Recently, I started to see a new counsellor which has got me thinking a lot about different approaches to counselling and therapy, and how it’s so different for every person. I’ve seen various types of therapists over the last fifteen-ish years and I’d never really thought much about different approaches but the person I’m seeing at the moment has a very specific way of working- person-centred counselling which I’d heard of but I’d never really come across before. As anyone who’s read my blog posts before will know, I’m a massive advocate for DBT and approaches that have a direct, structured way to manage intense thoughts or emotions and the person-centred approach is about as far from that as you can get, so I’m not overly surprised I’ve found it difficult but it’s taken a few sessions to realise what it is about the approach I don’t really get on with.
In theory, person-centred counselling is a really good idea. It works on the idea that a person’s experience is individual and that they should be in control of the sessions and what is brought up- the counsellor/therapist is a facilitator who encourages the person to talk about how they feel and their experiences while being empathetic, non-judgmental and accepting of what the person is saying. There’s no ‘set’ format for the sessions and the idea is that the person talks about whatever they are feeling and want to discuss, and the counsellor/therapist listens to and empathises with the person so that they feel validated and can explore their feelings more openly in order to facilitate changes in themselves. I can see how, for a lot of people, this could be a really useful approach and could effect real change in how a person is feeling in a supportive and non-threatening way, but I’ve found it really difficult to get used to and I don’t think it’s the right approach for me which is a bit frustrating because I really do want to change the way I’m thinking and feeling and learn better ways to manage it.
I found the first session particularly difficult and uncomfortable. It was partly due to seeing someone new which is always scary and awkward, but also because of the unstructuredness of the session and the whole concept that it was up to me to decide what to talk about and I genuinely had no idea. There were a few things that made me uncomfortable and I think the counsellor was feeling similar, and I started to feel really, really anxious which didn’t help because I’d started to fidget a lot and dig my nails into my arm without realising it which is my automatic way to manage anxiety in social situations but I don’t think the counsellor realised that. She kept saying that I was in control of the sessions and that I should talk about how I’m feeling but part of the problem is that I don’t know how I’m feeling or what the feelings are and they’re too intense anyway, and I just want to get rid of them not talk about them! And I really need structure, which was making me really anxious.
At first, I thought that it was the lack of structure and focus on ‘feelings’ which was making me uncomfortable and in the second session, I was totally honest with her and said that I didn’t like the approach, I needed structure to the sessions, I didn’t know how I was feeling or if I even had ‘real’ emotions and that I didn’t like the idea of life as a ‘journey’ because it doesn’t feel like that, it’s just like existing at any given moment, and to be fair to her she did try to adjust to that and wrote a list of things to talk about. It didn’t really help though, it just felt artificial and she was still asking me to come up with the things on the list, but I know she was trying so I didn’t say anything. I realised pretty quickly though that the lack of structure wasn’t the main thing that was making me really anxious and uncomfortable- it was the ‘connection’ between the person and the counsellor that I really didn’t like and I’m not sure if I can keep going to the sessions if that’s an intrinsic part of the approach.
A big emphasis in person-centred counselling is the relationship between the person and the counsellor, and it’s meant to be a genuine, empathetic and unconditional sort of relationship. I really, really don’t feel comfortable with that at all- I’m not an emotional-type person, I very rarely get ‘close’ to people (even people I trust) and the whole idea makes me really anxious. She keeps talking about ‘walking with me’ which I don’t like or want- I’m really not comfortable with anything like that and she hardly knows me, and I’d much rather have a professional-type relationship where there’s no emotional connection at all. I can count on one hand the people I currently feel ‘close’ to and the fact that there’s more than one person terrifies me anyway, and I don’t like it.
The relationship idea makes me really anxious and I can feel my defences going up when I’m talking to her- I’m minimising everything, shutting down any emotional reaction, being very matter-of-fact about anything that makes me even remotely upset or emotional, and I don’t think it’s helpful in any way at all. A few years ago, I saw a psychologist who used an integrative approach and sometimes veered into psychodynamic which has a similar feeling of unstructuredness and focus on ‘you’ and your experiences, and she used to comment that I “intellectualised” everything which I didn’t understand at the time but I’m more aware of now- it’s the way that I can actually feel my defences going up and I’m shutting her out without before I’ve even realised it. She doesn’t see that (thankfully) and I think she thinks that because I’m on the autism spectrum, I don’t get upset or anything like that in the same ’emotional’ way as a lot of people do, and I’m OK with her thinking that and I’ve even found myself encouraging it by agreeing that I don’t have ‘feelings’ (whereas actually, I do have the intensely but I don’t know what they are).
The other thing I’ve realised that I really don’t like about the approach is the ‘unconditional positive regard’ aspect of it, which is one of the foundations of person-centred counselling. The reason I think that I’m not comfortable with it is because I need boundaries and to know that the other person will tell me if I get something wrong or if I’m annoying them or anything like that. The problem with unconditional acceptance is that it kind of takes boundaries away because there’s no ‘right’ or ‘wrong’, and that doesn’t feel safe. I know that a lot of my thoughts aren’t OK and I don’t want them to be ‘accepted’, and I need to know that she’s going to be direct about that except that I know she won’t because of the approach. She’s said a few times that nothing’s ‘wrong’ and everything you say is ‘OK’ but some thoughts aren’t OK, and that makes me feel really uncomfortable because I need to know that she’d say that, otherwise I can’t trust anything she says because I know she’ll just say everything’s OK and acceptable even if it really obviously isn’t. It’s like friendships- I feel much, much safer in a friendship if I know the other person will be direct and honest with me if I’m annoying or being too intense, and I need the same boundaries in counselling.
I could go on about this for ages but I think the main thing I’ve realised is that person-centred counselling really isn’t the right approach for me, which is frustrating but at least I’ve tried it. The counsellor said that I need to get a psychiatrist appointment to try to access more structured support so that’s the next step, I think… Would be really interested to hear from anyone else who’s had experience of person-centred counselling and hear your thoughts! Or any tips for being able to engage with it??