Paul Salvage Archives | Brighton and Hove Psychotherapy

July 8, 2019 by Brighton & Hove Psychotherapy Leave a Comment

The Therapeutic Relationship and the Unconscious

Therapy is often referred to in terms of it being relational, or as a relationship, albeit a particular type of relationship, one that has very specific parameters, particularly around money, time, touch, and about whose inner life is there to be explored.

Despite this, in some ways, very one-way relationship, an awful lot of what goes on is a kind of relating. The therapist will encourage the client to speak as freely as possible and through a careful listening to the client’s words and to what is evoked in themselves, through this listening, they will try and relate as closely as possible to the clients experience and will feed this understanding back via their own comments, or interpretations.

What makes this different from other listening conversations, is that the therapists understanding and feedback will be influenced by the therapists training, specifically their own therapy and their learning of theories, which provide maps of mental structures and types of human experience and distress.

The therapist as well as listening to the stories, will also listen for patterns, for words, they will try and be attuned to what is going on emotionally for the client and also pay attention to the actions of therapy, to the how the client goes about relating to the therapist. When the therapist feels something useful has been understood, they will share this.

Sometimes this may not have been consciously known by the client, and this is why it can be useful. However, it can also be unnerving, as we like to believe we are the masters of our own houses, independent and not in need of the help of another.

Freud said there have been three great blows to man’s ego, the Copernican discovery that the solar system didn’t revolve around the earth, Darwin’s discovery that we are descended from animals, and share an essentially mammalian brain structure and Freuds own discovery that we have a dynamic unconscious, that the rational beings we like to believe ourselves to be is only one part of the story.

Part of this unconscious is the repressed unconscious, the place where we store the things we don’t want to know about ourselves, however these things are known at some level and we can expound a great deal of energy trying not to know them.

Getting to know and understand these parts of ourselves although often frightening to begin with, can actually be a huge relief as we come to know and accept these parts of ourselves, parts of ourselves that may seem like monsters under the bed and cast scary shadows but are usually essentially human characteristics.

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 –

A Nation Divided

Adolescence: the trials and tribulations

Does the male mid-life crisis exist?

April 15, 2019 by Brighton & Hove Psychotherapy Leave a Comment

How to find a Therapist

I’m in agreement with Brett Kharr who argues that unfortunately we have a strange situation in therapy where there are an almost innumerable different types of therapies to choose from. I think this reflects the consumerist, swipe right, swipe left age we live in and actually makes starting therapy more confusing for clients.

Richard Chessick, a Psychoanalyst, writes that;

“It is the experience of the therapists personality and the encounter with the therapist as a human who is truly present, rather than any verbal exchange, that makes the fundamental difference in therapy. It forms a link, that brings the patient in consistently over years of treatment, even at times when the patient is very angry or upset. (85).”

If, as a client, you are serious about wanting to change things and about wanting to engage in therapy then it does pay to think a bit about which therapist and therapy may be a good match for you. Sometimes you may feel comfortable with the first therapist you meet after perhaps doing some online research or obtaining a personal recommendation. Sometimes you may want to have a few initial consultations with different therapists. As a therapist I would always be more than happy for you to do this. As a client I would advise on being as honest as possible with the therapists you meet about this, as it’s a good chance to gage their reaction. A therapist where you feel you might have to worry about hurting their feelings, may not be the best choice.

When I began my training the course leader, in one of our first seminars, talked about the therapists needing to have personal therapy and how to choose and get the most out of therapy, said one thing that has stuck with me –

“Make sure to give your therapist hell”.

I have often thought about that statement and have come to appreciate, that I think at essence, its saying how important it is to be as honest as possible in therapy, especially about the things you don’t want to say and especially about the things you don’t want to say to your therapist.

This may feel strange. You may feel your therapist is annoying, a disappointment, etc. What’s useful about this and I believe unique to therapy is that the therapist who has had a thorough therapy themselves won’t take it personally, they will be able to reflect on the bits that may be true, but also may be able to help you think about the bits you may be bringing that you may also bring to other areas of your life. Is the experience of finding your therapist annoying/boring/uncaring or whatever, something you experience in other areas of your life in relation to other people? If so the special circumstances of the therapeutic relationship can be a unique chance gain insight into these recurring patterns as they are happening, not just in an intellectual way but also at a deeper more affective level. It is at that level that I believe change can really occur.

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

February 18, 2019 by Brighton & Hove Psychotherapy 1 Comment

A Nation divided

There has been much talk of how Brexit has divided our country, and indeed, in my own extended family I have members on both sides of the debate.

In this blog I want to write a little bit about how we as humans are divided and how Psychotherapy can ease some of the conflict contained in that. This divide, or split, can happen when we think or do things that don’t accord with what we believe to be our own beliefs. Beliefs about ourselves as doers of good, thinkers of pure thoughts etc.

Freud describes how these splits can be repressed, by quoting Nietzsche’s phrase: –

“’I did that’ says my memory; ‘I cannot have done that’, says my pride and refuses to yield. Finally – memory gives way.’”

Splitting is not necessarily a bad thing, it is often a way to manage something that cannot be managed at the time, so, cleverly, the psyche represses it. However, this repression is never total so the thing that wasn’t able to be managed, perhaps due to it being too overwhelming at that time, seeks to come out in some other way.

The outpouring of grief at Princess Diana’s funeral, for instance, was not only about the sad and untimely death of Diana but also presented a triggering of an outpouring repressed and split off grief in so many people and perhaps goes to show how much grief so many of us carry around.

Another way splits can occur is when we have, as we almost always do, conflicting feelings of love and hate to those we are close to. This can sometimes create a terrible conflict, where the anger or disappointment or hurt, feels like it can’t be expressed for fear of hurting the one that is also loved and therefore potentially causing us to lose that person.

However, the feelings are still there, so find other ways to come out; – road rage, shouting at the TV, getting into arguments at work, etc. Most of us want to be good and can find these parts of ourselves distasteful and best not thought about. However, that has side effects, sometimes serious ones and that is when a person will sometimes seek psychotherapy.

The psychotherapist will work to facilitate the unearthing of these conflicts in a way that is sensitive, non-shaming and understanding, in order to allow their expression and lessen their negative effects on the client’s life.

To start with this can seem strange and almost feel like the therapist is only interested in their ‘bad bits’. However, it is not that the therapist wants to humiliate the client, but rather to do the opposite of colluding with the sometimes-long history and input of well-meaning friends and family who have tried to make them feel better by joining in the game of pretending to look the other way.

As Carl Jung said :-

“One does not become enlightened by imagining figures of light, but by making the darkness conscious.”

October 29, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Adolescence: the trials and tribulations

In this blog, I want to briefly outline some of the reasons I like working with adolescents and what are perhaps some of the key struggles faced by adolescents, their carers’ and those who work with or alongside them.

One of the most famous depictions of adolescents’ in my memory is probably Kevin, of Kevin and Perry fame, a very funny, exaggerated, but not unrecognizable depiction of a ‘teenager’. Kevin is by turns, childlike, demanding, exasperated at his parents, however reasonable they try and be, and genuinely struggling with the desire to experience the thrills adult world as he sees it and his unbearable lack of experience and shyness.

I think a good indicator of how it hits a note, is that some of the teenagers I know well, loved this depiction and found it hilarious.

What the characters focus is on the conflict the adolescent faces in needing to leave the world of childhood and its unquestioned dependence on caregivers, to somehow find their own identity. This can involve a painful, but perhaps temporary jettisoning of everything the parental figures seem to represent, however benign they may or may not be.

I think the pleasure and the pain of working with adolescents is how they remind us of some of the fundamental conflicts of, all of our lives, sometime ones, we have dealt with by; ‘letting sleeping dogs lie.’

Adolescents are suddenly faced with issues of what sex is, or means, how to belong or not and whether they may or may not want to. They are often in a position of having to make serious life choices, with only really a very limited knowledge of what those choices may mean.

The Psychotherapist Adam Phillips, writes, that in working with adolescents; “Violent feelings, dejection, sexual obsession, serious self-doubt and terrible self-image are something everyone who is at all awake can’t help but feel” …and that “Anyone who does this work with any real commitment will feel destabilised by it”.

So why do it?

I think because of precisely these issues, working with adolescents reminds us of what it is to be human, to be alive to the rawness of experience, the thrills, the highs and the lows. Adolescents’ are serious about this and often dedicate a great deal of thought about it, and finally as Phillips notes, that, ‘despite sometimes overwhelming feeling of powerlessness and disturbance,’, they can be, ‘committed pleasure seekers; something we as adults are not always so good at.’

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.

September 24, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Does the male mid-life crisis exist?

The Man’o’Pause

Much has been depicted of the male ‘mid life crisis, most of it mocking. However in my experience as a Psychotherapist, I wholly agree with author Marian Keyes, who notes, “no one really goes through a midlife crisis without experiencing real despair, real fear and real soul-searching about ‘what have you done with your life?’.

I suspect much of the mocking relates to the often-painful consequences of the acting out of this pain, in searches for ways to make this manageable. Most recognizably perhaps in the breakdown of relationships and families.

Gender specific?

Of course, a mid-life crisis is not gender specific.

It can be, a pause to take stock of a life, where the initial manic scramble to achieve goals has been fulfilled and once that finish line has been to some extent crossed, another, much more frightening one appears, that of the inevitability of our own death, sometimes brought home by loss of people close to us from older generations.

How can psychotherapy help?

Psychotherapy offers the opportunity to assess this in detail, to explore what values and ways of being are chosen for their merits and what are perhaps inherited unconsciously, driving on, the acting out of old unconscious roles. In order for a role to be chosen, the unconscious roles being played need to be made conscious in order to allow comes more choice about which future roles we decide to take or leave.

The Psychoanalyst Donald Meltzer, suggested that most adults have an adolescent personality structure until mid-life when either a struggle toward greater integration commences or a return to latency period rigidity which he described as ‘settling into middle age’.

This ‘crisis’, then is also an important and vital opportunity to assess and evaluate what kind of life is to be chosen for this second half, where the existential reality of death, brings into sharper focus the decisions and choices we make.

The Therapeutic Relationship and the Unconscious

How to find a Therapist

A Nation divided

Adolescence: the trials and tribulations

So why do it?

Does the male mid-life crisis exist?

The Man’o’Pause

Gender specific?

How can psychotherapy help?

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