APPROACHES

TO
COUNSELLING
Uwasara Arambewale Weerakoon
Psychologist
MPhil in Clinical Psychology (SL);
Graduate Diploma in Psychology (AUS);
BS in Psychology (USA)
• There are many approaches to counselling and providing therapy. More
approaches are further being formulated to better understand individuals and
support them.
• Approaches can be divided into 5 broad categories (APA, 2021)
1. Psychodynamic and psychoanalytic approaches
2. Behavioural approaches
3. Cognitive approaches
4. Humanistic approaches
5. Integrative or holistic therapy
PSYCHODYNAMIC
AND
PSYCHOANALYTIC
APPROACH
INTRODUCTION AND FRAMEWORK
• Based on the concept that individuals are unaware of the many factors that cause their
maladaptive behaviours and discomforting emotions.
• This approach explores how the unconscious mind influences thoughts and
behaviours, with the aim of offering insight and resolution to the person seeking
support.
• Highly individualized, lengthy in duration and focuses on identifying how early
childhood experiences have affected the individual’s life/ personality and presenting
problems.
• Aims to make deep-seated changes in personality and emotional development.
• Highly influential during the first half of the 20 th century.
• Pioneers of the fid were mostly neuroscientists: Josef Breuer; Jean Martin Charcot
• Further adaptations and refining by Sigmund Freud (neurologist)
• Basic Assumptions:
1. Human beings are basically determined by psychic energy and by early experiences
2. Unconscious motives and conflicts are central in present behaviour
3. Irrational forces are strong: the person is driven by sexual and aggressive forces
4. Early development is of critical importance because later personality problems have
their roots in repressed childhood conflicts.
KEY CONCEPTS

• Normal personality development is based on successful resolution and integration of

psychosexual stages of development.

• Faulty personality development is the result of inadequate resolution of some specific

stage.

• Id, ego and superego constitute the basis of personality structure.

• Anxiety is a result of repression and basic conflicts

 Psychosexual stages of development
• According to Freud, all human beings pass through an innate sequence of stages. At each

stage, pleasure is focused on a different region of the body.

• Erogenous Zone: Area on body capable of producing pleasure

• Excessive investment of psychic energy in a particular stage of psychosexual development

is identified as fixation (unresolved conflict or emotional hang up). This results in various

types of psychological disorders.

• Oral Stage: Ages 0-1. Most of infant’s pleasure comes from stimulation of the mouth. If a
child is overfed or frustrated, oral traits will develop. Early oral fixations can cause:

• Oral Dependent Personality: Gullible, passive, and need lots of attention.

• Later oral fixations can cause:

• Oral-aggressive adults who like to argue and exploit others

• Anal Stage: Ages 1-3. Centered on the anus and elimination as a source of pleasure. Child
can gain approval or express aggression by letting go or holding on. Ego develops. Harsh or
lenient toilet training can make a child:

Anal Retentive: Stubborn, stingy, orderly, and compulsively clean

Anal Expulsive: Disorderly, messy, destructive, or cruel

• Phallic Stage: Ages 3-6. Centered on the genitals and sexual identification as a source
of pleasure.

• Oedipus Complex: is described as the process whereby a boy desires his mother and
fears castration from the father, in order to create an ally of the father, the male learns
traditional male roles

• Electra Complex: is described a similar but less clearly resolved in the female child with
her desire for the father, competition with the mother; and thus, learns the traditional female
roles.
• Latency stage (6 years- puberty) is a time of little sexual interest in Freud’s

developmental view. This stage is characterized with peer activities, academic and

social learning, and development of physical skills.

• Genital stage begins with the onset of puberty. If the other stages have been

successfully negotiated, the young person will take an interest in and establish sexual

relationships.
 PERSONALITY
• Sigmund Freud proposed that there are three levels of consciousness:

1. Conscious

2. Preconscious

3. Unconscious
• He also proposed three basic parts of personality

1. Id (desire)

2. Ego (reason)

3. Superego (conscience)
• The id is present at birth and is part of the unconscious. It contains the most basic of human

instincts, drives, and genetic endowments.

• Works on Pleasure Principle: Wishes to have its desires (pleasurable) satisfied NOW, without

waiting and regardless of the consequences (immediate pleasure is the sole motivation for

behaviour)

• The id does not have a sense of right or wrong, is impulsive, and is not rational.
• The ego is the second system to develop and it functions primarily in the conscious

mind and in the preconscious mind.

• It serves as a moderator between the id and the superego, controlling wishes and

desires.

• Works on the Reality Principle : the external consequences of behaviour are

considered in the regulation of expression of impulses from the id.

• The superego sets the ideal standards and morals for the individual. The superego

operates on the moral principle which rewards the individual for following parental

and societal dictates.

• Guilt is produced when a person violates the ideal ego denying or ignoring the rules of

the superego.
 EGO DEFENCE MECHANISMS
• Ego defence mechanisms were believed by Freud to protect the individual from being
overwhelmed by anxiety. He considered them normal and operating on the
unconscious level.
Defence Description Example

Denial When a smoker refused to admit that

arguing against an anxiety
smoking is bad for their health
provoking stimuli by stating it
although he knows it is making him
doesn’t exist
vulnerable to lung disease.
Displacement Picking up arguments with children
taking out impulses on a less
everyday because of work pressure.
threatening target
Intellectualization Coping with a breakup by analysing
avoiding unacceptable
what went wrong in the relationship
emotions by focusing on the
rather than coping with the difficult
intellectual aspects
emotions.
Projection Husband who has anger control
placing unacceptable impulses in
problems accusing the wife of having
yourself onto someone else
anger management problems.
Rationalization supplying a logical or rational A person who didn’t get an expected
promotion at work coping with it by saying
reason as opposed to the real he couldn’t have handled the responsibilities
reason attached to the position.

Reaction formation taking the opposite belief A girl who has a crush on a boy shows
dislike towards him.
because the true belief causes
anxiety

A child experiencing emotions of jealousy due

Regression returning to a previous stage
to mother bonding with a younger sibling
of development asking to be fed milk from a bottle

Repression pulling into the unconscious A child who has been sexually abused
completely forgetting that experience
Sublimation acting out unacceptable A person experiencing extreme anger taking
up kick boxing as a means of venting
impulses in a socially frustration.
acceptable way

Suppression pushing into the unconscious A student who gets insulted in the
examination hall, doesn’t think about that
specific experience when preparing for an
exam
ROLE OF THE COUNSELOR

To encourage the development of transference, giving the client a sense of safety and

acceptance. The client freely explores difficult material and experiences from their past,

gaining insight and working through unresolved issues. The counsellor is an expert, who

interprets for the client.

GOALS OF THERAPY
1. Helping the client bring into the conscious the unconscious.

2. Helping the client work through a developmental stage that was not resolved or

where the client became fixated.

3. To reconstruct the basic personality.

4. To assist clients in reliving earlier experiences and working through repressed

conflicts.

5. To achieve intellectual awareness.

6. Help the client adjust to the demands of work, intimacy, and society.
THERAPEUTIC RELATIONSHIP
• The analyst remains anonymous, and clients develop projections toward him/her.

• Focus is on reducing the resistances that develop in working with transference and on

establishing more rational control.

• Clients undergo long-term analysis, engage in free association, to uncover conflicts, and gain

insight by talking.

• The analyst makes interpretations to teach them the meaning of current behaviour as related to

the past.
TECHNIQUES OF THERAPY
1. Free Association is a process where the client verbalizes any thoughts that may without
censorship, no matter how trivial the thoughts or feeling may be to the client.
2. Dream Analysis is a process where the client relates their dreams to the counsellor. The
counsellor interprets the obvious or manifest content and the hidden meanings or latent
content.
3. Analysis of transference is a process where the client is encouraged to attribute to
counsellor those issues that have caused difficulties with significant authority figures in
their lives. The counsellor helps the client to gain insight by the conflicts and feelings
expressed.
4. Analysis of resistance is a process where the counsellor helps the client to gain insight
into what causes form the basis for a hesitation or halting of therapy.
5. Interpretation is a process where the counsellor helps the client to gain insight into past
and present events.

• All above techniques are designed to help clients gain access to their unconscious
conflicts, which leads to insight and eventual assimilation of new material by the ego.
• Diagnosis and testing are often used. Questions are used to develop a case history.
APPLICATIONS

• Better suited for more general concerns such as depression, anxiety, relationship

difficulties, sexual problem, self-esteem issues, phobias and sleeping problems.

LIMITATIONS
• Requires lengthy training for therapists and much time and expense for clients.

• The model stresses biological and instinctive factors to the neglect of social, cultural,

and interpersonal ones. Its methods are not applicable for solving specific problems of

clients in lower socioeconomic classes and are not appropriate for many ethnic and

cultural groups.

• Many clients lack the degree of ego strength needed for regressive and reconstructive

therapy. It is inappropriate for the typical counselling setting.