Psychotherapy, as defined by the Oxford Dictionary, is ‘the
treatment of mental disorder by psychological means’. Though true, this does little
to describe what treatment entails. Psychotherapy, with its various schools is best
understood in term of its 19th century origins. Freudian psychoanalysis has
made a huge contribution to common perceptions of neurosis and psychological health and
Freud’s thinking still influence psychotherapeutic practice today.
However, its highly elaborated theoretical framework has been largely
replaced by more accessible therapies focused on behavioural change. These have been
supported by research based on the long-term observation of children with an emphasis on
‘good-enough’ parenting. Practitioners are now trained to have a broadly based
understanding of personality and offer various approaches to the psychological problems of
their clients. These are broadly psychodynamic or humanistic in origin and offer the
recipient insight and symptom relief.
There is an ‘evidence base’ for cognitive and brief therapies
which, with short-term counselling, are available within the National Health Service.
Accreditation of training is a requirement for practice and both the UK
Conference of Psychotherapy (UKCP) and the British Association for Counselling and
Psychotherapy (BACP) provide lists of qualified practitioners nationally.
Individuals and couples with personal and relationship problems,
including sexual problems and individuals with psychosomatic illness. It is not unusual
for someone to come for consultation with a physical problem put down to strain, overwork
or ageing for which the cause, although manifest by physical symptoms, has psychological
roots. Grief, separation and loss are universally experienced and a common reason for
seeking to be counselled. Burnout, mid-life crisis, the ‘empty nest’ and
retirement all refer to life events that may be transited better with skilled support.
Long-term emotional difficulty, with unhappiness in relationships, lack
of confidence, sexual difficulties, anxiety and depression, are examples of what can be
benefited by psychotherapy. Unresolved stress may lead to psychosomatic illness and a lack of quality in daily living.
In ‘couples’ therapy a damaged relationship may improve or
the way eased for a constructive separation. At all ages, from male or female
perspectives, we aspire to love ‘well’. As regards sex, the emphasis for men is
often on performance while for women, sex is frequently the expression of a loving
relationship
Coming to the their relationship with different experience men and
women have different expectations. With less social constraint on separation, a
couple’s dissatisfaction and disillusionment is more likely to lead to a break-up.
Psychotherapy will help couples base expectations on reality to create co-operative
agreements and make/accept loving confrontation when necessary.
The number of sessions depends on the nature of the problem and the
goal of therapy. The first sessions provide time to understand a problem and explore
approaches to its management
Dr Perring received a medical degree from Trinity College, Cambridge
then trained at St Bartholamew’s Hospital, London. He has a certificate in General
Practice, a higher degree in Internal Medicine and a Diploma in Psychological medicine. He
trained as an Integrated Psychotherapist at the Metanoia Institute and completed
post-diploma training at the Tavistock Clinic, London.
He is a registered psychotherapist and accredited by the British
Association of Sexual and Marital Therapists of which he is a founder member.
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