A k o le g m n c n w d e e ts

Belglings

I w ish to th ank a nu mber of peopl e who have facil itated the writing of this book. In particular my husband, Peter, has been generous in his support and encouragement. My thanks also go to Brian Solts and Sue Kobler for their sug?gestions and help in reading draft chapters and to Alessandra Lemma for her encouragement to take on the challenge. Lastly I would like to thank my editors Alison Poyner and Windy Dryden.

viously depressed. He was smartly dressed, cheerful mid self-assured and as he sat in the chair seemed to take up a lot of space in my room. He said he didn't quite know why he had come; h

for this and suggested that it might be the result of stress.

ties sleeping and was quite distracted at work. I said it sounded as though the row had upset him very much and asked film what it had been about. He told me that he had asked his wife

'I'm not really that upset about it' he said. 'I've been to America

before and I don't need to go again. And anyway it would cost a lot of money, even if we did stay wit

Acknowledgements

thanks also go to Brian Solts and Sue Kobler for their sug?gestions and help in reading draft chapters and to Alessandra Lemma for her

at he would not upset her again by complaining.

which counselling techniques will bring about psychological change. fight against their respective families had brought them closer together, and for the first seven years of their marriage he had no regrets.'The prob? ress the issue at all, or I might have addressed 11 more directly by reassuring him that I would take him seriously. But by saying that I won

It

Ma

MM

II

with many other psychodynamic practitioners I have not sought to gain informed consent at this stage and have done so for a numbe ent in a way that is different from other models of counselling. Nearly all forms of therapeutic work pay attention to the importance of

ct that there could be a link between the two.

relationship between us which will allow the emergence of unconscious material. As I twirl above, the therapeutic relationship is the central

the perselective of both counsellor and client. In Chapter 5 1 describe some of the practical skills involved in psychodynamic counse

1 1 o the sake of clarity, I will refer to the counsellor as'she' and the clien as 'he' throughout, except when describing specific case studies.

as had some experience of the approach so that he better understands what he is consenting to. To some extent making a distinction b

that John has given implicit consent to counselling by

selling.

Key Concepts in Psychodynamic Counselling

ght of experience and research. At the same time they acknowledge that some of what he said remains relevant today. Much of wha

we greet a client, to the use of advanced therapeutic skills like making interpretations, our whole way of relating to and thinking about our clie

t. But it is largely unconscious, meaning that we are by definition unaware of it and do not have access so easily. At one time the notion of the

psychoanalytic thinking) trace their lineage back to Freud and psychoanalysis. Psychoanalysis remains the most influential of the psychodyn

ocesses are not constrained by reality. Time can collapse, so that an event that happened many years ago can be experienced as though nd meaning. The latent content was usually to do with forbid infantile sexual or aggressive wishes and therefore too anxiety provoking to

by ourselves and by other people, for example, by how we behave, the things we say or feelings we experience. More specifically it can b

plain to his friend that he could not afford to pay for the fuel she became very angry with him and said she wasn't going to go with him if he couldn't G

11

d unconscious) being populated

by the

important people in our lives, like parents or other carers, or a sibling. These people are known

ue the jour- ney with him. I wondered about the extent to which, at an unconscious level, he already experienced me as unsympa?thetic to

; also our relationship to ourselves and important others in our minds. By external sources I mean events or relationships in the outer world th

t totally in charge of our feelings or behaviour. As a species we have a tendency to think we can control most things, and this belief is supporte

We all Experience Inner Conflict

Wry often we experience these convection currents as a clash or a conflict, and this notion
15

14this

only compromise we have to make. We also have our own set of internal guiding principles about how we should live life. So we cannot do

hodynamic model is particularly interested in toose defencesget to. Atdeploy unconsciously. Freud saw repression', awill be other conflicts t low conscious aware?ness and therefore not tho difficult to that we a deeper level of his unconscious mind there form of forgetting, as p

something that is uncomfortable. John used both defences in talking about his disappointment about his trip to America. At first he denie

n beings have a strong tendency to split things into opposites and only see one aspect of a complex situation. In particular we tend to see othe

t of With we seek out relationships in whatever way we are able according to our level of maturation. Our survival depends on our abilit

our Instincts

on't even remember have a profound and lasting influence on the adults we become? Freud first made the link in 1893 in his groundbreaking p

21

ot entirely in control. Psychodynamic theorists know that our instinctual needs can powerfully over-ride other, more 'civilized', behaviour. W

But what stayed the same was Freud's emphasis on just how important our early experience is. Again, this can be a very uncomfortable

ain both the relationship witha sfer' ontoour adult personalities and our psychological difficulties in relation to our developmental history. It is for this reason that psychodyn

t people) as children. Our early re - lationships thus become the template for our expectations of later relationships. We are quite active in at

23

s also caught between wanting to be special and needed and learning an intrusive closeness that might be too uncomfortable and arouse unw

ent and his counsellor at the centre of the work. It goes beyond recognizing how necessary it is that client and counsellor develop a good ient. Sometimes the pressure to respond in a way that fits her client's template can result in the counsellor feeling and even behaving in a

ery difficult to face the outside world, so he was careful not to push her too far away for fear of losing her altogether. In the relationship with me he

How Did Here? Key e History of c Idea Developments Psycho

ting John gave me an indication about how difficult he might find it to change when he told me about what happened when he tried to talk t

areer as a neurolo-gist in Vienna, turned his attention to the psychological disturbance that had fascinated him when he was at the Salpe

auma, and Freud concluded that knowledge the seduction was being kept quite deliberately out of con scions memory because it was too painfu tuals had been interested in the idea of the unconscious fo

ud did not invent the idea, but he was th first to propose that it was the receptacle into which w

hed or repressed those ideas or memorie that we want to ignore. But why should we want to ignor

the ideas ar conscious? Freud's attempts to answer these questions, and the techniques that he developed to help his patients access their mem

his treatment of women, whom he seemed to view as some?thing akin to 'Adam's rib'.
suffic

ences on psychodynamic thinking after Freud. Her ideas diverged

iently from Freud's that there was considerable disagreement betwee

e t of how we cope with our instinctual drives at dif?ferent stages of development in childhood. In doing so he revolutionized theories of the m

and not all of his thinking is obsolete today. I am often surprised on revisiting his work to discover how fresh and up-to-date certain

was very protective of his theory and did not brook dissent. He fell out with most of his collaborators when they developed their

28

search and his emphasis on the importance of actual experience led him to fall out with his psycho-analytic colleagues. At that time ma

del, Freud proposed that there are, three systems or levels of consciousness - the conscious, the preconscious and the unconscious. The con

ich are not in your conscious awareness. It is rather like the files on a commuter that are not in current use, but which can be accesse puter files are often surprised when they realize that psychodynamic hard drive that can no longer be accessed except by special -the way aise. They that have been wiped but which still have a trace on the theories are not only concerned with psychopathology means. F

curb

This material is actively kept out of consciou awareness by a force known as 'repression'. As his ideas developed Freud realized the limitations
o

model. Although he continued to se the division of the mind into conscious and unconscious a

984: 351) he developed a second model to account for the develop meats in his thinking. Known as the structural model, in i

t the self is always seen as failing to live up to the ego-ideal. It is part of the work of counselling with clients with harsh super-egos to r

es at about six months of and in Freud's model it is the conflict between these priorities that is an important contributor to conflict. have different priorities, age, at which time the individual becomes a self rather than being just an amalgamation of urges and needs. Part of

ds cannot tolerate frustration. So, for example, should they be hungry they might steal food rather than wait until they get home to a me as they are perceived by the child. Part of its job is to stop the id from getting out of control by imposing rules to

he consequences (an id wish), but his ego was in touch with the reality of the consequences should he do so.

same-sexed one. The idea is based on the Greek myth about Oedipus, who unknow?Ingly married his mother after killing his father. Acco
their

ifying with their mother to possess

father vicariously. Here Freud reveals the depth of his phallo-centrism as he never properly accounts fo

35 spicion from being orally frustrated. Over-indulgence results in a tendency to idealize others. The second stage is the anal

s ta ge

lasting

34

1920s. to cope with the fact that he does not have exclusive relationships with was also an extension of his theory. e needs Taken as a whole, although Klein's work trans many of Freud's ideas, ithis parents and that they have a relationship with each

e inter of these-early object relationships that determined the child's inner world. This was the beginning of Object Relations Theory. O

38

ect (Klein, 1988). Klein's proposal that envy is innate, rather than the result of inadequate parenting and a frustrating environment, was

hungry he fantasizes the breast as something bad; this is through the process of projecting his discomfort of hunger into it. In turn he fee ntion to the fact that our fantasies about relationships do not always reflect the actual relationship; fantasy can interpret and distort event

41

hizoid functioning becomes more dominant in the normal course of events. Oneof these is in groups, where we te

yone achieves it as the dom?inant mode of functioning It has the potential to develop at about six months, but ca

eeds. a ll loved. However he also has to learn to take responsibility for his own aggression and not pro?ject it into othe
V

loggerheads over. Klein located the oedipus complex in the first year of life, and with it the pain of recognizin

Current thinking

All hough her theory was more concerned with relationships than Freud's, Klein's theory was not fully a two-person

ure or trauma affect the way in which fantasy develops, recognizing that there is a much more complex inte nd that she accepts them and transforms them into some?thing less frightening before giving them back. It is ra

sychodynarnic thinking towards recognizing the importance id the mother in development and away from Freud rly the death instinct. However, in common with other Independent thinkers, he did not dismiss the role of fan called primary maternal preoccupation, in which she becomes increasingly identified with and absorbed by her b

s and their children) led him to develop innovative ideas about child development, which he then translated

hat Winnicott called a 'holding environ?ment' the mother enabled the baby to naturally become autonomous. Z e it himself. You cannot choose a transitional object for a baby because it is in part a representation of his mother, and therefore can on

N ulties in forming truly intimate relation?ships, since his false self cannot allow him to be truly close to another person. Instead he might have om his innovations in therapeutic technique. He created a holding environment which allowed his patients to regress to a level of depend

44

ly identifying Bowlby's contributions.

esearchers Z like Daniel Stern (1985) who brought the findings in infant research to the attention of the psychodynamic world. Bu

for two decades he was 'virtually airbrushed out of the psy?choanalytic record - rather like some dissident in Stalinist times' (Holmes, 1 en indi?viduals to maintain the functioning of the group. Bowlby method of investigation in psychoanalytic theory-building. The latter involves careful observation during the course of analysis.

d that psychological problems are the result of deficiencies in a child's psychological environment rather than instinctual conflict. Unli

rying on separation and searching is at its maximum between 12 and 18 months, which is the age at which babies would be at risk from a

ached. An example is a mother who regu?larly ignores her baby's cries then picks him up when she wants to play rather than when the baby
X

However, attachment is not necessarily fixed for life at this point, and there is evidence that a child's attachment status can change in respo r transferred to other relationships (for example a counsellor). It determines how we see ourselves through their eyes and how we see them.

48

49

50

51

ached is that it facilitates mental health. Securely attached adults are more able to make intimate relationships, which itself is a protection

eparated from a loved one. People who have been bereaved often show some of. the behaviours that we observe in small children sepa

achment status.

ung babies. This occurs because, although we are born with all the brain cells we will ever have, the connections between those brain ce

ons work. This is especially so in government-funded treatment. One of the difficulties for psychodynamic therapies is prov?ing that what h

Notes

I The science of species-specific biologically-driven (instinctual) behaviour. For the sake of simplicity I will continue to refer to the primary carer as 'mother'; however, I acknowle fathers, grandparents and so on.

ress; the co-construction of autobiographical narrative; the use of interpretation and the value of regression. It is possible that in th

as libido might also begin to map onto brain anatomy and chemistry. However, as Solms counsels, we are still at the very early stages

52

53

Putting Concepts, Into Practice: What Happens in Psychodynamic Counseling?

unhurried. The counsellor will listen very carefully to what the client says, and is unlikely to make notes during the ses?sion. She will probab

lps him to take note of what he himself is saying or feel?ing. Her comments on the whole will make him more aware of what he thinks and ose a theoretical position that chimes with, and maybe even justifies, their personal style and beliefs. Furthermore, although psychodynam

m or during the session. The client will probably notice that the consulting room is not particularly personalized,

55

he door the counsellor space in which he is she might attend to a telephone ringing are painful. It can be much more difficult to as adul so that the client has a will answer it, or thatfree to explore those areas of his life that in the room.This may elicit childhood as well control p

him when

are usually punctual about starting and I finishing on time. This enables the client to know how long hissession will be, and that he has a

sulting rooms. They argue that if they give too much away about themselves it will inhibit the client's capacity to fantasize or will imp

ght wonder why a client is late, or says the most painful or important things just as th session is about to finish.

g this with his supervisor, he remembered that as a child Charlotte had arrived home from school some time before her mother had return
4!

E to

anger or disap?pointment with the counsellor. Many clients come to coun?selling having difficulties with the experience or expression of ne
C
t

Therapeutic Neutrality unsellor or therapist who engages very little with her client. Today it is accepted I hat the ideal of the blank screen is not only impossible, but

would be quite formal, and would not engage in social conversation or give personal information away. To do this often involves the co

58

et? The following example client something aboutwhich expectations about thethe work we are doing. I also need to feelbefore the client d by whether telling my highlights the extent to me would progress or hinder counselling relationship can be formed personally happy

past on his waythroughhis own clients. When he eventually came into me to become ill. Oncequickly clear that he experienced me as someone damaged me to see his negative feel?ings towards me, causing counselling it was very we had explored the fantasy I agreed to tell him

mother had in reality been absent when he was young. She had been ill for much of his childhood and often in hospital, so he had a real

61

6 3

mber have become carers at an early age. Clients in general might therefore elicit vicarious caring from us when they represent the needy part of ou

e need for ourstirs up early longings for, and fears of,need to beand intimacy and being looked after. The awakening of these transference f is needs. This own therapy or counselling. We also closeness aware of who we are to the client at any moment in the counselling ses?si

a session, unless it is clear that the client is unable to do so, and takes her lead from the client rather than suggesting a topic for discus

hat she was semi-retired, though he was concerned about the amount she was spending. I began to feel Impotent, that there was no 0

be difficult or embarrassing to say, and not make it past the client's internal censorship. My own stance is that free association is

64

65

internal world is structured, the nature of the trans- ference and the particular issue the client wants help with at that moment.

1963), but it has an important role in other forms of psychodynamic counselling as well. Some counsellors will ask a client to describe a rec

ence in this stage. If used transference interpretations might focus on deepening the transference.

us of the work begins to shift more towards an exploration of the transference and the client's internal world. This is when the bulk of th

be able to confront her with his unhappiness. However, as he faced up to the reality of her affair he began to realize how him dependence

that it is time to start working towards an ending. In this stage the major task is to saygoodbye. This is often a very difficult time for th

ngage with the counsellor or the work of counselling. During this time the client may talk about his uncertainty about whether to contin

Practical Skil

ychodynamic ng

y of saying goodbye becomes more acut previously unexplored issues arise leading to new wor Additionally issues that had been w

h his eyes, and to be non-judgemental In her attitude towards him. She also needs a number of specific skills, such as being able

ing, and for more advanced readin I recommend Lemma (2003). A word of caution is important here for those of you who want to work u

ve the potential to harm if used by untrained practitioner who is not in her own counsellin and supervision. To work ethically requires that you have

ychodynamic counselling and supervision fro trained psychodynamic practitioners.

Informed Consent

ent is a complex skill that requires degree of sensitivity to the client's readiness to discuss th

ling. Additionally, the counsellor should ensure that she is sufficiently familiar with other counselling approaches to be able to discu

ke sure the roots are growing. To avoid this ongoing consent is often taken as implicit, and this involves the dangers I discussed in Ch nt or 'trial' phase, which often means after approximate) three to six sessions. However, if a client asks about the' nature, risks and ben

an understand. The process should also be facilitate

nsference relationship; an understanding that psycho-dynamic counselling involves an exploration of the client's unconscious; and that ps

strive towards knowing and abhor uncertainty. Mon (1967) went further than this and advocated that we should begin a session withou

nal world. One of the factors thought to bring about change in psychodynamic work is the experience of being really attended to and e counsellor's own experience of her personal counselling. Personal counselling also facilitates becoming aware of one's own feelings, int evious session. While doing this I may start thinking about the story's possible hidden meaning. Does the story resonate with what I kn

rtunity to become aware of my feelings and thoughts without also having the responsibility for manag? ing a therapeu lling, ques?tioning that does not undermine him, an awareness of the gaps and inconsistencies in his story, an attent

n incident that had just happened at work. One of his colleagues

75

ainful affect' (2003: 176). This is not to say that we disbelieve what the client says or that we know better than him w

appens at a number id different levels and John's unconscious is by definition unknown, I could not be sure I had understood what he w

with me first. I then suggested that he might have experienced me as me and for us then in making the change to my holiday er, by being tenta?tive I also offer him the opportunity to disagree with being unreasonableto explore alternative understandings.d

thoughts

and associations

are. An association is a thought or feeling

that

comes to the client in response to something

he or him

78

s she actually was about her posi?tion in relation to her peers. As we explored her associa?tions further, Tania was able to begin to think about her lent that she was not loveable, and that u

ously.'I was at the airport in the queue to check In. I was late for the flight and I was anxious I was going to miss it. Then suddenly all these friends I was supposed to be travelling with arrived
Ile

nt's relationship to his counsel?Ior and who she represents for him at that moment. Extra?transference interpretations involve understanding the links between events, thoughts, feelings or

ured, had poor personal/professional boundaries. He had not known what to say to his friend, because he didn't want to upset her its she clearly liked her new counsellor, but at the same time h

whom we know well and who has been in counselling for some time. However, it is usually more acceptable to the client if a transfer Frank has become the mother who failed to protect her child from abuse. In making this interpretation Frank makes a link between th

s to take into account the client's perspective. Casement (1985) reminds us of the importance of thinking about the impact tour inter

from these feel?ings earlier in the session.

etation.the waythinking very carefully about the practical consequences of facing Anne with what you now know about her affair, but kes on 'You're to I lie consulting room.

mind about what she wanted from her pupils. I wondered whether the changes in my waiting room had accessed fears in John about my

82 beginning of the session is likely to be about the client's current preoccupa?tions, and he may well start the session by telling his coun?se

83

ownanxiety that she might damage her client. Such concerns about causing damage should be explored in the co

In the next chapter I will discuss how to find a counsellor Mid the differences between counselling and psycho

ed in his story and then standing back and taking an objective view of what he is saying and the interaction between them. She will m

reality into the room. Occasionally it is helpful to give a deeply upset client warning a few minutes before the end that the session

84

85

Beyond Theory and Practice: Psychodycounselling in context

ant to acknowledge them. The commonalties lie in the fact that they both adhere to the basic requirements of any psychodynamic training: th

onal counselling or therapy while training. Counsellors are usually required to have once-a-week counselling for a minimum number of sess psychotherapy, and then I will address the issues of how to find a suitable counsellor and what the benefits of counselling are. Finally I will e

ter difference in the style and qual?ity of work within groups of counsellors and groups of psy?chotherapists than between the two. So are th

ts as blank screens. However, many psychotherapists still use a couch because it helps both the client and the therapist be more in touch

The course content varies considerably across courses, but counselling courses tend to teach a wider range of theory than many psychothe

or the work they do. By contrast, most psychotherapy trainees have to pay for their own supervision, which is only partially offset by the fact t unselling and Psychotherapy) on the

88

89

erapists will offer mostly short-term work. can also requestpsychotherapists are send you a list of prac?titioners in your area or you can accessfind the right person for you, whate counsellors and the organizations to very difficult to quantify. It is much more important that you information about them on the inte

't necessarily. Some counsellors are prepared to discuss fees over the phone, while others will want to have a face-to-face discussion. S

he only way to find that out is to meet with your prospec?I ive counsellor. Some clients make appointments with three or four possible cou

rtakes. It is quite legitimate to ask about where and when someone qualified and what counselling or ther?apy organization they belon

yourself; you should also be stronger in the face of adversity. The care your counsel?lor has given you should have become internalize

sturbance and dis?tress we have more energy to get on with living our life in a way that allows us to reach our potential in those areas

d. Continuing counselling will enable you to explore these that his thoroughly Anne resolve some of from becoming or doing any?thing that might u maternal figure from whom he was unable to separate. He realized more fear of losing and had prevented him them so they are less painful. Another

t's shoes. Another benefit of personal counselling is that it is a unique oppor?tunity to experience at first hand a senior member of the p

mportant issue over recent years. The body that accredits both counselling courses and individual counsellors is the British Associa?tio

before deciding to embark on a course to think about why you want to do it. Usually our motives are mixed; a real desire to be of help
95

m of selection for the course or criteria for failing. A course that has neither might not hold the values and ethics of counselling as sufficien

theoretical orientation and requires you to have therapy and supervision in that model you need to think more care?fully about how at home the pro?fession later as part of a career or life change. The fact that most people pay for their own training may also ensure that only tho

e in and theirwith clients. Counsellors inoften at the end of a session the psychodynamic counsellor is left with difficult feelings to process. It i ess working projections is draining, and training often report that theoretical seminars or reading, which touch on issues personal to them, are

References

ald (1993) 'The patient's discovery of the psychoanalyst as a new object', International Journal of Psycho-Analysis, 74: 1223-33. Bion, Wilfred R. (1967 topher (1987) The Shadow of the Object. London: Free Association Books. (1988) A Secure Base: Clinical Implications of Attachment Theory. London: Routledge. eph and Freud, Sigmund (1974) Penguin Freud Library Volume 3: Studies on Hysteria. London: Penguin. (ed.) (2001) Kleinian Theory- A Contemporary Perspective. London: Whurr. Patrick (1985) On Learning from the Patient. London: Routledge. anding our clients and ourselves, but also how organizations and wider society function. a (1993) How to Survive as a Psychotherapist. London: Sheldon Press. uis (2002) who has to mourn Psychotherapy. New York: Norton. counsellor The Neuroscience of the loss of a series of inti?mate relationships. The nature of the relationship with our clients is not replicated i er (2001) Attachment Theory and Psychoanalysis. New York: Other Press. und (1923) 'Two Encyclopaedia Articles', Standard Edition 18: 234-62. London: Hogarth Press. und (1900/1976) Penguin Freud Library Volume 4: The Interpretation of Dreams. London: Penguin. und (1977) Penguin Freud Library Volume T On Sexuality. London: Penguin. und (1984) Penguin Freud Library Volume 11: The Ego and the Id. London: Penguin. ue (2004) Why Love Matters: How Affection Shapes a Baby's Brain. Hove: Brunner-Routledge.

Index

owards an integration', in V. Green (ed.), Emotional Development in Psychoanalysis, Attachment Theory and Neuroscience Hove: Brunner-Routledge.

Press (First edition, 1985). breastfeeding 39 Adult Attachment Interview 51 a g g r e s s i o n 3 9 - 4 0 , 4 3 anal stage 34-5 Jung, it, G. (1963) Memories, Dreams, Reflections. Trans R. we have British Association of Counselling and Psychotherapy (BACP) 88-9, 95 e doingCarlthough some we can feel uncomfortable when Winston attacked someone for having a characteristic we have projected int , analytic ear' 74-9 anxiety 3 88) Envy and Gratitude and Other Works 1946-1963. assessment phase 6, 70 associations 77-9 case ut those whose behaviour he condemned for their self-centredness, and atstudy extracts theoryI 30, 46-50selfish ands put 72-4needs before see also free association attachment crisestimes he hinted but impossible. At the same time we need our d 62 attachment that too was attentional skills my autonomy 44 beginnings unwise, not the London: Sage. Change. aim of psycho-dynamic work to eliminate them. That would not only be 1-3 countertransference 64, 82 defences 18 y. Chichester: Wiley. dreams 11, 78 babies endings 93-4 extratransference 79-80 personal revelations 60 projection 1 attachment theory 48-50 cognitive functioning 37, 39, 50-2 therapeutic abstinence 62-3 timekeeping 58 fantasies 38, 42 transference 24-5, 61, 62-3, 67, 79-80 ization as a way of keeping both me and her own feelings at a distance. At this level her defence had worked as she was succeeding Sage. impingement theory 43-4 unconscious communication 75-6 see also development theories BACP (British Association of castration anxiety 35 xperience. New York: Guilford. Counselling and challenges to counsellors 96-8 change resistance 25-6 985) The Interpersonal World of the Infant Psychotherapy) Books. benefits of counselling 92-4 bereavement 50 New York: Basic 88-9, 95 child time 84 ytic Re-Evaluation. Hove: Brun ner-Routiedge. Winnicott, Donald W. (1965) The Maturational Process and the Facilitating Environment London: Hogar childhood experiences 21-3 choosing a counsellor 90-2 collaboration 75 com biological drives 32 ute of Psycho-Analysis and Karnac Books. Wilfred 42 Bion, 24,74-9 'blank screen' counselling 59,88 conflict 12, 15-16 bonding 47-8, 91 conscience 16, 33 boundaries of counselling 57-8 B o w l b y , J o h n 3 0 , 4 6 - 5 0 brain functioning 51-2 conscious mind 10, 31, 92 consent 5-6, 70-1

herapy. Hove: the ones I've descri es, includingBrun ner- Routledge. bed above. However, modern psychodynamic thinking is I ess mechanistic and tends to look at how we can

of him. The process of taking back projections and owning them is called 'reintrojection'. In this case Jeremy needed help to recognize the ex

19