The Therapeutic Use of Self

Counselling practice, research and supervision

Val Wosket

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781135038465
• Edition: 2
• Topic: Psychologie
• Subtopic: Psychotherapeutische Beratung

The Therapeutic Use of Self has continued, since its publication in 1999, to be considered a key text within integrative, humanistic and relational approaches for the training and development of therapists in the UK and abroad.

This long-awaited classic edition includes powerful case examples and extensive research findings, presenting the counsellor's evaluation of their own practice as the main vehicle for the development of insight and awareness into individual 'therapeutic' characteristics. The book addresses many of the taboos and infrequently discussed aspects of therapy, such as:

• The value of therapist failure

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• Breaking the rules of counselling

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• Working beyond the accepted boundaries of counselling.

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The Therapeutic Use of Self will help professionals and trainees acknowledge, develop and value their own unique contribution to counselling and psychotherapy. The book remains a ground-breaking examination of the individual therapist's contribution to process and outcome in counselling and supervision.

1 Towards an approach to counselling based on the use of self

DOI: 10.4324/9780203772263-2

If psychotherapy is to forge its future, it must begin with the end of theory.

(Karasu 1996)

In this first chapter I do not intend to outline a model of counselling. This may come as something of a relief to readers who, like myself, feel that the world of counselling and psychotherapy already has a surfeit of schools, approaches and models. In any case, as Collier (1987: 53) has dryly remarked, ‘accounts of the “what I do in therapy” variety usually come to grief on the twin reefs of egoism and tedium’. Therefore, instead of recounting what I do as a counsellor, I intend to start this book with a review of recent literature on the use of self in therapy and then present a rationale for why I think greater attention should be given to the therapist's use of self. I will also offer some thoughts on where the use of self might fit into current trends and future developments in the field of counselling and psychotherapy.

Recent developments in the field have seen something of a burgeoning of interest in the therapist's use of self. Several publications have focused exclusively on this aspect of the therapist's contribution to process and outcome in psychotherapy (Andrews 1991; Baldwin and Satir 1987; Lambert 1989; Real 1990; UKCP 1997) and others have recently highlighted the self of the therapist as an important determinant in the therapeutic encounter. But what, precisely, is meant by the term ‘the therapeutic use of self’?

TOWARDS A DEFINITION OF THE SELF

Before proceeding further I will hazard a working definition of self in the sense that I will be using the term in this volume. This is not an easy task as the question who, or what, is the self is one that has long vexed philosophers, novelists, poets, psychologists and sociologists and continues to intrigue authors of the psychotherapeutic literature today (see, for example, Baldwin, D. 1987; Bragan 1996; Brazier 1993; Erwin 1997; Gergen 1996; Hobson 1985; Holdstock 1993; Stevens 1996b). Erwin points out that the term ‘self’ has many different connotations and meanings within the psychotherapy literature amongst which are: a person, the ego, the mental apparatus, the whole or the core of the personality, a set of self representations or an inner agent or entity. The situation is further confounded if we consider that in much that is currently being written about the self, as Erwin (1997: 47) has commented, it is not always clear ‘whether the author is really postulating an inner self, or is merely speaking metaphorically, or perhaps just writing carelessly’.

A number of writers have emphasised that the self is primarily constructed through interaction with others (e.g. Andrews 1991; Cashdan 1988; Friedman 1992; Howe 1993; Laing 1977, 1990; Mann 1994; Stevens 1996a). This is a view espoused particularly by feminist psychologists and arises from their assertion that identity for women is principally constructed from their sense of self in relationship with others (Zweig 1996). This view is not, however, limited to a feminist perspective. Cashdan (1988: 47) proposes that ‘the child does not begin life with a self but incrementally constructs one through socially engaging others’, while Laing asserts that ‘every relationship implies a definition of self by other and other by self’ (Laing 1977: 86). A sense of identity, according to these writers, is initially and profoundly formed by the relationships one experiences as an infant and further refined by the cultural and historical context in which one develops. ‘The seed of one's self-concept is the internalization of how significant others, beginning with parents, have communicated to one, about one, in the past’ (Andrews 1991: 8). As Laing puts it ‘one's first social identity is conferred on one. We learn to be whom we are told we are’ (Laing 1977: 95).

I share the view that while the sense of self is initially formed by early relational configurations it is not forever fixed and defined by these. A number of contemporary writers who have considered the notion of self in psychology and psychotherapy emphasise its fluid and reflexive nature (e.g. Andrews 1991; Cashdan 1988; van Deurzen-Smith 1988; Gergen 1996; King 1996; Mann 1994; Peavy 1996; Stevens 1996a; Wetherell and Maybin 1996). According to Andrews, initial self-concept does not necessarily remain fixed but is constantly being adapted and refined in response to environmental factors.

[T]here is an active, in-motion quality about the sense of self. It is not only that a person ‘has’ a self-concept, an image of personal qualities and characteristics; in addition, he or she is continually testing, confirming, extending, and reconceiving that image in each new situation. The sense of self is as much verb as noun. And it is this fluidity of self-conceiving – the fact that the self concept is sustained by an ongoing definitional process – that makes psychotherapy possible and fruitful. The central function of the therapist is to help the client channel that process.

(Andrews 1991: 6)

In the chapters that follow I take this view of the self-in-process. This is the perspective espoused by Carl Rogers (1967, 1980, 1989) who considered the self to be a fluid, growing, changing phenomenon, full of the possibilities of becoming, rather than a fixed and fully formed entity. For Rogers the pre-eminently important environmental factor for the client in the process of becoming is the person of the therapist.

Thus in a good enough therapeutic relationship clients may redefine themselves. Winnicott (1965, 1986), in promoting the idea of ‘good enough’ mothering, has observed that ‘in the therapeutic child-care situation’, where inadequate mothering is corrected by therapeutic intervention, ‘one is often rewarded by the emergence of a child who is for the first time an individual’ (Winnicott 1965: 17). Winnicott has further asserted that ‘what we do in therapy is to attempt to imitate the natural process that characterizes the behaviour of any mother of her own infant’ (ibid.: 19–20). The same process may apply to the adult client who will emerge from a therapeutic relationship in which they have been well cared for with a more integrated and differentiated sense of self. More about the ‘good enough’ therapeutic relationship is said in Chapter 2.

So it appears, if this view of the self is adopted, that being in a relationship has the potential to both limit and liberate the self. The majority of our clients will initially present as if the self and its attitudes and behaviours are fixed and I see it as a primary function of the therapist to intervene in such a way that the client experiences their self-concept unfreezing and becoming open to change and development. To begin to let go of what one has long considered to be certainties about oneself can be frightening and disorientating for the client and the daunting task for the therapist is to provide the right balance of care and safety with sufficient disconfirmation of the client's fixed or false sense of self to effect dissonance that can then lead to growth and healing. This takes patience, sensitivity and tenacity on the part of the therapist. If, as I believe, such a process of redefinition of self applies to the client in the therapeutic relationship it will also apply to some degree to the therapist as co-creator of the relationship. The way that therapeutic work impacts on the self of the counsellor provides one of the great motivators and rewards of our profession. This proposition is discussed further in subsequent chapters.

USE OF SELF AND THE PERSON OF THE THERAPIST

It is important to note that in what follows I am making a distinction between the person of the therapist and the therapist's use of self. Because the person of the therapist pervades the therapeutic relationship, some aspects of who the therapist is unavoidably become accessible to the client to a greater or lesser degree. Therapists inadvertently reveal themselves in innumerable small ways as they present themselves to clients through such aspects as dress, accent, age, voice intonation, skin colour, involuntary changes in movement or facial expression, mannerisms, the furnishings and state of orderliness of the counselling room, and so on. Yet inadvertent self-disclosure is not the same thing as intentional use of the self.

Vanaerschot (1993: 49) has commented that ‘the important part of the therapist's attitude is not the fact that, in his contact to the client, the therapist eliminates himself as a person, but the very way in which he applies himself’. Rennie (1998: 103) makes a similar observation in pointing out that the therapist may be ‘present as an attentive listener … but absent as a personality’ (original emphasis). Rennie suggests that Carl Rogers, despite his unsurpassed skills of empathy and attentive listening, for the most part kept himself aloof in the therapeutic encounter and showed a marked reluctance to explore his impact on clients (whilst displaying sustained interest in how clients impacted on him).

If the therapist's personhood is a given presence in the therapeutic encounter, their use of self is evident in the way that they extend aspects of their personality with the intention of influencing the client. Use of self involves the operationalisation of personal characteristics so that they impact on the client in such a way as to become potentially significant determinants of the therapeutic process. Most extended training courses in counselling and psychotherapy now include a substantial component of personal growth work whereby students are required to address aspects of self-development (Connor 1994). A growing number of courses have a requirement that students undertake a period of counselling or therapy whilst in training in order to deal with their own personal issues that arise in the process. Few, if any, explicitly address the topic of the therapist's use of self by guiding students through a systematic and rigorous educational process designed to help them identify, research, evaluate, enhance and integrate attributes of self in order to begin to meld these into their own unique and individual styles of counselling.

PROFESSIONALISATION AND THE USE OF SELF

Now that counselling and psychotherapy have reached the proportions of an industry (Bond and Shea 1997; Thorne 1995), moves to regulate that industry are in full swing. The professionalisation of counselling appears to be proceeding apace with the advent of registration, licensing and accreditation procedures and the emergence of training standards related to the assessment of competence, as pioneered by the Lead Body for Advice, Guidance, Counselling and Psychotherapy (AGC and PLB 1995).

One danger inherent in the increased clamour for accountability and professionalisation is that the therapist who takes an individualistic and unorthodox stance will have their voice ignored or, worse still, find themselves scapegoated and driven underground. Clarkson and Aviram (1998) have suggested that orthodox adherence to established theory is one way in which innovation is stifled and existing power structures within the profession are shored up. Hutterer (1993: 280–1) has written about the pressures to conform apparent within the ‘trend towards instrumentalism and technology’ that has become evident in the world of counselling in recent years. He sees this trend being fuelled by ‘economic demands and competition between distinct therapeutic schools’ and considers that it is the pressure to be successful which, in turn, has promoted ‘closed and narrow views of effectiveness’. The trend has led to a growth in technical eclecticism and the popularisation of time-limited interventionist approaches, particularly cognitive-behavioural ones. The therapists who are most likely to lose out if this trend continues are those who eschew the power of technique in favour of viewing the therapist as the primary instrument of healing.

My informal conversations with experienced practitioners suggest that in this climate there may be a vibrant underground of therapists who are working in more personally determined ways and my own research (see Chapters 5, 6 and 7) confirms this. Duncan et al. (1992) have identified a pragmatic process of professional development that takes place for many therapists as they ‘discover the need to reassess their assumptions about their clinical practices after experience shatters the illusions provided by their chosen orientations’ (p. vii). They point out that no model of therapy is without its limitations, nor is wholly accommodating of the numerous exigencies of clinical practice. Once the model acquired in training has been thoroughly tested and found wanting, seasoned therapists who wish to grow in professional stature will naturally re-engage in a renewed search ‘for a reliable but flexible intellectual framework to guide the therapeutic process’ (p. x). Kottler (1986: 15) puts a time-scale to this process and suggests that ‘the first decade of our professional life is spent imitating the master clinicians before we ever consider what we really believe in our hearts’.

Whenever I bring up the subject of unorthodox practice in the company of one or two therapists I find agreement ...