Brighton and Hove Psychotherapy

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

For the past year we have largely been confined to our homes, a lot of us working from home and only going out for regular exercise. Our social lives have been depleted, we’ve not been able to see friends and family and generally life may have become quite repetitive.

As we come out of lockdown there will be mixed feelings, some people may feel really ready to socialise again and are already filling their calendars with get togethers and events. For others, they might be more cautious and be worried about feeling anxious in group settings.

Perhaps you’ve always found social gatherings difficult and so the lockdowns gave you permission to not have to socialise. By having to keep ourselves to ourselves anxiety has not been triggered or challenged and so confidence in social settings may have reduced. The prospect of now going into situations where there are more than two people may feel quite daunting.

Because we’ve not had much going on in our lives we may start to worry that we have nothing to talk about. Or perhaps our appearance has changed a little, we’ve put on some weight, or we’re not as toned as we were or our hair is more grey than it was, and so we are worried we will not look physically good enough. Or perhaps we are worried whether our friends will still want to see us after all this time.

These are normal thoughts that we may experience but they aren’t helpful and we may have to work at keeping them in check. It’s worth reminding ourselves that thoughts are not facts and whilst we may have these thoughts about ourselves it doesn’t mean that others are having these thoughts about us.

We’ve all been socially deprived over the last year and when you haven’t done something for a while it can feel uncomfortable going back into it, its normal to feel some level of anxiety. Just as the more we avoid something the harder it becomes to do. Be kind to yourself, don’t expect yourself to be able to go straight into large social gatherings. It’s better to return to socialising in a graded way. If it feels too big it’s ok to say you’re not ready.

When we are feeling socially anxious we can start to worry about how we come across to others and feel like we’re in the spotlight. The more we focus on ourselves the more self conscious we can become and the more this happens the more we end up in our own head. The more we start to judge ourselves and the more difficult it becomes to interact with others. We can’t be concentrating on what is going on around us or what others are saying if we’re so busy in our heads judging ourselves. Try shifting your focus onto others, paying attention to what’s being said rather than your internal dialogue. By shifting your focus of attention outwards to others, from internal to external, you can keep more relaxed.

A common fear to have when socially anxious is thinking you should be interesting all of the time. How realistic is this? particularly given that none of us have had very interesting lives recently. Take the pressure off yourself to perform, it’s about being with others, not entertaining others. Share how bored you’ve been, I’m sure others will have been to. Try to reduce those high expectations of yourself.

Another fear is to think that others can see your anxiety however the research tells us that this is not the case. What feels magnified and obvious to you, such as shaking or sweating, isn’t visible to others.

It is also unhelpful to prepare things to talk about as this again puts pressure on yourself to perform and maintains self focus. If you’re so busy thinking about the list of things you’ve prepared you’re not going with the flow of conversation, you become more self focused and can appear uninterested in what’s being said or aloof.

Lastly don’t allow yourself to replay or dwell on what you said or did later. No one else will be giving a second thought to what you’ve said or done, they will have moved onto the next thing in their day. You’re the only one analysing yourself and giving yourself a hard time.

Remember social interactions are a two way street, it’s not all your responsibility. The more we can focus on the social event rather than ourselves the more we are likely to enjoy the social interaction.

 

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 –

New Year’s Resolutions

Making Changes

Social Connections

Back to ‘Bace’ics

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Unexpressed emotions will never die

Short sharp, to the point and written by Freud. His full quote is ‘Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways’. What does he mean and is he right? 

With this statement Freud is defining on the pillars of psycho-analysis and psychotherapy – to uncover repressed and unconscious memories and provide a relationship in which those ‘traumas’ can be expressed through language and contact. 

What evidence is there that unexpressed emotions don’t die, after all, is passage of time not a great healer as the popular expression goes? We know that unexpressed emotions don’t die because otherwise people with traumas would simply recover and live contented and fulfilling lives.  Instead we know that this is not the case and trauma gets ‘stuck’. 

And with regards to the glib statement that ‘time heals’, this is only true when feelings can be expressed – losses grieved – and reality come to terms with, otherwise the past will continue to repeat itself in unconscious ways in the present. After all, the unconscious has no concept of time. 

How do unexpressed emotions come forth?

Unexpressed emotions – in other words emotions that cannot be acknowledged for fear of their impact on the psyche – express through a variety of means and present in an infinite number of actual behaviours or presentations. For me it brings to mind a quote from a Woody Allen movie where a character (played by Allen) says ‘I never get angry …. I grow a tumour instead’. 

Some of what we see as clinicians with clients who are defending against expressing difficult feelings can be: 

Acting out – Engaging in behaviours that are destructive to self and or others the reasons for which the client is often unaware of; 

Mania – Frantically ‘doing’ to avoid being in touch with one’s inner world; 

Depression – A pervasive deadness and inability to be in touch with desire as a result of emotions  being unexpressed. Being dead is preferable to feeling; 

Repetition compulsion – The compulsion to repeat an event or behaviour over and over again without an ability to clearly think about and consider why that may be; 

Reaction formation – A defence against the anxiety produced by feelings towards something causing the person to over-compensate in the opposite direction – an example would be someone terrified of death who engages in dangerous sports or activities; 

Mental illness – This is a catch all phrase, a product of the medicalisation of psychiatry whereby clusters of ‘symptoms’ are given different diagnoses. Essentially, mental health diagnosis or not, the work remains the same. And psychosis can be seen as the mind protecting itself from unbearable feelings and emotions by ‘going mad’. 

Somatic (body) symptoms – Back to the Woody Allen quote – in lieu of feeling, many of us develop physical ‘pains’ far less dramatic than tumours, but chronic nonetheless. Examples could be  gastro-intestinal problems (IBS), migraines or other more obscure symptoms. 

Dissociation – We all dissociate, which broadly means to ‘zone out’, however dissociation can manifest in powerful and extreme ways whereby the person ‘splits’ their mind akin to ‘the left hand  not knowing what the right hand is doing’, however rather than it being about one hand not knowing what the other is doing, it is in reality one hand not knowing what is BEING DONE to the other. 

And this list is by no means exhaustive or conclusive. 

Expression vs repression – living vs dying 

Expression of emotion is essential, however, cruelly paradoxically, those who have needed to repress have done so because there has not been a sufficiently available adult (in chronological as well as psychological terms) to be in relationship with. This is the role of the therapeutic relationship. 

Without titrated expression of emotion – I am no fan of new-age catharsis – and done in the context of relationship, living is simply not possible; only existence is possible where the client is at the mercy of powerful unconscious forces and exposed to their repressed emotions coming forth later in uglier ways. 

Grieving is part of living 

Grieving is extremely painful – whether that is grieving a loss in the present, or grieving the loss of what never was. However, without grieving we cannot feel alive – we cannot be born. 

Being born in the biological sense means leaving the safety of the womb, but also the ‘nothingness’ of the womb. In the womb we cannot experience reality other that filtered through our mothers. And so it is psychologically too – being born through psychotherapy means to face losses and bear reality, however painful that may be, and through that to come alive. If loss can be borne then desire for life can emerge and emerge it will. 

Psychotherapy is about expressing what has previously been inexpressible and it is in the context of the therapeutic relationship and encounter using language that this takes place: language gives trauma shape and form.

 

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

 

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 ready by Mark Vahrmeyer –

What is the purpose of intimate relationships?

Why ‘Cancel Culture’ is about the inability to tolerate difference

The Phenomenon of ‘Manifesting – The Law of Attraction’ and the inability to tolerate reality

Why does the difference between counselling and psychotherapy matter?

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Why is Love Island so Popular? And why it’s not for the reasons we think

For those of you that don’t know, Love Island is a British ‘reality television’ concept that has become a global phenomenon. Arguably deriving from the first global reality programme, Big Brother, which launched in 1997 it is the latest incarnation of this genre.

The premise is one whereby a group of (young, physically attractive) singletons are isolated from the rest of the world in a luxury villa dotted with cameras throughout. The singletons then must avoid elimination (eviction) from the villa through coupling up with another contestant. And like Big Brother the public ‘votes’ to eliminate contestants who do not please them. The ultimate price? Love? Eternal happiness? No, a pot of money.

What is the appeal of watching reality television?
To answer this question we first have to define how reality TV differs from regular TV. Clearly, reality TV is (to a greater or lesser extent) unscripted. And a cynic may argue that it is cheap to produce as the ‘talent’ is free, however I am more interested in the viewers drive rather than the profit margins of the production company.

For the viewer, they are aware it is unscripted – anything could happen. And with offering the audience a piece of the action – the control to vote out contestants, the experience becomes seemingly interactive, almost relational in that viewers feel a form of connection to the contestants.

Reality TV is reminiscent of the Romans and their staged ‘fights’ between gladiators and prisoners, or between imprisoned wild animals and unfortunate humans. And whilst the humble Roman had no direct power over who survived, they could look to their Emperor who would decide with a simple thumb’s-up or -down whether to spare the life of the barely alive prisoner. In turn the Emperor would be guided by the furore of the crowd, hence the illusion of control and investment in the outcome. Fundamentally though, it was entertainment at the expense of an
other(s).

Now let’s consider how reality TV and regular drama such as soaps – Eastenders and the like – differ. Watching a soap opera is a narcissistic endeavour where the lives of fictitious characters are watched according to a script. All are aware of the ‘pretend’ quality. A performance is being given and the boundaries between real people and characters are clear.

Reality television invites the participants to ‘star’ in a version of life judged by the viewer. And the viewer rewards the contestant through sparing them or eliminating them dependent on how ‘entertained’ they feel. It is a game of exhibitionism and voyeurism. One can argue that unlike prisoners of the Romans who were ‘thrown to the lions’, reality TV stars enter into the ‘game’ with their eyes fully open and can be handsomely rewarded. On the face of it this is true, however, taking ‘Love Island’ alone, there has been significant media coverage of three suicides of people
connected to the show. Whether the latter is causation or correlation, my argument is that both the contestants and viewers of reality TV are being driven by something unconscious.

So what’s the appeal?
I believe that this genre of television has become so extraordinarily popular because it appeals to out innate need to feel part of a community. Unlike soap operas, we know that what happens is real – and even if it is not; both contestant and viewer believe it is so the fantasy is complete.

In reality TV we are invited into the intimate lives of a group of people and can exert influence over them – it creates a kind of pseudo-connection. Exactly the kind of pseudo-connection present in a collusive exhibitionistic/voyeuristic encounter. By definition therefore, it is a form of perverse relationship in that it is rigid and without emotional contact. It is a relationship based on power and control rather than real intimacy.

And like any pseudo-connection, whilst it may feel exciting and glamorous, it has the nasty habit of leaving us feeling less connected and thus more prone to feelings of depression, anxiety and loneliness when it all ends. And it always does. For the viewer, they can move onto the next reality TV series thereby keeping their need for authentic connection and vulnerability at bay; for the contestant, they can perpetuate the fantasy through building a career (brand) build on image, or they fall spectacularly from grace or fade away (both are equally devastating for the narcissist).

A loss of belonging
I therefore suggest that ultimately the rise of reality TV correlates with the erosion of community and a sense of belonging. It correlates with an increasingly individualistic world where narcissistic interactions are the norm.

Ultimately though, it speaks of our desire for contact and real relationship, something that can never be fulfilled through reality television or any other kind of perverse relationship where the premise is power and control.

Connection and belonging come from community and from real relationships where two people can take up space and each have their ‘real’ experience validated and understood by the other, rather than one having to be a performing (glamorous) monkey in order to manage to survive (elimination). The latter is pure and simply the definition of a deeply narcissistic and perverse relationship.

 

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

 

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

What is the purpose of intimate relationships?

Why ‘Cancel Culture’ is about the inability to tolerate difference

The Phenomenon of ‘Manifesting – The Law of Attraction’ and the inability to tolerate reality

Why does the difference between counselling and psychotherapy matter?

Love in the time of Covid

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When Home and Work Merge

The onset of national lockdowns in early 2020 (and subsequent restrictions) have made working from home the ‘new normal’. What was once seen as an ideal for many, free from commuting and office politics, suddenly became an enforced reality for all of us.

Our homes, which were previously separate, became our place of work, schoolroom or therapy room. The initial sense that being at home was an exciting new way of living and working, gave way, for many, to a sense that home and work were one and the same.

When home and work take place in the same space does it make us think about what function the workplace has? The workplace allows us to leave a lot of work-related stress there when we go home. Ad hoc chats with colleagues are part of how we manage some of the anxiety and challenges of working life. In short, the places that we work at and the people that we work with, hold a lot of our emotions.

This sense of something being held by a place and the people in it chimes with what Bion (1962) referred to as ‘containment’. Bion’s theory was based on the idea that it’s a person, invariably an early caregiver, who the infant looks to, to help them to process unbearable feelings. The infant cries and expels their feelings and the caregiver, through touch, facial expressions and sound makes these feelings more tolerable and, this in turn, calms the infant.

Bion felt that this cycle of learning what it is like to have feelings contained by another was part of how an individual learns to cope with their own feelings in later life. Once we learn this we can contain our own feelings and we can also trust others to contain them.

How does this translate to the impact on our lives of working and living in the same space? Bion spoke about the impact of the caring parent on a child. Might this sense of something being contained by another also relate to the place in which we work? This place forms it’s own sense of containment that may be lost with home working. It is somewhere that we engage with unconsciously as a space where we leave the challenging feelings that are evoked by the tasks carried out there. This place holds our feelings and leaves us free to go home and leave them behind.

Home working challenges us to find a way to manage this lack of separation and hold a boundary between what is work and what is not – and the anxiety that comes with that. How we do this is as individual as we are.

 

To enquire about psychotherapy sessions with David Work, please contact him here, or to view our full clinical team, please click here.
David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove and Lewes.

 

Reference:

Bion, W. (1962). Learning From Experience. London: Karnac Books.

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The Problem with Change

When people come into therapy it is usually with the wish or hope for something to change. If not, they want help with adapting or stabilising following a major change.

It is a paradox that change is such a constant in our lives. As we age our bodies inevitably change and if nothing else this makes living itself a profoundly transitional experience.

Changes in our lives can come in many forms. For example, there are key developmental milestones at various life stages – adolescence and mid-life are perhaps the most discussed of these.

Significant events in life can also impact and bring about profound change in ourselves. These changes always involve beginnings and losses and can lead to crisis. Crisis too can bring about change. Even positive changes – like getting married or starting a new job for example – are often cited as highly stressful, so societally we very much recognise the equation of change and crisis.

Psychotherapy and psychoanalysis have had huge influences in how we might understand changes and crises in life stages and events.

For example, Elliott Jaques, a Canadian psychoanalyst, coined the term ‘midlife crisis’ in his 1965 paper (1). Jaques wrote about how this crisis repeats earlier intense transitions from adolescence and infancy and explored what he saw as a tendency for the individual to lose or discover creativity as a response to this life-stage.

And it is largely due to Winnicott’s seminal work (2) that we understand the level of intense feelings that typifies adolescent transitions, when the young person is caught in a fraught conflict between childhood and adulthood.
In psychotherapy we think about therapeutic change, meaning an internal change for the better. I think most people come into therapy welcoming this idea of inner change and certainly those who are assessed as being suitable for psychotherapy will partly be so on the basis that they recognise the need for some internal change.

Initially in therapy, changes are often experienced as positive. Being heard and supported and gaining insight generally increases confidence and a sense of self. At the same time people can find quite that more negative feelings towards themselves seem less extreme. These changes are important and real. However, deeper changes that take place in therapy, in my experience, are not always so welcomed. This is partly because of the disruptive nature of change and its relationship to crisis.

Undergoing the kinds of powerful changes that therapy can offer can feel destabilising and bewildering. As mentioned earlier, change always involves loss of some kind. What might need to be given up may be experienced – consciously or more often unconsciously – as vital to the person’s sense of self. Even unwanted aspects to one’s psyche and behaviour are still familiar and what is known is experienced as safe, even when it is also recognised as harmful and self-limiting.

While we might recognise the likelihood, even perhaps inevitability of crisis in change, experiencing this in therapy can, for some people, feel understandably counter-intuitive.

Many people who come through therapy find a way of tolerating and working through these unsettling if not disturbing experiences of therapeutic change. But some become too frightened or overwhelmed and may then leave suddenly.

In my experience, those who stay are able, with the support and help of the therapist, to recalibrate and restabilise – much as after major life stages and events. As things settle, they can then experience and enjoy the positive benefits of the internal work and changes they have undertaken. However, inevitably and necessarily, in time the problematic process of change will be repeated.

 

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

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes –

What is it like being in a Psychotherapy Group? Case study – Joe

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

 

References – 

Death and the Mid-Life Crisis. Elliott Jaques, 1965
Contemporary Concepts of Adolescent Development and their Implications for Higher Education, from Playing and Reality. Winnicott, 1971

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Executive Function (part 2): Ideas for Supporting Thinking Skills Development in Children

Referring back to my previous blog – Children and young people with Executive Functioning Difficulties need us to:

Accept that they have gaps and delays in these skills.

Learn, by spending time with them and observing, which Executive Function Skills need scaffolding and practice.

Support by being the air-traffic controller when a child can’t do this alone, building in steps like:

  • modify the environment – reduce noise/ remove other distractions, create comfort, provide easy access to resources, use visual aids/ prompts, movement/ sensory breaks.
  • simplify tasks – reduce language and instructions, keep tasks short and achievable.
  • support completion of tasks – help child get started and ensure he/ she understands and can access materials required – check in regularly; if needed, be alongside throughout a short task before child tries a similar one with less support.
  • Use memory cards – if child needs to wait for your support, write it down on a card for each of you – and if possible the approximate time you will return to the task with them.
  • build EF skills development through practice – carefully chosen activities/ games/ projects.

The best way to develop executive function skills is to do meaningful activities which require Executive Function (thinking) skills to be used. To be able to engage in these kinds of activities and draw on thinking skills, children need first to feel safe, regulated and connected – for this they need a regulated, consistent adult to support them. Children also need activities which interest them and which are achievable, matched to their emotional age and ability level or the level they could manage with support. The following ideas for activities and games are just a few of many which might help.

HOME-BASED ACTIVITIES
Many of these activities involve the use of working memory in order to plan, prioritize, and get organised. They may also require self-control to stay focused and flexibility to solve problems:

  • Build a bird box or bug hotel/ grow things/ make a wormery/ catch falling leaves/ watch birds
  • Bake/ plan and cook a meal/ make a rug/ make a puppet/ do a mosaic/ make fimo beads
  • upcycle furniture/ decorate a room/ mend a bike puncture/ junk modelling
  • start a collection/ invent games/ create hunts and trails for each other
  • do a jigsaw/ make lego models – either from the box or made up
  • make music or playlists/ make up dance routines/ do puppet shows/ role-play/ tell stories

MEMORY GAMES

  • Matching pairs (working memory, flexibility, self-control). Adapt this to suit attention span and memory skills by reducing the number of cards. Can be cooperative if you work as a team to see how many turns it takes you to find all the pairs.
  • I went to the shops (working memory). Take turns in a pair or group to add to a shopping list, repeating the full list each time – invent various (I went for a walk and I saw a …… ; I went exploring and I found a ……) – be as flexible as you need to be to keep child engaged – eg. give clues if they struggle to remember a word.

WORD GAMES

  • Word tennis (working memory, task initiation, attention, flexibility). Play cooperatively in pairs or a group. Take turns to pick a topic and see how many things you can name from that topic – pass a ball/ soft toy as you do it. Continue for as long as you can without repeating a word. If you wish, time how long you can all keep going for or count the number of words.
  • Cooperative Bananagrams (planning, prioritising, flexibility). For children not ready for the competitive version of this game, work altogether as a team to use all the letters to make lots of mini crosswords or one giant one. Adapt this for your child’s attention span by choosing how many letters you play with.

PICTURE / MOVEMENT GAMES

  • Jenga (self-control, flexibility, planning) – Adapt this game in any way that suits your child, eg. leave out the requirement to pile bricks on top, use a smaller stack, create a rule that when a brick is taken there are other actions to follow, which might be drawn from a pile of cards. Or, just use the bricks to create mini collaborative challenges. Eg. Let’s see how high we can make a staircase, What’s the tallest tower we can make? Can we make a domino rally in the shape of an S? Are there enough bricks to make an outline of both my arms?
  • Home-made Pictionary/ charades (flexibility, self-control) – Create your own bank of words/ pictures/ phrases to be drawn or acted out for others to guess – or use cards from published games. Avoid time limits if this creates stress. Play in pairs if this helps a child to participate – whisper together about how you’re going to draw or act out the word.
  • Freeze (focus, self control). Play music while everyone dances or moves in any way they want. Freeze when the music stops. Or everyone moves about and one person just shouts “Freeze!” Try holding your poses for a count of 5/10/ longer.
  • Dobble (focus, initiation, self-control) – a matching game done at speed – the twist is that matching pairs of images may be different in size and surprisingly hard to spot! There are different ways to play the game and various themed versions available.

STRATEGY GAMES

  • Forbidden Desert (planning, prioritising). This is designed as a cooperative game where participants work together to escape from a desert by finding pieces of a sun-powered flying-machine, whilst avoiding sandstorms and keeping water supplies topped up.
  • Quirkle (Planning, organisation, flexible thinking). A simple but original game based on matching colours and shapes on wooden painted blocks. Players need to think about where best to place their pieces for the maximum score. Work in teams if this suits your child best. And you could try using the blocks to make patterns – see what your child comes up with.
  • Rush Hour (Focus, flexible thinking, working memory, perseverance). This is the original version of a game which has been replicated on many apps. The real thing is a fun way of moving vehicles to enable an ice-cream van to leave a car park. There are 4 levels so it’s easily adapted.
  • Genius Square (Focus, flexible thinking, perseverance). This game can be played solo or against a partner/ other team. The task is to fit the blocks into the grid around where the dots are placed. There are always lots of possible solutions.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Further resources and ideas are available at:

HARVARD Centre for the Developing Child website for activity ideas by age group –https://developingchild.harvard.edu/guide/a-guide-to-executive-function/

UNDERSTOOD website for ideas on supporting different areas of executive function.
https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/executive-functioning-issues-strategies-you-can-try-at-home?_ul=1*2sfyod*domain_userid*YW1wLVppUDNOQ3JWZXUwSTIzekQyall5N3c.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Relax: Watching people using their hands

Stuck at home I don’t always want to chat with friends and family or listen to any more news, podcasts or watch TV drama or read a book. Yet I want to be taken out of myself. I want to be elsewhere and with my own thoughts at the same time.

Being engaged in an activity that uses our hands is recognised as having therapeutic benefits. During the privations of Covid-19 lockdowns making and baking have become popular. You can find numerous examples of famous faces presenting the results on social media. For example, the Olympic diver Tom Daley says he took up knitting to help him relax and he has knitted clothes for his husband and child. Finding no knitting patterns for men’s swimwear he adapted a pattern for bikini bottoms and produced a pair of crocheted speedos for himself.

There is also a therapeutic effect when we watch someone else using their hands. Think about the close-ups on hands in cooking programmes. Might this satisfaction in watching be something to do with mirror neurones. Discovered in the 1990s, mirror neurones fire in the brain of observers whilst watching or listening to another person performing an activity. The neurones that fire in the brain of the person performing the activity are mirrored in the observer. That is, the same neurones fire in the brain of the observer. It seems we can experience what another is experiencing at the same time. This has led to research investigating the role of mirror neurones in how empathy operates and how we learn.

Whilst watching the gardener raking the Zen garden in this video clip, I find I can sense his body movements, almost feel the weight of the rake and the resistance and flow of the gravel. And then I watch it again. I can be there in that garden and at the same time sitting at home relaxing into my own thoughts and imagination.

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 –

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 sysmptons

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

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

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What is Transactional Analysis?

Transactional Analysis (TA) is a widely recognised form of modern counselling and psychotherapy, originally conceived by Eric Berne in the 1950’s and which is now used not only in therapy but also in education and organisational training and consultancy.

It is a theory of personality, behaviour and communication, and draws on tools and methodology from a wide range of psychological disciplines, including humanistic, psychodynamic, person centered and relational therapies.

It is therefore a flexible form of therapy that can be tailored to an individual’s needs to facilitate personal growth and change.

How is Transactional Analysis used in counselling and psychotherapy?

A Transactional Analysis counsellor or psychotherapist has a wide variety of theory to hand including the theory of personality, communication and child development.

Transactional Analysis theory has an emphasis on the therapy being contractual, with a negotiated agreement between the therapist and client on what will be explored in the therapy sessions with a view to an end goal or change. The agreement is not fixed but rather is a dynamic and fluid process where the agreement can be re-negotiated at any time. This enables an active participation, both by the client and the therapist, and an equal partnership which is built on the core values of clear communication, respect, and openness.

Transactional Analysis counselling and psychotherapy can be used for individuals, couples, and groups and for a wide range of issues, including anxiety, depression, bereavement, and other life changing issues.

Some key concepts of Transactional Analysis theory

Transactions– this looks at both the verbal and non-verbal messages we use to communicate with ourselves and others, which can give us an insight to how we think, feel and behave and how we view the world around us.
Unconscious Scripts – this is our life story or ‘script’ that we unconsciously write for ourselves when we are young, uniquely interpreting both internal and external events which influence our thoughts, feelings and behaviour. Transactional Analysis can help facilitate exploration of which of our thoughts, feelings or behavior is archaic and no longer serves us, and is therefore having an impact on how we want to live our lives in the ‘here and now’.
Ego States – Ego states theory relates to personality and is linked to which of our thoughts, feelings or behaviour has either been learnt from our caregivers and other significant people in our formative years (Parent ego state), from past experiences in our childhood (Child ego state) and which are direct responses to the ‘here and now’ (Adult ego state). It may be familiar to you that you play different ‘roles’ depending on the situation you are in, such as at work, or with friends or family and switch between these ‘roles’ many times during the day. In Transactional Analysis we see this as switching between ego states.

Transactional Analysis Counselling and Psychotherapy helps facilitate awareness of your life ‘script’ and its link to archaic perceptions and beliefs with exploration of how you would like to live in the ‘here and now’ to have a more fulfilling, enjoyable, and happier life.

 

Louise Herbert is a psychotherapeutic counsellor who is in the final year of specialist training in Transactional Analysis Psychotherapy. To get in touch with Louise, please contact us.

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

I don’t know about you, but I have been riding the Covid-19 emotional roller coaster since March 2020 with very little roadmap, whilst trying to guide those who I work with like “the blind leading the blind”.

I also see my own psychotherapist and supervisers in the exact same boat. They are supposed to know more than me, but actually I get the sense that we are all struggling together.

Nonetheless, as a mental health professional, business owner and with all my family living in different countries, I have been dealing with my own set of challenges as a result of Covid-19, as well as trying to be the best support I can for my clients. I have also felt grateful for the support of a therapist throughout this period and couldn’t imagine a better time to be in therapy other than now.

All helping professionals are going through their own predicaments throughout this crisis whilst trying to help others as well. This can be both rewarding and also incredibly taxing. I noticed feeling more tired than ever at the end of last year – an exhaustion which felt both familiar and entirely new. Self-care has become more important than ever.

We all had to adapt to new working practices and navigate the unknown over past months. This has been both unsettling and reassuring in that most of us have survived and gotten through in our own way. There have been losses for sure and they have taught us that we can survive them too.

Professionals in support roles have been working through the pandemic feeling mostly under-resourced themselves. Under such unusual set of circumstances this can only be expected. It has been humbling.

Having weekly psychotherapy sessions has helped and continues to help me enormously. Therapists need their own therapy now more than ever. If we are to continue to be of help to our clients, first we need to have the support ourselves.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email.

 

Sam Jahara is a UKCP Registered Psychotherapist and clinical Superviser. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

What shapes us?

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Executive Function Skills (part 1) – What They Are And Why Some Children Struggle With Them.

Executive functions are the cognitive skills we use to control and regulate our thoughts, emotions and actions to achieve goals. These three main areas of executive function work together:

  • Self-control/ inhibition – the ability to resist doing something distracting/ tempting in order to do what’s needed to complete a given task, helping us to pay attention, act less impulsively and stay focused.
  • Working memory – the ability to hold information in mind and use it to make connections between ideas, make mental calculations and prioritize action.
  • Cognitive flexibility – the ability to think creatively, switch gears and be flexible to changing requests and situations, allowing us to use imagination and creativity to solve problems.

For example, all three areas are needed in social pretend play:

  • Child needs to hold their own role and those of others in mind (working memory)
  • Child needs to inhibit acting out of character (employ self-control), and
  • Child needs to flexibly adjust to twists and turns in the evolving plot (cognitive flexibility)

The joint forces of our executive function skills can be thought about as . . .

  • the conductor of an orchestra, organising multiple instruments to make one unified sound or
  • an air-traffic controller managing safe take-off and landing for hundreds of air-craft

Executive functions are controlled by the frontal lobes of the brain which are connected with and control the activities in many other regions of the brain.

Hot and Cool Executive Functions
Hot executive functions are the self-management skills we use in the heat of the moment when emotions run high – they require concerted conscious effort and help us give up short term gain for the sake of a more important goal. Examples include: resisting temptation; focusing on a boring task; breaking an old habit; and biting our lip when angry. Cool executive functions are the skills we use when emotions aren’t really a factor. Examples include: remembering a list of numbers and repeating them back in reverse order and following a simple recipe.

Executive function skills are a vital part of learning. They help children to be in the right place at the right time with the right equipment, listen to the teacher, wait for a turn and not call out. They are also pivotal in managing frustration, getting started on a task, staying focused, accepting constructive criticism and asking for appropriate help. They enable children to notice and correct mistakes, prioritise, persevere and complete challenging activities, resist the urge to retaliate and feel more confident about managing in school.

Children with under-developed executive function skills may act without thinking, overreact to small problems, be upset by changes in plans, forget to hand in homework, delay starting effortful tasks, switch between tasks without finishing any, lose or misplace things, struggle to meet deadlines and set goals, and lack insight into their behaviour.

Factors which can make it harder to access our executive function include tiredness and sleep deprivation, dyslexia and more complex learning difficulties, neuro-developmental conditions like Autism and ADHD, environments which overwhelm our senses and create stress, one-off traumatic incidents and complex trauma as a result of Adverse Childhood Experiences.

Given their significance, difficulties with Executive Function can contribute to social, emotional and mental health difficulties if they are unsupported and children who are already vulnerable for any of the above reasons may experience a compounding of the challenges they face. It is therefore essential that we take time to understand what these issues look like for each individual and adjust parenting, schooling and community interventions accordingly.

Look out for my forthcoming blog –  Executive Function Skills (Part 2) for ideas on how to support children with these difficulties.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Additional resources –

  • UNDERSTOOD website: https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/what-is-executive-function
  • The book  Why Can’t I Do That? A Book About Switches by Fi and Gail Newood is designed to help children understand what Executive Function skills are and how they link to everyday challenges.

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Fear and hope in the time of Covid – part 2

I am writing a follow on from the wonderful blog written by Gerry Gilmartin back in August. 6 months on and here we are again, facing new Covid-related challenges with more restrictive measures in place, more infections and more deaths.

The theme of Gerry’s blog revolves around fear and hope, and how to work with these polarities which coexist in most of us. Psychotherapy is very much about learning to live with polarities within ourselves as well as acknowledge them in others. In psychotherapy we gradually increase our capacity to understand and be with complex human emotions, and to reduce polarised black-and-white thinking. Gerry writes:

“The uncontrollability of the corona virus may reflect something of the uncontrollability of a globalised world. Both highlight our mutual dependence and by implication our mutual vulnerability. At a time when a sense of universal unity might be prescient it is also a time at which it seems extremely unlikely. In a state of fear the instinct is to contract mentally and physically, to batten down the hatches against a real or imagined enemy. In a state of fear we may abandon our capacities for hope and for trust…. On a global as well as an individual level”.

Talking about what we are afraid of can be enlightening. It helps us separate fantasy from reality and to stay connected to ourselves and others. It can be difficult to ‘stay sane’ when we are constantly being bombarded with news items which are designed to retain our attention as much as possible by scaring us into remaining watchful and alert to yet more bad news, just in case we weren’t already frightened enough.

This process actives our fight or flight systems, sending us into survival mode which is never conducive to reflective states of mind required for conscious thought and creativity. In fact, the very type of thinking that is required for effective leadership and decision-making.

Part of our job is to help people to think when they have stopped thinking and are living in fear or in a state of hyperarousal. Of course, this isn’t always possible. However, it is possible in most cases and an outcome which is see in psychotherapy time and time again. People arrive contracted and fearful and leave feeling hopeful and with a more expansive and different mindset – each week, each month, each year this process deepens until it becomes second nature.

Through the establishment of a trusting relationship with another, we begin to create a microcosm of safety where difficult feelings can exist without the urgency to get rid of them. We learn to tolerate the intolerable, which may also result in setting limits, taking action, or even doing nothing. Whatever the choice, it will be one which emerges from a place of more awareness and hopefully lead to a more fulfilling life.

 

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

Sam Jahara is a UKCP Registered Psychotherapist with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

What shapes us?

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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New Year’s Resolutions

In my last blog I wrote about goals for change and linking these to our values. When someone decides to come into therapy it is often because they would like to make changes and it can help to set goals as a means of knowing when these changes have been achieved.

Given this is a time of year when we might have made New Year’s Resolutions it seems quite fitting to talk a little more about setting ourselves goals for change. It is often the case that at the start of the year we have all these wonderful ideas of what we want to achieve and we start off really motivated with all good intentions and then several months in we start to lose heart and give up.

A common goal at this time of year is dry January and this can quite often be successful because its time limited. We know that after a month we can return to our favourite tipple. However, for some this is difficult, particularly in the current situation with the stressors of Covid. Complete abstinence can be too challenging as its very all or nothing. It might be more helpful to consider cutting down and reducing frequency, e.g. limit to just one drink once or twice a week. In this way we can make the goal more achievable. Making our goals for change realistic and time limited is really important for achievement.

Another common goal for this time of year is to get fit and start exercising. To start with when we are motivated it goes well. It’s the trying to keep it up that’s difficult. Part of the battle is finding what exercise you enjoy. There’s no point pushing yourself to do something you don’t like. Often when people think of exercise they think they have to do something cardio related. However, there are lots of low impact workouts that are good forms of exercise, such as walking, yoga and pilates. Whatever choice you make its important to start small and build up. It’s the achievement that helps to maintain the motivation. So the first week or two you might aim to exercise for 20 minutes twice a week and then the third week, 3 times per week. Once you have comfortably achieved the first goal you set another, building on the first to push yourself that little bit further. All the time holding in mind where you want to be and this is where it can be useful to link goals to your values. In this example its values around physical well being and of course exercise is also great for our mental health.

Losing weight or eating healthier is another very common goal for people to set themselves at this time of year. And again is another that can be difficult to maintain. So rather than push yourself to go on a really restrictive diet or to cut out entire food groups consider aiming for a ‘better’ diet. Try reducing unhealthy food groups, reducing treats, and swapping to more healthy options. It can be more helpful to aim to eat healthily for 75% of the time or to eat healthily in the week and let yourself indulge a little at weekends. Again, it’s about trying to set more realistic goals for yourself. For example if your norm is to eat half a packet of biscuits with your cup of tea to allow yourself just 2 biscuits rather than going for complete abstinence.

Thinking about setting the right goals is really important and if you don’t achieve them, that’s o.k. There’s no such thing as a failed goal. If you don’t achieve your goal then there is still useful information – ask yourself why wasn’t I able to achieve this? What got in the way? What is the learning from this? What can I do differently next time? Are there any supports available to me to assist in this? Often we don’t achieve our goals because they are too big and need to be broken down further.

None of this is rocket science but we all to easily forget the basics. We can impose high expectations on ourselves and then become disheartened when we don’t achieve them. Our self critical voice kicks in and this can have a negative impact on our mood. Given the difficulties we are all facing currently its even more important to be kind to ourselves and realistic of what we can and can’t achieve.

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

 

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 –

Making Changes

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

Face to Face and Online Therapy Help Available Now

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What’s wrong with good advice?

Often, the people who engage in therapy with me will ask for advice, tips on managing anxiety, what to do about a relationship situation, how to manage a tricky situation at work. Sometimes someone might ask for general ‘life advice’. Of course, mostly what they want is some sort of reassurance and although its not true that therapists never give advice I tend not to offer reassurance. Why not?

Well to start with, the problem is rarely not knowing what the right thing to do is. If someone wants ‘tips’ on sleep or anxiety strategies, I might advise them to look on the internet, there’s plenty of it out there and its free and of course generally sound. Eat your greens, go to bed at a regular time, do some exercise, especially yoga and don’t take too many or too much, mind altering substances.

This reminds me of a joke, –

‘Doctor, If I stop drinking alcohol altogether, eat my greens and give up sex, will I live longer?

Dr – Well I can’t tell you with any certainty whether you’ll live any longer, but one thing I do know, it will certainly seem much longer!’

Of course, what people struggle with is not, not knowing, what the healthy thing to do is, it’s doing it and the reason for this is that they/we are conflicted.

Many clients may come saying they want to stop, whatever it is, that is causing them problems. So I ask why don’t they then? and they say I don’t know. Well the answer is simple, another part of them doesn’t want to stop, whatever it is there doing, is serving some purpose, even if the consequences of continuing to do it are grave. Of course, in many cases this can indeed be tragic, people find themselves compulsively doing things that they know hurt themselves or others, damage, destroy or put important, sometimes essential relationships at risk.

Therefore, advice on stopping the behaviour rarely works as the addiction or compulsion is a solution to another, sometimes, -unconscious problem., as Depache Mode noted, they’re, “looking for love in all the wrong places”.

– “in the woods of anguish, it’s easy to lose your way”. (George Nash 7.9.2020)

The difficulty in a way is in beginning therapy, as the client and therapist needs to come to a together about what the problem is and what the contract of work is.

I have had many clients come with problems and basically say, well, I’ve told you the problem, now over to you to give me the right advice to fix it. Needless to say, these client’s often leave before the work starts. For instance, someone I saw with a destructive addiction was clearly harbouring a long festering repressed grief about an abandonment by his father, however this wound was so repressed that any interpretation of mine that it might be important to look at this just didn’t work and we were immediately at a stalemate.

Of course, my job is to be as tactful as possible, to not push the client beyond where they are ready to go and to be as patient as possible, BUT, destructive behaviour is always the result of past hurts and unless we do find a way together to think about these, a stalemate or premature ending will be the result.

 

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 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 –

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

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The Pandemic and the Emerging Mental Health Epidemic

There is a lot of talk about how Covid-19 and the resulting lockdown cycles are causing a mental health crisis in the UK. This blog aims to unpack and list some of the reasons why the response to the pandemic is also causing a mental health epidemic amongst us.

This year has been very hard on most of us, personally and professionally. I don’t think I have come across anyone who has not been negatively impacted by the pandemic and resulting lockdown cycles since last March. The pandemic and deaths resulting from Covid-19 are only one aspect of this crisis. The efforts to avoid death and transmission, not overwhelm the health service, and its resulting policies, in conjunction with how the Covid narrative is portrayed in the media, is what is driving the mental health crisis.

Before the pandemic hit, we were already living and dealing with normal day to day challenges linked with work, relationships, raising children, making decisions, caring for relatives, ageing and death, etc, etc. As psychotherapists, we listen to and work with these challenges everyday. The pandemic has added another layer to pre-existing issues in society, exacerbating them for everyone through the fear of death, loss, survival and health anxieties, to name a few issues which are both specifically linked to the pandemic but also issues to do with being human.

It has even become difficult to distinguish whether some of the difficulties experienced are linked to Covid or not. For instance, relationship issues which were pre-existing became exacerbated during lockdown and having to work together to home school children. Or someone with an already high level of health anxiety becomes even more anxious about becoming infected with Covid and isolates themselves even further from others.

There was a big drive to bring more awareness to mental health issues in UK society before any of us even heard of Covid-19. A large number of people were already experiencing pressures on their mental health through a variety of factors, which have now become more exacerbated through the fear of death and transmission, confinement at home, business closures, lack of outlet with entertainment venues, cafes, leisure and restaurants closed.

We have lost a large proportion of our social connections due to not being able to meet socially and professionally as we used to. Even small daily exchanges which used to make us feel more socially connected have been taken away, such as a visit to a local shop or the hairdresser.

The list is endless: Professionals who derive their identity and social contacts through work and running their businesses and had to close them, the elderly who were already lonely and have now become even more isolated, workers in the gig economy who were already struggling to survive and are now out of work, parents who were already under pressure and now have to home school as well. The list goes on…

It is vital that enough mental health support is available. In my work as a therapist, I acknowledge the collective impact in society yet focus on how it affects people on an individual level. We are all fighting our own battles at the moment, each one is dealing with a separate set of challenges pertinent to their life circumstances. It is vital for us to acknowledge and talk about what is troubling us and not just “get through”.

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

Sam Jahara is a UKCP Registered Psychotherapist, Transactional Analyst and Supervisor with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Leaving the Family

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Love and family

The family is our first social group. It is the crucible in which our passions are born and our capacities to love and to live are shaped – and misshaped. The family imbues its members with its own specific culture, habits and attitudes.

As an organism, it too is shaped by the cultural moment and the social environment, the hopes, fears and attitudes of the day. It is the bedrock of our most durable and intense emotions and the fertile soil of our satisfactions and discontents. The family reconfigures with each new life that enters and exits. Constantly changing, constantly staying the same it is both dynamic and flexible, coded and predictable. We are all indelibly touched, one way or another by its authority. We learn to love in the context of ‘family’, each in our own idiosyncratic way. Every family has its own cast of characters ((step)parents, grandparents, (step) siblings, aunts, uncles etc). All players in a unique drama. Family is a stage where universal themes are navigated, power, sex and money, hierarchy and democracy, passion and ambivalence, in all their dark, tumultuous, devastating and innocuous glory.

Universal themes

From Greek myth to Shakespearean tragedy, the depths and breadth of family relations provide a turbulent, brooding backdrop to moral, ethical and philosophical considerations of a universal scale. So often in these epic tales, we are reminded what an unruly emotion love is, indeed how uncomfortably close it resides to its shadowy counterpoint hate. Disowning his most beloved youngest daughter Cordelia, King Lear in a fit of vanity and rage is consumed by vengeful hate, abdicating love and reason in its wake he casts her out. Her failure to satisfy his insatiable need for flattery and primacy, to go against her own nature, disrupts their bond, unleashes chaos and eventual tragedy. This is an epic tale of family conflicts, of power, love and greed. Most family dramas do not play out on such a grand scale, but remain hidden in the shadows of secrecy, shame and trauma, creating a legacy that can trickle (or cascade) down through generations to come.

Changing Families

Whilst the major human themes endure in families across generations, the architecture of family life and living is continually changing with the socio-political and economic tides. Every generation spawns its own raft of experts on the family and its constituent members, from the institutions of religion, state, medical and social science and philosophy. The current moment, in particular, is one in which the couple is the central organising pillar upon which the success of the family depends. Bred in ever smaller numbers, the modern child is also a major focus of scrutiny and opinion. As the birth rate has decreased so children’s value has increased. Parents invest heavily in their offspring financially, emotionally, educationally etc. We dedicate ourselves to their health and happiness, often discounting our own in the process. As an antidote to our high tech fast-moving, demanding lives we create a utopia of childhood and perhaps (without knowing) locate many of our own unmet hopes and passions in our beloved and precious innocents.

Love them or hate them (and indeed it is within our families that we learn about both) idealise or reject them it is within the context of the family that we learn about the social world and our place in it. It is in this original grouping that we have our first experience of grief and loss, it is where we learn to trust (or not) and to express (or inhibit) our desires. Family life is fraught with misunderstandings and pain and is the vessel in which our virtues are forged, kindness, loyalty generosity and fortitude. Interestingly, even when we grow up and leave them we will most often seek out another with whom we wish to form a family. At this very particular COVID moment, we are all forced to reconsider what family means to us.

 

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

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

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