How I Cleared My Depression with 12 steps – step 3

I used the steps from Alcoholics Anonymous to clear my depression. You can too.

Step 3 – I made a decision to turn my will and my life over to the care of God as I understand Him.

This is about surrender. It was really hard for me. I thought I had to be strong; I had to defeat my own demons on my own. I had tried to do this and I hadn’t succeeded. I just seemed to be digging myself in deeper. I used to be pretty independent and self-reliant. It seemed like the only way. Then after my career disaster I became financially dependent on my husband. This still didn’t help me. I had got rid of one problem that depressed me (my work) but now I had other problems – poverty, lack of self-worth, lack of meaning and purpose…I still hadn’t made the shift. I was still looking for the wrong things to make me happy and medicating myself daily with red wine.

I had a blockage about surrendering to God. I kind of worried about being a Christian. I had met plenty of Christians I didn’t like – judgemental, obsessed with other people’s sex lives, joyless, cruel. I had met many Christian teachers like this and I did not want to be like them. Christianity has a strange history and a lot of skeletons in its closet. On the Alpha course I started thinking about the true message- the words of Jesus which really are astounding. Jesus is nothing like the sort of Christians I had met in the past. My favourite passage is the Sermon on the Mount, particularly ‘Consider the lilies…’ Go and check it out if you haven’t read it. It is about surrendering to God and letting go. It really is the hardest thing but the most worthwhile thing. God clothes even the wild flowers of the field with beauty. They don’t work for it, they don’t strive yet God looks after them. He will look after you too because you mean more to Him. Notice there is no Protestant work ethic here. Where did that come from because it didn’t come out of the mouth of Jesus? Surrendering to God causes a change in your consciousness. It doesn’t mean you won’t do things wrong (sin) and mess things up. You will but it’s ok.

The plan I had for my life didn’t work. It was a rubbish plan. I was working in the education system that I didn’t believe in. In the end it drove me to break down. Then I thought I would write books but that didn’t work out either. My plans were all wrong. I accepted help from God and at this point I realised change was possible. I am still not where I want to be. I have held back from total commitment. I am not a nun or a holy person on a mountain. I haven’t made it in to Mother Theresa territory – yet. I ask God for help every day. When I feel despair I pray. I remember that I am Divine – I am made in the image of God. That helps me. I still have some bad habits. I still drink wine but nothing like as much as I used to. I am trying to phase it out completely but I keep failing. I have a daily spiritual practice involving reading the Bible, praying, meditation and yoga. I am working on myself bit by bit. I am an ongoing project. If I mess up I ask for forgiveness and start again. I can observe my emotions and detach from them. I am training as a therapist so I can be of service to others.

Accept help from God as you understand Him. It does not have to be the Christian God. It could be Ganesha or Buddha or nature or Allah. It’s up to you.

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How I Cleared My Depression with 12 steps – step 2

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I used the 12 steps from Alcoholics Anonymous to overcome depression.

Step 2

I came to believe that a power greater than me could restore me to sanity.

This was a big shift for me. All my life I feel like I have been surrounded by atheists: my family, my friends. They know it all. They don’t need God. But I did. After years of vague belief I finally submitted. I became a Christian on the Alpha Course. This helped me a lot. Therapists often say you have to fix yourself; that it has to come from within. That’s good advice for many people but I had been trying to fix myself for years. There was something about surrendering myself to a loving God that worked for me.

I have suffered in the past from depression, low self-esteem and a sense of worthlessness. This just leads to nihilism: there seems no point in doing anything in a meaningless universe. Christianity gave me a way out of this trap.When the Bible is explained to you as an unfolding story it all starts to make sense. There is order in the universe, there is purpose and intention. Most of all there is love. Love is the thing I have been lacking. God loves me just as I am with all my flaws and faults. I don’t have to be perfect. I am good enough just the way I am. This is a revelation to me. We are all sinners. God knows this but he forgives us and accepts us through the blood of Jesus.

Being a Christian gives me meaning and purpose. I am still early on in my journey and I haven’t figured everything out yet but I read the Bible every day and pray and I attend the local abbey and sometimes my village church which has intermittent services. When somebody at Alpha prayed over me I felt like some evil thing left my body and something else came in its place. My depression began to lift there and then. I didn’t get rid of it overnight but it was the start of my journey to recovery. A lot of people have trouble with the word God. If you prefer you can use Higher Power or Nature or whatever you like. For me God works best though. I feel better when I think of something external to me helping me: a great spirit. I can’t make it on my own but I can make it with God. And so can you. Surrender to Him and you can heal yourself of all kinds of issues. Just one step at a time each day.

Personal Therapy Philosophy

In this essay, I will outline my own ideas about hypnotherapy which will form the foundation of my private practice. Firstly, I will explain my background, values, and beliefs which will affect my practice. Then, I will describe the integrative approach to therapy I will take incorporating elements from humanistic therapy, cognitive-behavioural therapy (CBT), and psychodynamic approaches which I will combine with transformational hypnotherapy. I will explain my reasons and give evidence for my stance. It will be argued that integrative practice is the approach most likely to help the majority of clients with varying issues. I will then explore the argument taken by the NHS that cognitive-behavioural therapy is all that is necessary for modern psychotherapeutic treatment and find reasons to reject this argument.

Firstly, it is necessary for me to explain my own background as it is important for a therapist to work in a way which is comfortable for them and in line with their belief systems (Corey, 2001). This gives the therapist authenticity. I have a fairly academic background. My first degree was an MA in Philosophy which gave me a life long interest in ideas and the ‘big questions’ about the meaning of life and the nature of reality. I have a second degree which is a BSc in Psychology which was very science based and concerned with evidence. It was not particularly relevant to therapy. I am currently undertaking an MSc in Psychology which is concentrating on research methods and again is not particularly focused on therapy. This educational experience has given me the tendency to look for evidence to support the claims of different modalities but at the same time to be aware of the flawed nature of much evidence in psychology. I have had a long career in teaching which has given me a practical insight into human nature. I ended my career prematurely due to inability to cope with prolonged stress which also led to bouts of depression. This experience gave me an interest in mental health and I have received CBT, counselling and transformational hypnotherapy which have all helped me to manage my mental health. I sought training in hypnotherapy as I wished to help others who were undergoing similar issues to me. I have a particular interest in anxiety and depression. Recently, I became a Christian and before that I was a practising Buddhist. I now blend these two belief systems and think of myself as a Christian Buddhist. I have a daily spiritual practice and spirituality is an important part of my life and gives me meaning. My education, spiritual life, and life experience have informed my values. I believe that the purpose of life is to develop yourself as much as possible, to self-actualise, and then to help others by sharing your skills and knowledge. I am motivated by the values of kindness and compassion and I would like to see a more spiritual, caring society. I see therapy as a way of helping people with their life problems so enabling them to live more fulfilling lives and reach their personal potential. I would not wish to impose my spiritual beliefs on anyone but if it was wished by the client, he or she could find a safe space to explore these issues.

Contemplating my life story has led me to embrace some of the humanistic tradition in psychotherapy, particularly the ideas of Maslow (1993, cited in Joseph, 2010) and Rogers (1959, cited in Joseph 2010). I feel that the transpersonal approach to psychology, emphasising spiritual experience, is the one to which I feel most attracted. Rogers (1980, cited in Joseph, 2010) wrote that he felt he was most effective as a therapist when his inner spirit reached out and touched the inner spirit of another. The relationship transcends itself and becomes part of a larger phenomenon enabling deep growth and healing. Maslow (1968, cited in Joseph 2010) developed the idea of a hierarchy of needs beginning with physiological needs such as food and water and ending with self-actualization where individuals are self-directed, creative, and independent and are willing to try to understand other people’s point of view and are open to new experiences. Such experiences could be what Maslow calls ‘peak experiences’ which transcend ordinary human consciousness and can be spiritual in nature: beyond the person. The transpersonal approach also draws on the work of Jung (1957, cited in Joseph, 2010) who developed the idea of a collective unconscious that exists beyond the boundaries of space and time and reflects a cosmic intelligence. The collective unconscious provides an inner wisdom for healing. Some transpersonal notions have much in common with Buddhism as individuals come to an understanding that there is no real self. Clients can undergo a transformation where their current way of seeing the world is shattered and they realise the unity of all things (Wilber, 1998, cited in Joseph, 2010). Meditation techniques can form part of transpersonal approaches. The therapist is co-operating with the client to allow inner healing to take place. Transpersonal therapists are not much concerned with scientific evidence and it can be argued that their approach is difficult to research effectively. However, there is some research that suggests that humanistic approaches are just as effective as other forms of therapy (Grof, 2007). In spite of my enthusiasm for the transpersonal approach I am aware it will not be appropriate for all clients which is why I intend to practice therapy in an integrative way with the transpersonal approach underlying my broader range of techniques.

I am drawn to the integrative approach as much of the research into the effectiveness of psychotherapy has emphasised the importance of common factors between therapies. Ablon and Jones (2010) have shown that in practice skilled, experienced therapists integrate techniques belonging to several approaches, adapting to the individual needs of their patients. A positive relationship between the therapist and patient is of paramount importance in the success of the treatment. This is known as the therapeutic alliance (Grencavage and Norcross, 1990). It has also been suggested that successful treatment may depend on various non-specific therapeutic factors: the confidence of the therapist in the treatment, the patient’s perception of the therapist as skilled and confident, a patient’s expectation that the treatment will be successful, characteristics of the patient such as commitment to therapy, being able to formulate problems and a willingness to challenge themselves (Wampold, 2015), (Cuijpers, 2013), (Ablon and Marci, 2004). The genuine interest of the counsellor in improving another person’s quality of life is vital (Schneider and Langle, 2012). It is likely that it is these mechanisms of change that predict the success of psychotherapeutic treatment, rather than the type of therapy that is utilised. As a result of these findings, I intend to work on creating a strong therapeutic alliance where I collaborate with the client to find solutions to their issues. I also intend to incorporate Rogers’ core conditions from person centred therapy: congruence, empathy and unconditional positive regard (Rogers, 1959, cited in Joseph, 2010). Congruence means the therapist is being his or her real self which is also close to his or her idealised self and he or she is integrated into the relationship with the client. Empathy means the therapist understands the client’s feelings. Unconditional positive regard means that the therapist will accept and support the client whatever he or she does or says. There is a real warmth and respect in the relationship.

Some clients’ issues may not be suitable for humanistic therapy so I will also make use of cognitive-behavioural techniques (CBT). The therapy focuses on the present rather than the past, and on changing negative patterns of thinking and behaviour (Joseph, 2010). Theoretically, CBT is rooted in behaviourism. Behaviourists believed that only observable, measurable, outward behaviour was worthy of scientific inquiry (Skinner, 1974, cited in Joseph, 2010). This theory was further developed by Beck (1976, cited in House and Loewenthal, 2008), who added a cognitive element. My reason for choosing CBT is that it has an impressive evidence base in research which suggests it is as good as or superior to other psychotherapies (Barth, Munder, Gerger, Nuesch, Trelle, Znoj and Cuiijpers, 2013), (Cuijpers, van Straten, Andersson, and van Oppen, 2008), (King, 2007), (Elkin, Shea, Watkins, Imber, Sotsky, Collins and Parloff, 1989). The approach is appropriate for clients who want fast solutions to their presenting issues and don’t wish for greater self-knowledge, spiritual development or to revisit the past.

The third approach I will integrate into my psychotherapy practice is psychodynamic therapy. There is great emphasis placed on the relationship between the patient and the therapist (Joseph, 2010). This has the advantage of giving primacy to the interactions between the two, which can be analysed in the course of the dialogue, thus finding solutions. However, this emphasis has raised criticisms. Unethical practitioners have abused the therapeutic relationship with its inherent power imbalance and there have been cases of sexual abuse of patients and other humiliating experiences (Masson, 1992). There is a focus on defence mechanisms and transference of issues from the past onto the counsellor. The emphasis is on the unconscious mind and early childhood experiences. At its best, the patient and therapist form an equal partnership, where the patient makes a breakthrough by working through issues from the past, bringing the unconscious causes of behaviour into conscious awareness and thus relieving current symptoms and empowering the patient (Joseph, 2010). This emphasis on the past has been criticised, as some therapists have been accused of unwittingly planting false memories in patients, particularly of sexual abuse, which can seriously harm people (Masson, 1992). Psychodynamic therapy is grounded in the work of Freud, (1901, cited in Joseph 2010) which gives it a firm theoretical basis and long history (Milton 2008, cited in House and Loewenthal, 2008). Freud developed psychoanalysis from a small series of case studies of his patients in Vienna. He believed that human behaviour has its origins in the unconscious mind, which is full of irrational, conflicting needs. In recent times, Freud’s ideas have been heavily criticised as they are based on studies of a limited number of people and they lack empirical evidence (Eysenck and Wilson, 1973, cited in Joseph, 2010). The cultural values of Edwardian Austria may not apply across the world. In spite of these criticisms, psychodynamic therapy has a strong evidence base, particularly for depression (Shedler, 2010). I choose to integrate elements of this approach in my practice as it will be suitable for clients who wish to revisit the past due to traumatic experiences. Modern psychodynamic therapy can be delivered in relatively short time frames such as 10-16 sessions. I am drawn to this approach more than CBT as I have found revisiting the past has been helpful to me in my own personal therapy so I believe it will help others.

Finally, the fourth approach which will be an important part of my practice is transformative hypnotherapy. I was very impressed on the course with the work of Boyne (2018) as he could produce real change in a short period of time by revisiting traumatic events in the past and giving new more helpful ways of regarding them and new ways of living after the release of emotion from dealing with the past. I have had personal transformative therapy recently from Peer (2018) who has developed her own version and I found it very helpful to me. I would like to incorporate this into my own practice as well as using techniques from Milton Erickson (Rosen, 1982) such as hypnotic language and the use of stories and metaphor. I also wish to use the technique of guided imagery which has its roots in the work of Jung (1957, cited in Joseph, 2010) as I have seen the powerful, transforming effect of this method and I find Jung to have spiritual values which are similar to my own. There is a growing body of research which finds hypnotherapy is useful for a great many issues, even physical medical issues such as IBS especially when it is combined with psychotherapy (Kraft and Kraft, 2007).

There is a school of thought that only one therapeutic modality should be used, particularly by beginning practitioners, as the therapist needs a firm grounding in one technique and cannot hope to be expert in all therapies (Corey, 2001). Following this line, the NHS has decided that CBT is now virtually the only therapy it offers due to its strong evidence base and its value for money and speed (NICE, 2018). While I have some sympathy for this view I do not believe that CBT is appropriate for every person and every issue. It is far too reductive in reducing complex human states to merely thoughts and behaviour while ignoring emotions, the social context, the past and the unconscious mind. One argument against CBT is that it is telling people how to think and reprogramming them in line with the expectations of society. ‘Faulty’ individuals are to be made to fit in with the current culture rather than attempting to change the culture. Thus, CBT is not counselling, but just a series of tools to ‘fix’ symptoms. As a result, this treatment does not address the underlying issues of the client (Woolfolk and Richardson, 2008, cited in House and Loewenthal, 2008). As a consequence, CBT therapy becomes a political act, aligning with governmental needs for a healthy workforce. CBT is offering a kind of sticking plaster to control the emotional and behavioural impact of a lack of meaning and spirituality, rather than addressing such existential concerns. Furthermore, it is possibly unethical, as it is imposing solutions, rather than being patient-led. There is a power imbalance between the counsellor and patient (Brazier 2008, cited in House and Loewenthal, 2008).

Effective, integrative therapy has been summed up by Paul (1967, cited in Corey, 2001) as: ‘What treatment by whom, is the most effective for this individual with that specific problem, and under which set of circumstances?’However, there is a problem theoretically that the approaches are incompatible. For example, the humanistic approach believes people are basically good while the psychodynamic approach points to darker, irrational drives suggesting people have evil within them. My own belief is that people are neither good or bad but a mixture of both so I don’t fully subscribe to either theory though I lean to the humanistic. I am taking a pragmatic approach and using what works from each therapeutic modality in order to maximise my ability to help clients.

In this essay I have revealed that I intend to take an integrative approach to therapy using techniques from humanistic traditions, CBT, psychodynamic therapy and transformative hypnotherapy. This approach is underpinned by my belief in the value of transpersonal therapy as an overarching concept which will guide my practice. This is in line with my beliefs and values and enables me to help a great many people in the most effective way for them. I have supported my philosophy with research evidence.

References

Ablon, J. and Jones, E. (2010) ‘How expert clinicians’ prototypes of an ideal treatment correlate with outcome in psychodynamic and cognitive-behavioural therapy’ Psychotherapy Research vol. 8, no.1, pp. 71-83 (Online). Available at doi: 10.1080/10503309812331332207 (Accessed on 5th April, 2018)

Ablon, J. and Marci, C. (2004) ‘Psychotherapy process: the missing link: comment on Westen, Novotny, and Thompson-Brenner’ Psychological Bulletin vol. 130, no. 4, pp. 664-668 (Online). Available at doi: http://dx.doi.org/10.1037/0033-2909.130.4.664 (Accessed on 5th April, 2018)

Barth, J., Munder, T., Gerger, H., Nuesch, E., Trelle, S., Znoj, H. and Cuijpers, P. (2013) ‘Comparative efficacy of seven psychotherapeutic interventions for depressed patients: a network of meta-analysis’ PLoS Medicine, vol. 10, no. 5, pp. 1-17 (Online). Available at https://doi.org/10.1371/journal.pmed.1001454 (Accessed on 5th April, 2018)

Boyne, G. (2018) Gil-Boyne.com (Online) Available at http://gil-boyne.com (Accessed on 13th June, 2018)

Corey, G. (2001) Theory and Practice of Counseling and Psychotherapy, Stamford, Wadsworth

Cuijpers, P., van Straten, A., Andersson, G. and van Oppen, P. (2008) ‘Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies’ Journal of Consultant Clinical Psychology vol. 76, no. 6, pp. 909-22 (Online). Available at doi: 10.1037/a0013075 (Accessed on 1st April, 2018)

Cuijpers, P. (2013) ‘Effective therapies or effective mechanisms in treatment guidelines for depression?’ in Depression and Anxiety vol. 30, no. 11, pp. 1055-1057 (Online). Available at doi: 10.1002/da.22205 (Accessed on 5th April, 2018)

Elkin, I., Shea, M., Watkins, J., Imber, S., Sotsky, S., Collins, J. and Parloff, M. (1989) ‘National Institute of Mental Health Treatment of Depression Collaborative Research Program General Effectiveness of Treatments’ Arch Gen Psychiatry vol. 46, no. 11, pp. 971–982 (Online). Available at doi: 10.1001/archpsyc.1989.01810110013002 (Accessed on 5th April, 2018)

Grencavage, L., and Norcross, J., (1990) ‘Where Are the Commonalities Among the Therapeutic Common Factors?’ in Professional Psychology: Research and Practice vol. 21, no. 5, pp. 372-378 (Online). Available at doi: 10.1037/0735-7028.21.5.372 (Accessed on 5th April, 2018)

Grof, S. (2007) ‘Theoretical and Empirical Foundations of Transpersonal Psychology’ (Online) Available at http://www.stanislavgrof.com/wp-content/uploads/2015/02/FoundationsTP.pdf (Accessed on 13th June, 2018)

House, R. and Loewenthal, D. (eds.) (2008) Against and For CBT: Towards a Constructive Dialogue, Monmouth, PCCS Books.

Joseph, S. (2010) Theories of Counselling and Psychotherapy, Hampshire, Palgrave Macmillan.

King, R. (2007) ‘Evidence-based practice: Where is the evidence? The case of cognitive behaviour therapy and depression’ Australian Psychologist vol. 33, no. 2, pp. 83-88 (Online). Available at doi: 10.1080/00050069808257386 (Accessed on 5th April, 2018)

Kraft, T. and Kraft, D. (2007) ‘Irritable Bowel Syndrome: Symptomatic Treatment Versus Integrative Psychotherapy’ in Contemp. Hypnosis vol. 24 no. 4 pp. 161-177 (Online) Available at DOI: 10.1002/ch.339 (Accessed on 13th June, 2018)

Masson, J. (1992) Against Therapy, London, Flamingo

NICE (2018) Depression in Adults, London, (Online). Available at https://www.nice.org.uk/guidance/cg90/chapter/Appendix-Assessing-depression-and-its-severity (Accessed on 4th April, 2018)

O’Neal, P., Jackson, A. and McDermott, F. (2014) ‘A review of the efficacy and effectiveness of cognitive behavioural therapy and short-term psychodynamic therapy in the treatment of major depression’ Australian Social Work vol. 67, no. 2, pp. 197-213 (Online). Available at doi: 10.1080/0312407X.2013.778307 (Accessed on 4th April, 2018)

Peer, M. (2018) Marisa Peer (Online) Available at https://www.marisapeer.com (Accessed on 13th June, 2018)

Rosen, S. (1982) My Voice Will Go With You, London, Norton and Co.

Schneider, A. and Langle, K. (2012) ‘The Renewal of Humanism in Psychotherapy: Summary and Conclusion’ Psychotherapy Vol. 49, No. 4, pp. 480–481 (Online). Available at doi: 10.1037/a0028026 (Accessed on 5th April, 2018)

Shedler, J. (2010) ‘The efficacy of psychodynamic psychotherapy’ American Psychologist vol. 65, no.22, pp. 98-109 (Online). Available at
http://dx.doi.org/10.1037/a0018378 (Accessed on 5th April, 2018)

Wampold, B. (2015) ‘How important are the common factors in psychotherapy? An update’ in World Psychiatry vol. 14, no. 3, pp. 270–277 (Online). Available at http://doi.org/10.1002/wps.20238 (Accessed on 5th April, 2018)

On being a new Christian

I have been a Christian for about two months now. I got a real high at first when I was filled with the Holy Spirit on the Alpha Course but it hasn’t lasted. I have been studying the Bible, praying and going to Church. My moods have been up and down. In general, I really like having a structure to my life. I think I need a framework to hang things on and Christianity has certainly given me that.

I am fully aware of my many faults and failings and I am working on them daily. I have learned to speak in tongues which I am quite ambivalent about. I use it sometimes to pray and it comes out as song which is quite beautiful and joyful. I feel like I am worshipping God through it though I have no idea what I am saying. The nonsense language aspect of it is the bit that bothers me.

My main problem has been with the Church I have been attending. It is charismatic and evangelical and the service is quite American in style in my view. There is a lot of arm waving and crying out. The services are mostly the pastor speaking and the Bible is referred to briefly. Leaders from the congregation are invited to preach and sometimes there are visiting preachers. The songs are modern. There is a prayer team who lay hands on people at the end and pray for them. There is a great emphasis on emotion and I have  found myself crying many times.

In spite of the un-Britishness of it all I was just about coping and I did feel God was at work in the Church. The thing that bothers me the most is the words of knowledge. These are supposed snippets of information from God, often though not always about the future. A section of the service is handed over for this. People go to the front and announce their words of knowledge. Last week it was all quite innocuous about bad backs and changing jobs and so on. It may be harmless but it worries me that these messages are said to come from God. How does anyone actually know?

This week was the final straw for me. There were three baptisms of teenagers. After they were dunked in the tub their faces were really joyful so that was a lovely thing to see. They were given ‘words of knowledge’ saying things like they were flowers just about to open. All inspirational and fine and dandy.

We went back to the main hall and two of the congregation were preaching. All they were really doing were giving words of knowledge. Somebody was told they had leadership qualities and I can’t remember the others. Then the female turned to me. I was picked out as the lady with the tartan scarf. Then I was harangued for five full minutes. I was accused of not giving my burdens to Jesus. I was informed in a raised voice that Jesus is not in his grave but is alive today so why don’t I accept him? I had already accepted Jesus a month previously so I had no idea what this tirade was about or why it was being addressed to me. Her face was full of malevolence. I could feel the tears pouring down my face. Everyone else gets beautiful flowers opening and I get this. I must be a black hearted sinner indeed.

I was in shock afterwards and for the rest of the day. I won’t be going back to that Church. As far as I can see this is bullying. It could happen again or to anyone at any time. As a fragile new Christian I really don’t need this approach. Even my novice reading of the Bible has taught me that words of knowledge are controversial and should be tested. Parts of the Bible warn against them. Parts seem to condone them. Such is the Bible.

I have contacted another Church, a local abbey. I will be going there next Sunday. It will be full High Church Mass and all the trimmings. I’m hoping nobody will see the need to shame me from the pulpit.

I am sad as I shall miss some of the lovely people I have met but I have learned to protect myself by now.

Goodbye to all that.

PSYCHOANALYSIS

 

Discuss one Theory used in Psychotherapy

 

 

Lynn Matheson

This paper will discuss psychoanalysis. It is both a therapeutic technique and a theory of mind. Psychoanalysis is important, as it is the founding theory behind psychotherapy. What psychoanalysis is will be examined, the theory behind the method, and how psychoanalytic ideas have changed over time as well as its purpose and goals. Its influence on more modern psychotherapy theories will be detailed. Finally, its usefulness in the modern day will be discussed and it will be argued that it still has value.

 

Firstly, what is psychoanalysis? In classical psychoanalysis two people – the patient and the psychoanalyst meet as much as five times a week at set times usually for fifty minutes each time. The patient lies on a couch and the analyst sits behind him without eye contact. The patient says whatever comes to mind. This is known as free association. The analyst is often silent but not passive. The aim is to act as a catalyst, clarifying and interpreting what is said. This exploration of the mind can bring about lasting change for the patient leading to improved mental health (Pick 2015).

 

Secondly, the theory that led to this method of therapy will be examined. Psychoanalysis was developed by Freud (1856-1939) in Vienna. Freud referred to his method as the ‘talking cure’ and he used it with his patients, who had been diagnosed with hysteria, beginning in the 1880s. These patients were suffering from psychological stress which affected their physical as well as mental health. His theory used empirical data from case studies of his patients, most famously Anna O, as he referred to one of them (Pick 2015). The main idea developed was that thoughts can exist of which we are unconscious. This unconscious is dynamic, full of conflicting forces trying to gain access to consciousness and ego defences preventing such access (Eagle 2018). Freud (1920) provided evidence for these unconscious processes from slips of the tongue, which reveal hidden intentions, as well as dreams. Freud (1920) also finds evidence of a sort from fantasies, or as he refers to them phantasies, which are disguised fulfilments of instinctual wishes. Listening to his patients led Freud to develop the concept of transference; baggage from the past is brought into present relationships. Patients can transfer feelings onto the analyst, which are really meant for someone else.

 

Freud believed that his patients repressed thoughts of unbearable early memories. Many patients described experiences of childhood sexual abuse often from family members. Freud later came to doubt that these were always real events but could be fears or fantasies. Freud held that children feel both hate and love for their parents and this leads to ambivalence which is necessary to separate from them to gain a sense of identity (Pick 2015). These ideas led to Freud developing the famous Oedipus Complex which includes: universal incestuous wishes towards the opposite sex parent and hostile wishes towards the same sex parent, the incest taboo, and choice of mate based on parental templates. How the individual resolves these conflicts determines their psychological development. The infant goes through stages of psychosexual development: oral, anal, phallic, latency and genital. People can become fixated which means they are stuck at one stage of development (Eagle 2018). Freud conceptualised the conflict between immediate gratification and the need to delay gratification as one between the pleasure principle and the reality principle. This leads to Freud’s model of the mind involving the superego (largely unconscious reproaches), the ego (mediates internal and external reality), and the id (unconscious instinctual urges and passions which can erupt and overtake us). Analysis can strengthen the ego and make the superego and the id less destructive. A very critical superego can lead to feelings of worthlessness and abjection (Pick 2015).

 

The concept of defence is also central to psychoanalysis. This occurs when there is an incompatibility between the ego and an idea presented to it. These unacceptable thoughts are banished from consciousness by an act of will; they are repressed. Not all Freud’s ideas concerned sex. He also believed in the death drive: a tendency to self-destruction and also aggression towards others. Coping with these internal and external forces leads to anxiety. The process of analysis between the analyst and patient can lead to a release of these conflicts and an understanding of them, which can provide relief for the patient, and a lessening of their ‘hysterical’ symptoms. Many of Freud’s patients reported an improvement in their conditions but the treatment was not always successful (Pick 2015).

 

Next, how psychoanalytic theory has changed over time will be examined. Freud himself did not have static ideas but changed and developed his ideas over the course of his life. Freud worked with other psychoanalysts but many disagreed with many of his ideas and split from him and developed their own theories. Jung diverged from Freud and introduced a spiritual dimension (cited in Pick 2015). Adler and Klein (cited in Pick 2015) also split off from Freud. Klein did a lot of work with children and developed a theory of the relational dimension of the mind. Hartmann (cited in Pick 2015) developed ego psychology and became convinced that the ego could operate conflict free with the help of analysis. This view was also held by Anna Freud (cited in Pick 2015). Lacan (cited in Pick 2015) was interested in words and felt that the ego is constituted by our relationships to our own images. We are involved in a constant searching for others. Winnicott (cited in Pick 2015) became interested in the primacy of the relationship between mother and infant and developed the idea of the good enough mother. Bion (cited in Pick 2015) was interested in work with groups and introduced the concept of projective identification. Less desirable qualities in ourselves are projected onto others. Ferenczi (cited in Pick 2015) was concerned that there should be more warmth in the analyst. Psychoanalysis has developed differently in different countries. Currently it is in decline due to the rise in popularity of other therapies (Pick 2015).

 

In spite of this decline there are still practitioners today working as psychoanalysts though many do not fully accept all of Freud’s ideas. What remains accepted is that our behaviour, thoughts and feelings are influenced by factors outside of our conscious awareness and that we do indulge in defences and self-deceptions. These illusions protect our self-image. There is also much evidence supporting the idea of unconscious mental processing. However, there is not much evidence for Freud’s notion of a dynamic unconscious as a seething mass of primal desires. The unconscious in modern research is seen as consisting of internal working models which are acquired in childhood and can be difficult to change. There is little evidence for a universal Oedipus complex or that it has a role in psychological development. Modern psychoanalysts have reconceptualised this as a tension between the regressive lure of identification with the caregiver and the progressive urge for separation. How these tensions are resolved are important for healthy psychological development. Research evidence has provided support for viewing delay of gratification, affect regulation and executive functions as concerning the adequacy of an individual’s ego functions. In essence, modern psychoanalysis has moved from seeing psychopathology as resulting from repressed conflictual wishes and impulses towards seeing it as early acquisition of maladaptive representations. It is not always necessary to become aware of one’s representations and their influence on behaviour but these representations can be altered through the therapeutic relationship itself without interpretation. Therapy can provide emotional correction. However, it still seems that self-knowledge can be important in becoming a healthy individual (Eagle 2018).

 

Psychoanalysis has been criticised for lacking scientific rigour. It cannot be falsified. Freud only used a small sample of patients to generate his theories so they cannot be generalised to all human beings (Joseph 2010). However, Bergin (1971, cited in Lambert 2013) found that 80 % of patients undergoing psychoanalysis showed significant improvement, which suggests this style of therapy can have considerable value.

Next, the purpose and goals of psychoanalysis will be examined. The goal is better mental health by a patient understanding his or her neuroses. Freud’s patients often had physical symptoms such as paralysis. Through ‘working through’ how neuroses have developed through talking about painful memories and thoughts the patient can be helped to understand the condition and resolve it. Formerly unconscious material is brought into conscious awareness and reintegrated into the total structure of the personality. Symptoms are seen as having a psychological rather than a physical cause (Joseph 2015).

 

This paper has chosen to concentrate on psychoanalysis, as it is important as the founding father of psychotherapy. It brings in the notion that psychological processes rather than biological processes can sometimes result in psychological problems. Freud was the first to point out that unconscious motives and defence mechanisms influence behaviour and that early childhood experiences influence adult personality. The idea of transference is utilised by many therapists today.

 

Finally, other modern psychotherapy techniques will be examined to tease out the influence of psychoanalysis on them. Many modern therapists refer to themselves as psychodynamic. These therapists use many of the techniques of psychoanalysis but they have adapted them to a modern context. It is not considered necessary to see the therapist as much as five times a week and most have abandoned the couch and will sit face to face with the patient. They are more likely to intervene in the interaction in order to help the patient. Psychodynamic techniques like this are still recommended for some cases of depression and schizophrenia. They can also be useful for clients wanting to develop interpersonal skills, to enhance self-understanding and overcome self-defeating behaviour (Joseph 2010). Modern psychodynamic therapists do not usually support all of Freud’s ideas but will still work with inner conflict and transference to help their patients.

 

Humanistic approaches to psychotherapy emerged in the middle of the twentieth century. They were a reaction against the pessimistic view of human nature painted by psychoanalysis in which people are selfish, driven by sexual and aggressive impulses. The humanistic approach sees human nature as essentially positive and emphasises choices, values and purpose. Carl Rogers (1902-1987) is one of its most well known proponents. He developed the person-centred approach. The foundation of the theory is the actualizing tendency, which is a natural force in people directed towards constructive growth and development. This tendency in a child is thwarted by an internalized belief that he must please others. The therapist provides a supportive environment where the client can become their actualized self. This approach can be seen as a radical departure from the ideas of psychoanalysis. However, its echoes can still be felt. Person centred therapy is still a talking therapy and events in childhood are given prominence. Not much research has been done on the effectiveness of this therapy but some work has suggested it is just as effective as other forms (Joseph 2010).

 

Another humanistic approach is Perl’s Gestalt therapy. The client experiences the total configuration of who they are. It emphasises choice and responsibility. It is a more confrontational approach than that of Rogers, encouraging the client to heighten their emotions. Little research has been done into the effectiveness of Gestalt (Joseph 2010). Its emphasis on the here and now suggests a clear break with the approach of psychoanalysis.

 

Berne (Joseph 2010) introduced a form of humanistic counselling called transactional analysis. This approach assumes people are ‘ok’. The therapist values and esteems the client. Each person can make decisions about their life and the way they think is their own choice. It is closer than the other humanistic approaches to psychoanalysis and can be seen as a development of this theory as Berne himself trained in psychoanalysis. Berne developed a model of the mind consisting of the child, the parent and the adult. In many ways this model echoes Freud’s ideas of the id, ego and superego. The approach also echoes the Freudian idea that problems have their roots in childhood.

 

The transpersonal approach is associated with Maslow. He saw human beings as striving to achieve their potential. Maslow described a hierarchy of human needs with physical needs such as food at the bottom and self-actualisation at the top. Actualized individuals are self-directed, creative and independent. Self-actualized individuals can have peak experiences, which transcend ordinary human consciousness and can be regarded as spiritual in nature. This approach has little in common with Freud. There has not been much research into the effectiveness of the transpersonal approach (Joseph 2010).

 

Cognitive Behavioural Therapy is a widely used approach used today both in the NHS and in private practice. This is a merging of cognitive and behaviourist ideas about the human mind. The approach works on changing a client’s behaviour and the way they think about themselves through checking their internal dialogue and removing negative, critical thoughts. Much research has backed up this approach and it has gained respectability by adopting psychiatric language. However, it has been criticised for being overly simplistic with scientific experiments not always relevant to complex, intractable problems of patients (Smail 1996, cited in Joseph 2010). This approach with its emphasis on the present shows a resounding rejection of the ideas of psychoanalysis.

 

Now, psychoanalysis in the present day will be examined. Classical psychoanalysis as described by Freud is rare today. It is still possible to train in at various institutions around the world. As the client is required to come for sessions as much as five times a week and the therapy can go on for years it remains too expensive, time consuming and impractical for many people. Many of Freud’s key ideas have also been severely criticised as having no scientific basis. As a result of this psychoanalysis is in decline. It survives in private practice and is rarely used in the NHS, which is constrained by economic factors. It has been overtaken in popularity by Cognitive Behavioural Therapy. However, it still survives in modified form in psychodynamic therapies in private practice. Many psychodynamic practitioners use psychoanalytic ideas of unconscious conflicts and transference in their work. They may follow other theorists more closely than Freud but who are still within the analytic tradition such as Jung, Klein, Adler and Erikson. This kind of approach can still be useful for deep-seated depression, which has not responded to other techniques. Modern therapy is moving towards an integrative approach where the therapist uses what works best for the client. In this way, psychoanalytic ideas still survive (Joseph 2010).

 

 

This paper has examined psychoanalysis discussing what it is, its purpose and goals and its influence on other psychotherapies. It has been seen that its legacy has been great though it is currently in decline. Psychoanalytic ideas have been much criticised but many practitioners have found their use in therapy to be beneficial in helping patients. New research into the effectiveness of different approaches may well show that psychoanalytic ideas still have value.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

 

Eagle, M. N. (2018) Core Concepts in Classical Psychoanalysis Abingdon: Routledge

 

Freud, S. (1920) A General Introduction to Psychoanalysis New York: Boni and Liveright

 

Joseph, S. (2010) Theories of Counselling and Psychotherapy Basingstoke: Palgrave Macmillan

Lambert, M.J. (2013) ‘Outcome in Psychotherapy: The Past and Important Advances’ Psychotherapy American Psychological Association, Vol. 50, No. 1, 42–51

Pick, D. (2015) Psychoanalysis A Very Short Introduction. Oxford: Oxford University Press

 

 

New Year’s Resolutions

I know we are all tired of resolutions and I have failed to keep many in the past but I still need goals so here are mine.

 

1 Read the Bible every day

2 Pray every day in English and in tongues.

3 Meditate every day

4 Find out all I can about different mental health therapies  by reading and having therapy. Choose one that works for me

5 Diligently work on my hypnotherapy training and become qualified in it.

6 Diligently work on my MSc Psychology and complete the first module.

7 Do not drink alcohol

8 Do not eat meat

9 Attend the Alive Church every week and decide if it is the right Church for me.

10 Find paid employment.

11 Do voluntary work.

12 Find out all I can about Christianity by reading and talking to other Christians.

13 Rework my second book and self publish it.

14 Start and complete a third novel.

15 Increase my social circle.

Yogi Cameron The One Plan weeks 9 and 10

I have been really bad at following the One Plan these past few weeks. It’s all about getting rid of extra possessions that you don’t need. I have done this in the past and I tend to live simply and don’t have a lot of things. I still have some junk I could clear out but as I live with someone else I can’t throw out everything I would like to as some of it is his.

I haven’t been following the diet properly and I have been drinking wine so lots of backsliding.

In this two weeks I became a Christian so my focus has shifted. I am still going to continue the One Plan and follow most of the recommendations as I think they are valuable and try to incorporate them into my new Christian lifestyle.

It is really cold in England at the moment and that always has a bad effect on me and makes me not want to do anything much.

So hopefully I can shake myself up and get back on the health track next week.

The Alpha Course – A Personal View

A couple of months ago I signed up for the Alpha Course. I am doing it in the neighbouring town of Wymondham about 20 minutes drive away. It has been running once every two weeks in the evening.

I got interested in it because I have been seeing these ads for Alpha for years but never dived in. I was brought up by Communists so though Christened no attention was ever paid to my spiritual development. I got introduced to Christianity at school and through friends. I dabbled a bit but didn’t completely get involved. At university it was the same. I went to a few prayer meetings in my Hall, attended Church a few times and then abandoned it for other things. I have always been quite spiritual though and returned sporadically to exploring. I have dabbled in Paganism, witchcraft, the occult in a New Agey way, Spiritualism, Hinduism and Buddhism.  The Buddhism was my most recent foray and I really liked it. I have been to the Norwich Buddhist Centre and learned to meditate. I still wasn’t sure which one was for me.

So I decided to learn more about Christianity. The Alpha Course is supposed to be for non-believers, agnostics or new Christians and is an introduction to the basics of the faith. I hoped I would get answers to my questions like the problem of evil in the world and why God made the world.

When I arrived at the hall I found that everyone there was already a member of the charismatic Church which used the Hall. I was the only vague one. I hadn’t expected this. What struck me the most was how pleasant everyone was. It was very welcoming. The pastor and leaders didn’t wear any particular clothes. It was very casual and relaxed.

Each session takes the same format. There is a meal prepared by the Church members and then a video headed up by Nicky Gumbel the founder of Alpha. Then we break into groups and discuss the topic. There is an accompanying booklet. I was hoping for some intellectual discussion but this didn’t really happen in my group. Everyone was already a true believer so they just believed. Sometimes I asked questions nobody could answer such as why the Old Testament is in the Christian Bible when there is a new promise of the New Testament. The leader who was incredibly sweet looked it up on Google for me the next week. They all seemed to take the Bible literally as the word of God so didn’t question anything. I realised I wasn’t going to be converted by clever arguments.

One thing struck me from the very beginning. They were all incredibly open and honest. Most had had life traumas which they discussed candidly. The Church was for broken people. At least this one was. I would fit right in. I warmed to them over the weeks though I often felt awkward and didn’t know what to say.

One week I finally cracked and cried as I thought about how sinful I had been and how I hadn’t come to Jesus properly even though he had given me plenty of opportunities.

The first few sessions were about what it meant to be a Christian but it swiftly turned into a conversion course.  I didn’t mind this but I could imagine some people would. In fact I wanted to be converted. I really need something solid in my life and I know the pick and mix spirituality is never going to work.

I felt I was on a roller coaster ride and I really was confronting my past and my failings and being honest with myself. I often went home in deep thought but I was enjoying it. I worked my way through the New Testament though I have done this many times before. The group leader behaves as if I am a complete atheist but I have actually read the Bible many times. I like the core message but I find lots of it confusing and contradictory. I still had lots of unanswered questions. I knew I wasn’t going to get them answered. If I wanted this I had to just go with it in my heart.

So I girded up my courage and prayed the conversion prayer recommended by Alpha. I repented and asked Jesus into my life. To my disappointment no Damascene miracle happened on the spot. Slightly sadly, I went out to walk the dog. In the church yard glebe at dusk I saw a huge white barn owl with wings outstretched hunting over  and over on the same patch of ground. It was completely unconcerned by my presence. As I stopped to watch it I was aware it looked a little like an angel. I took this as a sign. Maybe it was a very weak sign and just a coincidence but it was something.

The following week at Alpha there was a Holy Spirit day which was on a Saturday in the Church. For some reason I had a total foreboding about this and nearly didn’t go. When I got there it was all set up for a service. We watched no less than three videos in a row which were building up for the Holy Spirit experience. We had a short discussion and then the experience began. We all stood up and prayed and started to sing a hymn. We asked the Holy Spirit to come. The leaders went around and prayed for people. My group leader came to me and asked if I wanted to be prayed for. I said yes. Already I had started to feel quite strange even before this. My nose was running and I felt hot and shivery. She prayed for me and put her hands on my head. Then she started speaking in tongues and asked me to copy her. As I started I felt incredibly hot in my forehead and shivery but not cold. Then I felt like a great force came into me and something went out of me. I screamed I think about three times. Bizarrely, I can only compare it to orgasm. I am embarrassed I had a very loud orgasmic experience in front of a lot of fundamentalist Christians. Joking aside it was quite an incredible happening. I was also crying and my cheeks were wet when I opened my eyes. This was the Holy Spirit in me.

I sat down for a while afterwards feeling completely strange. I was different. One of the other leaders came over and asked if I wanted to learn to speak in tongues. I was inclined to say I had had enough for one morning but he was quite insistent so I agreed. He laid hands on my forehead again and spoke in tongues. It sounded like Ancient Aramaic. As I repeated it I had the hot sensation again and lots of lights were appearing under my closed eyelids like little fires. He said the Holy Spirit is upon you and carried on chanting. I found I could chant away on my own these strange words but I had no idea what I was saying. The same hot feeling was there but it wasn’t as intense as the first time.

Later on  a few of us joined in a circle and spoke in tongues.

I still feel in shock a few days later and I don’t quite know what to make of it. I do know that something profound happened to me and there was definitely something supernatural in the room. My rational mind has tried to make sense of it but come up with no explanation. I feel like there is something different in my mind. When I meditate or pray my brain feels different.

So I think I have become a Christian. I have been praying and reading the Bible and going about my usual tasks. The inital high has worn off but I still know I am changed. I have prayed in tongues and found it just flows out of me but I don’t know what I’m saying.

There are still a few sessions of the course to go but I feel like I have converted. It has taken me fifty years to fully accept Christ but here I am.

I don’t want to give up my daily meditation but maybe I don’t have to. I have a lot to learn but I have started the journey.

 

Yogi Cameron The One Plan Week 5 and 6 Review

So I am still keeping up my Yogi Cameron plan kind of. I STILL haven’t lost any weight in spite of my Spartan diet. I have had some cheat days but I would have expected at least some weight loss.  Why is my body holding on to its weight?

On the spiritual side these two weeks have been about non-stealing. By this Yogi Cameron means not just literal stealing but things like cheating on your taxes and taking someone’s parking space. I’ve realised I’m a pretty honest person as I don’t do any of these things. This is something I can be proud of at last. I am ethical. I am honest. I have empathy. This is all good for my spiritual growth.

I have been feeling better. I have cut down my portions and now I have even stopped having rice. So I am existing on fruit and vegetables mostly with vast amounts of herbal tea. I have had a few cheat days. Husband has this effect on me. He encourages me to drink wine and takes me out to lunch to places that never have anything healthy on the menu.

I have massively upped my exercise regime. I am doing yoga and then HIIT and then weight training with dumb bells. I am only doing the weight training three times a week but the other exercise every day except Sunday. This is as well as dog walking which is often miles and miles around Norfolk lanes. My legs ache most of the time.

I am also meditating and praying daily.

I have upped my productivity massively and managed to finish my novel. It just needs editing now and adding to. I am quite pleased with it but it still needs some work.

I have also started my MSc in Psychology at the Open University. It is brilliant so far and I amr really interested in it. I have sent in my first essay.

I have also started a course in Hypnotherapy training. I am really hoping this could be a new career for me. It will take me ten months. I really enjoyed the first weekend and I got some compliments. Maybe I will actually be good at this. I am hopeful. The course was very relaxed and supportive. It was right for me. My anxiety melted away.

My depression is being held at bay. My strategy has been to force myself to do things even though I don’t feel like it. This has been effective and I feel better afterwards. I still haven’t got to the stage of joy yet but I am smiling more.

I have had another intervention as I have been going to CBT sesssions with the NHS. It’s not really therapy. I sit in a room  with other people and listen to a lecture on CBT from a very young man. Then I get a booklet and tasks to do at home. There are some useful ideas in it but you can tell it’s just trying to deal with people on the cheap. One size does not fit all in my view.

I still have the problem of no income. I do need to work on this. I do everything to avoid applying for jobs. I think it must be anxiety from my previous experiences. I much prefer doing courses. I still want to work for myself ultimately. Of course I want to be a writer but unless I have a bestseller I am not going to make any money. Being a therapist would be good too. I would like to help people cope with their problems. I have had so many issues it would be lovely to help other people not go into the depths like I did.

I have had to take a long look at myself and there are still lots of things wrong. It’s painful to examine your inner life. I still have very little in the way of a social network. I feel totally alienated from family but let’s face it I always did anyway. I can’t do anything right as far as they are concerned. Maybe being reclusive is my natural state. Of course I would love to have a perfect life like people in a TV ad but maybe I’m just not made that way.

I have felt a longing for children over the last few weeks. Sadly I think I am too old. When I was younger the time never felt right. I have a lot of regrets about the past. I suppose you can regret everything or regret nothing. I am finally waking up and facing my fears.

Onwards!

Yogi Cameron The One Plan Day 19

Weight: 63.5 kg

Breakfast: berry smoothie with almond milk

Lunch: Carrot and butter bean soup. Two slices of homemade wholemeal bread and butter

Dinner: vegetable quiche, salad, cupcake

Exercise: 30 mins yoga, 20 mins HIT routine, dog walking 1 hour

Meditation: 20 mins

Mood medium. I feel like my energy levels are improving. I went to the Alpha course in the evening so had to have the meal. Social events are really difficult for dieting. I have eaten too much yet again. I still feel proud of myself for giving up caffeine and alcohol. It is strange that the physical withdrawal from caffeine was so hard and yet there are no physical symptoms from the withdrawal from alcohol. It shows I was only psychologically addicted, not physically. I had quite a productive day and did quite a bit of university work. I also managed some gardening and planted pansies in my pots at the front of the house. The weather was fine which made dog walking a pleasure. There are lots of mushrooms growing in the lanes. The Alpha Course made me think a lot about Christianity and spirituality. There are lots of people with painful pasts there. I am not alone.