Psychotherapy and Counselling, Difference Between Counselling and Psychotherapy
Practice of Medicine

Psychotherapy And Counselling

Talking about yourself and your problems to a trained and experienced listener can often help you understand the causes of mental or emotional pain and express feelings which you have buried , psychotherapists and counselors work with their clients to move toward finding solutions .

Mental or emotional pain can be buried in us from childhood or it be the result of some recent trauma , such as bereavement or a problem in a relationship . psychotherapy and counseling give the client the freedom to explore and express emotions and thoughts that they have not wished to voice or confront in absolute confidentiality . In most western countries it is becoming increasingly common to find professional counselors and psychotherapists allied to doctor’s surgeries , health centers and clinics .

In the more traditional forms of psychotherapy the client may delve into childhood memories and achieve revealing insights into current problems

COUNSELLING : counseling can be an extremely effective way of helping many people cope with periods of major emotional stress and strain , caused perhaps by a failed relationship redundancy or sexual problems , many counselors specialize in one of these areas and will see you on a one-to-one basis or perhaps with a partner or other family members .

PSYCHOTHERAPY :  as with counseling psychotherapy is a method of allowing people to talk through emotional and mental problems and receive support and guidance for them . however psychotherapy also goes much further , tackling the deeper often hidden , underlying causes of emotional distress by trying to get the client to understand and face up to psychological problems within themselves . this can be done on either an individual basis or as part of a group . Psychotherapy developed out of psychoanalysis when both clients and practitioners began to be critical of the more analytical approach of the science pioneered by Sigmund Freud . There are now many types and styles of approach from the complex (psychoanalysis)to the down –to-earth (laughter therapy)each suited to different people and problems . Soma psychotherapists will mostly sit and listen to you . others will work more actively through creating situations by encouraging the release of childhood . Emotions or by following a course of gradual desensitization for a phobia . Therapists and this includes a growing numbers of doctors who specialize in any of these approaches tend to be familiar with the other types and will guide someone to the right analyst if they can not help that person themselves , many people find that talking with others in a group setting can alleviate anxiety and distress .

In the more traditional forms psychotherapy the client may delve into childhood memories and achieve revealing insights into current problems

HYPNOTHERAPY : A variety of problems can be helped by hypnotherapy , some psychological problems can be quite specific , such as addictions or fears  ; others may go back to some trauma which the patient cannot consciously remember . Disorders which may have a psychosomatic cause such as skin complaints or irritable bowel can also be helped by hypnotherapy

COUNSELING AND PSYCHOTHERAPY

Rogers was a psychotherapist with a difference . He had no medical back ground . He was a psychologist with some training in ministry , until his time it was commonly believed that a psychotherapist should necessarily have a medical back ground . Rogers exploded this myth “He destroyed the gap between counseling and psychotherapy by denying that any difference existed “(Lewis-1970). In counseling and psychotherapy Rogers holds that both counseling and psychotherapy are exactly the same.  Modern counseling psychologists owe a great deal to him for his positive contribution to the technique of counseling . However we do not entirely agree with his position . We believe that Rogers has created some confusion in the minds of counselors and others and that psychotherapy is a much wider field that embraces counseling in its fold . The relation between counseling and psychotherapy has been ambiguous as a result of the fact that the terms are amorphously defined and loosely used . there are at least two reasons for this confusion –

1)the habit of the representatives of the medical profession to include psychotherapy under the legal definition of the of medicine , persons with a medical back ground hold that psychotherapy is a concern of the medical field , medical jurisprudence has lent considerable weightage to the position that psychotherapy is a medical process

2)the semantic characteristics of the words psychotherapy and counseling are not strictly the same , for example the latter is not concerned with the restructuring of personality , there are other points of difference which would be of interest . many practitioners medically trained are obviously at a great disadvantage owing to their ignorance of the theory and facts concerning personality change . psychotherapy is usually concerned with severely disturbed persons who have to be entrusted to institutional care . But on the other hand as in the medical field minor disorders do not require any institutionalization , persons with such disorders are treated as out patients

Rogers (1961)describes the counseling process in seven steps or stages which form a continuum :

STAGE –1 :

  1. there is an unwillingness to communicate about the self ;communication if any is only about externals , such as experiences which have no deep significance for himself
  2. feelings and meaning full personal experiences are neither recognized nor accepted
  3. client’s personal constructs are extremely rigid
  4. close communicative relationships are often viewed as dangerous and interpreted like wise
  5. the client does not recognize or perceive any problems
  6. owing to blockage of internal communication (non-perception of incongruence) there is no desire to change the experiential field .
  7. individuals at this stage do not recognize and do not come voluntarily for help

STAGE-2 :

  1. in this stage the client begins to express his feelings about non-self objects . the client may speak about other things which are remote in relation to his self
  2. problems if perceived are looked upon as external to self .
  3. there is no sense of personal responsibility in problems
  4. feelings may be exhibited or expressed as unrelated to himself and are not owned
  5. ways of experiencing generally follow past tendencies as distorted by the self structure acquired in the past .
  6. clients personal constructs are rigid feelings may be shown of personal meanings and recognition of contradictions . clients may begin therapy at this stage

STAGE-3 :

  1. the client feels free to express his feelings . the process started in the previous stage continues more freely . another significant improvement is that the client talks about the self as an object past feelings and personal feelings which are usually negative are expressed . however the client does not accept them , for most part the feelings are revealed as something shameful , bad or abnormal or unacceptable in other ways . certain experiences are described as in the past or as some what remote from the self
  2. personal constructs , though rigid are recognized
  3. differentiation of feelings and meanings is better and less general , there is some recognition of contradictions in experience
  4. the client is able to see his personal choices as ineffective but not in their proper perspective .

STAGE  –4:

  1. the client describes more intense feelings experienced in the past and does not refer to the feelings in the present
  2. the client is able to overcome hid defenses occationally and express his feelings as experienced in the present
  3. the tendency towards experiencing feelings in the immediate present is dominant but there is distrust and fear of experiencing
  4. the client does not show open acceptance of feelings though occasionally this is exhibited .
  5. the client is able to express his experience as experienced in the present and is less bound by the self-structure and is less remote
  6. acceptance understanding and empathy enable the client to move smoothly in the direction of therapy
  7. there is a realization about contradictions and incongruence between experience and self
  8. the client shows feelings of self responsibility in problems in problems but there is a tendency to vacillate
  9. the client is still wary about close relationships.

STAGE-5 :

  1. feelings are expressed FREELY IN THE PRESENT
  2. feelings are very close to being fully experienced though fear distrust and lack of clarity are still present
  3. self feelings are increasingly owned and accepted
  4. responsibility for problems is accepted
  5. the client is increasingly able to accept contradictions and in congruencies in experiences

STAGE-6 :

  1. the client who was previously inhibiting a feeling is able to experience the same with immediacy and with out any difficulty
  2. feelings are freely experienced and expressed , the immediacy of experiencing and the feeling which constitutes its content are accepted and not denied , feared and /or struggled against , in other words negatives give place to positives
  3. self as an object tends to disappear
  4. the incongruence between experience and awareness is vividly experienced as it disappears into congruence that is incongruence becomes congruence . in this stage there are no longer any problems external or internal . physiological concomitants of a loosening , relaxing nature tears , sighs , muscular relaxation , improved circulation are present .

STAGE-7 :

New feelings are experienced with immediacy and richness of detail , changing feelings are accepted and owned . there is a feeling of trust in the total organismic process . all the elements of his experiences are now available to awareness and there is experiencing of real and effective choice in new ways of being . the counselee becomes a fully functioning person by which is meant that each individual has an innate tendency toward actualizing himself that is realizing his inherent capacity and potentiality . in brief counseling process involves :

  1. a loosening of feelings
  2. a change in the manner of experiencing
  3. a shift from incongruence to congruence
  4. a change in the manner and extent to which individual is willing and able to communicate himself in a receptive climate
  5. a widening of the cognitive maps of experience and a breaking of rigid boundaries
  6. a change in the individual’s manner of relating himself to others and to his own experiences
  7. a change in the individual’s reactions to his problems

THE MAJOR SHORT COMINGS OF CLIENT –CENTERED THERAPY ARE ;

  1. This approach emphasizes the affective determinants of behavior ignoring the importance of intellectual cognitive and rational aspects of human nature
  2. it totally ignores the usefulness of providing information which may be of value to the counselees
  3. it has the same goal for all the clients , namely maximizing that is making them self actualizing individuals , this general goal does not take into account the individual needs of clients , category of individuals
  4. it does not consider the who accept little responsibility for their problems .
  5. as a client centered approach it claims to give freedom to the client to set the goal but more often than not counseling goals emerge from the setting in which the counselee and counselor work
  6. in this approach the counselor is expected to be neutral and not communicate his own values to the client but in natural , inter personal relations it is difficult to conceive of neutral value free and bland relations .

THE POSITIVE CONTRIBUTIONS OF THIS APPROACH ARE :

  1. It successfully drives home the point that the counselee rather than the counselor is the center or focus of the counseling process that is , it is for the counselee to take the initiative and overcome his problems .
  2. it emphasizes the importance of the counseling relationship in facilitating personality change
  3. it stresses the importance of the counselor’s attitudes rather than his techniques in effecting the counseling relationships .
  4. it emphasizes the importance of the effective domain in the counseling process and holds that counseling should concern itself with emotions and feelings .

In order to be effective , a counselor can not function as a mere professional worker who mechanically applies certain rules of thumb methods . He has to be actively involved as a catalyst agent , helping the client gain the meaning of his existence , in this process of counseling the counselor’s behavior produces the experience that facilitates the understanding of the significance of the client’s existence . The counselor employs his knowledge and resources to help the client solve his problems on his own .

Becoming a counselor is not a matter of learning how to counsel . counseling involves understanding of the concept of ‘self as instrument’ and regards becoming as essential to it , this implies that the focus is on persons rather than competencies and offers a challenge to creative persons capable of rising to the demands of individual situations , there can not be a fixed pattern of approach to clients .

What is the role of counseling : The basic goal of counseling is self actualization in the client . the counselor can not achieve “self actualization” in the counselee by a one sided effort the counselee has to realize it himself . the counselor helps the counselee in this process . the conception of self actualization is fairly new and unfamiliar in the psychotherapeutic context . adjustment has long been regarded as a goal of psychotherapy and counseling . A well adjusted individual was considered a normal individual as an average person . self actualization involves positive ways of thinking , feeling and acting about oneself and in relation to others such an individual believes that he is liked .

Dr B.S Suvarna
Author: Dr B.S Suvarna

B.A, D.I.Hom[Lond.], M.I.H, PhD, PGDPC (Psychotherapy & Counselling, USA) HOMOEO PHYSICIAN MAMTHA HOMOEO CLINIC Jeevan Shanthi KALYAN NAGAR BYPASS ROAD. Karnataka State, India CHICKMAGALUR

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