Professional counsellor - Richard Pascall

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The most important factor in any therapy
is the relationship between client and therapist
— Richard Pascall

My name is Richard Pascall. I have worked as a counsellor/ psychotherapist in private practice in Northamptonshire since 007. 

I see clients who suffer from depression, stress, anxiety, loss and bereavement, anger management problems, weight/ eating and body problems, and addiction issues. I use different methods to help clients with their individual issues. Everyone has a unique life and a distinct set of problems, so I believe it is important to work with clients using an approach modelled to their needs and requirements. 

There are many schools of psychotherapeutic thought, ranging from the traditional Freudian psychoanalysis to more recent Cognitive Behavioural Therapy (CBT). The most important factor in any therapy is the relationship between client and therapist – get the relationship right and the style of counselling becomes less significant. 

CBT was developed and evolved by Aaron Beck (and others) in the seventies. It is widely used in the UK by the NHS as a short term therapy for clients with anxiety, stress and depression. CBT is based on the premise that our interpretation of an event is crucial, for it determines how we will react and feel. 

One way of explaining this is to the look at the ABC of a particular event. A is the activating event – going for a job interview perhaps. Many of us will jump straight to C – consequences, which usually mean getting really anxious, trying to find a way out and getting desperately worried. 

What really happens is that on the way from A to C, we pass through B – belief (often very quickly). We might believe that we are not good enough, that there will be better people applying for the job, or that we will not be able to speak clearly or answer questions well at the interview itself. 

The CBT therapist will help the client to question those beliefs, to re-frame them as an inference and challenge whether or not it is true. Slowly the belief can be changed, which then alters the reaction – the anxiety becomes lessened and the client can build confidence in their ability to present as well as possible at the interview. 

 
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An example of the way I work is with a recent client presenting with anxiety problems. She had become unable to carry out simple daily tasks, and had become confined to her front room not watching TV. After a few sessions it became clear that her anxiety was deep-rooted, and was eventually found to be centred on sexual abuse she had suffered as a child (she is now 69). 

At the time she had not told anyone, managed somehow to park the distressing thoughts and feelings, and had got on with her life. However, recent events in her life, connected to her family (and the constant media interest in historic abuse cases) had triggered these thoughts. Unable to cope with them after all this time, she slumped into a world of anxiety. 

Her interpretation of events had always been that she should not tell anyone, why would anyone believe her? It must be her fault that she was abused? Even now, as she told me, she believed that I wouldn’t want to hear her story, that I shouldn’t hear such things. Using a very gentle and understanding approach, partly based on CBT, partly based on building a good relationship, I have been able to help the client begin to come to terms with her thoughts and feelings. I have helped her challenge the idea that she was at fault, and that no-one would believe her. 

Therapy can sometimes take a single session or many years of work, and everything in between – everyone is individual, complex and has a unique set of needs. If you have any questions regarding CBT or therapy, please contact me via my website. - Richard Pascall

 
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