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Can Chatbot Companions Relieve our Loneliness?

In recent weeks I have seen various articles espousing the virtues of having an ‘AI companion’ or chatbot friend.  Apparently these are particularly popular with the younger demographic. One of these is ‘Replika’ – a prophetic name if there ever was one.

Chatbot ‘friends’ are touted as being helpful in alleviating loneliness through to functioning as some sort of antidote to mild mental health problems. Reading through the ‘testimonial’s’ on Replika’s website the interaction is linguistically framed as a relationship, with reference to the duration the AI avatar and human have ‘been together’ and, based on the published testimonials alone (which are undoubtably biased), some people seem to get something from this encounter.

As a psychotherapist it is not my role dismantle another person’s way of being in the world. This would be arrogant at best and dangerous at worst. However, psychotherapy, at least in the way I practice it, is all about relationship and one of the foundational belies is that what has gone wrong in relationship can only be healed through relationship. This is because human beings, like all mammals, are relational but we are the most relational of all if relational refers to our psychological, emotional and cognitive development being contingent on the consistency of a caregiver. Other mammals, once weaned, can fend for themselves. Humans remain dependent for longer than any other mammal.

We are shaped and defined by the relationship with our primary caregivers and, with the risk of providing an opening for the historical and clichéd attacks on psychoanalysis, we are most shaped by the relationship with our primary carer, who is our mother. 

These early relationships are what help us to understand our emotions and grow a mind. If satisfactory enough, we learn that whilst others can and will disappoint us, we need relationships with others throughout our lives. It is true that some people have more need for contact with others, but contact is needed nonetheless.

In my clinical practice I am always thinking about whom my patient is having a relationship with – even if they are single and isolated, in fact especially so in such cases. As children we internalise important relationships with others, starting with our mothers and then broadening out as we grow older. In the British school of psychoanalysis we refer to such internalised relationships as ‘object relations’. Therefore, when I am thinking about whom someone is having a relationship with, I am referring to their object relations – whom have they internalised and therefore whom are they projecting onto other relationships?

If we have ‘good enough’ parenting, we are likely to feel fairly secure in relationships and are able to operate in a world populated by others. These others have minds that are different to our own and by extension are having different experiences moment to moment. We have internalised a ‘good object’ (good parent) and can tolerate frustrations and difference in others without becoming unduly affected.

An indication of someone who has healthy relational dynamics is someone who is able to tolerate difference in others and hold onto the good of what the relationship offers. One of the (many) frustrations about being a grown up, or rather having a psychologically mature mind, is that we learn that relationships with others are inherently frustrating alongside being rewarding. 

Returning to Replika and systems like it, I can well see why, by applying enough denial to the encounter, it can, on the surface, seem satisfying as despite the illusion, we are not having to content with thew mind of another and thus the difference of another. The system ‘pretends’ to be different but in fact mirrors back to us what we want to see and hear. 

Narcissism by another name

In the myth of Narcissus and Echo, Narcissus is a young man who finds relationships with others confronting. Through happenstance, or what we might call fate, Narcissus finds himself isolated in the woods and discovers the most beautiful ‘Other’ he has ever seen in a still pool of water. This is of course his own reflection and yet Narcissus falls hopelessly in love and even when part of him knows that he is deluding himself, he cannot bear to tear himself away from this ‘perfect Other’. The story of Narcissus is ultimately a tragic one as he wastes his life away yearning for something he cannot have – the perfect relationship.

A character whom is rarely referenced in relation to Narcissus is Echo, the river nymph who loves Narcissus and has been condemned by a Goddess to only be able to repeat the last words anyone says. In other words, she is an echo. She too sacrifices her life waiting for Narcissus to notice her but, of course, as she is ‘different’ he cannot allow himself to notice her other than to drive her away.

I see the rise of these artificial ‘friends’ and the ‘relationships’ that ensue to be modern versions of the myth of Narcissus and Echo. ‘Replika’, or replica, when spelled correctly, quite literally means ‘clone’ or ‘copy’ but one can just as easily translate this to ‘reflection’. Chatbots reflect back to the user what they want to see and hear – from literally dictating how the AI avatar looks, through to receiving the expected responses. The user is turned into Narcissus and an echo is all they receive in return. Of course since Echo in this modern myth is but a machine, ‘she’ will never die.

We all secretly, or not so secretly, hold fantasies of the perfect Other. This fantasy forms the basis of all modern romcoms all the way back through our collective history. It is epitomised in the idea of a ‘soulmate’ and fuels our drive for the perfect partner – something that in itself is driven through technology in the shape of dating apps; we have the illusion of infinite choice but choose nobody as once we do, they become real and thus disappoint.

Growing up psychologically, maturing and individuating, means letting go of fantasies. It means recognising that relationships are essential to us and that in order to have something real and fulfilling, we must tolerate the frustration and sense of difference. 

Rather than difference needing to be threatening, as it increasingly seems to have become in modern society, difference between people is evidence of reality – the very fact that we are encountering a different mind.

Real relationships are about expressing our thoughts and feelings – our experience of the world – and knowing that someone is there to receive them and us, irrespective of whether they ‘mirror’ those exact thoughts and feelings. It is through and via this process that we get a sense of ourselves in the world and with others.

Narcissus was in a clinical sense deluded and descended into psychosis, withering away on the bank of that fateful pool. Chatbot friends encourage this same delusion. I am not suggesting it will lead to psychosis, but reality it is not. There is no relationship to be had and there is no thinking mind alongside you. You are just as alone as Narcissus and cannot grow from a reflection – for that a real relationship is required. 

 

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 are feelings anyway?

Client or patient; patient or client – does it matter?

The psychological impact of the recession

Why do people watch horror movies?

How to minimise Christmas stress if you are hosting

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You’re not watching me, Mummy!

Is it ever too late in life to change? Despite many decades of accomplished professional practice and conspicuous recognition for his achievements, the psychotherapist Irvin Yalom was stunned to discover he still had personal work to do.

In his memoir, Becoming Myself , he recalls attending an academic event where he realises (1) he is to be the target of gentle but sustained mockery from his Stanford University colleagues. That night he has a powerful dream from which he wakes to conclude, ‘I am still looking for validation, but not from my wife, my children, my friends, colleagues, students or patients, but from my mother!’

Although Yalom’s real mother was long dead at the time of his unsettling dream, his self-discovery revealed that her frequent harshly critical judgements of him as a child had become part of his lifelong personality, rising suddenly within him at times of stress, such as when he became the particular focus of others’ attention. In his dream, isolated and scared, he plaintively cries out, ‘How did I do, Momma? How did I do?’.

We might pause to consider how it could possibly be that a richly experienced practitioner, one expert in helping others to understand themselves better, could be so suddenly blindsided by such a self-revelation. On the other hand, what Yalom is disclosing about his experience here might be seen as one of the most fundamental of human realities.

In psychotherapy we speak of the developmental process of ‘introjection’, whereby we unconsciously adopt the thoughts, feelings and behaviours of significant others, particularly the most powerful others in our early lives. In the modality of Transactional Analysis we call this part of us our Parent ‘ego state’. This proposes that during the
development of our ‘self’ we naturally take into our own way of being key aspects of the others we depend on, how they think, feel and behave: we thereby install their potency into our developing personality.

This is a natural survival strategy and serves us well when it provides us with valuable parental impulses that guide us to operate safely in the world and help us to nurture ourselves when under stress. The downside of this strategy is that, depending on the quality of the care we received and how we responded to it, the Parent ego state we carry
forward can contain persecutory impulses, parental fears and smothering tendencies combining in us to create significant inner conflict in our adult life.

Engaging in psychotherapy can be effective in helping us to explore those aspects of ourselves that seem to echo the powerful personalities of our past lives. Careful exploration with a curious and empathic therapist can help us to surface parental messages we may be carrying that contribute to previously unexamined self beliefs. In uncovering these ‘introjects’ we can more clearly see how what we chose to take on from others in the days when we first learnt to be ourselves might be limiting us now in living more freely and spontaneously in the world.

Yalom’s insight, late into his own life, was to see that the way he had incorporated his mother’s harshness into his own process was preventing him from being able to truly recognise and celebrate his own worth.

His particular way of dealing with this was to look for the compassion in himself for ‘that mother that I disliked so thoroughly.’ He writes of achieving a different perspective on her through his later realisation she had a deeply conflictual relationship with her own mother, always remaining desperate for a recognition from her that never came.

Coming to understand the possible motivations behind his mother’s persecutory behaviour, Yalom found a way in which he could simultaneously diminish the power of the fierce inner critic that he had made of her. Like many of his patients, he discovered it was never too late to become himself.

 

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 –

I’m the problem – It’s me!

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

 

Resources –

(1) Yalom, I (2017). Becoming Myself: A Psychiatrist’s Memoir. Piatkus 1

 

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What to expect from couples counselling

Starting couple counselling can feel both daunting and anxiety provoking, especially if it something you have not previously undertaken.  Knowing up-front what to expect can reduce some of the anxiety and enable you to focus on what you actually want to get from your sessions.

Your counsellor or psychotherapist should be suitably qualified

You are taking an emotional risk inviting a third party into your relationship and thus it is imperative that they are well trained in working with couples as well as suitably supervised and have membership of either the BACP (in the case of counsellors) or the UKCP (in the case of psychotherapists).

You have the right to enquire about a clinician’s training and experience and you also have the right to make the decision that you do not wish to work with a particular person if you do not feel comfortable enough in their presence.

Your counsellor is not invested in the outcome of your work

Whilst it may sound counter-intuitive, couple counselling or psychotherapy is not about ensuring that a couple stay together. A good therapist will work with you to establish what it is that you as individuals wish to get from the process and then how best to support you and work with you as a couple.

A successful piece of work from the perspective of a couple counsellor or psychotherapist is where a couple are able to, with support, navigate difficult conversations together and reach an outcome where both parties can consider the other’s feelings and experience.

Where children are involved and a couple make the decision to end their relationship (whether driven by one or both member of the couple), the therapist will be considering the needs of the children throughout the process and working with the couple to ensure that the separation is as kind as possible to all concerned.

Impartiality

You can expect your couple counsellor or psychotherapist to be impartial – indeed, this is essential to the work. Your therapist is not there to take sides and their role is to ‘hold’ the couple as an entity, rather than focus on one individual’s needs at the expense of the others.

Session regularity

If you and your counsellor contract to work together then it is likely that this will be weekly initially, possibly moving to fortnightly over time. The process can take time.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

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How do I know if I am ready to become a parent?

No, I am not addressing this to women caught in the age old story of young women fearing the passing of time and the urgency of finding a partner to start a family, although this is an important fact of life.  I am thinking of what questions we might need to ask ourselves before we even begin our search for the right partner. 

Questions such as:

  • Am I sure that I am psychologically ready to take on the task?
  • Are there aspects of my psychological self that I am unsure of that need attention before I make such a life changing commitment? 
  • Have I discussed this fully with my partner or am I happy to be a single parent?
  • What was my own childhood like and how would I like to be a different parent to my own? 

Understanding what being a parent means

For us to make these choices we need to be conscious of the demands on us as new parents. The need to understand, to discover for ourselves, our childhood experiences and the patterns we have inherited along the way that will support us or hinder us in our role as parents.  Some will be good, others need working through before entering into this new phase of life. 

A lot of what we bring to our parental role will be hidden deep in our unconscious mind only emerging once we are faced with the situation of being a parent. What is unknown before having a baby is now ‘out of the blue’ post birth, confronting us with what can be difficult emotional feelings.  

For example, I may feel jealous of the baby taking my partner away from me by demanding a lot of him or her time.  These may not be the feelings we were prepared for, would it not be better to have spent sometime reflecting on this before entering into parenthood?

Parental choices

We live in an open and free society where we have choices in the matter of whether to be parents or not. And we have the choice of when to have children.  The LGBT community has influenced the narrative towards a child-centered and mindful approach to becoming a parent; the process by its very nature has to be a conscious act on the part of the couple.

Too often parents enter into parenthood without thinking about whether it is what they really want and in failing to consider how equipped they are to parent – especially where they have been failed by their own parents.

I am suggesting that approaching life with an open and inquisitive mind is preferable to allow events to overtake you and this is where psychotherapy and your psychotherapist as an ally can be extremely helpful.

 

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 – 

Our emotions are shaped by our relationships?

Group Analytic Psychotherapy – the slow open group

It is never too late to start therapy

The Unconscious Mind

Groups for Mental Health

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When it comes to parenting, are you a builder or a gardener?

What a job it is to raise a child! So full of difficulty, so many moving parts in the process, so much resourcefulness and energy required. Then, just when the parent takes breath to admire their creation, off goes the young adult – at times with barely a backward glance. The parents are left behind wondering where those years have gone and trying desperately to remember what life was like before children.

But what about the process of raising a child? The very fact that there are piles of self-help books on an entirely natural process – after all, our species have been doing it for millennia – is enough in itself to make us pause and reflect. How has parenting just got so complicated and how can thinking about builders and gardeners make us reflect on our parenting style?

One of the factors that makes parenting so difficult is the way parents see themselves in the role. As society puts increasing value on the care and wellbeing of children, so the pressure is on parents to do a better job in raising them – to be accountable. Of course, much of this will be driven by the interests of the child – but there is also self interest involved. After all, that child will be a part of the parent, representing what the parent represents. Homer Simpson captured this idea of children replicating the values system of their parents in his usual comic fashion when he said that what he really liked about having children is ‘you can make them grow up to hate all the things you hate!’ Homer saw his children as extensions of himself, carrying within him some model of what he thought his grown-up child should look like – and seeing his job as making sure the way they see the world corresponds with the way he sees it. We might class his parenting style as project based – like a builder, following a set of plans to some fixed outcome.

Others might be comfortable in their role as parent without such a plan, perhaps allowing the child more freedom to find their own way. Rather than building, they might see their job as nurturing and hence we might class their parenting style as gardening. Whilst most of us will fall somewhere on a continuum between the extremes of these two approaches, thinking about them offers us the chance to re-assess what is going on for us, and for our children, in the process.

Builders

Parents who think in ‘building’ terms, might also be seen as project-focussed parents. They will often carry in their heads some template or plan as to what their child is to become. Self-help guides might be more like manuals in their minds. They will busy themselves with gathering the resources to realise that project. Ballet lessons, music lessons, sports sessions – all might be part of that plan. Of course, education will be crucial: the right school, the right approach and right attitude to progress. The aim will be to achieve the right outcome.

It can be extremely frustrating for these project-focussed parents when things do not go according to the plan. It is not unusual for there to be an amount of conflict, either with the child or with the support around them. Talk to any school head and they will have countless stories of this sort of difficulty.

The intention is a good one: to give the child the very best chance to achieve a particular – often aspirational – goal. The difficulty is that the model of the child-as-adult that is carried in the head of the parent may not be the one that the child carries for themself. It is a situation that can lead to anxiety in both camps. For the parents, they have to come to terms with the reality that they may not be able to determine outcome, and they may have to deal with disappointment and a sense of loss, as their children follow a path that was never in their (the parents’) plan. For the child, whom at some stage at least will have wanted to please their parents, they, too, will have to deal with difficult emotions that may involve a sense of having failed in some way. Not surprisingly, low mood and anxiety can be the result.

Gardeners

It would be unfair to say that gardener-parents have no plans for their children, but it is not quite as prescribed as it is in the case of builder-parents. Rather than a fixed plan and a fixed route to a clear end goal, gardeners look to provide the right context or culture for the child to develop – just as a literal gardener would provide the right soil for their plants. The parent sees their role as nurturer – providing the care that is required for their offspring to grow. There may still be ballet lessons, music lessons and extra sports classes, but these are not so much to build towards a pre-conceived plan – more to encourage and find the ‘soil’ that is going to best suit the child, whom, the parents hope, will learn to put down their own roots and gradually begin to nourish themselves.

The neuroscience of nurture and independence

If we consider our species, we will understand the need for parents to want the best for their child – if they did not, there would be many more neglected children and infant mortality would put at risk the propagation of the species. Likewise, it makes considerable evolutionary sense for children to want to please their parents – the people who are going to nourish them through to the point where they can provide for themselves and, once again, continue to propagate the species. These two neurobiological drives can often work in harmony for the infant years of the child, but the onset of adolescence is likely to cause some disruption. The child now is looking to become independent, whereas the parents might still be wanting (or needing) to follow the plan.

Difficult Feelings

Wherever we sit on this spectrum of parental styles, we are unlikely to escape having to deal with difficult moments in the raising of our children. What can sometimes help us is to recognise and separate what belongs to us and what belongs to the child. When we feel disappointed because our child does not seem to be matching the plans for them that we have in our own mind as parents, then the difficult feelings that arise within us will constitute a real challenge. Our own fantasies – ideas we carry about what might and might not be – can sometimes leave us bereft and never more so than in dealings with our children. We need to keep those feelings with us and avoid any temptation to visit them on our children. It is hardly their fault that they do not always carry the same fantasies as we do. We want our children to be independent, but sometimes that can be a very difficult place to get to unless we let go, not just of the child, but of all the plans we carry for them. Then, despite the very difficult feelings of loss, our children’s leaving us with barely a backward glance might just be a mark of a job well done.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

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

 

Further reading by Kevin Collins –

I never thought my son would watch pornography

Care for a dance?

Name that tune

Why is it hard to make decisions?

Communication, communication, communication

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Parental Alienation and the impact on children

Separation or divorce are painful, difficult and time consuming processes and more so where children are involved. Few couples manage to amicably separate and sadly, this applies to couples who have a child or children together too.

Although it may seem obvious, my experience is that couples who are separating and have children often fail to recognise that they in fact will always have a relationship with each other as parents of the same children. Whether this is openly and maturely acknowledged as in the case of couples who co-parent, or not, as in the extreme case of parental alienation, there remains, nonetheless a relationship.

What is Parental Alienation?

Broadly, parental alienation occurs when a child becomes hostile, fearful and generally unwilling to engage with one parent as a result of the either the psychological manipulation of one parent or, more often, the toxic relationship between both parents. It is extremely damaging to children and can lead to mental health issues including self harm and suicidal ideation.

Parental alienation is on a scale from a parent making negative remarks about the other parent, or one parent ‘forgetting’ their responsibilities on relation to their child (an agreement to pick them up etc.) through to psychological manipulation and control.

The child as centre stage

Whilst the process of separating can be extremely painful and difficult, it is critical that parents find a way to establish a working relationship in co-parenting their child. This starts from the point of agreeing together the narrative they are going to tell their child about the separation through to long-term parenting commitments.

The role of psychotherapy

Experienced couple’s psychotherapists are able to work with a couple to move beyond their
grievances and establish a framework within which they will work together to fulfil the same job: raise their child and create emotional stability for them.

The impact of divorce on children

Society and parents tend to enormously underestimate the impact that separation and divorce can have on a child. For children, their entire stability is predicated on the stability of the parental unit and when this gets rocked or shaken to its foundations, the impact on a child can be enormous.

Studies have been undertaken measuring the impact of divorce on children and in many cases the psychological impact can be greater than losing a parent through death. The reason is because, generally, when a child is bereaved, the other parent (along with the broader family and society) enables the child to grieve a very tangible loss. With divorce, and especially where the split is contentious, children often feel they need to ‘pick a side’ and are unable to grieve the loss of the parental unit.

Top tips to focus on when separating and a child or children are involved –

  • Separate out grievances towards each other about the end of the relationship and your job as parents;
  • Agree a narrative that is age appropriate to tell your child about what is happening;
  • Reassure your child that you continue to both be there for them;
  • Avoid displays of conflict in front of your child;
  • Recognise that you NEED to put your child first and that all children want two parents and would prefer their parents to stay together;
  • Allow and facilitate the grieving process for your child.

 

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

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?

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

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Using empathy to re-build connection with children and young people

This last year of global pandemic has been a time of massive disruption to almost everyone. With it has come disconnection in various forms and the challenge of reconnecting at points when restrictions have lifted. Children and young people have faced their own particular challenges with school closures preventing contact with peers and friends, in addition to the stress of uncertainty about exams and other limitations related to online learning. At a time when many teens would normally be exploring social freedoms to the full, those who have kept to the rules have made do with scraps of interaction and often relied heavily on digital forums. Sadly, a considerable number have struggled to hold onto what fragile self-esteem and social confidence they formally knew. Even some of those used to thriving have found their resilience quashed and required additional support to pull through.

We are still in the early days of reconnecting with the world and all the structures of human engagement that we once took for granted and, with time, we will no doubt start to see the fuller picture of how people’s lives have been impacted by COVID and all that has come in its wake. For some, reconnecting is proving to be a battle. There are those for whom the protection of a smaller, quieter world felt safer and some are simply feeling rusty about conversing and interfacing with real live people.

Hardships faced by those whose lives COVID has touched in very tangible ways, have brought forth numerous stories of lived empathy in response to people encountering terrible pain and the loss of health and loved ones, empathy perhaps evoked by the realisation that these losses could become reality for any of us. Likewise, there has been widespread, heartfelt support for the thousands of frontline workers who have sacrificed their own safety for the wellbeing of others and for those who have lost jobs, income and businesses. Many have felt for children deprived of opportunities to learn and play as they usually would and this continues to be a time when the younger generation needs us to recognise and engage with what they are going through.

Children and young people with social and emotional difficulties always require our empathy as part of recovery and perhaps even more so in these times. Empathy is what helps them feel understood, paving the way for self-acceptance, which in turn makes it more possible to seek support from others. Daniel A. Hughes (pioneer of Dyadic Developmental Psychotherapy) places Empathy at the core of the PACE approach, along with Acceptance and Curiosity (see my other blogs on these two subjects). In his book, co-written with John Baylin (The Neurobiology of Attachment-Focused Therapy: Enhancing Connection and Trust) he talks about embracing “the child’s defensiveness, putting connection before correction” and offering “radical acceptance” of the child’s mistrust.

In this context, Hughes and Baylin were referring to the particular struggles faced by traumatised children with attachment difficulties but we could apply the same principle to supporting children and young people who are emotionally and socially adjusting to each “new normal” they are faced with, whether or not they have experienced additional childhood trauma pre-COVID.

Hughes and Baylin recognise that this is no easy task, likening it to “hugging a porcupine”. Social and emotional defences, by their nature, are often difficult to permeate and can repel. A child or young person who repeatedly gives off a vibe of wanting to be left alone can leave the person reaching out feeling confused, rejected, useless and resentful and can lead, understandably, to withdrawal. This makes it even harder for the child or young person to reconnect, risking further disconnection, isolation and all the ill-effects that these states can bring.

If we can catch ourselves withdrawing and find empathy within ourselves for how the child or young person may be feeling in that very moment when they are unable to allow us in, we provide a bridge back into connection. This is so powerful as it communicates that we have not given up and that we see the child or young person as worth sticking with – we still see that part of them which has the potential to be in relationship with others and the world.
Brene Brown, in a Youtube clip based on part of her Tedtalk on Empathy, beautifully describes how “empathy fuels connection”. She refers to Teresa Wiseman’s 4 qualities of empathy: recognising another person’s perspective is their truth, staying out of judgement, recognising emotion in others and then communicating this. This is about “feeling with people” she says. Being with others is so much more effective than trying to fix the situation by saying the right thing: “Rarely can a response make something better, what makes something better is connection.”

In taking an empathic stance, we make an active choice to suspend our own anxiety and impatience about the pace at which a child or young person is re-engaging with life post-lockdown. We accept where things are at and we take time to understand as best we can. We then make what Brene Brown calls a “vulnerable choice”, that is choosing to connect with something in ourselves which knows the feeling we have encountered in another. This vulnerable choice is a risk well worth taking if we are serious about wanting to mitigate against the secondary effects of COVID on the mental health and wellbeing of children and young people today.

 

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. Online therapy is available.

 

References – 

See more from Brene Brown at: https://www.youtube.com/watch?v=jz1g1SpD9Zo

Read more from Baylin and Hughes.

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The Unconscious Mind

How do we bring to mind what is unconscious? Is it important to make this journey? These two questions are central to the therapeutic process of psychological therapy. When we are young we depend on our primary carer’s usually our parents, to hold and contain our emotional needs.

In childhood, none of us have a mature mind to guide us we rely on adults, siblings or our extended social network to help us grow into mature people. Siblings play an important role in our social development our place in the pecking order can determine how we deal later on with competition, rivalry our reaction to authority, etc. This effect can impact on us throughout our lives. Bringing to the conscious mind these experiences can help with regulation of our emotional responses as adults.

Our unconscious can exercise its influence on us leading to destructive patterns in our relationships with family, friends and work colleagues. This is often the primary motivation for people to seek out psychotherapy.

When we are grown up the experiences of childhood can exhort their influence on us leaving us bewildered at our difficulty in managing our emotional responses in everyday situations. It is as if a shadow is caste over us, we are driven by something beyond our control to act out.

Feelings, emotions and experiences from childhood or the accumulation of a long period of small daily undermining by family dynamics or bullying at school can lead to trauma. When we are traumatised, either by an event or the cumulative effect of oppression, our only escape is to detach. This may result in retreating into a fantasy world or addiction, compulsive behaviour or other psychological defenses in order to survive.

The work with the therapist or group on the unconscious allows us to revisit this hidden material. To experience in a safe environment the painful and disturbing events that triggered a defensive psychological response.

This blog to asks more questions than gives you answers. Its aim is to offer you whatever your age, ethnicity or orientation to consider looking at your own journey with greater understanding. You can follow-up this blog by watching a utube webinar “Three Ways of Connecting With Our Unconscious Mind” by Kirsten Heynisch’s, Clinical Psychologist’s description of accessing the unconscious and working with it. This can inform your work with the process of change in Individual or Group Psychoanalytic Psychotherapy.

 

To enquire about group sessions with Thea Beach, 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

Groups for Mental Health

Group Psychotherapy in a post ‘Pandemic World’

Termination and endings in Psychotherapy

What is Social Unconsciousness?

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Intimacy: pillars and obstacles

Our capacity for intimacy as adults is widely understood to be shaped by our early relational experiences. Theorists from diverse orientations emphasise the link between early attachment patterns and subsequent adult love relationships. When our formative experience is one of loving reciprocity with our caregivers, our abilities to give and receive love freely and fully later in life are enhanced. Children who experience themselves as loved and valued in the context of a harmonious parent/child dyad are more likely to develop a secure sense of self and will have a more robust relationship to (their own and others) autonomy and dependence.

We all struggle to find a balance between a need to be a part of something greater than ourselves and a need to be apart from – to be separate. Some of us will navigate the continuum between proximity and distance with fluidity and ease. Others will experience greater comfort at one end of the continuum or another. For all of us our capacity to experience intimacy will reflect in some measure our abilities to risk closeness and separateness. 

Separateness

The growing infant internalises their primary care giver(s) through the process of separation-individuation. A parent’s recognition and validation of the baby’s unique self will initially be expressed in the child’s specific preferences for being held, soothed and fed. The feedback loop between child and caregiver as the child seeks to explore the world beyond (m)other is critical. When attuned, the child will learn that separation is both pleasurable and manageable  and that it will not entail the loss of the love object. The process of separation-individuation is repeated throughout the life cycle, in adolescence, in marriage and in parenthood. At each stage there is an  opportunity to rework or repeat old patterns and to adopt either old or new solutions. 

Mutuality

To give, to receive and to share in the spirit of joint reciprocal endeavour is the cornerstone of mutuality, another pillar of successful intimacy. Once again it is understood that the capacity for mutuality is rooted in our early experiences with a “good enough” caregiver. The infant develops trust and confidence through interactive engagement with an attentive other. Through this exchange expectations of safety, effectiveness and pleasure are cultivated or impaired. 

Successful intimacy requires the capacity to regress and be dependent, and in an adult partnership, for each individual to be able to tolerate these states in both themselves and the other. This requires a secure sense of individuation on both sides so that closeness is not experienced as an engulfing fusion and a threat to a cohesive sense of self, and separation is not experienced as a catastrophic rejection or abandonment. 

Empathy

Feeling what another person feels whilst maintaining psychological separateness is the essence of empathy. It involves the capacity to immerse oneself in the emotional life of another, temporarily leaving one’s own world without experiencing a loss of self. As such it is fraught with difficulty and risk for the individual who is not securely individuated. Empathy is a two way process in which each partner must have an investment in both understanding and being understood. Early developmental deficits or excesses will inevitably interfere with our capacity for empathy and mature intimacy in our adult pairings.

Viable Intimacy

Intimacy can evoke fear ( conscious or unconscious) in any relationship. Fear of loss or merger, fear of shame, fear of attack or of one’s own aggressive impulse, fear of disappointment and fear of needing. The path to intimacy is complicated and fraught with risk, never more so when we bring our unattended psychic wounds to our adult partnerships in hope of healing. For intimacy to be viable  it will probably help to have an idea of our appetites for closeness and distance. Armed with this self understanding and willing to understand the appetites of our partners we will be better positioned to navigate and negotiate this most foundational relational terrain.

 

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

 

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

 

Further reading by Gerry Gilmartin – 

Love and Family

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

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Executive Function Skills (part 1) – What They Are And Why Some Children Struggle With Them.

Executive functions are the cognitive skills we use to control and regulate our thoughts, emotions and actions to achieve goals. These three main areas of executive function work together:

  • Self-control/ inhibition – the ability to resist doing something distracting/ tempting in order to do what’s needed to complete a given task, helping us to pay attention, act less impulsively and stay focused.
  • Working memory – the ability to hold information in mind and use it to make connections between ideas, make mental calculations and prioritize action.
  • Cognitive flexibility – the ability to think creatively, switch gears and be flexible to changing requests and situations, allowing us to use imagination and creativity to solve problems.

For example, all three areas are needed in social pretend play:

  • Child needs to hold their own role and those of others in mind (working memory)
  • Child needs to inhibit acting out of character (employ self-control), and
  • Child needs to flexibly adjust to twists and turns in the evolving plot (cognitive flexibility)

The joint forces of our executive function skills can be thought about as . . .

  • the conductor of an orchestra, organising multiple instruments to make one unified sound or
  • an air-traffic controller managing safe take-off and landing for hundreds of air-craft

Executive functions are controlled by the frontal lobes of the brain which are connected with and control the activities in many other regions of the brain.

Hot and Cool Executive Functions
Hot executive functions are the self-management skills we use in the heat of the moment when emotions run high – they require concerted conscious effort and help us give up short term gain for the sake of a more important goal. Examples include: resisting temptation; focusing on a boring task; breaking an old habit; and biting our lip when angry. Cool executive functions are the skills we use when emotions aren’t really a factor. Examples include: remembering a list of numbers and repeating them back in reverse order and following a simple recipe.

Executive function skills are a vital part of learning. They help children to be in the right place at the right time with the right equipment, listen to the teacher, wait for a turn and not call out. They are also pivotal in managing frustration, getting started on a task, staying focused, accepting constructive criticism and asking for appropriate help. They enable children to notice and correct mistakes, prioritise, persevere and complete challenging activities, resist the urge to retaliate and feel more confident about managing in school.

Children with under-developed executive function skills may act without thinking, overreact to small problems, be upset by changes in plans, forget to hand in homework, delay starting effortful tasks, switch between tasks without finishing any, lose or misplace things, struggle to meet deadlines and set goals, and lack insight into their behaviour.

Factors which can make it harder to access our executive function include tiredness and sleep deprivation, dyslexia and more complex learning difficulties, neuro-developmental conditions like Autism and ADHD, environments which overwhelm our senses and create stress, one-off traumatic incidents and complex trauma as a result of Adverse Childhood Experiences.

Given their significance, difficulties with Executive Function can contribute to social, emotional and mental health difficulties if they are unsupported and children who are already vulnerable for any of the above reasons may experience a compounding of the challenges they face. It is therefore essential that we take time to understand what these issues look like for each individual and adjust parenting, schooling and community interventions accordingly.

Look out for my forthcoming blog –  Executive Function Skills (Part 2) for ideas on how to support children with these difficulties.

 

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. Online therapy is available.

 

Additional resources –

  • UNDERSTOOD website: https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/what-is-executive-function
  • The book  Why Can’t I Do That? A Book About Switches by Fi and Gail Newood is designed to help children understand what Executive Function skills are and how they link to everyday challenges.

Face to Face and Online Therapy Help Available Now

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Love and family

The family is our first social group. It is the crucible in which our passions are born and our capacities to love and to live are shaped – and misshaped. The family imbues its members with its own specific culture, habits and attitudes.

As an organism, it too is shaped by the cultural moment and the social environment, the hopes, fears and attitudes of the day. It is the bedrock of our most durable and intense emotions and the fertile soil of our satisfactions and discontents. The family reconfigures with each new life that enters and exits. Constantly changing, constantly staying the same it is both dynamic and flexible, coded and predictable. We are all indelibly touched, one way or another by its authority. We learn to love in the context of ‘family’, each in our own idiosyncratic way. Every family has its own cast of characters ((step)parents, grandparents, (step) siblings, aunts, uncles etc). All players in a unique drama. Family is a stage where universal themes are navigated, power, sex and money, hierarchy and democracy, passion and ambivalence, in all their dark, tumultuous, devastating and innocuous glory.

Universal themes

From Greek myth to Shakespearean tragedy, the depths and breadth of family relations provide a turbulent, brooding backdrop to moral, ethical and philosophical considerations of a universal scale. So often in these epic tales, we are reminded what an unruly emotion love is, indeed how uncomfortably close it resides to its shadowy counterpoint hate. Disowning his most beloved youngest daughter Cordelia, King Lear in a fit of vanity and rage is consumed by vengeful hate, abdicating love and reason in its wake he casts her out. Her failure to satisfy his insatiable need for flattery and primacy, to go against her own nature, disrupts their bond, unleashes chaos and eventual tragedy. This is an epic tale of family conflicts, of power, love and greed. Most family dramas do not play out on such a grand scale, but remain hidden in the shadows of secrecy, shame and trauma, creating a legacy that can trickle (or cascade) down through generations to come.

Changing Families

Whilst the major human themes endure in families across generations, the architecture of family life and living is continually changing with the socio-political and economic tides. Every generation spawns its own raft of experts on the family and its constituent members, from the institutions of religion, state, medical and social science and philosophy. The current moment, in particular, is one in which the couple is the central organising pillar upon which the success of the family depends. Bred in ever smaller numbers, the modern child is also a major focus of scrutiny and opinion. As the birth rate has decreased so children’s value has increased. Parents invest heavily in their offspring financially, emotionally, educationally etc. We dedicate ourselves to their health and happiness, often discounting our own in the process. As an antidote to our high tech fast-moving, demanding lives we create a utopia of childhood and perhaps (without knowing) locate many of our own unmet hopes and passions in our beloved and precious innocents.

Love them or hate them (and indeed it is within our families that we learn about both) idealise or reject them it is within the context of the family that we learn about the social world and our place in it. It is in this original grouping that we have our first experience of grief and loss, it is where we learn to trust (or not) and to express (or inhibit) our desires. Family life is fraught with misunderstandings and pain and is the vessel in which our virtues are forged, kindness, loyalty generosity and fortitude. Interestingly, even when we grow up and leave them we will most often seek out another with whom we wish to form a family. At this very particular COVID moment, we are all forced to reconsider what family means to us.

 

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

 

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

 

Further reading by Gerry Gilmartin

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Helping Children With Loss Through Story Books

Children, like all of us, encounter loss in their lives, temporary and permanent. They may lose a treasured possession, a loved one who dies, a parent who leaves or is imprisoned, a friend who moves away, or a valued teacher in the transition between year groups or schools. Some are unlucky enough to lose their health or abilities they once took for granted. Others lose their home or their country and there are those who lose their innocence through exploitation and with it perhaps their sense of self and any respect and trust they had for the world.

With loss comes associated feelings, held in the conscious or unconscious mind or both. Support in processing losses may or may not be available and the degree to which children show lasting difficulties will vary accordingly. Stories are just one tool which can help children connect with and work through internal emotional conflicts associated with experience of loss.

Like art, stories help us to take new perspectives and understand ourselves, others and the world differently. They can offer comfort or challenge, enliven or unsettle us. By engaging the imagination, not only can stories transport us to another time and place but they can also open up a rich emotional landscape which might otherwise be off limits to the defended conscious mind.

Most children speak and understand the language of play and they live stories, in their everyday playful interactions with food, sounds, textures, objects, animals and people. And, of course most are introduced to and love books, from a young age. Well-told children’s stories tap into a child’s thirst for make-believe, for adventure and for powerful emotive themes such as love and hate, despair and hope, failure and redemption.

For this blog, I have selected 6 story picture books which I will briefly summarise:

Amos And Boris by William Steig (1971)
This beautifully written tale of enduring friendship focuses on the unlikely alliance of a mouse (Amos) and a whale (Boris), who become acquainted when Amos falls off the boat he has made (which is sadly lost forever) and Boris rescues him. The two travel together, learn about their differences, survive a falling-out, share ideas and develop “a deep admiration for one another”, becoming “the closest possible friends”. Coming one from land, one from sea, the time comes for them to separate: “. . . we can’t be together . . . I’ll never forget you though.” Years later, Boris is beached by a hurricane and Amos, aided by elephants, is then able to save his life. The wrench of what may be
their final parting is sad and tender yet secure in the knowledge that each will continue to be remembered in the other’s heart and mind.

Badgers Parting Gifts by Susan Varley (1984)
This story opens with the inevitability of the ageing Badger’s death and his awareness of the loss his friends will feel after he’s gone. When he dies, Badger is sorely missed by all the animals but especially Mole, who feels “lost, alone and desperately unhappy.” The friends’ sadness is intensified by Badger’s absence, as it was he who had always been there for them in times of trouble. And in missing him, they start to come together and share memories. This, in turn, highlights to them the gifts which Badger has left behind, skills he taught each of them when he was alive which they can now remember him by and use to support each other. Gradually, sadness gives way to a comforting and emboldening remembrance and gratitude.

The Red Tree by Shaun Tan (2001)
This story tells of a girl who loses her sense of purpose and place in the world, and with it any sense of hope. Through unique, extraordinary, incredibly crafted images, and condensed, graphic text, we travel into the girl’s mind, inhabited by surreal, exaggerated and often frightening forms and scenes which overwhelm her. She is not seen, heard or understood and oscillates between these worlds of chaos and a relentless nothingness. A happy, colourful life is out of reach and all seems doomed and irresolvable. She has lost everything and become lost herself. And then, suddenly, life returns (thankfully!) and with it hope and joy. This speaks to the immense value there is in sitting alongside and fully taking in the realities of another person’s bleak experience. As the reader, we witness the
girl’s pain, perhaps helping her to mourn her losses and then re-discover herself.

The Day The Sea Went Out And Never Came Back by Margot Sunderland (2006)
Eric the sand dragon lives on a beach and adores the beautiful sea beyond, which in its daily rhythm comes and goes predictably, with the tides. One day the sea goes out and does not return. This is devastating for Eric who waits and longs for the sea to come back and is then overwhelmed with the pain of his loss. He becomes trapped and isolated inside himself. Eventually, attracted to the vulnerability of a dying wild flower, which he then saves, Eric is drawn back into life himself. He saves more flowers and a rock pool garden is created. Eric starts to feel safe enough to fully mourn his loss and in so doing discovers that remembering his beloved sea builds a treasure store in his mind which
he can keep forever.

The Lonely Tree by Nicholas Halliday (2006)
Set in the New Forest, this original book uses the seasons to chart the forest life-cycle through the friendship between an old, story-telling oak tree and a young, curious evergreen. As the oaks sleep for the winter, the evergreen becomes acutely lonely and, when spring finally comes, all hope is cruelly crushed when his oak-tree friend fails to wake up, his long life ended. The evergreen cannot comprehend what has happened but holds onto his cherished memories, through the sadness. Hope returns as a fallen acorn germinates and a new oak is born, destined to form a new friendship with the evergreen. Stories of the forest are retold and, as they are, the trees’ roots go “deeper and
deeper into the ground”, reminding us that with companionship we can endure and process the pain of loss and live a more enriched life.

The Heart And The Bottle by Oliver Jeffries (2010)
Beautiful illustrations alongside a concise narrative makes for great dramatic effect, telling the story of a delightfully curious and creative little girl who experiences the apparently abrupt and unexplained loss of an adored grandparent, with whom she had discovered and shared many wonders. She puts her heart into a bottle for safe keeping but as she grows up becomes limited and encumbered by its seclusion, which she finds she is unable to reverse. It is only through connecting with her own daughter’s zest for life that she allows her heart to be freed and re-discovers treasured memories of her beloved grandparent who she can now enjoy remembering. Her inner-child, in league with her actual child become the unwitting healers.

These books, like many others, model that feelings are okay, they are a normal response to loss and are to be expected. This is an important message to our children, particularly given that many of us are still filtering cultural and familial influences in our own lives which would have us discount feelings in order not to rock the boat or blow other people’s stiff-upper-lip cover. Children are expert at tuning into our sensitive pressure points and while they may push our anger buttons quite readily, they may avoid talking about sadness if they sense we may be uncomfortable and find it hard to hear and hold them. In turn, to avoid burdening others or being alone with pain, their own natural defences against connecting with sadness can become strengthened and entrenched.

A story book can serve as a helpful third party, a neutral but enriching messenger, able to venture into forbidden territory within the safety of metaphor. Connection with characters breeds understanding and empathy for one’s own pain. We can read the story exactly as it is or go off piste, filling in blanks with a child, co-creating a personalised narrative, re-writing the ending and reflecting all the while. Repetition can work wonders, enabling a child to use pictures as prompts and retell the story from memory. Each retelling can add meaning and a layer of digestion for the child, outside of his/her awareness, whether or not any overt life parallels are drawn.

All 5 of these books also convey a sense of hope, always integrated into the experience of loss. Again, this is a powerful lesson in a world which all too often splits artificially the good from the bad. We might not long for loss or wish it upon anyone else, but when it comes we, alongside our children, can do what we can to to feel it, to know it, to share it and to find new life somewhere within it.

 

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. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Supporting children and young people with stress and anxiety

Stress is caused by an existing stress-causing factor or stressor. Stress can be ‘routine’, related to everyday activities or ‘sudden’, brought about by a change or transition, or ‘traumatic’, in relation to an overwhelming event.

During stressful events our adrenal glands release adrenaline, a hormone which activates the sympathetic nervous system, our body’s defence mechanism which causes our heart to pound, blood pressure to rise, muscles to tense, and the pupils of our eyes to dilate. Historically, this prepared us to respond to attackers with one of three responses – fight, flight or freeze.

This stress response can still be helpful to us today. It provides a burst of energy which can help us to stay safe when suddenly facing a speeding car, for example. Or, it might help us meet deadlines and goals through increased efficiency and focus. Our stress response ceases to be helpful if it is activated too easily or at a level which is too intense or if it goes on for too long, preventing us from returning to a relaxed state.

Anxiety is stress that continues after that stressor is gone. When we are anxious, fear can take over whenever there is worry and apprehension. This can lead to irritability, low mood, social withdrawal, lack of motivation, poor concentration and nervousness, as well as physical symptoms like chest pains, disruption to eating routines, dizziness, shortness of breath, fatigue and panic attacks.

There are multiple triggers for stress and anxiety in young people today. Those most commonly reported include school, exams and future prospects; social difficulties including peer pressure, social media issues and bullying; family concerns such as conflict or financial problems; and major world events. For some, these factors can become overwhelming.

A good place to start when helping children and young people with stress and anxiety is to be aware of what we are thinking, feeling and doing ourselves. This will help us to tune in to kids and look after ourselves so that we can stay calm, alert and responsive. There are many routes to self-care – the 5 Ways to Wellbeing is one of them – How are you doing right now? What steps might help you to build your own self awareness and take care of your own support needs?

Secondly, psychotherapeutic work is naturally based on a belief that by talking and thinking about difficulties we create space for creative exploration, digestion/ processing, increased understanding and new perspectives/ opportunities. It can be helpful to take a moment to consider where you stand yourself with regards to talking about feelings.

And do you think your child/ teenager believes it is okay to have feelings? Whether the answer is yes or no, how might he/she have picked up this message? What do we think is likely to help give a message that it is okay to feel feelings and to talk about them?

We can begin by making time to notice how young people are doing, listen to their concerns without judgement and then take them seriously. In ‘How To Talk So Teens Will Listen’ and ‘Listen So Teens Will Talk’, Faber and Mazlish (2006) advocate: “Identifying thoughts and feelings . . . Acknowledging feelings with a word or sound . . . Giving in fantasy what you can’t give in reality . . . and . . . Accepting feelings as you redirect behaviour.” (p31).

To make the above possible, it helps if we can stay calm and avoid becoming either frustrated or overwhelmed with our own worries about the child’s worry. We also want to steer clear of trying to fix things too quickly as this can seem like we’re not really interested in a child’s felt experience.

Being listened to can start to give shape to what might often feel like a formless mass of uncontrolled emotion. Feeling understood can, in itself, help to bring anxiety under control. It then becomes more possible to actively build self-awareness through tools like a stress-graph or diary, which maps stress intensity across a day, week or year. Other visual systems using scales and colours can be helpful too. A 0-5 scale, for example, can enable children to identify the difference between a slight glitch, a small/ medium/ large problem, and a situation which feels quite huge or even like an emergency. Other systems like the ‘Zones of Regulation’ or the similar ‘Just Right State Program’ (widely used in Brighton and Hove schools) help young people to notice their emotional/arousal state at any given time and to learn what helps them either to up-regulate or down-regulate in those moments in order that they can relate and learn effectively.

Specific calming approaches can be taught such as deep belly-breathing or simple, unobtrusive techniques for the classroom like hand-breathing or square breathing. Positive self-statements can also help – in place of an ‘all or nothing’ catastrophic approach (“I’ve messed up this essay, I may as well give up”) the young person might say to herself, “I’ve done it before, I can do it again” or “this feeling will pass”. Others may benefit from being helped to express thoughts and feelings through writing or drawing. Others might need to move around, take sensory breaks, do Yoga, make a mess with clay, cook a meal together, make a special den, imagine a calm place, complete a puzzle, make a list or listen to a favourite story or a book about anxiety, like ‘The Huge Bag of Worries’ by Virginia Ironside. Lots of helpful ideas for activities can be found in Karen Triesman’s ‘Treasure Deck of Grounding, Soothing, Coping and Regulating cards’.

Young people who are feeling sufficiently safe and regulated might also be able to consider the bigger picture of how their thoughts, feelings, body sensations and behaviour all inter-relate and where they might be able to make one small change which could then have a beneficial knock-on effect. Read more on these approaches in books like ‘Starving the Anxiety Gremlin’ (Kate Collins-Donnelly) and ‘Overcoming your child’s fears and worries’ (Cathy Cresswell).

For young people who are specifically stressed about exams, the following links may be helpful:

– The #NoStressSuccess series of video clips on Youtube about a wide range of opportunities for education and training post-16, made by Brighton Met College students.
– The ASAP Science Youtube clips: 9 Best Scientific Study Tips and 7 Tips to Beat Exam Anxiety.

As supporters of children and young people, one challenge we have is to be regulated in the way that we offer help and ideas. If we overload with strategies and things to ‘do’ to make the stress go away, we can be in danger of increasing pressure rather than decreasing it. If we can remember to be accepting of our children and if we model self-acceptance ourselves, we might go a long way towards helping them effectively manage stress in their lives. Dan Millman has said: “Resistance creates suffering. Stress happens when your mind resists what is. The only problem in your life is your mind’s resistance to life as it unfolds.” And in a similar vein, the following Chinese Proverb tells
us that: “Tension is who you think you should be. Relaxation is who you are.”

 

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. Online therapy is available.

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The Benefits of Yoga Breathing for Children with a History of Trauma

When children feel helpless, angry, or scared for long periods of time, it can be remembered in their bodies. This is particularly so in the case of trauma, whereby specific (trauma-implicated) body parts may start to feel somewhat disconnected to the rest of the body (e.g. headaches, neck pain, stomach aches, back spasms, etc.). Body tension is also common in children who were very young at the time of their trauma and, therefore, may have no conscious or verbal memory of it. This phenomenon can be hard for parents (and professionals!) to make sense of and can often lead to them seeking assessment and treatment for many things before considering the long-lasting impact of historical stress or trauma on child. An important task of a psychologist, therefore, is to help chronically stressed or traumatized children to tolerate physical sensations without being afraid of then. This includes teaching them how to regulate their own internal arousal.

The brain-body system that we target in this kind of work is known as the Autonomic Nervous System (ANS) – also known as our ‘survival system’. At its most basic level, the ANS is comprised of two discrete branches called the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS). The SNS is associated with the release of chemicals such as adrenaline, which spur the brain and body into action. The PNS on the other hand, is associated with the release of chemicals such as acetylcholine, which enables us to be calm and to regulate important bodily systems such as our digestion and sleep. In a healthy child, the SNS and PNS work closely together to enable a child to have an optimum awareness of both themselves and their environment, so that they can respond to each appropriately. For some children, however, historical stress and trauma can cause the SNS too become too powerful, leaving the child vulnerable to quickly dysregulating in response to misunderstood internal sensations or external stressors.

One biological marker that has been identified as a strong indicator of how well the ANS is working is ‘heart rate variability’ (HRV). In healthy children, the very act of breathing leads to steady, rhythmical fluctuations in their heart rate, which in turn is a measure of their wellbeing. This is because inhalation activates the SNS (and therefore raises their heart rate), whereas exhalation activates the PNS (and therefore slows heart rate down). Good HRV – and therefore, good balance between the SNS and PNS, enables children to execute a reasonable degree of self-regulation, including being able to calmly appraise upsetting situations without dysregulating, such as disappointment or peer rejection. Poor modulation between the two systems, however, negatively affects how their body and brain responds to stress. Research indicates that people with posttraumatic stress disorder (PTSD) often have poor HRV (Hopper, et al., 2006).

One way to improve HRV, has been shown to be through focused breathing techniques. Indeed, simply changing the way one breathes, has been associated with a wide range of positive physical and psychological outcomes, including marked improvement in mood disorders, asthma, and back pain (e.g. Pilkington, et al., 2005; Sherman, et al., 2005; Streeter, et al., 2010). Focused breathing techniques for children can be found in many forms, but one particularly successful form has been shown to be via Yoga. This may be because Yoga supports children to pay attention to what is happening within their bodies rather than just outside of it – teaching them that all sensations peak and fall, with a beginning, middle and end (Van der Kolk, 2014). This can be of particular benefit to children who rely on either sensory numbing or over-stimulation, or who may need additional support to feel ‘safe’ in their bodies.

In my clinical experience, I regularly find that children, even without a history of trauma, can still benefit hugely from mindfulness-based breathing exercises. For this reason, I am very grateful to Dr Emma Stevens (Clinical Psychologist), for recommending a lovely book of breathing for young children based on the principles of Yoga – “Frog’s Breathtaking Speech” (Chissock and Peacock). My children have loved reading this story and learning the techniques. I hope yours will too!

 

References:

Chissock, M. & Peacock, S. (2020). Frog’s Breathtaking Speech How children (and frogs) can use Yoga breathing to deal with anxiety, anger and tension.

Hopper, J., et al. (2006). Preliminary evidence of parasympathetic influence on basal heart rate in posttraumatic stress disorder. Journal of Psychosomatic Research, 60 (1), pp. 83-90.

Pilkington, K., et al. (2005). Yoga for Depression: The Research Evidence. Journal of Affective Disorders, 89, pp.269-85.

Sherman, K., et al., (2005). Comparing Yoga, exercise and a self-care book for chronic low back pain. Pain, 115, pp. 107-17.

Streeter, C., et al. (2010). Effects of Yoga versus walking on mood, anxiety and brain GABA levels: A randomized controlled MRS study. Journal of Alternative and Complementary Medicine, 16, pp. 1143-52.

 

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. Online therapy is available.

 

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Why behavioural approaches do not work for all children

One of the most frequently asked questions put to me in clinic, is why some children do not respond to traditional reward/punishment based behavioural strategies. The answer is simple – because, contrary to popular opinion, these strategies do not work for all children in all situations.

This is because the ability to make a mental link between a behaviour and a punishment, and to then be to be subsequently less motivated to use that behaviour again, actually involves quite sophisticated cognitive processes. It also requires specific parts of the brain to be functioning well. Difficulties with this may apply to children with learning disabilities or neurological conditions. It may also apply to children who are anxious, fearful or traumatised. This is because anxious or fearful children are often operating from a very primitive part of their brain that physically impedes their ability to access more developed parts of their brains. This in turn makes it harder for them to make cause and effect links, to generalise, to suppress their impulses, to make rational decisions, to maintain empathy for others and, in some cases, even to trust in the motivations of others. Punishing these children without supporting them to understand what is happening for them, therefore, is actually more likely to increase their fearful behaviours and further undermine their trust in those around them. For some children, it can also exacerbate feelings of shame.

A second concern with an overly heavy reliance on behaviourist principles when applied to children, is the theoretical and research origins upon which these principles are based. Behaviourism was largely developed in the 1950s and 1960s in laboratories with small mammals such as dogs, cats and rats – animals with significantly less developed brains than our own. Whilst these experiments can teach us a lot about how to shape behaviour in its purist sense therefore (i.e. classical and operant conditioning), they offer nothing in terms of how we build children’s self-esteem, build their intrinsic motivation, or even how to protect their attachment relationships. For instance, classically conditioning young babies to sleep by ignoring their attachment-seeking behaviours, can have detrimental effects on a child’s subsequent relational security and internal regulation skills. Similarly, a heavy reliance on operantly conditioning ‘good behaviour’ in young children with external motivators (e.g. star charts) has been shown to undermine a child’s natural desire to problem solve, be creative and to keep building on their successes when these external motivators are later removed.

Whilst some behavioural principles within a parenting repertoire can undoubtedly be helpful, therefore, when used to excess, and particularly when used in the absence of a broader context of sensitive, loving and developmentally appropriate care, they can quickly become damaging. This is because human children have brains that require so much more from the parent-carer relationship than simple behavioural conditioning.

Part of my role as a Clinical Psychologist, therefore, is to help parents, carers and professionals, to find new and more effective ways of supporting children to reach their full potential.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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