Brighton and Hove Psychotherapy

01273 921 355
Online therapy In the press
  • Home
  • Therapy services
    • Fees
    • How psychotherapy works
    • Who is it for?
    • Individual psychotherapy
    • Child therapy
    • Couples counselling and therapy in Brighton
    • Marriage counselling
    • Family therapy and counselling
    • Group psychotherapy
    • Corporate services
    • Leadership coaching and consultancy
    • Clinical supervision for individuals and organisations
    • FAQs
  • Types of therapy
    • Acceptance commitment therapy (ACT)
    • Analytic psychotherapy
    • Body-orientated psychotherapy
    • Private clinical psychology
    • Cognitive behavioural therapy (CBT)
    • Compassion focused therapy (CFT)
    • Cult Recovery
    • Dialectical behaviour therapy (DBT)
    • Therapy for divorce or separation
    • Eye movement desensitisation and reprocessing (EMDR)
    • Existential therapy
    • Group analytic psychotherapy
    • Integrative therapy
    • Interpersonal psychotherapy (IPT)
    • Non-violent resistance (NVR)
    • Family and systemic psychotherapy
    • Schema therapy
    • Transactional analysis (TA)
    • Trauma psychotherapy
  • Types of issues
    • Abuse
    • Addiction counselling Brighton
      • Gambling addiction therapy
      • Porn addiction help
    • Affairs
    • Anger management counselling in Brighton
    • Anxiety
    • Bereavement counselling
    • Cross-cultural issues
    • Depression
    • Family issues
    • LGBT+ issues and therapy
    • Low self-esteem
    • Relationship issues
    • Sexual issues
    • Stress
  • Online therapy
    • Online anger management therapy
    • Online anxiety therapy
    • Online therapy for bereavement
    • Online therapy for depression
    • Online relationship counselling
  • Find my therapist
    • Our practitioners
  • Blog
    • Ageing
    • Attachment
    • Child development
    • Families
    • Gender
    • Groups
    • Loss
    • Mental health
    • Neuroscience
    • Parenting
    • Psychotherapy
    • Relationships
    • Sexuality
    • Sleep
    • Society
    • Spirituality
    • Work
  • About us
    • Sustainability
    • Work with us
    • Press
  • Contact us
    • Contact us – Brighton and Hove practice
    • Contact us – Lewes practice
    • Contact us – online therapy
    • Contact us – press
    • Privacy policy

April 27, 2020 by Brighton and Hove Psychotherapy Leave a Comment

Coronavirus Lock-Down – Physical Health vs Mental Health

As I write this blog, we are entering into the fourth week of so-called ‘lock-down’ across the UK. Despite daily speculation, nobody has any idea how long the restrictions on life will last for. 

Everything has changed and this has been hard to cope with in a society where stability and the ordinary continuity of life has been severely disrupted and curtailed; the UK population is currently in limbo, isolated from the wider community and possibly in closer physical contact with family than ever before. 

We know why we are doing this – we are reminded multiple times per day – to ‘save lives’ and ‘protect the NHS’. 

There has been much talk of the compelling priorities of the health of the nation vs the health of the economy. Arguably initially it was the later that took precedent in this country meaning we are now facing large numbers of fatalities. However, beyond the obvious economic costs of ‘lock-down’ and social distancing, the mental health impact seems to have been largely overlooked. 

Why start now? 

Despite a strong history and legacy of psychoanalysis and psychotherapy in the UK, mental health provision has long-since slipped from the forefront of policy-makers minds. Gone is the aptitude to be curious and instead a culture of symptoms has emerged increasingly oblivious to the fact that symptoms are communicating emotional and psychic distress. Depression has ceased to be seen as an inability to mourn and is instead an illness to be medicalised – as if it can be caught from the air like Coronavirus. 

So, in the midst of the pandemic, it is not surprising that any meaningful discussion on the impacts of quarantine, lock-down and social distancing will have on mental health, not to mention the ongoing rhetoric of how the socially interactive parts of our lives will be ‘changed forever’; today the WHO suggested that wearing a face-mask in public must become the long-term norm without the being any consideration to what the psychological impacts on self and others would be from such a policy. For example, where healthy development of an infant is contingent on them constantly scanning their care-givers face for reassurance and validation, what will the effect be of masking these quite literally behind a surgical mask? 

Compelling needs 

Whilst some of us may remain in denial, there is no question that social distancing is the only real means available at present to combat this pandemic. It is the oldest method in the book for dealing with epidemics and remains all we have (at present). 

However, for relational beings (which is what humans are) the strategy is psychologically and emotionally challenging (and for many catastrophic). 

Humans understand themselves and gain a sense of meaning through relationships with others. This is not a luxury – it is essential both as we develop and throughout our lives. Not only do humans needs to be able to communicate verbally, but we also require contact that is ‘non-verbal’. 

The mortality of isolation 

Isolation may keep us safe from the Coronavirus, however isolation is linked is not the cause of many mental health problems such as depression and anxiety and is fatal, particularly for the elderly (who, it would seem, are also being most impacted by Covid-19). Indeed, some studies have shown that loneliness is, indirectly, the biggest killer of the elderly. 

Virtual connections 

We live in an age where we can make use of virtual connections and video conference software to stay in touch with each other – my profession – psychotherapy – has overnight shifted to online working to ensure the continuity of therapy sessions. This is a positive, however, it will not migrate the tsunami of mental health and relationship problems that will arrive in the wake of the health crisis. 

Meaning making propositions 

For many, our daily lives, often revolving around work, provide us with a profound and anchoring sense of meaning and purpose. Not only has the ‘treadmill’ stopped, but with it much of the sense of purpose and meaning that many of us have. These two combined can be difficult to manage contributing to anxiety and depression – a literal crisis of meaning. 

Anxiety 

In the absence of meaning and purpose, and with the distractions of ‘ordinary’ life removed, anxiety can bubble up. It can leave us with a profound sense of unease and discomfort in our own skin and the wider world. And at present, it is hard to escape from. Of course, in reality anxiety can never be escaped from – it is part of us. It can, however, be faced and used to ask difficult questions about how we live our lives. 

Depression 

We are faced with a narrative from the media and politicians that ‘things will never be the same again’. I am unsure really what this means other than that it sounds like a warning or premonition of some kind. Being alive means accepting that things cannot remain the same and that we adapt. Change is hard and it forces us to be confronted with difficult emotions that many of us would rather run from. In the current climate of Covid, running from emotions has simply become harder. 

Whilst there simply cannot be a national or state managed balance between physical and mental health needs at present, this does not mean that as individuals we cannot be staying with our discomfort and asking ourselves what we ultimately want from this precarious life. 

 

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 –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Ageing, Mark Vahrmeyer, Sleep, Society, Work Tagged With: anxiety, Covid-19, Relationships

April 13, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Why psychotherapy sessions should end on time

Boundaries are critical not only to a psychotherapeutic relationship, but, as many clients learn through therapy, are essential to healthy adult-to-adult relationships.

In a good psychotherapeutic relationship, there is a solid contract between client and therapist such that clients know what to expect and when.  And part of this knowing by the client is knowing what time the session ends; most psychotherapy sessions last for a ‘therapeutic hour’ or 50 minutes.

Door-stop moments

Every clinician has encountered what are known as ‘door-stop moments’ with clients – they happen in the moments leading up to the end of a session where a client suddenly blurts out something emotive and important that can throw the therapist and lead them to extend the session by some further minutes.

Unconsciously, door-stop moments have much significance and represent a relational process between the client and therapist.  Yes, the content may be important, however, why is it being brought into the room (and relationship) in the final moments?

The client may unconsciously want to control the session by ensuring their therapist has no time to explore the content in detail; they may wish to ‘leave’ something difficult with their therapist to hold for a week; and they may be testing whether the therapist will hold the boundaries.  Or all of the above and more.

On hiding an being found

Donald Winnicott, esteemed 20th Century British analyst famously said “it is a joy to be hidden, and a disaster not to be found”.  Winnicott was making reference to the children’s game of hide and seek, which, is only enjoyable if we imagine that someone is looking for us.  If the other game participants give up and leave, we are left hiding with nobody holding us in mind – a disaster.  In this quote, Winnicott is talking about many concepts, but amongst others he is making reference to boundaries and holding others in mind.

Even though in the game of hide and seek the winner triumphs by not being found, they paradoxically only win if the other(s) are still searching for them – the game therefore is profoundly relational and based on an agreed set of rules.

Psychotherapy is also relational at its core and based on a set of rules (boundaries).  One of these is that sessions end on time.  Clients will find all sorts of ways to ‘hide’ from their psychotherapist, however, this is only ‘joyful’ if they believe that they will be found (seen and contained).

When a client presents a door-stop moment to us, it cannot be allowed to derail the boundaries of the relationship or the rules of the game.  Otherwise the client gets what they think they want (more time) but feels omnipotent and thus unsafe with their psychotherapist – in other words, the client has hidden so well the psychotherapist has forgotten about them.

It is never about the client even though it seems it is

Extending a session due to a door-stop moment is never about the client’s needs and always about the psychotherapist’s.  The client relies on their psychotherapist to ‘hold them in mind’ and thus hold their best interests in mind.  It is the latter that gets lost when a session is extended.

How can it be in the psychotherapists interests to extend a session?

Unconsciously the psychotherapist has also ‘got lost’ and is unable to remain separate from the client’s needs.  They thus extend the session to try and ‘please’, or appease the client, which fundamentally is about avoiding the client’s anger’ rage and disappointment.  And the job of a psychotherapist is precisely to survive these feelings in their client and what it makes them feel.

Don’t become a psychotherapist if you want your clients to like you

Psychotherapy is only happening when a client feels either positive or negative feelings towards their psychotherapist (and vice-versa).  If the relationship is neutral, nothing is happening.

It is easy to bask in the glow of a client’s adoration but beware, a fall will come.  And so it should.  As psychotherapists we are not there to be liked – we are there to remain constant in the face of our client’s emotions.

And being constant means ending the session on time.

 

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 –

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Can Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Psychotherapy Tagged With: Counselling, Psychotherapy, psychotherapy services

March 16, 2020 by Brighton & Hove Psychotherapy 1 Comment

Popping a bluey – young men and Viagra

Following on from my earlier blog about the physiological effects of Viagra, in this blog I am going to discuss some of the psychological and social issues that make young men pop a blue pill.

There is common notion that young men are constantly getting erections and always up for having sex. Various sources indicate the reality is different. Peggy Orensteins’s recent book ‘Boys and Sex’ cites a General Social Survey study showing young men between 18 and 29 are having less sex. This is indicated by the increase in the number of men who declare themselves abstinent, which rose from 10% in 2008 to 28% in 2019.

Orensteins’s conversations with young men reveal the extent of their performance anxiety. They fear that girls would be more knowledgeable and experienced and in contrast they will be unsatisfactory sexual partners. They are anxious that any inadequacy, such as not being able to undo a bra strap or coming too quickly will be broadcast to their peer group on social media and result in humiliation. They are also concerned that girls will take it personally if they can’t get an erection. Young men seem to feel that they are responsible for the success of a sexual encounter.

At the same time online pornography has set up unrealistic expectations about opportunity, performance and satisfaction. The Reward Foundation is an educational charity that focuses on the internet, love, sex and relationships; they have found a correlation between erectile dysfunction in young men and an increase in access to internet porn. Whether or not young men actually believe that the sexual relationships and encounters they view on screen are ‘real’, these representations have an impact. As a young presenter on VICE online magazine said, “In my head I’m thinking that girls will be expecting me to fuck them like a porn star.”

First dates or sexual encounters can be extremely anxious events. Dating apps like Tinder and Grinder make it easy to move on to a new sexual partner if the sex does not meet expectations the first time. This may increase pressure on men to have a prolonged erection or several erections and Viagra can be an ‘insurance policy’ or a ‘booster shot’ to ensure a good performance the first time they have sex with a new partner. If the relationship continues they may continue to take Viagra to maintain their performance and hide the fact that they took it in the first place.

So what’s the problem with young men using Viagra to perform better? If young men believe that the standardised notion of good sex is a good performance as Orenstein’s study suggested, we can see that taking Viagra would be a way to avoid some of the stress about being a good performer. Unfortunately this can create a psychological dependency making it more and more difficult to stop taking Viagra and harder to open up the subject with a partner. Like any kind of emotional withholding keeping Viagra a secret is likely to be a negative factor in a sexual relationship.

Good sex can be whatever is good for each couple and is far more nuanced and complex than a good performance. In a relationship of mutual consent sex can bring physical and emotional intimacy but sex does not always go smoothly, misunderstandings and disappointments happen. Exploring sexual dissatisfaction and difficulties makes people feel extremely vulnerable. By using Viagra to focus on performance, young men are avoiding the opportunity to speak honestly about what they expect and want from sex as well as finding out what pleases their partners. Trusting each other and exploring differences and desires together can build a stronger relationship as well as a more satisfying sex life.

 

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

Filed Under: Gender, Mark Vahrmeyer, Relationships Tagged With: anxiety, Relationships, sexuality

March 16, 2020 by Brighton & Hove Psychotherapy Leave a Comment

COVID-19 (CORONAVIRUS) Important Notice

We would like to reassure all our clients that Brighton and Hove Psychotherapy, including The Barn, in Lewes,  is operating as normal despite the current situation. 

We are coordinating our response to the virus to ensure we can continue to deliver sessions to our clients, look after the welfare of our associates and maintain the continuity of our practices.

Psychotherapy sessions do not involve physical contact and a boundaried physical working distance of more than a metre between clinician and client is maintained in sessions as general good practice.

Should clients or clinicians need to self-isolate, regular sessions will continue using video call or telephone as an alternative means of working, until face-to-face sessions can be resumed.

We are monitoring the situation closely, guided by appropriate health organisation advice (PHE) and relevant government guidelines.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Mark Vahrmeyer, Psychotherapy

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

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Who wants to be ordinary? The word has unpleasant connotations; like something that offers little that is good or substantial. And yet it is a word I often think about and return to in my clinical practice. It could even be one of the primary goals of therapy: to become ordinary.

In the world today there is more and more in place to protect us from being ordinary, that is, to protect us from being ourselves.

We have an almost infinite number of television channels, live streaming of every conceivable film and box-set and console games set in technicolour virtual reality.  The whole world is modelled on making us all feel special. And it is within reach for us all, if only we have just enough about us to win the latest talent show broadcast at primetime, or to garner enough Youtube followers or win the Lotto – after all ‘it could be you’.

All this presupposes that being simply ordinary is wrong; that being ordinary is settling for something less than. However, being ordinary in the truest sense of the world means being able to be in relationship with our inner world and make decisions and life choices – choices based on desire rather than the need to shore up our defences.

What is ordinary?

If being ordinary has little to do with accepting the mundane or second-rate life, then what does it mean?  Being ordinary means being in the real world, rather than retreating to a ‘fantasy world’ each time the real world becomes uncomfortable.  Or in some cases retreating from the real world to avoid it even the anticipation of discomfort.

On defences

I have previously written about manic defences enlisted in order to protect us from discomfort.  And whilst this blog in essence remains about manic defences, the use of certain defences to avoid ordinariness and strive for the extraordinary are a particular subset in the cluster of manic defences known as narcissistic defences.

Neglected children always construct a story of specialness

Whether it is story of being ‘special’ to a parent who leans on them for emotional support, or it is specialness born out of surviving a difficult childhood, being special or extraordinary can be a short-term invaluable solution to feeling helpless, hopeless, enraged and depressed. Or even mad.

Being extraordinary shores up the empty core of the neglected and abused child.  It enables them to cope and to construct a ‘pseudo-self’ so they can navigate the world. At least for a while.

A special kind of defence

There is an argument that as a society (western), we are becoming increasingly narcissistic: focused on consumerism and fantasy rather than connection and relationship.

The consumer world makes it easy to ‘sell’ specialness or the attainability of extraordinariness.  Even in the western spiritual model specialness is promoted through maxims such as ‘you are unique’; ‘you have a special gift to offer the world’ and so forth.

What’s so bad about being extraordinary?

Life should not be a choice between being extraordinary or being nothing (feeling like one does not exist).  Being ordinary is not the contrary of being extraordinary, at least not in psychotherapy. Being ordinary is the third position.

Being ordinary is a mature position of being able to withstand and navigate real life without flights of fancy; it is a position whereby we can make decisions from a position of strength and desire rather than from an ongoing defence of the fragile self.

In tangible terms, being ordinary means living a real and fulfilling life without a constant need for external validation and approval.  Without being defined by Facebook or Instagram ‘likes’.

Being ordinary is an authentic position and one through which we may have extraordinary experiences if we are lucky, but they will be rooted in reality.

All in all, it seems to me that being ordinary has really become something extraordinary in the modern world.

 

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 Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

What is the difference between fate and destiny?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Mark Vahrmeyer, Mental health, Relationships Tagged With: Interpersonal relationships, Narcissism, Relationships

November 11, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Don’t just do something, sit there! On the role of manic defences

We have all heard the phrase.  Often shouted at a moment of crisis on a television programme or film: “Don’t just sit there, do something!”  As if ‘doing something’, anything at all, will make a difference.  Of course, the reality is that doing something does make a difference, if not to the outcome of the crisis, then at least to how the protagonists in the crisis feel.

Doing something – anything – at a moment of crisis or even simply at a moment of inner discomfort, can be a common way of avoiding uncomfortable feelings.  Doing something can convert those feelings into an external activity whereby they, at least for the duration of the ‘doing something’ do not need to be consciously experienced.

We call defences, such as these manic defences, as their purpose is to rigorously protect us from having to be in touch with uncomfortable feelings.

Is manic defence linked to depression?

Most people associate the term manic defence, or ‘mania’ with depression and in particular bipolar disorder.  And whilst it is correct that some sufferers from bipolar disorder experience acute manic episodes which may or may not include psychosis, all of us use manic defences as an unconscious way of protecting ourselves against psychic pain.

The clinical bit

Manic defences arise developmentally sometime between the age of six months and a year.  This stage is when the infant is starting to come to terms with the fact that his/her primary carer (I shall use the term mother here for simplicity) is separate to them.  In other words, the mother is not a ‘part’ of the infant and that therefore she will frustrate and anger the infant in not being perfect in meeting their needs.  Manic defences protect the infant against painful feelings of control, contempt and triumph, according to Melanie Klein.  Manic defences, therefore, protect the infant against their own uncomfortable feelings and protect the mother, from the infant’s rage.

How do we use manic feelings?

Manic defences come into play to stave off a whole range of difficult feelings from boredom, through to rage and anger – often feelings where we feel impotent, helpless or fear our own strength of emotion.

An example could be to go shopping after a tough day at work.  And, with the advent of the internet, ‘shopping’ is invariably always at our fingertips.

What’s the problem?

The developmental process of growing up is one in which we should all learn to be able to face our emotional and mental discomfort and then use it in a growth-orientated manner to move forwards in our life.

Without this, we remain at the mercy of early, primitive defences that stop us engaging with who we are and how we feel and severely limit our capacity to become an integrated whole person.

How can psychotherapy help?

In order to grow up in a methodical way using our wisdom to make sense of our internal and external world, we must rely on others to teach us what is required.  This is ideally the role of a parent, however, if we have a parent who has been unable to truly separate from their parents and relies on manic defences to navigate the world, then we cannot learn this from them.

Psychotherapy offers and represents a relationship in which our inner worlds can be understood and tolerated.  This is not an easy process, but it is a fulfilling one: when the going gets tough, the tough go to therapy.

Returning to the title of this piece, perhaps the challenge for us all is in being able to resist doing anything, and to simply sit there and observe our internal process and acknowledge our feelings.  This is the mature response, but does not make for dramatic television!

 

Mark Vahrmeyer is a UKCP registered integrative psychotherapist who draws strongly on existential thoughts and theory to help clients make sense on an increasingly senseless world.  He sees clients in Hove and Lewes.

 

Further reading by Mark Vahrmeyer –

Can Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

How do I choose a Psychotherapist?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Mark Vahrmeyer, Society Tagged With: bipolar, Depression, Psychotherapy

September 27, 2019 by Brighton & Hove Psychotherapy 4 Comments

Can psychotherapy or counselling be a business expense?

A question that is often asked of us whether or not psychotherapy, and indeed counselling or clinical psychology, can ever be claimed as a legitimate business expense?

What are business expenses?

I shall start this peace with a caveat – I am not an accountant and the information I am sharing has come from my own experience and that of patients I have treated who have been self-employed or run their own businesses in the UK.

Business expenses are classified as allowable expenses which constitute the running costs of your business. These will, obviously, vary from business to business. The question of whether psychotherapy is a legitimate business expense therefore applies to people who are self-employed, ranging from freelance workers through to business owners (although for limited companies slightly different rules apply).

How can psychotherapy ever be a business expense?

The answer to that in some cases it can. For example, any counsellor, psychotherapist or clinical psychologist can legitimately claim their own personal therapy as a business expense. Not only is this appropriate as an expense, but it is arguable that all mental health clinicians should be in their own ongoing personal therapy for self-development and to ensure that they are being appropriately supported in the emotional work they do with their clients.

However, in my own practice I have many patients who claim their personal psychotherapy as a business expense and who work in completely unrelated fields ranging from property development through to creative endeavours such as being musicians. So how is this justified?

Therapist's sofa

 

What is psychotherapy?

Counselling, psychotherapy and clinical psychology all wall under the heading of ‘talk therapy’. They are concerned in similar ways with helping people to work through loss and trauma. However, both the concept of ‘talk therapy’ and the idea of ‘working through loss and trauma’ cover an enormously large remit and in many instances, this remit impacts upon our ability to work. Let’s consider an example:

Ellie, a freelance musician, has recently been offered a position playing with a major orchestra. This has come about as a result of many years of hard work and dedication; it offers the potential of being the pinnacle of her career. However, to her utter astonishment she notices that every time she joins the new orchestra for rehearsals, she experiences sleepless nights and strong symptoms of anxiety that impact on her ability to play to the best of her ability. Clearly, in this example, Sarah would both benefit from psychotherapy and it can be legitimately argued that psychotherapy for her performance anxiety is a legitimate business expense as her symptoms relate directly to her work and are impeding her ability to earn a living.

The reasons for Sarah’s anxiety could be numerous such as for example, an unconscious fear of success rooted in her mother’s low opinion of her, through to feelings of inadequacy and shame around ‘being seen’. However, from a business expense perspective, the causes are less important that the manifestation of Sarah’s symptoms – her anxiety is impacting on her ability to ply her trade.

Is psychotherapy only a valid business expense in times of personal crisis?

Many people initially enquire and start psychotherapy when they hit a crisis – in other words when their symptoms become debilitating, or at least too distracting to ignore any longer.

So, whilst the initial part of any psychotherapy process often overtly works with the crisis the patient brings, the underlying process will be addressing deeper relational issues.

It is not uncommon for patients to expect to undergo a period of psychotherapy which then turns into a deep, meaningful, intimate and ongoing relationship that continues week after week and month after month. And, in many instances, long-term ongoing psychotherapy remains a valid business expense.

Most businesses are comprised of relationships. Whether that simply means working on behalf of external clients, through to being a part of a team or leading an organisation. And as psychotherapy is a relational process of deepening one’s understanding of the self through the unique relationship with a psychotherapist, many patients continue to find that an ongoing process of psychotherapy becomes an asset in how they manage stress and anxiety and, in turn, their relationships with their colleagues.

 

Can couple therapy be a business expense?

Again, the answer to this depends on how the couple relationship is intertwined with the business.  For couples who run a business together – often a complex and stressful experience – couple therapy or marriage counselling can be both invaluable in stabilising the relationship but also in assisting the couple in improving dialogue with each other so as to improve their working relationship. In such a context couple therapy could be a valid business expense.

What if I am not self-employed?

Business expenses apply to those who work for themselves and submit their own (or company) tax returns. So, if you are employed, clearly psychotherapy cannot be a business expense, however, this does not necessarily mean that you cannot get help or support in attending and/or paying for psychotherapy. Increasingly employers are both aware and invested in the mental health of their staff and editor have Employee Assistance Programmes in place, or are willing to contribute to the personal therapy or clinical supervision of their staff when required.

Private health insurance

Increasingly private health insurance is offered as a benefit to salaried workers and most private health insurance providers provide cover for psychological support from appropriately trained and registered counsellors, psychotherapists and clinical psychologists. This cover may be capped in terms of a value amount or in terms of the number of sessions, so it is worth checking with you provider to find out more.

Time off from work to attend psychotherapy

And lastly, where employers may not choose or be able to offer private medical coverage as a benefit, an ever increasing number of employers are recognising how important it is to support mental health issues. It is therefore not uncommon for employers to allow staff to attend psychotherapy during working hours (with time made up on another day) or to come to a flexible arrangement with staff, such as working from home, to enable them to attend sessions. The stigma around mental health has not been eradicated, however, it has become easier in most organisations to raise mental health issues as a problem and to request support from your employer in accessing support.

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer

September 16, 2019 by Brighton & Hove Psychotherapy 31 Comments

Counselling vs Psychotherapy: Understanding the Key Differences

What is the difference between a counsellor and a psychotherapist?

The terms counselling and psychotherapy are often used interchangeably and many mental health practitioners use both terms to describe themselves.  In this article I explore whether there is a difference between counselling and psychotherapy, what that difference may be and why may matter.

In very simple terms, counsellors work at a more immediate level generally focusing on a current issue that is affecting the client. The work is therefore often considered of more limited duration although this is not exclusively the case.

Psychotherapists both think and work at a deeper process level considering how the structure of the client’s personality is affecting their experience of relationships and being in the world.  This is reflected in the training depth, duration and intensity of each discipline.  Let’s go deeper into this:

Defining counselling and psychotherapy: a brief history

Counselling and psychotherapy are two practices that are closely related that both fall under the category of ‘Talk Therapy’. All talk therapy hails back to the last century and Sigmund Freud, broadly seen as the ‘father’ of modern applied psychology.

Many people know that Freud ‘invented’ psychoanalysis – the practice of patients lying on a couch out of view of their analyst and sharing whatever comes into their mind – free associating – with their analyst who, as he or she is out of view, gets ‘projected’ onto by the patient. The analyst is therefore not related to as a whole person as the analysand (the person being analysed) knows very little about the life of the analysts and cannot see them due to the seating arrangement.

Psychoanalysis changed the way we thought about the both the actual human mind and its lexicon – repression, ego, libido, to name a few – all of which have become ubiquitous in everyday language. Far from being redundant, psychoanalysis has continued to evolve over the years with a strong British school emerging during the mid-20th century that has shaped how we think about infant and child development, as well as our relationship to self and others.

From Freud to modern therapy: the evolution of talking therapies

Classical psychoanalysis led to an explosion in us wanting to understand mental health with many trained analysts in the 1960’s, in particular, pivoting away from traditional analysis towards other more ‘relational’ therapeutic approaches. Many of these new approaches continue to exist to this day and have evolved as evidence-based practices in treating mental health problems. It is the practice of these approaches that sits within the categories of counselling and psychotherapy.

Where psychoanalysis would require patients to attend analysis at least three, and often five times per week (and still does), counselling and psychotherapy typically require patients or clients to attend one, or possibly a couple of sessions per week.

An analysis is also a very long-term affair, frequently taking many years or even a decade. And it was and is also not uncommon for patients to undergo a second analysis later in their lives.

For many, psychoanalysis is simply too expensive and too much of a time commitment, however, this does not suggest that analysis does not have its place and can often be the only appropriate treatment for some patients. Indeed, some patients will be prescribed ‘psychotherapy’ before entering into analysis and some clients are may be too unwell for weekly psychotherapy where they are too regressed and psychoanalysis may be more appropriate and holding.

Counselling vs psychotherapy: structure, depth, and duration

We have established that all modern talking therapies hail from psychoanalysis and that psychoanalysis remains an extremely important and in-depth treatment for certain patient groups. So, are the terms counselling and psychotherapy interchangeable? No.

An anecdote I believe sheds some light on the overlap and difference is that I have met many counsellors who call themselves psychotherapists, but no psychotherapists who call themselves counsellors. 

Unlike analysis, counselling and psychotherapy do look, at least to the layperson, rather similar: two people sitting in a room talking. They meet for a therapy hour (usually) and tend to meet on the same day at the same time, weekly (again, usually). However, what looks the same on the surface belies a profound difference in depth of thought, application and clinical process.

One of the fundamental differences between counselling and psychotherapy is that psychotherapists are trained to formulate – to diagnose – according to their therapeutic approach. This is critical when dealing with issues that are deep-rooted and impact on the patient/client’s relationship to self and others. Counsellors do not have this training.

Formulation drives the treatment plan for psychotherapists – knowing what one is treating and why.

In order to learn to formulate, psychotherapists undertake rigorous training which generally extends over a period of four to five years at post-graduate level. During this training period, they learn to conceptualise in one or more approaches and to become proficient in working with psychological process at depth. The training includes their own process of personal therapy over the duration of their training, a mental health placement and a minimum of 450 training hours of clinical work.

Working at depth with the psychological process – what is happening beneath the content of what the patient is bringing and what is manifesting between the patient and psychotherapist in the relationship – is a complex and core element of psychotherapy.  A useful synopsis of this process is that psychotherapists are constantly asking themselves ‘what is it that the patient wants me to know about them?’ irrespective of the content of the session.  This can then be brought to light and explored in the therapeutic relationship.

What psychotherapists are trained to do that counsellors are not

In the UK, counselling and psychotherapy are not regulated by the government. This is unlike clinical psychology, which is, and it is therefore illegal for someone who is not a clinical psychologist to claim to be one. 

The lack of legislative regulation brings with its certain benefits and disadvantages. A benefit is that counselling and psychotherapy offer a broad range of approaches in working with the human mind – arguably broader and deeper that clinical psychology (and clinical psychologists are under no obligation to undergo their own personal therapy!) . However, one of the disadvantages is that it can be difficult for prospective patients to ascertain whether a clinician is really as proficient as they say they are.

Regulation of counselling and psychotherapy in the UK

There are two main professional bodies for general counselling and psychotherapy in the UK: the BACP and UKCP. The BACP is the main register for counsellors and encompasses the name ‘psychotherapy’ in its title subscribing to the perspective that the two terms are interchangeable. If a clinician is a BACP member and not a UKCP member, then it is a fair assumption that they are a counsellor.

The UKCP is the main professional body for psychotherapy in the UK. Members must evidence meeting rigorous training and practice standards. Full UKCP members are psychotherapists.

There is a consultation in process between the BACP, the UKCP and other bodies to differentiate between counsellors and psychotherapists in a way that will be meaningful to the lay person, but as of re-visiting this article in June 2023, this process is far from concluded.

Do you need a counsellor or a psychotherapist?

It can be difficult to work out whether counselling or psychotherapy is right for you. If you are considering the question, then it may be that you are in a period of crisis, such as a life change, divorce, bereavement or are struggling with stress, anxiety or depression, for example.

If you believe that your issue requires a more present-based intervention – meaning that it is an isolated experience and not something that relates to the past or is a repeating pattern in your life, then a period of counselling may be sufficient for you.

If, however, you are concerned about how your past experience affects your present life, you want to address the deeper roots of unhealthy ways of thinking and behaving, and look at how you relate to self and others, then psychotherapy would most likely be better suited to you.

And if you have a history of mental health problems, or a diagnosis, then psychotherapy would be the advisable route to take.

“The unexamined life is not worth living”

The above statement is a quote attributed to Socrates of ancient Greece and is based on his premise that in the face of mortality – certain death – it is incumbent on us all to find meaning and purpose in our lives. This, it can be argued, is the greatest value of psychotherapy.

Freud stated that it was not until a crisis had been resolved that psycho(analysis)therapy begins. Perhaps this is the greatest value that an ongoing process of psychotherapy can offer us all – it is a deep, intimate, ongoing relationship where, through relating with a separate other who is there to hold us in mind, we can in turn establish a calmer and more ordinary relationship with ourselves. A relationship wherein the important questions about being human can be examined. Some see this as a luxury, preferring to be distracted by the mania of modern life; I would argue that with such our limited lives it is essential and it is questionable whether anything could, in fact, be more important.

How to choose the right psychotherapist

When choosing a counsellor or psychotherapist it is important to not only consider how they present themselves, but also evaluate whether they are truly able to work to the standard that the say they are. Most clinicians offer an initial consultation, and this is a time and place for you to ask appropriate questions to enable you to make an informed decision about whether to embark on this important relationship.

All psychotherapists should be members of an appropriate profession body as discussed above. All psychotherapists should be in clinical supervision with at least one supervisor, who overseas their clinical work and ensures that the therapist is working ethically and constructively with each client.

And, whilst not mandatory, ethical clinicians who take their profession seriously will be in their own ongoing psychotherapy so that they too can be emotionally and psychologically supported in their work and lives.

Lastly, it is essential that you ‘feel’ whether you can work with the counsellor or psychotherapist sat in front of you. A therapeutic relationship should ‘feel safe, but not too safe’. What does this mean? You need to feel that you are working with someone who can remain separate to you; who can hold onto their own thinking mind even when you struggle to do so. Otherwise they can end up colluding with you and change becomes impossible. Your psychotherapist is not there to be your friend nor to ‘validate’ the way you live your life. They are there to help you understand yourself and how you operate in relationships with others.

Finding a reputable psychotherapist or clinic

There are many directory websites on the internet that provide lists of counsellors and psychotherapists based on your location. However, whilst these websites may rank well, this in itself provides no guarantee of the calibre of clinician on offer.

Both the BACP and UKCP provide their own lists of qualified counsellors and psychotherapists enabling patients to search with the assurance that a clinician in in fact registered with the appropriate professional body.

You may also wish to consider whether you psychotherapist of choice is part of a clinic like Brighton and Hove Psychotherapy – a ‘bricks and mortar’ organisation who hold clinic meetings, is populated by clinicians working with different client groups and who can cross-refer to each other.  There are many directories of clinicians on the web who purport to be ‘practices’; few actually are, so do your research and ask questions!

Lastly, the field of mental health has been identified by ‘big tech’ as a goldmine and increasingly us bona fide clinicians working in physical collegial settings are facing stiff completion from websites purporting to be able to ‘hook you up’ with the most suitable clinician based on your needs. Aside from this being no measure of whether someone is well-trained, ethical and able to clinically work with you, there have been numerous privacy scandals where patient data has been sold or used by other third parties. One of the most basic tenets of psychotherapy is that confidentiality is sacrosanct and this is being violated by these platforms at the expense of vulnerable people.

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer Tagged With: BACP vs UKCP, choosing a therapist UK, counselling vs psychotherapy, difference between counsellor and psychotherapist, how to find a psychotherapist, psychoanalysis and modern therapy, psychotherapy training UK, talk therapy explained, what is counselling, what is psychotherapy

July 29, 2019 by Brighton & Hove Psychotherapy Leave a Comment

What is the difference between fate and destiny?

Many people will use the terms ‘fate’ and ‘ interchangeably and it can often not only be difficult to differentiate between the two, but also to understand what is actually meant by them. Both terms essentially refer to predetermined events that lie outside of our control and thus imply some sort of ‘higher power’ rendering them essentially religious in meaning.   But what is the real difference and are they useful words?

I believe that the word ‘destiny’ implies a degree of positivity as well as agency that one may have over their future; fate feels particularly hopeless to me in terms of the capacity for a person to have any sort of influence over the outcome.  Hollywood would have us believe that we are destined for good things, and fated to bad, however this negates free will and assumes pre-determined destiny.  As a clinician who believes in free choice as a basic tenet of the psychotherapeutic process, I have a resistance to both terms, instead preferring to consider how a person makes meaning in a world limited by circumstance – personal and existential.

Accepting reality

Much of the work of psychotherapy is around coming to terms with reality – past and present.  This means accepting what was in terms of our experience of childhood or past traumas and working through the complex emotions around them.  It often means grieving both what we had and what we didn’t.  Seeing something as fate or destiny can be protective in the short-term but can massively hinder how we approach life.  I consider it to be a degree of ‘magical thinking’ whereby there is a belief in a force, entity or deity who overseas our lives – the magical thinking is in psychological terms the belief in an all-mighty parent.

Accepting reality in the present also means accepting uncomfortable limitations which we may now not be able to change.  For example, it may mean coming to terms with the end of a relationship and accepting our role in its demise; or it may mean coming to terms with a biological loss – such as an inability to have a child – and accepting that this is not fate, but painfully, it is random and unfair.  And life is unfair and random.

Protection in a higher meaning

There is an illusion of protection in imagining that ‘things happen for a reason’ when this is simply not how the world operates.  This does not negate personal responsibility and scientific cause and effect, however, to make sense of the world through ascribing meaning to events that lie outside of our control is childlike and an avoidance of reality – the reality being that we are not in control.

Perhaps this is ultimately where we can draw a clinical distinction between fate and destiny: once we have come to terms with reality and accepted the experiences of the past and the limitations of the present, then where we take responsibility for our life, we are shaping our destiny.  In this context I believe this word can be used whilst being firmly rooted in reality and it conveys an acceptance of our past and our limitations and that we are willing and able to shape our future to the best of our abilities.

In this sense destiny is self-prescribed based on authentic living and choosing a life of substance.  It means identifying and then choosing to engage with that which brings our life meaning.  It means making decisions whilst accepting the ramifications of those decisions and the losses that accompany them.

Decisions – all decisions – are expensive, in that once taken, alternatives are precluded.  Bearing reality and accepting loss are therefore build into making any decision, even one as simple as choosing the pasta dish over the salad in a restaurant – the loss of choosing pasta is the salad, but also the idea of what the pasta would be like – we allow the fantasy of the pasta to become a reality and accept it, or at least bear it.  It may exceed our expectations; it may disappoint, but whatever happens, it will be different to how we imagined.

Opportunity cost

Economists often talk of opportunity costs – the cost paid in making one choice and therefore forfeiting the other possible choices.

Opportunity cost applies just as much in the field of psychology.  If we make certain choices in life, we will not be able to choose other life paths.  Despite what Instagram and Facebook promise – none of us can have it all!

One can argue that the terms of fate and destiny are simply that – words to describe something.  However, when our experience of the world is shaped and understood through words, they become exceptionally powerful and potentially limiting.  Therefore, whilst not as esoteric and catchy, I prefer the terms ‘loss and responsibility’ as replacements for ‘fate and destiny’.  At least we can come to terms with loss and then exercise a conscious sense of responsibility in shaping our lives going forward.

 

Mark Vahrmeyer is a UKCP registered integrative psychotherapist who draws strongly on existential thoughts and theory to help clients make sense on an increasingly senseless world.  He sees clients in Hove and Lewes.

Further reading by Mark Vahrmeyer –

How do I choose a Psychotherapist?

Is growing up in a different culture always a good thing?

What causes insomnia?

Why does psychotherapy matter in the modern world?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Mental health Tagged With: childhood developmental trauma, Psychotherapy, Relationships

July 1, 2019 by Brighton & Hove Psychotherapy Leave a Comment

How do I choose a psychotherapist?

Deciding that you want or need psychological help can be a difficult position to arrive at.  Choosing the right practitioner to work with can feel like a daunting task with so many different fields of talk therapy, types of therapy and professional bodies overseeing the field.  This blog is a guide to helping you find your way to the right psychotherapist for you.

Counselling, psychotherapy or psychology?

Counselling, psychotherapy and psychology all broadly fall under the category of ‘talking therapy’.  They have much in common, yet are also very different.  I have previously written a piece on the difference between counselling and psychotherapy; the former being largely for shorter-term work and the latter being appropriate for deeper and long-term work on the personality.  We also have an in-depth page on psychology here so I shall not go into more detail about that here.

Depth of work

In choosing a psychotherapist, it can be helpful to have a sense of what it is you are seeking to gain from therapy.  Generally, psychotherapy is longer term than counselling and rather than working with one specific issue, is instead a relationship through which the client can work through relational patterns (with themselves and others), formed in childhood that they wish to change. Depth relational psychotherapy takes time – months to years – to understand and process relational, or attachment, losses. It is a commitment to a process of therapy and to oneself with sessions being as a minimum weekly, at the same time and on the same day each week.

Professional Body

There are a few professional bodies who offer voluntary registration to counsellors and psychotherapists – the BACP and UKCP. Whilst the BACP includes the ‘P’ for ‘psychotherapist in its acronym, the minimum training requirements of the BACP for someone to call themselves a psychotherapist are quite low. The UKCP, on the other hand requires all registered psychotherapists to undertake a minimum of four years of post-graduate training at an accredited training institution alongside a mental health placement and four years of personal therapy, before permitting applicants to join.  At Brighton and Hove Psychotherapy, all of our psychotherapists have trained at least to this standard and many far beyond.

Training

Psychotherapy training is long, challenging and requires the candidate to be in their own personal therapy throughout the training period.  Most training institutions are located in London, or further afield, and so a great deal of commitment is required to reach the necessary training standards. One of the main aspects that sets UKCP registered psychotherapists apart from counsellors is that they have been trained to ‘formulate’, which is another work for diagnose, or understand, more complex trauma and mental health issues.

First Appointment

If you have never previously been in therapy, then the prospect of the first appointment can be daunting. It is the job of your psychotherapist to set clear boundaries and create an environment that ‘feels safe, but not too safe’.  What does this mean?  Psychotherapy is about learning to tolerate difficult feelings and your psychotherapist is there to facilitate this process through their relationship with you.  They are not there to be liked, or to be your friend, as this would not be beneficial to you or to your process. If all goes well at the initial consultation then you and your psychotherapist may ‘contract’, or agree, to work together.  This means that they have assessed what work is required to facilitate change for you and you have decided that you are going to enter into an intimate relationship unlike one you have perhaps ever had before.

Length of Contract

How long is a piece of string?  Most psychotherapy can last for months or years, however little can be inferred from the duration.  For example, someone attending a year of therapy is not necessarily ‘healthier’ or ‘saner’ than someone who attends weekly for many years.  It is entirely dependent on the work required, how the client wishes to ‘use’ therapy and the relationship formed. Freud famously believed that therapy only begins when the client is no longer in a crisis.

Final Thoughts

Finding a good psychotherapist begins on paper but ends with a feeling, or a set of feelings.  As it is in the relationship that the unravelling of the past takes place, it is critical that as a client, you feel you can build a therapeutic relationship with your psychotherapist. The capacity to do this will hinge on their degree of training, clinical experience and therapeutic boundaries, as well as on it being a relationship that feels ‘safe enough’ – not too safe to not be challenging – within which the therapeutic process can unfold.  

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Mark Vahrmeyer, Mental health, Psychotherapy Tagged With: Counselling, Mental Health, Psychotherapy

June 10, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Is growing up in a different culture always a good thing?

The world today seems smaller than ever before.  We think nothing of travelling to once exotic destinations for our annual holiday and more and more of us are choosing to live in countries other than that of our birth.

Alongside these effects of globalisation is that of children who are now growing up in cultures other than that of their parents and yet remaining to varying degrees apart from the culture of the country they live in.  These children are known as Third Culture Kids.

What defines a Third Culture Kid?

The term Third Culture Kids (TCKs) was first defined in the 1950’s to give a classification and understanding to American children growing up outside of the United States.  Technically it refers to a child who is likely to have parents (or a parent) who are working in a foreign country (or countries) for a period of time and the child therefore spends a significant part of their development growing up in that country; they therefore neither really belong to their original nor host culture and are defined as being of a ‘third culture’.

Effects of globalisation

More and more children are growing up as TCKs as people think less and less of living and working in other cultures and countries.  The benefits of being a TKD are obvious if not always ubiquitous: TCKs learn to mix with other cultures; they frequently speak multiple languages; they are more likely to undertake a degree and can easily feel at home anywhere.

So, are there only positives?

Put simply, no.  If a child grows up as a TCK and has a ‘secure base’ – is securely attached to their caregivers – then the experience can often be largely positive though still comes with a price such as a loss of belonging, limited contact with wider family, confused loyalties etc.

However, if a child has a less than ‘good enough’ home environment then the experience of being a TCK can exacerbate their lack of boundaries and can make neglect and/or abuse more likely as there is no wider family network or community to care for the child.

It takes a village to raise a child

In my clinical work I have come across individuals who have survived extremely neglectful or virtually non-existent parenting, who have nonetheless managed to locate enough consistency in adults around them in order to be OK.  In other words, there is great truth and wisdom to the old adage that it takes a village to raise a child and often, the village is the container and parent for the child where their biological parents have failed them.

Third culture kids and loss

Loss is a key aspect of growing up as a TCK.  There is often the initial loss of ‘home; to overcome – house, town, culture, extended family, friends, identity – which can be a significant shock in itself.

However, the losses continue to define TCKs as it is extremely likely that if they are growing up as part of an expatriate community, friends, teachers and familiar faces will come and go fairly frequently as contracts end and jobs take the adults elsewhere in the globe.  This can be a particular challenge when it comes to the frequent and ongoing loss of friends which is often the hardest part of a TCKs experience.

On a psychological level the losses combined with a lack of cultural embeddedness and identity can lead to difficulty in settling down, committing and fitting in.  This can then translate to anxiety, depression and a sense of free-floating dread.

A rolling stone gathers no moss

Third Culture Kids can grow up to become Global Nomads, relishing the confidence that being able to settle anywhere brings to them.  However, this is also often not the case and TCKs can oscillate between a dread of not belonging versus a fear of putting roots down and building an ordinary life with substance.

As with most experiences, whether something is positive, or negative is so very often contingent on how secure a child feels in the relationship with their parents.  With a secure base, we feel safe enough to venture further from home, even when that means exploring other cultures.

Mark Vahrmeyer is a UKCP registered psychotherapist and a self-defined Third Culture Kid who, by the age of 12, had attended 10 schools across five countries.  He speaks four languages and is attuned to working with Third Culture Kids, Global Nomads and Existential Migrants, as well as anyone struggling with cross-cultural experiences. Mark sees clients in Hove and Lewes.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Society Tagged With: anxiety, child therapy, Depression

May 20, 2019 by Brighton & Hove Psychotherapy Leave a Comment

What causes insomnia?

Insomnia is defined as being a habitual, or regular, inability to sleep.

Whilst it can be linked to medical conditions, the most common causes of insomnia are lifestyle related as well as anxiety, depression and stress related.

With regards to anxiety, depression and stress, insomnia is not only caused by these conditions, but it further exacerbates them too creating a vicious circle.

What can I do to help with my insomnia?

Improve your sleep hygiene

Sleep hygiene is a term used to describe a holistic approach to sleeping encompassing who you are as an individual and your sleep environment. Improving sleep hygiene involves thinking about where you sleep, how you sleep and what may work best for you.  Sometimes this will involve a degree of experimentation, for example, do you sleep better with the window open or closed? 

Stick to a routine of sleeping and waking

Research has shown that we are biologically predisposed to sleep and wake at the same time each day, ideally in synch with the setting and rising of the sun.  Whilst the latter is a far cry from modern life, coming up with a routine and sticking to it can be extremely beneficial to both your sleep patterns as well as your physical health.

Avoid stimulants

We all know that caffeine and alcohol will impact on the quantity and quality of our sleep.  However, watching a disturbing drama right before going to bed – or the news – can have an enormous impact on the ability for us to get to sleep.  It is much better to consume the news in the morning when we have the mental capacity and waking hours to digest it.

Why do anxiety and depression make insomnia worse?

Anxiety and depression are two seemingly different mental health problems that frequently find themselves side-by-side in the same sentence.  This is because they are essentially two-sides of the same coin.

Anxiety is an uncomfortable (at times, unbearable) feeling that gives us the sense that all is not well with the world.  It is an ordinary element of being a human being and many scholars believe that we are ‘cursed’ with anxiety due to our (largely unconscious) awareness that we are going to die.

Anxiety causes restlessness and many people deal with anxiety by channelling it into activity – something that fails when it comes to going to bed.  Anxiety is often described as ‘free-floating’ and will seek to attach itself to something.  We can then convince ourselves that the ‘thing’ our anxiety has attached to is the real problem, however, this is rarely the case.

Depression is a state of inertia but an uncomfortable one.  Anxiety (and stress) can have the function of protecting us from depression, however, eventually, anxiety will give way to the hopelessness of depression.  One may think that sleep would come easily in a state of depression but this is often not the case as hopelessness can feel unbearable.

Can counselling or psychotherapy help with insomnia?

If a client presented with insomnia than I would want to understand what may be causing the insomnia and to work with the client to gain a deeper understanding of what their feelings may be telling them – particularly any anxiety or depression.

Whilst anxiety is a normal element of being a human being, it should not be debilitating and an ideal is to engage in a meaningful life whereby the anxiety is channelled in a healthy way. 

Alongside this is a deepening of the relationship with ourselves in order to learn to better tolerate difficult feelings without becoming overwhelmed by them.

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Mental health Tagged With: anxiety, Depression, therapy rooms Brighton and Hove

April 22, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Why does psychotherapy matter in the modern world?

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

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Mental health, Psychotherapy, Society Tagged With: consulting rooms Brighton and Hove, Counselling, integrative psychotherapy

March 12, 2019 by Brighton & Hove Psychotherapy Leave a Comment

An Interview with Mark Vahrmeyer – Viva Lewes March ’19

Mark Vahrmeyer was recently approached by Viva Lewes for an interview on ‘Mending the Mind.  Below is a scanned copy of the full interview:

 

Mark 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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Psychotherapy Tagged With: Counselling, integrative psychotherapy, Psychotherapy

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.

Filed Under: Attachment, Brighton and Hove Psychotherapy, Mark Vahrmeyer, Mental health, Psychotherapy Tagged With: attachment, Psychotherapy

  • « Previous Page
  • 1
  • …
  • 3
  • 4
  • 5
  • 6
  • 7
  • …
  • 9
  • Next Page »

Find your practitioner

loader
Meta Data and Taxonomies Filter

Locations -

  • Brighton
  • Lewes
  • Online
loader
loader
loader
loader
loader

Search for your practitioner by location

Brighton
Lewes

Therapy services +

Therapy services: 

Therapy types

Therapy types: 

Our practitioners

  • Sam Jahara
  • Mark Vahrmeyer
  • Gerry Gilmartin
  • Dr Simon Cassar
  • Claire Barnes
  • David Work
  • Shiraz El Showk
  • Thad Hickman
  • Susanna Petitpierre
  • David Keighley
  • Kirsty Toal
  • Joseph Bailey
  • Lucie Ramet
  • Georgie Leake

Search our blog

Work with us

Find out more….

Subscribe to our Newsletter

Charities we support

One Earth Logo

Hove clinic
49 Church Road, Hove, East Sussex, BN3 2BE

Lewes clinic
Star Brewery, Studio 22, 1 Castle Ditch Lane, Lewes, BN7 1YJ

Copyright © 2025
Press enquiries
Privacy policy
Resources
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptReject Privacy Policy
Privacy & Cookies Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Non-necessary
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
SAVE & ACCEPT