Practical Applications: 22 Guidelines for Counseling and Psychotherapy

By Breggin, Peter R. | Ethical Human Psychology and Psychiatry, April 1, 2008 | Go to article overview

Practical Applications: 22 Guidelines for Counseling and Psychotherapy


Breggin, Peter R., Ethical Human Psychology and Psychiatry


This article describes 22 principles for the conduct of therapy or counseling, most of which are also applicable to all human relationships. The creation of a safe space and a caring, trustworthy relationship is essential to therapy and basic to the helping process. Conducting therapy requires the application of the highest ethics and ideals.

Keywords: psychotherapy; counseling; drug-free treatment; therapy guidelines; counseling principles

Psychotherapy and counseling take many forms, but there are basic principles or guidelines that can be applied to all therapy and ultimately too all human relationships. Originally developed for the treatment of deeply disturbed persons, these guidelines in some ways reflect a practical applications of Martin Buber's (1968) "I-Thou" relationship, which treasures the other human being. These guidelines draw on several of my earlier publications, including the Heart of Being Helpful (Breggin, 1997a) and Dimensions of Empathic Therapy (Breggin, Breggin, & Bemak, 2002).

In more extreme circumstances, therapy requires us to relate to individuals who feel unable to relate to other people in their lives at home, at work, or elsewhere. Sometimes these injured persons have withdrawn from human beings into a private world of their own making. At other times, their problems may not be as severe, but in all cases, the therapist must find a way to relate to people who feel distressed and in need of care and reassurance.

These guidelines are adapted from the final chapter of the recently published second edition of my book Brain-Disabling Treatments in Psychiatry (2008). I have added two new guideless to this version: "Address your client's feelings of helplessness" and "On the importance of not having emergencies."

1. Every session, welcome the person as you would a new friend, someone you have been eagerly awaiting, someone you feel privileged to meet, someone you would never offend, someone whose feelings you will treat with exquisite tenderness.

The Quakers speak of relating to "that of God" in each person. Humanists see every human being as having inherent value. Find your own way of conceptualizing your respect and concern for the preciousness of each individual human life. Build your helping relationships around this kind reverence for the other. When you tend toward feeling superior, repeat to yourself the mantra of good therapists: "There but for the grace of God go I."

In a more humorous vein, I have described "A Dangerous Assignment" that I sometimes give my patients-for one week to treat everyone they meet with kindness and interest, and to see how often it is returned (Breggin, 2000). Why it is a dangerous assignment? Because your client may learn to expect the same kind of wonderful treatment from you.

2. Dare to be caring.

Of course, everyone knows that it can be scary to be caring. Caring risks rejection. It can be misunderstood and even taken advantage of by distressed or unscrupulous people. It doesn't seem "professional." It can get out of hand and lead to the breaking of boundaries in most unfortunate ways. Yet a caring relationship is the core of healing .

By caring, I do not mean a sad or even sympathetic attitude. It does not help to be dragged down by your patients' plight. In The Heart of Being Helpful (Breggin, 1997a) I call this induced emotional suffering, where the witness to the suffering actually becomes relatively helpless or even incapacitated by the induced emotional pain. Induced suffering makes people feel guilty and angry, and may lead them to avoid or even to harm the other person.

Empathic suffering is different, especially in regard to feelings of guilt and helplessness. As a subtle aspect of caring-a way of keeping close company with the individual's suffering-it is critical to all forms of therapy (Breggin, 1999; Breggin & Stern, 1996). True empathy brings us closer to the other human being and makes us more able to listen, to hear, and to offer comfort and direction. …

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