Psychotherapy in general cannot be described without making reference to diagnosis. Diagnoses in the medical world describe a group of symptoms that causes distress, such as depression, anxiety and addiction. Diagnoses such as these describe a prevalent behaviour or mood but do not describe the experience of the whole person who presents with the problem or the cause of the problem.
Often symptoms are the result of a person’s attempt to cope, adapt to stress or avoid (defend) painful or threatening feelings or memories. When the symptom is problematic it means that this attempt to cope is not working.
A thorough history taking is essential for me to gain a deeper insight into the problem. For example, we will think about when the problem first began, how it developed, what was attempted in an effort to manage the problem, what was successful, what was not successful, the effect on work, family and relationships, and so much more.
A thorough history taking is important as it allows me to treat more than the symptoms; it allows me to treat the whole person, to think about their psychological life as well as their external life past and present relationships. Often a client knows what the problem is that brings them to treatment - such as an addiction, binge eating, social anxiety, relationship problems or low self-esteem.
The exploratory discussion that takes place during the history taking forms part of treatment as patterns and themes are highlighted, symptoms explored and insight gained. These themes are discussed at feedback where we will talk about treatment options. The psychotherapeutic conversation that follows in therapy is informed by the history taking. However, as the client’s story unfolds there will be a deeper self discovery and so the treatment focus will broaden too.