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June 20, 2022 by BHP Leave a Comment

Are People with Mental Health Problems Violent?

The stigmatisation of mental health and mental illness is nothing new and can be traced back through the centuries and across cultures.

Despite much improvement in the treatment of mental illness and an increasingly open dialogue about the effects of mental illness from sufferers and professionals, the evidence shows that paradoxically increasing numbers of the general public fear violence from those who are mentally ill.

What is mental illness?

Whilst the term mental illness is ubiquitous, it is a ‘catch all’ term which fails to differentiate between people struggling with their general mental health, people who struggle to regulate their emotions and the tiny minority who have an actual illness as defined in psychiatric terms.

In its most extreme form, mental illness is an inability to ‘hold’ onto reality and is a terrifying experience for the sufferer – this would be the definition of psychosis. However, as terrifying as this is, there is simply no correlation between violence and mental illness.

Where does this fear come from?

The fear of mental illness seems to be profoundly primal. Human beings pride themselves on the rationality and intellect and to be exposed to someone who has ‘lost their mind’ triggers fear – if it can happen to them, can it happen to me? Losing ones mind can feel like losing the connection with what makes us human.

Periodically these fears are brought back to the surface, often as a direct result of some unfathomable act such as the recent school shooting in Texas where 19 children and two adults were murdered by an 18 year old gunman. How can something like this happen? Who would do such a thing?

Human beings seek to ‘fit in’. We all to a greater or lesser extent abide by the rules and laws laid down by our culture and society. Where we abide by the rules and perform well, society tends to reward us. The rewards are multiple, but are generally related to social standing and financial payment which propels us to continue to do well: fitting into culture affords us self esteem.

Many people who suffer from mental health problems have experienced trauma during their lives – it can be argued all of them. We now know, in no small part thanks for the 1998 ACE study (Adverse Childhood Experiences) conducted by the CDC-Kaiser Permanente, that the more adverse childhood experiences a child is exposed to, the higher the likelihood that they will suffer from mental illness.

However, whilst striking, it was not only their mental health that was likely to be affected, the higher the number of ACE’s, the higher the risk of emotional and cognitive impairment, physical disease, poverty, criminality, social problems and substance abuse problems, all culminating in a higher likelihood of an early death. Trauma therefore impacts on a person in every facet of their future life. Trauma is not caused by poor mental health – poor mental health comes about through trauma, accompanied with the long list of symptoms above.

All human beings harbour thoughts and feelings that we consider to be in conflict to how we see ourselves and how we wish to be seen. Psychoanalysis was the first discipline to start to talk about how we all have sadistic drives, harbour murderous thoughts and take glee in the suffering of others. Psychotherapy seeks, amongst other things, to help people know themselves and to integrate these parts of their character.

However, where this integration has not happened people can ‘split’ these parts of themselves off – as if it simply is not a part of themselves – and ‘project’ them into others: I am ‘good’, you are ‘bad’, or in this case, I am ‘sane’ you are ‘mad’.

I would therefore suggest that much of what drives the stigma around mental illness and the association between the latter and violence is driven by fear leading to the psychological defence called projection. ‘Mental illness’ or ‘mental health’ is a convenient scapegoat for the parts of ourselves that we disavoy.

What can be done to challenge the misconceptions around mental health and violence?

In order to challenge the misconception that people with mental health problems are violent, we need to be able to have a mature and complex conversation about society, trauma and how we are all collectively responsible for ‘othering’: scapegoating and ostracising certain groups of people who are vulnerable. There is correlation between childhood trauma and violence, but violence is not caused by mental illness.

Alongside this we need to use factual statistic to show that simply having a psychiatric diagnosis or ‘suffering from depression’ makes a person no more likely to be violent or to commit a crime than anyone else. What does significantly increase the possibility is childhood trauma, contributing to feelings of low self esteem, a lack of belonging in society, poverty and feelings of disempowerment.

The effects of stigmatising those with mental health problems

Through engaging in an open and honest debate around mental health and mental illness, we can not only support those who are suffering to talk about their experiences and seek help, but also acknowledge to ourselves that we are all in no small part likely to be affected by a mental health issue at some point in our lives. This makes it ‘our’ problem rather than ‘theirs’.

Where people with mental health problems are stigmatised it further alienates them from mainstream society and the opportunity to ‘contribute’ to that society and feel a sense of belonging, purpose all leading to greater
self-esteem.

Stigma and scapegoating leads to shame and shame makes it even harder for people to access help. People with mental health issues need support, compassion (not sympathy) and a pathway to belonging in society. It is no more helpful to pretend that they have no problems than it is to demonise them.

Mental illness is a social problem

As discussed earlier, trauma – particularly childhood developmental trauma – impacts on every aspect of a persons ability to lead a fulfilling, healthy life. And trauma begets trauma, meaning that it is passed from generation to generation. Therefore, rather that scapegoating those with mental health problems, perhaps we need to collectively pause, reflect and look in the mirror to see what sort society we are all contributing to.

 

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

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Filed Under: Mark Vahrmeyer, Mental Health, Society Tagged With: childhood developmental trauma, Mental Health, Mental Illness

May 30, 2022 by BHP Leave a Comment

An In-Depth Approach to Leadership Coaching

Coaching in organisations has become increasingly popular over the past 20 years as workplaces become less hierarchical and organisations seek a more sophisticated approach to leadership.  The more recent shift linked to the pandemic has sped-up changes already on the horizon. 

Leaders are feeling an increasing sense of pressure and responsibility, alongside a collective shift towards a more balanced life. The two positions are difficult to reconcile leading to more pressure on the leadership as employees demand more empathy and flexibility, alongside added pressures on organisations linked to global uncertainty, supply chain issues and political instability.

We are living in times where things are constantly shifting and adapting quickly is a must. We want better relationships and a better work-life balance. Technology is connecting and isolating us at the same time – online meetings demonstrates this paradox well. Those in positions of leadership require an ever more empathic and sophisticated approach to their role, alongside being one-step ahead in an already fast-moving world. 

The Role of Leadership Coaching 

The role of Leadership Coaching is to be alongside leaders through these challenging times. An exploration of the challenges and opportunities within a person’s role requires more than a behavioural and goal-oriented approach. A more psychological approach to leadership coaching requires a coach who can think ‘outside the box’ and work with what lies beneath the surface. This entails understanding what motivates and drives the client, the demands of the organisation, the story behind the client’s career choices or trajectory, their resources and pitfalls.

An exploration of the story behind an individual’s career choice and understanding of their relationships at work speaks volumes. This exercise can be very interesting for both coach and coachee and lead further understanding some of the issues at hand. Given that success is linked to relationships – to self, others and the organisation – exploring these is an essential aspect of leadership coaching.  

Finally, it is vital for leaders to have a place to discuss their anxieties, worries, and fears. Leaders must learn to know their vulnerabilities, and not deny or bury them. Facing and understanding these emotions is what leads to change. It is also through exploration that these anxieties and fears begin to lessen, and the client can start to focus their energies on more creative pursuits rather than constantly firefighting.

With space for reflection, a better understanding of one own emotions and relationships, and energies freed up for more important tasks and creativity, work starts to become more enjoyable. With better self-awareness leaders can enjoy their role and stand in uncertainty with more confidence. 

 

Sam Jahara is a UKCP Registered Psychotherapist and Tavistock Certified Coach. She coaches individuals and groups in organisations as well as those who are self-employed or run their own business.

 

Further reading by Sam Jahara

Demystifying mental health

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

Filed Under: Mental Health, Relationships, Sam Jahara, Work Tagged With: Coaching, coaching in organisations, Mental Health

May 23, 2022 by BHP 2 Comments

The Limitations of Online Therapy

Online psychotherapy is not a new concept; it was around before the pandemic and successfully used as a medium for delivering psychotherapy, counselling and coaching. However, what is new is how nearly all of us were obliged to work online to maintain continuity of sessions for our patients and clients during lockdown and how ubiquitous it remains. It is clearly here to stay but does that mean that in-person psychotherapy is a thing of the past?

Online psychotherapy brings with it some advantages over seeing a psychotherapist ‘in the flesh’ such as:

  • Access to a wider pool of clinicians;
  • Less time consuming as no travel is required;
  • Some people may find it easier to ‘open-up’ online rather than in person.

Like many psychotherapists, during the pandemic I had to abruptly move my whole practice online and together with my clients adapt to virtual sessions. Now at the tail-end of the pandemic the world is a different place and yet I have found that the vast majority of my clients have of their own volition decide to return to in-person sessions. I have explored this with them and below is a synthesis of some of the limitations of online psychotherapy and why, I believe, it will never replace in-person face-to-face sessions.

Psychotherapy is a body to body communication

Though often referred to a ‘talking therapy’ psychotherapy is much more a ‘listening therapy’ and the clinician is trained to listen in a very particular way – to what the client says as well as how they say it.

More than half of our communication is non-verbal and is a combination of tone and delivery in conjunction with body language. With online therapy much of the latter is lost due to the limitations of what can be seen on screen. But there is another reason why it gets lost – online psychotherapy is ever so slightly ‘out of synch’. It is almost imperceptible (most of the time) but there is a slight lag between the delivery of the sound and the delivery of the image which makes for a disconnect between the spoken and unspoken. And whilst almost imperceptible to the conscious mind, it gets registered by the emotional system.

Psychotherapy as re-parenting

Everyone who crosses the threshold of a psychotherapist’s consulting room is bringing with them unresolved experiences and patterns from their childhood. Many of the patterns are laid down in the formative years of bonding and dictate our attachment style. And because they were laid down between birth and around 2 years of age, they are non-verbal (and unconscious).

Psychotherapy is about working with these patterns – often referred to as ‘working in the transference’ – to understand how the client ‘does’ relationships; in this sense it is a process of re-pare helping the client to feel safer and more secure in relationships and in expressing boundaries.

The transitional space – travelling to therapy

Travelling to sessions in person can be time consuming and with today’s fuel prices, expensive. However, the travelling aspect has an important psychological function as it operates as a transitional space between the ordinary world and the unique world of introspective psychotherapy.

In online sessions I have often found that clients can be distracted as they have literally just ‘left work’ and entered my virtual consulting room – they have no given themselves time to make the journey to psychotherapy and it can then often take a significant part of the sessions for them to arrive.

Likewise, I have had clients who have scheduled work meetings immediately after their online therapy which can act as a powerful prohibitor to allowing themselves to ‘be in therapy’ as “I don’t want to get upset because I have a meeting with my boss”.

Lastly, when clients visit my consulting room in person, I am responsible for most of the physical boundaries. Clients know where they will be sitting, where the furniture will be positioned and this will remain the same week after week – it is part of be providing a consistent experience. Seeing a psychotherapist from home may mean that the space feels less safe with other members of the family in the same home or just simply having daily distractions around such as a picture of the family on the desk next to the monitor.

Psychotherapy is about making contact

Starting psychotherapy in any realm can feel like a daunting prospect. Coming into a consulting room, which is the domain of the psychotherapist, is a brave step.

Clients have often sat on my couch and mused or fretted about what to talk about. I generally sit in silence as they try and find their words as, to me, what they say is often less important than why they are telling me. If a client tells me anything they are telling me something about themselves that they feel is important and that they want me to see as important – often we need to figure out together why it is important but we generally get there in the end.

Therefore, psychotherapy is about ‘coming into contact with another’ – taking a risk to be seen and heard. Whilst this can be achieved to some extent online, nothing can be a substitute for in person contact where two bodies are in the same room and in communication and contact with each other.

Until we start raising babies and infants over virtual connections and can do so successfully – which is neither desirable nor remotely possible due to our physiological and psychological make-up – face-to-pace in person psychotherapy is not going anywhere.

 

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 –

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Parental Alienation and the impact on children

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

May 16, 2022 by BHP Leave a Comment

The Challenge of Change

While it might not be explicitly named, ‘change’ is often alluded to as a desirable outcome of psychotherapy. Thoughts about feeling, being and living differently are expressed and the client is invited to understand what it is that they want. The ‘wished for’ life can often feel desirable and easy to describe, yet can feel so hard to achieve. Alternatively what it is that is desired can feel difficult to define, but what is known is that carrying on as one is does not feel possible.

Change can be thought about, talked about, imagined and yet it can feel no nearer to being achievable. It can feel that one is stuck and powerless to move forward. Change can feel more impossible than possible.

Feeling ‘stuck’

Thinking about change when one feels ‘stuck’ can feel unbearable as it brings up thoughts about why change feels so difficult. Is it in some way a reflection of the self? Thinking that ‘I know what I want’, but feel unable to achieve it. Not being able to effect change could be felt as a failure and a lack of capability. Talking about it and hearing other voices can be helpful, but when these voices have an edge of ‘snap out of it’ it’s experienced as unsupportive, critical and unhelpful. This all can lead to difficult self-critical feelings and so change feels like a challenge not worth pursuing. To have and share the desire for change, yet feel reminded of ones own shortcomings.

When we consider our own capacity for change we also bring in our own sense of capability. Can one believe that it is possible to change or is the sense of being ‘stuck’ in itself now stuck? How can we challenge feeling stuck or does it become just another thing that makes us unable to think of change? The thinking can become circular.

Familiarity and change

Change is challenging because change makes us move out of what is known and understood. A situation might be far from what is desired, yet it is familiar. Such familiarity allows a degree of certainty based on knowing what to expect. The result of change is unknown, not understood and potentially so unsettling it feels like it isn’t worth engaging with.

What is achievable?

When we think of a desired outcome we have to balance this with what is achievable. If we set the bar high are we setting ourselves up to fail and falling back into the circular thinking about not being capable. Coping with setbacks and being able to acknowledge what is possible are all part of how to move beyond feeling stuck.

How we can think of change?

To reflect on change we need to be aware of how we can be stuck and how hard that is. ‘Stuck’ isn’t something that is wished for, nor is it self created. Feeling stuck is a reflection of the challenge of change. To think of change we maybe first need to think of ourselves and take a more compassionate view. Compassion in the sense that we are allowed to imagine, wish for and achieve something different.

Psychotherapy offers the opportunity to understand what it is that we might want to change. The hope is that through exploring and thinking together, we can think of change as being more possible than impossible.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove .

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

 

Further reading by David Work –

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

When Home and Work merge

Filed Under: David Work, Mental Health, Society Tagged With: challenges, Change, outcomes

May 9, 2022 by BHP Leave a Comment

Loneliness and CBT

People feel lonely for a wide range of reasons. Loneliness can be linked to mental health difficulties such as depression, anxiety, social anxiety, perfectionism, low self esteem or eating disorders. It can also be linked to autism, loss, difficulties disclosing, early adulthood, elderly. This is not an exhaustive list but illustrates how many factors can be linked to the problem of loneliness.

Loneliness is the perceived discrepancy between what we want and what we’ve got, a mismatch between actual and desired social situation, a lack of meaningful relationships. Social isolation doesn’t have to equal loneliness. We can be alone without feeling lonely.

Triggers to feeling lonely can be internal psychological factors, such as attitudes to participating in social interaction / having a negative interpersonal appraisal, e.g. other people don’t like me; or external factors, such as bereavement or living far away from friends and family. These factors evoke an emotional response such as anxiety or sadness
and can lead to counter productive behaviour such as avoidance and a decrease in valued social contact or unhelpful cognitive processes in the social domain, e.g. self focused attention or hypervigilance to rejection. This then impacts on our perception and our interpretation of our relationships / social situations and can inadvertently become a
perpetuating cycle of loneliness.

Social media also has a big impact on loneliness, particularly in early adulthood. People share and post what they want us to see and we can end up comparing ourselves to others. The pandemic too has had an impact on loneliness. Spending less time with friends and family, self isolating and shielding are all contributory factors to feeling lonely. If we struggle with technology this too may play a part.

So how do we change things? In CBT we look at four domains: the individual, their relationships, social relations and the community. In terms of strategies behavioural activation is key with a focus on increasing the amount of social interaction, social contact and social networks. We can explore values and once we have identified these set goals to
help meet where the person wants to be in their values. We can introduce and identify unhelpful thought patterns and beliefs, and learn techniques to restructure these. We can learn strategies to reduce rumination and use behavioural experiments to make changes and gather information, e.g. finding out what happens if you do disclose and share with others. Additionally whilst engaging in behavioural activation we can practise exposure
whilst reducing safety behaviours.

Everyone is different and because loneliness can be for many different reasons there is no one size fits all. Other strategies may also be used, such as social skills and communication training, mindfulness, mapping social opportunities, emotional awareness and psycho-education.

To address loneliness in older adults Age UK and the befriending service, such as Silverline, can be a great resource. Age UK offer all sorts such as social activities, lunch clubs, IT Training, transport, day centres. Younger adults may benefit from Meet Up groups, Young Minds or The Mix.

Reaching out, connecting with others and using the supports that are available to us are fundamental in combatting loneliness. Remember we all feel lonely at times in our lives.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

 

Further reading by Rebecca Mead –

Enhancing the Positive Self 

Is that a fact or an opinion? 

As we come out of lockdown, will a number of us be feeling socially anxious?

New Year’s Resolutions

Making Changes

Filed Under: Mental Health, Rebecca Mead, Society Tagged With: anxiety, Depression, loneliness, social anxiety

April 25, 2022 by BHP Leave a Comment

“I’m interested in therapy but isn’t it a bit self-indulgent?”

Some of the people I see exploring whether to begin therapy, often express doubts as to whether their troubles are significant enough. I often hear the refrain – “nothing that bad has happened to me, maybe I’m just being self-indulgent, or isn’t this all a bit naval gazing?.” 

I think simplified, what the client is really saying is; “Am I justified in feeling this pain and am I worthy of this attention ? ” 

This blog will look at how therapy can help us incorporate our painful experiences as part of a fuller engagement with ourselves, the people in our lives (our relationships) and as a different approach to living

The Psychoanalyst Melanie Klein who was interested in early development, theorised that a key early and ongoing development task is the sad but necessary realisation that others are different and separate from us, with their own needs rather than as extensions of our own. This confronts us with the loss of what we hope and want the other person to be, but if we are able to face and mourn this loss, we can move onto to a more realistic and more liveable life. When the disappointments by the other are too great, or conversely, the other attempts to be everything for us, this task is all the harder. 

Voltaire, the French philosopher and writer, in his novel ‘Candide’, tells the story of a group of travellers who have suffered various trials and tribulations. On hearing of a murder at the Ottoman court they pass an old man peacefully tending his garden. They ask the old man about the trouble at the court and he replies that he doesn’t know anything about it, since he doesn’t keep up with the affairs there. Rather he tends calmly to his own small holding. Voltaire used this example to put forward the idea that in order to live a ‘good life’, we should not overly concern ourselves with worldly affairs, but find a task we can attend to, that leaves us satisfied but tired at the end of the day. 

In my therapy practice I relate to this, not in the sense that we should ignore politics or activism, I think these are important, but in the sense that I regularly experience how clients want to engage me in their ‘rages against the machine’, with different viewpoints and perspectives.  What I often find is that, smuggled into these arguments are parts of themselves they find difficult, or are unable, to face: the bad one is the other one over there – and if only they thought like me, the world would be fine. 

What often lies behind these projections, are painful feelings of despair, hopelessness, insecurities, personal failure, upset, grief, rejection and so on. 

I try to carefully and tactfully sense what is behind these things, and the defenses or shames against feeling them, and try to create a safe enough space where these grievances and pains can be heard, allowing air to the wounds. Allowing, over time, a sad but realistic acceptance of the wounds, limits and realities of ourselves and perhaps the human condition. Rather then than therapy being self indulgent, perhaps it is one the best things we can do for the world, by trying to understand ourselves so that we don’t project our own hurts and conflicts outwards. This is why in therapy I will always be thinking about, and trying to help you understand what is happening inside of yourself, using myself as an instrument to understand what is happening between us, utilising the self awareness I’ve gained through my own work on myself, to help you understand and accept yourself more fully. 

In his book, Voltaire argues that the melancholic position is the only one from which we – any of us who have suffered disappointments, broken hearts, loss, (all adults that I know) – can ever truly live. He contests that we cannot escape suffering, since to some degree, the world is a brutal and cruel place to live. Perhaps rather than getting lost in despair or raging about this, what we can do, is to cultivate our inner worlds, pulling up the weeds, planting, feeling, exploring. Not trying to rid ourselves of the pain or anxieties of life, or the world, but to learn – as sad as it is – to try and accept that these are part of the human condition. That after we have loved and lost, battled our own minds, tried to find the magical other, and failed, that perhaps the best way forward is to attend modestly and honestly to our own human natures, to its wild thorny ways, to our own sometimes unkind and cruel ways, and to do our best to be honest about these, rather than defend against them, driving them underground. To cultivate what we can, humility, acceptance, forgiveness and grace. Like tending a garden, the work is never complete.

 

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

Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

Compassionate Curiosity and the fundamental rule of psychoanalysis

Why there’s nothing as infuriating as Anger Management

What makes Psychotherapy Different?

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Filed Under: Mental Health, Psychotherapy, Relationships, Society Tagged With: Mental Health, Psychodynamic, Relationships, society

April 18, 2022 by BHP Leave a Comment

The Process of Joining a Therapy Group

Below, I am going to outline the process for joining a therapy group. It is important to say at the outset that I am describing my own practice and while the underlying principles will generally be shared by other group analysts, the specific processes and procedures will be variable. 

Taking the First Step

People come into my groups in a variety of ways. Some people get in touch because they have decided for themselves that group therapy might be helpful for them; they may even have been in a therapy group in the past, or a group might have been suggested to them. 

If you fall into this category, the chances are you will have already been thinking about the benefits of a group and are now ready to take that next step in joining one.

Others come with a little more uncertainty. They may have had a group suggested to them by their therapist or been assessed and a group strongly recommended. If someone hasn’t been thinking about a group before and doesn’t know much about group therapy, this suggestion can come as a surprise and, for some, take some getting used to.

If you fall into this category, then you may be feeling a little more cautious and might need more time to think about this idea of group therapy. 

Initial Consultation

When anyone gets in touch with me, with an interest in joining a group at the practice, I offer a short, free telephone consultation. This usually takes around 20-25 minutes and gives us both an opportunity to think about; why they are considering a group, whether group therapy is suitable for them and what spaces are available in which groups here at our practice. I may also ask a few questions about their background, current situation, and particular issues and most likely, we will touch on what might be beneficial and challenging about being in a group for them. 

This telephone conversation can lead to a range of outcomes. For the purposes of this article, I shall focus solely on what happens if we agree that a group appears to be timely and suitable for the person and I have a group space at a time they can make. 

Assessment

While the telephone conversation is useful in clarifying any immediate obstacles to someone joining one of my groups, it is not an assessment. Therefore, the next step would be to have a face-to-face assessment. This is done in-person if possible – unless of course it is an online group we are considering. 

This session will explore in greater depth what we would have covered briefly on the telephone. I will also ask more about the person’s history and encourage some thinking about their relationship to groups, such as, family, school, friends, work etc. As in all psychotherapy assessments, I will want to find out a bit more about the person’s relationships, problems, needs, risks, medication, previous psychological input, and levels of function. 

This session also gives them the opportunity to think in more depth about the idea of being in a group. This is helpful to get a firmer sense of why a group might help but also what challenges a group might present to them. 

Sometimes we need more than one of these assessment sessions before we’re clear that the person is ready and wanting to join a group. 

Finding a Time to Join

Once we’ve agreed that someone is ready, we need to think about when they will join. In a new group this is relatively straight forward – I give all prospective members a start date and they all join at the same time.

Joining an established group is a little more complicated as the group also needs to be ready to accept a new member. These groups are called ‘slow’ and ‘open’ which means while people join ongoingly we make sure this happens at a slow pace. This helps the group continue to feel stable and secure. 

As well as this factor, before the individual joins the group, they also need to be ‘ready’ and they will need some help in preparing for this. 

Preparation and Contracting 

I have generally found that anyone joining a group requires at least 2 or 3 preparatory sessions. Some need more and some decide to do some individual work with me first before joining the group. 

The preparatory sessions offer an opportunity to explore further the themes picked up in the assessment process. In addition, people often find it helpful to make some space for any anxieties that might arise.

This preparatory stage also allows me to talk about what is expected of group members. To keep the group therapeutically safe, all members are asked to agree to certain boundaries. An obvious example is confidentiality. Another is that members do not have contact with each other outside the sessions. These and other boundaries can be seen as making a contract with the group to keep it safe and therapeutic. 

First session

The first session can feel daunting, even for those relatively confident in groups. 

In a new group there can be a lot of anxious feelings in the group which can take several sessions to start to properly settle. However, everyone is in the same boat and often people find that reassuring and helpful. It can also feel important for some to feel that they have been in a group from its earliest inception.

In an established group, being the new person is always going to feel challenging to some extent and likely to bring up earlier experiences of being new (for e.g., starting school). However, the atmosphere is likely to be much calmer and less anxious than that of a brand-new group. Established members will also be able to help the new member settle in. Some people can also enjoy the feeling of being special that their newness gives them. 

Despite the expected anxious feelings new members are often surprised how quickly they form bonds and get to know other members of the group. This process is helped by the preparatory work and the boundaries agreed to by the members. 

Conclusion 

Whatever the experience of joining a therapy group the likelihood is it will feel powerful and tap into earlier histories and experiences of both groups and beginnings. The emphasis on stages of initial consultation, assessment, preparation, and contracting, are all in place to hopefully help and support the new group member in their own joining process. 

Joining a Group

If you are interested in exploring joining one of the groups mentioned above, please do contact me through the enquiry form.

Groups run by Claire Barnes

Claire currently runs two groups at Brighton and Hove Psychotherapy 

  •  once weekly group on Thursday evenings
  •  twice weekly group on late Monday afternoons, and Wednesday evenings.

She is also now taking referrals for a new face-to-face group, to run on Thursday mornings at the same practice and address. 

 

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

What happens in Group Therapy: Mirroring

Filed Under: Claire Barnes, Groups, Mental Health Tagged With: group psychotherapy, group therapy, support groups

April 4, 2022 by BHP 2 Comments

How are you?

How are you at just sitting down quietly by yourself? 

Some years ago I completed a mindfulness meditation course and first encountered the philosopher Pascal‘s assertion that, ‘all the misfortunes of men derive from one single thing, which is their inability to be at ease in a room’. Our teacher suggested Pascal referred to the harm caused due to our periodic inability to tolerate the sheer intensity of thoughts and feelings that can rise within us, when no distractions are available. 

Having worked through meditation guidance books at earlier times in my life, I found attending this formal course was an enriching way to discover that engaging in mindful meditation could be a useful aspect of my own wellbeing.

The paradox of mindfulness – ostensibly sitting alone not ‘doing’ anything – is that it’s an active practice, requiring our presence in the moment and making it a regular habit in order to be effective. The health benefits of mindful meditation have been increasingly suggested in numerous research studies. 

Pioneers such as Jon Kabat-Zinn have taught how cultivating a focused awareness of our thoughts, feelings and physical sensations increases our capacity to tolerate their extremes. 

More recently the psychiatrist Dan Siegel has developed his ‘Wheel of Awareness’ practice: a structured meditation session inviting us to develop both awareness and compassion for ourselves that we then extend to our personal relationships, wider humanity and all life in our natural world.

Just as many have found meditation a valuable resource at particular times of stress or crisis in their lives, so psychotherapy has taken its place as an important activity that addresses the challenges we face in seeking to be at ease with ourselves. 

And for this activity we might turn to the insight of another giant of French thought, Montaigne, who wrote, ‘The greatest thing in the world is to know how to be oneself.’

In the therapeutic process we move beyond sitting with ourselves into a particular kind of beneficial relationship. The therapy room offers us a space where we can enlist the full attention of another person – a trained therapist – who is professionally committed to helping us explore those aspects of ourselves that can be hardest to uncover and often too painful to encounter by ourselves. 

And just as meditation is called a ‘practice’, so psychotherapy is often referred to as ‘the work’ in an acknowledgement of the purposeful regularity of this process of deeply supported self-examination.  

If the goal of mindfulness is to achieve a greater sense of wellbeing though cultivated awareness, it seems to me the aim of psychotherapy is to help us truly know not who, but as Montaigne suggests, how we are in the world. Only by understanding much more about how we have come to think, feel and act in the way we do can we begin to understand how we might choose to be different.

 

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

Chris Horton is a registered member of the British Association for Counselling & Psychotherapy (BACP) and a psychotherapeutic counsellor with experience in a diverse range of occupational settings. He works with individuals (young people/adults) in private practice.  He is available at our Lewes and Brighton & Hove Practice.

 

Further reading by Chris Horton

Out of Sight, Out of Mind

Filed Under: Chris Horton, Mental Health, Relationships Tagged With: meditation, Mindfulness, wellbeing

March 21, 2022 by BHP Leave a Comment

Demystifying Mental Health Issues

In the last few years there has been increased awareness of mental health issues in the media, way before the pandemic hit. Mental health professionals are seeing a growing mental health epidemic which has become significantly worse due to the human and financial cost of Covid-19, prolonged lockdowns, and a general shift in how people live, work and study. Nowadays, most of us know someone with a mental health issue or have experienced it ourselves.

Mental Health Issues are Human Issues 

The language used in the mainstream media to describe mental health does not adequately portray the issues people present with in therapy.  Terms such as trauma, anxiety and depression are often overused and do not describe their full meaning. Most of us experience fear, grief, sadness, and fluctuation in emotions. Whether we choose to acknowledge it or not, most of us have been through a challenging life event(s) or loss(es) with significant emotional and psychological impact.

Anxiety and Depression – An Emotional Accumulation 

I often hear people say that they or someone else “suffers with” anxiety or depression, or “has a mental health issue”. My first thought is: what does this mean? Though these terms have been fed to us through both clinicians and the media, I believe there are much better ways of describing someone’s experience in a less diagnostic, medical and all-encompassing way. 

Although some of us may say “I feel anxious” or “I feel depressed”, anxiety and depression are not actual feelings but a cluster or accumulation of many things. Feelings and emotions when undealt with (supressed) and poorly understood, can result in what we currently describe as depression or anxiety. 

For instance, a prolonged period of low mood which we call depression can ensue as a response to anything from prolonged grief to suppressed anger, feelings of powerlessness and helplessness, just to name a few. Depression can range from low mood to intense depressive episodes, depending on cause and other psychological and biological factors. 

A prolonged or chronic state of high alert resulting in unpleasant feelings of fear or dread which we call anxiety, often manifests when we are responding internally to a certain situation that we perceive as a threat of some description, either actual or imagined. Like depression, anxiety symptoms range from generalised anxiety to panic disorder, depending on the level of accumulation of emotions, life circumstances, personal resilience, previous trauma, etc. 

Finally, our mood is also impacted by environmental and physiological factors such as sleep, hormones, mood altering substances such as caffeine, alcohol and drugs (illegal or prescribed), exercise, fresh air and sunshine, screen time, etc.

The Role of Psychotherapy

Is to help people make sense of why they feel the way they do. To understand what is behind the symptoms that people label as anxiety or depression because they do not know what they are experiencing and why. Uncovering the ‘why’ is a big part of the process of getting better – the more we know why, the more we know ourselves.

Elsewhere on this website we list the issues that people commonly seek therapy for. Anyone who comes to therapy seeking help with a particular issue or issues, also brings with them a rich context and personal history. Making links between symptoms and experience (past and present) is an essential part of understanding, accepting and therefore overcoming some of the barriers we face in feeling mentally well and more at ease with ourselves. 

 

Sam Jahara is a UKCP Registered Psychotherapist and Clinical Supervisor and Executive Coach. She works with individuals in Hove and  Lewes.

 

Further reading by Sam Jahara

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

What shapes us?

Filed Under: Mental Health, Sam Jahara, Society Tagged With: anxiety, Depression, Mental Health

February 7, 2022 by BHP Leave a Comment

Executive Coaching, Psychotherapy, or both?

Executive or Leadership coaching is nowadays widely offered in organisations. Employers know the benefits of investing in developing their leaders and employing a coach is one of the best ways of doing this. 

What Makes a Good Leader?

Good leaders need to be self-aware, emotionally intelligent and have excellent interpersonal skills. The leaders who develop such qualities fair far better than those who have risen to the top due to high performance in their respective fields, but do not have the qualities needed to lead a team. Leaders of people need to know how to do relationships. This includes setting boundaries, being assertive and knowing how to communicate well with their peers and staff.

Psychotherapy is all about relationships – to self, others and the world. In psychotherapy, we learn to understand ourselves on a deeper level. This translates into knowing how we impact and are impacted by others. The aim of self-knowledge is to become more perceptive about patterns we repeat that are unhelpful or even harmful to ourselves and those around us. This extends to relationships at work, where the leader has a responsibility to shape the culture of an organisation and create an environment where people have the best chance to perform well. 

The leader and their staff‘s performance directly impacts the success of an organisation, which brings us back to the importance of good interpersonal relationships, communication and self-knowledge, especially when what is required is seeing and working with what lies beneath the surface.

What is the Difference Between Psychotherapy and Coaching?

Psychotherapy and leadership coaching are two distinct professions, each with a with their own set of skills and training. However, coaches with psychotherapy training under their belt are in a good position to coach executives due to their in-depth training in psychological theories and processes. Psychotherapists are trained on what makes people think, feel and behave the way they do. This knowledge can be directly applied to organisational and team dynamics. 

However, this does not in itself make any psychotherapist into a skilled leadership coach. Coaching leaders in the context in which they are working requires training, knowledge and experience in the field of business and as well as psychology. It also requires an ongoing interest in both, and the drive to constantly learn.   

Psychotherapists who work as coaches also need to know how the two differ and where they overlap. No one wants to engage in coaching and end up receiving psychotherapy instead, or vice-versa. Executive coaching is work focused, usually time-limited and takes place less frequently than psychotherapy. People engage in coaching usually to work through challenges they are experiencing at work, to develop themselves in their role or to explore changes in their career. Finally, psychotherapy and coaching can take place alongside one another, with two different professionals who will support the client in distinct but possibly overlapping areas of the person’s life. 

 

Sam Jahara is a UKCP registered Psychotherapist and Tavistock trained Executive Coach. She has a special interest on the impact of unconscious dynamics at work. She was born in Brazil and lived in Germany, The Netherlands and Australia. Sam currently lives and works in the UK and sees clients from her Lewes and Hove offices as well as online. You can get in touch with Sam directly via her profile.

 

Further reading by Sam Jahara

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

What shapes us?

Filed Under: Mental Health, Sam Jahara, Work Tagged With: Coaching, Psychotherapy, Workplace

January 31, 2022 by BHP Leave a Comment

Compassionate Curiosity and the fundamental rule of Psychoanalysis

Freud said that there was only one rule in Psychoanalysis which was to say whatever comes to your mind, even and perhaps most importantly when we don’t want to. In this way we can start to listen to different parts of ourselves and start to discover the dynamics within. We discover quite quickly how much of what goes on inside of ourselves is blocked from entering our consciousness. We become aware of all sorts of inhibitions and repressions, shames and conditioning. We may have all sorts of prepared narratives about who and why we are the way we are. Often these have been constructed to deal with difficulties in our lives and may have been to some extent useful coping mechanisms. However, what often brings someone to therapy is the realisation that these coping strategies or defence mechanisms have actually become a problem in themselves. 

Aspects of ourselves that we don’t like or believe are shameful become feared parts of ourselves that have to be avoided or sanitised. Like the idea of the monster under the bed, often understandable thoughts behaviours and emotions, become magnified and terrifying. 

Aspects of ourselves don’t match the identity, we feel we need to create, to be acceptable to ourselves and others. This doesn’t mean that psychoanalysis seeks to condone problematic behaviour, but rather by taking a neutral unmoralizing stance there can be space for these troubling areas to surface and to be understood,  lessening their power and likelihood of being enacted. 

Therapists will have spent a lot of time getting to know these parts of themselves in their own therapy helping them understand the nature of the human psyche through personal reflection on their own ‘stuff’. 

Resistances arise as this unmoralizing stance can feel shocking, and be experienced as if the therapist is being critical, as any light shone on these repressed parts can feel shameful. However hopefully over time it can be understood that the therapist’s unflinching observance of these parts, is not in way an intention to criticize or shame but to be compassionately curious. When this can be understood, hopefully the patient too can start to feel less afraid and more curious about themselves, the power of the ‘superego’ or internalized judge, with its narrow rules and harsh judgments can be lessened as we accept what we came to believe was unacceptable and had to be repressed.

The following poem hopefully gives a flavour of this:-

“Be curious, not judgmental.”

  • Be curious. Wonder awhile, listen, allow yourself to not know.
  • Not judgmental. Not “I know what this means”, not imagining the worst, not coming to hasty conclusions.

Be here, not there. Be now, not then. Be curious, not judgmental…

Walt Whitman. 

 

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

 

Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

Why there’s nothing as infuriating as Anger Management

What makes Psychotherapy Different?

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Filed Under: Mental Health, Paul Salvage, Society Tagged With: acceptance, coping, psychoanalysis

January 17, 2022 by BHP Leave a Comment

How much time should I devote to self care?

In this blog I explore the concept of self care – what it means and how much time you need to consciously devote to active self care per day: it is probably less than you think!

What do I mean by self care?

In basic terms, self care refers to ‘looking after oneself’. Some people really struggle with the basics of this and once external factors such as poverty have been eliminated, good basic self care correlates to good mental health.

People struggling with depression can find it really difficult to undertake tasks such as getting out of bed in the morning or getting themselves to work.

People with anxiety can struggle with focusing, controlling their thoughts and feelings and in holding onto a thinking mind.

And people who are dealing with eating disorders can struggle to eat for healthy reasons using food to suppress difficult feelings (obesity) or retain an illusion of control over the body (anorexia).

And people who struggle with bulimia can struggle to ingest ‘bite size chunks of life’, instead feeling flooded by others and eventually having to vomit it al out.

These are all real and serious mental health problems and psychotherapy is there to work through what set up these coping patterns and to bit-by-bit help people to better manage their emotions.

The 50 minute hour

Most psychotherapy session are of the duration of what we in the trade call ‘a psychotherapy hour’, which is in fact 50 minutes.

Good psychotherapists stick to the hour and do not overrun as this is unhelpful for the client – it demonstrates poor boundaries and a lack of self care on the part of the therapist.

Over time, clients must learn to keep the therapy and their therapist ‘alive’ between sessions; they must learn to bridge the gap from one session to the next. This means internalising their psychotherapist and thereby holding themselves in mind outside of the therapy room in the way their therapist does. This is where the shift happens from dealing with the presenting crisis (depression, anxiety etc.) to more sophisticated methods of self care.

Psychotherapy is not enough, but it is essential

It is not enough to simply attend therapy and then expect miracles to happen- they won’t.

By bridging the gap between sessions, clients hold themselves in mind and can become curious about what else would be helpful to them in living calmer, more fulfilling lives.

At first bad habits may get dropped – staying up late on work nights, drinking a glass of wine or two every evening, eating junk food – and then a shift can occur to an active engagement with good habits.

These are in addition to living a calm and ordinary life and are constitute self care that is aimed at good mental and emotional health (arguably good physical health too).

Examples may include yoga, meditation, dancing, singing, walking, swimming, meeting friends for connected conversation and so on. The list is virtually endless providing whatever you engage in is mindful (you are present with what you are doing) and leads to sustainable and enduring good feelings afterwards.

Can you spare 4% of your day?

Imagine if all it really took was 4% of your day to make an enduring and significant difference to how you felt and felt about yourself? Well, this is arguably a good figure (and achievable figure) to aim for and guess what? It is only one hour of your day!

So, on days when you are not in therapy, how about spending one hour actively self caring by mindfully engaging with an activity (or activities) that makes you feel alive, positive, brings you into you body and sets you up for the day?

Dedicating one hour per day to self care is a good way of bridging the gap between sessions and in devoting the weekly therapy hour to active self care on the other six.

 

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

 

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

 

Further reading by Mark Vahrmeyer

Why is Netflix’s Squid Game so popular?

Space: The Final Frontier of Manic Defence

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

What is the purpose of intimate relationships?

Filed Under: Mark Vahrmeyer, Mental Health, Psychotherapy Tagged With: self-awareness, self-care, self-development

December 6, 2021 by BHP Leave a Comment

Save? Edit? Delete?

In 2002 an Australian journalist coined the term ‘selfie’. June 2007 saw the launch of iPhone and by 2013 the word ‘selfie’ was chosen by the Oxford English Dictionary as the ‘Word Of The Year’. Never as individuals have we been more likely to have a picture taken as we are now. An awareness of how we look, other than what we see in the mirror, is part of our lived experience.

Technology allows us to edit, manipulate or delete images, as we choose. What we don’t like can be edited out, what we can’t bear can simply be deleted. We can edit our selves to a degree that subverts reality.

The selfie could be seen as an expression of a narcissistic, self absorbed, society in which the individual and their image becomes overly important. The selfie could also be a reaction against societal expectations and ideals and a means of expressing individuality. Through a picture one can imagine themselves to be all the things that they might feel that they are, or aren’t.

Which side of the debate you find yourself on we can’t avoid this idea that there is a good, idealized image of ourselves which is sought, and a bad, devalued, version which can end up deleted.

When we speak of idealization and devaluation we’re looking at ways of coping with unbearable feelings. Taking, editing and sharing the perfect picture projects our idealized sense of who we are to the world. It helps us to defend against those feelings which come when confronted by an image that shows a version of ourselves that we find hard to see.

This ‘split’ into either good or bad, idealized and devalued as seen through the relationship to pictures may be revealing unconscious feelings around our sense of who we are. Can we bear to hold onto the images of oneself as ‘less than perfect’?

Thinking about this spilt therapeutically it invites an exploration as to what the client makes of their rejection of some and celebration of other images. Can we help them to recognise these splits and to consider what they might be an expression of? The aim of this is to help the individual to integrate both the idealized and the devalued parts of themselves into a coherent sense of self.

The selfie as a metaphor for how we feel about ourselves could feel like a simplistic idea, but if we can’t hold on to the images that aren’t ideal, are we showing more than we think?

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove and Lewes.

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

 

Further reading by David Work –

Football, psychotherapy and engaging with male clients

When Home and Work merge

 

Filed Under: David Work, Mental Health, Society Tagged With: relationship, self-awareness, society

August 30, 2021 by BHP Leave a Comment

What makes Psychotherapy Different?

“The Patient who will not suffer pain fails to suffer pleasure.” Wilfred Bion 1970.

I’ve been a therapist for over ten years now and one of the things I love about the job is how demanding it is of me to stay awake and stay alive. The training never stops and development is always a work in progress.

After many years of various work and an enduring interest in self-development and study, encompassing Eastern thoughts and practices and various experiential group experiences, I started my formal Psychotherapy training in 2008 and finished in 2014. However, what I didn’t realise was that this was the beginning much more than the end of something.

What makes Psychotherapy so important to me is that it requires one to become a psychotherapist rather than to do psychotherapy. The non-behavioural psychotherapeutic interaction is not one where I teach someone strategies, but one where I seek to on a sustained, regular and meaningful way to contact another human being, always in service of them and focusing on them but using my own present being to help make sense and bring to awareness what is going for them. I do this with all that I have available my mind, my senses, my bodily feelings, my intuition, to try and get a felt sense of what things are like for them.

Jonathon Shedler, the American Psychotherapist and researcher, says “don’t ask what model your therapist practises but how much therapy they have had.”

For me this is what makes psychotherapy truly interesting, of course learning about different theories of the mind and the way it functions and disfunctions is hugely important but it is in our own therapy that we truly learn the ‘praxis’, (practice) of psychotherapy. This involves being challenged to reflect deeply on our own internal processes, our own avoidance and defence mechanisms all human difficulties are on a spectrum and that if we look deeply enough all of us can relate to our patients through our own reflecting selves.

 

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

 

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

Filed Under: Mental Health, Paul Salvage, Psychotherapy Tagged With: Psychodynamic, Psychotherapy, psychotherapy services

July 12, 2021 by BHP 14 Comments

‘The Wisdom of Trauma’ a film by Gabor Maté – A Critical Review

Both the name, Gabor Maté, and the word, trauma, have become synonymous and ubiquitous in recent years.

Dr. Maté is a Hungarian born physician and author of ‘In The Realm of The Hungry Ghosts’, which was first published back in 2008 and offered a compassionate and insightful understanding of addiction as a response to trauma. Since then Dr Maté has steadily risen to fame as an addiction and trauma expert. He has now released a documentary film entitled ‘The Wisdom of Trauma’, which was brought to my attention by a couple of my clients. I decided to watch it.

The film follows Dr Maté on his journey of defining trauma, most specifically, childhood developmental trauma (CPTSD) and covers his work and learnings from treating street addicts in Vancouver’s Downtown Eastside.

As a mental health professional and clinician, I am all in favour of any well-researched productions that aim to highlight the impact of CPTSD, educate the masses and ideally bring about change at a societal level in how we conceptualise trauma and treatment. I therefore had high hopes for Dr Maté’s oeuvre. Sadly, as the film progressed, I became increasingly uneasy with the content and was ultimately left with the impression that the film was more about glorifying Dr Maté and his self-professed ‘new’ trauma informed approach to treating trauma, than a piece of work aimed at bringing together the teachings and learnings of many clinicians over the years on whose shoulders Dr Maté, like the rest of us, stand (see Alan Shore, Babette Rothschild, Pat Ogden, Steven Porges, Antonio Damasio, Daniel Siegel to name a few).

There is a powerful sequence in the film filmed in a prison where Fritzi Horstman, founder of the Compassion Prison Project, undertakes some meaningful work with inmates based on the ACE principles (see Adverse Childhood Experiences study 1995 – 1997, conducted by Kaiser Permanente). The work of the Compassion Prison Project is clearly meaningful, research based and healing, however, the link between this project and Gabor Maté remained at best utterly unclear and secondly, there was no reference to the original ACE study and the importance of it so viewers were left in the dark around context and thus perhaps invited to imagine that this was somehow connected to Dr Mate. To be clear, the ACE study has nothing to do with Dr Maté.

As the film progresses, Dr Maté moves into sharing his experiences of healing through the use of psychedelics, namely Ayahuasca, with footage shown of a ceremony taking place in Peru. The study of psychedelics and their possible use in treating mental health problems is in its absolute infancy and the research being conducted is done so in strictly controlled environments where participants combine the use of medical doses of psychedelics with psychotherapy – no mention was made of this. Whilst promising in specific clinical settings (as opposed to the Peruvian rain forest) and for specific applications, psychedelics can potentially do more harm than good,
particularly for patients with weak egos or personality disorders. There also remain valid questions about the long-term benefits of psychedelics in treating trauma, with most studies showing that symptoms tend to return over time once psychedelic use was suspended (generally 6 months to a year).

There is then a sequence wherein a man in his early 50’s with a stage 4 prostate cancer diagnosis appears to enter into remission through therapy with Dr Maté with the implied cause of his previously terminal illness being put down to trauma. I am a clinician who profoundly believes in the body-mind connection as have many more learned clinicians before me (see Winnicott and psyche-soma integration), however, whilst our emotions are experienced through the body and the ACE study has shown correlation between adverse childhood experiences and illness,
correlation is not the same as causation.

Finally, there are numerous sequences where Dr Maté is conducting his own brand of ‘trauma informed therapy’ which he suggests is in some way unique and the way to heal trauma. And yet again, trauma informed therapy is neither a new phenomenon nor something that has been invented by Dr Maté; indeed, any well-trained and experienced psychotherapist who works with trauma (and we all do), should be educated in understanding the presentation and defensive structures around CPTSD.

The message of the documentary – a trauma informed approach to healing society as a whole – is a positive one and yet despite his profile, I was disappointed to see how Dr Maté fails to engage and influence policy makers, educators, physicians and mental health professionals and actively seems to undermine his own message through an irresponsible focus on psychedelics, terminal illness being healed through trauma talk-therapy and a guru-esque approach to practicing his own therapeutic approach.

The sad reality of relational trauma is that it occurred in relationship and so can only be treated and worked through in relationship. And working through is not necessarily the same as ‘healing’.  Good psychotherapy is painful and slow and the main reason it takes time is because the traumatised part of the patient (client) needs to overcome resistance and form a dependent relationship on their therapist; thus the client dictates the speed of therapy.

The Wisdom of Trauma seemed to me to subscribe to an all too common narrative of recent years – there is a ‘fix’ for everything and it can be quick. This is not my experience of working with trauma and nor is it that of my clients, many whom learn to live with their trauma rather than somehow leave it behind. Perhaps a better title would have simple been: ‘The Wisdom of Gabor Maté’ as the documentary was essentially about him and his views, despite the enormous work in this field undertaken by the likes of Freud, Winnicot, Bowlby etc., all the way through to ordinary psychotherapists like myself and all my ‘ordinary’ colleagues.

 

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

 

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

 

Further reading by Mark Vahrmeyer

‘The Wisdom of Trauma’ a film by Gabor Maté – A Critical Review

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

What is the purpose of intimate relationships?

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

Filed Under: Mark Vahrmeyer, Mental Health, Psychotherapy Tagged With: complex trauma, Gabor Maté, The Wisdom of Trauma, Trauma

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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