Chris Horton Blogs - Brighton and Hove Psychotherapy

April 10, 2023 by BHP Leave a Comment

The End

Just as what goes up must come down, so whatever begins must end.

Each of us comes to deal with this existential reality imposed on our own lives and all the living beings that we care for. As truly relational creatures we humans encounter the inescapable fact of death in those who die before us and we experience the pain of loss and bereavement.

And grief work itself is a common reason for people to seek therapeutic support. But whether it is through debilitating loss, or one of the many other reasons that spur people to commit to regular therapy, it is a fact that once therapy has begun, an ending of some sort will surely follow in the fullness of time.

Indeed the business of deciding when and how to end therapy is not straightforward.

Aspects that might make it easier to recognise when work is coming to an end can sit within the very beginnings of the work. Sometimes we go to therapy with a higher level of self knowledge about where our difficulties lie. With the help of our chosen therapist we can identify a working goal that will help us to recognise desirable change and a means of measuring how we will know when this has been achieved.

Through this means an ending may well present itself. In some senses this work might be likened to sailing whilst keeping the shoreline always in view.

Perhaps more often than not though, we can approach therapy with a less clear picture of who we are in our lives at that particular point in time, maybe even feeling unsure about quite what is ailing us or why.

In this case the beginnings of therapy can require a willingness to tolerate uncertainty. To deepen our self awareness, we might contract with our therapist to explore more deeply how we are in the world and this might come with a commitment to developing skills for new ways of being. We might compare this approach with setting sail beyond coastal waters to the open sea in search of new horizons.

When client and therapist first meet one question swirls for each of them: how is this for me to meet in relationship with this new person? And when the time comes to end therapy the question’s twin will arrive: how is this for me to end my relationship with this person I have known? An attuning therapist will process both these questions in the service of her client. For the client these valuable questions offer a way to better understand themselves and to evaluate any differences they experience in who they were back then at the beginning and who they feel they are now, at ‘the end’.

Much has been written about endings in therapy in terms of how this might relate to the ways in which both client and therapist have processed loss and bereavement in their own lives. Some family systems therapists have proposed that we can conceive other contexts to finishing therapeutic work than (1) ‘ending as loss’. Their framings suggest to me some useful additional questions for both client and therapist to consider:

• Ending as cure: does the client feel ‘better’ in relation to the way they originally felt ‘bad’?
• Ending as transition: how has this therapy supported the client to grow developmentally?
• Ending as release: does either client or therapist feel relief in this ending and if so, what might this mean?
• Ending as metamorphosis: how have both client and therapist changed through this relationship?

Reviewing these questions here reminds me of the vital importance of beginnings and endings in shaping the content of therapy and the emerging relationship between practitioner and client. Thus therapeutic beginnings and endings always invite our special attention.

As it is ultimately the client who decides to finish in therapy one final question becomes theirs alone: having begun, how much time and space will I allow myself to end?

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

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

Further reading by Chris Horton –

I’m the problem – It’s me!

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

Resources –

Fredman G. & Dalal C. (1998) Ending discourses: implications for relationships and action in therapy. 1
Human Systems: The Journal of Systemic Consultation & Management. Vol 9 (Issue 1)

March 20, 2023 by BHP Leave a Comment

You’re not watching me, Mummy!

Is it ever too late in life to change? Despite many decades of accomplished professional practice and conspicuous recognition for his achievements, the psychotherapist Irvin Yalom was stunned to discover he still had personal work to do.

In his memoir, Becoming Myself , he recalls attending an academic event where he realises (1) he is to be the target of gentle but sustained mockery from his Stanford University colleagues. That night he has a powerful dream from which he wakes to conclude, ‘I am still looking for validation, but not from my wife, my children, my friends, colleagues, students or patients, but from my mother!’

Although Yalom’s real mother was long dead at the time of his unsettling dream, his self-discovery revealed that her frequent harshly critical judgements of him as a child had become part of his lifelong personality, rising suddenly within him at times of stress, such as when he became the particular focus of others’ attention. In his dream, isolated and scared, he plaintively cries out, ‘How did I do, Momma? How did I do?’.

We might pause to consider how it could possibly be that a richly experienced practitioner, one expert in helping others to understand themselves better, could be so suddenly blindsided by such a self-revelation. On the other hand, what Yalom is disclosing about his experience here might be seen as one of the most fundamental of human realities.

In psychotherapy we speak of the developmental process of ‘introjection’, whereby we unconsciously adopt the thoughts, feelings and behaviours of significant others, particularly the most powerful others in our early lives. In the modality of Transactional Analysis we call this part of us our Parent ‘ego state’. This proposes that during the
development of our ‘self’ we naturally take into our own way of being key aspects of the others we depend on, how they think, feel and behave: we thereby install their potency into our developing personality.

This is a natural survival strategy and serves us well when it provides us with valuable parental impulses that guide us to operate safely in the world and help us to nurture ourselves when under stress. The downside of this strategy is that, depending on the quality of the care we received and how we responded to it, the Parent ego state we carry
forward can contain persecutory impulses, parental fears and smothering tendencies combining in us to create significant inner conflict in our adult life.

Engaging in psychotherapy can be effective in helping us to explore those aspects of ourselves that seem to echo the powerful personalities of our past lives. Careful exploration with a curious and empathic therapist can help us to surface parental messages we may be carrying that contribute to previously unexamined self beliefs. In uncovering these ‘introjects’ we can more clearly see how what we chose to take on from others in the days when we first learnt to be ourselves might be limiting us now in living more freely and spontaneously in the world.

Yalom’s insight, late into his own life, was to see that the way he had incorporated his mother’s harshness into his own process was preventing him from being able to truly recognise and celebrate his own worth.

His particular way of dealing with this was to look for the compassion in himself for ‘that mother that I disliked so thoroughly.’ He writes of achieving a different perspective on her through his later realisation she had a deeply conflictual relationship with her own mother, always remaining desperate for a recognition from her that never came.

Coming to understand the possible motivations behind his mother’s persecutory behaviour, Yalom found a way in which he could simultaneously diminish the power of the fierce inner critic that he had made of her. Like many of his patients, he discovered it was never too late to become himself.

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

Further reading by Chris Horton –

I’m the problem – It’s me!

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

Resources –

(1) Yalom, I (2017). Becoming Myself: A Psychiatrist’s Memoir. Piatkus 1

January 16, 2023 by BHP Leave a Comment

I’m the Problem – It’s Me!

Are you curious to know the most popular song in the world right now? Of course, you might not have been able to miss it.

This autumn, a musical milestone was achieved by Taylor Swift, who has become the first musician to claim all ten top slots of the US Billboard Top 100. Of her ten conquering songs the one that’s found most popularity with streamers is Anti-Hero, with its choral refrain, ‘I’m the problem, it’s me’.

And this phrase has been reported as being rapidly taken up in social media trends almost as an anthem for our times. The promotional video accompanying the song depicts multiple versions of Swift portraying a character riven by internal conflict, struggling to relate to others and self-medicating with alcohol to cope.

Clearly, apart from its evident musical catchiness, something in the central message of this song is resonating with fans of an artist whose online followers number more than 100 million, mostly young, people. Is it that the singer’s conflation of her very identity with her problem seems to fit their own experience?

So what’s ‘the problem’?

The word ‘problem’ has been defined as ‘a situation, person, or thing that needs attention and needs to be dealt with or solved’. Just to speak the word involves compressing the lips twice to form the first syllable with its explosive ‘p’ and ‘b’ in a verbal stumble, almost expressive of something being expelled. It’s derived from the Greek ‘proballein’, a combination of ‘pro’ meaning ‘before’ and ‘ballein’ meaning ‘to throw’. And perhaps there is an ancient wisdom in the root of this word in its suggestion that we experience the need to ‘throw’ a perceived problem out of us.

Working with ‘the problem’ in therapy

This has recalled me to thinking about the uses of therapy as a means for practitioner and client to work purposefully together in addressing the recurrent phenomena of ‘the problem’.

Narrative therapy offers a framework for supporting families and individuals who present accounts of their life experience as ‘problem saturated’. Where someone has concluded they are the problem, in locating the problem inwardly in this way, they have formed what is called a ‘dominant story’ about themselves, one that could become powerfully restricting in narrowing possibilities for them to uncover other meanings or perspectives on their lives. It’s argued that this way of seeing only supports and sustains the presenting problem.

Linked with the original meaning of the word as ‘throwing’ something away from us, narrative therapy invites us to separate the person from the problem. Therapist and client engage in a collaborative search for an ‘alternative story’ that will challenge a person’s dominant story through techniques of ‘problem externalisation’. This starts with the contention that ‘the problem is the problem’ and focuses instead on the relationship between the person and the problem.

In therapeutic practice, fruitful ways of externalising any problem often involve using language creatively in naming it and even placing the problem where it may be visualised in the room and personified in its own right as an entity with its own curious qualities. So depending on the nature of the difficulty, practitioner and client might be working together to discover more about what the client them self names as, for example, the ‘Anxiety Wave’, the ‘Constant Conflict’ or even, in the case of Taylor Swift’s Anti-Hero, the ‘Monster On The Hill’.

This is an approach that honours the deep distress experienced by many individuals for whom a problem has become an inextricable and debilitating part of themselves. Through supporting them to separate from their problem, alternative stories can emerge that surface previously unacknowledged – or discounted – personal skills and competencies, revealing new capacities for agency.

Arguably Taylor’s song has done a service for those who most identify with her protagonist’s dominant story of problem internalisation. I hope it leads them to ways in which they might find their own alternative stories to effect preferred positive change in their own lives.

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

Further reading by Chris Horton –

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

July 25, 2022 by BHP Leave a Comment

Making Sense of our Multiple Selves

How many people are you? Personally, I know I’m quite a few and always will be.

Some years ago at a conference on ways of treating trauma a speaker was challenged from the audience to define what ‘mental health’ was. She paused for a moment and then replied that a mentally healthy person was ‘comfortable with self, comfortable with others’.

I admired the way she met this challenging question with a clear definition that describes a state of true wellbeing. At the same time I wondered, which ‘self’ are we referring to here?

Being in Relationship

Underlying that speaker’s definition of mental health is the notion of relationship and the recognition that to be a person is to always be in relationship with others and, most especially, with ourselves. In fact this learning how to be with ourselves is a process intricately linked to how we come to be ‘our selves’ in early development through relationships with our primary caregivers and other family members.

This notion that each of us appears to have multiple selves – or at least multiple parts of our ‘self’ – chimes with the reported experience of most people. This sense can be most acute when we face a life situation where we cannot decide on something, as though different parts of us are conflicting with each other to determine what is best for us as a ‘whole’ self.

The Parent, Adult & Child Model of the Self

A radical and deceptively simple idea for accounting for our different selves first emerged in the 1960s in the modality of Transactional Analysis (TA) (1) . This proposed that we naturally relate to ourselves and to others through a constant interplay between three different ways of thinking, feeling and behaving.

We first learn how to be from our close observation of the all-powerful others we meet in infancy.

We borrow aspects of how they behave towards us and incorporate these into our own way of being. This has been termed our ‘Parent’ ego state, of which we can have many different ‘borrowings’ from the authoritative figures of our early years. Borrowing these parental ways of being is useful when it allows us to provide ourselves with parental comfort and structure to safely navigate the world, such as soothing ourselves by rubbing a bruised knee or remembering to stop and hold hands at the kerb. This becomes unhelpful when any borrowed forms of the parenting we received prevent us fully accepting and loving ourselves.

We also learn by actively storing as separate ‘Child’ ego states within us our earliest intense aspects of previous emotional experiences and imaginings about the world. By replaying these old experiences in different situations, they give us guiding models for expressing our innermost impulses or adapting in order to successfully maintain relationships with others. This is less helpful to us when previous fears overwhelm us in the present or we over adapt to the demands of others at the expense of our own needs.

Our third and probably most common way of being is to operate in the here and now – or our ‘Adult’ ego state – where we use our accumulated knowledge of the world to solve daily challenges and get our needs met. Problems can arise when our ability to function in the moment is compromised by us bringing our more unhelpful Parent or Child ways of being into our present.

Making sense of our multiple selves

So when we face times in our lives when we do become ‘uncomfortable’ or worse, it can be instructive to use this powerfully simplified model to explore how aspects of our Parent, Adult or Child ego states might now be limiting our capacity to live well.

TA Psychotherapy

Part of the process of TA Psychotherapy is to focus with compassion on how our borrowed and previous selves continue to serve us and to explore with care and curiosity those aspects of ourselves that are now no longer helping us to change or grow. For example, we might identify the origins of self-critical voices and practise liberating new nurturing parts of ourselves. Or we might explore those moments in our lives when we seem to be suddenly incapacitated by childhood vulnerabilities and work to resolve why this is so.

To return to our speaker, if the definition of mental health is indeed to be ‘comfortable with self, comfortable with others’, then I would like to suggest that the vitally important process towards this healthy state is of one of ‘compassion for self, compassion for others’, a process that TA and many other forms of psychotherapy can very effectively support.

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

Further reading by Chris Horton –

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

Resources –

(1) Berne, E. (1961). Transactional analysis in psychotherapy: A systematic individual and social psychiatry. New
York: Grove Press.

June 6, 2022 by BHP Leave a Comment

Let’s not go round again – How we repeat ourselves!

Earworm

Have you ever had a song go round and round in your head for longer than you’d like? I certainly have. It’s a common enough experience for which in recent years the term ‘earworm’ has been coined. More academically, it’s known through American Psychological Association research as Involuntary Musical Imagery (INMI), defined as ‘the spontaneous recall and repeating of a tune in one’s mind’.

A persistent earworm of mine belongs to a radio staple of my youth: the Scottish funk group Average White Band’s disco hit, ‘Let’s Go Round Again’.

If you’re unfamiliar with it I hesitate to recommend you listen, lest I pass its catchy stickiness to you. But in the song the singer returns from unspecified travels to entreat a former lover to reconnect with him in the way they were and so ‘turn back the hands of time’. Mining a commonly held nostalgia for revisiting the passionate phases of former loves, I think the song’s sentiment succeeds most through its appeal to the very human need for repetition in relationship.

Repetition compulsion

Just over 100 years ago in Freud’s essay, Beyond The Pleasure Principle , he outlined long observed patterns of behaviour in his many patients as manifestations of a ‘compulsion to repeat’. He cites a case study of a little boy who created a game of regularly throwing and retrieving from his cot a favoured reel on a piece of string. He would throw it out to a word meaning ‘gone’, then retrieve it with a joyful sound meaning ‘there’. Within the context of the family, Freud offers the interpretation that the child’s invented game of disappearance and return was a way ‘to revenge himself on his mother for going away from him’.

He goes on to speculate that children repeat unpleasant experiences in order to gain some kind of mastery over them and then observes that many of his adult patients show behavioural repetitions resulting in misfortunes ‘for the most part arranged by themselves and determined by early infantile influences’.

Psychological games

Later in the 1960s an analysand of one of Freud’s followers developed this notion of repetition in human behaviour, identifying common relationship patterns in those reported by his own patients. He named these patterns psychological ‘games’: repeated transactions played out of conscious awareness by both parties in a relationship. Eric Berne’s ‘Games People Play’ (1964) became a 60s best seller and is a founding text in the development of the modality of Transactional Analysis.

In essence, Berne extended Freud’s earlier insights to suggest that each of us in infancy develops a repertoire of repetitive behaviours that we use to protect ourselves. The proposal is that at a deeply unconscious level we seek relationships with others who will allow us to repeat roles and situations that for us confirm fundamental beliefs about ourselves and other people, in order to keep ourselves safe.

Whenever we encounter relationship issues in our lives, it can often seem as though our difficulties take the form of repeated patterns of thinking, feeling and behaving. The process of psychotherapy can support us with self inquiry into the types of repeated behaviours we favoured when small, with a view to us breaking our adult patterns. It can help us pose the interlinked questions, ‘How might I be different with myself, so I might be different with others?’

In the penultimate verse of Let’s Go Round Again, the lover sings, ‘Baby, I know that you think I will be different now. Inside of me nothing has changed. So, I’m asking you again, please.’ And of course, the prerequisite for repetition is for nothing to change inside.

I like to think the old lover he is addressing greets the singer warmly but invites him this time into a different kind of relationship, where they can both explore new ways of being together that don’t leave them going round and round.

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

Further reading by Chris Horton

How are you?

Out of Sight, Out of Mind

References –

1 Jakubowski, Kelly; Finkel, Sebastian; Stewart, Lauren; Müllensiefen, Daniel (2017) Dissecting an Earworm:

2 Melodic Features and Song Popularity Predict Involuntary Musical Imagery,

3 Freud, S (2015) Beyond the Pleasure Principal, Dover Thrift Editions

4 Berne, E. (1964) Games people play: The psychology of human relationships. New York: Ballantine.

April 4, 2022 by BHP 2 Comments

How are you?

How are you at just sitting down quietly by yourself?

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

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

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

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

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

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

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

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

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

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

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

Further reading by Chris Horton

Out of Sight, Out of Mind

February 28, 2022 by BHP Leave a Comment

Out of sight, out of mind

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

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

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

Not seeing the bigger things

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

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

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

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

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

Not seeing the smaller things

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

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

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

The uses of psychotherapy

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

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

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

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

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

The End

You’re not watching me, Mummy!

I’m the Problem – It’s Me!

Making Sense of our Multiple Selves

Let’s not go round again – How we repeat ourselves!

How are you?

Out of sight, out of mind

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