Schools of Psychotherapy

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I said that there are various major camps of Counselling and Psychotherapy, into which many of the different therapeutic approaches fit. I made mention of the Humanistic, the Cognitive-Behavioural, and the Psychodynamic therapies, as well Existential Therapy in which I specialised. I will discuss each of these in turn, with respect to how I practiced them as a mainstream therapist, and how they now enter into my Philosophical Counselling.

Humanistic Therapy

Humanistic Therapy emerged in response to the philosophical movements of Existentialism and Phenomenology, which were at the intellectual cutting during the early and middle-20th century in Europe and America. Phenomenology arose in response to the scientism of the 19th and early 20th century, for example Logical Positivism, which claimed that only that which can be empirically verified is true. No logical positivist ever got around to empirically verifying that claim, of course, which kind of matters when that claim is the starting point of your whole philosophy, but of course a concern for contradiction never stopped people from stating that "There is no such thing as truth" (i.e. the truth is there is no such thing as truth) or that "You shouldn't judge" (i.e. the morally right judgement is to reject all moral judgements) or "But that's a generalisation!" (i.e. as a general rule you must never generalise). 

Phenomenology studies conscious life. It attends to experience as it is lived: perception, thought, value, meaning, desire. Many of the most important things in life—the concerns of the heart, the things that make life worthwhile—can only be adequately understood from the inside, as experiences. Phenomenology is therefore a descriptive form of analysis, rather than a hypothetical one. When we do phenomenology we are not speculating or theorising or explaining, rather we are paying deep, careful attention to reality as we experience it. We are finding words to capture that experience in its form, quality, meaning, patterns.

I should add that Phenomenology is a form of modern philosophy, and once again it repeats that habit of reducing the whole to the part. Classical philosophy recognises the legitimacy and need to do both descriptive and metaphysical work. (We cannot escape metaphysics, for example if you claim you have no metaphysics, that simple means you are ignorant of the one you have; nevertheless it is directing your thought.) We cannot do descriptive work only. The idea of experience in Phenomenology becomes narrow, to the point that it becomes closer to a psychological phenomenon. This is its limitation from a philosophical perspective, and it means that it can distort our vision when our main discipline is phenomenology. At the same time, it also means that phenomenology becomes a powerful and ready resource for Psychotherapy. 

Many of the Humanistic therapies are, in essence, phenomenology adapted for therapeutic purposes. This is like my claim that Counselling is the exercise and cultivation of practical wisdom—some therapists will disagree, while others will agree, and yet others may find the idea compelling without deciding on it. Certainly, when it comes to Existential Therapy this claim, and the points I make about the power of therapeutic phenomenology, are not controversial, although once again there are different kinds of Existential Therapy and not all are focused on the same thing. Emmy van Deurzen, for example, is less focused on the therapeutic relationship compared to Irvin Yalom.

In therapeutic phenomenology those aspects of the discipline that have personal healing and growth potential are emphasised. This means means that there are differences between philosophical and therapeutic phenomenology. ​Philosophical phenomenology typically works with individual experience in the pursuit of a more general level of truth—there is an emphasis on the truths of our common humanity. Therapeutic phenomenology is certainly concerned with that, but it places more emphasis on getting at particular, individual truths—the truths of your life, your history, your inner world, which may differ from mine. For this reason, there is also greater emphasis on the therapist's relational way of being: their embodiment of warmth, empathy, and non-judgemental curiosity in service of the client's insight, well-being, and growth.

How is therapeutic phenomenology so helpful? It may sound strange to say, but in fact we are often blind to our own experience of life. I noted earlier that people can live without much awareness at the concious level, and this includes with respect to our experience even as it is happening. Of course, people vary in this respect, with some having rather good self-awareness, and some very poor self-awareness. The fact that somebody claims to have excellent self-awareness does not mean that they do; we are often blind to our own blindness. The challenge gets worse because such blindness is a form of vulnerability, and so our defensive ego gets involved, leading to an even greater entanglement. This is why phenomenological therapy can be so helpful. It is training and guidance in becoming more self-aware. To be self-aware is to gain insight into yourself.

The self-awareness and insight gained through this work is both a form of seeing, and a form of being in touch with, your experience. Its benefits are profound:

• It gives you understanding of the currents of your conscious life. Understanding is often good in itself; we value it for its own sake.  
• That understanding provides information for working on yourself, whatever form that further work may take—existential, cognitive-behavioural, philosophical.  
• Getting in touch with your experience is itself a form of processing and so shifting emotional knots: old wounds, current grief, patterns that have held you for years.  
• Insight can also be spontaneously transformative in itself, even without further effort. It can be intrinsically healing, liberating, clarifying, reorienting. Consider how new information or a powerful realisation has changed you in the past. I am speaking not only of general truths--"I see now: this struggle is part of the human condition, not proof that I am uniquely flawed"—but also of particular truths: "I never noticed what I was doing, but now I see the structure of my despair: I feel hope, but that invites fear, which is painful, so I meet it with aggression, which takes the form of denying that any hope exists." Once you see the game you have been playing, you may simply stop playing it.  
• Phenomenological insight puts you in touch with richer dimensions of your inner life that may have been blocked. It liberates passion and depth of experience. It puts you in touch with desire, so you can see what you truly want. That knowledge lifts you out of decision-paralysis, enables better choices, and constitutes the motivational energy to enact those choices. It helps you assert boundaries, not least because you are more in touch with the spirited part of yourself. And all of this insight into yourself makes you better able to understand others, which makes you a better parent, partner, friend.

The phenomenological humanistic therapist is a guide who helps you to engage in such reflection, aimed at this self-awareness. They have walked this same kind of path many times before, in themselves, and alongside others. You hire them as a guide in this kind of terrain, in search of the above kinds of goods.

To help you explore your inner terrain and find these goods, the therapist invites you to join them in seeing and being in certain ways. Just as Philosophical Counselling helps you become more wise by inviting you into wiser conversation, phenomenological therapy invites you into a phenomenological way of being. The two of you are not merely doing phenomenology as a detached technique; you are being together in a phenomenological way. You learn by doing. This is why the achievements of the therapy are in fact your achievements. The therapist merely walks the walk and invites you to walk with them. You decide whether to accept the invitation and make the effort to see and be with yourself in this powerful way.

The therapeutic relationship, and what I call the therapeutic gaze, are another powerful aspect of such therapy. Have you ever had your sense of self transformed by a good lover, a good friend, a good mentor, or the like? The therapist joins those ranks. Through the therapeutic gaze, the client may come to see themselves as the therapist sees them. This again is fundamentally up to the client, and so it is their achievement—somebody may offer you food, but it is up to you whether you take and eat. 

The founder of Person-Centred Therapy, Carl Rogers, referred to that therapeutic gaze, therapeutic way of being, and therapeutic relationship as one of unconditional positive regard, accurate empathy, and genuineness. Using the language of the philosopher Simone Weil we might call it "a just and loving gaze" which is "a need of the soul." Some may react aversely to the notion of a therapist offering a just and loving gaze, as if there were something grandiose and out of place for a professional relationship, but consider the language carefully. Justice: seeing clearly, with balance. Loving: respectful, empathetic, kind, encouraging. Or to use earlier terms: a gaze that is as true and good as possible. Remember that phrase? It is my definition of wisdom. Again in philosophical language, a part of the therapist's role is to offer a wise gaze, a wise vision of the client, which they may internalise if they are willing to do so. For we learn how to see, by seeing how others see, by seeing things in the light of another's vision. To see yourself in the light of a a more true and good vision is to begin to have this vision of yourself. That may be fleeting at first, but the work of ongoing therapy is to strengthen and deepen it. 

Is this a description of Humanistic Therapy as it is generally understood, or a description of my very particular vision of it as a philosopher. It is both, for my vision has been honed not only by my training in mainstream humanistic therapies, but by my perspective as a philosopher who came to study therapy, and by my years of humanistic and existential therapeutic practice, followed by years of philosophical counselling. It is a vision of Humanistic Therapy that can be readily integrated into Philosophical Counselling, and all that I have described above is present in my work, depending on the wants and needs of the individual client. Remember I said that phenomenology is a part of a greater whole. 

Cognitive-Behavioural Therapy

I draw also on Cognitive-Behavioural Therapy (CBT) because it offers many powerful and practical tools. Cognitive-Behavioural Therapy is the-therapist-as tradesman, as personal trainer, but whose material and tools are psychological.

CBT guides you to examine the causal relationships between your thoughts, feelings, and actions—the mechanisms of the psyche, so to speak. Many people feel trapped in patterns they can sense but not name—loops of self-criticism, spirals of anxiety that seems to begin from nowhere. In CBT,  we learn to catch the automatic thoughts that flash through the mind, often so fast and so habitual that they feel like reality rather than what they are: interpretations, assumptions, learned responses. By bringing these thoughts into the light, we can examine them with a kind but clear-eyed curiosity. Are they accurate? Are they fair? Are they serving your deeper values?

CBT is not about mere positive thinking or denying genuine pain. It is about helping you see that many of the thoughts you treat as facts are questionable assumptions and interpretations. Such insight, in itself, loosens the grip of a cognitive habit. Sometimes that is enough. At other times, as with classical philosophy, we push that process along by engaging in better activities of thought, feeling, or action, doing so intentionally and repeatedly so that such activities become habits, and this becomes our new way of being and psychological state.

Psychodynamic Psychotherapy

Psychodynamic Psychotherapy starts with the insight that so much of what shapes our lives—our fears, our relational struggles, our repeating disappointments—is rooted in material of which we are not fully conscious. Many people experience repetition and stuckness not because they lack insight or effort, but because something older, something buried, keeps pulling the strings. Psychodynamic work is about bringing those hidden dynamics into awareness. It recognises that our earliest relationships, especially with caregivers, create blueprints that we carry into adult life. We might find ourselves drawn again and again to unavailable partners, or paralysed by authority figures, or unable to express anger without overwhelming guilt, without understanding why. Our very perception of reality, for example whether somebody is being kind or manipulative, can be distorted by these unconscious dynamics. 

One of the most useful things I take from Psychodynamic Psychotherapy is the concept and analysis of psychological defenses. It can be incredibly helpful to a person to be able to recognise when they are acting out a defense, and the nature of that defense, and its effects in their life, and its triggers, plus its origins in their life. This is not only an exercise in self-knowledge, it is an exercise is overcoming madness: coming to distinguish between your psychologically-blinded states versus more lucid states of perception, and freeing yourself from the former.

Consider just a handful of the most common defenses. Projection casts your own unacceptable feelings or traits onto someone else. The angry person experiences others as angry, the egotist is shocked at the egotism of others. Rationalisation spins elegant, plausible reasons for what you have done or failed to do, shielding you from your true motivations such as envy, fear, or whatever it is that you and/or others find unacceptable or shameful. Reaction formation turns a forbidden impulse into its exaggerated opposite—cruelty masquerading as overprotective care, or contempt dressing itself in saccharine politeness. Avoidance (including its sophisticated cousin, intellectualisation) keeps you at a safe distance from emotional material by changing the subject, busying yourself with tasks, or explaining and theorising rather than feeling. Splitting divides the world into all-good and all-bad, protecting you from the anxiety of ambivalence, but at the cost of never seeing people—or yourself—in their full, flawed but acceptable humanity. Perhaps the most pervasive of all, denial, simply refuses to register what is plainly there, whether it is a partner's distress, your own burnout, or a terrible trajectory. The defenses are driven by base desires for comfort, whether in the avoidance of discomfort, or the getting of something we want. If a human being is analogous to a rider and a horse, the defenses are the horse taking over, the unconscious animal blinding and directing consciousness.

To name the defenses, to catch them in action, is to slowly reclaim the territory of your own mind—not to eliminate them entirely (for they are part of being human), but to reduce their unconscious grip. While there are psychodynamic means for addressing the defenses and changing our patterns, the main power of this approach is the insight we gain. We can then choose to work on our problematic psychological patterns them others means, for example the tools of Cognitive-Behavioural Therapy or the powerful perspectives of Existential Therapy, or of course the work of Philosphical Counselling with its cultivation of the virtues.