N1 Psychotherapy                      
 
                    
                                                                                                        Aaron Balick
What does integrative mean?
The concept of integrative psychotherapy means different things to different people.  In general, though, rather than allying itself with one psychological theory (cognitive, psychodynamic, existential, etc.), integrative therapists recognise that they all have something different to offer.  Rather than choosing a dogma, the integrative therapist is trained in several theories and integrates them in a way that is authentic both to them, and the needs of the client.  In short; the needs of the client and doing what works comes before attachment to any one method or theory.
 
I have developed my own integration of theory and practice that reflects my training background, the most recent research in the field, and my personality.  My methods and orientation have changed a great deal over the years as a response to my experiences.
 
In my practice, it is most important for me to learn about my client: his or her needs, desires, strengths and weaknesses: aims and goals.  By learning from the client first, I am better placed to decide with my client’s consistent input how best to move forward.  I prefer to work in a collegiate way -- that means that the clients’ needs are something that the two of us aim to address together.  While I bring a great deal of skills and experience to the effort -- it is my client who is likely to have the clearest idea what they would like to do, and what works best for them.
 
Though being broadly “client centred,” I do believe that many theoretical and practical models can do a great deal to enhance the psychotherapeutic process.  There are hundreds of such models, and thousands of variations of them.  I have chosen some major models from which I have build a thoughtful integration and I list them here.
 
PSYCHODYNAMIC:
 
Psychodynamic psychotherapy is concerned with the client's personal history and how it affects the way they are in the present.  Psychodynamic theory draws a lot from Freud and Jung, and more contemporary theories like relational psychoanalysis, attachment theory, and object relations.  Each of these schools have their own complex meanings and backgrounds -- but they are primarily interested in how early relationships affect current ones.  I am a member of the International Association for Relational Psychoanalysis and Psychotherapy (IARPP), a contemporary form of psychotherapy and analysis that sees relating as one of the human's primary drives (and primary difficulties).
The goal of this sort of therapy is to look at some patterns that you might unconsciously be repeating in your life.  This may be the way you do relationships, the way you think or worry about things, or simply events in your life that seem to happen over and over again that make you unhappy.  By becoming conscious of these patterns, you can begin to take control of them and be in a position to make better choices.  This part of the process is "analytic" where the focus is on interpreting and understanding experience.  While understanding is certainly a good step -- it doesn't end there.  While the past may be important, I’m cognisant of the fact that we live in the present -- and that’s central to my work.
Psychodynamic work is best utilised for clients who wish to be in psychotherapy for the longer term and to get a deeper understanding of unconscious processes and relational dynamics.
COGNITIVE/BEHAVIOURAL
 
While psychodynamic work can be very effective for deep set patterns, long-term change, and learning more about yourself, it can be a relief to know, too, that some very simple things can be done to relieve anxiety, build self esteem, and work with some issues around depression.  Cognitive behavioural work is most interested in working with your thoughts, and how your sometimes irrational thoughts will affect your behaviour, and then certain outcomes in your life.  By working directly with your thoughts, and sometimes asking you to ‘try things out’ at home, we can begin to make serious inroads into some difficult areas.
 
Cognitive Behavioural Therapy or (CBT) is generally much more active on the part of the therapist than either psychodynamic or humanistic methods.  For that reason, CBT may be suited for individuals who wish to have a shorter time in therapy -- or for those who are not particularly interested in long term analytic work.  As I work integratively, it is my belief that CBT and analysis are not mutually exclusive (in fact there is a therapy called Cognitive Analytic Therapy (CAT) which combines the two) -- and I endeavour to use both in an effort to best assist my clients.
 
HUMANISTIC INFLUENCE
 
Humanistic therapy was developed in the late fifties as a reaction to the “expert led” psychologies like psychoanalysis and CBT.  Humanistic practitioners felt that the needs of the client were being lost to the dominating theoretical models.  Theorists such as Abraham Maslow and Carl Rogers began to develop an alternative that was much more gentle, and client led.  This was a very important change in the way that therapy was delivered, reminding therapists that though they have a great deal of theory under their belts, it does not mean that they know more about their clients than their clients do themselves.
 
Humanistic counsellors and therapists generally have a much less active aproach to their clients -- they are more interested in facilitating their clients’ progress and making space for them to explore.  While I believe that this is a necessary component of individual therapy -- I also believe that a more active approach from the side of the therapist may be necessary to aid effective and desired changed.
 
Because of my active approach, I do not identify as a humanistic therapist.  However, I feel that the humanistic movement has an awful lot to offer with regard to the practice of psychotherapy.  Most importantly is the reminder that therapy is first and foremost about the CLIENT.  This means that however much a theory may be helpful with regard to grounding and treatment, each individual is unique, and that individual uniqueness is CENTRAL to the work.  Sometimes theories need to be left behind for the benefit of simply understanding where the client is coming from.  I try to maintain this position in my work.
 
When I choose a more active approach, it is always in consultation with the client.
 
A FEW OTHER INFLUENCES
 
I have recently been most influenced by the relational movement (mentioned above under psychodynamic) and by the developments in the work of Carl Jung.  You may know that Jung, after breaking with Freud, created anther view of the psyche after 1912.  Out of his many concepts, I am most interested in his concept of individuation.  Individuation is a term that understands that human experience is more than just getting through the day; it’s also about becoming authentically who we are.  There are lots of blocks to individuation, and the therapeutic goal here is to identify what we need to become, and to learn how to work with our blocks in that direction.
 
Unlike many psychotherapists, I do not hold a derogatory and defensive position with regard to disciplines like coaching and NLP.  I feel that though neither of these things are ‘psychotherapy’ on their own, they do have interesting and worthwhile perspective and techniques -- techniques that can be helpful to individuals in psychotherapy.  With discretion, and in communication with clients, some of these skills can be used in the context of psychotherapy.