Research and Publications. Developing holistic approaches to counselling, coaching and psychotherapy, by researching and writing articles, papers and books for publication. Executive Director: Dr Jim Byrne FISPC
What is E-CENT Counselling?
E-CENT Paper No.2 (a):
What is Emotive-Cognitive Embodied-Narrative Therapy (E-CENT)?
By Dr Jim Byrne
Copyright (c) 2009-2016, Jim Byrne
(Updated March/April 2020)
Summary
In this 22 page paper, the author describes the nature of Emotive-Cognitive Embodied-Narrative Therapy (E-CENT). He introduces some of the E-CENT models of the human mind; outlines the foundations of the basic theory of E-CENT counselling, by summarizing eight of the nineteen key features, or principles, which characterize this integrative system; lists a small number of the main models that are used to structure E-CENT counselling sessions; and ends by describing the E-CENT therapist’s style.
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1. Introduction
The following quotation provides a concise flavour of the E-CENT approach to counselling and therapy:
“E-CENT sees humans as essentially (emotional) story tellers, to ourselves and others, and storytellers who live in a world of narratives and scripts, which include reasonable and unreasonable elements, logical and illogical elements, and defensible and indefensible elements. Humans often tend to push away (or repress) unpleasant experiences, to fail to process them, and to then become the (unconscious) victims of those repressed, undigested experiences. E-CENT also sees adult relationships as being the acting out of childhood experiences with parents and siblings, because some part of those earlier relationships have not been properly digested and completed”.
Extract from E-CENT Counselling: How to apply Emotive-Cognitive Embodied-Narrative Therapy in counselling and self-help, By Dr Jim Byrne.***
Emotive-Cognitive Embodied-Narrative Therapy (E-CENT) is a system of counselling and psychotherapy which helps clients to work on their brain-mind-body-and-relationships in order to reduce and control negative or painful emotions and behaviours, like anger, anxiety, depression, stress, self confidence and couple conflict.
E-CENT theorizing began by trying to integrate elements of Rational Emotive Behaviour Therapy (REBT), Transactional Analysis (TA), Attachment theory, moderate Zen Buddhist philosophy, moderate Stoicism, Gestalt therapy, moral philosophy, and some other cognitive, narrative and dynamic therapies. But the REBT component gradually crumbled upon closer examination, and fell out of the mix. And E-CENT moved well beyond those other systems, to create some original emotive-cognitive techniques, models and perspectives.
E-CENT is not an eclectic system which has merely bolted elements of different counselling systems together. It is a truly integrative system which began by revisiting the basic model of the human personality developed by Sigmund Freud and asking:
How does this model link up with the ABC model (of REBT/CBT?)
What are the necessary implications of assuming that there is substantial truth in both models?
The same process was conducted with Transactional Analysis and cognitive science. The resulting model was then compared with the implications of the Object Relations School. Moral philosophy and Zen Buddhism were also interrogated in this process of model building. That work of model building is described in Papers No.1(a)[1] and No.9[2].
Before that system of integration of models was begun, I had studied thirteen different systems of counselling and therapy, including: Freud and Jung, Rogers and Perles, Behaviour Therapy theory and practice, Cognitive Therapy and Rational Emotive Behaviour Therapy, Reality Therapy and Transactional Analysis, Existential Therapy and Logotherapy, Multimodal Therapy and Cognitive-Humanistic Therapy; and also committed myself to the proposition that all systems of counselling and therapy that are designed to be therapeutic are broadly equivalent in terms of the outcomes achieved for the client, as argued by Wampold (2001)[3], and Messer and Wampold (2000)[4].
And I had begun to teach my clients and readers that diet, exercise and relationship-connection – as well as family history and current life stressors – are important elements of what makes us emotionally well or emotionally distressed.
E-CENT evolved in phases. 1968 to 1980 was a kind of incubation of some core ideas, triggered by a partial Freudian analysis, combined with art therapy, music therapy, relaxation therapy, group therapy, and some others. And 1980 to 1998 involved active exploration of various systems of therapy and self development (including Gestalt and Psychosynthesis, and autogenic training). Then, 1999 to 2007 saw an intensification of thinking and learning about the core elements of the thirteen systems mentioned above. And finally, over the past seven and more years (from 2007) – of developing and applying the emerging E-CENT model – a basic theory of human personality and psychological disturbance emerged.
The Bamboo Paradox: The limits of human flexibility in a cruel world – and how to protect, defend and strengthen yourself
Finding the Golden Mean that leads to strength and viable flexibility, in order to be happy, healthy and realistically successful
By Dr Jim Byrne.
With contributed chapters by Renata Taylor-Byrne
~~~
The Institute for E-CENT Publications: 2020
~~~
Are human beings like bamboo? Are we designed to withstand unlimited pressure, stress and strain? Is our destiny to be sacrificed on the altar of other-directed ‘flexible working arrangements’?
We live in a world in which there are dark forces that wish us to forget that we are fleshy bodies, with physical and mental needs; and physical and mental limitations; and to be willing to function like mere cogs in the wheels of somebody else’s financial or technological empire.
Rational Emotive Behaviour Therapy (REBT) has played into this narrative, and given it philosophical support, by promoting a form of Extreme Stoicism in the name of therapy and wisdom, which it patently is not. (General Cognitive Behaviour Therapy [CBT] also supports this agenda, but to a lesser degree, or in a less obvious way! And some forms of Extreme Buddhism also advocate ‘detachment’ from material concerns, such as the need for a balanced life!)
In this book, I review the research that we have done on the limits of human endurance, and the determinants of that endurance – as well as identifying a viable philosophy of life – which will help you to optimize your strength and flexibility, while at the same time taking care of your health and happiness.
If you want to take good care of yourself in the modern mad-market, you could benefit from studying this book. It will provide you with both a compass and a suit of armour which will support you with the challenges and battles you will inevitably face.
2. Brief introduction to the E-CENT models of mind
After more than fifteen years of studying, exploring and developing models of the human mind (between 2001 and 2016), we concluded that tripartite (or three-part) models have more explanatory power than ‘binary (two-part) models’; and that both are preferable to the ‘black box’ model of behaviourism (and behaviour therapy).
Of course, the human brain-mind is the most complex entity in the known universe, and therefore any attempt to sum it up – to ‘simplify it’ – is fraught with difficulty and danger. However, in the interest of making the management of mind accessible to counselling clients, we have to take some risks in summing up what we have learned about the human brain-mind.
The most important tripartite models seem to have come from Plato, Freud and Eric Berne. (However, the Hindu/Buddhist binary model – of the Elephant and Rider – is also helpful, up to a point. [It seems the Elephant and Rider model was first mentioned by Lord Krishna in the Maharabhata]. And Freud’s other model, [the binary distinction between the Life urge {Eros} and the Death urge {Thanatos}] also needs to be taken into account –which we do in our theory of the Good and Bad Wolf sides of human character).
From the main elements of the tripartite models of Plato, Freud and Eric Berne, we infer that:
1. The most basic E-CENT model of the dialectical interaction of the mother and baby is the best way to conceptualize the origin of the child’s ‘personality’ or ‘self’.
In this view, the body-mind of the new-born baby interacts with the caring role of the mother, and in the process, the brain-mind of the child becomes wired up in terms of feelings-related-to-experiences.
This is also the best way to conceptualize the social nature of the child (and later adult).
This is how I presented it originally (as presented in Byrne, 2009a)[5] and in Byrne (2009b)[6]:
The most basic model of E-CENT – The dialectical nature of the individual/social ego. The ego is a product of relationship, and cannot exist without (external and/or internalized) relationship
The (normal, ‘good enough’) mother has no real choice but to ‘colonize’ the new born baby, as it is totally helpless. She must ‘march in’, take over, and run the baby’s life for ‘it’, otherwise (unless it is colonized by a mother substitute) it will surely die. The neonate, or baby, is also most likely wired up by evolutionary forces to ‘seek’ a connection with what must seem (physically, emotionally) to be “another part” of itself: thus creating a ‘natural symbiosis’ which satisfies some innate needs of the baby, and some innate and socially shaped needs of the new mother. (The urge to seek a breast and suckle seems to be innate to all mammals).
~~~
2. The best way to understand the structures of the mind is to use another of the models I developed in 2009 (in Byrne 2009b), as follows:
How the ten elements of the PAC model – (4 Ps, 4Cs, 2 As) – emerge within the dialectical ego space between the mother and child
This shows the way in which the overlapping psychic space where the mind of the mother and child meet is divided into:
(a) A good side and a bad side;
(b) A Parent component; an Adult component; and a Child component. (See Byrne 2009b for a full explanation of this model).
Lifestyle Counselling and Coaching for the Whole Person:
Or how to integrate nutritional insights, exercise and sleep coaching into talk therapy.
Cover design by Charles Saul
By Dr Jim Byrne, with Renata Taylor-Byrne
This book has been found in practice to be very helpful to counsellors and psychotherapists who want to understand the role of lifestyle factors in human disturbance. Because diet, exercise and sleep are increasingly seen to be important determinants of mental health and emotional well-being, it is now necessary to rethink our models of counselling and therapy.
This book shows counsellors how to incorporate lifestyle coaching and counselling into their system of talk therapy. It will also help self-help enthusiasts to take better care of their own mental and physical health, and emotional well-being.
Prices: from £4.26 GBP (Kindle) to £12.64 (paperback)
3. And the best way to understand the process of counselling and therapy is that, in the majority of cases, the client has most likely got one or more of the following four problems. (There may be some problems which cannot be subsumed under one of the following headings, but not many).
(a) Their (emotive) ‘appetitive part’ (or ‘id’ [Freud], or Child ego state [Berne]) is too powerful relative to the other two parts: (which are, the Parent [or super-ego] and the Adult [or ego]).
(b) Their (emotive) ‘Parent ego state’ [or super-ego] is too punitive in relation to the Child ego state [or id], resulting in excessive and inappropriate guilt, shame and ego weaknesses.
(c) The individual’s (emotive, cognitive and behavioural) coping resources may be inadequate to cope with the various, and very real, external pressures bearing down upon them in their daily lives.
(d) They had a maladaptive relationship to mum and/or dad when they were a baby/infant/child, and this has not yet been fully corrected through subsequent corrective relationships.
(Rational Emotive Behaviour Therapy seems to make the mistake of believing that all psychological problems derive from items (a) or (b) above; and they overlook (c) and (d).
The role of the counsellor (from an E-CENT perspective) is then, either:
(a) To help the client to correct the power imbalance between its appetitive part, on the one hand, and its more Adult and/or Parent parts, on the other hand[7]; or:
(b) To help the client to distinguish between appropriate and inappropriate guilt and shame. To help them to grow their Adult, and to find ways of ‘cutting the ties’ from destructive Parent figures.
(c) To help the client to either: (i) reduce the stresses in their life; and/or (ii) to increase their coping resources; or:
(d) To act as a ‘secure base’ – or temporary, ‘good enough’ mother/ carer substitute – for the client; so they can learn to feel ‘securely attached’ to the counsellor. Once this secure attachment has been achieved – which is called ‘earned security’ – the client can generalize this new way of relating to include the significant other people in their life.
In a broader sense than that above, E-CENT was developed by this author over many years of study and application, in private practice with more than 850 clients. As a result, we have developed nineteen principles (by January 2016).
Here are the first eight of the key features of E-CENT:
Firstly, we do not make the mistake of extrapolating from adult functioning in order to understand the psychology of human nature. Instead, we begin with the baby in the mother’s womb (where the mother may be more or less stressed, and more or less well nourished, depending upon the actual circumstances of her life). We then move on to the baby post-birth, which is colonized by a carer (normally mother) who may be more or less sensitive to the baby’s signals of comfort and discomfort; more or less responsive to the baby’s needs; and more or less caring. And we also take account of how stressed the mother was, by her life circumstances, even before the baby was conceived. These are the foundations of human psychological functioning.
Secondly, we accept the Attachment theory proposition, that the baby is born with an innate attachment drive, which causes it (after some period of weeks of development) to seek to attach itself to a main carer. That attachment becomes either secure or insecure, depending upon whether the mother is “good enough” – meaning sensitive, responsive, and caring enough to soothe the affective states of the baby. Later father and siblings become important attachment figures for the baby. And the baby forms a set of internal working model of relationship based upon those earliest relationships.
Third, the first five or six years of life are taken to be determinants of what kind of life the individual will live. Very largely, the narratives, scripts and frames that the child learns and forms during this period – which manifests in the form of moods and emotional states, expectations, beliefs and habitual patterns of behaviour – will determine its trajectory through life, all other things being equal. There is, of course, some degree of malleability of the human mind, and so what was once shaped badly (by relationship experiences) can to some extent be reshaped into a better form by subsequent ‘curative experiences’, with a love partner or with a counsellor or psychotherapist.
Fourth: With regard to the narratives, stories, schemas, scripts and frames that the individual learns and/or creates: these are, as Bruner said, enactive (or experiences of doing), iconic (or experiences of seeing) and semantic (or language based abstractions and interpretations of events and objects). In cognitive psychology, the development of the child and later adult is mapped through studies of attention, perception, memory, language and thinking; and emotion only gets a brief mention at the end of standard textbooks – as an afterthought. However, in E-CENT, we teach that it is an emotional being that pays attention; it is an emotional being that perceives; it is an emotional beingthat forms memories; it is an emotional being which uses language; it is an emotional being that thinks. And even the most abstract of academic thinking cannot be totally separated from the emotionality of the person engaging in it. In other words, the brain-mind is an emotional brain-mind. Human beings are emotional beings, at their very foundations, and they can also think. They are not ‘cognitive beings’, if by cognitive beings we mean ‘computer like’. Computers do not have emotions. And humans are not computers! (This is why we developed cognitive-emotive therapy, because cognition and emotion cannot ever be separated!) Indeed, we could say that human beings are not thinking beings at all. They are actually perfinking beings: beings who perceive-feel-and-think all in one grasp of the mind. And the feeling component never sleeps! You cannot leave it at the door on your way into school or work.
Fifth: We accept that temperamental differences are detectable in new born babies; that an individual may be born with a tendency towards introversion or extraversion; and that the new born baby may also be more emotionally disturbable, or less emotionally disturbable. We accept that there are fundamental differences (emotionally and behaviourally) between boys and girls. We accept that the innate nature of the baby will influence and impact the mother in how she relates to the baby; and the mother’s personality and character and temperament will also influence and impact the baby. (But in general the mother has more influence than the baby. “Genetic determinism” has been replaced by “epigenetics”, which accepts that genes have to be “switched on” by an environment, and that the genes of identical twins can be changed – as often as not – by placing them in two different home environments). This dialectical cross-influence between mother and baby will eventually settle down into a stable pattern of relating, which will be experienced by the baby (and the mother) as more, or less, satisfactory. Depending upon whether or not the mother can function as a ‘good enough’ mother (in terms of being sensitive, caring, responsive and in good communication with her baby), the child may develop a secure or insecure ‘attachment style’.
Sixth: Throughout the whole of the life of the individual, the external environment will continue to exert an impact on the moods and emotions of the individual. Only the most highly trained and committed Stoic or Zen practitioner could ever come close to ignoring (or being largely unaffected by) their external environment! Indeed, only a rock, or lump of wood, or other inanimate object, ever achieves complete indifference to its environment.
Seventh, (1). E-CENT theory takes into account that we are bodies as well as minds, and so diet, exercise, sleep, relaxation/ medi-tation, relationships, social and economic circumstances, drugs and other physical inputs and stimuli are seen as important factors in determining the emotional state of the individual client. That is to say we have needs!
Seventh, (2). We have physical and emotional needs.
Seventh, (3). For example, we need to be loved, liked and accepted by some significant others. (This need is very strong when we are babies, and it continues to be strong throughout our lives. How-ever, it is not as strong as our need for oxygen or food. If we fail to get oxygen, we will die in seconds; if we feel to get food, we will die within days; and if we fail to (give and) get love, we will wither and die more quickly than those individuals who do learn to give and get love.
Eighth: E-CENT starts from the assumption that we are primarily social animals, and not solitary individuals. We are social to our very roots, especially from the moment of parturition, when we are handed into the arms of our mothers. Everything that happens from that point onwards – and also including the original birth trauma – is significant for the development of the so-called ‘individual’ (who is really an amalgam of significant other ‘individuals’ with whom we are related from birth onwards, and who we ‘internalize’ as ‘models’). In particular, our mothers and fathers are braided into the very foundations of our personality and character.
4. Therapy models used in E-CENT counselling sessions
E-CENT uses a number of different models to structure counselling and therapy sessions. In this section we will take a look at just a few of them.
There is no standard or invariable structure that can be applied to all E-CENT counselling and therapy sessions. There are several core models that guide our counselling process – and they will be reviewed below – but they tend to occur in various, unpredictable patterns, depending upon the client’s narrative.
There are standard principles that guide the thinking of the therapist, but not all of these are activated by any particular client or client-problem: (See Chapter 2). And the E-CENT counsellor is, in any case, guided from non-conscious levels of mind, rather than consciously working out how to respond. So how can we quickly give you an overview of a ‘fairly typical’ process of counselling an individual, as a map of the territory to be explored?
Here is my ‘quick tutorial’ on how to apply E-CENT counselling in practice, drawn from my impressions of thousands of counselling sessions. If I have to try to summarize ‘the process’, here is my best approximation:
Build a relationship with the client, while trying to find out what they want and need.
Get an outline of the client’s story – the ‘confession’ – about the client’s presenting problem.
Help them to explore their story, and to refine it, so it becomes more accurate – more complete; or more digested; more known. For examples, help them to check if their story has been subjected to any deletions, distortions or over-generalizations. Help them to explore their story of origins and their story of relationships.
Help them to see that their stories (including their emotions about events) could be edited (‘re-framed’)[8] so that they are less disturbing, less wounding, and more tolerable than they originally seemed.
Teach the client that the quality of the story that they live inside of is strongly and unavoidably affected by their diet[9], physical exercise regime, relaxation processes, relationship support (adequate or inadequate) and social connections (good and/or bad)[10], etc.; as well as their inner-dialogue (or self-talk; mainly at non-conscious levels of mind).
Teach the client:
(a) To dedicate themselves to reality at all cost![11] (Even though it is hard for a human to know what is ‘real’, because we automatically interpret every event/object on the basis of our prior, cumulative, interpretive, cultural experience.)
(b) To accept the things they cannot change, and only try to change the things they can. (Even though it is actually very difficult to find out what might be controllable!)
(c) To live a moral life (on the basis that “You cannot live The Good Life unless you are willing to live A Good [Moral] Life!”). This involves growing their Good Wolf side (or virtuous side), and shrinking (starving) their Bad Wolf side (or the vicious, evil side of their character).
(d) To keep their expectations in line with reality. (Even though it is difficult to identify what is actually ‘real’!)
(e) To understand their emotions, and also how to manage them. (See Chapter 5, above, on human emotion).
(f) To grow their Adult ego state, and to shrink their inappropriate Controlling Parent, Critical Parent, and Adapted/Rebellious Child ego states.
(g) To restrain their tendencies towards passivity or aggression, and to mainly try to engage in assertive communication with others.
(h) To love some significant individuals; and offer love as a way to get love.
(i) To take responsibility for their life. Nobody is coming on a white charger (or in shining armour) to rescue them. If it’s to be, it’s up to them!
(j) To commit themselves to personal and professional development; and, if they are up for it, some form of spiritual development.
Most of the models and processes which went into forming the theoretical foundations of E-CENT counselling come from one or more of the ten systems of therapy which were evaluated by Smith and Glass (1977), and found to be not only effective, but fairly equally effective![12] So we do not feel any need to waste resources funding a Randomized Control Trial to ‘prove’ the efficacy of E-CENT. (West and Byrne, 2009[13]).
(The main types of therapy validated by Smith and Glass (1977, 1982)[14], and also by later studies[15], and used in E-CENT counselling, are: Transactional analysis; Rational emotive therapy; Psychodynamic approaches; Gestalt therapy; Client-centred; and Systematic desensitization).
The mainexceptions to this rule – that E-CENT has been constructed from validated systems of counselling and therapy (validated by the Common Factors School of research – Smith and Glass [1980]; Wampold and Messer [2001]; and others) – include the use of:
Elements of Attachment theory (which is perhaps the most researched and validated approach to developmental psychology in use today) – See: Wallin (2007); and Bowlby (1988)[16].
Aspects of the most popular approaches to Moral philosophy (including The Golden Rule; Rule utilitarianism; Duty ethics; and Virtue ethics.)[17]
Aspects of Buddhist philosophy, including elements of the Zen perspective on language; and some of the insights of the Dhammapada.[18]
The Narrative approach to counselling and therapy, which has become increasingly popular, mainly as a result of the work of White and Epston; and Kenneth Gergen; plus Theodore Sarbin[19]
Most systems of counselling and therapy have a characteristic ‘session structure’ to which trainee counsellors are expected to conform, and this seems to carry on into full professional practice for many systems (including Rational Emotive Behaviour Therapy)[20]. And the publishing industry has tended to accentuate this requirement: that a system of therapy must have a beginning, a middle and an end phase, which are distinct and clearly specifiable, with common tasks for each phase. (See in particular the Sage Publications’ ‘Counselling in Action’ series).
However, as stated above, E-CENT counselling does not have a predetermined or predictable session structure. On the other hand, it may be necessary to imagine a ‘typical’ (though not invariable) structure, in order to teach some of the standard models and processes that we commonly use. For example, in this chapter, it might help to explore the models and processes of E-CENT counselling by using the standard Jungian therapy session structure. The Jungian approach has the following four stages: (1) Confession; (2) Elucidation; (3) Education; and (4) Transformation.
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6.(1): Confession
The main model that we use to open the ‘confession’ stage is our own version of the Rapport > Contract > Focus > Process model, as shown in figure 6.1.
Figure 6.1: The Rapport> Contract> Focus> Process model (RCFP)
It is particularly appropriate that we use the concept of confession here, because the creator of E-CENT was raised as a Catholic, and went to confession on an almost weekly basis, up to the age of eighteen years; and even now, sometimes – with some clients – is prone to ask (humorously): “How long is it since our last confession?” However, it is also important to note that E-CENT has a secular approach to spirituality; and a link to Buddhism and Stoicism, rather than any brand of Christianity.
Confessions we do hear, but we do not begin our counselling and therapy work by asking the client to confess, or even to open up. We actually begin with a very gentle process, based on our Rapport> Contract> Focus> Process (RCFP) model.
This model determines and structures how we meet and greet our clients, and how we work slowly towards a therapy focus; and thereafter we (spontaneously, intuitively) select additional models to guide the processing (P) of the client’s communications.
The RCFP model is structured as follows:
R = Rapport. Build rapport[21] with the client as a basis for a strong therapeutic alliance. (This is increasingly seen as our role of providing a ‘secure base’, as defined in Attachment theory. [See Wallin, 2007, and Bowlby, 1988]). It also includes the core conditions of genuineness, empathy and non-possessive love/caring[22]).
C = Contract. Find out what the client wants to work on, as a contractual undertaking. But bear in mind that this might be the first of more than one ‘presenting problem’, before the client feels secure enough to reveal the ‘real’ problem. (To ‘confess’, or ‘own up’ – or to arrive at some new stage of conscious awareness of some previously hidden aspect of their problem).
F = Focus. Focus in on an area of work that will assist in the pursuit of the client’s goals, as implied by the contract (C).
P = Process. Process the client’s communications and concerns about this ‘area of work’ through one (at a time) of the various models available, which are discussed below.
(This RCFP model was inspired by a similar model developed by Dr Ed Jacobs, in his system of Impact Therapy)[23].
~~~
Some of the unsolicited client testimonials, which we often receive, testify to the importance of our emphasis on building rapport. Here are two recent examples:
♣ “Hello Jim, I am so grateful to you for all the skilful help you’ve given me over the two years that I’ve been seeing you. You have given me a new kind of life; new ways of relating; and an improved view of myself as a person in the world. Thank you so much.”
P.A.G., Crag Vale, Calderdale. (20+ sessions of face to face counselling for a range of attachment, relationship and self-esteem issues).
♣ “Dear Jim, I want to express my gratitude for the help you gave me over the past few weeks. I was in a bad way, lost, and not understood elsewhere – but you understood me, believed in me, and helped me to work out a better understanding of my condition. You were right to focus on my diet and lack of physical fitness, rather than the psychiatric emphasis on my ‘brain chemicals’! I am now back on my feet, and back in my university studying. (In fact, I did a resit exam last week, and got a ‘grade A’ pass.) Thank you for your excellent diagnostic and humanitarian skills.”
H.H.G., Bradford. (Six sessions of face to face counselling for unusual physical sensations and panic about personal identity difficulties).
Questioning strategies: From the beginning of the counsellor’s relationship with each client, and especially as rapport is achieved, there is a need for effective, systematic questioning. Effective, systematic questioning has a number of features:
In the opening encounters with a new client, we normally offer an invitation to speak, rather than a tightly focused question. We are trying to establish a relationship, tentatively, carefully. We want to hear from the client, in their own words, and in their usual way of conversing.
We then explain that we want to arrive at a contract which will involve us (the counsellors) working on the client’s key issues. Of course, we also know that they may begin with a ‘presenting problem’ which is not their main concern. We may have to wait some time before they feel safe enough to present the real issue.
~~~
In the confession stage, we are still mainly dealing with the client’s presenting problem, which may not go deep enough in terms of understanding what it really causing the client’s main difficulties in life.
When thwarted goals seems to be a significant part of the problem, we might use the WDEP model. From Dr William Glasser’s ‘Reality therapy’, this model asks:
W = What do you Want?
D = What are you Doing to get what you want?
E = How well is this going (the Evaluation stage)? And:
P = Let’s re-Plan, or produce an explicit Plan linked to what you Want.
~~~
If there is a tension between what the client wants and what they are doing, we are immediately into the elucidation stage; helping the client to change either what they want, or what they are doing, so they both line up.
If there is no tension between what the client wants and what they are doing, we often switch to the Egan Model
The Egan model: This is a more detailed exploration of the client’s goals and resources for making progress. In its simplest form it includes asking the client the following three questions:
Where are you now (in your inner and outer life)? Or what is the problem with which you are stuck?
Where are you trying to get to? Or what would need to change for the problem to be resolved?
What (new or revised) action could you take to get from 1 to 2? Or how could you begin to build a bridge towards your goal?
~~~
This process often gives us a ‘focus area’ to begin to work upon.
~~~
During the confession stage, some clients have admitted to serious wrong-doing, such as being unfaithful to their partner, or stealing family assets. At this point we switch from confession to education, and begin to teach the importance of pursuing a virtuous life, and avoiding vice, because of the inevitable outcome of ‘bad karma’[24]. We tend to reap what we sow, and we cannot have a happy life if we live in an unprincipled manner. We teach the Golden Rule[25], and often recommend reading of the Dhammapada (which outlines basic Buddhist teachings)[26].
~~~
One of the main models used during the education stage is our Six Windows Model.Plus:
– the Event-Framing-Response model;
– the APET model – (Activating event > Pattern matching > Emotional response > Thought) – from the Human Givens school;
– the Parent-Adult-Child model from Transactional Analysis;
7. Therapist style: All of those models are taught and applied in a way that promotes a secure base for the client, and promotes both attachment to, and autonomy from, the counsellor/therapist. That is to say, we work from an attitude of loving kindness, and sensitivity and caring for the client. We do not normally ask the classic REBT questions (called, incorrectly, ‘Socratic Questioning’). We teach, and we explore. In our explorations, we are guided by all of the theories and models outlined above, and many more. Our questions are designed to ask for information, to give information, to cause the client’s thinking to start up, to cause the client to focus on a particular point, and to bring the client’s thinking to a conclusion.
We believe human communication is very difficult, and so we operate very skilfully with the client, in terms of what we ask and what we say.
And we relate to the client as a feeling being who can also (hopefully) think (to some extent); rather than assuming the client is a fleshy computer.
E-CENT is, ultimately, as appropriate, a form of re-parenting therapy.
~~~
To reference this paper in a publication, please use the following citation:
Byrne, J. (2009/2016) What is Emotive-Cognitive Embodied-Narrative Therapy (E-CENT)? E-CENT Paper No.2(a). Hebden Bridge: The Institute for E-CENT. Available online.
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April 2016/April 2020
Copyright (c) Dr Jim Byrne, 2009-2016, The Institute for E-CENT
[1] Byrne, J. (2009a) Rethinking the psychological models underpinning Rational Emotive Behaviour Therapy (REBT). E-CENT Paper No.1(a). Hebden Bridge: The Institute for E-CENT. Available online.
[2] Byrne, J. (2009b) The ‘Individual’ and its Social Relationships – The E-CENT Perspective. E-CENT Paper No.9. Hebden Bridge: The Institute for E-CENT. Available online.
[3] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum.
[4] Messer, S. and Wampold, B. (2002) Let’s face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice. 9: 21-25.
[5] Byrne, J. (2009x) How to analyse autobiographical narratives in Emotive-Cognitive Embodied-Narrative Therapy. Hebden Bridge: The Institute for E-CENT. Available online.
[6] Byrne, J. (2009b) The ‘Individual’ and its Social Relationships – The E-CENT Perspective. E-CENT Paper No.9. Hebden Bridge: The Institute for E-CENT. Available online
[7] This most often involves the counsellor in modelling Good Parent and/or Good Adult behaviours and attitudes for the client to learn and internalize, so they can control their appetites.
[8] See Chapter 3 – ‘Shaping our narratives’ – in Wilson, T.D. (2011) Redirect: The Surprising New Science of Psychological Change. London: Allen Lane/Penguin.
[13] West, W., and Byrne, J., (2009) ‘Some ethical concerns about counselling research’: Counselling Psychology Quarterly, 22(3) 309-318.
[14] Smith, M.L. and Glass, G.V. (1977) Meta-analysis of psychotherapy outcomes studies. American Psychologists, 32, 752-760.
Smith, M., Glass, G. and Miller, T. (1980) The Benefits of Psychotherapy. Baltimore, Maryland: The Johns Hopkins University Press.
[15] Wampold, B.E. (2001) The Great Psychotherapy Debate: Model, methods, and findings. Mahwah, NJ: Lawrence Erlbaum.
Wampold, B.E., Ahn, H., and Coleman, H.K.L. (2001) Medical model as metaphor: Old habits die hard. Journal of Counselling Psychology, 48, 268-273.
[16] Bowlby, J. (1988/2005) A Secure Base. London: Routledge Classics.
[17] Beauchamp, T.L. and Childress, J.F. (1994) Principles of Biomedical Ethics. Fourth edition. New York. Oxford University Press. And:
Bond, T. (2000) Standards and Ethics for Counselling in Action. Second edition. London: Sage.
[18] Watts, A. (1962/1990) The Way of Zen. London: Arkana/Penguin. And:
The Dhammapada (1973/2015) Taken from Juan Mascaró’s translation and edition, first published in 1973. London: Penguin Books (Little Black Classics No.80)
Sarbin, T. R. (1989). Emotions as narrative emplotments. In M. J. Packer & R. B. Addison (eds.) Entering the circle: Hermeneutic investigations in psychology (pp. 185-201). Albany, NY: State University of New York Press. And:
Sarbin, T. R. (2001). Embodiment and the narrative structure of emotional life. Narrative Inquiry, 11, 217-225.
Gergen, K. (1985) The social constructionist movement in modern psychology. American Psychologist, 40: 266-275. And:
Gergen, K. J. (1994). Toward Transformation in Social Knowledge. London: Sage Publications. And:
Gergen, K.J. and Gergen, M.M. (1986) Narrative form and the construction of psychological science. In T.R. Sarbin (ed), Narrative Psychology: the storied nature of human conduct. New York: Praeger. And:
Chapter 4 – ‘What’s the story’ – in Philippa Perry (2012) How to Stay Sane. London: Macmillan.
[20] In the Master Therapist Series of video tapes produced by the Albert Ellis Institute, each of the ‘master therapists’ used the A-B-C-D-E model as the invariable structure of their sessions.
[21] Definition of rapport = “A close and harmonious relationship, in which the counsellor and client understand each other’s words, attitudes, feelings or ideas, and communicate well with each other”.
[22] Nelson-Jones, R. (2001) Theory and Practice of Counselling and Therapy. Third edition. London: Continuum.
[24] We use a secular definition of ‘karma’ as meaning the results of all of our actions in the real world of this (the only) life we have lived so far (or the only life we can know about!) This combines both earned merit/demerit, plus accidents of being in the right or wrong place at a particular point in time. “Your karma is what happens to you. You don’t have to be very wise about that!” Werner Erhard.
[25] The Golden Rule, which goes back to ancient China, and is preserved in both Catholic dogma and in the thinking of Immanuel Kant, goes like this: Do not do unto others what you would not want them to do to you in similar circumstances. Or: Treat other people in ways that you would like to be treated.
[26]The Dhammapada (1973/2015) Taken from Juan Mascaró’s translation and edition, first published in 1973. London: Penguin Books (Little Black Classics No.80)
What is Emotive-Cognitive Embodied-Narrative Therapy (E-CENT)?
In this 22 page paper, the author describes the nature of Emotive-Cognitive Embodied-Narrative Therapy (E-CENT). He introduces some of the E-CENT models of the human mind; outlines the foundations of the basic theory of E-CENT counselling, by summarizing eight of the nineteen key features, or principles, which characterize this integrative system; lists a small number of the main models that are used to structure E-CENT counselling sessions; and ends by describing the E-CENT therapist’s style.
By Dr Jim Byrne.
(The main types of therapy validated by Smith and Glass (1977, 1982)[14], and also by later studies[15], and used in E-CENT counselling, are: Transactional analysis; Rational emotive therapy; Psychodynamic approaches; Gestalt therapy; Client-centred; and Systematic desensitization).
C = Contract. Find out what the client wants to work on, as a contractual undertaking. But bear in mind that this might be the first of more than one ‘presenting problem’, before the client feels secure enough to reveal the ‘real’ problem. (To ‘confess’, or ‘own up’ – or to arrive at some new stage of conscious awareness of some previously hidden aspect of their problem).
Questioning strategies: From the beginning of the counsellor’s relationship with each client, and especially as rapport is achieved, there is a need for effective, systematic questioning. Effective, systematic questioning has a number of features:
To learn more about the general theory of E-CENT counselling,
The Institute for Emotive-Cognitive Embodied Narrative Therapy (E-CENT) 