telling

selective abstraction

focusing on single detail in a situation while ignoring other more relevant aspects – eg getting praise for work, but focus on small piece of criticism and conclude we are failing

magnification and minimisation

events are over exaggerated/downplayed and dismissed

eg– make a mistake at work- this is disaster- when we complete big project- no big deal anyone could do that

dichotomous or black/white thinking

always/never rather than someones

• i missed gym sesh

• exercise goal ruised

emotional reasoning

assume our emotions represent the way things actually are

• if i feel boring i must be boring

arbitrary inferences

draw conclusion about events without sufficient evidence- when we run late to meeting assume peers think we are irresponsible

labelling and mislabelling

when we attach a negative label to ourselves or someone else- rather than acknowledging it as a single event- im a failure

mental filtering

more general than selective abstraction

focusing on the negative

eg- when reviewing lecture, notice bored students, remember tech glitches

catastrophising

imagining the worst possible thing is going to happen and you wont be able to cope

• ill fail exam, kicked out of course, parents disown me

overgeneralisation

holding extreme beleifs on the basis of a single incident

eg one bad date= you are a terrible date who will never find love

personalisation

relating external events to ourselves even when no basis for connections

• partner is upset, i must have done something

mind reading

more specific form of arbitrary inferences

assuming we know what others are thinking about us

eg all making fun of me

fortune telling

when we predict things will turn out bad, the future is set in stone and negative

eg. i just know im going to fail my exam

what is a framework

• A coherent statement of the ideas, principles and beliefs that guide our action in counselling practice

• A tool to assist our reflection and to ensure that what we do in therapy matches our stated theoretical, and philosophical positions

• A tool to assist coherence and ethical integrity in counselling practice

• A statement that supports us to articulate to both ourselves and others what we are doing in therapy and why?

 

 

values in practice- proctor 2014

 

• Idea that every decision we make is underpinned by what we value in life: every action and inaction

• Our values shape everything we do; they underpin human agency, choice and autonomy

• Values are inescapable and inherent in our behaviour and everyday decisions

 

Modernist assumptions ; Hansen, 2004:132

 

1. Clients are able to accurately acknowledge what they are experiencing

2. These experiences can be communicated to the counsellor through language.

3. Through language, counsellors can gain an accurate understanding of the experience their client is conveying

4. Counsellor can then draw on universal law of human functioning (counselling theory) to impart a corrective or healing intervention.

5. Clients, like all people have a relatively stable psychological core or personality. Changes to personal psychology will generalize to situations outside of counselling.

Constructed reality and fundamental reality- Bacon, 2019

• Constructed – what is invented – gender roles, beauty ideals

• Fundamental – what is discovered – water boils at 100 degrees

• Constructed – mimics fundamental – romantic loves feels as real as the fact that bridges need x amount of support to stay up

• Both feel equally solid & real – Constructed reality is not false reality – both real and unreal

• What this means for us?

existentialism : what it says about people

• he significance of our existence is never fixed once and for all – we continually recreate ourselves.

 

• Humans are in a constant state of transition, emerging, evolving and becoming.

 

• Being human – discovering and making sense of our existence – continuously questioning ourselves, others and the world.

 

• Continuously questioning – Who am I? Who have I been? Whom can I become? Where am I going?

 

how does existential therapy see people

People - beings who are self-aware, capable of choice, and responsible for creating meaning in their lives.

We are not just products of biology or environment; we exist in relationship with ourselves, others, and the world.

 

mitwelt

our social world: relationships, community and cultural context shape who we are. are you living an authentic life? conforming to what others want or honouring whats important to us?

umwelt

physical world: we are embodied beings, bound by nature, biological and physical reality. limitations are present- age, sickness. grounds us in reality- how does this influence who we are

eigenwelt

our inner world: the personal, subjective experience of being ourselves, including our thoughts, feelings, and self reflection. they are all at play within us, if they arent respected etc, this is where isolation etc occurs

problems existentialism

problems often rooted in the givens of existence and the universal realities we face. when they are avoided, denied or create conflict, distress can result

problems

• meaninglessness: struggling to find purpose can leave people feeling lost, aimless, hopeless

• death: awareness of our morality can trigger anxiety, avoidance or a clinging to security

• isolation: even in relationships, there is an existential aloneness; avoiding this awareness can hinder authentic connection

• freedom: the responsibility that comes with freedom can feel overwhelming, leading to avoidance, indecision, or surrendering control to others

meaninglessness

heart of theory is that our primary driveis to search for meaning, even in situations of extreme suffering. the posisbility of finding meaning gives life purpose adn direction.

1. life experience and loss

2. the will to meaning

3. meaning in suffering

4. humour and perspective

5. the existential vacuum

existential vacuum

a state marked by emptiness, apathy, confusion, and despair. left unresolved, this vacuum can lead to anxiety, depression and destructive behaviours. often when life feels devoid of meaning