IICP College

BA (Hons) in Integrative Counselling and Psychotherapeutic Studies

Name of Student Malgorzata (Gosia) Siwek

Student Number 2000492

Module Lecturer Dermot O’Neill

Module Title Advanced Theoretical Issues

Date Assignment Due 30.4.2022

Date Assignment Received

by IICP
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DECLARATION:
I hereby certify that this material, which I now submit for assessment on the programme of
study leading to the award of BA (Hons) Degree in Counselling and Psychotherapeutic
Studies, is entirely my own work, devised specifically for this programme, and has not been
taken from the work of others save and to the extent that such work has been cited and
acknowledged within the text of my work.

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Personal Philosophy of Integration and Case Example

Introduction

According to Irvin D. Yalom “Only the wounded healer can truly heal.”. Going through the
healing process in full depth, authenticity and integrity first, also in my opinion, prepares a
therapist better to guide their clients on their own adventurous healing journey, that is full of
uncertainty and ‘dark corners’. Yet, although ‘wounded healer’ can recognise some of the
‘landmarks’ along the journey of the client, each journey is unique and requires open
presence, continuous curiosity and patient humility along the way. All of that is necessary to
stay receptive to the client’s needs and current experiences, guarding therapist’s biases, that
may impact clients negatively. Helping to choose most optimal interventions, approaches and
modalities of healing. In that way a ‘wounded healer’ joins a ‘wounded traveller’ on a
journey of mutual discovery and transformation. That was also my story of becoming an
integrative therapist.

Format of integration

I currently use assimilative integration model in my practice. It is a model, that is basing on

one main system of approach, like humanistic or psychodynamic, with openness of including
strategies from other therapeutic approaches depending on a need at hand, in considered
manner.

“The driving force for assimilative integration is a sense that an existing approach can be enhanced or extended
by the inclusion of new elements, as long as there new elements do not undermine the balance if the
practitioner’s previous network of ideas and methods. (…) It is a strategy that allows therapist to remain
grounded in a primary approach while gradually trying out different ideas and techniques, and provides a secure
set of criteria for evaluating these innovations (‘are they consistent with what I already know?’).“ (McLeod,
2019, p. 294).

My main system is Rogerian person-centered, where I learn to recognize and trust human
potential of my clients, providing them with empathy and unconditional positive regard being
continuously as congruent as I can, in order to facilitate beneficial transformation in them.
Following Rogerian philosophy I endeavour to tap into “(…) empathic identification, where

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the counsellor is perceiving the hater and hoes and fears of the client through immersion in an
empathic process (…)”. (Rogers, 2021, p. 28).

My focus is to see unique quality in every single client, that will guide me and our
relationship, capturing their essence in presence of both of us. “Transcendence is passing
over to being’s other, but otherwise than being. And not to not-be; passing over is not here
equivalent to dying. Being and not-being illuminate one another, and unfold a speculative
dialectic which is a determination of being.” Levinas, 1981, p.3). Whenever it is useful, I
avoid directing the course of a session flow, following the client’s lead, offering support,
guidance, and structure to every topic, helping them to discover solutions within themselves.

Following Multicultural Theory and Social Justice, I try to assess not only the
presented issue of the client, but also their social and economic background to take also their
mezzo and macro context to inform me about the best tactical and strategical course of action
attempting to capture the overall issue and a solution, that often is not limited to the
psychological struggle but also their life conditions. “In order to expand counsellors’ roles as
advocates and integrate multiculturalism and social justice counselling competency into
practice (…), we must reach for additional theories that help us conceptualize privilege,
oppression, power, and advocacy within the counselling relationship.“ (Singh, Appling, and
Trepal, 2020, p.262).

As mentioned, I apply strategies outside of PCT, that can work very effectively in a
given moment and contribute greatly to the overall journey, while keeping PCT philosophy at
all times.

“Gestalt practitioners affirm the primary values of the living existential encounter between two real
human beings, both of whom are risking themselves in the dialogue of the healing process. The central focus is
the moment-to-moment process of the relationship between he client and the counsellor. In this encounter, the
goal is a full and complete authentic meeting between these two people.” (Clarkson and Cavicchia, 2013, p. 19).

Gestalt therapy is my most often used approach to explore instinctive thoughts and bodily
sensations, empowering a client to bring it to the conscious and own it, adding to their self-
awareness.

“Gestalt is characterised by a willingness on the part of the counsellor to be active, present as a person and to
intervene in the counselling relationship. This is based on the assumption that treating the client as a human
being with intelligence, responsibility and active choices a any moment in time is most likely to invite client into
autonomy, self-healing and integration” (Clarkson and Cavicchia, 2013, p. 25).

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Often, it is enough to initiate a change, however gradual it may be. When the unconscious
becomes more conscious, I may use CBT to establish new routines of thinking and reacting to
some of those self-believes and automatic thought, introducing more space for a client
between action and reaction. From the Gestalt ‘tool box’ I often use ‘an empty chair’ exercise
giving a client opportunity to have more honest ‘talks’ with people from present or past, that
they found difficult or impossible to negotiate their boundaries or hurts with. Moment like
that often serve as powerful catharsis for the client stretching their believes of what’s
possible… In that context, I often pair these experiences with few psychodynamic sessions
after agreeing upon it with a client.

Whatever the technique or approach I am adding to a therapeutic journey with a client, I try
to introduce a sense of wonder and curiosity while exploring current or past experiences with
a client. Helping them to see their reality and themselves with an eye of a wonderer that has
no judgement, only curiosity to discover layers of perspectives and understanding, which
often relieves clients from a fear of looking at places and aspect of their lives, that are
challenging. My ultimate goal is to encourage and strengthen their self-awareness to be able
to develop greater sense of industry and empowerment in their daily life, knowing themselves
better and therefore having more space to make the right choices in place of working from
‘wounded default’…

For the clients, that come with an urgent problem or a challenge, expecting certain
results or a guidance towards a preferred version of reality, I often apply Choice Theory
paired it with CBT as a start, to let them relax into the ‘problem solving aspect’ of their
expectation. Later on, however, often I switch into my main approach (described above), as
our trust deepens and their therapeutic journey progresses and they become more open deeper
exploration.

“The main focus of [choice] therapy is (…) to encourage the client to stop choosing to do things that
lead to unhappiness, and to begin to choose to do things that are consistent with their inner sense of what is right
for them (their internal ‘quality world’). The emphasis on choice, alongside a lack od interest in exploring how
the client feels, might appear to locate reality therapy as a member of the cognitive therapy/ CBT family of
therapies. Reality therapy incorporates strategies for cognitive change that could, in fact, be seen as an
improvement on standard CBT practice.” (McLeod, 2019, p. 289).

That approach may be closer to the theoretical integration or a ‘skilled helper’ model
assessing the present scenario, clarifying the preferred scenario and establishing strategies to
help a client to realise it in their life. Theoretical integration is an assimilation of theories and
philosophies of various approaches to help dealing with a specific problem. In here each

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transition from present scenario to developing preferred scenario to actionable strategies, can
be supported by chosen approach to bring most optimal results.

“Egan suggests that clients, who seek assistance from counsellors and other helpers are experiencing difficulties
in comping with problems in their lives, and that the primary task of the helper is to enable the person to find
and act on appropriate solutions to these problems. The emphasis is therefore on a problem-solving process,
involving three stages. First, the client is helped to describe and explore the ‘present scenario’, the problem
situation that they are faced with at the present time. The second stage is to ‘articulate a ‘preferred scenario’,
including future goals and objectives. The third stage is to develop and implement action strategies for moving
from the current to the preferred scenario.” (McLeod, 2019, p. 289-290).

In all appropriate moments, I try to incorporate the spiritual point of view into client’s
challenges, in attempt of adding deeper meaning while helping a client to take responsibility
in their life exercising freedom to transform their limitations, creating more satisfactory life
for themselves, enabling their own self-actualisation process. “(…) the therapist concentrates
upon increasing the patient’s awareness that (like it or not) he or she is faced with choice and
cannot escape this freedom.’ (Yalom, 2020,p. 243).

In order to be fully present with the client I train myself in mindfulness and offer supportive
mindfulness exercises within a session to facilitate more embodied experience of the process,
while providing space for reflection and review of what is happening. These reflections serve
also as assessments and revaluation of the process, that inform me about possible need for
changing the approach.

Throughout the therapeutic process I endeavour to instil hope in my client’s wellbeing and at
the same time help them becoming ‘captains of their own ship’ prepared for joys and
potential misfortunes ahead.

‘4. There are more things, Lucilius, likely to frighten us than there are to crush us; we suffer more often in
imagination than in reality. I am not speaking with you in the Stoic strain but in my milder style. For it is our
Stoic fashion to speak of all those things, which provoke cries and groans, as unimportant and beneath notice;
but you and I must drop such great-sounding words, although, haven knows, they are true enough. What I advise
you to do is, not to be unhappy before the crisis comes; since it may be that the dangers before which you paled
as if they were threatening you, will never come upon you: they certainly have not yet come. 5. Accordingly,
some things torment us more than they ought; some torment us before they ought; and some torment us when
they ought not to torment us at all. We are in the habit of exaggerating, or imagining, or anticipating, sorrow.”
(Seneca, 2016, p. 34). [XII On Groundless Fears]

Training in wisdom of assessing what is in our control and can be improved, and what is out
of our control and can be delt with by changing attitude towards it, may be a life-changing
skill.

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Shaping my format of integration

My journey in refining the format of integration had a lot to do with experiences with my
clients and reflecting on them with my supervisors. Starting off, I was swinging on the
extremes of either being full time person-centered or trying to fix the problem for a client. I
started three years ago seeing clients with idea, that I will be mostly adopting humanistic
approaches in my practice with elements of mindfulness, (as I am Buddhist and experienced
benefits of these methods in everyday life), giving clients a space to explore their own
dilemmas and serving as a ‘non-invasive helping hand’. I quickly noticed, that many of my
clients do not have a vocabulary to express what they feel often mistaking thoughts for
feelings and vice versa. I realised the need of adopting a psychoeducation into the sessions
while building trust and therapeutic bond. With encouragement of my supervisor, I started
experimenting with Gestalt as a bridge to mindfulness and healing past and present
relationships, that clients often were coming with as a underlying issues. Some clients were
coming with other challenges like addictions or unsatisfactory body or mind condition
expecting to have quick results or at least a good strategy to ‘fix them’. This is when I was
falling into the other extreme of trying to help ‘fixing’ their problem without enough attention
on self-responsibility giving templates of solutions. Having realised that mistake thanks to
journaling from every session and chats with my first and second supervisors, I decided to set
my and clients expectations in more healthy direction. To attend these needs, I started to
apply more and more Choice Theory and CBT techniques to give my clients confidence in
aiming towards that desired goal while keeping their intrinsic motivation on course.
I began to realise, that there is no ‘golden blueprint’ of successful therapy, that it all depends
on the client, their presenting issue, their diligence and types of their wounding as much as
preferred modality of operation. That I should be attuned to all these factors, using my
mindfulness and curiosity to ‘pick up on it’ and weave it into each session and overall
strategy of the individual journeys without interrupting their natural process of ‘here and
now’. That made me grounded and calmer in my dealings with clients because I understood,
that my usefulness to the client lie not in ‘doing more’ but in ‘being more’ with them. It tough
me humility and I realised, that each client and each day, just like each minute in an each
session should be informing me what is the best thing to do, not my learned theories and
favourite techniques. Since then each session with any of my client is like a meditation
session to me; reading the client, listening to their tacit and explicit messages, giving them
space to decide where they want to go with equal effort on my part to propose most optimal

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strategy and approach to the need of the moment, forsaking the previous plan, if needed. It’s
like a dance of awareness and curiosity in every second of being with the client. Taking my
ego out of equation, being ready to forsake my ‘best idea’ from past 5 minute to transform
into utterly different approach because of the cue I just received. It’s not about me being
right, it is about me being there to read the current need and apply suitable intervention for
the client’s benefit.
Since then I started experimenting with various methodologies and approaches and found few
that work naturally with different needs and modalities of clients. I was apprehensive at first;
didn’t know if it is ok to ‘mix so many things’ just because they felt right. I was learning
different theories but none of them said ‘best use with Theory X after theory Z’… That is
why I found he support in especially my last supervisor, that present integrative approach in
her practice too. She understood my point and began encouraging me to experiment with
various integration models, that worked with cases I had and we were analysing my solutions
and defining next steps for many months. That was an eye opener for me. I realised
integration of various techniques can bring better results in many cases, and since it was
natural for me to use them anyway, with the help of my supervisor, I started using them more
deliberately. I must admit, that often my format of integration is still dynamic; it changes
over time with my long-term clients especially, as our relationship develops. I dare to propose
different technique or approach and come to agreement with the client on the next step, which
indicates combination of technical eclecticism and the collaborative pluralism with elements
of common factors. It all depends on a presenting issue, stage of our relationship, level of the
client’s self-denial and resistance and their overall personality, that I try to read at all times
continuously.

Stretching the comfort zone

Truth to be told, I do not ‘strictly’ follow any integrative model, rather various integrative
approaches depending on the client, their case, stage in life, openness for spirituality or
rationality in explaining the issue and preferred style of journeying. I am so ever thankful to
my integrative supervisor I work for the past 2 years, that encouraged me to explore my
integrative style in so many ways. I have learned to apply few formats of integration and I am
determined never to stop learning and exploring my knowledge even by stretching my
comfort zones. I do not claim to know everything, and I do not ever expect to, yet, I can use
my life to learn how to benefit clients the most.

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For example the common factors approach, is present in each of my therapeutic session with
clients. I always try to develop a supportive relationship with my clients by showing, that I
am always there for them, ‘keeping their corner’, no matter what they come with. They feel I
am on their side. With each presented issue, I endeavour to offer a credible rational, so they
understand what are the potential causes and ways of tackling it so we are on the same page
and they can feel informed and assured about the direction we are heading. In their vulnerable
moments, I validate the current experiences with them while instilling a hope, that everything
is to be moulded in a different, better quality of life by changing our interpretation and mental
and behavioural attitudes. I always do it genuinely, believing in this message, so they feel
motivated and reassured, however difficult the situation may present at the moment. I give
my clients opportunities for expressing their emotions by using various tools. I use for that
Gestalt body-mind awareness of emotions stored and exploring their qualities, trying to
connect with them and ‘give them a voice’. Sometimes I would encourage the client to
perform a psychodrama or a conversation with somebody on the ‘empty chair’ to start
naming pains and emotions, that haven’t been funnelled yet. That creates a catharsis for them,
preparing for the next level of healing that follows. I would like to explore a bodywork, that
could add additional depth to that process. I am already looking for courses, I can sign up for
to build that competency. I also encourage and facilitate healing rituals during sessions: any
helpful charts like genogram, lifespan, confidence pot, artwork to describe states of mind,
that are hard to describe. On a few occasions I also facilitated burning resentment by
directing it on piece of paper and setting it on fire in especially prepared by me metal can
next to the window and let the client observe the process. All of these to elicit a sense of
empowerment in the context of their life; giving them a language to talk and understand the
process and creating an experience of making a progress. I feel drawn to the art therapy too,
wanting to empower clients further, so I would like to add it to my educational program by
attending another course. I also try to reveal my qualities as a counsellor, that yields trust so
the client can feel safe and fully open to the transformational and healing journey. I know, in
order to achieve it I should continue my self-developmental journey, training my authenticity,
openness to the feedback and mindfulness. I will use my Buddhist life philosophy, daily
meditation practice and honest exchange with my supervisor, friends and clients to train these
qualities continuously.
When it comes to stretching of my ‘therapeutic comfort one’, it has to do with applying
CBT to my practice more. I was resisting CBT for quite a while, as strictly tangible approach
is not my natural one. I like to leave a space for the spontaneous occurrences during the
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session to lead its direction. Yet, I noted, that integrating it to my main approaches: PC and
Gestalt has powerful implications. Few months into my practicing as a trainee therapist I
started including a homework to the client’s process to support new insights and give clients
a chance to exercise newly discovered awareness. To encourage a routine of noticing their
mental or behavioural tendencies by keeping a daily journal or/and applying certain exercise
strengthening a sense of emotional awareness and empowerment. Some of these exercises I
even encourage during the sessions, to explore new depths in ‘here and now’ and to show
how to do it at home. I saw, that I was resisting tangible approach as a main format of therapy
but it appeared to be so beneficial as its element. I plan to get more comfortable with
applying CBT in my practice. Maybe additional CBT courses I will enrol after completing
this degree. Also, in terms of my arbitrary choice of tools, methodologies and approaches in
my practice, I continuously ask my clients for a feedback and, of course, my supervisor, to be
able to train my ability to apply the most suitable method in the best possible way
continuously growing as a therapist. In order to be a better therapist, I need to continue grow
as a person too. I am aware of quite a few biases of mine, that healed and semi-healed
wounds mold my attention in clients stories. Yet, I believe there are still subtle ‘blind spots’ I
am to discover and for that I am committed to life-long self-development as an intelligent,
feeling and spiritual being. This is my commitment to myself and others, that I am to meet on
my life journey. I believe, I can only help others in their self-discovery and self-healing
journey as much I self-discover, heal and expand myself. As a Buddhist practitioner, ever
curious philosopher and constant learner, in order to continue and excel on that path. I would
like to explore the body work as much as art work to incorporate them to my skillset as I
realised an immense value of the non-verbal tools in a therapy setting for clients, that cannot
conceptualise their trauma.

Case study

On the case of Joanna I will present another integrative model of psychotherapy I tested,
technical eclecticism. It is a type of integration, where counsellor chooses most effective
intervention for a given client with the specific problem within given set of circumstances, in
order to meet the needs of this specific client.

“An eclectic approach to therapy is one in which the therapist chooses the best or most appropriate techniques
from a range of theories or models, in order to meet the needs of each individual client. One of the distinctive

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features of eclecticism, as applied in therapy, is that it has focused almost entirely on the selection of therapeutic
techniques and procedures, and has paid little attention to the question of the theoretical framework within
which there interventions have been developed.” (McLeod, 2019, p. 285).

Joanna was 45 year old divorcee from rural Ireland, brought up in traditional Irish
family from Westmeath. Parents still alive, in their late 70's, father very patriarchal type and
mother always tried to keep family together, often at the expense of interpersonal
authenticity. Having three children, from which the youngest was thirteen, she was leaving
the marriage that lasted eighteen years. She came to me confused and lacking direction, self-
esteem and self-identity beyond roles she was playing in her family life. Initially she escaped
her rigid and patriarchal family rules to study in Dublin and become someone more
independent and respected. This is where she met her future husband, and after working for
few years as a teacher, she devoted herself fully to the family life as a full time mom. Now
divorced past twelve months, was trying to find out a person she is, struggling to re-establish
a sense of self in a new reality. She started to work in a school again, that she loves and even
met somebody. However, her low self-esteem, wounds of trust from her former partnership
and lack of clear vision who she is, were preventing her from making the best of it. She
presented various signs of self-sabotage, deflections and introjections, that stems from
insecure believes about herself, that she was carrying from her previous relationship.
Experiencing an identity crisis as a result of entering new stage of her life, trust issues
towards potential partner, lack of self-believe (that she can handle new life), Joanna needed to
start a journey of developing new sense of identity, in spite of experiencing maternal guilt
towards her three children.
During first sessions, after contracting and initial introduction to her story, I offered
Joanna basic rational for her current challenges (outlined above) so she understands it is
natural to feel how she does. I also asked for her preferred scenario she would like to work
towards how her life would look like, how she would feel about herself and the reality around
her, proposing the plan to get us there, asking if she is willing to commit to that process. To
support Joanna I applied here also a Choice Theory helping her to assess possible scenarios
and outcomes she could expect or create. That is way I initiated three stage process to start
with, so the client can feel safe knowing the direction we are heading and feel empowered
committing to it. Next session we started exploring her self-esteem challenges with the use of
Gestalt techniques on an example of the life scenario that happened that week. We were
exploring client’s internal process and stopping often to feel emotions, identify them in the

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body and visualise them using Narrative Therapy to give them shape, size, colour,
temperature etc… to start owning and normalise them, bringing it to the conscious. The client
felt empowered describing sensations appearing, giving them a name and a place, slowly
containing all phenomena appearing in her space. I checked with her how these interventions
impact her and with her enthusiasm and permission, we were to explore it further in the
future. As some sensations brought up evens from the past and Joana’s family of origin, we
were taking few session working on the premises of Psychodynamic, exploring relationships
especially with her parents, inviting Gestalt methods to bring additional layers of awareness
to the old stories and motives and explore old emotions, hide in subconscious until now. As a
result of that exploration, we identified quite a few self-beliefs, the client developed in
childhood and puberty. Some of these believes were not only sabotaging her now but
possibly also during her marriage. We decided to work on them with the use of CBT
techniques in combination with the Transaction Theory, noticing during the week whenever
she was criticising herself, to write down which role/ part/ person stands behind a given
though. Is it her patriarchal father, that never seen value in her, or a mother that tries to
devaluate her efforts? Maybe part of herself, that is afraid of taking control and tries to push
responsibility on others blaming them for her misery? In that process, Joanna realised, she is
often operating from the victimhood mentality blaming others for outcomes she is now
responsible for. That initially shocked her but then empowered her to really work on her self-
believes and we made a CBT routine with slightly different tasks every week, that she would
monitor her change in believes behind decisions.
During that process I was often resorting back to the Narrative Theory to help Joanna
to shape further the vision of the future she created during first sessions. Maybe something
changed? Maybe she discovered other possibilities? I encouraged her to visualise herself as a
flourishing city, that requires fresh water supply to fully grow with plenty of ‘nourishing
juices’. I asked her what type of water supply she needs; pipes, maybe aqueducts..? How
these aqueducts would look like, what are they made of? What type of water they deliver?
What type of changes this fresh water contributes to within the city? How big the city grows?
Before that exercise I give her few minutes of mindful breathing so she can relax more into
her creative imagination and connect with her inner self easier instead of only participating in
the exercise intellectually.
After about twenty sessions, when we worked for a while on Joanna’s self-esteem,
self-beliefs and childhood memories and practical aspect of her life, I decided to apply
existential therapy and explore with her what is the meaning of life for her in the present
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context, encouraging her to become proactive bringing it about. Also, I decided to include
elements of loss and bereavement therapy to address loss of her former identity as a young
mother and a wife, now entering her middle-age life with new needs and expectations. We
explored various parts of Joanna and identified which one needs which type of treatment and
how they can be satisfied. In that, I switched into person-cantered approach, leaving space for
Joanna to lead the process, encouraging her to engage in feelings while mirroring and
reaffirming her words and experience so she can hear herself back and reflect. Often during
these sessions, I supported her with mindfulness techniques, when she needed to fully
embody emotions felt.
In that way, we started to integrate the whole journey into a new understanding of Joanna as a
synthesis of all past experiences, wisdoms, lessons learned and emotions experienced. Joanna
was at first reluctant to looks at her lifepath with a ‘fresh eye’ but soon she started to become
excited about her new definition of a woman, a human being she is, and her new life purpose.

Conclusion

In my early stage of evolution as an integrated counsellor, I became aware of so many

benefits of merging theoretical and practical counselling tools, that I am committed to life-
long learning journey of becoming better and better at using them, hoping to benefit many
clients. I am aware of the importance of my personal development as a contributing factor to
that vision, and I plan never to stop that journey either. In my observation, nothing ultimately
can ever replace human empathy, authenticity and unconditional regard, that yield trust and
create conditions for powerful healing transformations, and I am committed to embody that
qualities more and more.

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