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CORONAVIRUS – How Psychotherapy can help you navigate your way through the crisis

I am writing this blog four days after the UK government imposed an effective ‘lockdown’ in response to the spread of the Covid-19 virus.  Inevitably this crisis will have a considerable impact on all of us be it emotionally, financially, physically, spiritually and psychologically. Depending on our character, disposition and ways of thinking we will experience the impact in specific and particular ways. We may be very aware of feeling lonely, anxious, frightened, overwhelmed, sick, vulnerable, frustrated, bored, angry and our unconscious fears almost certainly will be highlighted by this unprecedented situation.

From what my clients have been telling me over the last couple of weeks it seems to me that the most difficult aspect of this situation for people is the uncertainty.  We don’t how long the threat of the virus will stop us from leading our ‘normal’ lives.  We don’t know what life will be like at the end, how it will end and what the longer lasting effects will be on us, our families, our communities and the world at large.

As human beings we struggle with uncertainties and ‘not knowing’. We may not always be aware of it but the lack of certainty the ‘not knowing’ makes us feel afraid, ill at ease, out of control and so in order to protect ourselves from these uncomfortable feelings we unconsciously replace them with the illusion that we are in control and therefore we know exactly what will happen. Being certain, knowing what will happen narrows the mind, reduces the questions and makes life feel easier.  We usually forget to focus on the present moment and instead we make plans for the future, focussing on what we are going to do, where we’ll go, what we’ll buy, who we’ll see etc, confirming our illusion that we know what will happen and that we are in control.

Focussing on the future works until we are faced with a crisis or we are under threat then we focus completely on the present moment, it takes up all our thinking.  The present moment right now is frightening and for many people this is overwhelming.  Many people are struggling to bear the awfulness of it and the feelings of uncertainty they are having to cope with.

The reality is we cannot change what is happening, we cannot control outside forces we can only change the way we think about them and therefore how we feel in response to them.  In essence this is the work of psychotherapy.

Having a therapist to talk to at this time can help you bear the uncertainties of life and what feels overwhelming.  As therapists we are trained to work with the ‘not knowing’ and are therefore uniquely placed to help you face uncertainty and anxiety – it is our medium and what we work with all the time in our consulting rooms. Having a space where you can verbalise your anxieties and reframe your life so it becomes more bearable is invaluable right now.

 

Anna Reynolds is a UKCP registered Psychoanalytic Psychotherapist qualified to work with a broad range of psychological issues as well as more complex mental health conditions in adults.  Anna works with individuals and couples.  Anna is available at our Lewes Practice.

 

Further reading by Anna Reynolds –

The dangers of over medicalising

Attachment styles & how they affect relationships

The language of love: how couples communicate

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How Psychotherapy will be vital in helping people through the Covid-19 crisis

Many self-employed psychotherapists, psychologists and counsellors have immediately felt the economic impact of the crisis brought by Covid-19. As our clients began to either loose their jobs or face increasing economic uncertainty, many had to either put their sessions on hold or stop coming all together. Many of us have either dropped our fees or continued seeing people with the uncertainty of getting paid. Unfortunately, some people have lost their support system when they need it the most.

Private Psychotherapy has always been enjoyed by many in the UK and around the world, as most national health services cannot offer the same level of professional service due to cost.

Psychotherapy practices have always offered a vital service to the community, whether through charities, low cost services or full paying clinics. Psychotherapy is a place where people’s deepest mental anguishes have a place to exist, to unfold and to be healed.

The health and consequent economic crisis brought by Covid-19 is already affecting people’s mental health in several ways, some of which have not yet come to light. This is being felt and will continue to be felt for a while to come at all levels of society.

An Existential Crisis

Covid-19 has highlighted our main vulnerabilities as human beings. It has hit many people at a very fundamental existential level as many have lost their jobs and their livelihoods overnight. In addition to this, as more people become infected and die of Coronavirus, we have become much more aware of our mortality and that of those we love.

Living in a globalised world, the spread of the virus had happened so rapidly that we have not had the time to process and digest the changes which we have been required to make as a result of the restrictions imposed to keep the virus from spreading. Never could we have imagined that something which started in China a few months ago could spread and reach our doorstep so rapidly and dramatically. This further highlighted our lack of immunity to world events.

Impacts of Lockdown

With people being asked to stay at home to protect the NHS, schools and businesses closing and people being asked to work from home (if they still have work), suddenly the home has become office, school, gym, social hub and place of relaxation. Whilst some families are feeling more crowded as a result of these changes, some people living on their own have become more lonely, isolated and vulnerable.

Some families trying to make life work under lockdown are finding that their relationships are being put under more strain, whilst children of unhappy and even abusive families are being made to stay at home more.

Of course, there are also positive stories emerging as a result of families spending more time together and solidarity between people. In times such as this, we are seeing the best and the worst of human nature.

Why is Psychotherapy vital during these times?

To put it simply, in times of crisis psychotherapy helps us to hold onto our thinking. When our survival is threated, our ‘reptilian brain’ takes over and we can act impulsively (panic buying for instance) often resulting in harm to self or others. Thinking makes us slow down and consider options. In times of crisis we sometimes need to think quickly and make decisions. However, buying time to think enables us to put things into perspective and to make wise rather than impulsive decisions.

Because this is both a health and economic crisis, it is hitting many of us at our very core. The British attitude to “keep calm and carry on” works to a degree. Of course, we need to keep calm, but we also need a place to acknowledge and talk about our fears, losses, despair, sadness, anger, etc if we are going to survive this crisis in good mental health.

 

Sam Jahara is a Psychotherapist and Supervisor in private practice working with individuals and couples. She is also the co-founder of Brighton and Hove Psychotherapy, a multi-approach clinic, offering Psychotherapy, Psychology and Counselling to all client groups, both face-to-face and online.

 

Further reading by Sam Jahara

Leaving the Family

Psychotherapy and the climate crisis

Psychotherapy can change your life – but you may not want it to

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Spirituality and Mental Health

Spirituality is an often-used term these days, and around 20% of the population in the UK define themselves as spiritual, but not in the religious sense. So what does it mean to be spiritual?

There are many definitions of spirituality but generally we could say that it involves having a sense of something bigger than ourselves – a transcendental view of life where we start to realise that there is more to life that we see around us. This can include a sense that there is a God or creator, an intelligence in the universe, or maybe a deeper wisdom that we all carry. However we conceptualise it, spirituality often leads to a greater sense of purpose and meaning as we start to step back from the everyday world and see a bigger picture playing out before us. Spirituality also includes a sense of connectedness, which might be with others, ourselves or with something more transcendental. This feeling of connectedness can bring us a great deal of peace as we start to realise that perhaps we are not alone in the world. 

Spirituality is different from religion, but is linked to it. Religion is about adhering to a set of doctrines that define each particular faith. Religion will often have a spiritual component – a worldview that has an idea of something greater than us (God, for example) and may also involve a spiritual connection as part of the religious practice. However, you do not need to be religious to be spiritual, and indeed being religious doesn’t need to be spiritual!

So how important is spirituality to our mental health and wellbeing? There has been a lot of research over the past decade that considers this question. The findings show that engaging in spiritual practices have a positive impact on our mental health. Lower levels of depression can be found in those who are actively involved in spiritual communities. Levels of stress and anxiety can be lowered by engaging in spiritual practices, and spirituality can be instrumental in the recovery from trauma. Also, there can be a greater sense of purpose and meaning from having a spiritual perspective, which can have a positive impact on our wellbeing. 

Having a committed spiritual practice – whether it is mediation, prayer, or whatever feels right for you – reading spiritual philosophy and engaging with a spiritual or religious community can be hugely beneficial in improving and maintaining positive mental health. Even if you don’t consider yourself to be spiritual, it is worth spending a few moments thinking about life and the wonders that we see around us. It is easy to see that there is more to life than our own limited worldview and when we step back and consider this, our problems and daily issues can be put into perspective as we gain a more holistic view of life.

 

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

 

Further reading by Dr Simon Cassar –

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

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So what actually is a Psychologist?

It’s important to note that the term ‘psychologist’ is not actually a protected title.  So, anyone can technically call themselves a psychologist.  If someone claims to be a psychologist, then the question to ask is, what kind of psychologist are they, and perhaps more importantly, what qualifications do they have.

Undergraduate degrees may be undertaken as either a Batchelor of Science or of Arts.  Completing an undergraduate degree in psychology gives a good basic introduction to a wide range of psychological theories and applications, but not necessarily expertise in any one area.

The British Psychological Society describes psychology as:

‘the scientific study of the mind and how it dictates and influences our behaviour, from communication and memory to thought and emotion.  It’s about understanding what makes people tick and how this understanding can help us address many of the problems and issues in society today.’

There are many areas of both theory and application within psychology; health, educational, forensic, counselling, occupational, clinical, sports and exercise, and neuro.  Becoming qualified in one of these fields requires post-graduate study.

In the example of Clinical Psychology; the current route for training is a 3 year doctoral degree (after the undergraduate degree) which involves both university teaching days and days on placement with the NHS.  In order for someone to call themselves a Clinical Psychologist, they must have completed an approved training course, and be registered with the Health and Care Professions Council (HCPC).

The HCPC regulates all applied psychologists within the areas above. The below are protected titles, which means people can only use them if they have completed an approved training course and complete ongoing appropriate Continuing Professional Development.

  • Practitioner psychologist
  • Registered psychologist
  • Clinical psychologist
  • Forensic psychologist
  • Counselling psychologist
  • Health psychologist
  • Educational psychologist
  • Occupational psychologist
  • Sport and exercise psychologist

Any other titles, such as Media Psychologist, Celebrity Psychologist or TV Psychologist, such as are often seen in the media, say nothing about the qualifications or expertise of the individual.  Understandably this is often misunderstood by the public.  As a Clinical Psychologist it concerns me that people may put their trust in, or even pay for services delivered by, unqualified people.  In addition it is concerning that the reputation or credibility of the profession may be damaged by unqualified people providing a poor service.

It is a very confusing area, however, probably the most important thing to remember is if you are considering working with a psychologist in any of the fields above check that they are registered with the HCPC on www.hcpc-uk.org

 

Dr Emma Stevens, HCPC Registered, is an experienced Clinical Psychologist. She has an integrative approach drawing on Cognitive Behavioural, Systemic and Psychodynamic models, as well as Attachment Theory. Emma sees individuals primarily for sort-term work. Emma is available at our Lewes Practice.

 

Further reading by Dr Emma Stevens

Using the body to calm the mind

Emotional Well-being

What is EMDR?

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Silences in Therapy

Silences are an inevitable and potentially helpful part of the therapeutic process. However, a number of people I see as a therapist express a feeling that they are not getting something right when a silence arises in our work together. The psychotherapy world (in particular the psychoanalytic and group analytic fields) has also had some difficulties historically with accepting the value of silence.

A few years ago, I wrote about silence in relation to group analysis (Barnes, 2015) I felt compelled to do this as I had been working with a psychotherapy group that was gripped for some time by long, crippling silences. These silences affected the whole group and were intensely paralysing – for the group members and for me. I found it hard to help the group but also wasn’t helped myself by the general absence of clinical literature on this subject.

In my paper I made a case for the value and role of silence in therapy and specifically therapy groups. I explored how silence is a part of speech and that all speaking relies on pauses and breaks for our communications to make sense (this is, perhaps, most obviously understood in music). These rhythms and patterns in our communications are particularly important and central to the processes of therapy.

By just seeing silences as unhelpful we lose the opportunity to be curious about the different kinds of silences and what they might mean.  Below are some of the kinds of silences that can come up in the therapy relationship.

  • A common silence in therapy arises when both therapist and patient, or members of a therapy group, pull away from verbal interaction and retreat into a more internal space. Often, in my experience, this is when a discussion then moves onto a deeper level.
  • Sometimes silences are used to protect from scrutiny. Using silence as a defense can be bound up with early experiences of intrusion or a difficulty in asserting one’s self in interpersonal relations – the only protection then is to withdraw.
  • Then there is the paralysed silence, like the one that seemed to incapacitate my group for so long. People often say they can’t think in this kind of silence. When we’ve explored it more it seems they feel increasingly self-conscious in the silence and under pressure to break it – like it’s all too much responsibility. This seems to me bound up with shame.
  • But sometimes words just fail and just don’t feel enough. Silence can be used to convey this. Or to show a respect for the enormity of what is being felt.

In thinking about silence and speaking it’s also important to bear in mind the thoughts of French psychoanalyst Andre Green who pointed out how “behind the noise of words speech can be silent” (Green 1972). At times we talk in order to silence something uncomfortable, or just too painful.

Holding a silence can be a way – perhaps sometimes the only way – of staying with what feels difficult and communicating this.

References –

Barnes 2015 ‘Speaking with Silence. An Exploration of Silence and its Relationship to Speech in Analytic Groups’, Group Analysis, Vol 48 number 1

Green 1972’ On Private Madness,’ reprint Hogarth Press 1986

 

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

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

50 years on, how free are we from homophobia?

If you don’t like groups, could it be time to join one?

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