Is there a difference between Psychotherapy and Counselling?

In practice, psychotherapy and counselling overlap - both can help with personal problems and support the individual through difficult times. Here are some of the principal differences and similarities - distinctions which are tendencies, not cast iron rules:

What is Psychotherapy?

The psychotherapy process goes further than counselling, reaching the underlying causes of distress, and encouraging you to explore life patterns and the past, looking at childhood and relationships with parents and other significant people, and where these are affecting you in your present life. With the therapist, you can explore memories, fantasies, feelings, and dreams, relating to the past and the present. In examining the interactions between you, in the safe setting which allows for taking risks, you may discover the causes and effects of long-standing conflicts, and be able to transform destructive behaviour into a more creative way of being.

In enabling a deeper awareness and understanding of life processes, psychotherapy can bring about a profound recognition of aspects of your self which have been lost or alienated, allowing reconnection and integration to take place.

Who can benefit from counselling and psychotherapy?

There are many reasons why people seek counselling and psychotherapy. Some people have specific issues on which they want to focus. Others may be feeling anxious or depressed or have a general dissatisfaction with life without necessarily knowing why. Sometimes a crisis in a relationship, or an unexpected and traumatic event may impel us to reflect on our life more deeply and see ourselves in a different way. I can assist you in your inner quest to make sense of things which trouble you, identify changes you wish to make in your life and provide support for you during this period of change. The list below indicates the range of difficulties and concerns which people come with, although it is by no means definitive:

A specific problem is not considered necessary - feelings related to a lack of well-being, or a desire for greater self-knowledge are also valid reasons for seeking psychotherapy.

The experience of psychotherapy

Although everyone is unique, and so each individual course of therapy is inevitably different, it is the relationship itself which has lasting impact. To give you some idea of what this may be like, here is a personal statement from someone who has been in long-term psychotherapy, offering you an insight into what this experience can mean:

“I finally came to the end of therapy, after five long and sometimes intensely painful years. My psychotherapist recognised that I was well-practised in self-analysis, and knew better than I could how limited a scope that was.

As I began this most rigorous phase of my own self-examination she would allow no self-deception. It was a process that was always ultimately loving, although to begin with, she held the love for me, until eventually I was able to feel it for myself.

I see now how arrogant I was at the start: a fragile defence to protect the self-loathing and mistrust of my apparent confidence and honesty from any eyes perceptive enough to see in. Eyes, looking in on me, turned out to be a core issue. In my inner world, those parental eyes were always judging and scathing, regarding me with distaste and expectation of intrinsic badness. My therapist’s eyes reflected back to me my wariness, shame and fear of penetration, and somewhere beyond that projection an expression of compassionate acceptance that took me almost the whole of that five years to find.

Only through therapy did I fully allow myself to surrender into love. And only then could I grieve for the loss of all that had never been, for the intimacy I believed would never be possible for me. And yet a special kind of intimacy was there in that relationship. She created a perfect womb in which I experienced a sustaining and enduring nurture, where initially I constantly rejected her warmth as too threatening and retreated to my own cold and cut off place. She never went away. She always offered more. And she never punished me for my refusal. Nor did she force-feed me, or blame me for choosing not to trust her. And gradually, gradually, I let in the warmth. I began to believe in her. I found the courage through her courage, to dare to be – and eventually, to believe in my self.

Now I experience humility along with the knowledge of my own true strength. I realise my therapist was a shape-shifter, altering to accommodate my projections, while retaining something infinitely dependable behind them, to which she held steadfastly, however tough it got. Once she wept, as I disappeared across vast tracts of an icy desert, accusing her of rejecting me. Her tears shocked me. I didn’t know how we had come to this place, or why it felt so utterly desolate – only that it was horribly familiar, a place I knew so well from childhood. I sensed her tears revealed genuine empathy, and I was free from any obligation to make it all right. It couldn’t be.

The world had fallen apart, the sky had caved in, and I believed our relationship was destroyed. Yet I mark this now as the point where I truly entered therapy. The next week I came back, knowing that in spite of the pain, I could trust this process… and a deeper phase of our relationship began. She helped me pick up all the pieces of the me I thought I was, the debris of the fallen walls of Troy: the defended city that hid my tender, aching heart.

How I felt about my therapist changed as I did. I began with such antipathy, distrust and secret belief in her unworthiness. She reminded me, I eventually came to see, of my mother. And much later on in the process came the realisation that it was actually me I saw. And when I came to love her, in a very deep and real way, it was my self for which I finally felt compassion.

I know that somewhere is the woman she really is, forever unknown to me, in the particulars of her ‘ordinary’ life. In that sense we will never be intimate friends. I can never enter her secret spaces, as she came into mine: as I invited her into mine. And I know that our ending was maybe the most important part of the whole process, that I had to leave her to find the self I would never find in therapy, yet would never have found without it. I had to have the wounded feminine healed in me before I could move on and grow. There was a sense of finally coming home to myself, of quiet peace and completion as well as a vibrant new beginning.

In the time since then, something wild and proud and magnificent has emerged in me: reclaimed from an ancient place, long ago cut down in my psyche, but somehow - it seems to me now - symbolic of a battle that goes back far beyond my own origins: maybe to the dawn of time, the first splitting. I had to come to this place to begin to understand how it is for all us, what it means not only to be a woman, but to be a human being, a part of this beautiful world we inhabit, all of us children of the universe.”