Brighton and Hove Psychotherapy

Online Therapy
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The limitations of online therapy

Online psychotherapy is not a new concept; it was around before the pandemic and successfully used as a medium for delivering psychotherapy, counselling and coaching. However, what is new is how nearly all of us were obliged to work online to maintain continuity of sessions for our patients and clients during lockdown and how ubiquitous it remains. It is clearly here to stay but does that mean that in-person psychotherapy is a thing of the past?

Online psychotherapy brings with it some advantages over seeing a psychotherapist ‘in the flesh’ such as:

  • Access to a wider pool of clinicians;
  • Less time consuming as no travel is required;
  • Some people may find it easier to ‘open-up’ online rather than in person.

Like many psychotherapists, during the pandemic I had to abruptly move my whole practice online and together with my clients adapt to virtual sessions. Now at the tail-end of the pandemic the world is a different place and yet I have found that the vast majority of my clients have of their own volition decide to return to in-person sessions. I have explored this with them and below is a synthesis of some of the limitations of online psychotherapy and why, I believe, it will never replace in-person face-to-face sessions.

Psychotherapy is a body to body communication

Though often referred to a ‘talking therapy’ psychotherapy is much more a ‘listening therapy’ and the clinician is trained to listen in a very particular way – to what the client says as well as how they say it.

More than half of our communication is non-verbal and is a combination of tone and delivery in conjunction with body language. With online therapy much of the latter is lost due to the limitations of what can be seen on screen. But there is another reason why it gets lost – online psychotherapy is ever so slightly ‘out of synch’. It is almost imperceptible (most of the time) but there is a slight lag between the delivery of the sound and the delivery of the image which makes for a disconnect between the spoken and unspoken. And whilst almost imperceptible to the conscious mind, it gets registered by the emotional system.

Psychotherapy as re-parenting

Everyone who crosses the threshold of a psychotherapist’s consulting room is bringing with them unresolved experiences and patterns from their childhood. Many of the patterns are laid down in the formative years of bonding and dictate our attachment style. And because they were laid down between birth and around 2 years of age, they are non-verbal (and unconscious).

Psychotherapy is about working with these patterns – often referred to as ‘working in the transference’ – to understand how the client ‘does’ relationships; in this sense it is a process of re-pare helping the client to feel safer and more secure in relationships and in expressing boundaries.

The transitional space – travelling to therapy

Travelling to sessions in person can be time consuming and with today’s fuel prices, expensive. However, the travelling aspect has an important psychological function as it operates as a transitional space between the ordinary world and the unique world of introspective psychotherapy.

In online sessions I have often found that clients can be distracted as they have literally just ‘left work’ and entered my virtual consulting room – they have no given themselves time to make the journey to psychotherapy and it can then often take a significant part of the sessions for them to arrive.

Likewise, I have had clients who have scheduled work meetings immediately after their online therapy which can act as a powerful prohibitor to allowing themselves to ‘be in therapy’ as “I don’t want to get upset because I have a meeting with my boss”.

Lastly, when clients visit my consulting room in person, I am responsible for most of the physical boundaries. Clients know where they will be sitting, where the furniture will be positioned and this will remain the same week after week – it is part of be providing a consistent experience. Seeing a psychotherapist from home may mean that the space feels less safe with other members of the family in the same home or just simply having daily distractions around such as a picture of the family on the desk next to the monitor.

Psychotherapy is about making contact

Starting psychotherapy in any realm can feel like a daunting prospect. Coming into a consulting room, which is the domain of the psychotherapist, is a brave step.

Clients have often sat on my couch and mused or fretted about what to talk about. I generally sit in silence as they try and find their words as, to me, what they say is often less important than why they are telling me. If a client tells me anything they are telling me something about themselves that they feel is important and that they want me to see as important – often we need to figure out together why it is important but we generally get there in the end.

Therefore, psychotherapy is about ‘coming into contact with another’ – taking a risk to be seen and heard. Whilst this can be achieved to some extent online, nothing can be a substitute for in person contact where two bodies are in the same room and in communication and contact with each other.

Until we start raising babies and infants over virtual connections and can do so successfully – which is neither desirable nor remotely possible due to our physiological and psychological make-up – face-to-pace in person psychotherapy is not going anywhere.

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer –

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Parental Alienation and the impact on children

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The Challenge of Change

While it might not be explicitly named, ‘change’ is often alluded to as a desirable outcome of psychotherapy. Thoughts about feeling, being and living differently are expressed and the client is invited to understand what it is that they want. The ‘wished for’ life can often feel desirable and easy to describe, yet can feel so hard to achieve. Alternatively what it is that is desired can feel difficult to define, but what is known is that carrying on as one is does not feel possible.

Change can be thought about, talked about, imagined and yet it can feel no nearer to being achievable. It can feel that one is stuck and powerless to move forward. Change can feel more impossible than possible.

Feeling ‘stuck’

Thinking about change when one feels ‘stuck’ can feel unbearable as it brings up thoughts about why change feels so difficult. Is it in some way a reflection of the self? Thinking that ‘I know what I want’, but feel unable to achieve it. Not being able to effect change could be felt as a failure and a lack of capability. Talking about it and hearing other voices can be helpful, but when these voices have an edge of ‘snap out of it’ it’s experienced as unsupportive, critical and unhelpful. This all can lead to difficult self-critical feelings and so change feels like a challenge not worth pursuing. To have and share the desire for change, yet feel reminded of ones own shortcomings.

When we consider our own capacity for change we also bring in our own sense of capability. Can one believe that it is possible to change or is the sense of being ‘stuck’ in itself now stuck? How can we challenge feeling stuck or does it become just another thing that makes us unable to think of change? The thinking can become circular.

Familiarity and change

Change is challenging because change makes us move out of what is known and understood. A situation might be far from what is desired, yet it is familiar. Such familiarity allows a degree of certainty based on knowing what to expect. The result of change is unknown, not understood and potentially so unsettling it feels like it isn’t worth engaging with.

What is achievable?

When we think of a desired outcome we have to balance this with what is achievable. If we set the bar high are we setting ourselves up to fail and falling back into the circular thinking about not being capable. Coping with setbacks and being able to acknowledge what is possible are all part of how to move beyond feeling stuck.

How we can think of change?

To reflect on change we need to be aware of how we can be stuck and how hard that is. ‘Stuck’ isn’t something that is wished for, nor is it self created. Feeling stuck is a reflection of the challenge of change. To think of change we maybe first need to think of ourselves and take a more compassionate view. Compassion in the sense that we are allowed to imagine, wish for and achieve something different.

Psychotherapy offers the opportunity to understand what it is that we might want to change. The hope is that through exploring and thinking together, we can think of change as being more possible than impossible.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove .

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

 

Further reading by David Work –

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

When Home and Work merge

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The Challenge of Change

While it might not be explicitly named, ‘change’ is often alluded to as a desirable outcome of psychotherapy. Thoughts about feeling, being and living differently are expressed and the client is invited to understand what it is that they want. The ‘wished for’ life can often feel desirable and easy to describe, yet can feel so hard to achieve. Alternatively what it is that is desired can feel difficult to define, but what is known is that carrying on as one is does not feel possible.

Change can be thought about, talked about, imagined and yet it can feel no nearer to being achievable. It can feel that one is stuck and powerless to move forward. Change can feel more impossible than possible.

Feeling ‘stuck’

Thinking about change when one feels ‘stuck’ can feel unbearable as it brings up thoughts about why change feels so difficult. Is it in some way a reflection of the self? Thinking that ‘I know what I want’, but feel unable to achieve it. Not being able to effect change could be felt as a failure and a lack of capability. Talking about it and hearing other voices can be helpful, but when these voices have an edge of ‘snap out of it’ it’s experienced as unsupportive, critical and unhelpful. This all can lead to difficult self-critical feelings and so change feels like a challenge not worth pursuing. To have and share the desire for change, yet feel reminded of ones own shortcomings.

When we consider our own capacity for change we also bring in our own sense of capability. Can one believe that it is possible to change or is the sense of being ‘stuck’ in itself now stuck? How can we challenge feeling stuck or does it become just another thing that makes us unable to think of change? The thinking can become circular.

Familiarity and change

Change is challenging because change makes us move out of what is known and understood. A situation might be far from what is desired, yet it is familiar. Such familiarity allows a degree of certainty based on knowing what to expect. The result of change is unknown, not understood and potentially so unsettling it feels like it isn’t worth engaging with.

What is achievable?

When we think of a desired outcome we have to balance this with what is achievable. If we set the bar high are we setting ourselves up to fail and falling back into the circular thinking about not being capable. Coping with setbacks and being able to acknowledge what is possible are all part of how to move beyond feeling stuck.

How we can think of change?

To reflect on change we need to be aware of how we can be stuck and how hard that is. ‘Stuck’ isn’t something that is wished for, nor is it self created. Feeling stuck is a reflection of the challenge of change. To think of change we maybe first need to think of ourselves and take a more compassionate view. Compassion in the sense that we are allowed to imagine, wish for and achieve something different.

Psychotherapy offers the opportunity to understand what it is that we might want to change. The hope is that through exploring and thinking together, we can think of change as being more possible than impossible.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove .

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

 

Further reading by David Work –

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

When Home and Work merge

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Loneliness and CBT

People feel lonely for a wide range of reasons. Loneliness can be linked to mental health difficulties such as depression, anxiety, social anxiety, perfectionism, low self esteem or eating disorders. It can also be linked to autism, loss, difficulties disclosing, early adulthood, elderly. This is not an exhaustive list but illustrates how many factors can be linked to the problem of loneliness.

Loneliness is the perceived discrepancy between what we want and what we’ve got, a mismatch between actual and desired social situation, a lack of meaningful relationships. Social isolation doesn’t have to equal loneliness. We can be alone without feeling lonely.

Triggers to feeling lonely can be internal psychological factors, such as attitudes to participating in social interaction / having a negative interpersonal appraisal, e.g. other people don’t like me; or external factors, such as bereavement or living far away from friends and family. These factors evoke an emotional response such as anxiety or sadness
and can lead to counter productive behaviour such as avoidance and a decrease in valued social contact or unhelpful cognitive processes in the social domain, e.g. self focused attention or hypervigilance to rejection. This then impacts on our perception and our interpretation of our relationships / social situations and can inadvertently become a
perpetuating cycle of loneliness.

Social media also has a big impact on loneliness, particularly in early adulthood. People share and post what they want us to see and we can end up comparing ourselves to others. The pandemic too has had an impact on loneliness. Spending less time with friends and family, self isolating and shielding are all contributory factors to feeling lonely. If we struggle with technology this too may play a part.

So how do we change things? In CBT we look at four domains: the individual, their relationships, social relations and the community. In terms of strategies behavioural activation is key with a focus on increasing the amount of social interaction, social contact and social networks. We can explore values and once we have identified these set goals to
help meet where the person wants to be in their values. We can introduce and identify unhelpful thought patterns and beliefs, and learn techniques to restructure these. We can learn strategies to reduce rumination and use behavioural experiments to make changes and gather information, e.g. finding out what happens if you do disclose and share with others. Additionally whilst engaging in behavioural activation we can practise exposure
whilst reducing safety behaviours.

Everyone is different and because loneliness can be for many different reasons there is no one size fits all. Other strategies may also be used, such as social skills and communication training, mindfulness, mapping social opportunities, emotional awareness and psycho-education.

To address loneliness in older adults Age UK and the befriending service, such as Silverline, can be a great resource. Age UK offer all sorts such as social activities, lunch clubs, IT Training, transport, day centres. Younger adults may benefit from Meet Up groups, Young Minds or The Mix.

Reaching out, connecting with others and using the supports that are available to us are fundamental in combatting loneliness. Remember we all feel lonely at times in our lives.

 

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.

 

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

 

Further reading by Rebecca Mead –

Is that a fact or an opinion? 

As we come out of lockdown, will a number of us be feeling socially anxious?

New Year’s Resolutions

Making Changes

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Thinking about origins

Where do you come from?

It’s a question that many of us will have either asked, or been asked. What do we actually mean when we ask that of someone? Are we merely searching for a reference point as a means of friendly inquiry, or are we seeking something else?

When we think about identity and ask who we are, we often consider where we came from. What it is about our experience of our formative years spent in certain places that defines us? It could be a deep sense of belonging based on familial and cultural familiarity, or conversely, a desire to be separate and distant from a place, which has little resonance with us. In asking the question are we implying that there is something to be revealed in our sense of origin?

Origin as a point of reference

When we ask about origins we are looking for reference points, but also are we asking to be shown a version of the self based on regionally derived ideas? Whilst saying that we have predefined notions of identity isn’t comfortable to think of, we can often hold these as a way of making sense of origin in someone’s identity. No one wants to think in terms of ‘stereotypes’, but we might hold these as a way of giving a sense that we can relate to one another. What is important is that we can move beyond fixed notions and be curious about who we meet.

Origin and identity

For the individual the sense of origin and place easily become part of our sense of who we are. To say that you come from somewhere can say a lot about you, without having to elaborate. Strong local identities can be defining, whether this is desirable or not. This thought, that origin can be defining, is especially apparent when we relocate. Are we suddenly exposed? Does it raise the thought that we might allow our origin to actually define oneself in a way that isn’t authentically who we are? It could be that our origin is a means of holding onto our sense of self when we might not feel able to define ourselves otherwise.

Over time our relationship with our origins can change as we age and develop our own identity. What role does our historic origin play in our thoughts of where we are from? Is it a place that we romanticise, miss or hold with positive regard? Is it somewhere that we choose to keep a distance from? Do we feel the need to celebrate, defend or denigrate it? The relationship over time speaks of the influence of origin and brings up thoughts of what it is to ‘belong’.

For some the sense of origin is a complex mix of influences. The experience of migration and change impact a sense of being able to clearly answer where one is from. This displacement and sense of loss can be highlighted in the inquiry about one’s origins. Here we are challenged to explore what it is like to not have a simple answer. Can we think about loss and hold a sense of richness based on a diverse sense of origin, or is the loss harder to bear? Has migration made it hard to place oneself and make sense of ones own identity?

Questions around identity and origin are often present in everyday life. Working with a psychotherapist can help in developing a better sense of self and our identity when we question our origins.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove and Lewes.

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

 

Further reading by David Work –

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

When Home and Work merge

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“I’m interested in therapy but isn’t it a bit self-indulgent?”

Some of the people I see exploring whether to begin therapy, often express doubts as to whether their troubles are significant enough. I often hear the refrain – “nothing that bad has happened to me, maybe I’m just being self-indulgent, or isn’t this all a bit naval gazing?.” 

I think simplified, what the client is really saying is; “Am I justified in feeling this pain and am I worthy of this attention ? ” 

This blog will look at how therapy can help us incorporate our painful experiences as part of a fuller engagement with ourselves, the people in our lives (our relationships) and as a different approach to living

The Psychoanalyst Melanie Klein who was interested in early development, theorised that a key early and ongoing development task is the sad but necessary realisation that others are different and separate from us, with their own needs rather than as extensions of our own. This confronts us with the loss of what we hope and want the other person to be, but if we are able to face and mourn this loss, we can move onto to a more realistic and more liveable life. When the disappointments by the other are too great, or conversely, the other attempts to be everything for us, this task is all the harder. 

Voltaire, the French philosopher and writer, in his novel ‘Candide’, tells the story of a group of travellers who have suffered various trials and tribulations. On hearing of a murder at the Ottoman court they pass an old man peacefully tending his garden. They ask the old man about the trouble at the court and he replies that he doesn’t know anything about it, since he doesn’t keep up with the affairs there. Rather he tends calmly to his own small holding. Voltaire used this example to put forward the idea that in order to live a ‘good life’, we should not overly concern ourselves with worldly affairs, but find a task we can attend to, that leaves us satisfied but tired at the end of the day. 

In my therapy practice I relate to this, not in the sense that we should ignore politics or activism, I think these are important, but in the sense that I regularly experience how clients want to engage me in their ‘rages against the machine’, with different viewpoints and perspectives.  What I often find is that, smuggled into these arguments are parts of themselves they find difficult, or are unable, to face: the bad one is the other one over there – and if only they thought like me, the world would be fine. 

What often lies behind these projections, are painful feelings of despair, hopelessness, insecurities, personal failure, upset, grief, rejection and so on. 

I try to carefully and tactfully sense what is behind these things, and the defenses or shames against feeling them, and try to create a safe enough space where these grievances and pains can be heard, allowing air to the wounds. Allowing, over time, a sad but realistic acceptance of the wounds, limits and realities of ourselves and perhaps the human condition. Rather then than therapy being self indulgent, perhaps it is one the best things we can do for the world, by trying to understand ourselves so that we don’t project our own hurts and conflicts outwards. This is why in therapy I will always be thinking about, and trying to help you understand what is happening inside of yourself, using myself as an instrument to understand what is happening between us, utilising the self awareness I’ve gained through my own work on myself, to help you understand and accept yourself more fully. 

In his book, Voltaire argues that the melancholic position is the only one from which we – any of us who have suffered disappointments, broken hearts, loss, (all adults that I know) – can ever truly live. He contests that we cannot escape suffering, since to some degree, the world is a brutal and cruel place to live. Perhaps rather than getting lost in despair or raging about this, what we can do, is to cultivate our inner worlds, pulling up the weeds, planting, feeling, exploring. Not trying to rid ourselves of the pain or anxieties of life, or the world, but to learn – as sad as it is – to try and accept that these are part of the human condition. That after we have loved and lost, battled our own minds, tried to find the magical other, and failed, that perhaps the best way forward is to attend modestly and honestly to our own human natures, to its wild thorny ways, to our own sometimes unkind and cruel ways, and to do our best to be honest about these, rather than defend against them, driving them underground. To cultivate what we can, humility, acceptance, forgiveness and grace. Like tending a garden, the work is never complete.

 

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

Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

Compassionate Curiosity and the fundamental rule of psychoanalysis

Why there’s nothing as infuriating as Anger Management

What makes Psychotherapy Different?

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

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The Process of Joining a Therapy Group

Below, I am going to outline the process for joining a therapy group. It is important to say at the outset that I am describing my own practice and while the underlying principles will generally be shared by other group analysts, the specific processes and procedures will be variable. 

Taking the First Step

People come into my groups in a variety of ways. Some people get in touch because they have decided for themselves that group therapy might be helpful for them; they may even have been in a therapy group in the past, or a group might have been suggested to them. 

If you fall into this category, the chances are you will have already been thinking about the benefits of a group and are now ready to take that next step in joining one.

Others come with a little more uncertainty. They may have had a group suggested to them by their therapist or been assessed and a group strongly recommended. If someone hasn’t been thinking about a group before and doesn’t know much about group therapy, this suggestion can come as a surprise and, for some, take some getting used to.

If you fall into this category, then you may be feeling a little more cautious and might need more time to think about this idea of group therapy. 

Initial Consultation

When anyone gets in touch with me, with an interest in joining a group at the practice, I offer a short, free telephone consultation. This usually takes around 20-25 minutes and gives us both an opportunity to think about; why they are considering a group, whether group therapy is suitable for them and what spaces are available in which groups here at our practice. I may also ask a few questions about their background, current situation, and particular issues and most likely, we will touch on what might be beneficial and challenging about being in a group for them. 

This telephone conversation can lead to a range of outcomes. For the purposes of this article, I shall focus solely on what happens if we agree that a group appears to be timely and suitable for the person and I have a group space at a time they can make. 

Assessment

While the telephone conversation is useful in clarifying any immediate obstacles to someone joining one of my groups, it is not an assessment. Therefore, the next step would be to have a face-to-face assessment. This is done in-person if possible – unless of course it is an online group we are considering. 

This session will explore in greater depth what we would have covered briefly on the telephone. I will also ask more about the person’s history and encourage some thinking about their relationship to groups, such as, family, school, friends, work etc. As in all psychotherapy assessments, I will want to find out a bit more about the person’s relationships, problems, needs, risks, medication, previous psychological input, and levels of function. 

This session also gives them the opportunity to think in more depth about the idea of being in a group. This is helpful to get a firmer sense of why a group might help but also what challenges a group might present to them. 

Sometimes we need more than one of these assessment sessions before we’re clear that the person is ready and wanting to join a group. 

Finding a Time to Join

Once we’ve agreed that someone is ready, we need to think about when they will join. In a new group this is relatively straight forward – I give all prospective members a start date and they all join at the same time.

Joining an established group is a little more complicated as the group also needs to be ready to accept a new member. These groups are called ‘slow’ and ‘open’ which means while people join ongoingly we make sure this happens at a slow pace. This helps the group continue to feel stable and secure. 

As well as this factor, before the individual joins the group, they also need to be ‘ready’ and they will need some help in preparing for this. 

Preparation and Contracting 

I have generally found that anyone joining a group requires at least 2 or 3 preparatory sessions. Some need more and some decide to do some individual work with me first before joining the group. 

The preparatory sessions offer an opportunity to explore further the themes picked up in the assessment process. In addition, people often find it helpful to make some space for any anxieties that might arise.

This preparatory stage also allows me to talk about what is expected of group members. To keep the group therapeutically safe, all members are asked to agree to certain boundaries. An obvious example is confidentiality. Another is that members do not have contact with each other outside the sessions. These and other boundaries can be seen as making a contract with the group to keep it safe and therapeutic. 

First session

The first session can feel daunting, even for those relatively confident in groups. 

In a new group there can be a lot of anxious feelings in the group which can take several sessions to start to properly settle. However, everyone is in the same boat and often people find that reassuring and helpful. It can also feel important for some to feel that they have been in a group from its earliest inception.

In an established group, being the new person is always going to feel challenging to some extent and likely to bring up earlier experiences of being new (for e.g., starting school). However, the atmosphere is likely to be much calmer and less anxious than that of a brand-new group. Established members will also be able to help the new member settle in. Some people can also enjoy the feeling of being special that their newness gives them. 

Despite the expected anxious feelings new members are often surprised how quickly they form bonds and get to know other members of the group. This process is helped by the preparatory work and the boundaries agreed to by the members. 

Conclusion 

Whatever the experience of joining a therapy group the likelihood is it will feel powerful and tap into earlier histories and experiences of both groups and beginnings. The emphasis on stages of initial consultation, assessment, preparation, and contracting, are all in place to hopefully help and support the new group member in their own joining process. 

Joining a Group

If you are interested in exploring joining one of the groups mentioned above, please do contact me through the enquiry form.

Groups run by Claire Barnes

Claire currently runs two groups at Brighton and Hove Psychotherapy 

  •  once weekly group on Thursday evenings
  •  twice weekly group on late Monday afternoons, and Wednesday evenings.

She is also now taking referrals for a new face-to-face group, to run on Thursday mornings at the same practice and address. 

 

Further reading by Claire Barnes

What is ‘othering’ and why is it important?

How psychotherapy groups can help change our internalised family systems

Is a Therapy Group Right for Me? Am I Right for a Therapy Group?

What happens in Therapy Groups? The role of the Therapist

What happens in Group Therapy: Mirroring

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Some thoughts on becoming (part two) …

“‘This – is now my way – where is yours?’ Thus did I answer those who asked me ‘the way’. For the way – it doth not exist!”

(Nietzsche, Thus Spoke Zarathustra)

Nietzsche (1961) conceives of people as a process of becoming and thus creative and transformative in nature. Nietzsche (1973) calls us to focus on facing up to the realities of the world, develop a loving relationship to ourselves; our dynamic and multiple forces, sometimes conflicting (our passions and paradoxes), and take responsibility for the creation of them and our lives.  He uses the idea of our spirit being akin to a process of metamorphosis. Firstly, carrying the heavy weight that life has thrown at us, like a camel. But he calls us to consider and recognise the spirit of the lion within us too. Coining the will to power, not so much about taming, integrating or balancing these forces but more to do with inviting and using power, passion and assertion to guide the active forces and create. He promotes the body as the self; the place from which the will to power is generated.

He argued, once we accept and bear that which has been given to us we must also make space for freedom’s possibility and  “seize the right to” new values (p.55).  Understanding the significance of power and passions, embracing risk, uncertainty, impermanence and the importance of falling in the process of becoming and transformation.  Equally he invites us to consider the rejection of conformity, duty and obligation as a necessary part of the process in decentering and freeing the self. To perhaps see it as a movement. I am free to come and go, to feel the comfort of belonging but also to recognise it is limiting and never stationary.

Therapy can sometimes feel like a space whereby you can/ might begin to navigate this, with another.  Discovering, perhaps, through paying attention to how affects and intensities traverse and move through the body, and how we can learn from them. Investigating what has been difficult, whilst also considering what our greatest desires are, and aiming our flight towards them.

Existential therapy can be a way to approach this. Van Deurzen (2002) analogised the role of an existential therapist with an art tutor, one which may support the client to reach towards a sense of perspective and begin to create a more detailed picture of their past, present and possible desires for the future world. Understanding the patterns and burdens in which we have been carrying and acting out from and perhaps begin to hold them more lightly.  So that we might feel more able to be in relationship with the forever present, fluid and creative spaciousness where phenomena emerges. The creative space where things move, fluctuate and are impermanent,  thus always full of possibility and potential.

Perhaps a good place to start is by considering desire as a guiding light in these explorations. Tell me, what is your greatest desire?

This blog follows on from part one.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here.Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

Further reading by Susanna Petitpierre – 

Some thoughts on becoming (part one) …

What is the Menopause? (part two)

What is the Menopause? (part one)

Some existential musings from the sea

References:
  • van Deurzen (2002) Existential Counselling & Psychotherapy in Practice. London: Sage
  • Nietzsche, F (1973) The Will to Power in Science, Nature, Society and Art, New York: Random House. 
  • Nietzsche, F (1961) Thus Spoke Zarathustra. trans. R.J. Hollingdale ( Harmondsworth: Penguin).

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How are you?

How are you at just sitting down quietly by yourself? 

Some years ago I completed a mindfulness meditation course and first encountered the philosopher Pascal‘s assertion that, ‘all the misfortunes of men derive from one single thing, which is their inability to be at ease in a room’. Our teacher suggested Pascal referred to the harm caused due to our periodic inability to tolerate the sheer intensity of thoughts and feelings that can rise within us, when no distractions are available. 

Having worked through meditation guidance books at earlier times in my life, I found attending this formal course was an enriching way to discover that engaging in mindful meditation could be a useful aspect of my own wellbeing.

The paradox of mindfulness – ostensibly sitting alone not ‘doing’ anything – is that it’s an active practice, requiring our presence in the moment and making it a regular habit in order to be effective. The health benefits of mindful meditation have been increasingly suggested in numerous research studies. 

Pioneers such as Jon Kabat-Zinn have taught how cultivating a focused awareness of our thoughts, feelings and physical sensations increases our capacity to tolerate their extremes. 

More recently the psychiatrist Dan Siegel has developed his ‘Wheel of Awareness’ practice: a structured meditation session inviting us to develop both awareness and compassion for ourselves that we then extend to our personal relationships, wider humanity and all life in our natural world.

Just as many have found meditation a valuable resource at particular times of stress or crisis in their lives, so psychotherapy has taken its place as an important activity that addresses the challenges we face in seeking to be at ease with ourselves. 

And for this activity we might turn to the insight of another giant of French thought, Montaigne, who wrote, ‘The greatest thing in the world is to know how to be oneself.’

In the therapeutic process we move beyond sitting with ourselves into a particular kind of beneficial relationship. The therapy room offers us a space where we can enlist the full attention of another person – a trained therapist – who is professionally committed to helping us explore those aspects of ourselves that can be hardest to uncover and often too painful to encounter by ourselves. 

And just as meditation is called a ‘practice’, so psychotherapy is often referred to as ‘the work’ in an acknowledgement of the purposeful regularity of this process of deeply supported self-examination.  

If the goal of mindfulness is to achieve a greater sense of wellbeing though cultivated awareness, it seems to me the aim of psychotherapy is to help us truly know not who, but as Montaigne suggests, how we are in the world. Only by understanding much more about how we have come to think, feel and act in the way we do can we begin to understand how we might choose to be different.

 

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

Chris Horton is a registered member of the British Association for Counselling & Psychotherapy (BACP) and a psychotherapeutic counsellor with experience in a diverse range of occupational settings. He works with individuals (young people/adults) in private practice.  He is available at our Lewes and Brighton & Hove Practice.

 

Further reading by Chris Horton

Out of Sight, Out of Mind

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Some thoughts on becoming (part one) …

“First we are written and then we write.”  These words resound in my head daily. Helene Cixous, the speaker of those words, was immediately given special and spacial status in my lived experience. Her words speaking to the many dynamic forces that seemingly make up my lived experience including past, present and some yet to be birthed influences.

Her words help me understand the paradox and tensions in which I/we continually live; that of our essential solitude and our inescapable connection to the world,  the continual uncertainty we must create from and our responsibility to do so.  They inspire me to recognise that only I can be responsible for what I make of my life as opposed to holding others responsible.  This can sometimes shower me with a sense of liberation and at other times the opposite feeling of hopelessness.

Discovering a way to navigate our existence and relationships, amongst the many prevailing tensions can be hard sometimes. It might often feel difficult to not externalise, to blame others as responsible for what is happening or happened. There is an obvious morass of disparity, privilege and injustice everywhere. We can feel filled up by tragedy, dread and despair and often feel unable to loosen the grip of injustice, loss and fear and welcome uncertainty, ambiguity and difference.

Existential therapy talks of facticity, that which we are born and thrown into and which influences and shapes us and our surroundings. It is much of how we textually create our encounters with ourselves and the world. Some can be heavy forces, which we often feel powerless to when responding. Others we can utilise creatively to conduct and perhaps flow in the rhythm in which we move; cultivating the soil we traverse through more easily.

Merleau-ponty (1964, p. 116) posits,

“We must abandon the fundamental prejudice according to which the psyche is that which is accessible only to myself and cannot be seen from outside …My consciousness is turned primarily toward the world, turned towards things; it is above all a relation to the world.” 

Sartre (2003) also tells us about this relationship to the world, amongst many other things, when he discusses how the gaze of the other objectifies us in a position, a role to perform, calling us to be for the other. The gaze of the other interrupts our inherent freedom, consequently we might deprive ourselves of our existence as a being-for-itself and instead learn to insincerely self-identify as a being-in-itself. Sartre argues that if we look to the other to give us definition we are living in bad faith.  By not bearing the responsibility of what we are we are denying our freedom.

Sartre (1961) conveys,

“We only become what we are by the radical and deep-seated refusal of that which others have made of us.”  

Sartre highlights a paradox; we are discovered by the encounter with Other but it is us who creates our meaning.

These paradoxes, contradictions and tensions are complex and not linear. There is a continual impermanence, uncertainty, negotiation and relationship revealed and expressed via affects and intensities, within and without.  We are neither fixed nor congruent but always in passage and in motion.

We are called to create, enchant and become captivated. To remember the “heavy burden of the growing soul” (Elliot, 1964) and perhaps keep cultivating the yet unknown soil in which we breathe. To cease neither enrapturing and traversing the other nor becoming captivated and transformed by them. Perhaps, as Cixous writes,  “… to find in myself the possibility of the unexpected.” (p.39).

Part two of this blog can be found here.

To enquire about psychotherapy sessions with Susanna, please contact her here, or to view our full clinical team, please click here. Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

Further reading by Susanna Petitpierre – 

Some thoughts on becoming (part one)

What is the Menopause? (part two)

What is the Menopause? (part one)

Some existential musings from the sea

Nietzsche and the body

 

References:

  • Ciscoux, H. (1992).  On writing. In coming to writing and other essays. London: Harvard University Press  (pp. 1- 58).
  • Eliot. T.S. (1964) Animula. In Collected Poems 1909-1962 by T. S. Eliot, copyright,
  • 1936, by Harcourt, Brace & World Inc.
  • Merleau-Ponty, M. (1964) The child’s relations with others. In: Cobb, William, translator; Merleau-Ponty, M., editor. The primacy of perception. Evanston: Northwestern University Press; 1964.
  • Sartre, Jean-Paul (1961) Preface to Frantz Fanon’s “Wretched of the Earth”. In Fanon, Frantz (1925–1961). The wretched of the earth. Harmondsworth: Penguin. ISBN 9780140224542. OCLC 12480619.
  • Sartre, Jean-Paul (2003). Being and Nothingness. Hazel E. Barnes (trans.). London: Routledge.

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Demystifying Mental Health Issues

In the last few years there has been increased awareness of mental health issues in the media, way before the pandemic hit. Mental health professionals are seeing a growing mental health epidemic which has become significantly worse due to the human and financial cost of Covid-19, prolonged lockdowns, and a general shift in how people live, work and study. Nowadays, most of us know someone with a mental health issue or have experienced it ourselves.

Mental Health Issues are Human Issues 

The language used in the mainstream media to describe mental health does not adequately portray the issues people present with in therapy.  Terms such as trauma, anxiety and depression are often overused and do not describe their full meaning. Most of us experience fear, grief, sadness, and fluctuation in emotions. Whether we choose to acknowledge it or not, most of us have been through a challenging life event(s) or loss(es) with significant emotional and psychological impact.

Anxiety and Depression – An Emotional Accumulation 

I often hear people say that they or someone else “suffers with” anxiety or depression, or “has a mental health issue”. My first thought is: what does this mean? Though these terms have been fed to us through both clinicians and the media, I believe there are much better ways of describing someone’s experience in a less diagnostic, medical and all-encompassing way. 

Although some of us may say “I feel anxious” or “I feel depressed”, anxiety and depression are not actual feelings but a cluster or accumulation of many things. Feelings and emotions when undealt with (supressed) and poorly understood, can result in what we currently describe as depression or anxiety. 

For instance, a prolonged period of low mood which we call depression can ensue as a response to anything from prolonged grief to suppressed anger, feelings of powerlessness and helplessness, just to name a few. Depression can range from low mood to intense depressive episodes, depending on cause and other psychological and biological factors. 

A prolonged or chronic state of high alert resulting in unpleasant feelings of fear or dread which we call anxiety, often manifests when we are responding internally to a certain situation that we perceive as a threat of some description, either actual or imagined. Like depression, anxiety symptoms range from generalised anxiety to panic disorder, depending on the level of accumulation of emotions, life circumstances, personal resilience, previous trauma, etc. 

Finally, our mood is also impacted by environmental and physiological factors such as sleep, hormones, mood altering substances such as caffeine, alcohol and drugs (illegal or prescribed), exercise, fresh air and sunshine, screen time, etc.

The Role of Psychotherapy

Is to help people make sense of why they feel the way they do. To understand what is behind the symptoms that people label as anxiety or depression because they do not know what they are experiencing and why. Uncovering the ‘why’ is a big part of the process of getting better – the more we know why, the more we know ourselves.

Elsewhere on this website we list the issues that people commonly seek therapy for. Anyone who comes to therapy seeking help with a particular issue or issues, also brings with them a rich context and personal history. Making links between symptoms and experience (past and present) is an essential part of understanding, accepting and therefore overcoming some of the barriers we face in feeling mentally well and more at ease with ourselves. 

 

Sam Jahara is a UKCP Registered Psychotherapist and Clinical Supervisor and Executive Coach. She works with individuals in Hove and  Lewes.

 

Further reading by Sam Jahara

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

What shapes us?

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Understanding Sexual Desire

All couples in long term pairings know something of the vicissitudes of desire. The sexual intensity that more often typifies the early stages of a new relationship cannot remain the same over years of familiarity. The up close and personal experience of day to day coupledom means witnessing one’s partner in their least attractive states, both physically and mentally. The intimacy of familiarity is double edged. Whilst bringing a sense of safety and security to a partnership it  inevitably over time erodes an experience of the unknown, of mystery and “otherness” in which early attractions were ignited.

The capacity for surprise enjoyed by new lovers is intoxicating, the investment in pleasing each other extremely high…each person keen to present the best possible version of themselves. This stage of idealisation is both necessary and natural but inevitably gives way to a more complex intimacy as couples get to know each other as whole (flawed) people….for better and worse. A sense of responsibility grows wherever we find ourselves caring about the well-being of another. Discovering the fears, insecurities and sensitivities of someone to whom we are growing close adds a layer of emotional complexity that on entering the bedroom can, over time become a vampire to desire.

 Sexuality and Shame

A shameful secret in many relationships today is a lack of sex. Diminution of sexual desire has become a source of shame (and blame) in a cultural context in which desiring and being desired are highly valued. The idealisation of sexual intensity becomes a burden to many people who experience its absence as a private and very personal failure. Many couples are plagued by the doubt that they are not having enough sex or at least enough of the right kind of sex. All too many people believe that something about their sexuality is either abnormal or wrong. With the exception of new lovers at the height of their infatuation vast numbers of people in our culture feel less than happy with their sexuality.

Our sexuality is forged in the cauldron of family life and cultural context. So attuned and wired are we to the feeling states of our early carers that it is virtually impossible to imagine a childhood utterly free from any feeling of guilt or rejection. Our sexual fantasies and preferences are always creative solutions to unconscious problems. They arise from a need to transcend feelings of guilt, worry, rejection and helplessness. To a large extent these feelings are an inescapable part of the human condition and sexual desire will always have to navigate the complex landscapes of our internal subjectivities.

Pleasure and Pain

Beset, as is so often the case by painful judgements, it would seem a courageous enterprise to seek a greater understanding of our sexuality. We might develop greater tolerance and compassion both for ourselves and others when we learn more about the very important personal (and cultural) meanings in our sexual responses and attitudes. Taking the shame out of sex and broadening the conversation about our appetites need not be a passion killer….  The unrelenting grip of shame over time undoubtedly will be. At the end of the day, sex will most likely always remain complicated but understanding its dynamics need not put a dampener on pleasure. A failure to do so may make pleasure far harder to share.

 

To enquire about psychotherapy sessions with Gerry Gilmartin, please contact her here, or to view our full clinical team, please click here.

 

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 –

Reflections on freedom and security in a turbulent year

Reflections on getting back to normal

The Passage of Time and the Discipline of Attention

Intimacy: pillars and obstacles

Love and Family

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Thinking about the menopause in energetic terms

I often have women clients who are going through the peri-menopause or who are post-menopause and I am curious about how I might better support them therapeutically. I want to share some thoughts from a recent talk by Joanna Groves where she invited us to think about the peri- and post-menopause in more practical and energetic terms. The menopause is defined by 12 months without menstruation; on average this happens at 51 years old. The peri-menopause, the period when the sex hormones are reducing, can start from the late thirties to mid-forties and the symptoms can last for 4 or more years after the menopause.

Groves asked us to pay attention to the pressure of trying to maintain ‘normal’ life during a time of physiological and psychological change and to take seriously the stress this places on women’s physical and mental health. She outlines the physiological and psychological changes that occur during the peri-and post-menopause. There are common physiological symptoms including heart palpitations, sweating, sleep problems and fatigue, these are often accompanied by other changes such as food intolerances and sensitivity to alcohol. Along with anxiety and depression there are other psychological symptoms such as memory and concentration problems, confusion and a loss of confidence and self-esteem. The pressure to maintain work, family responsibilities and a relationship and manage everyday crises can become overwhelming, like trying to stop a burst pipe with a teacup and one hand tied behind your back.

The ‘fight, flight or freeze’ response is caused by Cortisol, the stress hormone. Cortisol is produced and managed by the adrenal glands and is a survival response, an alarm reaction to threat or danger. In contemporary life we’re not at risk from predators but we need cortisol to help us deal with an emergency or carry on under pressure. Cortisol helps us keep going partly by repressing non-essential functions such as digestion and the immune and reproductive systems. When the crisis is over or the pressure reduces cortisol levels drop and the body returns to equilibrium. But what if the pressure is continuous and we are in constant crisis? Eventually the adrenals become exhausted and we become energetically depleted, this can result in anxiety, depression, headaches, difficulties sleeping, digestive problems and burn out.

If all that wasn’t enough to contend with. Groves suggests that during the peri-and post-menopause as our emotional resilience reduces; we no longer have the energy to keep difficult emotional experiences supressed. Buried feelings of grief, loss and shame can re-emerge and memories of trauma can resurface. Long established relationships are examined and sometimes break up. What felt safe and secure no longer feels so and this can feel like a kind of madness.

Groves’ advice is to acknowledge that this time is a process of transition that will eventually lead to a new stage of life, a kind of post-menopausal rebirth with renewed energy. She highlights ways to reduce stress and conserve resources during this transition.

One key message from Groves is that ‘energy follows attention’ i.e. what we focus on consumes or generates energy. She invites us to reflect on this through several different aspects:

  • The importance of getting enough rest and sleep, this might mean delegating some responsibilities, reducing working hours and includes sensory rest such as time without a phone.
  • The physical benefits of movement and keeping mobile through activities like walking, stretching, swimming and gardening; movement creates energy.
  • Gut health and nutrition are two aspects that may need adapting, for example reducing the consumption of sugar and alcohol.
  • Relationships and friendships, it helps to prioritise friendships that sustain and nourish and to limit those that are draining. Family and romantic relationships can come under scrutiny and may be revived or changed irrevocably.
  • Finally Groves emphasises (self) compassion, this might include physical and/or holistic treatments, new creative experiences, practices such as meditation and psychotherapeutic support.

At the same time as outlining these practical approaches, Groves acknowledges that in a culture driven by productivity and achievement attempts to cut down responsibilities and become less productive may feel like ‘weakness’ or ‘failure’. Women in my practice have asked – if I can’t do what I used to do what am I good for – and said – I feel worthless like there is no place for me.

On a more positive note Groves identifies a paradigm shift around the menopause. It is not just women that go through this transition but those who accompany them, friends, colleagues, parents and especially partners and children. Hopefully by welcoming a wider range of experiences including accounts from transgender women we might develop ways to support and improve life transitions for us all. Meanwhile, as therapists we can offer a conversation to help understand and contextualise what is happening to those who find themselves at the centre of this particular life transition.

 

To enquire about psychotherapy sessions with Angela Rogers, please contact her here, or to view our full clinical team, please click here.

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Poetry: A space to ponder

Relax: Watching people using their hands

What is Andropause and what happens to men when their testosterone levels decline?

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric and the importance of tracking symptoms

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

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Out of sight, out of mind

Available entertainment over the recent end of year break included the chance to laugh at the prospect of us all being killed. The climate crisis satire, ‘Don’t Look Up’ presented a mirror of our times, with scientists struggling to communicate imminent planetary annihilation by comet to a disbelieving public.

This new year sees the 60th anniversary of Rachel Carson’s landmark environmental work, Silent Spring. Her ‘fable for tomorrow’ begins with a stark picture of a rural American town that has died, its people taken ill, its farm animals barren, its insect life no more and all birdsong silenced. Recognizing the widespread harm caused by indiscriminate use of highly toxic insecticides, her book inspired an emerging environmental protest movement, leading to stricter regulation and a new awareness of how human activity was damaging the natural world.

Separated by sixty years of change, what strikes me most about both these works of warning is they seek to call attention to signals in the environment others have missed – or simply cannot see – and each insists these signals have meanings, with implications for the need to take action for purposeful change.

Not seeing the bigger things

In the same decade that Carson was warning of environmental collapse, a pioneering psychiatrist turned her attention to another neglected area of human experience. Conducting over two hundred interviews with dying hospital patients, Elizabeth Kübler-Ross gave moving shape to their stories with a new theory of how we cope with loss.

In her equally ground breaking publication, On Death And Dying, she proposed five separate stages of coping: denial, anger, bargaining, depression and acceptance. Although later critiqued for proposing a linear ‘stage’ process to change, her assertion that our primary response to loss is ‘denial’ holds truest for me.

Although now commonplace to hear talk of someone being ‘in denial’, this can often sound critical, as though there were something dysfunctional about this deeply human response.

For Kübler-Ross the denial she encountered in her patient interviews struck her as a ‘healthy way of dealing with the uncomfortable and painful’.

I think our human propensity for denial is testament to our powerful capacity to use our brilliant imaginations for self-protection. When faced with the intolerable, we unconsciously block out what threatens our fundamental sense of security.

Not seeing the smaller things

Because denial has acquired this shade of critical meaning, I find a more psychotherapeutic term, the process of ‘discounting’, much more helpful to use.

This theory emerged from a school of thinking in Transactional Analysis in the 1970s, when it was recognised that patients struggling to manage their lives and relationships had one big thing in common: they each engaged in ‘discounting’, whereby their thoughts and behaviours were often based on being plainly unaware of significant aspects of themselves, other people or wider reality.

Just as we can deny our larger reality in a life crisis I believe that an unconscious unawareness of smaller things is part of our day to day human experience. We all regularly discount some aspect of ourselves, of others and the world, simply in order to live in the best way we can. And as our denial must eventually give way to our awareness for change and growth to happen, so must our discounting.

The uses of psychotherapy

Psychotherapy often involves the paradoxical question, ‘What is it, that at some level, I am unconsciously choosing not to notice, and why?’ I see the process of psychotherapy as a sustained collaborative inquiry between therapist and client, so that clients can move at their own pace from self-protective discounting to self-expanding awareness.

In Carson’s fictional doomed American town, her explanation for the crisis is, ‘The people had done it themselves’. And just as her work helped many people to become aware of what they were not seeing and begin to account for healthier ways of relating to nature, so the business of psychotherapy can liberate individuals.

It can do this through carefully exploring their beliefs, feelings and behaviours in order to increase awareness of other ways of being and discover new options for change. In this way, psychotherapy at its most effective helps people, in the only way possible, to do it for themselves.

 

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

Chris Horton is a registered member of the British Association for Counselling & Psychotherapy (BACP) and a psychotherapeutic counsellor with experience in a diverse range of occupational settings. He works with individuals (young people/adults) in private practice.  He is available at our Lewes and Brighton & Hove Practice.

 

Other reading:
Carson, R. (1962) Silent Spring Houghton Mifflin Co. Inc
Kübler-Ross E. (1969) On Death and Dying Routledge

 

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Pornography and the Online Safety bill

Having just come off a phone call with the Child Sexual Abuse and Exploitation Policy Lead, my thoughts have been drawn to the enormity of the problem we face with pornography and the ‘pornification’ of society, particular the world of young people.

Pornography use has become ubiquitous and normalised to the extent that increasingly the world of pornography seems to influence and infiltrate wider society through body shape, appearance, hair removal, sexual behaviour, dating, all the way through to the core of our identity.

From my perspective as a clinician, I have no particular moral take on what consenting adults do behind closed doors and indeed, it is my job to hold curiosity about this as with any other aspect of my clients’ lives.  It could be argued that pornography falls into this category.  However, whilst I have no particular moral take on (some) aspects of pornography (consumed by adults), I have a strong healthy perspective on the issue much like I do on the consumption of alcohol for example.

A person may choose to live their life drinking a bottle of wine per night.  Other than this they don’t negatively impact society, they maintain a job and pay their way in the world.  However, I would hold a health perspective on this issue and whilst as a lay person I am as aware as anyone else about the physical health risks of excessive alcohol consumption, I believe that in my role as a psychotherapist I can claim an expert position on the mental health impact of excessive alcohol use extending to the wider social context.  And so it is with pornography.

It is easier for anyone to access pornography via the internet than it is to buy alcohol.  At the very least, alcohol must be physically purchased and paid for whilst porn is free – in the monetary sense.  However, I believe that what seems free to consume is in fact a Faustian deal in which the consumer sells their soul – in this case their mental and emotional health.

It is also extremely disturbing and concerning that it is easier for children to access pornography of virtually any description than it is for them to be able to access alcohol.  Let’s be clear, I am not advocating children have access to alcohol, however surely it should be at least as well regulated and policed and the risks considered? To date, the impact of pornography use by children, teenagers and young people has been vastly underestimated and as a mental health professional, I and my colleagues see the fallout of this.

We face a pornification of society whereby the young now trade in sexual pictures of each other and sexual acts that would until very recently have been considered ‘fringe’ at best, have become normalised such as non-fatal strangulation.  The effects of this pornification of our young is leading to enormous self esteem issues, relational problems and mental health conditions such as eating disorders, depression and anxiety.

As a society we therefore need to safeguard children from child abuse – and to be clear, permitting children to view pornography constitutes child sexual abuse.  The online safety bill aims to do just this – it is imperfect and won’t solve the problem in that legislation can never solve social ills, however the first port of call is to safeguard children and then a more nuanced consideration of the insidious effects pornography is having on society can take place.

Psychotherapy is about relationships and at its core it is about helping clients to have a healthy relationship with themselves and others in a two-person world.  Pornography is by its very nature perverse – it is narcissistic and is about voyeurism and exhibitionism rather than relating.  It is therefore by its nature in conflict with the very essence of the psychotherapeutic journey and a healthy society.

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Space: The Final Frontier of Manic Defence

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

 

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