The Therapy Square

We met as the Fells and Dales group of therapists on Friday, April 9th, 2021 and the focus of our discussion was an article from “Therapy Today”, July 2020, entitled “The Therapy Square” by Anthony Prendergast. This article offers an interesting model and hence a  tool to potentially use with clients – a laminated sheet which has 4 quadrants. It  invites a client to identify and write down inhibiting emotions such as shame, guilt, fear or anxiety and the inhibiting messages conveyed by these feelings. It also includes “Human potential” which Prendergast believes we are born with but then , due to social conditioning (including internalised messages from parents), we “end up in blocked potential”. The goal of therapy is then to help us “get back to our full human potential”.

The author digresses to examine Malan’s triangle of conflict with the hypothesis of a Defence existing in reaction to Anxiety which is rooted in Hidden feelings which then need to be made conscious and worked through psychodynamically. Prendergast’s model adds 2 new concepts: the concept of Injunctions leading to inhibiting messages. He states that “Inhibiting messages are the crucial missing element driving internal conflict because without such messages there would be no inhibiting emotion to enforce it and , as a result, no blocked potential, internal conflict or transference”.

In the ensuing discussion, we gave clinical examples from clients of evidence of blocked potential and inhibiting messages and felt these were useful concepts to encapsulate some issues that clients bring.

An interesting image was discussed by one of us, who had worked with a client with autism, of a tree with many leaves- this arose when the therapist spoke to the client about the trunk of the tree as a kind of solid central core and the client said he could not relate to this since, for him, all parts of the tree had equal weight and importance and he couldn’t differentiate between them. We all felt this was a useful piece of learning in shedding light on the different ways our minds work and process information and feelings.

We all felt that it was valuable to know about different models of counselling and to ask ourselves “ Do I understand the model and how do I apply it?”. There was, however, a cautionary note about using a model with a client in the sense that it would be more likely to be effective and appropriate if the presentation of a model by the therapist arose spontaneously in the course of a session. For example, one of us recalled a colleague presenting a client who had suffered from trauma with a drawing done there and then of the window of tolerance and how this had worked well.

We also discussed how we might use transference in a session and whether it is effective to directly name it in the here-and-now with the client by looking at the relationship between you both.

Reference was made here to Malan’s 2 triangles which explore transference and counter-transference and the unconscious dynamics involved. Some of us felt that raising this question could be confusing or alienating for the client and needed to be handled sensitively if at all.

All in all, it was a stimulating and enriching meeting as is usually the case.

Rosemary Pitt

The Therapy Square