Week 5: 7th November 2008

An interesting case study that Anne read to us about STAN, whose relationship with his children had deteriorated due to his constant criticism of them, the therapist and indeed the whole world. Using his therapist as a screen, Stan explored his own childhood where he had been unduly criticised by his own parents. He then transferred this destructive behaviour to his own children. The class identified a psychodynamic model of counselling as appropriate for Stan because it would touch upon issues of transference, treatment, relationships, childhood and interpretation.

We then tried to define 'sympathy' and 'empathy'. Though the two seem similar, it was surprisingly hard to distinguish intellectually between the two:

Sympathy .... "a set of circumstances in which one shares in the feelings of another". Penguin dictionary of psychology, 1986 (I'm sure there is now an updated version of this).


"Empathy is often confused with sympathy, compassion, and emotional resonance. Although these are all important aspects of intimate relationships, empathy is somewhat different. Empathy is a hypothesis or educated guess concerning your client's internal state. It is a method of observation that relies on your interpersonal sensitivities and skills, combined with your capacity to think about what you are feeling. You dip into another's experience as best you can using your emotions and imagination, then subject your experiences to conscious consideration in light of your knowledge and training". The Making of a Therapist. Louis Cozolino, Norton 2004

Discussion of CBT (Cognitive Behavioural Technique) followed, which seeks change in the client but does not use a psychodynamic approach (which focuses on relationships) but instead deals with the feelings aroused in the client by events or thoughts that the client has.

EG: You walk down the street and you see your neighbour. She ignores you. What could your reaction be? Anger to indifference encompasses a range of instant automatic feelings. In turn, those feelings are governed by your experiences and upbringing. So, if you felt anger, a response might be 'she's so rude!' or the incident might upset you because it puzzles you. What have you done to upset her? If such incidents create undue anxiety then the scientific CBT approach would be to apply Socratic questioning to the incident:

- What is the evidence that your neighbour ignored you?
- What is the evidence that your neighbour likes you/doesn't like you?
- How much do you believe that?
- What's the worst that can happen if she doesn't like you?

Thus the client can recontextualise their experience.

Anne thinks that CBT is useful in treating panic attacks, phobias and depression. It's a buzz word in the NHS becasue it's a bit of a sticking plaster for particular conditions but doubtless useful.

We were encouraged to consider which model of counselling appealed to us. So far I would say person-centred. Simply because it closely echoes my own method of helping which seems to have evolved from giving out advice (often unasked for!) to asking questions which help whoever it is to explore their true feelings on the subject.

We moved onto transactional analysis. This was fascinating because it resembles the relationship frameworks of much written drama. Again quite scientific in its approach, Eric Bern identified the parent, child and adult ego states.

Parent ego state is either nurturing or authoritarian
Child ego state is unadapted (spontaneous) or adapted (cross or sulky)
Adult ego state is negotiating and adapting.

If, in a relationship both are are in the same state then the relationship is complementary.
if both are in different states then the transcactions are crossed and conflict ensues.

Thinking about it, this seems to be tha basis for parenting, in that both parents may assume different parent ego states. One is nurturing, one is authoritarian. Good cop, bad cop, I guess.

Anne asked us to consider whether 'scripts' played a part in our lives. That is to say if parental expectations of us eg:'you're hopeless and will amount to nothing' was something we confounded by working too hard or totally fulfilled and did nothing with our lives.

Finally, we discussed the dramatic triangle. Three points of a triangle marked VICTIM, PERSECUTOR, RESCUER. this was a great way of examining situations of high emotional content and how individuals might swap from one point of the triangle to another.

The Pied Piper Of Hamelin is a good archetypal story that demonstrates this model whilst in recent history, the Cleveland Child Abuse scandal could be interpreted in this way.