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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?

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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

 

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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

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‘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 because 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

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Do Psychotherapists Need to Love Their Clients?

Freud is an extraordinary and greatly misunderstood individual (and mental health practitioner).  Many believe we have ‘evolved’ beyond his ‘outdated’ theories and indeed, there are views and  theories of his that are no longer literally relevant. However, to dismiss him on this basis is myopic and superficial in that Freud’s writing has taken us to where we are today in the world of  psychotherapy; and so many of his theories are increasingly becoming ‘evidenced’ through technology and our understanding of brain plasticity and the need for relationship to grow a mind.  So, with this in mind, I shall now start my piece with a Freud quote: 

‘Psychoanalysis is in essence a cure through love’ Freud, S. (1906) correspondence with  Jung. 

What is love? 

The first question that must be considered in Freud’s statement is the question of what love is? 

Clearly Freud is not talking about Eros, or erotic love; he is referring to Agape, love towards fellow human beings. However, I believe Freud is saying something significantly more profound and more important: By using the terminology ‘love’ Freud is drawing a comparison to the role of the analyst (or psychotherapist) in the transference – the role of the parent who has let the child in the client down. 

Parents should love their children and most do. However, loving a child is complex as it means to allow and encourage that child to have their own experience – emotional and psychological – separate to the parent. It is about being able to encourage and tolerate difference and then celebrate it in own’s child. 

Children who have been let down – neglected, abused or abandoned – have learnt that their survival depends on ‘keeping their parent happy’ – they sacrifice their own separateness and own experience in order to hold on to a parent. This is not a child who is ‘loved’. But a child who is owned. 

Love therefore in Freud’s sense of the word is about true empathy – to be able to understand and accept another’s experience without becoming threatened by it, without collapsing and without colluding with it. And without sacrificing our own experience. 

Does loving a client mean accepting their behaviour? 

Behaviour, when driven unconsciously by effect (emotion) is termed ‘acting out’ and ‘acting out’ is mindless. Furthermore it is an attack on the therapy and an attack on the therapist. 

Much like a good parent will have empathy for a child’s fear of the dentist, or a child’s desire for sweets placed next to the till, this does not mean that the child gets what they want – the avoidance of the dental appointment or the indulgence of sweets. A ‘good enough’ parent is able to empathise with the child’s feelings but withstand their demands. In short, a parent’s job is to hold their child in mind and advocate for their best interests rather than the child’s self interests (or their  own self interests). 

Is Psychoanalysis in essence the same as a Person-Centred Approach? 

Now we have established what Freud probably means by love, we can consider whether the analytical approach is in essence the same as a person-centred approach – one of unconditional positive regard. Is this not love? 

To a point it is, however, in my view (and that of analytically minded clinicians) the person-centred approach leaves the whole idea of ‘the unconscious’ just there – in the unconscious: in other words it does not exist. What you see is what you get.

Without working with the unconscious and in the transference, a clinician cannot really ‘love’ their client as they are oblivious to the drives and projections that are paying out in the room – the meaning behind the strength of emotion from the client. And they remain oblivious to whom they represent for the client and thus where the loss or trauma resides relationally. 

An analytical clinician will work to understand whom the client is projecting onto them – the transference – and will work within the context of that to provide the client with a different experience of relationship 

Evicting the bad parent 

We all ‘internalise’ our parents – working models of how we experienced them. If this process of internalisation goes ‘well enough’ then we can draw on a solid sense of sense that is supportive of us taking up space in the world and in other relationships: we can bear our inner world However, if it goes awry somehow, then that working model can be punitive, critical and unsupportive and we avoid contact with our inner world at all costs. The process of analytical therapy is to ‘evict’ the bad  parent and offer the client an alternative object (person) to introject through the consistent therapeutic relationship. 

How to ‘love’ our clients 

Loving our clients is a hard thing to do not because they are unlikable or unlovable, but because it  means consistently offering the client a different experience of relationship that they will be unconsciously trying to sabotage in subtle ways. Freud also spoke of our fear of change and suggested that in order to mitigate against change, going forward we always seek to replicate the past. Abused and neglected children feel unconsciously ‘safe’ in abusive and neglectful relationships as then the ‘world makes sense’ and they can simply use their old defensive  mechanisms to carry on surviving. They also don’t need to feel vulnerable. 

Loving a client means holding appropriate boundaries, offering them support and understanding whilst resisting either being seduced or offended by attacks. And as with real life evictions, the internal parents will protest and fight back to stay put. 

Ultimately loving our clients means to hold them in mind in ways they never were – their best interest rather than self interests. 

 

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 –

What is the purpose of intimate relationships?

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

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

Why does the difference between counselling and psychotherapy matter?

Love in the time of Covid

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Is it ever too late to start psychotherapy?

Is it too late to consider going into therapy once we reach a certain age? As I walked through the gardens on an early spring morning, this was the question going through my mind. I intended to get down to writing this blog, an unfamiliar task, when I got back to my office.

We seem to have heard all year about mental and physical decline as we age so it was refreshing to read Levitin (see below) that the brain retains plasticity or the capacity to learn and change through out life. And if we are not taken down by dementia, brain injury or stroke, we can in fact retain a lively and flexible mind throughout life. We have to do the obvious things like follow a balanced diet, exercise, not give up purposeful activity (work) and maintain a good and diverse social network.

Throughout life, our close friends and family are important to our wellbeing. These relationships take enormous strain in a world where change is the only hope for survival. And they need looking after even if this means we might end a relationship, if we have children developing and sustaining a healthy connection can help our children to adjust to the world with a healthy out look.

Transitional periods, retirement, divorce, bereavement, empty-nest syndrome, can benefit from psychotherapy for one or both partners providing the space for increased awareness of ourselves, an opportunity for gaining insight and change.

Considering the later years are often filled with opportunities for reflection on a life lived there is always plenty material to explore in the therapy room. David Levitin, an American Neuroscientist, sees this period of life as an opportunity to see life afresh. His premise is the brain retains its capacity to change through out life, at its greatest in childhood and old age.

 

To enquire about group sessions with Thea Beech, please contact her here, or to view our full clinical team, please click here.

 

Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

The Unconscious Mind

Groups for Mental Health

Group Psychotherapy in a post ‘Pandemic World’

Termination and endings in Psychotherapy

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Unexpressed emotions will never die

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

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

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

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

How do unexpressed emotions come forth?

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

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

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

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

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

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

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

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

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

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

And this list is by no means exhaustive or conclusive. 

Expression vs repression – living vs dying 

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

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

Grieving is part of living 

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

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

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

 

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

 

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

 

Further ready by Mark Vahrmeyer –

What is the purpose of intimate relationships?

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

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

Why does the difference between counselling and psychotherapy matter?

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

I don’t know about you, but I have been riding the Covid-19 emotional roller coaster since March 2020 with very little roadmap, whilst trying to guide those who I work with like “the blind leading the blind”.

I also see my own psychotherapist and supervisers in the exact same boat. They are supposed to know more than me, but actually I get the sense that we are all struggling together.

Nonetheless, as a mental health professional, business owner and with all my family living in different countries, I have been dealing with my own set of challenges as a result of Covid-19, as well as trying to be the best support I can for my clients. I have also felt grateful for the support of a therapist throughout this period and couldn’t imagine a better time to be in therapy other than now.

All helping professionals are going through their own predicaments throughout this crisis whilst trying to help others as well. This can be both rewarding and also incredibly taxing. I noticed feeling more tired than ever at the end of last year – an exhaustion which felt both familiar and entirely new. Self-care has become more important than ever.

We all had to adapt to new working practices and navigate the unknown over past months. This has been both unsettling and reassuring in that most of us have survived and gotten through in our own way. There have been losses for sure and they have taught us that we can survive them too.

Professionals in support roles have been working through the pandemic feeling mostly under-resourced themselves. Under such unusual set of circumstances this can only be expected. It has been humbling.

Having weekly psychotherapy sessions has helped and continues to help me enormously. Therapists need their own therapy now more than ever. If we are to continue to be of help to our clients, first we need to have the support ourselves.

 

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 with us.

 

Sam Jahara is a UKCP Registered Psychotherapist and clinical Superviser. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

What shapes us?

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

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

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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What’s wrong with good advice?

Often, the people who engage in therapy with me will ask for advice, tips on managing anxiety, what to do about a relationship situation, how to manage a tricky situation at work. Sometimes someone might ask for general ‘life advice’. Of course, mostly what they want is some sort of reassurance and although its not true that therapists never give advice I tend not to offer reassurance. Why not?

Well to start with, the problem is rarely not knowing what the right thing to do is. If someone wants ‘tips’ on sleep or anxiety strategies, I might advise them to look on the internet, there’s plenty of it out there and its free and of course generally sound. Eat your greens, go to bed at a regular time, do some exercise, especially yoga and don’t take too many or too much, mind altering substances.

This reminds me of a joke, –

‘Doctor, If I stop drinking alcohol altogether, eat my greens and give up sex, will I live longer?

Dr – Well I can’t tell you with any certainty whether you’ll live any longer, but one thing I do know, it will certainly seem much longer!’

Of course, what people struggle with is not, not knowing, what the healthy thing to do is, it’s doing it and the reason for this is that they/we are conflicted.

Many clients may come saying they want to stop, whatever it is, that is causing them problems. So I ask why don’t they then? and they say I don’t know. Well the answer is simple, another part of them doesn’t want to stop, whatever it is there doing, is serving some purpose, even if the consequences of continuing to do it are grave. Of course, in many cases this can indeed be tragic, people find themselves compulsively doing things that they know hurt themselves or others, damage, destroy or put important, sometimes essential relationships at risk.

Therefore, advice on stopping the behaviour rarely works as the addiction or compulsion is a solution to another, sometimes, -unconscious problem., as Depache Mode noted, they’re, “looking for love in all the wrong places”.

– “in the woods of anguish, it’s easy to lose your way”. (George Nash 7.9.2020)

The difficulty in a way is in beginning therapy, as the client and therapist needs to come to a together about what the problem is and what the contract of work is.

I have had many clients come with problems and basically say, well, I’ve told you the problem, now over to you to give me the right advice to fix it. Needless to say, these client’s often leave before the work starts. For instance, someone I saw with a destructive addiction was clearly harbouring a long festering repressed grief about an abandonment by his father, however this wound was so repressed that any interpretation of mine that it might be important to look at this just didn’t work and we were immediately at a stalemate.

Of course, my job is to be as tactful as possible, to not push the client beyond where they are ready to go and to be as patient as possible, BUT, destructive behaviour is always the result of past hurts and unless we do find a way together to think about these, a stalemate or premature ending will be the result.

 

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 –

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

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What is Schema Therapy?

Schema Therapy (ST) is a flexible and comprehensive approach to therapy that focuses on understanding you as a person. It provides a helpful framework for us to make sense of some of the difficulties you might be experiencing. These might be difficulties with how you feel, your thought patterns, relationships, unhelpful behaviours, or a general dissatisfaction with your life.

ST was developed in the 1980s by psychologist Jeffrey Young and can be understood as an integrative model that draws on a number of therapeutic approaches, including cognitive behavioural (CBT), psychodynamic, gestalt, and person-centred.

CBT has a strong evidence base and because of this tends to be the treatment of choice for many common difficulties such as anxiety and depression; when delivering ST, I would be able to work with you to incorporate many of the effective components of CBT to support with the changes you make. In addition, ST goes deeper and puts more of an emphasis on understanding the links between childhood experiences and the development of patterns in thinking, feeling and behaving.

ST asserts that it is our schemas that link our past to our present. In ST, a schema can be understood as a deeply held belief which is often out of our conscious awareness. Schemas affect how we think, feel, and behave, and are sometimes described as our blueprints or software. They help us to make sense of the world, and are the patterns that run throughout our life. A goal of schema therapy is to help you to become more aware of your schemas and then to provide you with tools to change on an intellectual, emotional and behavioural level.

Another important part of ST is the focus on emotional needs. ST believes that schemas develop from experiences when our emotional needs were not met. One of the overarching goals of ST is to help you to develop an awareness of these needs and, over the course of therapy, develop a variety of ways of meeting them.

What happens in schema therapy?
In the early sessions of ST, we would work together to build an understanding of your current problems and how they developed. A crucial element of this is making links between your early life experiences and your current problems. The process of therapy is active, and, right from the start we would use different therapeutic techniques. These can be divided into: (i) emotion focussed strategies that aim to connect you with the emotional level of your experience, and include imagery and chair work; (ii) cognitive techniques that aim to promote flexible and compassionate thinking; and (iii) behavioural techniques that help you to challenge fears and break behavioural patterns.

What I like about schema therapy?
I really like the comprehensiveness and flexibility of ST. It provides a framework for understanding how we function on a deeper level and helps us to spot the common thinking and behavioural traps that we can all fall into. As a therapist I can be creative and draw on a number of proven techniques that aim to address problems on a variety of levels. ST also encourages therapists to play an active role in the therapy and to bring an authentic and open approach to the therapeutic relationship. This can help create a genuine connection, which is often the foundation for lasting change.

 

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

 

Dr John Burns  is an experienced Consultant Clinical Psychologist registered with the British Psychological Society, Health and Care Professions Council, and the British Association of Behavioural and Cognitive Psychotherapies.  He is available at our Brighton & Hove Practice.

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Online Anger Management Therapy

Anger issues can have a negative impact on your physical and mental health, as well as impacting other areas of your life such as your relationships. Online anger management therapy can be helpful in enabling you to control your anger before it controls your life.

What is Online Anger Management?

An online anger management counsellor can work with you to help you identify the signs of anger and to help you examine the triggers that cause your anger to flare up. Through learning how to control your emotions, you’ll be able to deal with your anger in a more constructive way.

Online anger management therapy isn’t about avoiding anger or removing it from your life entirely – anger is natural and, when expressed in a healthy way, it can actually be helpful in diminishing your negative feelings. Anger management is simply a tool to help you express your feelings in a more appropriate and assertive way.

Men often experience anger more than women, which may be because of how men are taught to express their emotions. Anger can often be seen as acceptable for men to express, rather than women, and it can often be used as a way of masking other feelings like sadness, grief or humiliation. But, of course, anger control issues can affect anyone and there is no shame in experiencing difficulty in controlling your anger.

An experienced professional therapist can help you find suitable ways to express your feelings, so you have a better hold over your emotions. Those struggling with anger issues may find it difficult to seek help or admit they have a problem. But online therapy can be a convenient way of finding ways to diffuse your anger and can highlight the areas of your life that are causing these emotions.

How Can Online Anger Management Therapy Help Me?

In many cases, anger is an appropriate emotion for the situation. In others, it may not be suitable or the level of anger you’re feeling may not be appropriate for what has happened. Online anger management therapy can help you learn what is a suitable emotion for the situation and find ways to express that anger in a healthy way.

For a lot of people, the thought of speaking to someone face-to-face about these issues can be embarrassing or awkward. Online therapy can be a great compromise that offers the benefits of speaking with a licensed therapist but at a time and location that suits you so you’re more relaxed and comfortable.

If you want to talk to our team, contact us today or take a look at our practitioners.

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


Online Bereavement Therapy

Grieving is an emotional, psychological and physical response to losing someone we’re close to. It can be an unsettling experience and many people feel as though something is wrong or missing from their life. Elizabeth Kubler-Ross’ Five Stages of Grief outline the core emotions as denial, anger, bargaining, depression and acceptance. But there are countless other emotions you may feel as a result of losing someone, which can make it confusing to comprehend. Online bereavement therapy is a popular way to help you deal with loss.

What is Online Bereavement Therapy?

Online bereavement therapy can be beneficial in helping you cope with your loss and come to accept what has happened. You’ll speak with a trained counsellor who has experience in helping people grieve and the issues that surround bereavement.

Since grief is often accompanied by feelings that are similar to depression, it can be all too easy to rely on anti-depressants to heal you. But this can often mask the impact of grief and delay the grieving process, causing more harm than good.

Online therapy will enable you to work through what has happened and come to terms with it. A counsellor can also help you understand that grieving is not a neat process and even after you’ve accepted your loss, you may still have difficult periods occur in the future. Your therapy may last several months or even longer – it all depends on the individual and how they process such events.

How Can Bereavement Therapy Help Me?

Some people find comfort in talking about how they feel, while others may find it difficult to talk about their emotions and withdraw from those around them. Grieving is incredibly tough, but you don’t need to feel as though you’re on your own. Offloading your worries and feelings onto someone else can be beneficial and help you work through the stages of grief.

Online bereavement therapy can help you during this mourning process – you’ll have the support of a trained professional and everything you discuss with them will remain completely confidential. It can help to discuss your loss and identify the emotions you’re feeling, whether it’s sadness, anger, guilt or helplessness.

Your counsellor can also help you in learning to live without the person you’ve lost, something that can be daunting. With the support of a counsellor, you’ll soon realise just how common and natural your responses to grief are which can make these emotions easier to deal with.

If you want to talk to our team, contact us today or take a look at our practitioners.

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


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Making Changes

As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.

What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?

Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.

One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.

We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.

It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.

If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.

Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.

Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.

 

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

 

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.

 

Further reading by Rebecca Mead –

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

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

What is Cancel Culture?

This seemingly new trend is one of promoting the ‘cancellation’ of people, brands or television shows as a result of what some (the cancellers) perceive to be some form of offensive comment, remark, view or behaviour. It has surged on social media with various derogatory hashtags, notably #RIP.

A recent high profile ‘celebrity’ who has been on the receiving end of social media trends to have her cancelled is J.K. Rowling for her, views on transgender issues that some find offensive.

Is it that new?

The term may be new and the platforms used may serve to whip up a storm of support against those who some wish to have cancelled, however the concept is by no means new at all. Cancel culture is essentially a form of social banishment whereby in traditional tribal communities one of the most severe punishments would be the banishment from the tribe: to be cast out.

To be cast out of ones tribe would mean more than social death; if not literal death through being vulnerable to attack from predators and other tribes, banishment most certainly meant the death of the sense of belonging, which in psychological terms, could potentially instigate a psychic collapse (going mad).

However, whilst this may seem primitive, historical and anthropological evidence shows that it would be a punishment of last resort and would be handed down by the elders of the tribe – in other words, there would be some form of judicial process in place that sanctioned the banishment.

This is where cancel culture differs profoundly from tribal banishment or ‘being cast out’. It is not a decree from wise elders or some sort of judiciary; it is generally used as an attack against the views, opinions or behaviours of others that some disagree with.

Why does it matter?

Put simply, it matters because there seems to be an ever decreasing array of opinions and voices allowed and cancel culture is an immature way of trying to ‘kill off’ anybody holding views or opinions that may not be comfortable for others to hear.

Feeling offended and causing offence

There is a difference between a person feeling upset or even offended by another’s views and with another trying to purposely hurt a person or group of people. The former is what we may experience when we encounter others and are confronted by a different perspective. The latter is when we encounter sadism.

Sadism is unacceptable and should not be tolerated, however the mark of being an adult is the capacity to tolerate a different perspective and a different mind. Even if we may feel offended.

On mergers and separation

Although separate from its mother, an infant, when born, cannot differentiate between their mother and themselves. In essence they believe that their mother is an extension of them. Of course, in reality, the mother in question is very much as separate entity, at least physically, and thus will eventually fail to meet the needs of her infant. This is extremely frustrating for the infant in question and the mind of the infant concocts an ingenious defence against the pain of separation – a good and a bad mother is created: the infant imagines it is the good mother who meets all their needs and the bad mother who frustrates them. It is a primitive psychological defence called splitting.

Infants split off the bad until through ‘good enough’ parenting they eventually integrate the two mothers and tolerate reality: mother is not part of them and frustrates them as she has a different mind and a different set of needs. However, mostly, she seems to meet their needs so on life goes and importantly, on psychological maturation goes. The child is on the path from mergers to a world where they can be in separate relationships with others and tolerate a different mind.

Why cancel culture is simply splitting by another name

To be unable to contain ones feelings when confronted by a different perspective and thus a different mind shows a lack of psychological maturity. The world is split into ‘good and ‘bad’ like in a child’s fairy tale. Bad must be killed off so good can live happily ever after. This is not how the real world works; it is how cancel culture works.

How does cancel culture relate to psychotherapy?

In essence, psychotherapy is about outgrowing cancel culture. It is about learning to be in a relationship where difference can be tolerated and acknowledged, without this needing to be threatening. For some this means they must learn for the first time to bring their needs ‘into the mix’ – something that can feel really confronting and may bring on fears of rejection and abandonment. For others it may mean the opposite which is to be able to cope with the separateness of their psychotherapist and tolerate this without throwing away ‘all the good’ – without ‘cancelling’ them, if you like.

Being an adult means tolerating the frustrations of the real world and the frustrations of the others who make up the real world. However, if this can be tolerated then real relationships are possible and people can locate substance and meaning thus moving them out of a fear/threat pattern into adult relating patterns.

If you would like to work on your own intolerances and relationships, get in touch with us to discuss whether psychotherapy may be appropriate for you.

 

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 does the difference between counselling and psychotherapy matter?

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Face to Face and Online Therapy Help Available Now

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Online Depression Psychotherapy

Depression is like a whole-body illness that affects not just your mood and thoughts but also your physical self, such as your appetite and sleep patterns, and how you view yourself, your capabilities and your emotions.

The symptoms of this condition vary from person to person, as well as in severity, but they can range from a feeling of helplessness and sadness to anxiety, insomnia, a loss of appetite, irritability and even suicidal thoughts.

How Can Psychotherapy Help?

There are several types of treatment available for depression, but the most effective is talking therapy in the shape of counselling or psychotherapy. Depression can be thought of as a ‘stickiness’ related to unexpressed emotion. A clinician trained in working with depression will listen to you without judgement, in a confidential and safe space to offer you the support you need to work through the problems that are troubling you. They can offer suggestions of strategies to deal with your depression and techniques to help you during the darker times.

Online depression counselling and psychotherapy makes it easier to speak with a trained professional, with sessions held remotely to make them more convenient and accessible. Depression can often make tasks feel insurmountable, so being able to speak to someone from your own home can also make therapy more approachable for many people.

Self-acceptance is fundamental in overcoming the destructive thoughts and beliefs one holds about themselves when they are depressed. Psychotherapy can help you recover trust in yourself and develop a better relationship with yourself through being in a relationship with your therapist.

Seeing a counsellor or psychotherapist work through depression enables you to learn a new approach in expressing your thoughts and feelings in the presence of another. Our clinical team are skilled in helping people deal with negative thoughts and feelings, as well as in providing objective advice and guidance to help you overcome the challenges related to this condition.

If you’re feeling depressed or want to talk to someone about how you’re feeling, get in touch with our team today and talk to someone.

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


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