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When life shifts without warning: finding your way through unwanted transitions

After many years of hard work, when life was finally falling into place, does it feel like everything is suddenly changing? That you’re blinking into a life transition you neither asked for nor saw coming?

In this article we’ll be discussing life transitions: how they can challenge us at a deep and even existential level, how our natural response can be to resist at all costs, the opportunities this process offers that we don’t necessarily see, and how we might better navigate this process.

The shock of change – even when expected

Many of life’s transitions are a common and known feature of the human experience, whether in middle-age, as we approach retirement or, in fact, at any other time across a lifespan. However, this logical view doesn’t really help us understand how we ourselves experience these seismic shifts.

The lived experience of a transition is often unexpected, if not a shock, arriving when we’re focused on something entirely different. Many of the fundamental building blocks we’ve nurtured and lovingly grown in our lives can suddenly feel threatened: our relationships, our work, our identity, our health. Each transition is different and unique, but at their most extreme they can feel like everything we’ve built is suddenly being washed out to sea – and all we can do is stand on the shore and watch it unravel.

Resisting the tide: why we push back against change

It’s therefore not surprising that these unplanned-for life changes can make us feel giddy and fearful. Instead of enjoying the fruits of all our life’s work, we’re desperately trying to hold onto what hasn’t already been swept away, worried about where it will all end.

The truth is that we’re being confronted with the need to accept that the life we’ve known is now changing course, as if it had a mind of its own. And the future we thought we knew, we now realise we don’t. And as our worries deepen, our daily life can drain of colour. So, it’s not therefore surprising that we throw everything at stopping this uninvited invader; we dig in to resist change at all costs.

And yet, building up high walls to defend ourselves from change doesn’t work either, and will only cause us more pain. We simply can’t stop the transition happening, no more than we can stop the incoming tide. It therefore serves us better to work with and not against transitional change, though this can feel counterintuitive initially.

This isn’t to diminish the difficulty you’re currently experiencing, but the reality is that by engaging with the process you’ll waste less energy fighting it, and you’ll be more likely to benefit from its opportunities. It’s just difficult to see these opportunities when you’re crouched down in your bunker.

As fearsome as the transition might look to you right now, by working with it, it becomes easier to manage and more easily offers up its insights. Such as starting to see what’s really happening to you, seeing past the fears that preoccupy you, understanding yourself in new and deeper ways, and better equipping yourself for what lies ahead.

The role of psychotherapy when life shifts without warning

The aim therefore is to take an active part in navigating this vital transition. By breathing in and stepping into the process it is more likely to open up to you and present its riches. And there will be riches. Yes, there will also be difficulties to deal with, but it is through working with them that they will lessen and dissipate, enabling you to move forwards. This might sound easier said than done but this is where psychotherapy can play a crucial part.

The role of the psychotherapist is to be alongside you through this process, as you start to navigate your way, keeping you steady in choppier waters, and open to receive and make sense of what emerges. In this way, a transition is about learning to engage with where you are now, understand your experience in ways that better
help you, see the options available to you, and decide how you want to proceed.

Therefore, an active engagement with this vital process can enable you to steer your own course as you enter this new chapter in life.

 

To enquire about psychotherapy sessions with Thad Hickman, please contact him here, or to view our full clinical team, please click here.

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman

What is the role of creativity in psychotherapy?

No space to be heard?

Does your life story make sense?

When something has to change

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Why do boundaries matter in psychotherapy groups?

The importance of boundaries in psychotherapy

I think it’s probably fair to say that all models of psychotherapy view boundaries as important. Analytic therapies particularly emphasise the role of boundaries and see them as integral to the psychotherapeutic process.

There are many ways of understanding why boundaries are crucial. When I reflect on my work as a therapist, I particularly think about how boundaries seem to offer containment, safety and consistency. These conditions seem vital for many reasons, not least because many people who enter therapy have not had them met sufficiently in their childhood.

In one-to-one therapy, it is the therapist who is responsible for holding the boundaries and keeping the work feeling safe and contained. For example, you can reasonably expect that the therapist will be on time to sessions, will aim to give plenty of notice for cancelled sessions (except obviously for emergencies like sickness), will keep the things you share and your identity confidential. It would also be reasonable to expect that the therapist will not be eating food or drinking anything other than water in the session and not be under the influence of drugs or alcohol. Most models disapprove of therapists making any physical contact with you – so no hugging or touching. And of course, essentially, the therapist must not confuse or abuse the relationship by becoming, or trying to become, something else, for example a sexual or romantic partner, friend, confidante or fellow patient.

Not only do boundaries offer a particular containment to the therapeutic work, how a patient might respond to them will also provide information and insights. This can prove useful for helping to understand ways in which they might struggle in the present or how boundaries (or perhaps lack of) were experienced as a child. Sometimes when people challenge boundaries in therapy, they are really trying to check that they will hold.

While therapists will regularly find boundaries pushed in individual work, overall, those who have had sufficient training and are working ethically, and in a patient-centred way, are generally able to keep the boundaries intact and the work secure and contained.

Boundaries in psychotherapy groups

In a group, keeping the therapy and members feeling contained becomes more complicated and the role of holding the boundaries can’t just reside with the therapist.

Before joining a group, potential members are asked to consider and commit to maintaining the group’s therapeutic boundaries. These are pretty much the same as those outlined earlier. In addition, keeping relationships safe and protected is helped by an explicit boundary of not having contact outside. Sometimes this isn’t possible for various reasons. In this situation, members need support and help from the group and therapist to maintain enough personal distance outside the group so they can keep themselves and the group feeling safe.

These boundaries are not rules for group members (there are no consequences to breaking them – within reason at least), but it is understandable that they can feel like it. Some of these boundaries are more obvious and easier to adhere to than others. For example, I have rarely experienced a group member under the influence of alcohol or drugs during a session and my experience is members are also very respectful of the need to protect each other’s confidentiality.

Where the boundaries become harder to maintain is more likely to be around repeated cancellations or lateness, or leaving the group without the required notice period. Also drinking coffee, tea or juice in the session, as opposed to just water, is in my experience not an uncommon boundary flouting. It’s harder perhaps to register the importance of these kinds of boundaries being held and to see why it matters. It can feel difficult for group members to question when they are being pushed by someone in the group. It’s easy perhaps to feel that they are making a fuss or doing something that is really the therapist’s ‘job’.

Because in group therapy there is more than one patient, there are multiple possibilities of boundary reactions and breaches, sometimes simultaneously. The group can feel the unsteadiness this creates at times. The therapist and the group members need to hold firm to help the group feel safe enough. The best way to do this is to name and talk about those times when members might test or push at the boundaries and explore the impact on the group, as well as the meaning for the individuals.

The aim, however, is not for members to never push boundaries (although it is a reality that some group members feel less compelled to than others). A group situation with no boundary challenges is unrealistic and, given what can be learned, not necessarily always helpful.

The theory underlying group analysis sees problems as belonging to the group, not just located in the individual member, and so anyone shaking the group boundary will be viewed as not just acting something out on their own behalf but also – more unconsciously – on behalf of the group. The culture of the group analytic therapy group, which includes being curious, means there is rich and therapeutic potential in thinking about the meaning of a boundary push on several levels – what it means for the individual, for the other group members and for the group as a whole.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.  She also offers couples therapy at BHP.

 

Further reading by Claire Barnes –

What is transference and why is it important?

What happens in groups: free-floating discussion

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

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Can AI offer therapy?

There is currently a great deal of noise and speculation about whether artificial intelligence (AI) can provide therapy. There are strong advocates on both sides of the argument, and evidence would suggest that, at least to some degree, AI can provide what some describe as ‘therapy’.

The NHS, in part driven by its chronic funding crisis, is using ‘chatbots’—a form of AI—to interact with patients. In principle, there seems to be no immediate harm in this, provided that data from patient interactions with chatbots remains wholly anonymous.

It also appears that some individuals find AI chatbots helpful in the context of their mental health. I am not in a position to dispute this. If such interactions offer some benefit, then—again in principle—I see no objection.

However, I believe that focusing on whether AI can offer therapy is the wrong question. This places undue emphasis on AI as a system, rather than addressing the far more important and nuanced issue of what actually constitutes therapy—more specifically, psychotherapy.

What is therapy?

‘Therapy’ is a nebulous, catch-all term. It describes something believed to be helpful to one’s mental health—a term which itself has, in recent years, been diluted and now often incorporates emotional, and even physical, wellbeing.

When members of the public describe something or someone as ‘therapeutic’, or beneficial to their mental health, they are usually speaking subjectively—referring to something that helps them feel better, whether temporarily or over the longer-term.

We all benefit from activities and relationships that support, calm, or stimulate us — depending on the context. This is a reflection of both individuality and temperament. Examples might include cold-water swimming, yoga, reading, eating nutritious food, or indeed seeing a psychotherapist. These may all be helpful, but they are not interchangeable. They are not all ‘therapy’, in the clinical sense of the term.

What is psychotherapy?

I have written extensively on this subject, but to summarise:

Psychotherapy, like counselling, emerged from the tradition of psychoanalysis. While counselling and psychotherapy may look similar on the surface—two people talking in a room—the depth, training, and  psychological work involved are fundamentally different.

In the UK, psychotherapy training typically takes 4–5 years at postgraduate level. It includes intensive assessment, a psychiatric placement, an ongoing personal therapy requirement, and at least 450 hours of supervised clinical practice. Counselling training is significantly shorter and less rigorous in all aspects.

UKCP and BPC-registered psychotherapists are trained to work at depth and to formulate—psychological diagnosis — based on the patient’s inner world and relational patterns. Counsellors are not trained to formulate.

Psychotherapy is an intimate and sustained relational process in which the clinician uses their mind and emotional presence to understand the patient’s unconscious processes.

The aim is to work through relational disturbances—most often rooted in early development—and to support the patient in grieving and integrating these experiences.

Psychotherapy helps patients disentangle themselves from the repeating patterns of their past so that they may live more freely and authentically in the present.

One could argue that psychotherapy involves a process of “re-parenting” the unconscious—a concept encapsulated in Freud’s idea of therapy being a “cure through love”.

Why can therapy only be provided by a human?

At its very core, psychotherapy is a human-to-human experience. It is a living, breathing relationship between two people—one of whom offers their presence, mind, and emotional attunement in service of the other.

We connect in relationships through a complex process that involves both our cognitive and emotional faculties.

What is a mind?

In psychotherapy, the mind refers not to the brain as an anatomical structure, but to the capacity to make sense of one’s own thoughts and feelings — and, crucially, to hold and make sense of another’s experience. The mind is what allows us to reflect, to empathise, and to regulate emotion.

What is an emotion?

An emotion is a physiological response to internal or external stimuli. It seeks to be communicated, first to ourselves, then to others. When we label our emotions using language, we call them feelings. Emotions originate in the body and without a body, there can be no emotional experience.

Why AI can never offer psychotherapy?

Psychotherapy can only occur between two (or more) human beings. It requires the full, embodied experience of another person in order to take place. The therapist must bring their humanness to the process—not only their intellect, but their feelings, their capacity to be impacted, and their ability to remain separate, yet deeply connected.

AI does not possess a mind. It simulates a mind.

AI does not feel emotion. It mimics emotional understanding.

AI is not embodied. It cannot reflect or hold another’s experience because it has no experience of its own, as it has no body.

If AI could truly offer psychotherapy, then AI could also raise children. The implication is chilling: we would, in effect, lose the essence of what it means to be human.

Can AI be helpful to mental health?

As I stated earlier, AI may well have a role to play in the broader realm of mental health—particularly as defined in its current, diluted cultural form. I meditate daily and do so for emotional and physiological benefit. Meditation may well quieten the mind, but it cannot grow one. Meditation is therefore not psychotherapy but may be a useful adjunct.

Minds are only grown in human-to-human relationships

This begins in-utero and throughout infancy—in the mother-infant dyad—where the child’s mind is shaped through emotional connection with a caregiving other. When that process is disrupted or fails, psychotherapy is the only viable path to develop a reflective, relational mind in adulthood. It is, in that way, profoundly unique.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further reading by Mark Vahrmeyer

Why staying in your chair is the key to being a good psychotherapist

What do dreams mean?

Is starting psychotherapy a good New Year’s resolution?

Twixtmas – surviving that dreaded time between Christmas and New Year

How to minimise Christmas stress if you are hosting

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Interdependence: between independence and dependence

Why interdependence is a healthy middle ground for mental and emotional wellness

How often do you hear people encouraging others to be ‘independent’ and ‘self-reliant’? Maybe you’ve even been that person trying to motivate someone to ‘stand on your own two feet’ and ‘try not to lean on others’.

Sentiments like this might be expressed when there seems to be an extreme level of dependence. Looking to others to always meet our needs can be familiar and comfortable, but it can also prevent personal growth and foster feelings of inadequacy. Even if we have legitimate needs that require us to depend on others, being informed and making your own choices can greatly enhance the experience of relying on other people.

On the opposite end of the spectrum is the concept of independence. The Cambridge dictionary defines it as ‘the ability to live your life without being helped or influenced by other people.’ While the idea of not needing others can be appealing, especially when trust has been broken or past relationships have let us down, excessive independence can lead to isolation, stress, and burnout. Though we all benefit from achieving success on our own at times, we may start to feel alone if we neglect to build and maintain healthy relationships.

Finding a balance between dependence and independence can be challenging, but the concept of interdependence offers a healthy middle ground.

Interdependence: no man is an island

We know, from both observation and scientific research, that no living thing on Earth can exist in complete isolation. Bees need flowers for pollen, plants rely on bees for pollination, soil requires plants for microbial health, and plants need soil for nutrients… and so on.

Interdependence describes a balanced, healthy reliance on others without total dependence and with give and take. It allows for stepping away and coming back together with trust and mutual respect. The 17th-century poet John Donne famously said, ‘No man is an island entire of itself; every man is a piece of the continent, a part of the main.’ His words emphasise the significance of our connection to others and the world around us.

The psychiatrist Donald Winnicott echoed this in his work with parents and infants, stating, ‘There is no such thing as an infant, meaning, of course, that whenever one finds an infant, one finds maternal care, and without maternal care there would be no infant.’ Winnicott highlighted the ideal bond between mother and child, suggesting that they cannot conceptually exist without each other. He believed this connection shapes the future relational experiences of the infant.

John Bowlby, the psychiatrist who pioneered attachment theory, also spoke to this, explaining that early relationships teach us how to form secure bonds later in life. A ‘secure base’ in relationships enables us to explore the world safely, with a stable place to return to when things become difficult, or we need rest and connection. This can be harder to develop in adulthood if it was not established in childhood.

Despite what can seem to be an emphasis on independence in our society, many social care and mental health services recognise the importance of relationships and connection in healing trauma and fostering fulfilling lives. One example of this in relation to interdependence is in therapeutic communities, designed for individuals often living with emotional distress and severe mental health challenges. These communities emphasise relational treatment, and the repair of early relational trauma through the experience of being with, doing with and, often, living with others. This, sometimes complex and difficult therapeutic process, creates space for belonging, connection and hope as members navigate conflict and care for one another through careful boundary setting and reflection. It offers an opportunity to relearn the value of healthy, supportive relationships.

I’ve witnessed first hand, in my work, how people can transform when they move from an isolated, independent, or dependent state to one of interdependence. Through this shift, individuals learn to establish and maintain boundaries, while fostering mutually supportive relationships and a sense of belonging. This approach can also be applied to social groups, workplaces, and families. Workplaces can even cultivate a resilient and secure workforce by nurturing a culture of interdependence.

Reflecting on your own relationship with independence and dependence

It can be helpful to reflect on your own patterns of independence and dependence by considering these questions:

  • Do you allow others to help you, and can you ask for help?
  • Do you prioritise helping others over helping yourself?
  • How do you cope when others are not around?
  • How could you cultivate more interdependent relationships in your life?
  • What do you offer others, and what do you truly need from them?

The answers to these questions may surprise you. You might find that some of your behaviours are rooted in deeper beliefs you have or experiences from the past. You might also identify areas where you want to make changes. If these questions stir up feelings of uncertainty or discomfort, it could be helpful to explore them further, whether on your own or, in the spirit of interdependence, with the support of others, to better understand and navigate these challenges.

 

Kirsty Toal is an experienced psychotherapist with a decade spent offering therapy, training and clinical supervision in a variety of settings. Kirsty offers short- and long-term psychodynamic and psychoanalytic psychotherapy to adults, in person in Lewes and online.

 

Further reading by Kirsty Toal

Understanding and managing the ‘green eyed-monster’

To be creative as an adult

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A journey into understanding Non-Violent Resistance

Non-violent resistance (NVR) is a hugely effective, forward-looking and relational approach which helps parents to un pick what is happening in the family, to begin to recognise and disrupt entrenched patterns of interaction and to break down the barriers which stand in the way of change. In so doing, parents, who might start the work feeling lost and depleted, powerless and helpless against destructive dynamics which threaten the stability of their family, are able to regain their parental strength. The approach focuses on supporting parents to develop narratives and impactful methods of resistance, and to align themselves alongside their child while encouraging them to get back in touch with their own boundaries, wants, needs and wishes – alongside recognising those of their children.

Fundamental principles within the approach of ‘presence’, ‘resistance’ and ‘community support’, provide an over-arching structure, which enables the exploration of the complexities of behaviours such as violence, aggression, control and coercion which challenge family systems.

Below is an extract of a reflective summary provided by a mother to a fifteen-year-old son, J, who frequently displayed significant violence towards his parents and siblings. J was diagnosed with ADHD at age twelve. The parents completed a short-term intervention of NVR support. Her summary highlights some of the reticence experienced by parents in considering starting to work with NVR, and of the challenges encountered along the way:

“As you know I was sceptical to say the least when a friend recommended my husband and I start a program of NVR. In fact, I was actually pretty annoyed, as if silently and subtly they were suggesting that our parenting wasn’t somehow good enough. Despite this though I did reach out, maybe because things were feeling so unbelievably broken and I felt like I had tried so much that just wasn’t working. I felt really anxious about coming to the first session and even started typing an email to cancel but my husband was determined we had to give it a go. I tried to read up a bit about the approach before we came in. In my mind though I think really I was getting ready to defend myself and to assure myself, my husband, my friend (and you) that we really didn’t need to do this work, that it was J who needed to see someone, not us, whilst at the same time also feeling desperate that my friend was right and that this could actually help.

What I liked instantly about the work was that you challenged us to look forwards. We’d been stuck as a family for a very long time, and I was feeling exhausted, angry, devastated, hopeless, helpless – completely lost. I think we look back on that time as very dark days and so it feels great to be writing this from a place which honestly feels so much lighter, brighter and optimistic – all things actually that I think we agreed when we first started talking about what we were striving for.

I remember feeling from that initial consultation ‘wow someone actually gets this’ because the way you summarised things from your experiences with other families really resonated with me. You asked in the first session what I was striving for, and I liked that some of this focus was framed about me – as just me – as well as around me as Mum to J, me as part of a couple with my husband, me as Mum to my other children and for us as a family, and likewise for my husband. In just that first session we began to recognise that because of all the awful behaviour that J was showing at home we were living in a state of chaos and panic. We had neglected our care of ourselves and lost each other as a couple – and I could see that its hardly a surprise that it was so hard to resist the violence when we were feeling so lost and so broken ourselves. I liked the way we explored what we want things to be like.

Just allowing ourselves to imagine a different future helped to begin to move us out of the hopelessness. We reflected on what family life had become for us and we considered some of the things that stopped things moving forwards. It’s lucky we always had a box of tissues in the room because I remember doing a lot of crying in some of those first weeks – and I remember joking with you mid-way through the work that the fact I wasn’t in tears was a good sign of the progress we were making! There seemed somehow a real simplicity in breaking down our experiences and exploring the NVR themes within the sessions. We had a structure around us, that we were able to take away and begin to test out at home. As we began to move deeper into the work together and explore all the different principles within NVR, I could feel it really starting to bed into my thinking and it started to come more naturally to me at home. At first, I remember it feeling quite clunky, and some of it even jarring as it turned some of what we’d been doing on its head, as part of what you described as disrupting the status quo. I liked that we could lean back on the idea that those elements were where we could get our power back as parents and to really begin to get things back on track for our family.

We reflected a lot on the community around our family and I can definitely say at this point I am so thankful to my friend for suggesting this approach. She has been absolutely alongside us, and J, and because she didn’t stay as a quiet bystander to our struggles we are now in an unrecognisable place as a family. Finding the courage to open up our world and let other people in was by far one of the hardest elements of the approach – we had worked so hard to batten down the hatches, to stay compliant to the secrecy and to shield ourselves, J and others from people knowing how bad things were, that the idea of reaching out to others for help felt really scary for lots of different reasons – but this was impactful in so many different ways.

It has definitely been a journey – and we are very aware we have to keep working at the relationship, but it feels easier, and J gives back in so many different ways now that it all just feels very different from where we started. J is now back in college and smokes a lot less weed. We were belly-laughing together last week about something silly, and he even told me about his new girlfriend yesterday. It feels so special to be allowed in… and as you know the violence has stopped. We see J working really hard to control his behaviour – obviously he still gets very cross at times, but it feels like we’re all invested in doing what we can to resolve conflict in new ways together.”

NVR is an approach which can lead to transformation and enduring change within families.

With its focus on relational balance and principles of resistance it is a suitable approach for supporting families with children of all ages. In my practice I have worked with parents of toddlers, young children, teens and adolescents right through to parents of adult children who may not even live in the same home any longer. It is an individualised approach, centred around the needs of all the individuals within the family, recognising it cannot be a one-size-fits-all approach. As such the approach is effective for supporting children and/or parents with neurodivergence.

 

Georgie Leake is an NVR UK accredited advanced level NVR practitioner and holds a BSc (Hons) in Psychology, a Master of Education (Special Needs and Inclusive Education), a Master of Arts in Social Sciences and QTLS. Georgie is available at our Brighton & Hove Practice, Lewes Practice and Online.

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How do I stop overthinking?

This is a question that I am often asked. Everyone overthinks sometimes however for some people this can feel like a constant. Some people worry a lot about what others think of them, they can rehash conversations they’ve had, worry about what they’ve said and if they should have said this or that or whether they may have upset someone. Some people overthink making decisions and this can lead to immobilisation. Others think about worse case scenarios that could potentially happen.

This type of thinking is often accompanied with distressing images of possible disasters. Either way overthinking can be all consuming and have a significant impact on mood. Overthinking tends to fall into two categories, either rumination about the past or worry about the future. If we are ruminating on past, we are replaying situations or events in our mind or questioning decisions that we have made. Rumination is often linked to low mood and low self-esteem. Persistent worry thoughts involve negative predictions about the future, usually catastrophic, and often linked to anxiety.

Rumination and worrying can be seen as unhelpful behaviours. This is when we don’t consider the content, we try to change the behaviour. The content of the rumination and worry are the unhelpful thoughts and to work with these we use thought challenging. Ideally, we need to challenge both behaviours and thoughts to make a change. This is what CBT aims to do. Both worrying and ruminating can become habitual and so you don’t always recognise when you are doing it until you are well into a cycle. Increasing awareness is the first step. Really notice when you are getting into a worry or ruminative cycle. By increasing awareness, you can make an intervention to change sooner. Start to really try and notice when you are getting into these cycles. Usually there will be a shift in mood, either worry and anxiety or feeling low and depressed.

When you notice that you are ruminating or worrying, remind yourself that this is not productive, thinking in this way is only helpful if it leads to a positive action. Is what you are worrying about an actual problem or a hypothetical one? If it’s hypothetical or one that you have no control over, then a strategy that can be helpful is to really try and shift your focus of attention to something else and engage in the present. This might be doing something physical, such as gardening or exercise, or engaging in conversation, or doing an activity that you find really absorbing such as baking, creative arts, a word puzzle or Sudoku. It’s normal for your thoughts to try and hook you back in. Just notice that this is what is happening, don’t engage with the thought, let it go. Focus on the activity that you are doing, notice what’s going on in the here and now. It might help to think about what you can see, hear, smell, taste. You want to try and be truly present to your external surroundings. The principle of this strategy comes from mindfulness. You are doing something in a mindful way. This strategy can also be used for ruminating on the past. We can’t change the past, so it is not helpful to keep going over it. Often when we are ruminating, we are being self-critical and understandably this is going to negatively impact our mood. We can get stuck in cycles of worrying about the future or ruminating on past. We want to shift our focus of attention to the present and be truly present to the here and now.

It can be helpful to write worry thoughts down, to ‘park’ the worry. Then allocate yourself a limited period of time later in the day to come back to these worries and allow yourself to think about them. This is referred to as ‘worry time’.

If what you are worrying about is an actual problem or something that you do have control over, then you can problem solve. Consider all the possible solutions, pick one that you consider will be the most do-able and helpful, and devise an action plan. Once you have your plan of action decide if you can implement this right now or do you need to schedule it. This is a positive action and productive. Once you have implemented your plan you can let it go and shift your focus of attention.

When getting into lots of negative thoughts it can be helpful to thought challenge. Firstly, it can be useful to consider if you are getting into unhelpful thinking patterns such as mind reading, catastrophising, emotional reasoning, being self-critical, making judgements, black and white thinking, negative mental filter, shoulds and musts. If this is what you are doing, remember thoughts aren’t facts, even if they might feel that they are. Ask yourself, is there any factual evidence to support these thoughts or are they opinions? Would your evidence be permissible in a court of law? (This is the fact/opinion approach). You can also use the STOPP approach. STOPP is an acronym: Stop, Take a breath, Observe, Pull back and put in some perspective, Practise what works. Ask yourself is there another way of looking at this? What would your best friend say to you in this situation? What advice would you give to someone else in this situation? Will it matter in six months’ time? Answering these questions can help you to gain a different perspective, hopefully a more realistic one. Once you have a more realistic perspective you can test this out by doing something different, consider what would be more helpful to you at this time and is it in line with being the person you want to be.

These are different CBT strategies used to manage overthinking. Change is difficult and takes time.

It’s a challenge. As with anything, these strategies will take practice. They may not always work and that’s okay too. Often, we are trying to change a way of being that has been around for a long time, so it is important to try and be gentle with yourself. Remember, you’re not alone, overthinking is something we can all do.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

New Year’s resolutions

Learning to embrace uncomfortable emotions

Should I seek therapy?

How does CBT help with low mood and depression?

How does CBT help with low self esteem?

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Do we need to do homework during psychotherapy?

For many people the word ‘homework’ stirs up rather negative memories of being forced to stay in when the sun was shining, or toiling over the complexities of maths equations rather than enjoying computer gaming or other hobbies.

But in psychotherapy, engaging in relevant tasks connected with mental wellbeing during the week between sessions can be hugely beneficial in consolidating and enhancing the changes involved in the therapeutic process.

One example of this is practising mindfulness. Time spent in reducing bodily tension and the down regulation of mental processes can yield important new insights and reduce levels of anxiety. It takes only a few minutes of session time to learn simple meditation techniques and they can be practised at home on a daily basis.

A second approach is through journaling. But how can writing help us to relax and lessen mental tension and worries?

Neuroscientist and psychotherapist Louis Cozolino, whose book “Why Therapy Works: Using Our Minds to Change Our Brains” (1), brilliantly explains in accessible terms the key elements of psychotherapy, outlines the important role of narrative and writing in improving our mental health.

A key point here is that all of us develop – as a result of our upbringing and life experiences good and bad – an endlessly shifting internal narrative and dialogue about who we are, our strengths and weaknesses and things that have gone right and wrong in our lives. This translates into the daily barrage of thoughts that enter our brains, and can become a key component in neurosis, a kind of internal echo chamber that intensifies our distress.

Cozolino states (2) :

“Putting feelings into words has long served a positive function for many individuals suffering from stress or trauma. Writing about your experiences supports top-down modulation of emotion and bodily responses … Therapists hope to teach their clients that not only can they edit their present story, they can also be authors of new stories. With the aid of self-reflection, we help our clients to become aware of narrative arcs of their life story and then help them understand that alternative story lines are possible. As the writing and editing proceed, new narrative arcs emerge with the possibility of experimenting with more adaptive ways of thinking, feeling and acting.”

In this context, journaling – broadly writing down what has happened to us and why – can be pivotal in both understanding the events in our lives and the possibilities for change. My recommendation to clients in this domain is to buy a simple hardback A4 sized ruled notebook and then to experiment. There are no hard and fast rules other than making the time to make entries on a loosely regular basis.

The benefits cannot be precisely quantified, but in my experience, they include (as well as those already pointed out by Cozolino):

  • The availability of a vent for the expression of pent-up primary negative emotions: fear, anger, disgust and sadness, as well as – more positively – joy.
  • Gradually gaining deeper insight into our internal experiences.
  • Identifying patterns in thoughts, behaviours and emotions, as well as bringing into focus the triggers that contribute to distress, such as bullying or being subjected to another’s anger.
  • Facilitating mood tracking and the safe processing of difficult experiences.
  • Our minds generate endlessly changing thoughts; journaling allows us to check progress over time, noting changes in thoughts, feelings and behaviours.
  • The writing process can continue the work done in the therapy room and allow clients to rehearse and practise the new approaches that are discussed.

Another key point is that journaling can also become relaxing – a way of unwinding – and even fun. The process of articulating and crystallising our thoughts can be challenging but it also brings its rewards. Our internal thoughts are hard to keep track of, but this is an outlet which can also become like a close friend, a place to unload and unwind.

I have personally written a journal for more than thirty years and began doing so when I first experienced therapy following a panic attack at work (in my then job in the media). It was among my then therapist’s first recommendation to me as his client. With the benefit of hindsight, it was a major turning point in my life that enabled me to build both greater self-esteem and a better sense of competence and agency – essentials in the creation of a secure base, the subject of another blog by me available on this site.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Further reading by David Keighley –

The empty chair in therapy

How therapy can help with anger issues

Do you have unrelenting standards?

Why we need a ‘secure base’

 

(1) Louis Cozolino, Why Therapy Works: Using Our Minds to Change Our Brains, W W Norton & Company, 2016

(2) Ibid p.24-5

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Understanding exercise addiction

In a previous blog we discussed the links between exercise and mental health and how exercise can be hugely important for raising and maintaining our mood. In this blog, we will discuss how the healthy habit of exercise can sometimes become addictive, and can actually harm both our physical and mental health.

When healthy habits turn harmful

For most people, exercise is a beneficial part of life. It boosts mood, enhances cardiovascular health, and offers a constructive way to manage stress. However, when the pursuit of fitness becomes obsessive, it can lead to exercise addiction. This condition is characterised by a compulsive need to work out, even in the face of injury, illness, or social isolation. Exercise ceases to be a pleasurable activity and becomes a ritualistic behaviour performed out of anxiety or guilt.

Often, exercise addiction emerges in tandem with body image issues. Many people who develop an unhealthy relationship with exercise are also preoccupied with how their body looks, which can overlap with symptoms of eating disorders. These eating disorders—such as anorexia nervosa, bulimia nervosa, or binge eating disorder—are complex mental health conditions where food intake and self-image become interwoven with one’s emotional state.

The psychological roots of compulsive exercise

At its core, exercise addiction is often about more than just physical fitness. It may represent an attempt to gain control over other areas of life that feel unpredictable or overwhelming. For some, the gym or running track becomes a sanctuary, a place where effort translates directly into visible progress. The immediate gratification of sweating out stress can mask deeper emotional pain or unresolved trauma. Over time, this behaviour can become a maladaptive coping mechanism—a substitute for addressing the underlying issues.

Often people can initially view their commitment to exercise as a form of self-care, only to later recognise that their routines are fuelled by deeper emotional distress. They may feel compelled to maintain rigorous exercise schedules to compensate for feelings of inadequacy or to assert control in an otherwise chaotic world. This psychological dependency can lead to a cycle where the body is pushed beyond its natural limits, resulting in physical injuries, chronic fatigue, or even immune system suppression.

It is also worth pointing out that a highly competitive sports person might also display characteristics of exercise addiction. There often needs to be a level of discipline and obsession in the sports to get to the championship winning level. So, understanding if the level of exercise and the obsession with the sport is healthy or not can be a difficult balance.

Intersecting pathways: exercise addiction and eating disorders

The connection between exercise addiction and eating disorders is profound. Often, the excessive drive to work out is linked with a distorted body image and a harsh inner critic. For instance, those who suffer from anorexia may engage in relentless physical activity as a way to further lose weight, believing that burning more calories will bring them closer to an ideal self-image. Similarly, those with bulimia might use exercise as a means to counterbalance episodes of binge eating. Also, an eating disorder can morph into exercise addiction – so food is no longer restricted, but exercise entirely replaces the need to restrict.

Both exercise addiction and eating disorders share a common trait: the relentless pursuit of perfection. This obsession can trap individuals in a vicious cycle where progress is measured by self-imposed, often unrealistic standards. The result is a continuous loop of reward and punishment, where every workout or meal becomes a test of one’s worth. Recognising this interconnectedness is crucial, as treatment must address both the behavioural components and the underlying emotional triggers.

Paths toward recovery

Recovery from exercise addiction and eating disorders involves a holistic approach. Cognitive behavioural therapy (CBT), mindfulness practices, and support groups can play pivotal roles in helping individuals regain balance. Also, creating a more compassionate relationship with yourself can be a key component in overcoming exercise addiction. This involves challenging the notion that self-worth is solely determined by physical appearance or performance in the gym or sports field.

An important part of the healing journey is understanding that recovery does not mean abandoning exercise altogether. Instead, it’s about reclaiming exercise as a healthy, enjoyable activity rather than an obligatory chore. Professional guidance from both a personal trainer and a psychotherapist can help reframe exercise habits, ensuring that they serve as a tool for wellbeing rather than a source of self-punishment.

While exercise is an essential aspect of a healthy lifestyle, it’s important to remain mindful of its potential to become addictive. When combined with factors like body image issues and eating disorders, the consequences can be both physically and emotionally damaging. Seeking psychotherapy can be an important step forward to acknowledging and tackling exercise addiction.

 

Dr Simon Cassar is an integrative existential therapist, trained in Person-Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available at our Lewes clinic and also works online.

 

Further reading by Dr Simon Cassar –

Can Buddhist thinking help with our emotions?

Exercise and mental health

Are you too sensitive?

Is spirituality an escape from reality?

Sleep and mental health

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How can I manage my emotions better?

This is a common question clients ask therapists.

Sometimes clients describe having mood swings, one minute they are feeling fine and the next are feeling very low, and for others it can be suddenly feeling irritable or angry. Sometimes there is an obvious trigger to the change in mood but often clients report no trigger, just a general feeling of their mood having changed.

Understandably this can feel frustrating as well as being difficult for those around them – clients often say that their mood swings impact on their relationships.

In therapy we might start by looking at the bigger picture. We might ask the client if this is something they have always experienced or is relatively new. It could be that there has been a build-up of stressors or that the client’s work-life balance has become unbalanced, and so as stress has increased it has become more difficult to manage their moods. Often stress can creep up on us. We have an expectation that we can maintain a permanent level of ‘doing’ however this isn’t true. Often people think because they used to do all these things they should be able to keep on doing all these things. We can often compare ourselves to how we used to be and hold an expectation that we should be able to keep going. However, stress can accumulate and over time this can become more difficult to manage. The analogy of the stress bucket is useful here. If you imagine the size of the bucket represents a person’s stress tolerance and this is influenced by personality, genetics, upbringing and experience. The bucket fills up with stressors from home, work, family, finances, illnesses etc. When the bucket is full up it can lead to problems such as low mood, anxiety, fatigue, headaches, sleep disturbance and overwhelm. We need strategies to stop the bucket overflowing.

This is where therapy can help. Together we can explore stress management strategies and talk through the stressors. Often difficult experiences build up and we don’t allow ourselves time to properly process them.

For others it could be that they have always found it difficult to manage their emotions. This could be because they’ve never really learnt to manage difficult emotions and so they struggle with tolerating them. Sometimes unhealthy ways to manage develop such as drinking too much alcohol, comfort eating, sleeping or taking drugs. These are different ways to avoid feeling difficult emotions. However, these only work in the short term, can be difficult to give up and can lead to mental health difficulties such as depression, anxiety and low self-esteem.

Cognitive behavioural therapy (CBT) is an effective treatment in managing emotions. It looks at the interaction between our thoughts, moods, physical symptoms and behaviours. It can be useful to use the basic CBT model to start to breakdown what’s going on when you first notice the shift in emotion/mood. When you first notice that shift in your mood ask yourself what was going through my mind at the time, what were the words my mind was saying (i.e. your internal dialogue); name the moods/emotions that you were feeling at the time (there can be more than one mood); how were you feeling inside of your body, what were the physical sensations; and what is it you were doing or not doing (behaviours). Also try to identify the trigger, what were you reacting to? Was it an event or situation or was it that you started to think about something, and this triggered a shift in your mood. By breaking down your experience in this way we can really look at what is going on. We can start to identify early signs and symptoms that happen when your mood changes. We can look at what might be unhelpful in the way you are thinking that could inadvertently be maintaining the cycle. We can see what you are doing or not doing that also might be contributing to maintaining the cycle.

It can help to write these answers down. The process of recording can help to give us clarity and can be a strategy in its own right. Once we have gathered this information and identified what’s unhelpful, we can start to look at ways to make changes, what might be more helpful.

Noticing your emotions and naming your feelings can be useful, but it’s not always easy to do this if it’s something you’re not used to doing. When we notice physical sensations happening in our body, we can think about why these might be happening. Was it that you were thinking of something that’s happened in the past or worrying about something in the future? Or was it that you were feeling a certain way and started to give a meaning to what you were feeling? How we are thinking impacts on how we feel emotionally and physically. Just as how we are feeling in our mood and in our body will impact on how we think.

When managing our emotions it’s important to be kind to ourselves: to think self compassionately; to treat ourselves how we would treat others; to forgive ourselves when we make mistakes; and not give ourselves a hard time when we don’t achieve everything we would’ve liked to. Be mindful of the way we talk to ourselves. We need to accept our different emotions rather than trying to fight them. It’s okay to feel ‘negative’ emotions, it’s part of being human. Telling ourselves we shouldn’t feel like this, judging ourselves harshly or criticising ourselves doesn’t help. Just as trying to avoid or dismiss the emotion doesn’t help. We need to learn how to self-soothe and reach out to others for support.

CBT helps us learn how to recognise unhelpful thoughts and challenge them, and to identify unhelpful behaviours. If we can make changes in these areas this will have a direct impact on our emotions.

We can all experience difficult emotions at times, it’s normal, just as we can all need a little help in how we manage them.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

New Year’s resolutions

Learning to embrace uncomfortable emotions

Should I seek therapy?

How does CBT help with low mood and depression?

How does CBT help with low self esteem?

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The dynamic maturation model: a new way of understanding how to cope with mental distress and create happier relationships

Psychotherapy was revolutionised in the second half of the last century by the development of attachment theory, the science of human bonding and needs. I wrote about this in my BHP blog ‘Why we need a secure base’. It describes how infants who do not have their primary needs met – for comfort, warmth and love – as they grow up often face emotional discomfort and turmoil when they become adults.

Those in a stable, loving and caring framework as children can enjoy life and deal with its many challenges with equanimity and resilience. The development of attachment science was a huge leap forward in the understanding of human psychology.

Over the past thirty years, Dr Pat Crittenden, a US child psychologist, has added a new and very important dimension to this core framework. It is called the dynamic maturation model (DMM). It shows how our behaviour in adult life is shaped through adaptive responses to early experiences. If the care we are given is deficient by being avoidant of emotions, or conversely, is based on exaggerated emotional responses, then in adult life we have difficulty in coping with perceived danger and stress.

Understanding the DMM can play an important role in creating self-awareness, personal growth, and emotional wellbeing. It is a fruitful way of explaining how we can best process information, manage our emotions and form relationships.

The DMM divides our survival strategies into three broad categories:

  • Type B: balanced/secure. Those who have experienced ‘good enough’ parenting – thus establishing a secure base – are able to integrate emotional and cognitive information in a balanced way. They experience the full array of emotions but can self-regulate and offer empathy to others. As a result, they form stable, caring relationships, and respond flexibly to stress.
  • Type A (avoidant/cognitively biased): As a result of their upbringing, these individuals learn to inhibit the expression of their emotions and place a disproportionate weight on logic to manage their environment. This strategy usually develops in response to caregivers who discourage emotional expression, leading to self-reliance and emotional suppression. They often come across as cold and unfeeling, even though their coping strategy is based on vulnerability.
  • Type C (preoccupied/emotionally exaggerated): These individuals are dominated by their emotions and persistently exaggerate their sense of fear, anger, sadness or disgust (the four primary emotions) to gain attention and reassurance. This makes them appear volatile, difficult to deal with, and unboundaried. Their strategy develops through childhood experiences where caregivers were inconsistent or unpredictable, triggering heightened emotional responses.

By identifying our own dominant strategy, we can begin to understand why we react to stress, relationships and challenges in particular ways.

Understanding relationships through the DMM

The attachment strategies outlined above play a crucial role in how we form and maintain relationships. The DMM explains why some individuals struggle with intimacy, trust, or conflict resolution:

  • Avoidant individuals (type A) may struggle with vulnerability and prefer independence over deep emotional connection.
  • Individuals who are preoccupied and express exaggerated emotional responses (type C) experience anxiety in relationships, fearing abandonment or rejection. This is because the volatility generated by a frequent resort to anger causes heightened friction.
  • Balanced individuals (type B) are more likely to navigate relationships with confidence and adaptability.

By understanding these patterns, individuals can make conscious choices to improve their interpersonal interactions, foster healthier relationships, and address attachment-related insecurities.

The DMM and personal growth

An empowering aspect of the DMM is that it views attachment strategies as dynamic and plastic rather than fixed. Unlike traditional attachment models, which often label people as permanently secure or insecure, the DMM acknowledges that strategies evolve based on life experiences and the exercise of personal agency. This means that personal growth is always possible. For example:

Individuals who recognise their avoidant tendencies (type A) can work on embracing emotions and allowing themselves to be vulnerable. Those with preoccupied/emotionally exaggerated strategies (type B) can practice balancing emotions with logical thinking, reducing emotional tension. Anyone can develop greater flexibility in responding to stress, thereby improving their emotional resilience.

Therapeutic approaches based on the DMM can help individuals adapt their strategies to become more balanced and effective in navigating relationships and challenges.

The DMM in everyday life

Understanding one’s attachment strategy through the DMM has practical benefits in daily life. It can improve:

  • Communication: Recognising one’s own biases in processing information leads to clearer and more effective communication.
  • Emotional regulation: Developing awareness of how emotions influence behaviour facilitates better self-control and stress management.
  • Decision-making: By balancing emotional and logical processing, individuals can make more rational and informed decisions.
  • Conflict resolution: Recognising attachment-driven reactions in conflicts helps people respond rather than react, leading to healthier outcomes.

Overall, the DMM is a powerful tool for generating self-understanding and personal development. By explaining how attachment strategies shape behaviour, emotional processing, and relationships, it provides a framework for individuals to recognise their behavioural patterns and make conscious changes. Unlike traditional attachment theory, the DMM offers a growth-oriented perspective, emphasising that attachment behaviours are adaptive and can evolve over time. By applying the insights of the DMM, individuals can
develop healthier relationships, regulate emotions more effectively, and navigate life with greater resilience and self-awareness.

Further reading: The DMM is described in more detail on Dr Crittenden’s main website The Family Relations Institute 

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Further reading by David Keighley –

The empty chair in therapy

How therapy can help with anger issues

Do you have unrelenting standards?

Why we need a ‘secure base’

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Why staying in your chair is the key to being a good psychotherapist

When working with trainees and supervisees, I frequently refer to the need for a psychotherapist to ‘stay in their chair’. Let me explain.

Psychotherapy is a relationship. It is a very intimate and unique relationship between the clinician and their patient, which is principally about the needs of the patient. This, however, does not mean that the psychotherapist acquiesces to every whim or request a patient may have. On the contrary.

The key to any successful relationship, whether a friendship, a romantic relationship or a parent-child relationship, is that there are clear boundaries. Often, if not always, when a patient comes into therapy it is because they have grown up in an environment where the boundaries were poor, inappropriate or non-existent. In other words, they grew up with relational deficiencies.

Poor boundaries create a psychological and at times physical environment, where there ceases to be a differentiation between self and other. This is often referred to as a merger. Where children grew up with a parent or parents with poor boundaries, the experience can be hugely impactful on their psychological and emotional development and, in attachment language, leads to insecure or disorganised attachment styles. In simple terms, it makes it very difficult for these individuals, once adults, to have healthy boundaries in two-person relationships; they are either at the mercy of the other, or conversely, make everything about themselves and fail to recognise the needs of the other.

As a psychotherapist with fifteen years of experience, I have yet to meet a single patient who crossed my threshold, who did not have issues with relationships and thus had attachment damage. It’s the work.

One of the primary roles of the psychotherapeutic relationship is to have a caring, loving relationship with the patient, that is in their best interests. It therefore is boundaried by definition.

One of the tenets of working as a psychotherapist is that it is always in the best interest of the patient for the clinician to hold the boundaries. Even if the patient pushes against these – and they will. Just as it is a parent’s role to hold the boundary with their child and hold their best interests in mind, since they cannot.

So, now we are coming to the meaning of ‘stay in your chair’ which I mean both literally and figuratively. Put simply it means stay in your role and hold the boundaries, because without boundaries, the psychotherapy ends.

Patients who have not grown up with clear and supportive boundaries will unconsciously try and recreate a familiar dynamic, generally stemming from their childhood, in the psychotherapy. Us clinicians refer to this as transference, which is a form of projection from the patient onto the clinician. The difference between projection and transference is that the role of the psychotherapist is to think about and understand the projection onto them, and within this to recognise the relational blueprint of the patient and whom the psychotherapist represents for the patient. In simple terms, the patient will attempt to ‘play out’ the most influential relational patterns from their childhood with their psychotherapist. And if this is not caught and thought about, then the therapy simply becomes a repeat of the patient’s childhood experience.

Whether a patient attacks or seduces, our role is to stay in our chair – to remain consistent and constant and to hold the boundaries. Patients will invariably ‘act out’, which is to say that they will embody and play out dynamics that are counter-productive to the therapy, but familiar to them. Our role as a clinician is to survive these acting outs and to protect the therapy at all costs, Sadly, the concept of psychotherapy has become increasingly diluted in the UK, in part due to a lack of differentiation between counselling and psychotherapy and a general ‘race to the bottom’ amongst training institutions. The result is that therapists increasingly have no concept of ‘staying in their chair’ and either move towards the patient when seduced into a collusion, or back away and abandon when attacked.

Lastly, this is not to say that as psychotherapists we should accept or ‘put up with’ attacks from patients. On the contrary, the boundaries are there to protect us too, and if a patient verbally attacks and cannot return to think alongside their therapist, then they may simply be unsuitable for the work, which is also a boundaried position to hold.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further reading by Mark Vahrmeyer –

What do dreams mean?

Is starting psychotherapy a good New Year’s resolution?

Twixtmas – surviving that dreaded time between Christmas and New Year

How to minimise Christmas stress if you are hosting

How do you get self esteem?

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Trauma and disconnection

Dissociation is a term used to describe the mental process of ‘getting rid of’ painful or traumatic feelings by banishing them to a ‘nothing’ place within – for good and for bad. The paradox of dissociation is that in the process of such banishment, far from being shut down, traumatic experience can take on a life of its own. Locked away, our painful feelings are not available for processing and cannot be integrated into a coherent narrative of our history. The consequent effect is that from this place these unwanted feelings may cause us trouble, without us necessarily having any idea of where the trouble is coming from.

A small child will learn early how to dissociate in the face of overwhelming traumatic experience, as a means by which to survive and to keep trauma out of narrative memory. Should that child find themselves in therapy at some later stage in their life, it is unlikely that there will be a ‘whole’ story of what happened to them available for recovery. It is more likely that memory of traumatic experience will present as disconnected and scattered fragments. Strewn across an internal landscape these scraps of memory may still be signalling distress through here-and-now symptoms: psychological, emotional, physical and relational.

Strategies for survival

There are many ways someone who has experienced trauma might attempt to discount or disconnect from uncomfortable or distressing memories and the feelings associated with them.

Emotional numbness, self-medication, overwork, addictions or psychosomatic illness are amongst the (out of awareness) strategies that can maintain the disconnect. The trouble is that when we are unable to connect to ourselves, we will likely struggle in our connections with others, and this is what can keep the effects of early relational trauma alive. When early experience of traumatic events leads to emotional disengagement and disconnection, this system of relating is likely to be replicated in the here and now, long after the original threats have passed.

Shame

A powerful after effect lingering in the shadows of relational trauma is shame. Shame is corrosive and debilitating and when in its grip we are diminished, privately believing ourselves to be defective. When a child can’t make sense of bad feelings an obvious conclusion is ‘there’s something wrong with me.’ Dissociation and disconnection, once the only option for survival, today prevents us from accessing and integrating painful feelings. This we carry as shame; a dirty little secret that controls us from within. On the outside shame might masquerade as anxiety but it’s likely an anxiety that breeds more shame: shame about the amount of work it takes to ‘keep a lid’ on things, to present a together and coherent face to the world; shame about the habits and obsessions that keep anxiety under control; shame about being isolated; shame about interpersonal difficulties. Shame colonises a fragmented psychic landscape and hijacks our interpersonal potential.

Remembering-with

Remembering, in therapy, how bad things once felt is a significant emotional risk for the dissociated client, especially when so much energy has been spent in putting difficult experience out of sight and out of mind. The attuned, sensitive and empathic therapist will understand the magnitude of risk that a client might feel. Remembering ‘with’ is not the same as revisiting traumatic events in (gratuitous) search of catharsis. Having someone bear witness to and validate all the pain, carried for so long and all alone is transformational. It is the way that pain is transformed into grief, and in its way, grief is the opposite of dissociation. In our grieving we can integrate past and present meanings and feelings, and it is in this way that we might finally lay trauma to rest.

 

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

 

 

Further reading by Gerry Gilmartin – 

Therapy and art… an intersection

Cultivating a tolerance for uncertainty

The importance of generosity and forgiveness in a hostile world

Understanding sexual desire

Reflections on freedom and security in a turbulent year

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Understanding and managing the ‘green-eyed monster’

As a psychotherapist, I sometimes encounter individuals struggling with the unsettling emotion of envy. While we might visualise the ‘green-eyed monster’ and make light of it, it can sometimes grow into a significant problem.

The socio-economic context 

Many of us face anxieties over whether what we have is enough. Today, even those who once felt financially secure are becoming more mindful of their spending, while those with more limited resources are stretched beyond their means, often to the point of poverty. Amidst this, we’re constantly bombarded with messages that we need more, the latest, and to seek some kind of perfection, especially from social media. This pursuit can leave us feeling dissatisfied, anxious, lacking, and often envious of others who seem to have what we desire.

The roots and impact of envy 

At its worst, envy can manifest as anger, resentment, and hatred towards others. It projects our unmet needs onto those who seem to have everything. This can lead to feelings of injustice, unworthiness, and resentment, fuelling negative beliefs about ourselves. It can be particularly confusing and distressing if we feel envy towards those we love, admire and care for.

These feelings often correlate with our childhood experiences of having our needs met. Envy, in its most basic form, reflects the mother and baby dynamic. Melanie Klein, a prominent psychoanalyst, described infant envy as a painful and powerful emotion marked by fury and hatred, where the mother has what the baby wants (care and nourishment), but it is not always instantly available so feels withheld from the baby.

Envy in mythology

Even the Greek goddess Aphrodite was envious of Psyche, a mortal whose incredible beauty shook Aphrodite’s sense of self. In hatred, she sent her son Eros to kill Psyche, but he fell in love with her instead. Aphrodite’s envy fuelled continuing efforts to cause Psyche great suffering in order to restore her own status and sense of superiority.

Envy and jealousy

It’s important to distinguish between envy and jealousy. Envy usually involves two people, while jealousy involves three and often relates to a baby’s desire to be the favoured one in a family unit, sometimes wanting to come between two parents. While both can be destructive, jealousy can be more helpful as it relates to our need for relationships and self-connection. Aphrodite likely experienced jealousy and loss as well as envy when her son favoured Psyche over her.

Envy and narcissism

Those deeply wounded and lacking in their upbringing may develop a false persona, seeking status and power to feel valuable, which can be deemed narcissistic.

Encountering someone with higher status can disturb their sense of self, creating immense fear and anxiety. They may blame the other person for their misery, viewing them as something to be hated. We all carry narcissistic wounds from early life when care might have been lacking or delayed, even if it was usually satisfactory. When our sense of self is threatened, we become vulnerable to envy, and this can happen
to all of us.

Managing envy

Understanding and managing envy can help emotional wellbeing. Chronic envy feels unbearable, and those affected often go to great lengths to relieve the pain. Many people find relief in religion, spiritual beliefs or community to feel valuable and worthy. There are many ways to foster a secure sense of self, usually involving
building healthy relationships with others and the self.

In therapy, through exploring self-awareness, understanding emotions, and examining relationships, you can begin to ease overwhelming feelings of envy. Envy can sometimes be unconsciously projected onto the therapist, as well as others, creating complex dynamics. This not unusual and building an understanding of these projections can address underlying feelings of inadequacy and deprivation. Everyone has a unique experience of envy, and everyone will find their own way of understanding what it means to them.

 

Kirsty Toal is an experienced psychotherapist with a decade spent offering therapy, training and clinical supervision in a variety of settings. Kirsty offers short- and long-term psychodynamic and psychoanalytic psychotherapy to adults, in person in Lewes and online.

 

Further reading by Kirsty Toal – 

To be creative as an adult

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The psychology of the cult leader

The image above* is of Jim Jones who led the Jonestown massacre in November 1978 where 909 people died, a quarter of whom were children. Jim decided that the children should be the first ones to drink the poison. He matches the broad definition of a cult leader, which I compiled from a range of authors in the field of cult psychology:

‘A grandiose, overinflated narcissist who seeks power by demeaning others, whilst making them believe it is for their own good or the good of humanity.’

The actual goal of any cult is always the self-aggrandisement of the leader and his organisation through the exploitation of his/her followers. There are several common characteristics of a cult leader:

Narcissism and sadism

Cult leaders score very high on narcissism and psychopathy, which means that they have a lack of empathy, and display grandiose and self-centred behaviour to mask a fragile self underneath. They are also extremely unstable, self-absorbed, paranoid and out of touch with reality. The psychological power and influence these leaders exert over their followers means that they can easily persuade others to also lose touch with reality and share in their grandiose delusion, as seen in the example of Jonestown.

Control and surrender

To compensate for their inadequacies, the leader demands total surrender so that they can have total control. If others don’t agree with them or submit, they are seen as a threat and are usually expelled or punished. This means followers live in a climate of fear whilst made to believe that they are lucky, blessed, privileged and doing something great.

Surrender, submission and devotion to a leader is usually measured with a high degree of personal self-sacrifice on the part of the follower. This normally involves boundless commitment of time and money, in addition to spreading the leader’s message to others and carrying out his/her orders.

Idealisation and denigration

Cult leaders are sadistic and keep pointing out what is wrong with other people, but mask it well with charismatic charm. They dehumanise others whilst keeping themselves in an idealised position. This entails employing all-or-nothing, good vs bad and black-and-white thinking. There are no grey areas, no room for challenge or critical thought.

However, this idealised and overinflated position is very hard to maintain. To maintain it, they use false promises, lies and deceit and they must continuously up the ante and keep moving the goal posts. Upping the ante usually leads to more outrageous, unlawful and abusive behaviour on the part of the leader and the group who blindly follow.

No checks or balances

Because cult leaders rule in a closed system, there are also no checks or balances and a total lack of accountability, which makes them particularly dangerous. Within an isolated and closed system, it is easy to abuse power and use manipulation and coercive control to exploit and abuse.

Finally, the cult leader has no shame and no boundaries. They create an organisation that reflects their internal world, which means they are given free licence to behave however they please. Because they are seen as the ultimate authority, saying ‘no’ isn’t an option and what they preach is seen as being for ‘the common good’. This is how people end up behaving in ways or committing crimes they would otherwise never have.

The above dynamics can play out in a variety of other settings such as political systems, authoritarian organisations, toxic families and one-on-one relationships as well. I would like to end this article with a quote from my colleague Dan Shaw:

‘A cult is any group of at least one leader and one follower, in which the leader can be identified as a traumatising narcissist. In such a group, members are required to suppress who they are and attempt to make themselves whatever kind of object the leader wants them to be’. (Shaw, 2014)

 

Sam Jahara is a UKCP registered psychotherapist and clinical supervisor. She is experienced in working with the psychological impact of high-control groups and cults on individuals, families and organisations. She has also given public talks and podcast interviews on this topic.

 

Further reading by Sam Jahara –

Why do people join cults?

The psychology of cults: part two – what is brainwashing?

The psychology of cults: part one – what defines a cult?

The psychological impact on children who grow up in cults

Why do therapists need their own therapy?

 

References – 
Thought Reform and the Psychology of Totalism (Lifton, Robert Jay. 1961)
Cults in our Midst: The Hidden Menace in our Everyday Lives (Singer, M.T. and J. Lalich. 1995) 
Combatting Cult Mind Control (Hassan, Steven, 1988)
Escaping Utopia (Lalich and McLaren 2018) 
Traumatic Narcissism: Relational Systems of Subjugation (Shaw, Daniel. 2013)
The Guru Papers, Masks of Authoritarian Power (Kramer and Alstad, 1993)

 

* Image – Reverend Jim Jones at an anti-eviction protest in front of the International Hotel, 848 Kearny Street in San Francisco, California, January 16, 1977. Bodyguard and adopted Jones son Tim Tupper behind Jones is talking to Cheryl Wilhite, a female security guard at Peoples Temple. Photo by Nancy Wong.

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Cultivating a growth mindset: a path to personal transformation and resilience

In the journey of personal development and mental wellbeing, the concept of a growth mindset has emerged as a powerful tool. Have you ever faced a challenge and felt like giving up because you thought you were not ‘good enough’? The idea of a growth mindset, coined by psychologist Carol Dweck, offers a different perspective—one that suggests our abilities, intelligence and even personality traits are not fixed but can evolve with effort, learning and perseverance (Dweck, 1999). This perspective is transformative, especially when navigating challenges or embarking on the path of therapy.

What is a growth mindset?

A growth mindset contrasts with a fixed mindset, where individuals believe their capabilities are static and unchangeable. Those with a fixed mindset might avoid challenges, give up easily, or feel threatened by others; success. In contrast, a growth mindset fosters resilience, encourages learning from setbacks, and inspires an appreciation for effort as a pathway to mastery (Yeager & Dweck, 2020).

This distinction is not merely theoretical. Research shows that adopting a growth mindset can have profound effects on various aspects of life, including academic achievement, mental health and social relationships (Burnette et al., 2023). For instance:

  • Academic : Have you ever struggled in school and thought, “I will never get this?” Students with a growth mindset often achieve higher grades, demonstrate greater persistence in learning, and embrace challenges as opportunities to improve.
  • Mental health: A growth mindset can help reduce depressive symptoms, encourage adaptive coping strategies, and build resilience when facing adversity.
  • Social relationships: Imagine approaching conflicts with empathy and a willingness to learn rather than defensiveness. A growth mindset fosters better conflict resolution skills, empathy and healthier, more constructive relationships.

Growth mindset in therapy

If you have ever felt stuck in therapy or wondered if meaningful change was possible, you are not alone. Therapy often involves facing deep-seated fears, confronting painful memories, or addressing long-standing patterns of behaviour. A fixed mindset might interpret these experiences as confirmation of personal limitations, leading to feelings of hopelessness. By cultivating a growth mindset, individuals can reframe these challenges as opportunities for self-discovery and transformation.

For example, clients with a growth mindset are more likely to:

  • Embrace challenges: Seeing difficulties as a natural part of growth rather than insurmountable barriers.
  • Persist through setbacks: Understanding that progress is not linear and setbacks provide valuable lessons.
  • Seek feedback: Valuing constructive input as a means to improve rather than as a critique of their worth.
  • Celebrate effort: Recognising that effort is an essential component of any meaningful change.

However, shifting from a fixed mindset to a growth mindset can feel challenging at first, especially if past experiences have reinforced self-doubt. Be patient with yourself and remember that growth is a gradual process.

Evidence supporting growth mindset interventions

Studies indicate that growth mindset interventions can positively impact mental health and wellbeing. Growth mindset interventions are structured activities or programmes designed to encourage individuals to believe that their abilities, intelligence and other traits are malleable and can improve with effort and persistence.

Examples include:

  • Education-based interventions: Students learn that the brain develops through effort and learning. Activities might include reflecting on past failures and identifying how persistence contributed to improvement (Yeager et al., 2019).
  • Therapeutic techniques: Reframing negative self-talk (e.g., “I am bad at this” becomes “I am not good at this yet”) and focusing on incremental progress toward goals.
  • Workplace applications: Training programmes that highlight the value of learning from constructive feedback and prioritising growth over immediate success.

These interventions have demonstrated improvements in motivation, goal-directed behaviour and reductions in depressive symptoms when individuals embrace a growth-oriented approach (Burnette et al., 2023; Yeager & Dweck, 2020). Notably, these strategies tend to be most effective for individuals facing significant challenges or stressors, providing an additional layer of hope and empowerment.

Applying the growth mindset in everyday life

Integrating a growth mindset into daily life can start with small but significant changes:

  1. Reframe negative thoughts: Instead of thinking, “I cannot do this” reframe to, “I cannot do this yet.”
  2. Set realistic goals: Break larger goals into manageable steps to maintain momentum and celebrate small victories.
  3. Practice self-compassion: Treat mistakes as learning opportunities rather than failures. For example, a client might view a missed goal in therapy as a chance to explore what barriers they faced, rather than as a failure.
  4. Surround yourself with support: Building a growth mindset is not a solo journey—your environment and relationships play a critical role. Choose positive influences who encourage growth, provide constructive feedback, and model resilience. Engage in communities that share a growth-oriented perspective and create spaces that inspire positivity and learning.

Final thoughts

The journey to personal growth and resilience is deeply individual, but the principles of a growth mindset provide a valuable compass. As clients and therapists work together, adopting this perspective can transform therapy into a space not just for healing but for flourishing. Whether you are navigating a personal challenge or seeking to understand yourself better, remember: growth is always possible.

 

Lucie Ramet is an experienced Chartered Psychologist and CBT & ACT Therapist offering short and long-term individual support to adolescents (16+) and adults. She works in English and French. She works Mondays and Fridays from our Brighton and Hove practice, She also offers online sessions.

 

Further reading by Lucie Ramet –

Your brain is not for thinking – it’s for survival and balance

Emotions: hardwired tools from our evolutionary past

Embracing a mindful new year: Achieving resolutions with ACT therapy

 

References –

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