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What is the Menopause? (part two)

The historian Susan Mattern argues there is no doubt there is some value to naming menopause as a concept. It has provided women with reasons and different perspectives and interventions on what can be sometimes very distressing symptoms. However she points out that modern medicine can have a tendency to locate cause and explanation inside the body vs society and environment.
Mattern writes – “for most of human history, people have seen menopause for what, as I argue, it really is: a developmental transition to an important stage of life; not a problem, but a solution”  (2019, P. 6). 
Mattern holds a space for the menopause (what she depicts as a post-reproductive period) as a significant life stage and essential for human flourishing. She argues that for much of human history menopause was not really considered a problem to be treated, and where it was considered it rarely had such negative connotations as it does today. She argues that for many this transition in life can be one of vigour and expansiveness. She uses the metaphor in the title of her book ‘The slow moon climbs’ as aligned with this phase of life.
In terms of historical and cultural meanings and understandings it does seem that our ideas around women’s experiences of menopause has definitely shifted over time. According to Mattern (2019) it is only in the modern era we have considered and discussed the menopause as a syndrome in need of medicalisation. She explores the influence of culture in the experience of menopause today and how the medicalisation of women’s menopausal experiences emerged.
Her book traces a plethora of historical aspects including evolutionary, philosophical, psychological and cultural understandings around the menopause and how meanings have changed.  She gives insight about evolutionary theories of menopause, the role it has played in human society and strategies around reproduction and more general aspects of human society. She also dives into how modernisation has altered our experiences and notions of menopause quite dramatically. In my opinion it is a book packed with fantastic information and well worth a read if you are curious.
There are many aspects in both peri-menopause and menopause that can greatly impact our lived experience. This does not always have to feel detrimental. In some of my research many women have found it a liberating sexual experience whilst also struggling with some aspects. Often there are many different factors and impacts within the menopausal experience: physical, psychological, social, sexual, political, cultural and spiritual. Frequently they can feel like they are in conflict.  Not knowing whether you should treat it medically or not can leave us at best feeling confused, at worst it can sometimes disrupt our whole lives in terms of its effect on personal relationships and work dimensions.
Whatever route you choose and whether you want to seek medical support, psychological support or just better understand the transition through your own enquiries, therapy can be a space to do this. I feel many transitional experiences can be incredibly meaningful and transformative despite the challenges they might bring. It can invite us to explore, challenge and question our beliefs and expectations and change how we feel, think and relate to ourselves and the world.
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
Reference – 
Mattern, S. (2019 ’The Slow Moon Climbs’ The Science and History, and Meaning of Menopause. Princeton University Press: Princeton & Oxford.
 (Book tracing historical and cultural understandings of this life stage.

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Parental Alienation and the impact on children

Separation or divorce are painful, difficult and time consuming processes and more so where children are involved. Few couples manage to amicably separate and sadly, this applies to couples who have a child or children together too.

Although it may seem obvious, my experience is that couples who are separating and have children often fail to recognise that they in fact will always have a relationship with each other as parents of the same children. Whether this is openly and maturely acknowledged as in the case of couples who co-parent, or not, as in the extreme case of parental alienation, there remains, nonetheless a relationship.

What is Parental Alienation?

Broadly, parental alienation occurs when a child becomes hostile, fearful and generally unwilling to engage with one parent as a result of the either the psychological manipulation of one parent or, more often, the toxic relationship between both parents. It is extremely damaging to children and can lead to mental health issues including self harm and suicidal ideation.

Parental alienation is on a scale from a parent making negative remarks about the other parent, or one parent ‘forgetting’ their responsibilities on relation to their child (an agreement to pick them up etc.) through to psychological manipulation and control.

The child as centre stage

Whilst the process of separating can be extremely painful and difficult, it is critical that parents find a way to establish a working relationship in co-parenting their child. This starts from the point of agreeing together the narrative they are going to tell their child about the separation through to long-term parenting commitments. The role of psychotherapy. Experienced couple’s psychotherapists are able to work with a couple to move beyond their
grievances and establish a framework within which they will work together to fulfil the same job: raise their child and create emotional stability for them.

The impact of divorce on children

Society and parents tend to enormously underestimate the impact that separation and divorce can have on a child. For children, their entire stability is predicated on the stability of the parental unit and when this gets rocked or shaken to its foundations, the impact on a child can be enormous.

Studies have been undertaken measuring the impact of divorce on children and in many cases the psychological impact can be greater than losing a parent through death. The reason is because, generally, when a child is bereaved, the other parent (along with the broader family and society) enables the child to grieve a very tangible loss. With divorce, and especially where the split is contentious, children often feel they need to ‘pick a side’ and are unable to grieve the loss of the parental unit.

Top tips to focus on when separating and a child or children are involved –

  • Separate out grievances towards each other about the end of the relationship and your job as parents;
  • Agree a narrative that is age appropriate to tell your child about what is happening;
  • Reassure your child that you continue to both be there for them;
  • Avoid displays of conflict in front of your child;
  • Recognise that you NEED to put your child first and that all children want two parents and would prefer their parents to stay together;
  • Allow and facilitate the grieving process for your child.

 

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

Space: The Final Frontier of Manic Defence

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

What is the purpose of intimate relationships?

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

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What is the Menopause? (part one)

I found myself being asked ‘what is the menopause?’ by a friend’s 13 year old son a few weeks ago. All the women in the room chimed in to answer. It was not surprising to me that he asked, nor was it surprising all the women answered. Interestingly I had no idea about the menopause at his age and I had absolutely no clue about peri-menopause until I was in my mid 30s. However, I found myself wondering how much louder the conversation seemingly is right now than when I was his age.
It does seem that the terms menopause and peri-menopause have become widely discussed in the media and medical world recently. In my experience, this does not always translate to it being more understood. It can be incredibly helpful to know discussions are happening as this can normalise the experience, conversely it can leave us feeling more adrift, especially if we find we are not fitting into any standardised categories or stories.
It led to me writing two short pieces (part two will be published at a later date). Both aim to provide a little portion of food for thought about the concept and possible options for personal explorations around the menopause. In my mind, there is no right or wrong way to consider or act in terms of the menopause, it is whatever feels right for the individual.
Medically the menopause is depicted as the final menstrual period (FMP). This is confirmed after one year of menstrual period. Typically it occurs around 51 years old, however UK statistics show this can vary between 44 and 55 years. One in 100 women can experience menopause before the age of 40 (often due to medical interventions).   The peri-menopause is a term used to depict another transition stage before the menopause whereby the ovaries start to make less oestrogen. This typically starts around 40 and can last between four and eight years.
Some people assume the menopause is a medical problem and prefer to manage it with drugs. Medical interventions can be a very positive experience. However, for others this is not always possible or perhaps how they want to relate to this life stage.
Some feel it is best to be with the experience, whilst others want to use alternative routes. Some might see it as an opportunity to face up to changes in their life span and ageing processes and some might not see it as a problem all all.
Whatever your choice or position there are some brilliant options, discussions and spaces which can support women going through these transformations (see some options in the links below).
I feel it is definitely worth exploring all the options and finding out what feels right for you. Therapy might be a space to do this. For me, it is also important to consider that we cannot always place the responsibility on the individual and it is worth considering how history and culture has impacted the medicalisation of these transitions and consequently how and what we think, feel and experience in terms of this life stage. If you are interested in this then you might want to read part two.
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 existential musings from the sea

Nietzsche and the body

Why read Nietzsche?

Magnificent Monsters

Death Anxiety

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Space: The Final Frontier of Manic Defence

As a boy I was fascinated by space travel. I remember being glued to the television set with awe as the Space Shuttle blasted off into space back in the early 80s – I was born after the epic Apollo programme came to an end and was just the right age to appreciate the engineering accomplishments in launching the Shuttle, without having fully lost my sense of wonder and amazement at the idea of man (and woman) going into space.

In recent years and months it seems a new type of space race has emerged – one that for me lacks much of the romance of the Apollo and even the Shuttle programme and instead halls of something very different indeed. I am referring to the race which seems to be be the vanity project of three of the richest (one middle-aged, and two bordering on elderly) men – Bezos, Branson and Musk.

What drives them?

Well, I am a good psychotherapist but cannot mind read. Nonetheless, there is some commonality between the three which I shall cover further on in this piece. What we can easily derive is that what drives these men has very little in common with the values and ideologies behind the original space race between The United States and The former Soviet Union.

The original space race was about many things but none more so than an affirmation of superiority over the other. Superiority in the space race meant, symbolically, superiority as a culture. Why does this matter? Culture, it can be argued from an existential perspective, is fundamentally religious in nature in that it provides us all with a mechanism be become ‘heroic’ and belong. Culture, whether the so called ‘primitive cultures’ of the world through to the now globally dominant Western culture all have three things in common : a story of how we got here, rules on how to behave whilst we are here and lastly, and perhaps most importantly, a story of what happens after we die. This is ostensibly why ever war ever fought is a war of one culture against another or, put more purely, one religion against another whether Christianity versus Islam or Communism versus Capitalism (or Freedom, as the Americans like to call it).

Bezos, Branson and Musk all share the reality that they have immense and almost infinite wealth. However, whilst this wealth is currently propelling them towards space like modern day space cowboys (a reference to Bezos’ cowboy hat attire after his space trip), they share something even more concrete than their wealth and it is something they share with the rest of us: no matter how wealthy, they are hurtling towards their own finitude (death) just like the rest of us and this renders them anxious.

Existential anxiety

Existentialists have long argued that to feel anxious is to be human; that our very being is defined by a knowing anxiety as we are, as far as we can discern, the only species on the planet who has such a profound awareness of our being that we also know we are going to die. This is unbearable for us and so we invent ways in which to stave off death anxiety – back to the raison d’être of culture.

Bezos, Branson and Musk all live on the same planet as the rest of us mere (financial) mortals – a planet that is reaching its limits on almost every level: we are fast running out of space, clean air, clean water and temperature ranges that provide liveable conditions for us and our animal cousins.

However, to engage with this is deeply anxiety provoking, not just for billionaires but for all of us and to contemplate the planet’s finitude is to be reminded of our own finitude.

A flight from death

Imagine how much good could be done with the combined wealth of these three individuals on this planet: third world debt could be resolved, huge investment created in renewables, diseases eradicated and so on. However to do this it would mean living within the constraints of reality – within the context of finitude. It would mean that each of these men would have to accept that despite their billions, they are mere mortals who are going to die.

Manic defence

A manic defence is a process (unconscious) that humans employ to distract themselves from uncomfortable truths, thoughts and feelings. It is, if you wish, the polar opposite of depression, where one is consumed by negative thoughts and feelings and nothing possible can be accessed.

It is a normal developmental process for infants to pass from a state of denial and splitting to the depressive position whereby reality, with all its disappointments, can be tolerated – not the same as clinical depression.

Whilst the latest wave of space travel is couched as progressive and future orientated by each of these billionaires, in reality what seems to be emerging is simply an expensive and highly polluting contest from see whom has the biggest ego (or other appendage if one is to reference the phallic shape of Bezos’ rocket ship). And what are they offering the world? The ‘opportunity’ for others who are wealthy, but slightly less so, to invest in this egotistical immortality project by becoming ‘space tourists’.

The little boy in me dreamt of space and the idea of being a space tourist. I now am firmly (and uncomfortably) rooted in the reality in accepting my own finitude and that of the planet we all share. Perhaps if the three protagonists in question had spent just a little of their fortune on a curiosity in exploring their inner ‘space’, they would be more able to tolerate actual reality themselves and rather than resorting to mania to defend against existential angst, find culturally heroic ways of making a difference and leaving their mark.

 

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

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

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

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Why there’s nothing as infuriating as Anger Management

Throughout my career as a Psychotherapist, particularly when working with statutory services, I have often been asked to provide, ‘Anger Management’. Now I do understand that some people desperately need help with their anger and that it often has destructive effects on them and their relationships. However, what was, (its much less heard of these days), called anger management often consisted of cognitive techniques to control anger, breathing exercises, counting backwards etc, and while these may help a few people they don’t really touch the surface for most. The appeal is in a simplistic idea of control, the idea that we can simply choose which emotions to feel.

Once a certain point of anger has been reached rational thought has gone and telling someone to just control their anger is a bit like saying to someone with depression, “hey bud, don’t be sad’.

The psychodynamic approach along with all exploratory therapeutic approaches, seeks to understand the hurt behind the anger, attempting to address the root rather than the surface ‘symptom’.

The root of anger is very individual, each person has their reason to be angry and an analytic approach seeks to understand the reasons, meaning and purpose of an individual’s anger, helping them feel understood.

Anger and Depression

Anger is often part of a complex set of internal feelings and conflicts and is felt to be a bad feeling and sought to be repressed, setting up feelings of guilt and self-criticism. The hurt behind the anger often relates to a personal sense of wounding, rejection and loss. Anger is sometimes directed inwardly towards the self and this is causal factor in depression.

This sense of internal rejection, which of course can come from very real experiences of feeling let down or rejected and while sometimes may be due to genuinely abusive experiences can also be due to a care givers unavoidable unavailability. For instance, if a caregiver themselves suffers a depression, the feeling of the child can be one of personal hurt and rejection, leading to a painful feeling of unwanted-ness, self-loathing and externalised or internalised anger.

However, it can be very hard to be angry at someone one needs or is dependent on, powerful guilt and/or anxiety can be stirred up about these aggressive feelings towards someone loved, with a feeling that these feelings may damage the loved person and therefore the anger has to be split off and directed elsewhere. Splitting is an age old defence mechanism, alive and well in todays world, whichever side of any given debate you can be sure that many on either side will be using that debate to project their bad feelings onto the others over theirs.

The ability to tolerate both angry and loving feelings (ambivalence) towards a loved person is hard and Psychotherapy aims to create a safe non-judgmental space where these feelings and conflicts can be expressed through words, easing the need to either split them off or act them out.

 

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 –

What makes Psychotherapy Different?

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

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The Passage of Time

Being human means living with the knowledge that we will one day die and that those we love will die too. As mortal beings we are the children of time and none of us are spared its reckoning. Time makes playthings of us all and we are powerless in its passage. A healer it may be but ultimately we do not escape the fatal wound inflicted upon us by time’s passing hours and minutes. There is no cure for time and this is the difficult truth that we must all live with. Religion and philosophy offer sustenance in the form of faith and knowledge. Science and medicine continually develop to improve our life expectancy but time flows relentlessly on…. we may transfigure time we cannot deny or destroy it.

Me, myself and I

Our mind shapes every experience we have, it is our greatest asset and our greatest tormentor. We spend most of our time literally lost in thought and when we are lost in thought we are by implication elsewhere and not in the present moment/reality (psychosis by another measure). It has long been understood in many contemplative traditions that being distracted by thought is the fundamental source of human suffering. It is not so much that our thoughts themselves are problematic but rather the way in which we identify with them. It is hard to truly recognise just how distracted we are and how much of the time, thoughts bond with feelings and feelings reinforce thoughts, both drag us from the present moment and hold us hostage to time…time which ticks on regardless, immune to our suffering.

“There’s a crack in everything, that’s how the light gets in”

Occasionally a crack opens up in time (or at least that might be a way of putting it) in which we have an experience akin to non time or timelessness. What characterises these moments is an experience of merger, probably best expressed through paradox and poetic imagery, as in Leonard Cohen’s evocative lyric. Love is one of these experiences. Love helps us look death in the face. Beyond pleasure and pain (and it is both) love is intensity. It cannot vanquish death but it makes it an integral part of life. Love cannot protect or preserve us from the risks inherent in living, no love ultimately escapes the ravages of time, age and ill health. Wherever there is rapture there will be rupture and like all the great creations of human kind, love is twofold, both joy and sorrow, an instant and an eternity.

Doorways

In order to become less identified with the tyranny of our thoughts and the drama of our own lives we might well be advised to consider cultivating new disciplines of attention. How might we allow for a crack in our convictions and cognitions such that a light may shine through? A sure fire way of busting through the doors of perception would be to ingest a powerful dose of a psychedelic substance such as psilocybin. For better or worse in such a state we would have a different experience of time and space, and a sense of total immersion in the present moment. (It goes without saying that if such an experience were to be truly useful the set and setting would be of fundamental importance.) Such an experience might shine a powerful light on the mind’s potential, far from that which might be available during the course of normal waking consciousness. However, a Peak experience is exactly that, fleeting in its nature and as such not coincident with everyday waking life (which presumably must go on). Meditation offers another potential way of breaking the spell of identification with thought and the persistent cycle of rumination and reactivity that so many of us are caught in so much of the time. Cultivating awareness via one intentional discipline or another seems, on balance, a useful proposition. A psychotherapeutic dialogue can be of significant value in helping to ground and integrate new insights and awareness into our everyday lives.

 

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.

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I Never Thought My Son Would Watch Pornography

It was a decade ago that was listening to the radio when I heard this line being spoken for the first time by a mother who was describing the time the police came to her house to enquire after certain pornographic material which had been downloaded using the family IP address. She described the early morning raid by the police, the taking away of the family computers, the suspicion hanging over her husband – until it was discovered that it was the couple’s 14-year-old son who had viewed the material in a curiosity-driven trawl through multiple pornographic internet sites.

That may have been the first time I came across that line, but I have heard it many times since in the intervening period as I have moved into work supporting young boys and men in their efforts to free themselves from their addiction to online pornography.

Pornography and the Adolescent Brain

There has been considerable research in recent years into the effects of consistent use of pornography on the adolescent brain and, indeed, on the brain in general. To summarise a complicated process briefly, the plasticity of the adolescent brain (with all brains, actually), combined with a leaning towards hyper-arousal when it comes to matters of sex, leaves the teenage child prone to a vulnerability of dependence, which can be frightening in its speed and grip. The reward centre of the brain is hard-wired to be stimulated and demanding when certain things connected to the propagation of the species are on offer. Food and drink come to mind – but sex is important, too. As a species, we need to have sex to survive.

For the young adolescent, perhaps still some years away from a sexual encounter with a real person, the online world offers instead a kaleidoscope of sexual experiences at the touch of a button. In the secrecy of their bedrooms they are free to explore material that would have been unimaginable (certainly illegal to print) just a few decades ago. The brain does not know the difference between a computer and a real person. It just knows that its owner is excited sexually. Its reward centre is activated, and it releases that precious drop of dopamine, which will prove to be both curse and blessing, the first step on the road to addiction. To put it bluntly, for the child, it feels good – and the brain will begin to lay out the neural pathways which will make it easier to access that feeling in the future. As in all things – from football to depression – the brain gets better at what it practices.

As the boy becomes more habituated to the use of the pornography, so it becomes more difficult to achieve the level of arousal that was easily done on first viewing. In essence, the brain is developing a level of tolerance. The user has to find newer forms of stimulation – generally much riskier, more challenging sites – in order to satisfy the brain’s demands and to receive that precious dopamine hit. It becomes more difficult to focus on one item. The user will begin to hop from site to site in an effort to find the ‘best bits’; the whole purpose will become about gratification, generally marked by masturbation, which once achieved, is the signal for the whole cycle to start again. It all feels so natural. There are no drugs involved – apart from the delicious ones supplied by the brain. The parts of the body that react are doing so naturally. What can be wrong with something that feels so right?

Boys and not girls

The research on girls’ use of pornography is scant, but what does exist points to their usage as being considerably lower, and less frequent, compared with that of boys, something supported by anecdotal dealings with young people. Although many young girls (estimates suggest as high as 40%) will have viewed pornography, this is more likely to be out of curiosity rather than habitual usage. This might be partly cultural, partly to do with the way arousal works and develops in adolescents, partly to do with the interest in internet activity shown by girls generally (interestingly, figures in gaming addiction, a process which ‘piggy-backs’ on to the reward system, has similar figures in favour of boys’ dependency), and significantly to do with the type of pornography available, which is overwhelmingly produced for the gratification of men, with women in the role of the passive provider. Even the dominatrix – which alludes to a degree of power for the female – is a male construction, designed to gratify male desires. Given this context, it is no surprise that even into adulthood, the vast majority of pornography is consumed by men.

Meanwhile, in the real world

At the young man develops, they will want to practise their sexuality in the world around them. The difficulty for them is that their brains, accustomed now to being aroused by digital sexual-stimulus, will already have an idea of what sex looks and feels like, how their partner should behave and, significantly, they will already have internalised an idea that sex is something that involves their gratification. The notion that giving pleasure to others might be a fulfilling part of sexual engagement is something that is beyond their experience – even though their experience in some respects is a considerable distance ahead of where it might be in a non-digitalised world. For the habituated user of online pornography, it can be very difficult to come to terms with the fact that the person within their arms has feelings and desires which are unlikely to conform to those who have aroused their senses online. The online world will often present an exaggerated view of sexuality: breasts and penises are larger; bodies are firmer; all imperfections (and hair) are removed. For the habituated user, it can be very difficult to achieve any kind of arousal, and desire is lost – only to be found again back in the online world, where the brain, comfortable, primed and ready, can once again be gratified.

There is another difficulty that habitual users have to face. Their online experience will have normalised certain aspects of sexual behaviour that in the real world would be considered shocking or taboo. Even on the blandest pornographic sites freely available to all, one will find countless ‘sex with my stepmother/ sister/ etc’ as titles. It is as though it is the most normal, routine practice in the world. There really are no boundaries.

Disadvantaged Parents

It would be easy to be judgemental with parents whose children become habituated to online pornography. But there are a number of reasons for their ignorance and then denial regarding the habits of their sons. Firstly, unless they have used pornography themselves, they will have no idea how much is available – unfiltered, free and without the requirement of age verification – at a simple click of a button. It is hardly their fault that they just don’t know what they don’t know. Secondly, as pornography and issues more widely to do with sex are practised in areas of secrecy, there is often a barrier of shame which makes any non-judgemental discussion of the subject impossible for parents and children. Thirdly, and linked to the former point, the image of their children that many parents carry in heads often allows no room for an activity they themselves would find abhorrent. It is why so often when parents come to see me with their sons, they are in a state of shock. It is not unusual for them to apologise for the fact that their son is in this position, claiming plaintively that they ‘never thought their son would be using pornography.’

As youngsters become men

Unfortunately, many adult men who have to deal with addiction to pornography fail to do so until they are much older. Many of the clients I have worked with on the issue have endured many years of habitual use before being forced to seek help by circumstance rather than because they see it as a problem. It might be to with failed relationships; it might be because of worries to do with their increasingly poor sexual performance in real relationships – often manifested in low mood, anxiety or depression; or it might be that their sexualised treatment of a partner or friend is not appropriate for one reason or another and they feel a strong sense of shame. This last is perhaps worth highlighting as it has been the topic of national debate recently.

One of the dangers facing habitual users of online pornography is that they must deal with a blurring of the lines between what is real and what is imagined. Of course, we all do this to some extent when we watch a television show: we are adept at sorting what lies either side of that line between the real and the imaginary. But these television shows are not tapping into the reward centre in our brains; they are not linked to our areas of desire, gratification and reward as is the sexual instinct. On top of this, for many young people, they will have no experience outside of their online practices to guide them as to what is appropriate or not. They haven’t yet learned what is normal. If they make a mistake in this area, they could be left with a legacy of shame and regret – or much worse if their actions pass into illegality.

What can parents do?

My advice to parents is always very clear on this. Before you do anything else, contact your internet provider to make sure your controls are locked down – and never share your passwords with your children, or even enter a code when the child is in the same room. It is another story, but never underestimate the ingenuity of young people for discovering their parents’ passwords! Then talk to your child. Be curious. Take a parental interest in their internet history – not in a judgmental way, but one which seeks to understand what is going on for that young person. If your son is using pornography habitually, seek support for yourself and for them. Do not ignore it, for in any number of cases it will not go away. Research indicates that those who become addicted to online pornography are likely to be prone to low mood and depression, not surprising given that they may well be living a kind of double life, a part of which exists in a place of secrecy and shame. Those last two bedfellows are hardly the harbingers of happy, fulfilled lives.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

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

 

Further reading by Kevin Collins –

Why is it hard to make decisions?

Communication, communication, communication

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What makes Psychotherapy Different?

“The Patient who will not suffer pain fails to suffer pleasure.” Wilfred Bion 1970.

I’ve been a therapist for over ten years now and one of the things I love about the job is how demanding it is of me to stay awake and stay alive. The training never stops and development is always a work in progress.

After many years of various work and an enduring interest in self-development and study, encompassing Eastern thoughts and practices and various experiential group experiences, I started my formal Psychotherapy training in 2008 and finished in 2014. However, what I didn’t realise was that this was the beginning much more than the end of something.

What makes Psychotherapy so important to me is that it requires one to become a psychotherapist rather than to do psychotherapy. The non-behavioural psychotherapeutic interaction is not one where I teach someone strategies, but one where I seek to on a sustained, regular and meaningful way to contact another human being, always in service of them and focusing on them but using my own present being to help make sense and bring to awareness what is going for them. I do this with all that I have available my mind, my senses, my bodily feelings, my intuition, to try and get a felt sense of what things are like for them.

Jonathon Shedler, the American Psychotherapist and researcher, says “don’t ask what model your therapist practises but how much therapy they have had.”

For me this is what makes psychotherapy truly interesting, of course learning about different theories of the mind and the way it functions and disfunctions is hugely important but it is in our own therapy that we truly learn the ‘praxis’, (practice) of psychotherapy. This involves being challenged to reflect deeply on our own internal processes, our own avoidance and defence mechanisms all human difficulties are on a spectrum and that if we look deeply enough all of us can relate to our patients through our own reflecting selves.

 

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 –

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

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Is that a fact or an opinion?

Now we are all starting to go out more and socialise again, I wanted to acknowledge how we can all experience anxious or self critical thoughts.

I have noticed, when meeting up with various girlfriends recently, how we’ve all shared thoughts of feeling slightly anxious about how others are perceiving us. Due to the various lockdowns over the last year and a half, we’ve been working from home, not exercising as much and possibly eating and drinking more, and for some of us, this has resulted in a slight change in appearance. Perhaps we’ve put on weight, are not as toned as we once were or are not looking so primped and preened as we used to. Various friends have shared some form of self criticism about their appearance. One friend referred to this as her ‘lockdown arse’. Another friend said she couldn’t possibly come out socially until she’d had her hair done and lost a few pounds. It occurred to me how we can all be self conscious and bothered by what others are thinking of us when we’ve not seen them for a while.

It’s normal.

We worry about what we think we should look like and worry that our friends will make judgements or look at us in a negative light if we are not the same shape/size as we were when they last saw us. Our internal dialogues are often talking to us in a critical way. We forget that we are acceptable to our friends however we are because it’s our friendship that is valued. Others want to see us for who we are and because we’re their friend not for what we look like.

If it wasn’t appearance that was being fretted about it was not having anything to say. Again because of lockdown and not being able to do much, friends would worry about not having anything to talk about, being dull and boring and having nothing interesting to say. Forgetting that we have all been in the same boat.

When these worry or self critical thoughts creep in they can have a profound effect on how we are feeling. They can make us feel anxious, low and even depressed. Our thoughts are very influential over our emotions and our behaviours. They can prevent us from doing what we’d really like to do. Thoughts not only affect our moods and behaviours but can affect our self esteem and our self worth. Yet when you unpick thoughts they are often not facts, they are our opinions. Thoughts can feel believable, real and true, yet really they are just a string of words. Our thoughts can be quite bullying, they can tell us that we’re not good enough, that we should be this or that, they come thick and fast and once you get on the negative spiral it can be quite difficult to get off. They are instantaneous and we often don’t question them. Our thoughts are our internal dialogue and can be very harsh and self critical. We wouldn’t talk to others as we do ourselves. So why is that ok?

When I’m aware I’m starting to get into worry thoughts about what others might think I find it quite useful to ask myself is that a fact or an opinion? Often I’m making an assumption or mind reading. If this is the case it can be helpful to ask yourself if there’s another way of looking at this? What would my best friend say to me in this scenario? Or what advice would I give to someone else? And would this matter in 6 months time? These sorts of questions can help us to gain an alternative perspective, to a more balanced way of thinking, that is kinder and more realistic.

These questions are some of the prompts on a CBT technique called a STOPP record.*

So the next time you are worrying about going out with your friends because you may look a little different or not have much to say try challenging those thoughts, ask yourself is that a fact or an opinion? Remind yourself that we can all have unhelpful thoughts at times, its normal.

(* The STOPP record technique can be found here: https://www.getselfhelp.co.uk/docs/STOPP5.pdf)

 

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 ready by Rebecca Mead –

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

New Year’s Resolutions

Making Changes

Social Connections

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Using empathy to re-build connection with children and young people

This last year of global pandemic has been a time of massive disruption to almost everyone. With it has come disconnection in various forms and the challenge of reconnecting at points when restrictions have lifted. Children and young people have faced their own particular challenges with school closures preventing contact with peers and friends, in addition to the stress of uncertainty about exams and other limitations related to online learning. At a time when many teens would normally be exploring social freedoms to the full, those who have kept to the rules have made do with scraps of interaction and often relied heavily on digital forums. Sadly, a considerable number have struggled to hold onto what fragile self-esteem and social confidence they formally knew. Even some of those used to thriving have found their resilience quashed and required additional support to pull through.

We are still in the early days of reconnecting with the world and all the structures of human engagement that we once took for granted and, with time, we will no doubt start to see the fuller picture of how people’s lives have been impacted by COVID and all that has come in its wake. For some, reconnecting is proving to be a battle. There are those for whom the protection of a smaller, quieter world felt safer and some are simply feeling rusty about conversing and interfacing with real live people.

Hardships faced by those whose lives COVID has touched in very tangible ways, have brought forth numerous stories of lived empathy in response to people encountering terrible pain and the loss of health and loved ones, empathy perhaps evoked by the realisation that these losses could become reality for any of us. Likewise, there has been widespread, heartfelt support for the thousands of frontline workers who have sacrificed their own safety for the wellbeing of others and for those who have lost jobs, income and businesses. Many have felt for children deprived of opportunities to learn and play as they usually would and this continues to be a time when the younger generation needs us to recognise and engage with what they are going through.

Children and young people with social and emotional difficulties always require our empathy as part of recovery and perhaps even more so in these times. Empathy is what helps them feel understood, paving the way for self-acceptance, which in turn makes it more possible to seek support from others. Daniel A. Hughes (pioneer of Dyadic Developmental Psychotherapy) places Empathy at the core of the PACE approach, along with Acceptance and Curiosity (see my other blogs on these two subjects). In his book, co-written with John Baylin (The Neurobiology of Attachment-Focused Therapy: Enhancing Connection and Trust) he talks about embracing “the child’s defensiveness, putting connection before correction” and offering “radical acceptance” of the child’s mistrust.

In this context, Hughes and Baylin were referring to the particular struggles faced by traumatised children with attachment difficulties but we could apply the same principle to supporting children and young people who are emotionally and socially adjusting to each “new normal” they are faced with, whether or not they have experienced additional childhood trauma pre-COVID.

Hughes and Baylin recognise that this is no easy task, likening it to “hugging a porcupine”. Social and emotional defences, by their nature, are often difficult to permeate and can repel. A child or young person who repeatedly gives off a vibe of wanting to be left alone can leave the person reaching out feeling confused, rejected, useless and resentful and can lead, understandably, to withdrawal. This makes it even harder for the child or young person to reconnect, risking further disconnection, isolation and all the ill-effects that these states can bring.

If we can catch ourselves withdrawing and find empathy within ourselves for how the child or young person may be feeling in that very moment when they are unable to allow us in, we provide a bridge back into connection. This is so powerful as it communicates that we have not given up and that we see the child or young person as worth sticking with – we still see that part of them which has the potential to be in relationship with others and the world.
Brene Brown, in a Youtube clip based on part of her Tedtalk on Empathy, beautifully describes how “empathy fuels connection”. She refers to Teresa Wiseman’s 4 qualities of empathy: recognising another person’s perspective is their truth, staying out of judgement, recognising emotion in others and then communicating this. This is about “feeling with people” she says. Being with others is so much more effective than trying to fix the situation by saying the right thing: “Rarely can a response make something better, what makes something better is connection.”

In taking an empathic stance, we make an active choice to suspend our own anxiety and impatience about the pace at which a child or young person is re-engaging with life post-lockdown. We accept where things are at and we take time to understand as best we can. We then make what Brene Brown calls a “vulnerable choice”, that is choosing to connect with something in ourselves which knows the feeling we have encountered in another. This vulnerable choice is a risk well worth taking if we are serious about wanting to mitigate against the secondary effects of COVID on the mental health and wellbeing of children and young people today.

 

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. Online therapy is available.

 

References – 

See more from Brene Brown at: https://www.youtube.com/watch?v=jz1g1SpD9Zo

Read more from Baylin and Hughes.

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Care for a Dance?

The considerable volume of writing on relationships is littered with metaphors to explore the intricate connections between people. Most frequent might be images of journeys (‘we had come to a crossroads – an obstacle’, ‘it always seems uphill’); of chemistry (‘I felt the spark had gone’; of sport (‘out of my league.’ ‘own goals’); even, of war (‘battles, bombs and victories’). There are many such in the lexicon, each proving useful in examining particular aspects of the emotional engine of relationships.

Dance as Metaphor

One of the most useful metaphor in working with couples is dance. It is an analogy which allows many of the complexities of a couple relationship to be examined. We might think about the negotiated ‘choreography’ – the way in which the individuals move symbolically in relation to each other and how distance and closeness might change according to the dance being played out. Or we could consider aspects of control, of who wants to take the lead (or give it up) and what this tells us about the relationship overall.

You do not need to be an expert on dance to understand that being in the moment and moving with some other person in the same space is going to take a degree of synchronicity. At times it will require that one leads as the other follows. And, inevitably, in keeping all things in balance, there will some testing periods in maintaining a consistent distance between the two protagonists, particularly as the music undergoes a change of dynamic. What seemed quite manageable in one context, can feel overwhelming in another.

What’s Your Role?

The roles agreed by the dancing couple are contracted quite consciously, but within a relationship that negotiation is often unconscious. As skills and desires change or grow, so the individuals might feel uncomfortable in their prescribed role – no matter how happy they might have been in that role previously. In the initial stages, one partner might have been happy to cede control, to allow themselves to be led and to enjoy the feeling of a protective and guiding presence. However, what once felt protective, might now feel smothering; what once felt guiding, might now feel controlling; where once we were happy to follow, now we want to lead. Understanding and making conscious these roles is important in avoiding resentment and anger.

When the dance gets difficult

When the dance flows, it feels effortless – but it can feel hectic. So much change, so much required – and on the hoof! It feels overwhelming at times – and may even make us think that giving up dancing altogether might be the answer. Perhaps we need a re-set – one where we would do well to remember that dance – like relationships generally – is one of the most natural, most primal of human activities. Our oldest human ancestors would have swayed in time to the beat of a drum – and they would have moved symbolically in likewise rhythm with family, friends and partners.

Learning to accommodate change – or doomed to repetition

The threat to us is not from the dance itself – after all, we well know how joyful and life enhancing it can be. The real threat is change. As the inner worlds of the protagonists seek to find meaning and expression, so the relationship plays out and the couple move around each other – closing and distancing, leading and following, taking and ceding – in a figurative dance within which both participants are testing and exploring their worlds. Change is likely – but it will not necessarily be synchronised. And neither will it necessarily be well communicated. Toes will be stepped on; profanities will be muttered. We may even believe that, with another partner, our dancing would be so much better. And so, we do that: we choose another partner. We begin another dance – closing and distancing, leading and following, taking and ceding – our inner selves being acted out repetitively until we learn to better understand ourselves and how we relate to the people around us – until we learn how to dance better!

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

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

 

Further reading by Kevin Collins –

Name that Tune

I never thought my son would be addicted to pornography

Why is it hard to make decisions?

Communication, communication, communication

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Poetry: A space to ponder

How many of us feel we don’t want to be known beyond what we present to the world and are relieved when our presentations are not tested? When we’re not found out.

The poem below by the American poet Jane Hirschfield, is an uncomfortable look at our response when we read about the shameful acts of others. Is it relief? Is it pleasure? Is it confirmation that we have maintained a reassuring surface?

For Horses, For Horseflies

We know nothing of the lives of others.
Under the surface, what strange desires,
what rages, weaknesses, fears.

Sometimes it breaks into the daily paper
and we shake our heads in wonder –
‘Who would behave in such a way?’ we ask.

Unspoken the thought: ‘Let me not be tested’.
Unspoken the thought: ‘Let me not be known’.

Under the surface, something that whispers.
‘Anything can be done’.

For horses, horseflies. For humans, shame.

The last line is curious and makes a comparison between horses and their experience of horseflies and human beings and our experience of shame. Perhaps it asks a question about an ever-present sense of shame that we might share. An irritation that occupies the space between human fallibility and the drive to be civilised. Rosanna Warren says Hirschfield’s poetry invites us to pause ‘our fast-forward habits of mind’ and ‘clear a space for reflection and change’.

Quotes from Warren’s award citation for Hirshfield’s 2004 Academy of American Poets’ Fellowship.

 

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 symptons

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?

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Name That Tune

How can an old parlour game help us reflect on the way we communicate? Quite a lot it would seem.

Many of us will have played the game where we tap out the rhythm of a tune or song and ask our partner to guess the name of the piece. The challenge for the person doing the listening is that they have to use only limited information (the rhythm) to piece together something much more complicated in its whole. It is a different story for the person tapping out the rhythm. For them, the whole tune is in their head and it seems obvious that what they are hearing (in their head), is also what is being heard by the recipient.

In a study using the game to explore expectations in communication, over 90% of the people tapping the tune expected the recipient to guess correctly – some admitting to be dumbfounded that their recipients could not understand them. Sadly, this expectation was not matched by the results, where only 14% of recipients managed to guess the tune correctly. Imagine the frustration on both sides!

The fact that the large majority (over 9 in 10) of the tappers (as we will call them), felt they had supplied all the information required for their message to be understood, makes a useful reminder of the difference between the message we think we are communicating and the meaning that is created by the recipient. It is interesting that in the study of the exercise referred to above, the recipients did not just say they didn’t know the answer – over 8 in 10 of them named a tune they were sure was correct even though it was often some distance from the one in the head of the tapper. In other words, they created a meaning from the message which was quite different from the one being communicated by the tapper – which, of course, led to even more frustration: ‘How could you possibly misunderstand that? It’s so obvious!’ Worryingly, when it comes to communication, what seems just so obvious to us, can lead to confusion or misunderstanding for those on the receiving end.

The tapping game might also make us reflect on just how limited words can be when it comes to communicating the thoughts and feelings we carry. Like the complex melody, much of the nuance may be lost without access to the pitch, timbre and colours which make up the detail. As humans, we are meaning-seeking creatures. If there are gaps in our understanding, we will fill them in an effort to make sense. But in those fillers, we often go awry – gloriously so in many cases, which is why metaphor and symbolism can be such fun – but awry, nonetheless.

It takes a lot of work to be really understood and a great deal more to understand fully. But when we feel anger or frustration at others for not getting our message, or when we deal with similar feelings when our friends or partners never seem to appreciate our understanding, we would do well to remember that the gap between what is being communicated and what is being understood is considerably wider than what might at first appear.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

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

 

Further reading by Kevin Collins –

I never thought my son would be addicted to pornography

Why is it hard to make decisions?

Communication, communication, communication

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Football, psychotherapy and engaging with male clients

I recently read that an English professional football team has a resident psychotherapist. Whilst the connection between clinical psychology and sporting outcomes is well established, having a team psychotherapist is something new. The therapist explained that they’re there to support the players, coaches and a team of staff through the emotional highs and lows of the professional game. Scoring goals isn’t the sole focus of the role, but it’s hoped that a happy and supported team will be more likely to score.

I read this not from a football supporter’s perspective, but from that of a therapist who is always mindful of how we engage with clients, especially men. There is no secret that men are less likely than women to engage with psychological services. Men are also more likely to hold gender based beliefs as to why they shouldn’t be sensitive to their own mental health.

The football team therapist spoke of how the engagement with players was less formal that traditional psychotherapy and could be anything from a few minutes chat to a longer session. It seems that being understanding and sensitive to the schedules of the players and being flexible around this, worked best for all parties.

Debating changing styles of therapy is a whole other discussion but it does make me question how greater engagement with men might be based on challenging concepts of masculinity whilst not taking men out of their own understood gender roles. In effect to reframe masculinity in a way that still feels masculine.

As a trainee therapist being in your own therapy is a requirement. The experience of being a client is something that shapes how we are as practitioners. The understanding of what it’s like to explore your own mind and how you can gain a deeper understanding of yourself can feel like a huge luxury. It can also feel like the most anxiety inducing and impossible task when you feel your own vulnerability in the face of another. As a trainee male practitioner this was the moment when I began to understand that I held many gendered views of what men did and didn’t do and how could I shift my perceptions without losing my own sense of my gender.

As therapists we are well aware of the challenges when clients begin to explore and think about their feelings. Knowing how that can feel for us we can empathise and think with them. When this is seen through a series of deeply held beliefs around gendered roles it can feel impossible. Here a myriad of gendered terms about ‘men not crying’ and being a ‘strong, silent type’ spring to mind. Is it any wonder that men can struggle to acknowledge, let alone engage with thoughts about mental health when there is so much messaging that it isn’t ‘masculine’?

Reading about a football club with a psychotherapist felt very positive. It wasn’t only an interesting article, but it very gently reminds us that attitudes towards men’s mental health, are changing. If the knowledge that a football team are supported and as a result successful by being sensitive to their own mental health it sends a subtle, yet positive, message. This can only be a good thing for helping men to think that being aware of their own mental health is not challenging their sense of their own masculinity, it is merely offering a different perspective.

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 –

When Home and Work merge

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‘The Wisdom of Trauma’ a film by Gabor Maté – A Critical Review

Both the name, Gabor Maté, and the word, trauma, have become synonymous and ubiquitous in recent years.

Dr. Maté is a Hungarian born physician and author of ‘In The Realm of The Hungry Ghosts’, which was first published back in 2008 and offered a compassionate and insightful understanding of addiction as a response to trauma. Since then Dr Maté has steadily risen to fame as an addiction and trauma expert. He has now released a documentary film entitled ‘The Wisdom of Trauma’, which was brought to my attention by a couple of my clients. I decided to watch it.

The film follows Dr Maté on his journey of defining trauma, most specifically, childhood developmental trauma (CPTSD) and covers his work and learnings from treating street addicts in Vancouver’s Downtown Eastside.

As a mental health professional and clinician, I am all in favour of any well-researched productions that aim to highlight the impact of CPTSD, educate the masses and ideally bring about change at a societal level in how we conceptualise trauma and treatment. I therefore had high hopes for Dr Maté’s oeuvre. Sadly, as the film progressed, I because increasingly uneasy with the content and was ultimately left with the impression that the film was more about glorifying Dr Maté and his self-professed ‘new’ trauma informed approach to treating trauma, than a piece of work aimed at bringing together the teachings and learnings of many clinicians over the years on whose shoulders Dr Maté, like the rest of us, stand (see Alan Shore, Babette Rothschild, Pat Ogden, Steven Porges, Antonio Damasio, Daniel Siegel to name a few).

There is a powerful sequence in the film filmed in a prison where Fritzi Horstman, founder of the Compassion Prison Project, undertakes some meaningful work with inmates based on the ACE principles (see Adverse Childhood Experiences study 1995 – 1997, conducted by Kaiser Permanente). The work of the Compassion Prison Project is clearly meaningful, research based and healing, however, the link between this project and Gabor Maté remained at best utterly unclear and secondly, there was no reference to the original ACE study and the importance of it so viewers were left in the dark around context and thus perhaps invited to imagine that this was somehow connected to Dr Mate. To be clear, the ACE study has nothing to do with Dr Maté.

As the film progresses, Dr Maté moves into sharing his experiences of healing through the use of psychedelics, namely Ayahuasca, with footage shown of a ceremony taking place in Peru. The study of psychedelics and their possible use in treating mental health problems is in its absolute infancy and the research being conducted is done so in strictly controlled environments where participants combine the use of medical doses of psychedelics with psychotherapy – no mention was made of this. Whilst promising in specific clinical settings (as opposed to the Peruvian rain forest) and for specific applications, psychedelics can potentially do more harm than good,
particularly for patients with weak egos or personality disorders. There also remain valid questions about the long-term benefits of psychedelics in treating trauma, with most studies showing that symptoms tend to return over time once psychedelic use was suspended (generally 6 months to a year).

There is then a sequence wherein a man in his early 50’s with a stage 4 prostate cancer diagnosis appears to enter into remission through therapy with Dr Maté with the implied cause of his previously terminal illness being put down to trauma. I am a clinician who profoundly believes in the body-mind connection as have many more learned clinicians before me (see Winnicott and psyche-soma integration), however, whilst our emotions are experienced through the body and the ACE study has shown correlation between adverse childhood experiences and illness,
correlation is not the same as causation.

Finally, there are numerous sequences where Dr Maté is conducting his own brand of ‘trauma informed therapy’ which he suggests is in some way unique and the way to heal trauma. And yet again, trauma informed therapy is neither a new phenomenon nor something that has been invented by Dr Maté; indeed, any well-trained and experienced psychotherapist who works with trauma (and we all do), should be educated in understanding the presentation and defensive structures around CPTSD.

The message of the documentary – a trauma informed approach to healing society as a whole – is a positive one and yet despite his profile, I was disappointed to see how Dr Maté fails to engage and influence policy makers, educators, physicians and mental health professionals and actively seems to undermine his own message through an irresponsible focus on psychedelics, terminal illness being healed through trauma talk-therapy and a guru-esque approach to practicing his own therapeutic approach.

The sad reality of relational trauma is that it occurred in relationship and so can only be treated and worked through in relationship. And working through is not necessarily the same as ‘healing’.  Good psychotherapy is painful and slow and the main reason it takes time is because the traumatised part of the patient (client) needs to overcome resistance and form a dependent relationship on their therapist; thus the client dictates the speed of therapy.

The Wisdom of Trauma seemed to me to subscribe to an all too common narrative of recent years – there is a ‘fix’ for everything and it can be quick. This is not my experience of working with trauma and nor is it that of my clients, many whom learn to live with their trauma rather than somehow leave it behind. Perhaps a better title would have simple been: ‘The Wisdom of Gabor Maté’ as the documentary was essentially about him and his views, despite the enormous work in this field undertaken by the likes of Freud, Winnicot, Bowlby etc., all the way through to ordinary
psychotherapists like myself and all my ‘ordinary’ colleagues.

 

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

‘The Wisdom of Trauma’ a film by Gabor Maté – A Critical Review

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

What is the purpose of intimate relationships?

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

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