Petruska Clarkson was born October 31st in South Africa, and died on May 21st 2006 at age 56 in Amsterdam. Her fields of study were Integrative/ Psychotherapy/ Gestalt her influences were Fritz and Laura Perls. Her key idea was systemic integrative psychotherapy. Her legacy was that she contributed to the philosophy of psychotherapy she was also a professor who presented lectures and role papers on gestalt therapy. Integrative therapy is when several distinct models of counselling and psychotherapy are used together.
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The first of Clarkson’s theories that I am going to explain is the Working alliance. The working alliance or psychotherapeutic, alliance is probably first encountered as a concept in psychoanalytic theory. (Greenson 1967 p.35)This is the relationship that’s is applied to the therapeutic process at the beginning to help the therapist and client to build the foundations for the relationship so that if the relationship goes through a rough patch the foundation will hold it together and make sure it can continue. This covers the practical things in the relationship, things like money if the client pays, what time the client and I will meet and what days we will meet, and that the client is motivated and responsible to go in to therapy. This can also cover things like the roles and responsibilities that myself and client hold. This can be things like holidays, breaks and missing sessions and the notification that both client and myself would like before the session starts. It can also be about the modalities of therapy and the clients learning style and the amount of sessions that I can offer within this agency that we will be working. The practical things have to be in place if the process and we are to be protected. This applies to my personal life in the sense that if I have a relationship that breaks down I would hope that at the beginning of our relationship. I would have built the relationship on a strong enough foundation that I would hope there would be a stage when we would be able to repair what has been broken in the relationship with the my friend or relative. Bordin (1979) p.38 conceptualised the alliance in terms of the three components of bond, goal and task. Different forms of therapy involve different characteristics and tasks and different characteristic goals.
The next is the transferential / countertransferential relationship is the experience of unconscious wishes and fears transferred onto or into the therapeutic partnership. Transference or counter transference phenomena are also probably the major contributions to ways in which the working alliance can be disrupted, impaired or destroyed. (Clarkson 1991c, 1991 p71). This is where both client and therapist are responding to each other from things that have happened in the past that are not under their conscious control. For example I have worked with clients that I have never met before that has immediately irritated me when I’m around them. These were the mental process in me going back in to my past and taking away certain influences from a past relationship and bring it in to the new relationship. It’s possible that they remind me of someone in my past and the person doesn’t have to look like the person it can be as simple as a turn of phrase that the person uses.
Or something that they are wearing it can literally be anything can trigger transference. Is the idea that we going back in our past and bringing things from a past relationship in to the new relationship. This can be very dangerous because I could be thinking about at the person in front of me. Not as a new person who we are exploring the relationship with but as the person in my past who I was thinking about. What can happen then is counter transference you can react to this new person in my life like this was the person from my past and that is dangerous because I could start to act this out; this works both ways so the client could see me as someone from their past and start getting irritated with me. And then start to project on to me and sometimes the projection can be them saying to me that I’m thinking something negative about them. The best way to deal with that is to be open and honest and ask them if I remind them of somebody. So transference can be damaging to the relationship where I am bringing my past in to the present and then acting that out with the new person. The drive theory period of psychoanalysis (Freud 1935) p.72 was when transference was regarded as a help where it was positive or as resistance where it was negative or seductive as well as a dangerous re-enactment of the past.
The next relationship is the reparative or reparenting relationship is an intentional provision by the counsellor of corrective, reparative or reparenting relationship or action where the parenting was deficient. (http://en.wikipedia.org/wiki/User:ClarksonP) The reparative relationship is where I have to be willing to be what my client’s fantasy needs when I say fantasy I am really talking about emotional support, not about the client being attracted to me although that can happen but we have to be willing to take that chance the theory tells us the client might need the therapist different ways. I may be turned in to a mother, a father, a sibling a teacher or authority figure, and the client might regress to an earlier stage. It might be that the client needs to take you figuratively speaking not physically and keep me in their mind to support them and this could be thing like when a situation is difficult for them. Them moving in to a position where they say I wonder I would deal with this or thinking about how I have been nurturing and empathic to them. So it’s like carrying a little bit of the therapist around. The therapist role in this might be a mother, a father, a sibling or an authority figure from the client’s life. Although this can be a good thing for the client, that they got a part of the therapist to sustain them. The danger is that they can regress back to a child state when they are with me and that has to be discussed or very gently talked about so that they can be brought back in to an adult state or from the person centred idea their organismic state where their accessing their adult self. As therapy come to an end the client will replace me with their own emotional regulation. So they will take you away and replace it with their own emotional regulation. In person centred they call it that organismic valuing process. Where they can trust their own thought s and needs and don’t need me on their shoulder being there to support them. Where the emphasis is on analysis alone, it is usually accompanied by written perspectives on human beings in terms of their drive or instinct version, which focuses on sex and death (Freud 1920).
The next relationship is the person to person relationship it is the real relationship or core relationship – as opposed to object relationship. I can understand another soul only by transforming my own, as one transforms one’s hand by placing it in another’s. (Bachelard 1986: 118) p.152 The real relationship is where the therapist is authentic, relation to the client in an I – You way, not in an I it way, if I go to my osteopath the relationship I have with him is a patient and professional relationship. I am his patient and that’s what I’m contracted for he’s not my therapist and that’s about it. It’s about a mechanism of him repairing, my back and it is not based on any other connection. That the contract we have and I am happy with that as far as I am concerned. With therapy it’s very much about having that I – You relationship where you are stepping to one side of the professional facade and working with the client and bringing an essence of yourself to the therapy. This is particularly important in humanistic work such as person centred therapy. Where the core conditions are offered by the therapist to the client, I know what this feels like when a therapist is really trying to build a humanistic relationship an I – You relationship with me as opposed to a doctor patient relationship. The therapist helps to heal by developing a genuine relationship with the patient. (Yalom 1980; 405) p. 155
The next relationship is the transpersonal relationship is a timeless facet of the psychotherapeutic relationship. In some traditions god is not engaged in a fight against evil, for evil is the other hand of god. (Watts 1978) p.218 This is harder to define in absolute terms; it can include an expansion of consciousness, which can be spiritual or healing. Perhaps one way of describing it is the feeling you have after going to a concert you enjoyed or (http://www.counsellingtutor.com/petruska-clarkson-5-relationship-model/ Counselling Tutor) spending a really special evening with friends. First we need to separate faith from spirituality even though they can be compatible and they sometimes are, but being spiritual is a feeling of connectedness. When I went to see Michael Jackson in concert I felt a real strong connection to everyone that was there. A real spiritual connection that can’t be measured and that’s what that is. And it’s for the me as the therapist to acknowledge that in the client not to try and analyse it or challenge that in the client, and to celebrate the client’s feeling of connectedness to the wider humanity, and that’s a good thing in therapy because when clients do this they are starting to access their own emotional regulation and feel part of society again because some client feel so disconnected from society.
The way that these models have been applied to my client work is for example when I started to work with Richard. I started by working in a person to person relationship offering the core conditions to him. With the intention to build a foundation where we can start to work together and make clear to him that he won’t be judged and that he would be understood and that I would listen to him to the best of my ability, plus I was being as transparent as I could. As the work started and he spoke about his problem with alcohol. And what it has done to his relationship with his ex partner. He went back to a time in his life when things were better than they are now. This made him happy while he was talking about it, and then he reached the part of his life where his daughter was born and things started to go downhill in his words. I could see that when he started to speak about it he got quite emotional when he spoke about it. That made me think for him it was like reliving the whole thing again. What came up for me was when I was in the same situation myself and this led me to start to understand his pain and how sad he was feeling inside. This led to some counter transference in the way that I responded to him. I responded to him from my frame of reference and experience which was that he would get over it, but that wasn’t the right thing for him because that’s what I felt about his situation.
I was working with a client called Sophie that had suffered from domestic abuse from her step father and had a problem with alcohol. Working with her after 4 or 5 sessions I found out that she had implicitly thought of me like a father figure. I brought this to supervision that she saw me as a father figure; my supervisor thought that I should continue to work with her. So that she could experience a different father daughter relationship, and work through the problems that she had with her father. I did and responded to her as if she were my daughter. My supervisor explained to me the reason for this would be for her to have a difference experience of that father daughter relationship without the fear of violence because that might be what she needs and wants but is hiding from me through fear of being criticized or judged by me. So I started to work with her in a reparative relationship that I think she found useful because most of the relationships she had with men was because she was looking for that father figure in her life someone who would take care of her and treat her right.
I started to work with a client called Chester who had a problem with alcohol. This had led to Chester getting arrested for assault on his ex partner one night when he was out with her at an event. He explained to me that when she called the police there was no need because what he had done was over and he said that he was sorry to her for slapping her, but as he was leaving he was arrested by the police and charged with assault and carrying an offensive weapon which was a knife. He always blamed his partner for calling the police not himself for getting drunk and reacting to his partner in the wrong way. When his court date was getting closer he told me in the session that he was reading his bible and praying for help to get him through the trouble he was in with the police and find him somewhere to live. He got off the first charge and only got a fine for the offensive weapon this led to him saying to me that he was a free man and to him it felt like all the weight had been lifted off his shoulders. He a got offered a hostel to live in that sorted out most of his pressing concerns. For Chester it was as if there was some kind of intervention by god that helped him through his court case and got him housing it was as if all in his life was right at that present time in the session, so I celebrated this with him in the session. I think this was a transpersonal relationship that we were working with at that time.
The transferential and counter transferential relationship, I was working with a client called Barry and his problem was alcohol, he had explained that his ex partner always complained when he was drinking and this led to their relationship breaking down. I remember that he would always hang around the door and not leave straight away and try to talk to me about something. I took this to supervision and was told that I probably really empathise with him and his situation because of my past experiences. Sometimes in the session he would be talking to me like I was his ex partner. This led to me thinking about my ex partner and what went on in my past with her. This made me a little uncomfortable and when I responded to him I was responding from my experiences and saying thing like you will get through this Barry, but not thinking that his relationship was totally different from mine and that he might not get through this. The fact that his partner had left him and took his children and wouldn’t allow him to see them. Just resonated with me so clearly now I look back on it. I did learn a lot from being with Barry that fact that sometimes if I am not aware of what I am saying and how I am feeling about a certain subject it can become part of the session and shift the focus of the session to my agenda.
The working alliance is that foundation of the counselling relationship. I was working with my client and this was the foundation of the relationship between me and Edwin. This included things like the contract and his presenting issue and maybe the realisation that we don’t really want to be in each other’s company. I can remember one time when he felt there was a block in the relationship because he thought that he knew nothing about me but felt I knew a lot of things about him. But I had to explaining to him that this isn’t about me. Then I asked why it is so important to you that you know something about me. He replied that I knew a lot of things about him. I sat with him for a while and spoke about the reasons that I can’t tell him anything about myself because it’s the organisations policy. We returned to the contract and started to repair the therapeutic alliance and entered a reparative phase. Then we were able to start to repair the block in out therapeutic relationship.
So to conclude when I think about the theories and how they are integrated in to my client work. I think that I am integrating the theory in the right way by using the theory to inform the way that I work with my clients. And to bring change to the clients if enough time is spent with my client. The client can also maybe get confused with the theories not understanding what is going on with them in the counselling relationship. The changing of theories throughout the relationship could confuse the client if their understanding is not clear of what you are doing in the work. (2917 words)
References
Clarkson, P. (2003) The Therapeutic Relationship, Second Edition, Whurr.
Greenson, R.R. (1967) The Technique And Practice Of Psychoanalysis, 1, New York: International Universities Press.
Bordin, E.S. (1979) The generalizability of the psychoanalytical concept of the working alliance. Psychotherapy: Theory, Research and Practice.
Freud, S (1935) A General Introduction To Psychoanalysis, Vol 1 New York: Liveright.
Freud, S. (1920) Beyond The Pleasure Principle. Standard Edition. Vol 19, pp. 1-64. London: Hogarth Press.
Bachelard, G. (1986) Lautreamont. The Dallas Institute Publications.
Yalom, I.D. (1980) Existential Therapy. New York, Basic Books
Watts, A. (1978) The Two Hands of God: The Myths of Polarity, Collier Books.
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