George is a 40 year old senior executive in a large company, a position he has only recently taken up. He was referred to counseling by his general practitioner to explore his mood swings. He has been married for nearly 5 years to a ‘warm and wonderful person’. There were no children yet, and the couple was wondering about the right time for having children. This has been an area of disagreement between George and his wife and has led to a number of heated arguments between the two of them.
George described himself as fairly conservative and not a risk taker, and said that sometimes he couldn’t believe he had accepted a job in such a large company. On questioning, George said that he sometimes felt OK and reasonably good about himself, but that these good feelings frequently gave way to incredible doubts and feelings of hopelessness, that he often felt ‘not good enough’ and ‘not worthy’. He had experienced these feelings before, but he felt they were more intense and more frequent since moving to his current position. He commented, “I’m not the person I thought I would turn out to be” and “I’m disappointed in myself”.
He reports being able to keep it together at work and that his work in not suffering at this stage. He has become more restless and irritable with people, especially in social situations which he describes as excruciating and pointless.
There are a number of potentially valuable therapies that vie for attention as possible curative options for George and his symptoms. However, gestalt therapy and REBT are the two approaches that I have decided to implement here. I will give a very brief synopsis of each approach before offering in-session therapeutic techniques that I will apply with George. In closing I will discuss some of the differences between the two chosen approaches, as well as offering a justification for a preferred approach for treating George.
The gestalt approach is a psychological
References: Antona, C. J., & Garcia-Lopez, L. J. (2008). Effects of exposure and cognitive restructuring in social phobia. International Journal of Psychology, 40 (2), 281-292. Bean, P Burns, D. D. (1999). The feeling good handbook. (Revised ed.). New York, NY: Plume. Coles, M Corey, G. (2009). Theory and practice of counselling and psychotherapy. (8th Ed.). Belmont, CA: Thomson Brooks/ Cole. Cowen, E Ellis, A. (1994). Reason and emotion in psychotherapy: Revised and updated. Secaucus, NJ: Carol Publishing Group. Ellis, A. (2008). Rational emotive behaviour therapy. In Corsini, J. & Wedding, D. (Ed.). Current Psychotherapies (pp. 187-222). Belmont, CA: Thomson Brooks/ Cole. Engle, D., & Holiman, M. (2002). A case illustration of resistance from a gestalt-experiential perspective. Psychotherapy in Practice, 58 (2), 151-156. Froggatt, W Hajzler, D., & Bernard, M. E. (1991). A review of rational emotive outcomes studies. School Psychology Studies, 6 (1), 27-29. Haug, T Ingram, R. E., Miranda, J., & Segal, Z. V. (1998). Cognitive vulnerability to depression. New York, NY: Guilford Press. Jacobs, L Leahy, R. L. (2003) Cognitive therapy techniques: A practitioner’s guide. New York, NY: Guilford Press. Malfait, R., & Wollants, G McCarthy, J., & Holliday, E. L. (2004). Help-seeking and counselling within a traditional male gender role: An examination from a multicultural perspective. Journal of Counselling and Development, 82, 25-30. Meth, R Neff, D. K., Kirkpatrick, L. K., & Rude, S. S. (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41, 139-154. O’Shea, L Silverman, M. S., McCarthy, M., & McGovern, T. (1992). A review of outcome studies of rational-emotive therapy from 1982-1989. Journal of Rational-Emotive and Cognitive Behaviour Therapy, 10 (3), 111-186. Sinclair, S Stern, D. N. (2004). The present moment in psychotherapy and everyday life. NY: W.W. Norton. Watson, P Yontef, G. (1982). Gestalt therapy: Its inheritance from gestalt psychology. Gestalt Theory, 4 (1/2), 23-39. Yontef, G Yontef, G., & Jacobs, L. (2008). Gestalt therapy. In Corsini, R. J., & Wedding, D. (Ed.). Current psychotherapies (pp. 328- 367). Belmont, CA: Thomson Brooks/ Cole.