Attachment Archives | Brighton and Hove Psychotherapy

June 3, 2019 by Brighton & Hove Psychotherapy Leave a Comment

What is ‘Blocked Care’ as it applies to parenting?

The phenomenon of parental ‘blocked care’ is a term coined by eminent Clinical Psychologists Dan Hughes and Jonathon Baylin and Psychiatrist Dan Siegal. It represents a central feature of the Dyadic Developmental Psychotherapy (DDP) approach to treating children and young people with a history of developmental trauma and attachment disruption.

Advancements in the areas of attachment, trauma and neurobiological development, teach us that children’s brains are shaped on a neurological level by their earliest caregiving experiences. Indeed, we now know that an infant’s brain is primed, even in utero, to adapt to the type of care that it anticipates receiving from its primary caregivers in order to maximise its chances of survival. What is perhaps less known however, is that parents’ brains are also neurologically influenced by their experience of caring for their child. When things are going well, five main areas or ‘care systems’ in the parental brain are optimally functioning. These are:

The Approach System: The system that enables us to fall in love with our children, to crave to be with them and to become completely absorbed in them. Not surprisingly, this system is associated with the release of oxytocin (the ‘love hormone’).
The Reward System: The system that enables mutual delight and attunement when a parent interacts with their child. This system is associated with the release of dopamine (the ‘addictive hormone’).
The Child Reading System: The system that enables parents to positively interpret our child’s behaviours and motivations and to remain interested in their unique qualities.
The Meaning-Making System: The system that enables parents to think positively and meaningfully about their relationship with their child.
The Executive System: The system that enables us to physically care for our children.

For some parent-child dyads however, things do not go so well. Some parents may face unmanageable levels of stress whilst caring for their infants, which may be exacerbated by their own poorly developed care and emotional-regulation systems. Others may be offering reparative foster parenting to children who, owing to previous experiences of abusive or neglectful parenting, now fear, mistrust and reject the care they are being offered, which can be extremely painful for their new carers to bear.

The real risk when things go wrong however, is that parents may enter (chronic or acute) periods of ‘blocked care’. When this happens, the first four systems listed above start to shut down. The parent no longer experiences joy or fulfilment of being with their child. They do not get the rushes of oxytocin and dopamine that other parents get, and they do not seek to be with their child. They also become much more likely to interpret their child’s behaviours and motivations with a negative bias (e.g. “he is manipulating me” or “she is a spiteful child”) as well as their relationship with the child (e.g. “I am a rubbish parent”).

A stressed-out parent is in survival mode. They are no longer able to remain open and engaged to the child’s emotional and developmental needs. Rather, they are liable to become extremely rigid, defensive and behaviorally-focused in their approach to parenting. Sadly, however, without support, the final care system, the executive system, may also start to shut down. This is the point when we start to see abusive or neglectful parenting emerge.

The growing evidence-base for blocked care, therefore, highlights the crucial need for psycho-education, as well as early and non-judgmental support to parents and carers who are most vulnerable to entering it.

References:

Hughes, D. & Baylin, J. (2012). Brain-Based Parenting: The Neuroscience of caregiving for healthy attachment. Norton

Hughes, D. & Baylin, J. (2016). The Neurobiology of Attachment-Focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents. Norton

Siegal, D. & Hartzell, M. (2003). Parenting from the Inside Out. Tarcher/Penguin

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes practice.

February 25, 2019 by Brighton & Hove Psychotherapy Leave a Comment

How are you going to Spend Your Emotional Currency in 2019?

Perhaps it seems odd to you to even think of emotions having an intrinsic value, isn’t it all rather cold and controlling. However, alongside purchasing a house, a car or other valuable object our relationships will need energy and investment of time to make them work well.

So in the next twelve months, wherever you are in the partnership process, there will be things to consider that will require the investment of emotional energy. If you are single you maybe considering looking for a partner or hoping love comes along, whichever way you approach this, a life-long partner will be one of the most important emotional investments you make.

Un-yet many of us go about this in a haphazard way, without giving sufficient thought to what we need to make a commitment to another person. Often we are under pressure from parents or peer group and the ever-present biological clock to get on and find someone or consolidate an existing relationship.

Some of us who are members of a religion will have priests or clergy to go to for advice and preparation before entering into a full commitment. However, this usually occurs after the couple have met and decided to enter into a long-term relationship. At this point the intention has been shared with family and friends, when it is more difficult withdraw, if the preparation phase uncovers areas of incompatibility in the relationship.

I have wondered, through working with couples, whether this should be done earlier in the relationship as soon as couples find they are talking about their future together.

Falling in love is an intense emotional, biological and physical experience, at times expressed as akin to madness. Delightful though this period of time is, it does hinder good decision-making.

Couples will come after a crisis, wanting help to mend a relationship after an event or betrayal has injured the mutual trust in the relationship. Or they come when a life event, such as the birth of the first child, loss of a job, children leaving home, retirement, illness or bereavement. All of these events put demands on the relationship, and people handle them in different ways. It helps to have a supportive family or friendship network around to contain and hold the couple as they navigate their way through these life-changing processes. All require the expenditure of emotional energy to maintain the relationship on an even keel.

So ideally we could envision a couple coming to relationship counseling before they finally decide this is the person they feel able and want to make this commitment to for the rest of their lives.

Dorothea Beech is a UKCP-registered Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst providing long and short-term psychotherapy to both couples and groups in Hove and Lewes.

January 7, 2019 by Brighton & Hove Psychotherapy Leave a Comment

How Psychotherapy Taught me to Live Life

This piece is written by a ‘fictional’ client who is a composite of three real-life clients who have shared their experience of psychotherapy with me. Some details have been changed to ensure confidentiality, however, the thoughts feeling and experiences expressed are those of three very real clients:

When I came to psychotherapy I did not even really know what it was. I knew I needed something because I knew I was struggling but whether that something was counselling, psychotherapy or what I simply had no idea.

As well as not having much of an idea about what to expect from my psychotherapy, I also had no idea about how long it would take. And I was impatient! It is therefore with a surprise that I look back upon my two-year journey of weekly one-to-one psychotherapy with some degree of awe with regards to how little I really understood what I needed and for how long; from my initial impatience, a sense of appreciation and security developed from knowing that on Tuesdays, at 5pm, I would be seeing my psychotherapist.

Where I say that psychotherapy taught me how to live life, I mean this in the sense of courageously living rather than existing.

Prior to psychotherapy I approached life and relationships from a default fear position. Not that I knew that at the time – the way I was all seemed perfectly normal to me. Normal is, after all what we are familiar with.

However, part of me also know that I felt unfulfilled and lacking in purpose and meaning. Meaning in terms of my own desires and meaning in terms of what relationships could offer me.

It has been through a slow process of learning to be in relationship with my psychotherapist that I have slowly learnt to have a healthy relationship with myself. Through being held in mind, I have learnt to hold myself on mind. And through trusting that the relationship with my psychotherapist was and is genuine, I have come to accept that just perhaps, relationships with others have something to offer me.

I am now two years into my ‘ongoing’ psychotherapy relationship. It has been hard, frustrating, frightening, constructive, containing and life enhancing all in equal measure. The only commitment: we both show up each week for the session.

How have I changed

Most of all I have let go of the past. My experiences still happened, of course. There is no magic to undo that. However I have accepted that I can still have a life without having gotten what I needed as a child. And through this have come to accept that I can treat myself differently to how I experienced my parents treating me.

My relationship with myself

‘Has psychotherapy made you happy?’, people I know sometimes ask me. No. But then happiness is not the purpose of life. I do, however, at times feel content and even happy. More importantly, I am able to feel the full range of human emotions without running away from them. I can navigate my emotional world using my mind in a way I simply could not before psychotherapy and instead would use all sorts of distractions to avoid feeling.

My relationship to others

I have far deeper and more authentic relationships with others – something I now realise I avoided in the past for fear of them really seeing me and then rejecting me.

Relationships have become important to me and I am far more able to tolerate difference in those around me – to accept that they have different minds.

In summary

Put simply, my life now has substance. I know more about who I am, who I have been and how I spent much of my life hiding from myself and others because of not feeling accepted; I now have compassion for this part of me.

Mark is an integrative psychotherapist primarily informed by attachment theory and object relations psychotherapy. He works relationally and sees individuals and couples in Hove and Lewes.

July 16, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What does Integration mean in Psychotherapy?

Psychotherapy is many things, but on a fundamental level it is about the integration of split-off parts of ourselves.

This cannot be achieved without the integration of psyche and soma (body), which is the function of the mind. We need the mind of another to grow a mind and this is what happens in the relationship children have with their parents, if all goes well. Emotional and psychological integration cannot happen outside of the context of a secure object relationship and it is this that is the function of psychotherapy.

Far too many ‘modalities’ of psychotherapy operate in ‘silos’, possibly reflecting the medical approach to the body and mind. This makes them limiting and we end up with ‘infighting’ around “my modality is better than yours”, or “this modality is NICE approved whereas that one isn’t”…. All of this in unhelpful to clients and to the profession. Without an integrated approach to helping clients to grow and use their minds to form a relationship with their whole being, little change is likely.

Going back to psychoanalysis

The old analysts, from Freud through Winnicott, understood integration and Winnicott wrote extensively about the ‘Mind Object’: where a mind becomes an external ‘object relationship’ for the patient/client, to compensate for a lack of secure primary object, but then persecutes the individual for having an emotional world (as it cannot process and contain emotion).

In the absence of a ‘good enough’ parent, the child projects his or her mind out of the body and uses it to navigate the world, however, this is a precocious mind that cannot help the client process emotion and attacks the client for their emotions.

The function of a mind is to make sense of the psyche and soma and be an ally to the individual. Integration in psychotherapy involves the client/patient growing a mind; learning to navigate their feelings and making sense of their thoughts, all whilst accepting reality and being in relationship to others. To do this requires and integration of approaches, not least Object Relations (psychoanalysis), Attachment Theory, Neuroscience, Embodiment and Existential Givens, all held within a relational therapeutic context.

Integration vs eclecticism

Being a potent psychotherapist means therefore being able to adapt our language and thoughts processes to those of the client in order to help them grow their mind and discover how they become integrated. It relies on the ability to move between languages (therapeutic, class, gender, culture, religious/spiritual) as well as being able to move between the client’s experience and our own. This is the true meaning of integration and the difference between integration and eclecticism.

Mark Vahrmeyer is a UKCP-registered integrative psychotherapist working in private practice in Hove and Lewes. He is integrates psychotherapeutic approaches with neuroscience and the body in his work.

March 13, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Lady Bird: a Psychotherapist’s Perspective on Key Themes

Ladybird

Warning – This article contains spoilers for anyone who has not seen the movie Lady Bird.

A critical success, this film about a mother and daughter relationship falls into the ‘coming of age’ genre, however it is also so much more than this in considering the systemic and unconscious processes at work that make this film both poignant and painful to watch.

There are many key themes present relating to those clients bring to psychotherapy, however I would like to pick out a couple that stood out for me which are perhaps better posed as questions we can imagine that Lady Bird (Christine), the protagonist, is grappling with unconsciously:

What is my desire?

How do I leave my family?

These two questions are in reality interconnected, as it is through desire that we leave the family. However, in a family where the roles are blurred, and for a young woman whose desire has always had to be curtailed to cope with her mother’s envy, the two questions are complex and the unconscious conflict immense.

From the opening scenes, we see a mother who struggles to see her daughter as separate to her. She clearly loves her, but also invests her own unfulfilled desires in her daughter. This is suffocating for Lady Bird, to the extent that in an early scene, she flings herself from the car to escape the literal confines of being with her mother: existence is impossible with her mother and hurling herself from a moving vehicle is less a thought-out action of leaving, than a murderous gesture – self destructive to her and to her mother.

As the film unfolds, the usual twists and turns of teenage experience are interspaced and amplified by the complexities of Lady Bird’s family. Her father is impotent – he loses his job and cannot separate mother and daughter. However, what he does know is that Lady Bird must leave, and he facilitates this through making financial arrangements for her university education, without involving his wife to whom he seems to be unable to stand up against (or to come alongside). This arrangement is pragmatically what Lady Bird needs, however, psychically it further undermines her autonomy and blurs any clarity of who she is in the family and who she is in relation to her mother.

An Envious Mother

Lady Bird understands, like so many of us who have had envious mothers, that she needs to ‘split off’ (disavow) her desire and get it met secretly, if at all. Or she can turn it into something destructive. Both choices aim to protect her relationship with her mother.

She gets in with the exciting, but bad crowd and swaps her boyfriend (who it turns out is gay) for an aloof boy who, like his friends, is nihilistic in his outlook on life. Neither her gay boyfriend nor her disinterested one will help her leave her family, as neither contain her true desire. Here Lady Bird seems to be asking herself less about her own desire and more about that of others: who am I for others and what do they want from me? A question she asks herself repeatedly in the relationship to her mother.

Owning her Desire

There are two scenes in the film which fill us with hope for Lady Bird: the first when she owns her wish to go to the school prom and be with her old friends, thereby stepping away from her less nihilistic friends who are ‘too cool’ for school, but who in reality actually have no idea about what they want, other than to rebel.

The second scene of hope is at the end of the film where Lady Bird is at an unnamed university in New York. Lady Bird’s father has slipped a pile of discarded attempts at a letter her mother tried to write to her into her suitcase which she finds. This is significant as Lady Bird’s father is finally able to help mother and daughter separate: he encourages his daughter to leave but provides her with the evidence her mother loves her; he assumes his rightful position as his wife’s husband by consoling her at the airport when she, as a result of her struggle to let her daughter have her own desire and individuate, misses her daughter’s departure.

To Individuate or Rebel?

Towards the finale, there is a perfectly ordinary scene with Lady Bird, at what me must assume is her first party in New York, she drinks, meets a guy and they end up at his or hers. She then becomes ill and the next scene is at a hospital where we learn she has drunk far too much. This scene is a reminder of the powerful unconscious forces at play in Lady Bird – whether she can find a way to individuate and own her desire or create distance from her internalised mother through self-destructive acts (think back to the hurling herself from the car).

Ultimately the viewer is left with hope as she seems to have enough psychic distance to claim her birth name – Christine – and to find ways to be like her parents (visiting a local church), without having to be defined by being them, or not being them.

Christine makes a call home to speak to her mother but she gets the answerphone. The message here? That her mother and family can survive her going and that they can too move on with their lives. She is free.

Sam Jahara is a UKCP registered psychotherapist, certified transactional analyst and clinical supervisor. She works with clients and supervisees in Hove and Lewes.