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  • Writer's picturefrederique STREF

Who to turn to

Updated: Feb 2, 2021

How difficult it must be today to choose a Counsellor & Psychology.

Like most practitioners, I have been trained in the various techniques and have experienced a number of them on a personal basis. I thought for a moment I would offer today an overview of some theories such as Psychoanalytic Theory, Person- Centred Theory, Gestalt Theory, Behaviour Theory, Cognitive Behaviour Theory, Solution Focused Brief Therapy, Family Systems Therapy, Post Traumatic Stress Disorder and so on, I may do so later ;

Finally I propose you a brief comparison between Psychoanalytic Therapy and Person- Centred Therapy.

Sigmund Freud and Carl Roger’s theory of personality are based on clinical researches in Europe where Sigmund Freud worked his entirely life and in US where Carl Rogers worked his entire life. The identical aim is treated client with psychological disorders, but with very different beliefs and expectations. Their conclusion about human nature and rationality in human motivation are opposed. The two theories mention a hidden personality however both concepts are very distinct. Freud pretends it is our natural state to be determined, while Rogers pretends it is the self-created by the demands of society.

Sigmund Freud (1856 to 1939) was a German neurologist and the founding father of psychoanalysis a clinical method for treating mental illness and also a theory which explains human behaviour.

This original method is elaborated to facilitate the verbalisation of what is for the subject inaccessible because repressed and that these repressed elements prevent the person from fully expressing his vitality, his creativity and can harm his balance in daily life.

It shows that the representation that everyone has of his life is linked to the present but also to the traces left by the past and that reactions to current situations are often only the repetition of reactions to similar situations belonging to in the past. Psychoanalysis has a protocol and a set of conceptions that make it possible to understand these unconscious logics and possibly help the subject who suffers from it to elucidate and, moreover, solve his problems.

Carl Ransom Rogers (1902 to 1987) was an American psychologist and founding father of the humanistic approach, Person Centred Therapy, psychotherapy approach.

This original method is elaborated to understand human personality and relationship. Based on Carl Rogers beliefs that how we live in the here-and-now and our current perceptions are more important than the past. He also believed close personal relationships with a supportive environment of warmth, genuineness, and understanding, are key for therapeutic change. Rogers believed people are capable of self-healing and personal growth, which leads to self-congruence.

For Freud, there is no continuity but a radical break between consciousness and unconscious separated by preconscious.Freud, from 1920, admits the existence of two fundamental instincts: the death impulses and sexual impulses (the most controversial part of his work)

The unconscious is a set of irrational forces, the energy of sexual impulse and the aggressive impulse as well as repressed feelings, obeying the principle of pleasure known as ID, principle of reality known as Ego and the interdictions he has internalized in the Superego while striving for ideal. The repressed material of the unconscious continues to exert pressure on the psyche, and determine the behavior as long as they have not been released through talking sessions.

Quote from Sigmund Freud (1926):

“Unexpressed emotions will never die. They are buried alive and will come later in uglier way.”

Person Centred therapy differs from other forms of therapy because it does not focus on therapeutic techniques. What's most important here is the quality of the relationship between the therapist and the client

When clients come for PCT, they are in a state of incongruence, meaning there is a difference between how they see themselves and reality. Having an accurate self-concept (the thoughts, feelings, and beliefs people have about themselves) is key to PCT. It is the aim of PCT therapists to help clients reach a state of congruence or a match between self-concept and reality.

Quote from Carl Rogers (1965):

“The curious paradox is that when I accept myself just as I am, then I can change.”

During the sessions:

During a psychoanalysis session, client says with his own words, everything that comes to mind and expresses his feelings, allowing the unconscious dimension to open up. Through his interventions and silences, the psychoanalyst promotes this quest. His specific listening allows the emergence of previously unconscious elements: words that could never have been formulated, forgotten memories, repressed emotions, unpublished thoughts, dreams, slips, missed acts ...

All these elements have for the client new senses; they allow him to have a different view of his history, to find his own place and to free himself from the forces that, prevented him from living. The client apprehends otherwise what contributed to build it and that frees its potentialities.

Quote from Sigmund Freud (1926)

“One day, in retrospect, the years of struggle will strike you as the most beautiful”.

One major condition in PCT sessions, it requires the client to take an active role in his treatment with the therapist being nondirective and supportive. The client determines the course and direction of treatment, while the therapist clarifies the client's responses to promote awareness and self-understanding. Rogers believed people are capable of self-healing and personal growth, which leads to integration. Integration refers to the tendency of all human beings to move forward, grow, and reach their full potential. Rogers believed self-actualization is hindered by negative, unhealthy attitudes about the self and emphases the fact an active listening and empathy are the most important assets to help clients to move toward openness and greater trust to self ; coincidence between his needs, his desires, the consciousness he has of it and the expression he gives it. It will incite the client to deconstruct his defence mechanisms to restore his own congruence.

Quote from Carl Rogers:

“The only person who is educated is the one who has learned how to learn and change.”

Freud (1912) has made the cold feelings a technical rule and says:

"It does not benefit the patient that the doctor, the therapeutic interest is marked with too much emotional focus. The best thing for him is that the doctor works coldly “

"I cannot urge colleagues to take as a model during psychoanalytic treatment the surgeon who puts aside all his affects and even his human compassion, and who sets a single goal to the forces of his mind: to perform operation by conforming as much as possible to the rules of the art "

This neutral attitude is emphasised during a psychoanalysis by the coach and chair disposition in the room. During the session, even eye contact can be avoided. It might be necessary for the therapist to adopt and maintain this distance to detect properly the manifestation of unconscious material while the client is talking, to interpret what seems apparently irrational elements, or incoherent and to detect there an intention and a meaning, to decipher what is masked, giving it intelligibility. Therapist needs to observe every single expression of a process as his intervention must be relevant at a specific moment for the client to be able to get the insight. As the number of interpretation and understanding is similar of the number of individual, this professional skills and competences are very challenging and random.

A key element of the professional formation is an individual work and necessarily implies a personal psychoanalysis. It is indispensable for the future psychoanalyst to analyse his psychic functioning and help him to identify in his reactions what comes from his own history, from his specific psychic defences so that they do not interfere with the client’s problematic and request. Good listening goes through the distinction of what comes from oneself and what comes from the other.

Rogers has made every effort to make the relationship a person-to-person relationship, as respectful as possible. He replaced the lying position by the face to face. He refrained from unmasking interpretations deduced from a dogmatic theory. The therapist tries to understand what the client is experiencing, their lived world and their frame of reference. He communicates part of his understanding through attitude and speech. Therapist adopts a mirroring behavior, he rephrases the person's words so that he can better understand his own reactions (beliefs, feelings, body experiences), integrate them, reorganize them and possibly replace them with others. While remaining himself, the therapist seeks to put himself in the customer's shoes, to enter his world and his feelings, trying to see them from the same angle as him. Also, when he suffers, the compassion he can read at the therapist gives him both the feeling of being understood and the feeling that his pain is shared, so lightened.

There is no typical cure. It all depends on the client's current experience, always privileged in relation to his past history. The therapist will listen with sympathy, in a relationship of trust and authenticity far from the neutrality of psychoanalysts, placed in front of his client, so that the latter can see his expressions, and must observe these fundamental attitudes precisely defined by Carl Rogers. Quote from Carl Rogers:

"One regards each aspect of the client's experience as being part of that client. It means a caring for the client, but not in a possessive way or in such a way as simply to satisfy the therapist's own needs. It means caring for the client as a separate person, with permission to have his own feelings, his own experiences."

For psychoanalysis, the demand for treatment is often the result of psychic suffering recognized by the client or a desire to know oneself. It can be worked and constructed in preliminary psychoanalytical interviews.

Freud (1926) states that if psychoanalysis is:

“a method of treating neurotic disorders, its aim is not to cure by abrading the symptom, but to recover its faculties of acting, thinking and to enjoy existence "

With PCT, the client will become open to experience, learn to trust themselves, develop an internal evaluation of themselves and have a willingness to continue growing.

Both approaches offer a place of freedom of speech, thought and feeling ; everything can be said, everything can be heard, without judgment. Clients experience a benefice leaving behind what was really heavy and negative in their daily lives and free their potentialities. it is argued that Rogers’ theory is to be preferred over the Freudian model because it is more in tune with findings of contemporary scientific research. Knowing that only psychoanalysis makes possible to take into account the conscious and unconscious psychic functioning of the person who comes to speak and so proposes a very deep understanding of self, one can expect a radical and definitive move from the previous depression or behaviour. An analysis takes a long time and it is a real investment on oneself . Its necessarily long duration repels some people whose symptoms are very debilitating and who will prefer the brief therapies of behavioural and cognitive types considered more effective. Anyone who suffers from a pain stress, depression, anxiety, family, marital or professional difficulties, psychosomatic disorders or inability to communicate, can benefit from one or the other therapy.

Unconditional acceptance from the therapist is needed, whatever the client says or lives. Psychological problems may stem from the fact that it is rare to have received such acceptance from one's parents in early childhood. This could lead to many people grow up seeking above all to please others, sacrificing their own personality and desires. It is therefore essential that the client feels respected without ever having the impression of being judged or evaluated, this is applicable for any practice. Trust, a source of freedom of expression and dynamic relationship, is indeed the driving force of therapy.

Each story is unique, each desire is unique, and whatever the approach it is important to remember that the work is done, or not done, in relation to the quality of the professional relationship between counsellor and client. For everyone, having a privileged safe environment and time slot, where one can feel absolutely free and safe , to be , to express , to depose everything that is not easy to let go in social environment, neither on one’s own can already be a treasure.

This picture was taken in CBD Singapore

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