In this video interview, Paul Salvage demystifies psychoanalytic psychotherapy and explains what clients can expect from the process. Paul is a UKCP registered psychoanalytic psychotherapist who works with individuals from our Hove practice.
We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?
There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.
There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?
Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.
Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.
A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.
Here are a few points you might want to consider if you want to access therapy online:
Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.
Further reading by Dr Simon Cassar –
On the face of it, a process that is long-term, happens at the same time, on the same day, each week, would seem to be in stark contrast to modern life.
We are promised, and expected to subscribe to, a world where our wants and needs can be met almost instantaneously, where we can have things exactly as we want them and everything – society, identity, gender and sexuality – is up to debate and can be changed. And changed and changed again.
Social media floods our senses with messages about how to be happy, grateful and fulfilled whilst espousing ‘hacks’ and quick fixes for depression, anxiety and every human condition in between.
The shelves in book shops buckle under the weight of the latest ‘self-help’ guru or fad and life coaching promises tangible change in a few sessions. And if it does not work for us? Well, then we are simply not trying hard enough.
Psychotherapy subscribes to, and offers, none of the above.
It is not quick, it is not an experience where you can get immediate gratification or a relationship that will affirm you as always being right. It is something very different.
In many ways, psychotherapy is an antidote to all of the above. It is about learning through relationship to be in relationship with ourselves.
Through relationships we begin to see ourselves through the separate eyes of another who is compassionate, boundaried and can withstand us; nobody should become a psychotherapist if they want to be loved.
Psychotherapy is the opposite of Instagram and Facebook – it is about deeply knowing and accepting who we are and learning to live a meaningful live of substance and depth: it is about learning to be ordinary. And it is about accepting the realities of life: that life is unfair, often hard and that the only substance is to be found in relationship.
Car crashes have a nasty habit of drawing our attention. And then, of course, the likely outcome is another crash. When we see a car crash it takes a mature mind and person to not join it; to keep their eyes on the road and focus on their own experience.
The modern world is comprised of ever more car crashes – not necessarily in the literal sense, but in the many dramas (real and streamed to us) that draw our attention away from the road. Psychotherapy is an antidote to this – helping people steer a steady course through the chaos and drama and remaining in relationship to themselves. In this sense, psychotherapy matters very much in the modern world.
Mark Vahrmeyer is UKCP Registered and is one of the Brighton & Hove Psychotherapy Co-founders. He 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 our Lewes and Brighton & Hove Practices.
I’m in agreement with Brett Kharr who argues that unfortunately we have a strange situation in therapy where there are an almost innumerable different types of therapies to choose from. I think this reflects the consumerist, swipe right, swipe left age we live in and actually makes starting therapy more confusing for clients.
Richard Chessick, a Psychoanalyst, writes that;
“It is the experience of the therapists personality and the encounter with the therapist as a human who is truly present, rather than any verbal exchange, that makes the fundamental difference in therapy. It forms a link, that brings the patient in consistently over years of treatment, even at times when the patient is very angry or upset. (85).”
If, as a client, you are serious about wanting to change things and about wanting to engage in therapy then it does pay to think a bit about which therapist and therapy may be a good match for you. Sometimes you may feel comfortable with the first therapist you meet after perhaps doing some online research or obtaining a personal recommendation. Sometimes you may want to have a few initial consultations with different therapists. As a therapist I would always be more than happy for you to do this. As a client I would advise on being as honest as possible with the therapists you meet about this, as it’s a good chance to gage their reaction. A therapist where you feel you might have to worry about hurting their feelings, may not be the best choice.
When I began my training the course leader, in one of our first seminars, talked about the therapists needing to have personal therapy and how to choose and get the most out of therapy, said one thing that has stuck with me –
“Make sure to give your therapist hell”.
I have often thought about that statement and have come to appreciate, that I think at essence, its saying how important it is to be as honest as possible in therapy, especially about the things you don’t want to say and especially about the things you don’t want to say to your therapist.
This may feel strange. You may feel your therapist is annoying, a disappointment, etc. What’s useful about this and I believe unique to therapy is that the therapist who has had a thorough therapy themselves won’t take it personally, they will be able to reflect on the bits that may be true, but also may be able to help you think about the bits you may be bringing that you may also bring to other areas of your life. Is the experience of finding your therapist annoying/boring/uncaring or whatever, something you experience in other areas of your life in relation to other people? If so the special circumstances of the therapeutic relationship can be a unique chance gain insight into these recurring patterns as they are happening, not just in an intellectual way but also at a deeper more affective level. It is at that level that I believe change can really occur.
Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.
Anyone who is or has been in “psychotherapy proper” will tell you that it can be really hard work.
First, you begin by telling a total stranger about the most intimate things in your life. Things you never even said out loud because it was all too difficult to admit to yourself, let alone to another human being.
Then, you find out that most things you were taught about yourself growing up turn out to not be true. Well, that’s a relief in most cases, especially since many of us are taught to believe pretty horrible and untrue things about ourselves like: “you’re stupid”, or “you’ll amount to nothing”, or something a bit subtler like “your sister is the good one”.
Next, you are encouraged to feel things you haven’t or couldn’t feel before because no one cared or knew how to deal with it. So, once you start learning that the stuff you swallowed in your childhood was more about your parent’s inadequacy rather than anything to do with you, you begin to feel pretty angry about this, or sad, or disappointed, etc
All of this inevitably leads to the painful realisation that your early life wasn’t as rosy as you thought it was, and therefore you are now feeling very anxious or depressed about seemingly unrelated things like work or your relationship. This then leads to more mourning of the loss of good experiences that you never had. And because you can’t go back in time and no one else can make up for these experiences, you then have to gradually come to terms with it.
Of course, this is all very uncomfortable and plus it turns your world completely upside down, which you weren’t expecting at all cause you just came here to talk to a lady (or man) with a nice face and (hopefully) a soothing voice.
But then, because you are feeling all this sad and angry stuff that you never felt before, you realize that you are also feeling other things, like relieved and happy. And that over time, you feel more and more alive and happy than sad and miserable.
This leads to you being more attractive to other people and them wanting to spend more time with you because you are a nicer and more interesting person.
You also get more secure in yourself and find better work, which in turn leads you to feeling even better about things and, oh gosh – a positive loop begins!
But of course, being sad and miserable has its advantages. People feel sorry for you and they try to rescue you. Plus, you don’t have to make any fundamental changes or feel very uncomfortable feelings and make some difficult realizations. It’s the devil you know, right?
Well, being in psychotherapy might change your life for good – it’s up to you whether you want to.
(P.S. The process of psychotherapy can take many different avenues, depending on what you are bringing and where you want to go. The above is only one general example).
Sam Jahara is UKCP Registered, CTA, PTSTA and is one of the Brighton & Hove Psychotherapy Co-founders. She is a Transactional Analysis Psychotherapist with experience of working with individuals and couples in short and long-term therapy. Sam is available at our Lewes and Brighton & Hove Practices.