I believe that unconditional positive
regard is one of the most important aspects to what I do as a therapist. It is
difficult as a therapist. We see lots of clients, and we don’t know whether
they are telling the truth or not, or whether they do what they say they are
going to do. And this is more difficult when we see clients on a long term
basis. And what do we do when someone is going to act in a certain way and we
don’t approve of this. Obviously, if it is an ethical concern one has to deal
with this appropriately with regard to UKCP regulations. But what if it is
something that we just feel is over the top or not right. We should delve into
our own consciousness to see whether we are showing signs of prejudice. If we
challenge our client we might break rapport.

This sounds a bit abstract, so I am going to give some example. What would you
do if you found out that your client was intending writing a long e-mail to
everyone in a Scout Group—all the organizers, the treasurer, chairman, all the
parents, the cleaners, secretary and so forth. Your client is upset that no one
was there to help him when he arrived last Thursday. He reads out a three page
e-mail with a reply from an irate lady. He now says that he is going to write
to the local MP, the houses of commons, the pope, Tony Blair and so forth.

You mention to him that this might be over the top, but you can do little more
than this. You can’t him not to do this. It will be difficult o show
unconditional positive regard after this. And, even if, through the words you
say, you are keeping to this principle, your body language may not be.
However, as far as possible, and there are no absolutes, one should have an
unconditional positive regard for one’s clients, even if it is difficult.
Another example is this.
What might you do after your client has had a huge transference and has
directed all his or her aggression towards you. This involved swearing,
accusations that you are useless and threatening language. One has to
understand why this transference has taken place. Even so, it might be very
difficult to show UPR after this experience.

Some initial thoughts…

With many of my clients, I feel that they
are constantly being challenged and not believed. They are being told off or
put in a compromising position. However, when speaking to me, this is often the
first time that they are not challenged. This is often the first time that they
feel supported unconditionally. And, whatever they say—within reason—they know
that they will have my support.

This enables them to say whatever they need to get better, or to work things
through. Because of my non-judgemental approach (Rogers, 1968)—which is
inextricably linked with UPR—they might be able to tell me about things they
haven’t told anyone else about. They can go into free association without fear
that they might be judged. This enables my clients to be ‘authentic’ (Rogers,
1971). UPR builds trust.

I have been meaning to say this for a while. The word subconscious has been used so frequently that people are regarding it as a synonym for the word ‘unconscious’ But the word is ‘unconscious’. I hope you don’t mind me saying this. I have heard it in seminars and have kept silent. I have heard lecturers (not at this college) use the term. It is true that it has now started to be used by lecturers and in academic journals. However, I feel, if you want to be taken seriously, use the term ‘unconscious’. Just a tip really… As soon as I hear someone talking about the ’subconscious’ I ask myself, does this person know what they are talking about?

Freud did refer to the ‘preconscious’ which includes material just coming to the surface but this, whether it exists or not, is quite different from the unconscious.

When I was observed by Fiona, for a case study, the lady had an abreaction. This was helpful for my client; she was able to release some built up emotion and work on what she needed to do in life. The subsequent session—a more positive, goal-directed session—was much better as a result. Fiona was also pleased. It was a spontaneous abreaction and she pointed out that it was great to see that she was getting something out of the session, even though, essentially, the session was an observational exercise.

Geoff Ibbotson and Ann Williamson (Ibbotson & Williamson, 2010) talk of the value of helping one’s client experience a silent abreaction, and that this is particularly useful in the treatment of PTSD. Having used this approach myself, I feel that it is helpful for many reasons. The approach that Geoff uses encourages the client to imagine felling a tree (Ibbotson, 2012): during this process the client is able to get rid of a huge amount of negative feelings that no longer serve any purpose. The client is then instructed to plant a new tree in its place. The process, therefore, involves (1) letting go, (2) an elimination of unwanted emotion and rumination and (3) a re-building of positive, adaptive energy or behaviour.

Some hypno-analysts might insist that, without an abreaction, therapy cannot take place. I disagree. Certainly, if the abreaction is spontaneous, it cannot be helped. The abreaction should be allowed to take its course; it should then be used in order to effect change. Abreaction can be very helpful in order to come to terms with inner conflict, anxiety and stress. However, why would a therapist deliberately try to cause an abreaction? For example, when dealing with someone with a past trauma, by going back to the original incident, one will only re-traumatise the client and one could make him or her worse (Williamson, 2008). It is important to use some dissociative mechanism in place in order to help the person come to terms with the event. One could use a dissociative mechanism in which the emotion is taken out of the event (Brookhouse, 2012) or a bubble in which to deal with the past (Alden, 1995; Biddle, 2012). In all incidences, one should associate with the positive and dissociative from the negative (Ibbotson, 2012).

Alden P (1995). Back to the past: introducing the ‘bubble’. Contemporary Hypnosis, 12: 59-67.

Biddle, F (2012). Personal communication.

Brookhouse, S (2012). Seminar for the National College of Hypnosis and Psychotherapy.

Ibbotson, G (2012). Using visualization in the treatment of PTSD. Advanced Module for the National College of Hypnosis and Psychotherapy.

Ibbotson, G. (2012). Post‐traumatic Stress Disorder (PTSD). In L. Brann, J. Owens and A. Williamson (Eds.) The handbook of contemporary clinical hypnosis: theory and practice, pp. 389-412. Chichester: Wiley & Sons.

Ibbotson, G., & Williamson, A. (2010). Treatment of post-traumatic stress disorder using trauma-focused hypnosis. Contemporary Hypnosis, 27, 257-267.

Williamson A (2008). Brief Psychological Interventions in Practice. Chichester: John Wiley.

Gestalt Questioning

As far as I can tell, there is no such
thing as ‘Gestalt questioning’ per se. What I mean by this is that the
expression, as far as I know from the literature, has not been used regularly
in this form. Only Sapp (2010) and Hall (1977) use the expression in this form.
However, questioning in Gestalt therapy is an extremely important
tool/technique in Gestalt therapy. Gestalt therapy focusses on the here and the
now. Questioning using the words what and how can be used to help clients’
awareness of the moment. It helps client to ask themselves how they are feeling
and to enjoy or discover information about the present, whereas why question
illicit inwardness and rationalizations. Here is an example of this. If the
therapist asks the question, ‘What is happening now?’, the client will think
about the experience at that moment. Other questions such as, ‘What are you
feeling at this time?, and ‘What does that hand position you are doing mean to
you?’ can also help in this process. The Gestalt therapist encourages his
client to experience the moment and to live his feelings rather than to talk
about them. It is perhaps the questions that help clients to be able to
re-enact the past in the present. Nevis (1987) talks about guided questioning.
He points out that by using questions, the therapist can help the client to
re-discover the present and feelings of the moment in a form which he describes
as ‘open, undirected awareness’.

Nanci Bell (1991) uses her questioning skills in her work which focuses on
Gestalt imagery. She feels that it is important in therapy for her clients to
be able to visualize a whole image. She points out that some individuals are
unable to visualize a complete image during language communication and that,
despite having good communication skills, they are sometimes unable to embrace
the meaning of some verbal interactions such as understanding directions, a
joke or group conversations. She describes this as being one of the main causes
of dyslexia. She uses her questioning skills to help her dyslexic clients to
illicit more specific information. Nanci showed her clients pictures and ask
her clients to describe in detail what was happening. The questions she asked
included ‘What does it look like?, ‘What shape is it?, ‘What colour is it?,
‘Where did it happen?’. What mood is being evoked?, and so forth. This form of
questioning helps her clients to understand the elements of the image.
Questioning using choice and contrast provides the client with more control of
the images presented to him. Later, Nanci uses her questioning to ask the
client what words can be used to describe an object or a person; finally, she
asks the clients how to describe stimuli using sentences.

But I feel that in the consulting room, if one uses what and how questions, one
challenges the client to think about how he or she behaves, feels and thinks in
the moment. Perls (1967) spoke of the ‘safe emergency’ of the situation. During
the interaction with Gloria, it seemed as if he believed that the confrontation
was safe and that by accepting our actions we can move on to understanding our
reality. He constantly challenged Gloria by asking how and what questions in
order or her to act authentically in the here and now. And, during this
‘playful’ exchange, he was encouraging her to be able to interact successfully
with him so that she could then do it with other people.

When Gloria says that Perls was not sharing her pain and anger, and that he was
detached, Perls asked the question, ‘How should I be?’, and ‘Tell me you
fantasy; How should I behave?’ With these questions, Perls is encouraging
Gloria to accept her ‘authentic’ feelings.

These questions are very helpful in Gestalt therapy, and I would be happy to
use these sorts of questioning in psychotherapy where appropriate.

What I like about psychosynthesis is the fact that, certainly with the practitioners I have met, they help their client look at the future. Many psychoanalysts focus on the fact that if you have experienced a difficult childhood—suffered abuse, emotional neglect or other forms of conflict—this will affect functioning in later life. Psychosynthesis psychologists (or psychotherapists) believe that repressing one’s ability to adapt and harness one’s healing potential, this will do still more damage and will be as debilitating as child trauma.
I have a client who has been sold the idea that he has no sense of self because he was cared for by his parents. He tells me, week after week, that he has had psychoanalysis for years and that his analyst told him that he was suffering from the fact that his parents didn’t give him the emotional support that he needed. But the analyst did not offer solutions. I feel that, one of the main premises of the training at the National College is that we offer solutions. We move into the future. Assagioli claimed that there was a higher level of consciousness in which individuals can experience a peak of potential. Later transpersonal therapists took on board some of these ideas.

Now there are lots of different types of therapists. There is now a huge organization of transpersonal psychotherapists and psychosynthesis therapists. I don’t think that Assagioli himself wanted to set up a huge organization like this, following his thoughts and evidence. But people often like to follow a leader. They did it with Milton Erickson with his form of hypnosis in psychotherapy, Francine Shapiro with EMDR, national socialism with Adolf Hitler, and so forth. But what I think Assagioli did want to do was to move people forward in their therapy. And, even though the bulk of psychosynthesis work involves an exploration of the past—particularly, childhood experiences—therapist trained in this form of therapy help their clients to resolve childhood trauma. There are countless examples in the literature of helping patients to re-frame past traumas to help them with phobic anxiety, other anxiety disorders and psychosomatic manifestations. We are, quite rightly, told at the National College to be careful when using regression, and that we should use some form of protective or dissociative mechanism in place—for instance, a bubble (Alden, 1995; Biddle, 2012), a magic carpet (Williamson, 2003) or film screen (Yapko, 2003). Sometimes going back to the past has its uses. What psychosynthesis practitioners do is o help their clients to discover rich inner resources of the self. I call this the ‘best self’ and find that this is a very good way of discovering inner potential (Callow, 1998).

The website for the Institute of Psychosynthesis talks about the importance of the self. It states the following:
‘Assagioli recognised a powerful integrative principle acting within the human psyche – the Self. While in transpersonal psychology there is a well-defined personal and collective unconscious, psychosynthesis as a psychospiritual psychology, adds the distinction of a ‘spiritual consciousness’ - that of the Self. This psychology regards the Self as a reality, a living entity, direct and certain knowledge or awareness of which can be had. It recognises that the Self is a Spiritual Being imbued with Love which can be present to us both in its immanent and in its transcendent state. The Self is seen to form ego structures within which the ‘I’ – personal identity – becomes conscious. The Self also continually invites and guides that ‘I’ to levels of healing and wholeness in the process of becoming conscious.
Psychosynthesis points to a Self which is distinct, but not separate from, any contents of the psyche. Thus the Self is a profound source of being which can be present to us in our brokenness as well as in our wholeness. This Self also stands on the boundary between the personal and the universal’.

As a psychotherapist I can understand the importance of this. I have a client who has a very difficult, over-controlling set of parents who try to anticipate and direct his movements, thoughts and words. Consequentially, he feels out of control at their home. He loves walking very much. When he is walking, he told me, he feels like himself. I suggested to him that he could take the countryside with him wherever he goes, and that this is himself—the ‘I’—which is a core which will be with him in all different situations. A psychosynthesis practitioner might call this an ‘inner spirit’. I am not so keen on this term, but I can see the importance of this for some people in therapy. This is, of course, closely related to one’s belief system, which may include one’s philosophy or religion.

There are many aspects of this theory, but here is a start at it.

The new international advisory board or The International Journal of Psychotherapy is as follows:

Paul Boyesen, Spain/France: Jacqueline Carleton, USA; Alexandra Chalfont, UK; Loray Dawes, Canada: Götz Egloff, Germany: Mony Elkaim, Belgium; Richard G. Erskine, Canada; Ken Evans, France; Dorothy Firman, USA; Miles Groth, USA; Bob Henley, USA; David Kraft, UK; Cornelia Krause-Girth, Germany; Eugenius Laurinaitis, Lithuania; Roberto Parrini, Italy; Adrian Rhodes, UK; Andrew Samuels, UK; Ganesh Shankar, India; Margherita Spagnuolo Lobb, Italy; Sígrun Toby Herman, Iceland; Daan van Baalen, Norway; Herzel Yogev, Israel; Riccardo Zerbetto, Italy

For an appointment, phone David Kraft on 0207 467 8564.

David Kraft is a psychotherapist in central London. The following is a list of his publications. He has written articles in both national and international journals.

(1) Kraft T & Kraft D (2004). Creating a virtual reality in hypnosis: a case of driving phobia. Contemporary Hypnosis, 21 (2): 79-85.

(2) Kraft T & Kraft D (2005). Covert sensitization revisited: six case studies. Contemporary Hypnosis, 22 (4): 202-209.

(3) Kraft T & Kraft D (2006). The place of hypnosis in psychiatry: its applications in treating anxiety disorders and sleep disturbances. Australian Journal of Clinical and Experimental Hypnosis, 34 (2): 187-203.

(4) Kraft T & Kraft D (2007). An integrative approach to the treatment of hyperhidrosis: review and case study. Contemporary Hypnosis, 24 (1): 38-45.

(5) Kraft T & Kraft D (2007). The place of hypnosis in psychiatry, part 2: its application to the treatment of sexual disorders. Australian Journal of Clinical and Experimental Hypnosis, 35 (1): 1-18.

(6) Kraft T & Kraft D (2007). Irritable Bowel Syndrome: symptomatic treatment approaches versus integrative psychotherapy. Contemporary Hypnosis, 24 (4): 161-177.

(7) Kraft D (2009). Tribute to Dr Thomas Kraft for BSCAH’ British Society of Clinical and Academic Hypnosis Newsletter,3 (1): 11-12.    

(8) Kraft D (2009) Obituary: Thomas Kraft’ British Medical Journal, 338: b265.    

(9) Kraft T & Kraft D (2009). The place of hypnosis in psychiatry, part 3: the application to the treatment of eating disorders. Australian Journal of Clinical and Experimental Hypnosis, 37 (1): 1–20.

(10) Kraft D & Kraft T (2010). Use of in vivo and in vitro desensitization in the treatment of mouse phobia: review and case study. Contemporary Hypnosis, 27 (3): 184-194.   

(11) Kraft D (2010). A tribute to Tom Kraft (1932-2008): psychiatrist, integrative psychotherapist, and teacher. Contemporary Hypnosis, 27 (3): 221-224.   

(12) Kraft D (2011). The place of hypnosis in psychiatry, part 4: its application to the treatment of agoraphobia and social phobia. Australian Journal of Clinical and Experimental Hypnosis, Vols 38 (2) & 39 (1): 91-110.

(13) Kraft D (2011). Sharing experience: the waiting room. British Society of Clinical and Academic Hypnosis Newsletter, 5 (2): 22-24.

(14) Kraft D & Hawkins PJ (2011). Eating disorders. In Les Brann, Jacky Owens, Ann Williamson (eds.) The Handbook of Contemporary Clinical Hypnosis: Theory & Practice (pp425-440). Wiley-Blackwell: Chichester.

(15) Kraft D (2011). Counteracting resistance in agoraphobia using hypnosis. Contemporary Hypnosis & Integrative Therapy, 28 (3):235-248.   

(16) Kraft D (2012). Panic disorder without agoraphobia. A multi-modal approach: solution-focused therapy, hypnosis and psychodynamic psychotherapy. Journal of Integrative Research, Counselling and Psychotherapy, 1 (1): 4-15.

(17) Kraft D (2012). Successful treatment of heavy smoker in one hour using split screen imagery, aversion, and suggestions to eliminate cravings. Contemporary Hypnosis & Integrative Therapy, 29 (2): 175-188.

(18) Kraft D (2012). Comment on Zimmerman’s use of the river metaphor in irritable bowel syndrome treatment. American Journal of Clinical Hypnosis, 55 (2): 160-167.

David has recently written and published a paper in the American Journal of Clinical Hypnosis.

There are different different types of phobia listed in DSM IV (American Psychiatric Association, 1994): agoraphobia, social phobia and specific phobia. Within the specific phobia category there are five subtypes of phobic anxiety: animal phobias, situational phobias, blood injection injury types, natural environment type and other type. Animal phobia usually has a childhood onset. Individuals who suffer from animal phobia can normally lead a normal life, but in some instances, a person might develop extreme avoidance and safety behaviours, and in these cases, it is helpful to seek psychotherapeutic support.

These are some examples of safety/avoidance behaviours:

1 Not being able to read a newspaper because of an uncontrollable fear that you might come across a cat on one of the pages.

2 Not being able to go on holiday abroad because of fear of seeing a large spider in the wild.

3 Screaming out loud and asking your boyfriend to check every room of the hotel for ants before you can go in.

If these scenarios sound familiar, it might be helpful for you o seek help now. The approach that David Kraft uses combines behaviour techniques with hypnosis. He will use systematic desensitization in order gradually and efficiently to reduce anticipatory anxiety to your feared object. The hypnosis will intensify you feelings of well being and control throughout the process.

David Kraft is a fellow of the Royal Society of Medicine and a full member of BSCAH. He runs a successful practice in Harley Street, London. To book a session, please ring 0207 467 8564.

London Hypnotherapy UK is the specialist partner of London Psychotherapy.

Offices and consulting rooms ar based at 10 Harley Street, London, W1G 9PF