My approach to psychotherapy

My work today is predominantly psychoanalytic, developed through more than fifteen years of training and clinical practice in experiential, embodied and psychoanalytic psychotherapy.

There has been a consistent thread throughout this development: an interest in aspects of ourselves that are not immediately available to conscious thought, but which nevertheless shape how we feel, relate to others and experience the world. My earlier training taught me to attend closely to unconscious patterns expressed through language, imagery and the body. Psychoanalytic training has deepened this considerably through its attention to unconscious conflict and phantasy, early relationships, transference and countertransference, and to what emerges within the relationship between therapist and patient.

These are distinct therapeutic traditions and I do not simply combine their techniques. Psychoanalytic thinking now provides the principal framework for my work, while my earlier experiential and embodied training continues to inform my sensitivity to bodily experience, non-verbal communication and experiences which may be felt or enacted before they can be put into words.

Psychoanalytic Psychotherapy

Psychoanalytic psychotherapy is the principal approach I use in my practice. It is concerned not only with the difficulties or symptoms that bring someone to therapy, but with the unconscious meanings, conflicts and patterns of relationship that may underlie them. Experiences from our earliest relationships can become part of our internal world, shaping how we experience ourselves and other people in ways that are often outside conscious awareness.

The work involves listening closely to what emerges through thoughts, feelings, memories, dreams and associations, but also to what may be communicated less directly: through silences, repetitions, contradictions, bodily experience and the emotional atmosphere that develops between us. The therapeutic relationship itself becomes an important part of the work, as longstanding expectations and ways of relating may gradually become perceptible within it.

This kind of psychotherapy is not primarily about giving advice or techniques for removing symptoms. Symptoms can themselves have psychological meaning. Together we try to understand what may lie beneath them and gradually develop a greater capacity to recognise, tolerate and think about emotional experience. This can sometimes be difficult or painful work, but it can also bring about substantial and enduring change.

Psychoanalytic psychotherapy is often longer-term and open-ended, particularly when difficulties are longstanding or complex. I usually work at a frequency of once or twice weekly, sometimes up to three times a week, depending upon the individual and the nature of the work.

Neurolinguistic Psychotherapy (NLPt)

Neurolinguistic Psychotherapy was my first substantial psychotherapy training. It introduced me to working experientially with aspects of ourselves that operate outside ordinary conscious awareness, and to exploring how patterns of language, imagery, memory and bodily experience can shape our subjective experience of ourselves and the world.

The approach is collaborative and pays attention not only to what someone thinks, but to how their experience is organised. My training included working with unconscious patterns, different aspects or ‘parts’ of the self, imagery, somatic experience and ways in which earlier experiences can continue to influence our responses in the present.

NLPt is not a psychoanalytic psychotherapy and approaches the unconscious differently. Looking back, however, I can see an important continuity: it first taught me to listen beneath the immediately conscious story and become curious about experiences and patterns that a person may not yet be able to recognise or articulate.

How these approaches come together in my work

I don’t regard these trainings as three separate sets of therapeutic techniques. They represent the development of my thinking as a psychotherapist.

My earlier experiential work taught me to be curious about how experience is organised beyond conscious awareness. Embodied psychotherapy developed my attention to how psychological and relational experience can be expressed through the body and through symbolic processes. Psychoanalytic psychotherapy has taken me further into understanding unconscious phantasy and conflict, internal relationships, defence, transference and countertransference, and the ways these become alive within the therapeutic relationship.

Today I therefore think primarily as a psychoanalytic psychotherapist while remaining alive to embodied and experiential processes. Sometimes something is known through the body, through an image, through the atmosphere between two people, or simply as a feeling for which there are not yet words. Part of psychotherapy can be allowing such experiences gradually to become thinkable.

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