People are often confused by the difference between the terms psychotherapist and counsellor, as they will come across both. But, essentially, there is no difference between them. How practitioners style themselves is usually just a matter of personal preference (for instance, some think the term counsellor sounds more friendly; others might think the term psychotherapist sounds more professional).
Newspaper and magazine articles on the subject of seeking therapy usually recommend that you check the register of certain organisations that accredit or register psychotherapists and counsellors. But, although well intentioned, this is not necessarily the best advice. How much training people have had, or which professional bodies they belong to, gives you no guarantee of their effectiveness as a therapist. Indeed, if practitioners stick rigidly to one model of therapy, as described above, they are not at all likely to be as effective as they could be.
The main point to remember is that whether people call themselves psychotherapists or counsellors, they will all encounter the same range of human distress in their work. All that really matters is how effective they are at helping other people.
Effective counselling checklist
What follows is a checklist prepared by experienced counsellors and psychotherapists. They stress that an effective psychotherapist or counsellor will:
- understand depression and how to lift people out of it
- help immediately with anxiety problems including trauma (post-traumatic stress disorder) or other fear related symptoms
- be prepared to give advice if needed or asked for
- not use jargon or 'psychobabble'
- not dwell unduly on the past
- be supportive when difficult feelings emerge, but not encourage people to remain in an emotionally aroused state
- assist individuals in developing social skills (when appropriate), so that their needs for affection, friendship, pleasure, intimacy, connection to the wider community, etc. can be better fulfilled
- help people to draw on their own resources (which may prove greater than they thought)
- be considerate of the effects of counselling on the people close to the individual concerned
- induce and teach deep relaxation
- help people think about their problems in a new and more empowering way use a wide range of techniques
- may set tasks to be done between sessions
- take as few sessions as possible
- increase self-confidence and independence and make sure clients feel better after every consultation.
There are some therapists who work with in this way and work in these ways.
There are some other important aspects to consider too, when making your choice.
Whatever type of therapist you see, you need to be sure that they have the I spare capacity' to work with you. Someone who is preoccupied with their own personal concerns or troubles will not be able to distance themselves sufficiently to work with yours. You will have to use your own judgement and instinct in deciding whether this is the case or not, but there is much to be gleaned from someone's manner - are they relaxed, warm and comfortable to be with, for instance, or slightly anxious or brittle?
Do they give you their full attention or are they too full of themselves and seeking attention from you? Or are they perhaps too keen to push you to talk about (or not talk about) certain issues, which may reflect their own unresolved concerns?
Remember, the therapist's responsibility is to work to help you. You should not feel that you need to accommodate the therapist.
Your reality, not theirs
Some people think that they need to see a therapist who comes from the same background or has the same sort of life experience, or has even experienced the same kind of trauma or discrimination as they themselves have - otherwise how will the therapist understand where they are 'coming from'? But this is quite irrelevant in an ideal psychotherapeutic approach. Because the emphasis is on what clients can do to meet their own needs, well trained therapists can work with anyone. What you wish to achieve or change in your life is your decision. It doesn't make any difference whether you are younger or older, from a different ethnic background, have a different religion or a different sexual orientation from the therapist you see. You establish, with their help, which needs are not being met in your life and set your own goals. The reality or world they are concerned with is yours, not theirs.
Working the way the brain works
High on the list of our important' human givens' is the ability to relax and imagine and think creatively. Some therapists 'tap into' their clients' innate ability to relax deeply and make use of that relaxed state to introduce positive suggestions and ideas, as well as helping them use their imaginations to rehearse success in new skills. When you are relaxed, the right (visual, more intuitive) hemisphere of your brain is dominant, while the left hemisphere (which is more involved in language, analysis and rational thought) takes a break). It is the right hemisphere that is active when we dream, and its natural way of working is through metaphor. (We are using metaphor whenever we say something tastes, looks or sounds like something else.) Metaphors conjure up pictures and sensations that the more imaginative right hemisphere can instantly relate to. And by bypassing the often resistant or negative rational part of our brains, we can take on board new ideas and useful analogies.
This is why metaphor is used a great deal in some psychotherapist's approach. To a young woman who loves nature and who has struggled throughout her life because of childhood abuse, talk of 'rooting' new ideas or 'fertile soil in which a fragile flower can at last flourish and grow strong' can be powerful indeed. Similarly, someone who is held back in their work life through their fear of taking risks, and who happens to be a keen swimmer, may respond to the idea of 'taking the plunge' and an image of rivers flowing freely. Stories are the kings and queens of metaphor, and much can be achieved instantly, with an apposite tale, that might otherwise have taken weeks. Tales of overcoming misfortune, heroic acts, kindness that triumphs, loyalty that never wavers, dreams that, with hard work and belief, come true - these connect with us through our natural pattern-matching facility and lead us unconsciously to make the link between the metaphor or story and our life.