How does counselling really work?

How does counselling really work? How are clients able to make significant and long lasting changes in their lives?

This is a common question that I am usually faced with when a person calls up to enquire regarding counselling and psychotherapy services that I provide. They ask me, will you solve my problem or will you give solutions to my problem? And when I tell them – No, I do not claim to solve my clients problems, but I facilitate the process through which my clients are enabled to seek the kind of solutions that work for them. They would ask – How does it work, if you won’t give me the solutions, and I don’t know the solution to my problem.

The short answer to that question is that, as a counsellor and therapist, the fundamental premise is that the solutions to your problems, whether dealing with it or coping with it lies within you.  Sometimes you might have the resources for the same within but are unable to access it, because of some roadblocks. And sometimes you might have to develop those resources and seek some of the resources from around you.  In the space of a warm, genuine, and non-judgemental therapeutic relationship, the client is enabled to seek and develop these resources and acquire the skills needed. The therapist brings in their understanding of psychology, human behavior, tools, methodologies etc, but the effort needs to come from the client.

Let me go a bit deeper and answer this question in greater detail.  For this I need to talk about two very important aspects of our brain, which are neurogenesis and neuroplasticity.

Neurogenesis is the process by which new neurons are formed in our brain. Though this process is the most active during the embryonic development, it also can create new neurons in specific areas of our brain throughout our life.

Neuroplasticity is the capability of our brain to change.  We can develop new neural networks throughout our life span. Our brain cells ie, neurons, communicate with each other, through specific connections creating pathways.   These pathways, determine our thought process, emotional responses, behaviour etc. They lead us to access old memories, learnings and experiences, provide us the heuristics to quickly make sense and meaning out of a situation, take decisions and so on.

When a new learning takes place, development of new neural connections/networks and in turn new pathways are made in our brains.

Let me explain with a case: Rajesh (Fictional client) came into individual counselling with certain problems in his marriage.  He was unable to express his love and affection to his partner, though he felt those emotions within himself.  His strong conditioning came from his childhood, where his parents would not express love and affection to each other or to the children openly.  Expressing emotions openly was not encouraged in the family. He was unable to receive overt love and affection, which made him very uncomfortable, as well as to show and give overt love and affection. He was also criticized for his inability to show love by his partner, and he felt inadequate in the relationship.

In the counselling process, he experienced genuine warmth and unconditional acceptance of who he was as a person, without any criticism or disapproval or approval. This gave him strength to explore his childhood experiences to understand the messages that he was given as a child, both explicitly and implicitly, that had defined his understanding about relationships and his behaviour in relationships as he grew up. With this understanding, he realised that he doesn’t have to be stuck with the childhood messages that he had learnt in this regard which were damaging his current relationship. He learns that he has a choice to be the adult that he wants to be, who can make real world choices. 

He is invited and motivated to reflect on his own thoughts, emotions and behavior, introspect on his strengths and weakness and over all his self-awareness improves and self esteem is bolstered.

When there is a focus on the positives and goals in the counselling process it radically interrupts the client’s established negative thinking patterns or unwanted behaviors. When new information is provided through psychoeducation, when new skills are developed, learning happens through formation of new neural networks and connections.  And when the learning is practiced in a safe environment, within the context of the therapeutic relationship, the new neural pathway becomes more established. He experienced unconditional positive regard in the counselling process. He experienced empathy in the process and his feelings and difficulties were validated, and his goals were highlighted. His feelings of inadequacy reduced and his motivation to make his relationship better enhanced.

His new experiences, new learning regarding  relationships, with better understanding of his behaviour and its origins, focus on practicing new desired behaviours and skills etc were enabled by development of new neural pathways, and these were reinforced by consistent practice of the behaviour. 

Rajesh was able to learn to accept positive strokes and appreciation, in the counselling process, and also learnt to provide appreciation to others. The process enabled him to receive as well as provide love and affection to his loved ones over time. Relationships improved dramatically.

In this case study, person centered counselling and Cognitive behavior therapy were the approaches used.  May other approaches and modalities could be applied. When the newly developed network-pathway is used repeatedly, they get strong and the corresponding older pathways are discarded by our brain. New advances in brain research provide the biological explanation on how counselling and therapy can create a lasting change for clients.

About the Author:

Kala Balasubramanian is a certified Counselling Psychologist/Psychotherapist with a Masters in Counselling and Psychotherapy, Diplomas in Counselling and has further certifications specializing in couple/marriage/relationship counselling and family counselling. As a professional counsellor she provides a supportive, understanding, professional and confidential environment to work with clients – Individuals and Couples explore their emotions, help them understand and manage their challenges, relationships and stress better.