Maybe fifteen years ago I visited the Tate Modern in London, and saw an exhibition hanging in the Turbine Hall. I don’t remember the name of the artist, but remember the work and have held on to a quote of his since: ‘the role of art is to protect ambiguity’.
The work itself hung from the ceiling of the Turbine Hall, in several pieces. They were enormous round shapes, made with wood, like ships, with fabric draped over them. Were they a landscape, or blood cells? Wet? Dead? Were they knowingly floating or horrifyingly hanged? Were they womb-like, ship-like carrying something; or perspective-flippingly monstrous husks of seeds? Maybe alien spaceships from a far-gone millennia, forced out of their land. Were they hollow and sonorous? They were out of reach and yet tantilisingly tactile. They evoked human-scale living, but grotesquely enlarged, engorged, emptied. They had nothing to prove or shout about. They were ancient. Hanging up in the Modern.
Clearly they had a powerful impact on me. They serve as a reminder of one of the ways in which art and therapy are the same exploration, and can be beautifully overlapping processes.
Our world wants to know whether something is either ‘this’ or ‘this’. It is a world of black-or-white categories and identities. (I’m enjoying Ian McGilchrist’s The Master and His Emissary, which explores how we have arrived at this left-brained cultural place.) But humans are not instinctively this pigeon-holed. We are more mysterious than that.
In therapy we welcome this swirling ‘both and’-ness by bringing into, perhaps uncomfortable, awareness that we might feel both love and hatred for a person; both care and anger; we allow ourselves to recognise that we feel both part of a family system and very different from it. There is skill in learning to simultaneously hold the ‘tension of the opposites’, rather than have to choose between the two. This skill isn’t too hard once we see that the therapist can comfortably hold the two opposites for us, facilitating and giving permission to our own ability to hold the two together ourselves.
The therapeutic role of protecting ambiguity also shows up as providing space for us to respond to the question ‘and what is that like?’ with something… uncertain… ‘I don’t know… it’s difficult… it’s a bit… gritty somehow… I want to move my lower back and take a breath… there’s something empty about it’. If we rush to a fixed answer – perhaps by naming an emotion before we’ve really considered the feeling of it – we shut off vital curiosity and exploration of our beautiful, ambiguous selves.
Ultimately, both in art and therapy, the facilitating, or protecting, of ambiguity conversely leads to something pertinent. It leads to the relief of seeing the actual truth about something, which is very possibly a ‘both and’.
The BBC recently released a short and helpful documentary about the prevalence on social media of self-declared counsellors or therapists, who promise to cure depression, anxiety, OCD or other disorders. The promises are tantalising – a cure within weeks or, reportedly, within several hours. They often require the vulnerable seeker to pay large sums and don't deliver their promises.
The initial problem, that is largely not in public awareness, is that the terms ‘counsellor’, ‘therapist’ or ‘psychotherapist’, are not protected terms. Anyone can build a website, create a certificate and call themselves any of the above titles. Legally.
Social media has a huge and useful role to play in providing a platform for promoting ways in which to support physical and mental health. There is plenty of great advice, tools, practices and community available to support you, however, for meeting some of the challenges mentioned above, nothing sufficiently replaces or is equivalent to regular therapy in a confidential relationship with a qualified therapist.
So how do you know whether you are approaching a trained, responsible, ethical therapist or a charlatan?
A really solid indicator is that they are a member of one or more governing bodies, and should be happy to show their membership certificate if you ask them. The British Association for Counselling and Psychotherapy (BACP) is the largest, oldest, and most respected body in the UK. To become a member of this organisation the therapist has to have trained at a BACP accredited college, usually for at least three years, and agree to adhere to the BACP ethical framework which keeps the client’s well-being firmly and safely at the centre of the therapeutic work. It includes structures around finance, confidentiality, the therapists continued CPD and supervision (their work is held, and even ‘checked-on’ by another, practising, qualified, registered therapist and supervisor). Other trustworthy bodies include UK Counsel for Psychotherapy (UKCP) and Health and Care Professions Counsel (HCP). A person cannot legally display the logos of any of these bodies on their websites without officially being a member, ie, having done the required training.
Another good indicator is that on initial contact, or in the content of their website or profile, the therapist is not flippant about the weight of your problems, or the speed with which they might be met. They don’t promise to ‘cure’ or ‘heal’ you. A properly trained therapist knows that debilitating problems like depression, anxiety, OCD or loneliness, have often taken a life-time to establish themselves, and are not going to be ‘solved’ in a handful of sessions. Therapy takes hard work both on the part of the client and the therapist, and it takes time.
A qualified therapist has put years of effort, money and work into training. They work both academically in studying theory, neuroscience and human development, and personally in their own therapy. It takes years of work to learn how to provide the right relational environment that can facilitate another person’s growth.
Painful things won't be healed easily. Problems deep in the human self, to do with our sense of identity, with feelings of isolation, or low self-worth have usually been created in our earliest relationships with our caregivers and compounded over years of repeated patterns. To be fully felt, met and resolved, these feelings need to be visited within the safety of a confidential, empathic, non-judgemental relationship with another human being, who has put in the time, effort and work on themselves in order to be able to provide conditions for change. And it takes time. And it is worth it.
‘Only by getting in touch with your body, by connecting viscerally with your self, can you regain a sense of who you are…’ (van der Kolk, 2014: 247)
This recent interview with body-minded psychiatrist and trauma specialist Bessel van der Kolk highlights the popularity of his book, The Body Keeps the Score. Published in 2014 it has sold two million copies worldwide, demonstrating the wide-spread curiosity to understand how the body and mind interrelate.
One significant early researcher in this field was Candace Pert, a neuroscientist and pharmacologist who studied neuropeptides throughout the 1970s and 80s. Her research led her to understand the ‘biochemical substrate of emotions’ and how ‘the body is the actual outward manifestation, in physical space, of the mind’ (Pert, 1997: 187). She even used the term ‘bodymind’ to emphasise the 'holistic relationship of body and mind’ (Dychtwald, 1977: 11). Current heavy-weight pioneering researchers, psychotherapists and trauma specialists in the field include Antonio Damasio, Peter Levine and Bruce Lipton, to name just a few.
In psychoanalysis, whilst Freud was interested in the psychological causes of 'hysteria', and Jung delved into the unconscious through dreams, Donald Winnicott came closest to what we are beginning to understand today. He understood that ‘Human nature is not a matter of mind and body – it is a matter of inter-related psyche and soma... The basis of psycho-somatics is live anatomy…’ (1988: 26).
Winnicott wrote extensively and insightfully about the psychosomatic field, long before the bodymind had been evidenced through neuroscientific research. There is now a widely held perspective in the therapeutic community, and increasingly in the medical community, that a psychological problem can also be addressed through a physical process of the body and vice versa. This is what van der Kolk’s book demonstrates so powerfully, through many varied case studies and years of practical research.
But what is our bodymind and what is it to do with counselling? Pert described the mind as a psychosomatic network, ‘the flow of information as it moves among the cells, organs and systems of the body’ (1997: 185). According to Pert, the mind is the network that unifies all our distinct elements into one being, or self. It was to emphasise this unifying role that she used the term 'bodymind'. Some of the information it carries might be emotional memories from our early years, that have been stored in the tissues of our bodies. Van der Kolk’s work and book evidences this explicitly, with countless examples of how clients’ bodies, symptoms or physical behaviours profoundly keep the emotional score.
Dychtwald, K; 1977; Bodymind; Pantheon Books, New York
Van der Kolk, B; 2014; The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma; Penguin Random House, UK
Pert, C; 1998; Molecules of Emotion, why you feel the way you feel; Simon and Schuster Inc., London
Winnicott, D.W.; 1988; Human Nature; Schocken Books, New York
Counselling may seem like something quite mysterious. It’s an intangible process that takes place between two people, historically explored with theory and increasingly understood by neuroscience, but really best described with metaphor. It deals with strange phrases such as our ‘inner landscape’, our ‘sense of self’, our ‘felt sense’, our ‘emotional awareness’ or ability to ‘meet parts of ourselves’. If you are curious about counselling and want some insight then I highly recommend the book ‘Counselling for Toads, A Psychological Adventure’, written by Robert de Board.
This delightful novel creatively, clearly and at times poignantly presents a narrative of a counselling journey. It is written as a sequel to Wind in the Willows, in which we meet the normally pompous and energetic Toad in the midst of suffering a depressive breakdown after all his adventures. His good friends Badger, Mole and Ratty come to his aid:
‘First they nursed him. Then they encouraged him. Then they told him to pull himself together… Finally, Badger could stand it no longer, “Now look here Toad, this can go on no longer,” he said sternly. “There is only one thing left. You must have counselling!” ‘
We follow Toad on his psychological adventure with the counsellor, Heron, who works from the Transactional Analysis model and explains much of the theory to Toad – and the reader – as the story progresses. We learn with Toad about emotional or psychological states we all inhabit: Natural or Adapted Child, Critical or Nurturing Parent, and Adult; we learn about a feelings thermometer, about the reality of living out a life script that has been set up for us in our earliest years, and the value of working towards a place of acknowledging that ‘I’m ok, you’re ok’.
Heron characterises the strange role that a counsellor provides by not rushing to fill silences; in asking questions rather than offering answers; and in non-defensively holding Toad’s eventual angry outburst, allowing him to process trapped emotions he had held towards his strict father.
The story is full of gems of realisation as Toad becomes familiar with himself. Having written a list of childhood strategies he had used to placate his parents Toad remarks:
‘You know, I am beginning to realise this list describes not only my past, but also my present.’
Reflecting on how it had felt to tell Heron his life story Toad realises that:
‘he was beginning to gain the capacity to recall without condemning. He made connections between events and looked at them objectively without feeling guilty’
The immediate impact that counselling had on Toad was that he had never before experienced somebody giving him exclusive, undivided attention. Over the course of the story we follow Toad rediscovering his enjoyment of boating, learning to hold boundaries in a conflict with Badger, and eventually making new plans for himself to build a life that is really his own, rather than a childlike facade of his parents’.
In their last session Heron congratulates Toad on his work, and explains the value of feeling things: ‘In counselling, we work not only with our brains but with our feelings. Whilst you can begin to understand behaviour intellectually, you can only fully understand yourself through getting in touch with your own emotions. As these become clearer to you, you realise that your feelings are not optional extras that can be ignored, but they are the very centre of yourself.’
You don’t need to have read or remembered the original Wind in the Willows to understand or appreciate this beautiful little book, nor do you need to already know anything about counselling. It is light and entertaining, and full of relationship and warmth. Just reading it will help you to understand more of yourself, and perhaps help you to begin your own psychological adventure.
‘If human beings live, die and thrive in relationships, it is through the relationship that the greatest therapeutic change may take place’ (Mearns and Cooper; 2018: 2)
Western society encourages us to hold the view that people are completely independent individuals who choose to have, or not to have, relationships with other completely independent individuals. Through years of research and theoretical development, psychotherapy takes the different view that people exist from the beginning, inseparably in relationship – a baby in a womb. The influential child psychotherapist Donald Winnicott (1896 - 1971) once even wrote that ‘there is no such thing as a baby… only a nursing couple’ (quoted in Mearns and Cooper 2018: 4) emphasising that a baby simply does not, cannot exist as an individual entity. The baby exists in relationship with its primary care giver. It is only through the natural process of personal development, which happens through relationships with our family, and increasingly wider circles of people, that we grow towards independence with a sense of our individual self.
So where does counselling fit in? Many of the problems that might bring somebody to counselling relate to a fragile or disrupted sense of self, perhaps low self-esteem, anxiety, depression, difficulties relating to others, or a sense that something just isn't right. There exists in our society a medical model that isolates the presenting symptom – depression, anxiety, ADD for example – and provides medication to make daily life more manageable. This can be a genuine lifesaver for millions of people. What long-term, humanistic counselling offers is a safe relationship – the human’s primary way of existing – in which the underlying roots of those symptoms can be met.
The counselling relationship is unique in that it has professional boundaries, but seeks to meet more deeply than a professional to a patient; and to offer more than a set of tools to fix a specific problem. Counselling and psychotherapy understand that as relational beings, much of our poor mental health lies in disconnection, both from others, and from parts of ourselves. This disconnection might show up in adulthood through behavioural patterns that were created in a child by a primary carer not fully able to meet the child’s relational needs. This could have been due to a wide host of understandable reasons – a parent with depression, or working all hours to put food on the table, a family crisis or grief, or many other situations.
As such, the basis of the work in humanistic therapies is often in creating a ‘reparative relationship’ (Clarkson, 2003: 113) with the client. This is one in which the therapist meets ‘the client where they are in the present moment, in the belief that [they] will thrive if the therapist provides a non-judgemental space and is able to respect them, be compassionate towards them and interact with them in a genuine way.’ (Aaronson, 2013: vxiii).
Aaronson goes on to describe that the reparative relationship can help an individual to ‘develop a stronger sense of who they are; be in touch with and understand their feelings, know what their needs are and have the sense that they can fulfil them.’ (2013: xxi)
The counselling relationship functions as a fundamentally human exchange. I am not there to ‘fix’ you, rather it is through our relationship that you will get to know more about the wounds in yourself that might be leading to the symptoms you are experiencing. Mick Cooper writes ‘if damage is caused through relationship, cannot healing too?’ (2018: 2).
References and further reading:
Aaronson, R: Addiction, This Being Human, 2013: Authorhouse, IN.
Clarkson, P; The Therapeutic Relationship, 2nd Ed, 2003: Whurr Publishers, London.
Mearns, D and Cooper, M; Working at Relational Depth, 2nd Ed, 2018: Sage, London.