Problems of personal coping `psycho-social'

Up to not so long ago going to a clinical psychologist or counsellor was a major source of threat. It is still the case that the last "ologist" that a person requiring help is sent to is a psychologist. This is not surprising, given the difficulties our culture continues to have with personal vulnerability and the expression of emergency feelings (anger, depression, despair, anxiety, jealousy). There is no doubt that men are more blocked in seeking affective help than women, but it has taken women a long time to wake up to their rights to be loved and seek help for their inner and outer conflicts. In many ways women are still only at the tip of the iceberg in terms of exploring the depths of the emotional, social, sexual, occupational, religious and political oppression they have endured. The primary source of depression is oppression - this explains why women have tended to exhibit more depression than men. Do not get me wrong here, for men have also been oppressed, but not as expansively as women.

Men's oppression has certainly been emotional and social, but they have had a lot more power than women in the social, occupational, religious, political and sexual fields. It is a healthy development that both men and women (more women than men, it has to be said) are seeking psycho-social help and are relying less on medical interventions to cope with their difficulties in living. Historically, it was never a good development that people in emotional and social distress came under the umbrella of medicine.

While I have no difficulty with short-term psychotropic medication, it needs to be seen that medication is not a therapy but only a symptom reducer. The underlying conflict continues to lurk below the "tranquility surface" that medication creates, and will resurface as clients become tolerant to the toxic cocktail.

Resolution of those conflicts can only be done by confronting those inner and outer demons. Such confrontation may need to be done with the support of a clinical psychologist or counsellor. However, many people seeking help are somewhat confused by the array of different kinds of therapies and helpers available.

For my own part I have stopped using the word "therapist" because it suggests that it is the helper who has the power to change the clients' lives and not the clients themselves.

Also, I am uncomfortable that the word "therapist" can be broken down to "the-rapist". In any case the idea of a "therapist" is very much a misnomer. The truth is that only the people seeking help can undertake the challenge of change and face the painful blocks to their progress in life. Nobody can do it for them. It is the failure to broadcast this that has led to much of the confusion and disillusionment for which dynamic psychiatry and psychotherapy have been responsible.

Experience has taught me each client is different and has a unique biographical history, and that each patient's symptoms are representative of his or her story and have no generalised meaning. My response needs to be a unique one and I hesitate at recommending any particular type of counselling to a client. In any case, research has shown that effective helping is a function of the personal qualities and maturity of the helper, rather than the type of counselling they practise. The bottom line is that each client needs a different kind of help. There are certain characteristics of an effective professional helper: the ability to love his or her clients unconditionally; to listen actively with both mind and heart; to communicate belief in the client's vast potential and giftedness; the provision of hope so that the person sees that the helper believes change is possible; openness to self-disclosure on one's own life's journey; the communication of understanding so that the client feels secure in revealing his actions and innermost thoughts, feelings, images and dreams; the provision of safety and support and the calm management of the major suffering that may emerge; the ability to empathise and show compassion when hurt, rage, guilt or heart-rending sadness rises to the surface.

The professional helper needs also to communicate that the presenting difficulties of adults, adolescents or children are responses to the past and present social contexts of their lives. Because of this, it is more accurate to say that all personal coping problems are psychosocial in nature and that is not just the inner life of the client that requires exploration. This may mean helping clients to separate from social contexts - home, workplace, school, community, church - that have been instrumental in blocking their progress in life. It also means, whenever possible, making an input into these cultures that subconsciously darkened the presence of the person seeking help.

Dr Tony Humphreys is a consultant clinical psychologist and author of the The Power of "Negative" Thinking