The British Association for Counselling and Psychotherapy
The British Association for Counselling and Psychotherapy (BACP) is an association for UK-based counselling professionals. It supports practitioners, enabling them to provide a better service.
The Austrian neurologist Sigmund Freud stands as one of psychology’s most famous figures of the twentieth century. Whilst his theories have been the subject of considerable controversy and debate, they have also helped to shape our views of childhood, personality, sexuality and therapy. As the founding father of psychoanalysis, Freud’s work pioneered the belief that not all mental health problems originate physiologically, but can also be the consequence of human experience, environment and culture. After studying medicine at the University of Vienna, Freud became fascinated with the emotional disorder known as hysteria (known currently as conversion disorder) and through his mentor Dr Josef Breuer became acquainted with the case study of a patient known as Anna O. Anna O’s symptoms included paralysis (numbness), hallucinations, mood changes, and muteness. However, over the course of her treatment Anna recalled several traumatic experiences, such as the death of her father, which Freud and Breuer believed had contributed to the presentation of her symptoms. They also noted, importantly, that Anna’s symptoms were substantially relieved when she was allowed to talk at liberty about her memories, experiences and thoughts. The case of Anna O was published in Freud’s and Breuer’s 1895 work 'Studies in Hysteria' and resulted in the developments of some key psychoanalytic concepts and techniques including free association, transference, unconscious resistance (defence mechanisms) and neurosis. Other notable work included Freud’s ideas on dream interpretation, ‘Freudian slips’, stages of psychosexual development, the Oedipus complex and the inner workings of the id, ego and superego. Collectively, these works came together to form the foundations of psychoanalysis which went on to influence some of psychology’s greatest thinkers such as Carl Jung, Melanie Klein, Anna Freud (Freud’s youngest daughter), Otto Rank and Ernst Jones.
Extra Reading: 'Freud: A Very Short Introduction' by Anthony Storr (2001)
Carl Gustav Jung was a Swiss psychiatrist and the founder of Analytical Psychology. Initially, he was a great admirer of Freud’s work, and after meeting him in Vienna in 1907 the story goes that the two talked for 13 hours straight, resulting in an intense five-year friendship. However, while Freud had first thought Jung the heir apparent to psychoanalysis, the relationship between the two began to rapidly deteriorate. Freud, in particular, was unhappy with Jung’s disagreement with some of the key concepts and ideas of Freudian theory. For example, Jung disagreed with Freud’s focus on sexuality as a key motivating behavioural force, as well as believing Freud’s concept of the unconscious as too limited and overly negative. In 1912, Jung published 'Psychology of the Unconscious' outlining the clear theoretical divergence between himself and Freud, as well as forming the basic tenets of Analytical Psychology. Jung believed the human psyche exists in three parts: the ego (the conscious mind), the personal unconscious and the collective unconscious (which included Jung’s ideas concerning Archetypes). Jung likened the collective unconscious to a reservoir, which stored all the experiences and knowledge of the human species, and was one of the clear distinctions between the Jungian definition of the unconscious and the Freudian. Jung’s proof of the collective unconscious was his concept of synchronicity, or the unexplainable feelings of connectedness that we all share. Further, Jung had an inexhaustible knowledge of mythology, religion and philosophy, and was particularly knowledgeable in the symbolism connected to traditions such as Alchemy, Kabala, Buddhism and Hinduism. Utilising this vast knowledge, Jung consequently believed that humans experienced the unconscious through numerous symbols encountered in various aspects of life such as dreams, art, and religion.
While Jungian theory has numerous critics, Carl Jung’s work has left a notable impact on the field of psychology. His concepts of introversion and extroversion have contributed extensively to personality psychology and have also greatly influenced psychotherapy.
Extra Reading: “Jung: A Very Short Introduction” by Anthony Stevens (2001)
Melanie Reizes Klein was an Austrian-born British psychoanalyst who was greatly influential in child psychology, particularly in her work devising therapeutic techniques for children and in her work on Object Relations Theory. Although she questioned some of the fundamental assumptions of Freudian theory, Klein was an avid admirer of Freud, and always considered herself faithful to Freudian ideology. As a divorced woman, with very few academic qualifications, Klein found herself at odds with a profession dominated by highly-educated male physicians and during the start of her career this proved problematic. Despite this, however, Klein had a huge impact on child psychology, particularly in Great Britain. She was the first person to use traditional psychoanalysis with young children, and after observing troubled children play with toys such as dolls, animals and plasticine, attempted to interpret the specific meaning behind children’s play. In 1932, Klein published 'The Psychoanalysis of Children' presenting her observations and revisions to traditional psychoanalysis theory and method in relation to child analysis. However, in 1938, Klein’s ideas came into conflict with those of Continental analysts such as Anna Freud (Sigmund Freud’s psychoanalyst daughter) who had migrated to Britain. Anna Freud was vehemently resistant to the revisions of both theory and method of psychoanalysis proposed by Klein in light of her work with young children. After several heated debates during the 1940s between the followers of Klein and the followers of Anna Freud, the British Psychoanalytical Society split into three separate training divisions: Kleinian, Freudian (Anna) and Independent which remains to the current day.
Extra Reading: “Melanie Klein” by Dr. Julia Segal (2004)
Aaron Temkin Beck is an American psychiatrist and professor emeritus in the department of psychiatry at the University of Pennsylvania. He is widely regarded as one of the most influential psychotherapists of all time, and has been listed as one of the ten individuals who have shaped the face of American Psychiatry. As a psychiatrist working in the early 1960s, Beck studied and practiced psychoanalysis. However, after undertaking a number of experiments to test the psychoanalytic concepts of depression, Beck found the results did not validate the theory of which he had trained and practised. Consequently, Beck began to investigate other ways of conceptualising depression. His investigations led him to discover that depressed patients often experienced spontaneous negative thoughts that were based around negative ideas about themselves, the world and the future. By identifying and evaluating these thoughts, Beck found that patients began to think more realistically and consequently their emotional and behavioural functioning began to improve. These observations formed the basic components of cognitive behavioural therapy, which has been efficacious in application to a number of disorders such as depression, addiction, and anxiety. Beck has also developed a number of self-report measures of depression and anxiety, including the Beck Depression Inventory (BDI), the Beck Hopelessness Scale, the Beck Scale for Suicidal Ideation (BSS), the Beck Anxiety Inventory (BAI) and the Beck Youth Inventories. Beck has received numerous awards including the 2006 Albert Lasker Clinical Medical Research Award for developing cognitive therapy, which fundamentally changed the way that psychopathology is viewed and treated.
Extra Reading: “Aaron T. Beck” by Professor Marjorie Weishaar (1993).
Alfred Adler was an Austrian psychotherapist and founder of the School of Individual Psychology. Along with Freud and Jung, he is considered one of the key members of the psychoanalytic movement which formed a core of the Vienna Psychoanalytic Society. However, Freud deemed Adler’s ideas too contrary, leading to Adler breaking away from psychoanalysis to form an independent school of psychotherapy. Adler’s ideas were concerned with promoting equality in therapy, and he was one of the first psychotherapists to discard the infamous analytic couch so that the clinician and the client could sit together as equals. His most famous work is that of the inferiority complex and the problems of self-esteem, which Adler linked to a number of negative human problems. Adler also argued for holism, in which therapists should view an individual holistically rather than reductively, as well as being one of the first to argue in favour of feminism. Consequently, Adler’s work and ideas are some of the most significant for modern-day counselling and psychotherapy.
Extra Reading: 'Understanding Life: An Introduction to the Psychology of Alfred Adler' by Alfred Adler (2009)
Albert Ellis was an American psychologist and founder of rational emotive behaviour therapy (REBT). Based on a 1982 professional survey of US and Canadian psychologists, he was considered as the second most influential psychotherapist in history. Although initially, Ellis was interested predominately in the theories of Sigmund Freud, his interests in modern and ancient philosophy as well as his own personal experiences began to influence a new theoretical direction. By 1955, Ellis had founded rational therapy which stressed working to change an individual’s self-defeating beliefs and behaviours by demonstrating their irrationality and rigidity. Ellis believed that through rational analysis and cognitive reconstruction, people could understand their self-defeatingness in light of their core irrational beliefs and then develop more rational thoughts and beliefs. While many of his ideas were criticised during the 1950s and 60s by the psychotherapeutic establishment, his reputation grew immensely during the preceding decades as the cognitive behavioural therapies were gaining further theoretical and scientific ground. Today, cognitive therapies are one of the most popular and efficacious treatments to mental health problems.
Extra Reading: 'All Out: An Autobiography' by Albert Ellis (2009)
Martin Seligman is an American psychologist and director of the Positive Psychology Centre at the University of Pennsylvania. His theory of 'learned helplessness' has been one of the key findings of the twentieth century and is one of the most frequently cited in introductory psychology textbooks. Seligman discovered that when an animal was repeatedly subjected to an unpleasant stimulus (and from which it cannot escape), eventually the animal will stop trying to avoid the stimulus and behave as if it is utterly helpless to change the situation. Seligman also noted that even when an opportunity to escape was presented, 'learned helplessness' will prevent the animal from doing so. From this Seligman saw strong similarities with severely depressed patients and argued that when people feel as they have no control over their circumstances they may also behave in a helpless manner and overlook opportunities to improve their situation. The implications of such work have not only been greatly influential across depressive disorders but also across a wide range of mental health problems.
Extra Reading:'Learned Helplessness: A Theory for the Age of Personal Control' by Christopher Peterson, Steven Maier and Martin Seligman (1996)
Carl Ransom Rogers was a greatly influential American psychologist and is widely considered to be of the most eminent psychologists of the 20th century. He was among the founders of the humanistic approach to psychology and his person-centred approach to understanding human personality and relationships has seen wide application in a variety of domains such as psychotherapy and education. Rogers began forming his humanistic ideas whilst working with abused children. He noted that the authoritative analysis conducted by psychoanalytical therapists prevented their clients from ever reaching what Rogers termed their self-actualisation or self growth. Rogers believed that each person has within them an inherent tendency to grow, develop and change and by creating a comfortable, non-judgemental environment, the therapist can aid individuals to find their own solutions to their problems. Rogers believed that for an individual to experience self-actualisation they must experience 'unconditional positive regard' from their therapist, which essentially means that the therapist must express complete acceptance of the client. By having this accepting and understanding therapeutic relationship, individuals can gain the necessary insight to resolve any difficulties they may be facing.
While the person-centred approach is one of the most widely used and most popular models in psychotherapy and counselling, it has also seen significant application in cross-cultural relations particularly the conflicts and challenges in South Africa and Northern Ireland. This work resulted in a Nobel Peace Prize nomination for Rogers.
Extra Reading: 'The Life and Work of Carl Rogers' by Howard Kirschenbaum (2007)
Edward 'John' Mostyn Bowlby was a British psychologist, psychiatrist and psychoanalyst, notable for his interest in child development and particularly his work in attachment theory. After working with children suffering from a number of behavioural problems, and the outbreak of World War II, Bowlby became particularly interested in the problem of separation and the work of other psychoanalysts looking at evacuees and orphans. By the late 1950s, he had accumulated a vast body of observational and theoretical work to indicate the fundamental importance for human development of attachment between a child and a caregiver. From this work, Bowlby formulated his theory of attachment where he believed the earliest bonds formed by children with their caregivers (particularly their mothers) had a tremendous impact that stayed with them throughout their life and formed a basis for later relationships. Additionally, Bowlby also proposed that attachment serves to keep the infant close to the mother and so improves the child’s chances of survival. As such, Bowlby proposed that mothers who are available and responsive to their infant’s needs establish a sense of security. Put simply, the child knows that the mother is dependable, and so by having a secure base is able to explore the world around them without fear. These ideas were taken up by Bowlby’s colleague, Mary Ainsworth, who developed a research tool called the 'Strange Situation Procedure' which allowed researchers to examine the attachment bond between child and caregiver by periodically making the caregiver leave a room and leaving a stranger with the child. By monitoring the child’s response to the caregiver upon their return, researchers are able to gain an idea of the strength of attachment between caregiver and child.
Although Bowlby’s attachment theory has received numerous criticisms, not least for its focus upon the mother as the primary caregiver, attachment theory has given rise to a great surge of empirical research surrounding early child development and remains one of the key theories in the formation of children’s close relationships.
Extra Reading: 'John Bowlby and Attachment Theory' by Jeremy Holmes (1993)
Whereas much of Freud’s work was devoted to illuminating the triangular Oedipus Complex, Donald Winnicott placed the mother-infant couple at the heart of his analytical explorations. A paediatrician, child psychiatrist and psychoanalyst, Winnicott’s theoretical and clinical concept changed the way we think about children and the adults they become.
Winnicott addressed mothers directly through an enduring series of radio broadcasts and in books with commonsense titles such as Talking to Parents and Babies and their Mothers. Winnicott’s distinctive voice and often poetic writing style introduced the general public to the rudiments of British object relations theory: the “ordinary devoted mother”, “good-enough mothering” and “primary maternal preoccupation” were ideas that a non-specialised audience could both readily understand and easily identify with.
Winnicott viewed the mother-infant dynamic as the model for the therapeutic relationship. The analyst – like the mother – strives to provide continuity of care and endeavours to create a “holding environment” in which the patient feels safe enough to explore his or her internal world and external reality.
Winnicott also placed great emphasis on the therapist’s capacity to contain conflicting emotions rather than desperately seeking a panacea: "The principle is that it is the patient and only the patient who has the answers". The analyst’s interpretations are important but collaboration, creativity, play and experimentation are equally fundamental to the therapeutic process. Indeed, a central tenet of Winnicott’s philosophy was that making mistakes can be as valuable as getting things right!
Unlike many of his peers, Winnicott insisted on the positive aspects of human nature: even ruthlessness, delinquency and antisocial behaviour may contain signs of hope. A child’s aggression, for example, may be understood as a natural part of his or her development and a means of testing the environment.
One of Winnicott’s lasting contributions to the history of psychoanalysis is the notion of “transitional phenomena”. A transitional object – a treasured toy, for instance, or even the child’s own thumb – sustains the infant during its mother’s absence and helps him or her on the road to independence. A “transitional space”, when applied to the consulting room, becomes an intermediate area where the patient can think creatively en route to developing a sense of personal meaning.
Extra reading: Winnicott by Adam Philips (2007)
Wilfred Ruprecht Bion, president of the British Psychoanalytical Society from 1962 to 1965, possessed one of psychoanalysis’s most original intellects. His clinical insights into severely disturbed patients contributed enormously to our understanding of psychotic personalities, whilst his pioneering observations about the unconscious life of groups – in particular his “basic assumption” theory (see below) – continue to have universal applicability.
Bion’s intense curiosity about unconscious phenomena built on the ideas of Freud and Klein as well as incorporating concepts from fields as diverse as algebra, physics and philosophy. Bion’s interest in individual and collective mental processes was also rooted in the fabric of his own life: he served as a teenage tank commander in the First World War before working as a military psychiatrist in the second.
Bion’s writings constantly invite us to “think about thinking”: How does the capacity to think evolve in healthy individuals? Why does this aptitude sometimes go awry? Why is actively thinking often such a reluctant pursuit? Bion developed a theory of the mind in which he formalised concepts such as “linking”, “maternal reverie” and “containment”. In the last of these, the mother acts as a “container” for her child’s feelings, converting raw experience into more digestible matter. In time, and under favourable circumstances, the infant will acquire the facility to think for itself.
Bion’s formulations about group mentality help us to make sense of the often puzzling behaviour of institutions, organisations and families. Noting that individuals frequently appear to lose their critical faculties in such environments, Bion posited that groups are unconsciously governed by very primitive forms of thinking. Groups react instinctively to conflict or anxiety by reverting to early emotional states: dependency (on an omnipotent leader, for example), pairing (two members uniting to rescue the group) or fight-flight (attacking or escaping from a common enemy). When a group is unknowingly in the grip of these survival strategies – termed “basic assumptions” – it is diverted from its primary task and may prefer to spend time discussing trivial matters or finding a suitable scapegoat (to name but two common examples).
Bion’s work is studded, according to one commentator, with “creative and destructive big bangs” and “creative explosions”; the reader can make up his or her own mind by delving into publications such as Experiences in Groups, Attention and Interpretation and Learning from Experience. Equally enlightening, and perhaps more accessible, is the first part of Bion’s memoires, The Long Week-End.
Extra reading: Bion Today by Chris Mawson (2010)
When Betty Joseph passed away in 2013 at the age of 96, the British press was united in its praise for “one of the great psychoanalysts of her day”, “one of the most influential psychoanalysts of her generation” and “one of the leading Kleinian thinkers of her generation”. Joseph was very much the “psychoanalyst’s psychoanalyst”, devoting her professional life to dissecting the minutiae of the analytic process, with a particular emphasis on transference, countertransference and projective identification.
Although Joseph’s written publications, like her celebrated workshops, were intended for fellow clinicians, many of her core contributions – the repetition compulsion, passivity and aggression, envy in everyday life – are likely to be of interest to anyone who is psychologically minded.
Joseph’s most notable work focused on patients who are apparently “good” but “stuck”: individuals who, on a conscious level, are intent on understanding and working through their anxieties but who, on an unconscious level, dedicate themselves to ensuring that nothing ever changes. In short, patients who are pulled towards retaining their existing “psychic equilibrium” no matter how unpleasant a place it might be. As Joseph explains: “Such patients feel in thrall to a part of the self that dominates and imprisons them and will not let them escape, even though they see life beckoning outside”.
Joseph paints a vivid picture of a “circular type of mental activity” in which patients go over and over a particular episode in their life, a failure or feeling of guilt or confrontation with a loved one, until the phantasies take on a life of their own. As Joseph points out, this “chuntering” is in reality the “complete antithesis of thought”.
But why should someone who attends analysis – the very purpose of which is to foster psychological change – seek to maintain the status quo? Joseph’s case studies reveal that patients may, at times, experience a certain excitement in constantly attacking themselves or may resent the capacity of another (the analyst) to understand them.
Above all, Joseph concluded that even the smallest changes in the way we think or feel about ourselves may leave us feeling threatened. As Feldman and Spillius emphasise in their commentary on Joseph’s Psychic Equilibrium and Psychic Change:
The patient may feel, consciously or unconsciously, that changing his present defensive system would plunge him into psychic chaos and disintegration. Thus he acts as if he fears that change will lead him into even worse experiences of anxiety than he already knows.By carefully listening to the patient, and attending to how the patient makes him or her feel, the analyst can help bring about change, which Joseph views as a continuous process rather than a state. On a technical level, Joseph underlines the importance of interpreting within the transference and countertransference; in simple terms, patients relive many of their unconscious thoughts and feelings within analysis – and the analyst can use this “total situation” as a guide to further their understanding of the patient’s mental processes and defences:
The transference is full of meaning and history… everything of importance in the patient’s psychic organisation based on his early and habitual ways of functioning, his phantasies, impulses, defences and conflicts, will be lived out in some way in the transference.
Extra Reading Psychic Equilibrium and Psychic Change: Selected papers of Betty Joseph by Betty Joseph, Routledge (1999)
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