Manchester Psychotherapy

Counselling in Manchester

What To Expect From Couples Counselling

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what to expect from couples counselling in ManchesterMany people are unsure of what to expect when they come for couples counselling.  In this post I will outline what you can expect if you work with me at Manchester Psychotherapy.  I use Imago Relationship Therapy in all my sessions.  Imago Relationship Therapy presumes that you are both OK, you both have needs that you are trying to get met, and that you are both well matched to help your partner get their needs met.

One thing I will not be doing is allowing you to come and spend time arguing.  You probably do lots of that at home and there is no point paying me to watch you do it!  The vast majority of the time you will be in dialogue with each other and I will be guiding you.

A typical session will look like this:

Arrival – focusing on getting you grounded and ready to listen to your partner.

Intentions – What do you want to achieve from this session?  How do you need to be to achieve it?

Dialogue – One partner will talk (we call this sending) and the other will listen (we call this receiving).  The receiver will mirror what the sender has said back to them, validate and empathise.  Can you imagine what that feels like?  Your partner will be listening to every word you say and mirroring it back – demonstrating that they really were listening.  Contrast this with the diatribe that usually happens in a relationship where one person talks then the other person talks back, usually invalidating what their partner has just said. Being listened to, validated and understood feels fantastic! Once the sender has finished sending the roles are swapped and the receiver now sends, often responding to what they have just heard from their partner.

When sending the focus is on owning feelings, staying away from blame and keeping your partner safe.  Senders use “I feel” statements or “the story I’m telling myself..” sentences to do this.  It’s my job as the therapist to make sure both partners do not feel attacked or criticised.

Towards the end of the session couples will move into appreciation dialogues – what they like about their partner either during the session or out of it.  This brings the positive into your awareness and reminds the couple of why they are together in the first place.

If you are in couples therapy then about 90% of what you have in your relationship is likely to be working.  The trouble is that we often can only see the 10% that’s not, just like a sore toe can make our whole body feel rotten.  Imago Relationship Therapy aims to bring that 90% back into your awareness.

So how do couples resolve disagreements in Imago Relationship Therapy?  When partners have things they want their other half to change the dialogue process will focus on “behaviour change requests”.  This is a way of dialoguing about something that you want done differently in your relationship and explaining what feelings go on for you when your partner behaves in that way.  These feelings are often linked to childhood and so there is some exploration of that area too.  Once the information about the issue has been sent the sender will also suggest ways in which their partner can do things differently. The receiver gets to choose which ones they may be able to “stretch into”.  If the receiver can’t see any other way of doing things then they couple will dialogue about that.

I’m sure you appreciate that this post can only cover the bare bones of what happens in a session. Imago Relationship Therapy provides an effective way of structuring couples therapy and keeps the process safe for both partners.  It’s about healing the wounds and bringing you together.  There is no sitting around slagging your partner off to the therapist or wallowing in all the bad things that have happened between you.  The aim is for you to be leaving the session feeling more positive about your relationship than when you came.  There will be times when you want to dialogue about painful events in your relationship and this will be done in a way that your partner can really listen, stay safe and avoid defensiveness.  By doing this wounds start to heal and the couple learn that their partner is an essential key to their own growth and happiness.

I’m going to finish this article by stating that I love doing Couples counselling, I feel passionate about it.  I think the Imago Relationship Therapy model I use is beautiful and I love seeing the couples I work with connecting with each other on a deep level whilst using it.  If your relationship is under pressure then I would love to work with you to help you realise the great relationship you could have too.

Does Therapy work?

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Does Therapy Work?Big question.  And as far as I’m concerned there is a simple answer.  Yes.  Therapy can work very effectively.   I can hear you now though, quite rightly, shouting at your monitor, “but you’re a therapist so you’re bound to say that” so let’s see if I can convince you further.

As a therapist my starting place has to be my own experience.  When I am working as a therapistI witness clients making positive changes in their lives consistently and I have also experienced these changes in my own life.  Sometimes it can take weeks for that “aha” moment to arrive, but when it does that moment can, literally, be life changing.  It was these moments, these insights into my own ways of thinking that stimulated my interest in psychotherapy.  I was able to use this knowledge to live my life differently, to develop better relationships and to change my behaviour for the better. Now, many years later, I have the privilege of being let into other people’s lives to support and guide them whilst they examine their lives and make positive change.

My next step is a quick trawl around the internet.  The website talkingcure gives many examples of where research supports the idea that therapy is effective.  Most of this research has been carried out by health services of countries around the world to see if they are getting their monies worth out of their counselling services (money is a great motivator for research!).

The following studies are just a couple of the examples included on the site:

  • Chiles et al (1999) found that psychological services reduced medical expenses in patients undergoing surgery and those with a history of over utilization.  On average, there was a 20% saving, even when the cost of providing the services was subtracted from the savings.
  • Research* showed that therapy carried out with men who batter their wives proved highly successful with 60% of men not re-offending within the thirty month follow up period and the wives of these men feeling “very safe” in 83% of cases.

Smith and Glass (1977) carried out research into the effectiveness of different types of therapy.  Results of nearly 400 controlled evaluations of psychotherapy and counselling were coded and integrated statistically. The findings provided convincing evidence of the efficacy of psychotherapy. On the average they concluded that the typical therapy client was better off than 75% of untreated individuals.  More interestingly, they found that the type of therapy received by the client had little bearing on the rate of success.  This is further evidence for the idea that it is what happens between the client and the therapist, the relationship that forms, that is the deciding factor for a successful outcome.

Martindale (1978) questions the validity of research into the effectiveness of psychotherapy and states that answering a question such as “does therapy work” is impossible as there are too many variables.  All clients are different, all therapists are different. He argues that a therapist may be effective for one client but ineffective for another.  It’s easy to see the logic of this argument and how we know which therapist is best for us will be the subject of another entry at a later date.

So where have we got to so far?  Both research and personal experience support the idea that therapy can be useful.  I appreciate that I have only given evidence of three research studies but I invite you to follow my links and check out my references for dozens of studies that conclude therapy is effective.

This does not mean however that we need to run to our nearest therapist and sign up for a course of treatment!  Going into therapy is a very personal and often very frightening step for many to take.  You take that step when you are ready to engage with the process and feel in your heart that it’s right for you.  I remember my first session even to this day.  I arrived fifteen minutes early and “cased” the joint to see if there was anyone around who would spot me going in. I seriously considered turning around and going back home!  Eventually I plucked up the courage, knocked on the door and therein began this journey.

I think that initial step of seeking emotional support from others may be more difficult for men than for women. This is backed up by the suicide figures for each sex where in 2008 where per 100000 of the UK population, 17.7 men committed suicide compared to just 5.4 women (age standardised rates taken from www.statistics.gov.uk).  Once more, I’m sure this will feature as a subject in my future writings.

So, to conclude, I would say that yes, therapy does work.  It can be an effective means to resolve problems as wide ranging as anxiety, stress, sexual identity, depression, lack of purpose, jealousy and a multitude of other issues that we can have whirling through our heads at particular times in our lives.  So when you’re ready, if you want to, pick up a phone and make that first appointment.

References

Chiles, J. et al. (1999). The impact of psychological interventions on medical cost offset: a meta-analytic review. Clinical Psychology, 6(2), 204-220.

Martindale, C. “The Therapist-as-Fixed-Effect Fallacy in Psychotherapy Research”. Journal of Consulting and Clinical Psychology 1978, Vol. 46, No. 6, 1526-1530

*Peterson, K. (July 27, 1988). Programs help men unlearn violence. USA Today, p. 1.

Smith, M. and Glass, G. “Meta-Analysis of Psychotherapy Outcome Studies”.  American Psychologist. September 1977. p752-760.

How To “Do” Therapy.

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How to "do" therapyNever had therapy? No idea of what to expect when you come for the first time to a therapist? Wondering what to “do”? All of these questions can naturally bring anxiety and tension for us and there’s no doubt that many are put off getting the help they need because they see counselling for “weak” people who should be able to sort their own problems out. Lets turn that around though. If we understand that many of us find the thought of going to a therapist for the first time daunting, then we can acknowledge that it takes bravery to step up to the plate and make that first appointment. It’s the first step down the road to positive change.

Any therapist worth their salt will recognise that you feel scared and unsure in your first session and will be supportive and reassuring. Once the initial session is over and you meet your therapist for the first time those stresses will ease and the fear factor will melt away.

In my first sessions working with individual clients and couples I spend time getting to know what has brought you into therapy and what you want the outcome to be. It’s also an opportunity for you to get a look at me and ask me any questions you have about the process, who I am, my method of working and decide whether you think I’m the right therapist for you.  It gives me an opportunity to decide whether I can help you or if it would be more appropriate to refer you to another therapist who could meet your needs more effectively.

So what are you as a client supposed to do when in therapy? Well the most important thing to do is be as open and as honest as you feel safe to be.  I’m not suggesting that you go into your first session and pour out your deepest thoughts and feelings, in fact I would advise strongly against doing that until you have tested the relationship with your therapist for a few weeks and you feel ready to expose yourself a little more.  Pace yourself, get used to the process and relax.

Many would argue that the type of therapy you have is unimportant.  They are all just different ways of reaching the same goal.  The relationship you have with your therapist is the key.  Building trust and learning intimacy in a unique safe setting can be a truly liberating experience.  The relationship you have with your therapist gives you the space and opportunity to test out a different way of relating to people in a safe environment.

Before you know it, you will be “doing” therapy without giving it a second thought.  Hopefully this will be a life changing experience.