David van der Want
MA Clinical Psychology (RAU)
Go to your bosom. Knock there and ask your heart what it doth know. - William Shakespeare
Orientation to Psychotherapy
We are all simultaneously creating and being created by our worlds
My training as a clinical psychologist was in the relationally focused systemic and interactional models of psychotherapy. This approach places great emphasis on relationship and seeks to understand how our behaviour, our sense of self and our understanding of the world is embedded in the patterning of our relationships, both in our early environments and in our current life circumstances.
In this sense we are all simultaneously creating and being created by our worlds - our experiences of distress, joy, pain, sadness, wonder and awe, our being in our worlds can be seen as the outworking of the relational patterning of our lives. Being in relationship as spouse, parent, child, friend, colleague, employer is a creative act that gives rise to the reality that we inhabit.
In the light of this, the therapeutic relationship becomes an arena for creative exploration and potentially for the repatterning of our responses to both ourselves and others. I view the therapeutic relationship as a privileged and sacred space characterised by warmth, deep understanding, openness and genuineness. My therapeutic stance is an attempt to engage in deep and non-threatening understanding of the other - my efforts are directed at creating with the client a space of open, non-judgemental communication where I work to listen with sensitivity, intuition and intelligence and to speak from a coherent, informed, compassionate and "useful" position.
Within this broad framework I tailor my approach to adapt to the needs of the client and the particulars of the client's circumstances. I draw on a broad range of theoretical knowledge that includes cognitive behavioural therapy, systemic and interactional therapy, gestalt therapy and is also influenced by narrative therapy and the solutions oriented and focused approaches. I endorse the family therapist, Lynn Hoffman's position that the training of psychotherapists should also draw on literature, drama and poetics as the understanding of the human spirit offered by the great writers and artists often surpasses the dry and watered down version offered by much psychological theorising.
My orientation to therapy de-emphases diagnosis and treatment in favour of exploration, growth and creativity. While I believe it is foolhardy to abandon the medical model's diagnostic language in it's entirety I favour a language that emphasises soul, being and human possibility.
To elaborate slightly - I believe that the approach traditionally taken to problems of living such as depression and anxiety implies that such "problems" are amenable to diagnosis treatment and ultimately cure. I am not convinced of this and believe that often "symptoms" of distress are a indicators requiring more subtle examination. Sometimes such experiences can be likened to "growth pains", sometimes they are signposts pointing like a compass needle to aspects of our lives that require attention and sometimes they may be a calling for us to grow in a different direction, one that we perhaps find threatening or that may require change and adjustment in our relationships.
Some questions and answers about my therapeutic style
Do you offer advice?
Literature about psychotherapy and counselling indicates that advice is not generally useful. The reasons for this include the following; it tends to be offered in place of understanding, it may mean the therapist is taking too much responsibility for the client's actions and that it may provide too simplistic an understanding of the client's situation - "just do this and then everything will be ok".
However, my approach to therapy is active and involved. I tend to be direct in my therapeutic style and if advice is requested I will offer a clear sense of my understanding of the situation. This may not necessarily include explicit advice but I believe that clients should leave a session with a sense of having "got" something, ideally an enriched understanding that allows for a clearer sense of direction and capacity to act.
Do I have to delve deeply into my childhood in therapy?
The answer to this is an equivocal "depends". If you have a sense that your childhood experiences are having a significant impact on your life then it may be useful to explore these. However, my orientation suggests to me that we cannot change what has happened but we can effect change and growth in the here and now. It is often useful to speak about the past, particularly if there is significant emotion attached to it but I do not believe that understanding our past by itself necessarily frees us from it's effects on our present.
How many sessions will I require?
This is a very difficult question to answer and it depends significantly on the reason that you are seeking therapy and a variety of other factors. While I do practice long term therapy if it is indicated the majority of therapies are of short to medium duration. I believe that if after four or five meetings a client does not have a sense of having moved in a desired direction or at least that there is a sense that some progress has been made then something is amiss.
My approach is that my door is open for as long as the client has a sense that the therapy is offering them something. In many situations an initial series of 5 to 10 weekly consultations followed by a series of follow up consultations staggered at fortnightly and then monthly intervals is sufficient.
A lot depends on the client's need though and many clients enter long term therapies to address ongoing difficulties.
Should you require any additional information please do not hesitate to contact me.