251 – Difference between PTSD and Complex PTSD

The Four Pillars of Gestalt Therapy – Talking about Sexual Intimacy in Therapy

In Episode 251 of the Counselling Tutor Podcast, your hosts Rory Lees-Oakes and Ken Kelly are back with this week’s three topics:

• Firstly in ‘Theory in Practice’ we look at the four pillars of Gestalt therapy.
• Then in ‘Practice Today’ Rory and Ken will discuss sexual intimacy.
• Lastly in ‘Practice Matters’, Rory speaks with Lou Lebentz on the difference between PTSD and complex PTSD (CPTSD).

The Four Pillars of Gestalt Therapy [starts at 02:45 mins]

First up this week, listen as Rory and Ken take us through the four pillars of Gestalt therapy:

• Phenomenology – how the individual views their world:
  • A client’s view may be very different to your own and you may even disagree.
  • Understand the reasons behind their views.
  • Meet the client where they are.
  • Through discussion, the client may change their view after looking into it further.
• The dialogical relationship – the relationship between therapist and client.
  • There needs to be dialogue between you as the therapist and them as the client.
  • Be empathetic, show your humanity and allow the client to engage with that.
  • The client should perceive you as someone who is working hard to try and understand their world view.
• Field theory – what’s going on around the client?
  • Their life and day-to-day will effect how they are with you.
  • Things happening both inside and outside of the therapy room.
  • This applies to both you and the client.
• Experimentation – clients encouraged to do experiments.
  • This is something not seen in person-centered therapy.
  • Experimentations such as empty chair -allows the client to speak the unspoken.
  • It can help the client have internal contact with the disconnected parts of themselves.
  • Doing things such as writing a letter and burning it if they find verbal communication uncomfortable.
• Gestalt therapy is all about connecting emotionally and physically with ourselves.

Talking about Sexual Intimacy in Therapy [starts at 22:37 mins]

Speaking about sexual intimacy may feel uncomfortable for some, but it is a large part of an individual’s life and should be welcomed in the therapy room.

The main points of this discussion include:

• If you as the therapist are reluctant, shy or worried about this topic, the client can’t go there with you – this means an important part of the client’s reality is shut off.
• Sexual intimacy and activity impacts a client’s whole life – sometimes clients will want to talk about it and that takes courage.
• Try considering how you would feel sharing this information with a professional, and how you would want them to approach that with you.
• You need to warmly welcome this part of your client.
• Become comfortable with the aspects of this discussion.
• Show the client the door is open, that it’s okay.
• If you’re struggling to engage with this subject, visit supervision and explore why that might be.
• The key things to take away are:
  • Welcome the topic.
  • Look for a framework, do some CPD, try talking about sexual intimacy.
  • Desensitize giggles, blushes and cringes – understand where your hidden prejudices lie.
• Read up on sexual health and consider speaking about this with your client – especially with young people.

Difference between PTSD and Complex PTSD [starts at 39:04 mins]

In this week’s ‘Practice Matters’, Rory speaks with Lou Lebentz on the difference between PTSD and complex PTSD (CPTSD).

• PTSD is often the result of a singular traumatic event e.g. a car crash, a natural disaster. Its difference to complex PTSD is CPTSD refers to someone who has experienced a series of traumas.
• They usually suffer from difficulty with emotional self-regulation.
• They may have a negative view of self: feelings of shame, guilt, feeling unworthy.
• There is an interpersonal disturbance.
• Mistrust of others, self-blame.
• CPTSD is often rooted in childhood.
• As a therapist you provide co-regulation – an external scaffold.
• All feelings are accepted in the therapy room – help the client learn to manage and regulate these feelings.
• Having your own therapy will be something to look into.
• EMDR (Eye Movement Desensitization and Reprocessing) presents itself a lot in trauma.
• You may take a body-led and body-based approach.
• Stay with the feeling of the client – don’t move over it or dismiss it.

Links and Resources

Counselling Skills Academy

Advanced Certificate in Counselling Supervision

Basic Counselling Skills: A Student Guide

Counsellor CPD

Counselling Study Resource

Counselling Theory in Practice: A Student Guide

Counselling Tutor Shop

Facebook group

Website

Online and Telephone Counselling: A Practitioner’s Guide

Online and Telephone Counselling Course