The following information has been largely taken from my new book due to be published by Sage Oct 2021.
Finlay, L. (2021 Forthcoming). The therapeutic use of self in counselling and psychotherapy, Sage.
What do our therapeutic relationships with clients involve? How do we create a safe space for clients to go exploring? What are we doing when we show clients respect and caring, attuned attention or when we challenge them to grow? How is our way of being with clients therapeutic? These questions around ‘doing’ and ‘being’ all relate to the idea of therapeutic use of self which can be defined as: "A therapist’s thoughtful, deliberate effort to use their self as a tool, one which embodies a self-aware therapeutic way of being in the service of clients and the client-therapist relationship" (Finlay, 2021 Forthcoming).
More specifically, therapeutic use of self is the self-aware intertwining of both our professional self (the one that uses knowledge, skills and techniques) and our personal self (which arises from our history, beliefs/values, personality and embodied lived experience). It involves our therapeutic practices that we’ve learned and our particular way of maintaining a caring, attuned, holding presence. In other words, therapeutic use of self involves the totality of our being and doing; it is present in our every intervention.
As therapists, we make deliberate choices about how and when to intervene. We continuously adapt and pace the levels of care, formality, spontaneity, emotionality, challenge, support, self-disclosure, intimacy, control and directiveness we offer. Early in the therapeutic relationship, we might listen in a reserved, empathic way as part of engaging a client in therapy. Then, as therapy develops, we might raise the element of challenge by adopting a more muscular, directive approach. These subtle moment-to-moment adjustments also occur when we meet clients outside the therapy context (at the supermarket, say, or on social media). How should we be? How much of ourselves should we show? In an introductory contracting session, we may be quite formal and boundaried to show that we are a trustworthy ‘professional’. Later, we might reveal more of ourselves as a ‘person’ as trust and intimacy grow. Sometimes, we find ourselves being lively and activating; at other times, our pacing may be slower in order to offer clients a space of stillness. There’s no magic formula here. It’s about exercising our professional judgement, minute-by-minute, in response to what we responsively assess is needed.
Our use of self is not something we do to the client. Instead, it emerges within the specific relationship and evolves as we adapt – over time – to the client’s needs and the relational context while they adapt to us. What is beneficial for one client could be problematic, even harmful, for another. Reaching out to comfort someone by holding their hand can be experienced as a lovely, supportive gesture. But in another context, or with another individual, it could be interpreted as patronising, invasive or even threatening. While a forceful challenge may help inspire a client to break with past patterns and behave differently, it could also nudge a client into a freeze or flight response. Our art involves attuning to the needs of both client and the therapeutic relationship towards evaluating when and how to intervene.
For me, therapeutic use of self is all about being a human being in relation with another human being. Its less about applying therapy techniques and more about finding a way to be-with our clients, in patience, curiosity, compassion, caring and challenge, while we go exploring together. In short, we need to move away from a view of the use of self as an internal/individual act towards seeing it as a dynamic, ethical and reflexive process that is profoundly relational. When we ‘go with the relational flow’ and trust the therapeutic process, the use of self is like the playing of a finely tuned musical instrument. Together, client and therapist find themselves immersed in a duet of co-created music.
Here are some of my personal favourites (the authors have been significant 'teachers' for me) on the topic of therapeutic use of self:
The therapeutic relationship, by Petruska Clarkson
Video: Interview with Irvin Yalom on the Art of psychotherapy. Available at: www.youtube.com/watch?v=ZdTFqpItd8I (I recommend watching any/all of his demonstration videos)
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