The definition of insanity is doing the same thing over and over again and expecting different results.
- Albert Einstein
These days, there are myriad forms of theoretical orientations and techniques that therapists use in their psychotherapy practice. Here, you’ll find an overview of the modalities offered at Knowthyself and that I personally practise as a psychotherapist and counsellor. These are by no means complete or exhaustive.
I believe information and psycho-education are fundamental in the process of achieving mental, emotional, physical and spiritual health and wellbeing. It is important that you are properly enabled to take that process into your own hands.
Acceptance & Commitment Therapy (ACT)
ACT is a cognitive behavioural method of psychology that emphasises using mindfulness and acceptance to help clients overcome obstacles in their lives. A key assumption is that pain and suffering are a normal and unavoidable part of the human experience; it is our attempts to control and avoid these experiences that actually lead to long-term suffering. So instead of teaching clients to control their thoughts, feelings and actions, ACT instead teaches to notice, accept and embrace.
Fundamentally, it is about accepting what is out of your personal control and committing to action that improves and enriches your life. The goal of therapy is not to eliminate certain parts of your experience, but rather to learn how to deal with these painful experiences and discern what is truly important and meaningful to you that will inspire you to change your life for the better.
According to ACT, the core of many life problems can be represented in the acronym FEAR:
Fusion with your thoughts
Evaluation of experiences
Avoidance of your experience
Reason for your behaviour
The healthy alternative is to ACT:
Accept your reactions and be present
Choose a valued direction
How does ACT work?
ACT can be delivered in many different ways: long or short term or ultra brief, depending on your needs and goals. ACT uses 3 broad techniques:
Mindfulness: bringing one’s attention to the present experience and learning to perceive thoughts, memories and emotions as what they are, not what they appear to be.
Acceptance: allowing feelings and memories to come and go without struggling to control or avoid them.
Commitment: discovering values that are important to you and committing to carrying them out.
During ACT, we will work closely together with you in a 50-minute session, to enable you to accept and act on your inner thoughts and beliefs. Through metaphor and experimental exercises, you will learn to make contact with your thoughts, feelings, physical sensations and memories that you would have previously feared or avoided. We will teach you the skills to recognise, re-contextualise and eventually accept these events, which will allow you to develop greater clarity about values that are important to you and commit to desired behaviour change.
What issues can ACT help with?
ACT can be used to treat a variety of psychological conditions, including depression and anxiety disorders. It is considered a highly effective treatment particularly for Post Traumatic Stress Disorder (PTSD), due to its use of acceptance of the event, rather than attempting to change the feelings that occur because of it. It is also commonly used to treat pain by helping individuals to accept pain and take the appropriate action to deal with it.
Cognitive Behavioural Therapy (CBT)
In this therapy, the client and therapist form a trusted relationship in order to address and dissect issues that are causing the client distress. Both work together closely to discover the most pervasive issue and begin addressing that issue first. A bond is formed between client and therapist as trust grows and the primary concern has received due attention.
CBT uses a practical approach to help the client understand the relationship between beliefs, feelings and thoughts, and the effect these have on behavioural patterns and actions. The client learns that perceptions will directly affect reactions to certain conditions and circumstances, and that this thought process is at the root of behaviour.
How does CBT work?
CBT combines many different therapeutic approaches to create a fluid and flexible technique. At Knowthyself, we will use several treatment tools, such as journaling, challenging beliefs, mindfulness and relaxation. We will work with you to recognise unrealistic perceptions and maladaptive behaviour patterns.
CBT may be short or long term, depending on your issues and goals. In the first consultation with us, we will indicate approximately how many CBT sessions are required.
What issues can CBT help with?
CBT is often used for the treatment of Obsessive Compulsive Disorders (OCD) and obsessive thinking, depression, anxiety as well as many mood disorders in conjunction with mood-stabilising medications.
The transformation process
The process of transformation is rarely fully recognised immediately. As you learn how to replace negative thoughts and destructive behaviours with beneficial images, beliefs and actions, recovery will start to happen. CBT is a collaborative effort between therapist and client, based on trust and honesty. As long as you are receptive and willing to commit to transformation, we can help you along in your transformation process.
Neither a modality nor a technique, constructive psychotherapy is more an organisational framework that evolves as the therapist and client both collaborate – sometimes creatively – within the boundaries of constructivism.
Constructive psychotherapy embraces diverse traditions in medicine, philosophy, psychology, and spiritual wisdom. We encourage clients to view themselves as active participants in their lives. It is about constructing, organising and creating order; finding meaning in life; change and the impermanence of life; as well as alternatives, contrast and the human condition. It is a way of thinking, of perceiving the world and who we are.
Using constructive psychotherapy, we will work with you to develop your own voice, take pride in your accomplishments and take ownership of the changes that you are bringing about in your life.
Couples & Marriage Counselling
We help couples in all types of intimate relationships – heterosexual or homosexual, married or not – to recognise and resolve conflicts and improve their relationships. Through couple counselling, you can make thoughtful decisions about rebuilding your relationship or going your separate ways.
How does couple & marriage counselling work?
There are many modalities and styles of couple and marriage counselling. At Knowthyself, our approach is client-centred, which means that your individual and relationship needs, challenges and goals are the priority and focus over the counselling modality. To this end, the relationship established between therapist and client will be crucial.
We may work with one or both partners, together or separately, and if necessary, interchangeably – depending on how the counselling process evolves. We may also work only with one partner, as when change is affected by one, the dynamics of the relationship are bound to shift as a result.
The specific treatment plan may be short or long term, depending on needs, issues and goals.
Because there are two individual worlds, backgrounds, histories, and sets of beliefs and values that have come together to create the relationship, the work that needs to be done involves dealing with individual as well as relationship issues. Working individually, for the benefit of the relationship, allows each person the space to express himself or herself freely. Individual sessions are confidential.
We will make a recommendation on the best way to work at the relationship – in individual or joint sessions, or a mix of both – during the first session.
For couples planning to get married, pre-marriage counselling allows them to achieve a deeper understanding of each other and to iron out differences before marriage.
In most cases, couples seek counselling to improve a troubled relationship and address specific issues, including:
Conflicts about child rearing or blended families
Couple counselling may also be helpful in cases of domestic abuse. If violence has escalated to the point that you're afraid, however, counselling alone isn't adequate. Please contact us if you would like advice in this area.
Existential Psychotherapy & Counselling
Existential psychotherapy and counselling is based on philosophical tradition rather than on medical or diagnostic principles. Unlike prescriptive approaches, existential therapy acknowledges that everyone has their own unique struggles, which may feel overwhelming at times. The human condition is the focus of investigation and the therapy focuses on the uniqueness of each individual’s particular experience.
Using existential practice, we will work with you to develop new awareness of the challenges that you feel confronted with. Together, we can help you uncover new choices and paths in overcoming life’s emotional difficulties. By building self-knowledge and self-awareness, you will be able to transform and conquer issues that may at times feel all consuming or overwhelming.
Suffering from anxiety, for example, is addressed through an understanding that anxiety is not like a virus that one catches in the same manner as a cold or flu, but is the outcome of choices that were made in the past, and that can be made in the future, in whatever context you may find yourself. By exploring your context or ‘worldview’ in therapy, it is possible to understand your choices and to create new opportunities, and see a way out of your personal suffering and situation.
What issues can existential therapy help with?
The fluid and relational nature of existential therapy makes it relevant and useful for the hugely varied and individual challenges that life uniquely presents to each of us. It is appropriate for both short and long term therapy.
These are some of the issues it can help with:
Unresolved childhood issues
This is a powerful experiential psychotherapy focusing on contact and awareness in the here and now. By following the client's ongoing process – with special attention to both the therapeutic relationship and the client's style of interrupting that process – the therapist helps the client to both work through and move beyond painful emotional blocks. This frees the client to begin exploring new behaviour, first in the ‘safe emergency’ of the therapeutic relationship and then, as appropriate, in the outside world.
Gestalt therapy is experiential, experimental and existential. Awareness, or consciousness with appropriate emotions, as well as the enactment of actions that were formerly unthinkable, provides a kind of healing power that surpasses mere cognitive comprehension. The emphasis of the therapy is not on talking about what has happened but on fully experiencing both what is, and what can be.
Techniques used by the therapist can vary according to his or her personality as well as that of the client and his or her preferred mode of experience. At Knowthyself, we work with a rich palette of interventions, including two-chairs, acting in and role playing.
What issues can Gestalt therapy help with?
The regressive and empowering nature of Gestalt therapy makes it relevant and useful for the hugely varied and individual challenges that life uniquely presents to each of us. It is appropriate for both short and long term therapy.
It is known for helping people deal with so-called “unfinished business”, including pent-up emotions or hang-ups from past experiences or current difficulties. Other related issues include:
This psychotherapy practice embraces an attitude that affirms the inherent value of each individual. It is a unifying psychotherapy that responds appropriately and effectively to the person at the affective, behavioural, cognitive, and physiological levels of functioning, while also addressing life’s spiritual dimension.
The term ‘integrative’ has a number of meanings. It refers to the process of integrating the personality: taking disowned, unaware, or unresolved aspects of the self and making them part of a cohesive personality; reducing the use of defence mechanisms that inhibit spontaneity and limit flexibility in problem solving, health maintenance and relating to people; and re-engaging the world with full contact.
Essentially, it is the process of making one whole. Through integration, you can face each fresh moment openly without the barrier of a pre-formed opinion, position, attitude or expectation.
Using integrative psychotherapy, our aim is to facilitate wholeness, so that you can learn to function and be your true self in any situation or relationship, with full awareness of your personal choices, limits and external constraints.
Life Coaching & Self-Development
Life coaching is a practice that can help you identify and achieve your personal goals and live life in more meaningful ways through self-development and awareness. It explores skills and capabilities that are within you, and enables them to be best used.
Life coaching uses a range of psychotherapy practises that can challenge your mind-set, shift your perspective, and explore different solutions to help achieve your goals, which could be in the areas of career, relationships, fitness and health, and spiritual growth.
We will work together with you to clarify your goals, look at potential obstacles, and equip you with the tools to fulfil your aims. We may use Cognitive Behavioural Therapy (CBT) strategies to challenge negative thought patterns and build self-belief; diaries or charts may also be used to monitor your progress.
Mindfulness & Meditation Therapy
Mindfulness has its roots in Eastern meditation practices that hark back thousands of years. The influx of these great traditions into the West provided psychologists not only with an expanded view of the self and of human potential, but also with effective techniques for focussing the mind and managing negative thoughts, feelings and behaviours. A teachable technique that now is gaining scientific acceptance for its effectiveness, mindfulness practice is at the core of Knowthyself.
Mindlessness vs Mindfulness
Many people spend much of their lives in a state of ‘mindlessness’, where attention is allowed to freely wander from the present, swept away by whatever thought is arising at that moment. Often, these are ruminations about the past or fantasies about the future. This can be counter-productive and lead to feelings of guilt/resentment or fear/anxiety. Ironically, vain attempts to resolve these negative thoughts usually involve giving them even more attention and going around in a vicious circle (as obsessions) or acting them out (as compulsions).
Fixating on problematic thoughts leaves us vulnerable to negative emotions and pulls our attention away from the present moment. Whenever we are not tuned into what that moment has to offer, we are essentially not living to our fullest potential.
Essentially, we cannot stop negative thoughts from arising in the first place, just like we cannot stop clouds from passing in the sky. This is the nature of mind. However, once a negative thought arises, its influence depends on how much time and energy we devote to it. Thoughts precede feelings, so keeping attention fixed on a negative thought will lead to negative emotions. Therefore the most effective means of managing our feelings is managing our thoughts.
‘Mindfulness’ is a state of mental awareness and focus that has been traditionally used in meditation practices, and has recently become popular as an element of certain cognitive behavioural therapies, such as Mindfulness Based Cognitive Therapy, Acceptance and Commitment Therapy, and Dialectic Behaviour Therapy.
At Knowthyself, we use mindfulness practice as a lead-in to discovering the nature of mind and learning how to manage thought processes, so that you can become free to design your state of mind and, as a result, the reality of your life.
How does mindfulness & meditation therapy work?
Mindfulness and meditation therapy is about being ‘aware’. Aware of what is as is, or what you are choosing to think moment by moment, and then learning techniques to evaluate your own thoughts for what they really are: just glitches in the ‘software’ of your brain.
When you are mindful, you are aware of both your external surroundings and your inner experience, including your own responses to what is going on around you in the present moment. The goal of mindfulness is to become aware without becoming attached to anything you are experiencing.
Thoughts form well-worn neuropathways in your brain and although they may run deep, like the well-worn tracks of a country road, they can be covered and new neuropathways can be created.
Once you become aware of your own thoughts, you can learn to stop your reactions to the ‘stressors’ (triggers) in your life. You cannot change people or events, but you can change how you react to them. You will learn how to have a dialogue with your own negative thoughts and manage the self-destructive, self-sabotaging and plain mean-spirited reactions that don’t serve you at all. You will learn to reprogram your brain, by inserting new thought patterns, perspectives and beliefs that can and will inspire you to take action and to succeed.
Essentially, mindfulness helps with how you manage life itself. At Knowthyself, we will teach you how to use it in a way that is relevant to your life situation and circumstance. Here are additional issues that mindfulness can help with:
Mindfulness also involves recognising when you are running on ‘automatic pilot’ - acting without thinking about what you are doing, as well as developing an attitude of ‘loving kindness’ - a friendly, uncritical attitude towards yourself and others.
While most of what we achieve is by ‘doing’, mindfulness achieves its ends by ‘not doing’, simply by observing. Thoughts and emotions are seen as they are, not something that rules our lives or to be believed in uncritically. With a feeling like anger, we can learn to realise that it is a feeling that is currently strong within us, but no more than that. We may currently have anger, but it doesn’t define us and it will pass. Our mind ceases to be in the control of strong feelings and thoughts, and slowly comes under our own control.
I have thoughts but I am not my thoughts.
I have bodily sensations but I am not my bodily sensations.
I have feelings but I am not my feelings.
I am something else.
Who am I?
What happens in a mindfulness session?
At Knowthyself, we will first help you understand the process intellectually, and then guide you through the practice, so you can make emotional sense of it. We will support you in establishing a daily mindfulness practice, usually centering on mindfulness of the breath.
Ultimately, the aim is to allow you to discover and manage the nature of your mind and how it works, and to develop a different, easier relationship with problematical thoughts, emotions and bodily sensations. The result of this is an increase in wellbeing, gaining more control over your own mind as you spend less time dealing with difficulties and more resources for important activities. Often difficulties can disappear altogether.
Benefits of mindfulness
Your mind is like any other part of your being. You will benefit from understanding how it works and training it to work better. Specifically, a mindfulness practice has the following benefits:
Stability of mind: maintaining your mind in an alert, clear space rather than at the two extremes of a dull or agitated mind.
Flexibility of mind: the ability to shift your mind to whatever you choose, rather than having it bounce haphazardly between a number of issues.
Self-awareness: being aware of the contents of your mind and understanding its typical patterns.
Acting rather than reacting: Becoming less reactive when emotions – such as anger – arise, and choosing how you will act.
It’s not called a practice for nothing. Like other forms of therapy, real change requires work and commitment. It will take a commitment of six days per week to maintain your mindfulness practice.
‘Mindfulness is paying attention in a particular way: on purpose, in the present moment, and non-judgmentally.’
Mindfulness Based Cognitive Therapy (MBCT)
MBCT is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of Cognitive Behavioural Therapy (CBT) with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterise mood disorders while simultaneously learning to develop a new relationship to them.
By combining meditation and CBT, this therapy can help you break the link between negative moods and negative thinking. It was developed by Zindel Segal, Mark Williams, and John Teasdale, and is based on Jon Kabat-Zinn's Mindfulness-Based Stress Reduction program.
How does MBCT work?
A major characteristic of depression is that it can feed on itself; a person gets depressed and then gets more depressed about being depressed. This soon becomes an automatic cycle of negative thoughts. MBCT can help challenge this cycle by teaching you how to become more mindful – or aware – of what is going on in your mind and body.
Strong evidence suggests that MBCT is highly effective in preventing relapse into depression. In early clinical trials, only half the people who completed the MBCT course relapsed (compared to an 80% relapse rate for people coming off antidepressants). MBCT is recommended by the National Institute of Health and Clinical Excellence guidelines for treatment of recurrent depression.
The ABCs of MBCT
A: You start by developing awareness of what is happening in your experience, through formal meditation, mindfulness exercises, and being mindful of activities during the day, such as walking or eating.
B: Next, you learn to be with our experience. Instead of pushing unwanted thoughts, emotions or experiences away – which can exacerbate things – you cultivate an attitude of acceptance. Acceptance provides opportunity to find out what's really going on. Being with your experience also allows you to fully savour pleasant experiences.
C: Finally, you learn to choose how best to respond to your experience. Sometimes the most helpful thing is to just be with your experience as best as you can, noting thoughts as “just” thoughts (and not facts), or noticing familiar unhelpful thinking patterns. Other times, it helps to take practical action by dealing with the issue or engaging in some pleasurable or satisfying activity.
Person-Centered Therapy (PCT)
This is the foundation of all psychotherapeutic approaches. PCT is a supportive approach where you are given the space and safety to share your concerns. It is based on the philosophy that individuals are full of potential for growth. Given the right conditions, we are all capable of being loving, creative and knowledgeable. It originates from Humanistic Therapy, which evolved in the 1950s and 1960s in the USA as part of a ‘human potential movement’.
How does PCT work?
PCT is applicable in all sessions. You will be asked questions that will lead you to deep discoveries about your feelings, blind spots, needs and hopes. At Knowthyself, Person Centred Counselling forms the backdrop to all our counselling work. Whatever your issue or challenge, your therapist will be empathic, understanding, supportive, congruent and non-judgemental.
Psychotherapy based on psychodynamic principles utilises the idea that your current behaviour is determined by past experiences. Psychodynamic practice aims to help you make sense of your existing situation and the feelings, thoughts and associated memories that are brought about by this situation. In psychodynamic counselling, these feelings, thoughts, images and even dreams may be analysed to gain deeper understanding of how you relate to yourself and to others.
How does psychodynamic psychotherapy work?
Psychodynamic counselling employs strict boundaries with regards to session time-keeping, setting a therapeutic contract, and breaks and endings. Such boundaries help to contain and hold the client. A psychodynamic counsellor usually observes the rule of abstinence and anonymity, so that the client knows little about the therapist. Working with ‘transference’, which is the process that occurs in therapy when the client responds to the counsellor as if to a significant other person from the client’s past, the counsellor can learn more about the client’s developmental course from child to adult.
Transference in the therapeutic relationship can be positive or negative. Positive transference may include feelings of care or concern for the other. Negative transference may involve feelings of dislike, loathing or mistrust. Psychodynamic therapists may also work with ‘counter transference’, which is the counsellor’s reaction towards the client.
These are some of the issues that psychodynamic therapy can help with:
Stress in the work place
Relationship issues (break-up, divorce, affairs, choosing inappropriate partners, loneliness, life adjustments, marital problems, arguments, jealousy, wedding & premarital counselling)
Trauma Obsessive-compulsive disorder
Eating problems & negative body image
Depression (including suicidal thoughts, low mood, social withdrawal)
Phobias & fears
Low-self esteem & confidence
Abuse (including verbal & sexual abuse)
Grief & loss
Developed by Robert and Mary Goulding, redecision therapy combines elements of transactional analysis and Gestalt therapy. Using positive strokes, encouragement and bringing the past into the present, clients can learn to change paths from decisions made at a young age.
How does Redecision Therapy work?
The first step of redecision therapy is to engage both client and therapist in a contractual agreement that outlines the particular changes a client would like to see through therapy. The therapist maintains a position of allegiance to the client’s true self and encourages the client to recognise and support that side of their personality. The client learns ways of relinquishing control; and specific actions and reactions are monitored and shared with the client. First person narratives are explored in which the client uses language and emotion to describe life situations that are currently occurring. Working together, the therapist and client can identify exactly what that expression reveals about himself or herself and the other people involved.
Ultimately, the client is encouraged to review all the choices and decisions that have influenced the situation at hand. The ones that had negative implications will be isolated and the client will be taught to release the emotions and images attached to them. This process allows clients to take a retrospective approach to their own healing. Past experiences are not dwelled upon, however they are a vital component to facilitate changes in behaviour that can result in a more productive and positive sense of wellbeing.
Relationships can be a great source of fulfilment, however when they become problematic we feel pain, disappointment, guilt, rejection or loneliness.
At Knowthyself, we work with both individuals and couples – whatever your background, sexual orientation or marital status – across a wide range of relationship concerns. Some issues include:
Arguments & conflict
Jealousy & anger
Separation & divorce
The relationship with your therapist is an important backdrop for good therapeutic work, which is done in a safe and objective arena. You will gain self-insight into patterns of relating and work towards making more informed choices and creating positive bonds with others.
Benefits of relationship counselling
Explore your historical patterns in relationships
Improve communication skills in relationships
Form healthier patterns of relating
Solution-Focused Brief Therapy (SFBT)
As its name suggests, SFBT targets the desired outcome of therapy as a solution rather than focusing on the symptoms or issues that brought the client to therapy. This technique only gives attention to the present and the future desires of the client, rather than focusing on past experiences. The therapist encourages the client to imagine their future as they want it to be and then both collaborate on a series of steps to achieve that goal.
This form of therapy involves reviewing and dissecting the client’s vision, and determining what skills, resources and abilities the client will develop and use to attain his or her desired outcome. SFBT was developed by Steve De Shazer, Insoo Kim Berg and their team at the Brief Family Therapy Family Center in Milwaukee, USA.
How does SFBT work?
SFBT is a form of talk therapy that maintains that change is inevitable and constant. When we conduct SFBT, we will examine the elements of your life that you wish to alter as well as elements that you want to leave unchanged. We will work together to devise a vision of what the possible future could look like, moulding and defining it to be as detailed as possible, so that you can hold a clear picture in your mind.
We will then guide you to find specific moments in your life when you felt similar to what you want to experience in your potential future image. Correlating the two visions or experiences allows you to identify which actions you took in the past to achieve a similar outcome to the one you would like to achieve in the future. Often, people are hindered from making forward progress due to the results that came following the happy experience. The basis for this therapy is to maintain a constant focus on the future, and to only rely on the past experiences as a resource.
Transactional Analysis (TA)
This is a user-friendly therapy that includes an understanding of personality based on an ego-state model. The structures of personality are linked to behaviour and to the re-playing of childhood strategies in adult life.
This approach can be used to understand personal and business relationships, and can be used in psychotherapy, counselling, communications and management training as well as organisational analysis. Redecision counselling and self-re-parenting strategies are important components of transactional analysis.
The basic concepts that underlie TA therapy include:
We are all OK. We all have a basic lovable core and a desire for positive growth.
All of our many facets have a positive value for us in some way.
Positive stroking (or reinforcement) increases (feelings of) OKness.
We are all responsible for the way we think, feel and act.
Our beliefs and behaviour are results of decisions we have made at critical times in our growth. Any decision can be re-decided.
All emotional difficulties are curable.
The client is a fully involved partner in the healing process.
Change is most likely to occur when the therapist and the client are both fully invested in a clear, healthy contract for the behavioural change sought.
The ultimate goal is internal awareness and harmony, spontaneity and authentic, open intimate communication with others.
How does TA work?
Transactional analysis can help with a wide range of problems, including:
Loss & grief
We will help you to explore the causes of your problems and to consider how you might be stopping yourself from being all you can be.
We will also help you analyse your transactions (i.e. interactions with self and others), so that you can better understand yourself and your relationships, and decide what changes you wish to make. As with many other therapeutic approaches, the relationship between therapist and client is seen as the most important factor for a successful outcome.