Mental Health Blogs - Brighton and Hove Psychotherapy

What makes us choose our career paths?

September 27, 2022 by BHP Leave a Comment

Will counselling save my marriage?

One of the most common questions asked by individuals enquiring about couple’s counselling is whether the process will save their marriage? This is an understandable question and is driven by anxiety in relation to thoughts of a break-up.

The answer to this question is not simple and the variables lie with the two individuals in the couple, rather than with the therapist. Allow me to explain:

If a couple enter into couple therapy with clarity about wanting to work through some difficulties with the goal of continuing with their relationship AND this is reflected in the work then it is likely that the outcome will be a stronger relationship between the two individuals in the couple resulting from improved dialogue and intimacy.

However, this is often simply not the case. At best one partly frequently has ambivalent feelings about staying in the relationship or simply cannot get in touch with whether this is something they want due to the strength of feeling around unresolved issues.

Let us take the example of an affair. This is a fairly common presenting issue with couples who seek out couple counselling. In a typical scenario where one party in the relationship has been unfaithful, the other is likely to be feeling betrayed, hurt, angry and mistrustful.

Until these emotions can be worked through in session (if they can) and the hurt party can both come to terms with the affair, as well as with how both parties in the couple contributed to a loss (or avoidance) of intimacy, the question of whether the marriage can be saved remains a moot point.

Working with a skilled counsellor or psychotherapist can only benefit your relationship in terms of providing you both with a therapeutic relationship and environment in which difficult feelings can be worked through and better dialogue and understanding reached between to two members of the couple.

As painful as it is, sometimes the best outcome for a couple can be that both amicably go their separate ways.

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.

September 21, 2022 by BHP Leave a Comment

How to prepare for couples counselling

So you have taken the difficult step to go to couple counselling – what do you do now?

Obviously there are a lot of variables when it comes to couples’ attending counselling together. Some couples are both on the same page and have a common goal, albeit they are struggling to reach that goal, whereas others may have very different wants and needs to each other. Your particular circumstances will dictate whether you prepare for your first session as a couple or you take a more individualistic approach.

If you are new to counselling in general and couple counselling specifically, the days and hours leading up to your first session may feel daunting and anxiety provoking. You are likely to worry about both how the session will go and whether or not your counsellor or psychotherapist will be someone you can work with.

On of the most common fears that individuals in a couple have is that the counsellor will ‘side’ with one party in the couple against the other. Indeed, one can go a step further and suggest that secretly this is often a wish that individuals in a couple may have: that the clinician will see things from their point of view and help explain to their partner where they are going wrong. Well, whether a wish or a fear, any couple counsellor who is well trained
is not going to take this position and will work instead to facilitate a dialogue between the couple and to establish the goals of the work.

Unlike open-ended psychotherapy which can go on for many months or years (indeed, it should), couple therapy is very different, in that it is far more goal orientated. The goal(s), however, are to be defined by the couple themselves and if this is unclear then this can often be the first piece of work that is done together.

A couple counsellor is not invested in whether a couple stay together or not. This may sound counter-intuitive, but they will work with the wants and needs of the couple and in couple counselling, whilst break-ups are invariably painful, a ‘good’ break-up can be an as successful a piece of work as where the couple decide to remain in the relationship.

Returning to the question of how best you can prepare for couple counselling, if you are working towards a common goal as a couple then it can be wise and productive to spend some time in advance of the session talking about what you each wish to get from the session(s) as well as what you as a couple wish to get. You will both have individual
needs and the couple as an entity also has needs.

If you are unable to communicate together, or are clearly on very different pages in terms of what you want, then I would suggest you spend some time on your own thinking about what you want to achieve from the work.

Lastly, it is important that you are both comfortable enough working with your couple counsellor. Inviting a third party into your relationship is an intimate act and you need to be sure that the person you are seeing is both qualified to help you as well as someone you both feel you can be honest with. If one of you is too uncomfortable to work with a particular clinician, then there is no point in proceeding with any further appointments.

September 19, 2022 by BHP Leave a Comment

Why is Mental Health Important?

Mental Health has become a hot topic in the last few years. We often hear about it in the media, and because of more public awareness about mental health issues, more employers are adopting mental health policies and offering employees more support. Whilst mental health used to be seen as something related to mental illness, nowadays people are talking more about the importance of mental health as a part of their overall wellbeing, such as exercise and healthy eating.

But what is mental health?

Mental health is dependent on a certain degree of emotional, psychological, and social equilibrium. It impacts thinking, feeling and behaviour and therefore our capacity to handle stress, maintain good relationships and make decisions, amongst other things.

Good mental health is a vital aspect of us being able to function well in the world, hence it’s importance. There are environmental, social and psychological factors that can affect our mental state, such as:
– Ongoing real or perceived threat or danger to one’s life and livelihood
– Traumatic experiences/ events, recent or historical
– A physical or mental health diagnosis/ symptoms
– Bereavement and loss
– Breakdown in relationship(s)
– Major life change or life crisis
– Financial problems/ stressors
– Work stress
– Loneliness and isolation
– Discrimination and bullying
– Poor sleep and/ or diet
– Sedentary lifestyle/ lack of exercise
– Lack of light and/ or fresh air
– Noise and pollution

It is only human to have experienced one or several of the list above, therefore mental health is of relevance to everyone.

How to Look After your Mental Health?

Environmental and lifestyle factors:
Many people underestimate the impact of sleep, diet, exercise and sunlight on their mental wellbeing. With the increase in the use of screens and less time spent outdoors, especially in the case of children, these very basic factors are not being attended to, with often drastic impact on quality of life. Poor diet, poor sleep and lack of exercise and natural light are interacting factors. Lack of natural light and fresh air affects our sleep, as does the consumption of certain foods such as sugar and caffeine. Exercise can help improve sleep quality and lead us to want to eat better. Good sleep quality helps combat sugar cravings and when we feel rested need to consume less caffeine, etc. Good habits feed other good habits – it’s a cycle.

Social factors:
We all live in society and in communities within society. A sense of belonging paired with a sense of purpose and meaning are significant factors in our sense of mental wellbeing. We all need social connections and to feel a part of something. This became very apparent during the Covid pandemic when we saw many people’s mental health decline because of social isolation. Good relationships and good support systems make us feel safer and cared
about. Helping others, sharing interests, exchanging ideas and working towards common goals helps create a positive social loop where we feel that our life is meaningful and our contributions matter.

Psychological factors:
Most of us have gone through a crisis, a loss or even suffered significant traumatic event(s). Many of us have also experienced challenges growing up in dysfunctional families or under challenging circumstances. These issues when not attended to psychologically, can easily become cumulative and affect our lives in negative ways, often leading to depression or chronic anxiety. Feeling alone with our problems further exacerbates these issues, creating
a negative cycle that is self-perpetuating.

How Psychotherapy can Help

Psychotherapy can help you get and remain mentally healthy in several ways. A skilled therapist will help you address psychological issues such as the ones listed above. Therapy can be very effective in helping people deal with past traumas, life crisis, relationship issues and process loss, amongst many other things. In psychotherapy you can also explore how certain behaviours are affecting your mental health and how to change or improve them.

Sometimes bad habits tell us something about how we were looked after, and therefore how we end looking after ourselves. Finally, it can also help us get to a better place within ourselves and therefore make better decisions. Sometimes issues are multi-faceted, layered, and complex. Being able to distinguish, pick apart and navigate a seemingly hopeless situation is empowering and puts us back in control of our lives.

Sam Jahara is a UKCP Registered Psychotherapist, Superviser and Tavistock Certified Executive Coach.

Further reading by Sam Jahara

Antidotes to coercive, controlling and narcissistic behaviour

An in-depth approach to leadership coaching

Demystifying mental health

Women and Anger

September 5, 2022 by BHP Leave a Comment

How to get a Mental Health Diagnosis

The term ‘mental health’ is pretty broad and encompasses emotional and psychological health.

When people talk about mental health they are often referring to symptoms such as depression or anxiety but rarely do they mean psychiatric disorders such as schizophrenia, for example. Therefore, the answer to how to go about getting a mental health diagnosis is – it depends.

It is possible to go to a GP in the UK and present with symptoms that fit the criteria for anxiety or depression and to receive a ‘diagnosis’ from this doctor. In turn they may ‘prescribe’ counselling or offer you medication such as anti-depressants.

However, receiving a mental health diagnosis is not the same as receiving a diagnosis for a physical disorder. Let me explain.

Nobody has seen a mind.

If you are unfortunate to break a bone due to a fall, it is safe to assume that unless you are encountering an incompetent doctor, you will receive the same diagnosis irrespective of which hospital you attend wherever in the world; a broken bone is exactly that.

When it comes to mental health, the criteria is different as we are really talking about the ‘health’ of the human mind (or in many cases the emotional system), and the problem is that nobody has ever seen a mind.

Most mental health diagnoses are therefore based on the presentation of ‘clusters’ or groups of symptoms that a patient experiences over time. A GP will consider your experiences and the duration over which you have experienced them and on that basis will offer you a ‘diagnosis’.

Whilst this may be helpful in order to access medication of brief counselling, it is unlikely to resolve matters. And bear in mind that most GP’s have had very little mental health training – generally only weeks, compared to the years of training around physical health.

A psychiatric diagnosis

If you have severe symptoms that quite possibly may include delusions, you may be referred to a psychiatrist. A psychiatrist is a medical doctor who has specialised in ‘diagnosing’ psychiatric disorders and on the basis of a diagnosis you will likely receive medication and/ or psychotherapy.

Counselling and Psychotherapy

The parallel but distinct professions of counselling and psychotherapy are both related to mental health and approach treatment of mental health conditions through what is known as ‘the talking cure’. In reality the cure comes about far more through listening, rather than talking on the part of the clinician.

Whilst there is disagreement about the fundamental differences between counselling and psychotherapy – which I have previously written about here – a reasonable differentiation is that counselling is used to as a shorter term treatment working on a more superficial level.

Psychotherapy, as defined by the UKCP _United Kingdom Council for Psychotherapy) involves a similar process to counselling but working with a clinician trained for a longer period of time who is crucially able to formulate, unlike counsellors.

Formulation is the word psychotherapists use to ‘diagnose’ but as we do not tend to work within the ‘medical model’ and recognise that mental health issues encompass both psychological as well as emotional issues, we use a different language and different models to the medical model in order to make sense of a person’s inner world.

Is psychotherapy about getting rid of symptoms?

Whilst most people presenting for psychotherapy simply wish to ‘feel better’, a large part of the process of therapy is to become curious about one’s symptoms in the context of the therapeutic relationship. Psychological or emotional symptoms, much like bodily symptoms, are often there to inform us of something important that needs attending to.

Psychotherapy is fundamentally about working to create a deeper relationship with oneself, through the relationship with the psychotherapist. And through this deeper relationship we can come to understand our symptoms better as signals that are telling us something about our life: often either about something in the past that has not been processed or worked through, or something about what we yearn for in the future.

Further reading by Mark Vahrmeyer –

Mental health problems in Brighton

Bereavement Counselling for Businesses

Bereavement can have a huge impact on the emotional and psychological well-being of a person. The death of a loved one – whether a parent, a partner or, unthinkably, a child – is an experience no one can be fully prepared to deal with. However, alongside this, it is something we will all experience at some point in our lives – grief through bereavement, which is the universal leveller. The feelings associated with grief are similar to the feelings of depression, and it can make continuing with normal tasks, such as going to work, a huge struggle.

Whether you’re a small or large organization, making sure your staff are supported when going through bereavement plays an important role in the wellbeing of your team, and in ensuring the continuity of your business.

What is bereavement?

Bereavement is the experience of losing someone close to us through their death. It is an encounter that all of us are likely to go through at some point in our lives, often multiple times.

To grieve is the process that we actively undertake to work through the complex range of emotions that bereavement can bring up for us. Bereavement is not a mental health issue, however, if not attended to and ‘worked through’, our grief through bereavement can become ‘stuck’ or problematic and manifest in a range of mental health issues including depression and anxiety.

If a staff member has experienced a close bereavement and is struggling to work through their grief, psychological support such as corporate bereavement counselling is available with Brighton and Hove Psychotherapy.

How can bereavement in the workplace have an impact?

Losing someone close to us can trigger a period of intense and prolonged grief defined by a range of emotions as we slowly and gradually adjust to the loss. Losing a loved one can be emotionally shocking, whether that be a partner, a family member, a friend, a pet, or a work colleague.

Some of the different symptoms that can be seen or experienced during bereavement include:

Shock and numbness, often described as being ‘in a daze’
Overwhelming sadness
Depression
Exhaustion or tiredness
Anger towards the person lost often expressed as anger in general
Guilt

How we experience grief and for how long will vary from person to person. There is no ‘right feeling’ nor ‘correct period’ of grieving. Whilst some people may find that they have adequate support in their lives to work through their grief and welcome the structure of ‘normal’ life, for others more support is required. It is not uncommon for those who are struggling to cope with their grief to feel the need to hide it, as they may believe that their experience is ‘wrong’ or ‘over the top’.

How we can help

Brighton and Hove Psychotherapy provides a well-planned and tailored approach to bereavement counselling for businesses. Our bereavement counselling offers help, not only to bereaved employees to cope with their loss, but will support management through their staff’s bereavement too.

For deaths that impact multiple staff members, such as a death in the workplace, we offer bespoke treatments for teams and departments such as individual or group sessions.

Bereavement counselling for businesses can help your staff deal with loss and support them in returning to work making the transition back into normal working life easier. We can offer bespoke help to any organisation to help single staff members during personal loss or roll out general support for workplace deaths including the death of a colleague.

Corporate Counselling for The Death of a Colleague

The death of an employee can have an impact on the whole workforce. It can be especially difficult in instances where the death is sudden or unexpected, or if there are friends and family of the employee at the same workplace.

Brighton and Hove Psychotherapy offers expert corporate counselling services for those who have lost a work friend. Our highly experienced and qualified practitioners can deliver first-class support for staff at all levels of your organisation.

Our psychotherapists and counsellors are trained to deal with many types of losses and have helped many staff members and businesses cope with death. Our practices are located in Lewes and Hove with clients spanning across Sussex and London. To discuss how we can help your business function following the death of a staff member or staff member’s loved ones, get in touch now to book a consultation.

August 29, 2022 by BHP Leave a Comment

What is Psychotherapy?

Psychotherapy is a method of treating mental health issues through psychological, rather than medical means.

Known as ‘the talking cure’ a psychotherapist’s role is to work with patients or clients, generally on a minimum of a weekly basis, over a period of months or years. The work takes place within what is called a ‘therapeutic relationship’, characterised by the psychotherapist listening and thinking carefully about the client’s experience and working with them to make sense of it. Thus, whilst known as the talking cure, it could be more accurately described as the listening cure.

Psychotherapy developed from psycho-analysis, which is similar in nature, but involves multiple weekly sessions (up to five) and can often last for up to a decade. Freud referred to (psycho) analysis as a ‘cure through love’ and this applies to psychotherapy in much the same way. The relationship between psychotherapist and client is unique and one in which all the focus, attention and thought is about the client’s process. The closest example to this type of relationship is between mother and child, or primary-caregiver and child, and it is often due to failings in this primary attachment relationship that clients seek out psychotherapy in later life.

Do I need to have a mental illness to go into therapy?

Whilst it is very common for people to seek out the assistance, support and expertise of a psychotherapy due to them feeling like they are in a crisis in their life, the crisis is often only the catalyst that brings a client into psychotherapy. Indeed, it was once again Freud who said that psychotherapy (analysis) only begins once the patient’s crisis has passed. What did he mean by this?

One of the goals of psychotherapy is to bring space and contemplation into a person’s life so that they feel less at the mercy of their emotions and more able to hold themselves in mind. Once a crisis has passed, clients can often start to focus on using the therapeutic relationship and space to examine why they think and feel the way they do and to develop a construct or idea about who they would like to be. Psychotherapy is thus about getting in touch with our appetite, or passions.

Whilst most people access psychotherapy due to an issue covered by the term ‘mental health’, most remain for months or years in order to learn to have a better relationship with themselves and others.

How does psychotherapy work?

Human beings are relational beings, meaning that we are, from the moment we are conceived, in relationship to another. Relationships shape not only our worldview and our relationships to others in our life, but also shape our relationship to ourselves.

If we have learnt through early relationship(s) that others are unsafe and/or that we are not worthy of love then this shapes our worldview of all our relationships going forward. If we have been wounded in relationship then it takes another (therapeutic) relationship to work through all the hurt and to discover a new way of relating through how we are related to.

What training do psychotherapists have?

In the UK, the terms of psychotherapist and counsellor are not legally protected meaning that virtually anybody can use these terms with impunity.

Whilst some clinicians use the terms of counsellor and psychotherapist interchangeably, the UKCP (United Kingdom Council for Psychotherapy) is the largest professional body for psychotherapy clinicians and lays out its training and membership expectations for clinical psychotherapist very clearly.

Psychotherapists in the UK (who are UKCP members) train for a minimum of four years at post-graduate level, undergoing their own psychotherapy throughout this period, obtain at least 450 clinical hours of experience and undertake a mental health placement. Most UKCP psychotherapists will therefore have a minimum of a Masters degree in the field.

What’s the difference between psychotherapy and counselling?

There is much disagreement about the differences between counselling and psychotherapy and this is something I have previously addressed here. Fundamentally, psychotherapists are trained to work at a deeper level than counsellors and have been trained to formulate – our word for diagnose.

How do I find a psychotherapist?

Finding a psychotherapist can feel daunting. Brighton and Hove Psychotherapy is a physical clinic comprised of a group of skilled clinicians offering psychotherapy across the greater Brighton and Hove area and Lewes. You can use our search function to find a psychotherapist near you.

Alternatively, the UKCP holds a directory of all registered UK based psychotherapists which can be found here.

Further reading by Mark Vahrmeyer –

How to improve mental health

The process of joining a therapy group

August 22, 2022 by BHP Leave a Comment

A New Psychotherapy Group

Starting a new psychotherapy group always gives me a sense of excitement. Until everyone is in the room together you never quite know what’s going to happen. And of course, that’s just the beginning.

Growing a group

In group analysis we often talk about ‘growing’ a group. It’s a useful way to describe the process. Tilling the ground, adding nutrients to the soil, planting seeds, watering, feeding; all these gardening activities symbolise the tasks involved in trying to create a nurturing environment for individuals to come together and flourish as a therapy group.

Firstly, finding a good setting is very important. (I am lucky to already have a lovely group room at Brighton and Hove Psychotherapy in which my two current groups meet, so this isn’t a task I have to be concerned about).

After the setting I settle on a regular time and day of week for the group to meet. And then I see if I can find individuals who might be interested, can make that time, and who I feel might benefit from a group.

Suitability for group therapy

Although exploring who will join the group means giving time and support for potential members to work out if a group will be right for them, I will also be thinking about their suitability for group therapy, and this particular group.

A fundamental question in my mind will be about the level of interest the person might have in themselves and others. Curiosity is vital for individuals to benefit from the group and, also, for the group to benefit from them.
And it needs to be the right time. For e.g. someone who has had a very recent trauma or bereavement, might need to get help with this first before they are ready to be in a group.

The joining process – boundaries and culture

The group culture is important in making the group feel safe and therapeutic so there are certain boundaries that people need to agree to – e.g. confidentiality etc – before joining.

See my blog on The Process of Joining a Therapy Group for more detail about this and other aspects of the joining process.

Differences between joining a new group and an established one

There are certainly some differences in joining a new group than an established one. One of the features – if not advantages – is that you are at the core of the experience from the start and will inevitably have influence in shaping how the group forms early on. It’s perhaps akin to being the oldest child, as opposed to children who come after who may never quite fully share and know all the family history.

The first session

The first session of a new group is nerve racking for everyone – including me! Generally, it goes much better than people expect. Inevitably it can feel a bit awkward at first, but once these initial steps have been taken people usually do start to feel comfortable enough to begin opening up. Often people are surprised by how intimate it can feel so early on.

Common ground is usually found and, for many, it’s a major relief from the outset to see how their worries and fears become quickly normalised.

New group starting

I will be starting a new psychotherapy group later this year, running Thursday mornings on a weekly basis. If you’d like to find out more or explore the possibility of joining, do get in touch with me through my practitioners’ page.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

Further reading by Claire Barnes –

What is ‘othering’ and why is it important?

How psychotherapy groups can help change our internalised family systems

Is a Therapy Group Right for Me? Am I Right for a Therapy Group?

What happens in Therapy Groups? The role of the Therapist

August 15, 2022 by BHP Leave a Comment

How to Improve Mental Health

Mental health is constantly in the news and not a day goes by without an article, blog post or news piece on the topic.

The great contradiction is that whilst we know more about mental health now and how to manage it, the busy, chaotic and plugged-in world we live in does little to help our mental health. Nor is it often that clear what exactly is meant by the term ‘mental health’.

Mental health is a ‘catch-all’ phrase that encompasses our emotional, psychological and social wellbeing. It therefore includes our mind, our emotional system and our social world. It stands to reason that good mental health means attending to all three, but I would argue that there is a fourth – the body – which is intrinsically connected to good mental health.

When people refer to their mental health, what are they really saying?

As I write this article, the media will have us believe that mental health is currently under crisis in the UK. Waiting times to see a mental health practitioner are at an all time high, people are increasingly struggling to cope with high stress levels and many folks remain isolated or fearful for social contact following the numerous and lengthy Covid lockdowns.

Poor mental health can manifest in a range of symptoms from low level depression and anxiety through to diagnosable psychiatric illnesses. For most people concerned about their mental health, the latter is fortunately not very common and therefore we can think about how you can take responsibility for improving your mental health.

Steps you can take

Sleep is crucial to good mental health and it is no coincidence that many of us struggle with poor sleep which ever time can have a very detrimental impact on our mental health (as well as our physical health).

Establish a sleep routine and stick to it – going to bed at a set time and avoiding stimulants such as caffeine before bed can be very helpful. Another stimulant that you would do well to avoid is watching the news prior to bed – whilst informative, the news impacts significantly on our nervous system and can leave us feeling ‘activated’ exactly when we need to get to sleep.

Exercise is good for the body, but also the mind. Many folks are put off exercise as they see it as something that involves strenuous exercise in a gym, however, this need not be the case.

Exercise does not need to cost anything and can be a way of combining being in nature with moving the body. A brisk walk or sea swim (in the midst of this heatwave) are both good forms of exercise.

Eating sensibly is another activity associated with physical health but which can also have a significant impact on our mental wellbeing. Stimulants such as coffee and sugar impact on moods and with this can in turn impact on sleep patterns, so be aware of when you consume stimulants and avoid eating anything late into the evening.

Socialising is not only enjoyable but is also good for our mental health. Human beings are relational, meaning that we are born into relationship and require relationship(s) to develop. Even when we are alone, in a psychological sense we are in relationship to someone – we call this an internal object – and constitutes how we hold ourselves in mind and make the ‘best’ choices for ourselves.

The mind body connection

All of our emotions stem from the body. They start as sensations and we then notice them and group them into emotions; feelings are the words we use to describe emotions.

Each feeling, or set of emotions, has its own somatic (body) blueprint, which means to say that each feeling is made up of a unique set of sensations in the body. For example, anger, whilst ‘feeling’ different for everyone has the in-common body sensations of tight stomach, tight jaw, clenched or tightened fists and a narrowing of the eyes. Conversely, joy, is felt in the body as an openness and moving towards something or someone. Joy tends to bring a smile to our face and it is as if our whole body opens to receive more of what we are enjoying.

Everyone has a different shaped and sized body and everyone has a body that can perform different tasks depending on fitness, ability, age and (dis)ability. However, unless a person has a ‘good enough’ relationship with their body, it is simply not possible to have good mental health.

Hence why the body must be included in psychotherapy and feelings stemming from the body attended to.

Practicing gratitude towards your body for what it can do and how it looks after you, getting curious about what your body needs and wants and treating your body with respect, are all significant pathways to good mental health.

Talk to someone

When things get too much it can be good to talk and whilst a social and support network is important, some things need to be thought about with a mental health professional such as a psychotherapist.

A psychotherapist is someone who has trained at postgraduate level for a minimum of four years and undergone their own journey of analysis or psychotherapy throughout their training and ideally well beyond. In the UK, psychotherapists are registered with the UKCP who hold a directory of qualified clinicians or you can search for one using the search function on our own website.

People generally enter in psychotherapy because of a crisis of some sort in their life, however, they tend to stay because they find the therapeutic relationship so invaluable in not only improving their mental health but in developing an appetite for their lives. As Freud said, psychotherapy (analysis) begins after the crisis has passed.

Further reading by Mark Vahrmeyer –

Mental health problems in Brighton

August 8, 2022 by BHP Leave a Comment

How do I find the right Psychotherapist?

Finding a psychotherapist can feel like a daunting task. For starters, the difference between a counsellor and psychotherapist may not immediately be apparent. Then there are the different modalities, or approaches to therapy. And lastly, there are the different professional bodies to make sense of.

The term ‘psychotherapist’, unlike ‘clinical psychologist’, is not a legally protected term in the UK. This means that there is very little to stop anyone claiming that they are a psychotherapist, without having undergone an accredited psychotherapy training (or indeed any training at all).

There is also, as of yet, no agreement across the different professional bodies as to what exactly constitutes a psychotherapist, which further muddies the water for anyone seeking psychotherapy.

If a client is wishing to go into therapy then my advice would be first and foremost to seek out a professional registered with either the UKCP or BACP and who can evidence significant clinical experience in the field. Both of these professional bodies have helpful websites which enables users to search for clinicians based on location, as well as other criteria.

Once you have a list of accredited psychotherapists, you may wish to consider which approach, or modality, in which the clinicians in question have been trained. Whilst this may seem confusing, it is important to remember that research has shown that it is the quality of the therapeutic relationship combined with the approach, that leads to the most successful outcomes in therapy. Therefore, look for a clinician who is able to explain how they think and work in clear and understandable language – remember, it is their job to help you understand how they can assist you, rather than you needing to figure it out by wading through complex jargon yourself.

Many people make the decision to seek out a psychotherapist when in a crisis. Whilst this is common and the sense of urgency strong, it is important to take the time to find the right ‘fit’ and this may mean contacting various clinicians, as well as attending potentially more than one initial consultation. When new clients come for an initial consultation with me, I always set a goal with them at the start of the session in suggesting that it is their job to work out whether they feel comfortable enough (but not too comfortable) working with me, and my job to work out if I believe that clinically, I can help them. This often comes as a surprise to new clients in that they are there to make a judgement and choice in relation to working with me, however, therapy needs to be a co-created and collaborative process from the outset.

How do I know if my therapist is right for me?

If you find that you are working with a therapist and it does not feel like you are getting what you hoped for or are feeling uncomfortable then raise this. As I stated earlier, psychotherapy is ‘work’ that two people undertake and a big part of the work is in establishing a particular kind of relationship – a therapeutic relationship – or alliance.

If your psychotherapist is unwilling to hear your concerns and to discuss these with you, then that is a strong warning sign that the person you are working with is not a good fit (and arguably not a very good clinician).

I suggested earlier that psychotherapy should be a process that feels supportive and comfortable, but not too comfortable – you have sought out a psychotherapist because you have a problem and want support. Your psychotherapist is not there to be your friend.

They are equally not there to collude with you, but to appropriately and mindfully challenge you.

I previously referenced the different approaches to psychotherapy – the methods. These can seem confusing – and even cause a fair bit of infighting amongst the therapeutic community! One way of thinking about these approaches is to consider them as ways of conceptualising, of thinking, about your inner world. It may be that after a period of time you discover the way your psychotherapist thinks simply does not ‘fit’ with the way you think. Remember, psychotherapy is about understanding the human mind and nobody has veer seen or touched a mind – it is a concept, a construct, and as such is shaped and brought to life by language.

What is ‘good’ psychotherapy?

There are many answers to the question – ‘what is psychotherapy?’ – which is another way of asking the question ‘what is good therapy?’. As there are so many ways of helping people make sense of their inner world, there are an equal number of answers as to the goals of therapy, however, there is commonality.

Rather than ‘good therapy’ being one thing, it can be better expressed as a formula: A solid frame combined with a containing relationship. Let me explain: Us psychotherapists frequently reference ; ‘the frame’ in psychotherapy and this refers to all the elements that enable a solid ‘containing’ relationship to form between the client and their therapist. The frame consists of a regular meeting day and time, a stable and unchanging consulting room, sessions that start and end on time, a therapist who is ready and attentive – these are some examples.

By ‘containing relationship’ we are talking about the very unique role that we, as psychotherapists, must play for our clients. We are there to think about the client every second of the encounter and must not make the relationship or sessions about us.

Therefore, when in psychotherapy, if you ask your psychotherapist a question – something such as ‘how was your weekend?’ – they will likely explore with you what lies behind the question before answering.

A containing psychotherapist is also one who can ‘survive’ their client – in other words, the client is free to express themselves how they wish and the job of the therapist is to be able to hold the boundary no matter what. When the frame and container are solid, that is a good starting point for successful therapy.

Can it be dangerous to see the wrong psychotherapist?

Let us assume that by ‘wrong’ therapist we are assuming a poor fit rather than any kind of abusive relationship, as clearly the latter presents significant risks to the client and would constitute a breach of the psychotherapist’s (BACP or UKCP) code of conduct.

Psychotherapy is, amongst other things, about helping client to understand their wants and needs and to help them put appropriate boundaries in place in relationships. If a client is continuing to see a psychotherapist where they are getting little to nothing from the sessions and feel that they cannot raise this, then this is only going to further undermine their self esteem and confidence which is utterly counter-productive to the process. This would be an example of the client’s experience in their relational world repeating in the therapy.

How important is it that my therapist is accredited and what should I look for?

As I have previously highlighted, psychotherapy remains largely formally unregulated in the UK. Membership of the various professional bodies is voluntary and for clients, it can be hard to distinguish between them.

As a UKCP registered psychotherapist I am acutely aware of the rigorous training standards of my professional body and understand the level of training that other psychotherapists, irrespective of their modality, have received who are fellow members.

Anyone crossing the threshold of a psychotherapist’s consulting room has been on the receiving end of some degree of neglect or abuse in their childhood. This makes them susceptible to further relational injury from working with someone who either is misrepresenting themselves, or has received inadequate training to understand their
limitations.

Mark Vahrmeyer is available at our Brighton and Hove practice and the Lewes Practice.

Further reading by Mark Vahrmeyer