Professional perspective

This page tells you something about the professional positions that I hold dear and that influence my way of practising psychotherapy. Instead of perspective, I could have called them "assumptions". They are not arbitrarily chosen, or just personal fancies. All of them are solidly based on the literature and experience of modern psychotherapy of over a century and its study, research and validation.

Psychotherapy is not like physics, because of human and social complexity. There are many ways of seeing, frameworks, methodological presuppositions: most of them have some validity, at least in particular situations and contexts. All such perspectives are grounded in a profession and in (social) science research; mine may be important for you if you want to have an idea how I situate myself professionally. This page is more theoretical than other pages of the website, and contains some jargon which I did not know how to avoid.

Unconscious processes

A fundamental assumption I make is that people have an unconscious, or more precisely, that unconscious processes go on inside them. Unconscious processes can also be called "automatic". This means that there are forces and patterns “inside” which influence them and which they are not conscious of, not aware of, and may have difficulty admitting to.  We do not know as much about ourselves as we think we do.

Unconscious processes not only underlie difficult behaviours that we feel powerless to change – they also are the basis for creativity, imagination, intuition and the deeper sources of spirituality, love and compassion. If the unconscious is relevant to what brings you to therapy, it may be important to identify this and try to bring these processes to light.

The idea of the unconscious can be formulated in many ways, and is consistent with a wide range of theories, from psychoanalysis to cognitive and biologically based psychological research.

Emotions

Emotions are fundamental to human living and behaviour. I believe that at least a set of basic emotions are innate (and shared with animals), and present from the earliest stage of life. It isn't the same with each person I work with, but mostly we will pay significant attention to emotions, increasing your awareness of what you feel and paying attention to how you express your feelings and what they mean.

It is important that you feel safe about expressing your feelings, and that you fully understand the link with bodily systems. Recent developments in physiology and neuroscience influence how I work with and talk about emotions.

Developmental psychology

The developmental approach is fundamental for my way of working. It means that a person’s behaviour, reaction patterns, and personality have been built up over time, often starting in childhood; they have not come instantaneously out of nowhere. This includes the influence of trauma and abuse of all kinds, earlier or later in life.  

It can be difficult to make changes in aspects of personality and behaviour patterns, but there is a consensus that change is possible. This can be expressed in behaviourist and learning theory terminology by saying “what has been learned can also be unlearned”. In neuroscience it is referred to as the neuroplasticity of the brain.  What can be modified includes the influence of past interpersonal relationships, which have been “internalised”, and continue to affect and be part of personality and behaviour.

Internal vs. external

I believe it can often be useful to ask yourself about a problem or issue - "do I think it is mainly caused by internal or by external factors"? External factors include the context, other people, and our relationships with them, the environment, the material world, experiences and our learnings from them, and (realistic) perceptions. Internal factors are our constitution and innate build-up, including innate drives and behavioural systems, our intrapsychic or inner world, and fantasies about others or about the outside world. Note that the distinction is subtle, and often a deeper analysis connects the two or shows that they can be seen as different perspectives of one whole.

To give an example, think about the situation of someone who has difficulties in her main intimate relationship. Does she deal with the problem by ending the relationship, or by (trying to) change her partner (external change)? Or by working on herself, acquiring better communication skills, adjusting her attitudes, values, what she is prepared to put up with (internal change)? 

Attachment theory

Attachment theory is a range of psychological ideas developed over the past 60 years, originally by John Bowlby, Mary Ainsworth, and Mary Main. It has wide applications in psychotherapy, developmental psychology and parenting. Bowlby advanced the idea that babies are born with an innate biological attachment behavioural system, which influences their behaviour and feelings substantially whenever they feel anxious. Further, he thought that major new insights into someone's patterns of relating can be derived from following the development of a person's attachment style through the course of their life. Attachment style does evolve, changes, and can be changed, but changes are not easy to make.

I have extensively trained in attachment theory. It has substantially influenced my thinking and my way of working.

Conflict and power

Conflict, anger, power, and powerlessness are normal and ubiquitous.  The question is how limited or extreme they are, how you deal with them, and how you handle the situations that trigger them or involve them.  Psychotherapy is often concerned with this range of issues, and I think it is important to give them a central place in psychotherapy, rather than avoiding them.

Anxiety and safety

People need a sense of safety. We are all concerned not to have fear or anxiety at uncomfortable levels. Working on this means looking again at the distinction between internal and external factors.  Does your environment need to be changed and made safer, and is this possible, or should you work on your capacity to deal with circumstances as they are? I think that a major part of the power of psychotherapy is the possibility to consider these questions in dialogue with, and in the safe presence of another person.