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Is There a Good Way to Break Up with Someone?

Breaking up with someone is hard to do. Often we feel a degree of ambivalence about our own emotions and our instinct is to both find the easiest and fastest way of ‘just ending it’.

Whilst this may seem seductive, the easiest and fastest way is often more likely to cause conflict and to leave us feeling ‘unresolved’ about the ending.

I believe that it is possible to end a meaningful relationship with another whilst holding ourselves in mind and essentially being ‘selfish’. I often refer to being ‘selfish’ (with a small ‘s’) in my consulting room as being the act of first and foremost holding ourselves in mind whilst not dismissing another’s experience.

Even good things must end

The first step in holding ourselves in mind is to bring an end to the relationship. If you have made up your mind then this represents a ‘hard boundary’ and is not one that can be negotiated.

The second step is to think about how you want to feel after the break-up. This is another step in being selfish in that you are thinking about your own sense of integrity and self esteem. If you are ending a relationship with someone you have cared about and the ending is a ‘no fault ending’ then it is unlikely you will feel good about yourself if you simply ‘ghost’ them.

Accepting different emotions

If your partner is not expecting the relationship to end, it is likely they will have a very different emotional response to the news than yours. Whilst this may feel uncomfortable, it is entirely natural and providing they do not verbally or physically attack you nor try and make you feel responsible for their emotions, they are allowed to have their emotional experience.

I would suggest that relationship endings should always be done in person and in private. It can be tempting to create distance when initiating a break up – such as ending things via text message – but this is far more likely to cause a ‘messy’ ending than by meeting with the person. By meeting in private it gives you both the opportunity to say what needs to be said and importantly feelings to be felt, without the discomfort of strangers witnessing your relationship coming to an end.

When we are uncomfortable about delivering a message that may hurt another, we can have the tendency to try and ‘soften the blow’ by using gentler language, however, this can backfire as the person receiving our message may hear this as a sign of hope and fail to recognise that the relationship is truly over. Clarity is ultimately kinder to you and your partner.

Being compassionate does not mean staying when you want to go

You can empathise with your partner’s feelings of shock, hurt, disappointment and sadness without backtracking on your decision or making yourself ‘wrong’. Remember, they are entitled to their emotions and you are entitled to yours.

I would recommend being boundaried with the time you spend delivering the message and thinking about where the balance lies between delivering what you have to say compassionately and sacrificing your needs. Perhaps plan in advance how long you will spend talking to your (ex) partner before leaving and creating some distance.

If your partner is able and willing to have a dialogue with you then you can discuss how you will approach letting your sider family and social circle know about the break-up and agree a narrative you both can adopt.
If possible, cut off all contact following the break-up, so as to allow space to grieve and start to move on. You can think about this in advance of your meeting and I would suggest that a minimum of a few months can be a helpful period of time to grieve some of the rawer feelings.

Let’s be friends…

Don’t commit to being ‘friends’ at the break-up. Whilst this again may feel seductive, neither of you know how you will feel about the other once the dust has settled and you have grieved. You may be able to be friends or you may not. The romantic relationship needs to first come to an end and only in time will you know whether any form of platonic relationship is possible.

Recognise that even though it is you who has initiated the break-up, this does not mean that you will not feel grief and need to give yourself time to let go of the relationship and your now ex-partner. Getting used to the ‘space’ left in our lives after a break up – a shift emotionally from ‘we’ to ‘me’ – can take time and feel uncomfortable. The inclination can be to ‘fill’ that space with dating, however, this rarely works out well and is a way of avoiding the grieving process.

 

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

Can Self-Help become an identity?

Can psychotherapy help narcissists?

Are we becoming more narcissistic?

What is narcissism?

The medicalisation of mental distress

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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)

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New Year’s Resolutions – why change might be so difficult

The start of a new year feels like a good time to make resolutions to change your life. Cut down on drinking, learn something new, be more efficient, be kinder, be more sociable or get fit.

Gym memberships regularly peak in January, increasing by 10%-20% but how many of those new memberships are used? According to research by Fridge Raiders, published in the Daily Mail in March 2019, 23% of Britons have gym memberships but only 12% use them often. They estimate that more than 4 billion pounds a year is wasted on unused gym memberships.

The reasons given for the 50 percent who did not attend regularly or at all, were to do with feeling self-conscious or intimidated, thinking that everyone was watching, finding repetitive activity boring and not knowing how to use the gym equipment. These could be valid reasons but Robert Kegan and Lisa Laskow Lahey think it goes deeper. They ask why do we stick with the status quo when we are unhappy or unwell and know that change will make us feel better or even make us live longer? Kegan and Lahey have been researching the resistance to change for many years. In their book Immunity to Change (2009) they discovered that strongly held values, often unconscious, prevented both collective and individual change.

The most quoted finding from their studies comes from interviews with patients with heart disease who were told they must change their habits around eating, drinking, smoking and exercise and take their medication otherwise they would die. Kegan and Lahey found that only one in seven was able to make the necessary changes. Making further enquiries they discovered that although patients recognised the imperative of their doctor’s advice there were deep seated beliefs that contradicted their desire to get well.

A composite example would be a man who said that cutting down on food and drink and taking medication for ‘old people’ would make him feel he was old and weak. This challenged his idea of himself as a competent man in the midst of a productive life. Beneath this was his fear of becoming incapacitated and dying that brought back memories of his father’s illness and death. At a deep level the fears that prevented him taking care of himself were the very things that were likely to happen to him if did not change his habits.

There are many other examples in their book. Another composite example would be a manager who wanted to be more collaborative and involve his team in decision-making.  Until he participated in the research he did not realise how much his fear of being a weak leader prevented him from being open to the ideas of others. This feeling stemmed from the unspoken culture of ‘you must be strong otherwise you won’t survive’ in the family he grew up in and was an integral belief about himself. When he could recognise this belief and its negative impact he was able to ask for support to change and eventually become a better and happier leader.

Kegan and Lahey’s research helps us understand why it might be so hard to change our habits to improve our lives. They offer an alternative to castigating ourselves for our indiscipline and lack of commitment and, I think, suggest that we begin by being kind to ourselves and curious.

 

References – 

https://www.dailymail.co.uk/news/article-6765171/Britons-spend-4-billion-year-unused-gym-memberships-new-survey-reveals.html

 

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. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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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Unexpressed emotions will never die

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

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

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

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

How do unexpressed emotions come forth?

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

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

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

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

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

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

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

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

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

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

And this list is by no means exhaustive or conclusive. 

Expression vs repression – living vs dying 

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

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

Grieving is part of living 

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

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

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

 

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

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further ready by Mark Vahrmeyer –

What is the purpose of intimate relationships?

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

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

Why does the difference between counselling and psychotherapy matter?

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Loss

You can hold yourself back from the sufferings of the world, that is something you are free to do and it accords with your nature, but perhaps this very holding back is the one suffering you could avoid.”? Franz Kafka

Loss is a feature in almost every encounter we experience as psychotherapists. It’s a common part of being human. In this article, we will look at what loss is and what we can do with it.

What Is Loss?

Loss is a term we use to describe many experiences and not just death. Although bereavement is what we associate with loss, more everyday losses that we experience include loss of identity, the loss of childhood experiences, the loss of friendships or relationships or simply the loss you feel from a change in situations. Loss can be experienced in a range of different ways, and if not properly processed, it can have a profound impact on your life and mental well-being.

How To Cope with Loss

Experiencing a loss can make you feel like you have a lack of control. It’s therefore helpful to look at the things you do have control over and do things to make you feel more in control. Breaking things down into smaller, more manageable pieces ensures you don’t overwhelm yourself. For example, maintaining a routine and slowly introducing smaller goals can give you a sense of purpose.

Therapy is also a great tool for working through your loss, whatever that loss may be.

How Therapy Can Help With Loss

Talking to a professional psychotherapist can help you understand your feelings of loss and support you in overcoming them. As therapists, we reflect mentally through our own experiences and mirror them onto our clients, so they feel understood. Grief and loss cause pain, and this must be managed to ensure a healthy life.

This reflective process helps clients understand what they are doing to manage their grief. We’re not here to judge, but to bring awareness to it so it can be looked at more in-depth. Over time, through exploration of these survival strategies, the frightening experience of grief will pass. Sometimes, a loss must be examined from different angles to be able to move forward.

As therapists, we don’t judge. We provide a safe, calm space to listen to you. We understand that people who have experienced loss have so much going on in their lives and can struggle to make sense of it. We help you reflect on what is happening and help you to navigate through it.

Darian Leader’s book, The New Black, revisits Freud’s concepts of Mourning and Melancholia and explores the more subtle experience of loss and argues that modern life holds pressure to treat loss with medication. However, this adjusts the chemicals within the brain which has led to complex and unconscious causes of depression. Although drugs can be helpful, they rarely resolve the underlying cause of loss and depression.

Leader while praising Freud’s new thinking about depression, argues that he misses a vital element of mourning, its communal aspect and looks at various cultures and how they share the process of mourning.

In the book, Darian Leader argues that Freud missed a vital element in mourning: its communal aspect. In different cultures, many share the process of mourning, and mourning should be shared whether it’s a death or more everyday loss.

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. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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A Nation divided

During Brexit, there was a lot of talk about how it divided our country. So we thought we would discuss how humans are divided and how Psychotherapy can ease some of the conflicts we have with ourselves and others. A personal ‘split’ can happen when we think or act in a way that doesn’t align with our beliefs.

In this quote, Freud describes how these splits can be repressed, by quoting Nietzsche’s phrase: –

“I did that’ says my memory; ‘I cannot have done that’, says my pride and refuses to yield. Finally – memory gives way.”

What Does it Mean to Have a Split?

Experiencing an emotional split isn’t always a bad thing. A split can be a way to manage feelings that can’t be properly managed at the time. So our mind represses it. However, the repression never goes away, and it will try and come out in some other way like displaced anger or depression.

An example of this is the conflicting feelings of love and hate for those we are close to. The feelings of anger and hurt towards a person are hard to express when we also feel love towards them, as we don’t want to hurt or lose them. Although we may not show certain emotions towards our loved ones, the feelings are still there and may come out in other ways through road rage to arguing with co-workers and even shouting at the TV.

When we feel these conflicts, it can be easy to dislike these parts of ourselves and push them aside. However, it’s important you work through these conflicts with therapy, as otherwise you may experience side effects that result in damaged relationships.

How Therapy Can Help

A therapist works with their client to uncover these conflicts in a safe, non-shaming and understanding environment. The client should feel they can honestly express themselves to their therapist which, in turn, will reduce the negative effects on their own life,

During therapy, a therapist will explore these conflicts without judgement. It is through this work a therapist can understand the emotions and whether they have been enabled by well-meaning friends and family.

As Carl Jung said:

“One does not become enlightened by imagining figures of light, but by making the darkness conscious.”

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. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Grief – how to grieve?

Grief is often referred to in the context of intense feelings experienced with the loss of a loved one. The loss we experience is often caused through death. Grief is, therefore, synonymous with bereavement.

This, however, is nowhere near the whole story. In order to know how to grieve, we need to understand grief.

When we are told that someone is grieving, we may assume they are feeling intensely sad. Although this is often true, grief is comprised of a multitude of emotions, and sadness is only one. One of the early pioneers of grief work (yes, there is such a thing), was Elizabeth Kübler-Ross. She suggested grieving was an active process that required a “working through of emotions” broken down into five core groups: denial, anger, bargaining, depression and acceptance. Sadness would fall into the ‘depression’ group in this model.

Since Kübler-Ross, plenty of other models have been proposed. All of these have added something to the field. I will not directly elaborate on these in this blog, but further information can be found on the Internet.

Grief is, therefore, an umbrella term for a whole host of emotions, and it is a verb.  It is something that we must allow ourselves to experience and actively engage with.

 Why should I grieve?

Emotions exist within us, whether we consciously acknowledge them or not.  Where we are unable to feel them (through repression, which is always unconscious) these emotions will often express themselves as a conversion reaction. They will be expressed through the body such as in aches and pains. They may be expressed through even more obscure symptoms, such as a loss of physical movement.

Where we are aware that we are feeling grief, but actively suppress the feeling, emotions are likely to manifest as anxiety or depressive symptoms, which can persist for years.

Thus, there is no escaping it, grief must be felt and ridden out, like a storm. To complicate things further, it is not a linear process. We might have felt anger (perhaps with our loved one for leaving us) and moved onto bargaining (“If only I had done more for them…”) However, this does not mean that we will not return to anger again. And again…

We must grieve because we need to acknowledge what we feel.  If we do not (because we can’t or won’t) things get complicated.

How do I grieve?

Grieving (in the context of bereavement) used to be a socially prescribed activity which was both acknowledged by the wider community and defined as a process. Those who were bereaved would often wear symbols of their grief – black clothes or a black armband. Within their community, it was acknowledged that they would be grieving for a set period of time, often a year. This practice has largely been lost in northern Europe. However, in southern Europe, it remains common in more traditional communities to see widows wearing black for the remainder of their lives.

Religion

Love it or hate it, the one thing religion gave (or gives) us is a powerful story of what happens after we die.  From the Vikings with Valhalla to the Christians and Heaven, the concept of an afterlife can bring great solace to loved ones who are left behind.  The loss of socially prescribed ways of mourning, combined with a loss of religious beliefs, has made grieving more difficult.

Meaning making

A universal task in coming to terms with grief is to find some sense of meaning within it, and to weave this together into a narrative. We are no longer provided with cultural narratives in the way that we once were. This then becomes something that we need to do ourselves.

Why is grief hard for some people?

When I embarked on my own professional psychotherapy career, working directly with dying patients and their relatives, I imagined that the loss of the deceased would be felt most acutely where relationships had been close, connected and happy. However, the inverse was true. Where relationships had been difficult, strained, or even devoid of contact for long periods of time, the bereaved would often struggle to process the loss far more. This occurred particularly where the relationship was between a parent and their (adult) child.

The reason for this lies in attachment and in how we learn, through attachment, to feel.  For those of us lucky enough to grow up in homes where there is no abuse or neglect, and no unexpected losses, we find it relatively easy to move in and out of relationship – to say ‘hello’ and ‘goodbye’. With the security of the relationship comes an ability to feel emotions and make sense of what is being felt. Thus, the process of grieving, whilst hard, is something that can be actively undertaken.

In some parent/child relationships, the child has been significantly disappointed by the parent in the past. Parental neglect and/or abuse can lead to an accumulation of unacknowledged earlier losses in the relationship. In these cases, the final physical loss of the parent can make it very hard to come to terms with the enormity of all the losses that person represents. The loss is not only of the relationship and person, but also of hope. If the relationship between parent and child was strained or difficult, it is likely the bereaved will be poor at navigating his or her emotional states. This makes grieving terrifying, at best, or unthinkable, at worst.

Grieving is normal

As a clinician, I get a lot of fulfilment in helping clients to grieve. It is different from any other presenting issue they bring to me. Grief is the universal leveller. We will all experience it at some point in our lives. The way out and through grief is always the same – we have to feel the full range of emotions that our grief brings up.

Grief is not a mental health condition, and yet many people become stuck with their grief. When this happens, the secondary symptoms can mutate into more complex conditions such as anxiety, clinical depression and panic attacks.

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

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Depression Counselling



One way of thinking about depression is that it is a prolonged state of feeling hopeless and often lacking any desire whatsoever.  Depression can range from mild to severe and can feel debilitating even in milder forms. Whilst the causes of depression may often not be obvious, therapy works to uncover and process unacknowledged emotions that may be feeling the depression. In fact, often the depression we feel is caused by earlier losses during our life, where the feelings at the time could not be felt and therefore become stuck. To discuss your situation with one of our psychotherapists, get in touch today.

What Causes Depression?

The causes of depression are usually multiple and differ from individual to individual. Common causes include: physical illness, issues dating back to childhood, current life circumstances, hormonal imbalances, poor diet and lifestyle, misuse of alcohol and/or drugs and relationship difficulties, to name a few.

Common Signs and Symptoms

Symptoms can range from mild to severe. Some common symptoms are:

  • Tiredness
  • Withdrawal
  • Enduring and prolonged sadness
  • Feeling helpless and hopeless
  • Lack of pleasure and enjoyment
  • Loss of self-confidence and feelings of worthlessness
  • Difficulty concentrating
  • Anxiety
  • Sleeping problems
  • Loss of sex drive and or appetite.
  • Suicidal thoughts and self-harm

Psychotherapy of Depression

When working with depression, we first try and establish what may be the underlying cause of the symptoms, that clustered together, feel like depression. For example, grief, such as that experienced after a significant bereavement, can feel very much like depression and clinically meets all the symptoms. However, the big difference is that it is completely normal to feel ‘depressed’ after the loss of someone we love, whereas it is not beneficial to feel unable to engage with the world for prolonged periods of time when there is no obvious cause.

As depression counsellors our job is to gently understand the many factors in a client’s life that may be contributing to their overwhelming feelings of sadness and then to help them to find a language to understand and process the feelings from the past or present. This may also involve an enquiry into the lifestyle factors that may be impacting or making the symptoms worse, and work with the client towards change.

Frequently Asked Questions

What is depression?  Read more

    Depression is an illness. Symptoms manifest differently for different people but it is often described as being a prolonged and deep sadness that does not lift or change. Depression can also be linked to a lack of desire where we are unable to feel ‘alive’ or engaged with life and what we may want – everything feels empty and hopeless. Depression is both mental and physical with sufferers often struggling to feel energised. It is also linked to anxiety with many sufferers reporting alternate feelings of depression and anxiety.

    How do I know if I am suffering with depression?  Read moreDepression varies from person to person, however, a good starting point is to consider whether the feelings of prolonged sadness and heaviness are linked to an event or not. For example, it is common to feel feelings similar to depression when grieving, however in this context, these feelings are appropriate and not depression. We all have ‘down’ days’ however, if you are struggling to engage with life and feel hopeless and these feelings continue for some weeks then you may be struggling with depression.

    What happens in a first session?  Read moreThe first session with one of our practitioners is an opportunity for you both to work out whether you feel able to work together. Your psychotherapist or psychologist will likely ask you various questions relating to what has brought you and explain the process of therapy to you. The first session is a two-way process where you have toe opportunity to ask questions and to decide whether you feel ‘safe enough’ working with your therapist.

    How do I find a psychotherapist of psychologist I want to work with?  Read moreAt Brighton and Hove Psychotherapy, we have two physical practices, one in Hove and one in Lewes, where we offer a full range of psychological therapies. On our website you can view each profile of our associates and contact them directly using the form on their profile page. You can also use our handy search function to find the right practitioner for your needs.

    How long will it take for me to see a psychologist or psychotherapist  Read more

    We aim to respond to all enquiries within 24 hours. You may either contact one of our practitioners directly via their profile page, or you can contact us directly and we will assist you in finding the right person to see as soon as possible. If the practitioner you wish to see has space then an appointment can usually be arranged within a week and sometimes much sooner.

    How can I get in touch with you?  Read moreYou can contact our practitioners directly via the contact forms on their profile pages. They will then reply to you directly.

    What age groups of clients do you work with?  Read moreWe have psychotherapists and psychologists trained to work with every age group from infants through to adults.

    Do you offer evening and/or weekend sessions?  Read moreWe offer sessions every day of the week including on Saturdays and sessions are available into the evening.

    What are your fees?  Read moreOur fees are set by each practitioner depending on the type of therapy. For individual psychotherapy or clinical psychology our fees range from £60 – £90 per session. For couple therapy our fees range from £70 – £100 per session.

    Is there parking near your Hove and Lewes practices?  Read moreBoth our Hove and Lewes practices are centrally located close to train stations, bus routes and with on-street parking.

    For more information on depression counselling across Brighton and Hove or to find out how we can help with the treatment of depression, get in touch with us today. At Brighton and Hove Psychotherapy, we have two physical practices, one in Hove and one in Lewes, where we offer a full range of psychological therapies. On our website, you can view each profile of our associates and contact them directly using the form on their profile page. You can also use our handy search function to find the right practitioner for your needs.

    We also offer online therapy for depression.

    All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.


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