What Comes after Psychological First Aid?

People seek counselling / psychotherapy for all sorts of reasons. For many people who seek help, the reason is pretty straightforward; they are in distress, they don’t know what to do and they want someone to give them immediate help with what they are going through. Knowing this, we counsellors and psychotherapists respond as best we can. That's what we might term psychological first aid. But there's a lot more a skilled therapist can do to help.

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Once the crisis has passed

But once the crisis has passed and you are starting to get back on their feet, the therapy may start to evolve into a different direction. In other words, once you have started to get a handle on the anxiety, or you are in less emotional pain, or you are feeling less angry – what do we talk about then? What comes after learning how to handle your strong feelings?

Going deeper that psychological first aid

For some people, this is the time that our work finishes. The crisis has passed and the problem seems solved. But other people realise that they have found the support that they get through psychotherapy helpful for them in unexpected areas of their life. they start to value the warmth that is essential to good psychotherapy.

They find that talking things through with a compassionate professional starts to awaken thoughts and feelings and other aspects of themselves that they were perhaps only slightly aware of previously.

They start to wonder about why they are the way they are, and who they really are. At this point, the work starts to transition, and the reason why they sought psychotherapy starts to become more obvious.

Understanding yourself

There are many different ways of looking at the purpose of psychotherapy; one approach that I like is the one proposed by Bernard Brandchaft, based on earlier work by Robert Stolorow and George Atwood. Paraphrasing, it is a process in which the client understands more about how their experiences have unconsciously influenced the way they are and view the world.

It is also an increased ability to change the way experiences affect them.

This goes far beyond the sort of ‘psychological first aid’ that you are often initially looking for. Instead, it starts to turn into a deeper exploration of yourself. Although this isn’t what everybody is looking for, it has value; it's this deeper work that can prevent the recurrence of the things that can periodically drive people into crisis.

Let me know what you think in the comments. Now, read about learning how to trust again.

– Tim Hill