Keeping an overview

Therapy comes in many forms and can be described in a number of different ways. So how about this for a mouthful: a bio-psychosocial-spiritual approach.

This was the subject of a recent article on the future of psychotherapy by John Lees, Associate Professor of Psychotherapy and Counselling at the University of Leeds. It might be an intimidating description of therapy, but let’s not be put off by a form of words that is just trying to capture the essential elements of what therapy is all about. We can break it down:

  • bio = our physical/biological self;
  • psycho = our ‘mind’ or our psychological part;
  • socio = the relating part of us that interacts with others;
  • spiritual = the part of us that senses connection with universal or transcendent aspects of our existence.

It was only during the latter part of the twentieth century that counselling and psychotherapy began to focus on all of these ‘parts’ of us when working with people experiencing psychological and emotional distress. This development resulted from increasing innovation and creativity within the profession over this period. John Lees rightly argues that we should continue to build on this progress in the twenty-first century.

As the therapy professions attend more fully to individual client needs, different parts of ourselves can be reached and acknowledged. However, our parts are not completely separate aspects of who we are – we need to take a holistic approach. We are complex living unities and our particular problems in living will almost certainly have arisen from more than one source. For example, chronic symptoms of physical pain may not just (or even) arise initially from physical/biological causes. So maintaining flexibility in our approach to therapy is essential if counsellors are to continue to develop and respond to the changing needs of their clients.

A difficulty here is that publicly funded mental health services will always be under pressure to produce clearly measurable results within a relatively structured and recognisable framework of ‘treatment’. This is understandable – we want the details of how public money is being spent to be available for scrutiny. But it is also understandable that counsellors need the freedom to respond to their individual client’s unique psychological and emotional needs, free of unhelpful constraints imposed by a more narrowly focused set of values. The tension between these two positions will not be resolved any time soon.

Returning to the client, if we compartmentalise our parts while we are struggling we can become trapped in uncomfortable patterns of functioning. The counsellor’s role is to facilitate the client’s exploration of this, to enable the client to challenge any limiting beliefs and explore how such beliefs might have developed. This is not straightforward work and it is to the credit of the therapy professions that some excellent results have been achieved through the very creativity and innovation that John Lees has highlighted.

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