My approach to therapy

I describe my approach to therapy as  integrative. This approach allows for multiple viewpoints and interpretations and it could be argued is the most ethical and neutral approach.  It obliges me to continue learning from colleagues, further study, supervision, and my own personal therapy.  With this approach I have to keep up the process of integration and self awareness.  Integration questions certainty of any one 'truth' and allows people to consider what might be the more useful or helpful interpretation.  I will ask clients "is there another way of looking at this behaviour, situation or feeling?"   It also takes into account the individual needs of the client.  The most important thing agreed by therapists across all modalities is the relationship between client and therapist.  The client needs to feel safe, trusted, listened to and heard.  They also, of course, need to trust the therapist especially when disclosing concerns about their most intimate problems relating to sex and intimacy. 

In couple therapy I regard the couple as the client and the relationship as co created.  We look at improving communication and helping partners to recognise each others triggers and gain an insight and an understanding of their partner's world.  This insight can engender empathy and acceptance which in turn promotes healing.  Encouraging partners to practise fully attentive listening is one of the most powerful tools in couple work.  Couple therapy can also be about negotiating the ending of the relationship so that both partners have an appreciation of what has been positive, what they can take with them into the future and what they will be relieved to leave behind.

I also encourage a ‘mindful’ approach to the therapeutic work.  Many sexual problems are related to anxiety and the, what I like to call,  ‘what if ?’ syndrome.  People worry about “what if I do this or that, or my partner doesn’t do this or does do that?  I will encourage people to try to give their attention in a kindly way to the present moment to the 'what is?'.  With this approach clients can become more aware of what they are actually feeling and sensing in the moment, rather than worrying about what might happen in the future.  It takes a lot of patient practise but can be very rewarding and self-affirming.  I don't think in terms of sexual ‘performance’ as I believe that sex with a partner or partners is an interactive shared experience and not a performance.  I can encourage lone sex, or masturbation as unique form of self-pleasure and exploration.  My approach also appreciates the enjoyment that many people derive from role play, erotic games etc.

There is no guarantee of success with any kind of therapy and it is important that even if it is two steps forward and one step back (and it often is)  that overall the client is finding it helpful.  If not, then it is important that we reflect on the work and think about how useful adjustments might be made according to individual needs.  I will also consider alternatives such as referral to other clinicians, therapists or support services.