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Brighton and Hove Psychotherapy

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Psychotherapy and the Climate Crisis

In times such as this, I question my role as a psychotherapist wishing that I had studied something that could truly and directly help the climate and environmental crisis that we face. I feel so connected to the natural world that to see it being destroyed, disregarded and exploited to this scale, to see us humans destroying what sustains us is truly horrifying and evoques in me a profound sense of helplessness.

I love my work because it entails looking at human psychology. In essence, understanding why we feel and behave they way we do.  This is much easier to do with an individual sitting in front of me than to speculate what drives us to collectively cause harm or do nothing.

Biologically we are wired towards survival. Capitalism and consumerism, paired with technology has made us more and more disconnected from our bodies, our food and our environment.

In psychotherapy we try to help people tolerate their feelings, be in their bodies, understand what drives them to make certain choices in life, etc. I believe that as a profession we can help to heal the wounds and traumas of the past so that we don’t have to continue repeating painful experiences. Psychotherapists can help individuals and groups to think the unthinkable and feel our most painful feelings. This is both a delicate and yet powerful process, which happens over time in order to not overwhelm the system.

Too much information, and we either react or disconnect.

A similar process is taking place collectively. The issues we are dealing with are huge and require serious attention. But how we pay attention is key. Reactivity and disconnection are inevitable responses to such overwhelmingly big issues. Therefore we need to learn to face things and not run away from them. We need to talk about and help one another grieve not just our personal losses but also the loss of nature and life, as we know it.

I deeply admire climate activists, environmentalists and all the scientists that dedicate their lives to bringing all this information to our attention and who are desperately trying to raise awareness to protect our natural world. But this depends on all of us waking up to what is happening and to begin treating ourselves and other humans/beings/the planet with care and respect.

We can only wake up and take action from a place of consciousness. So, it’s time we stop burying our heads in the sand and take a serious look at how we live, the choices we make and how we treat the planet every single day.

As a profession, a society and a nation, we need to face our areas of contradiction, our “splits”.  After all, the personal is the political.

In the words of Great Thunberg:

“If the walls of your house truly came tumbling down, surely you would set your differences aside and start cooperating.

Well, our house is falling apart. And we are rapidly running out of time. And yet basically nothing is happening.

Everyone and everything needs to change. So why waste precious time arguing about what and who needs to change first?

Everyone and everything needs to change.”

Global Climate Strike 20 and 27 September 2019

https://globalclimatestrike.net/

Further reading by Sam Jahara –

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

On rushing towards answers

How do Psychotherapists work with anxiety? Trio of Blogs – Part 3

 

Sam Jahara is UKCP Registered, CTA, PTSTA and is one of the Brighton & Hove Psychotherapy Co-founders.  She is an experienced Transactional Analysis Psychotherapist. Her special interests include culture, identity, belonging, sustainability and environmental issues. Sam is available at our Lewes and Brighton & Hove Practices.

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What is EMDR?

You might have seen EMDR being spoken about in the media a fair bit recently.  Many famous people have been speaking out about how it has helped them with psychological difficulties, most often past traumas, but what actually is it?

EMDR stands for Eye Movement Desensitisation and Reprocessing.  It was developed in 1987 by American Psychologist Francine Shapiro, initially as a treatment for trauma.  Shapiro tells how she discovered the main premise, almost by accident, as she walked in the park:  She noticed that as she thought about some distressing memories, her eyes moved back and forth and the distress she felt reduced.  From this she went on to develop EMDR, which is now widely practiced across the world.

The National Institute for Health and Care Excellence in the UK currently recommends EMDR as a treatment for Post Traumatic Stress Disorder.  There is also a significant and ever-growing evidence base for the use of EMDR to treat other psychological issues.  EMDR can be used effectively with children and adults.  Clients often notice quick changes (sometimes in even just 2 or 3 sessions) which can have long lasting effects.

There are several theories as to how EMDR actually works, although it still isn’t 100% clear.  The main premise is that the two sides of the brain are alternately stimulated whilst the person holds a difficult thought or memory in mind.  Traditionally the therapist would stimulate alternating sides of a person’s brain by moving their hand side to side, whilst the person tracks with their eyes (hence the name Eye Movement).  However, there are other techniques, such as alternating hand buzzers, hand taps, audio or light bars.  This allows things have that become ‘stuck’ to be re-processed, and therefore to be less distressing.  The eye movements (or other forms of alternating stimulation) form a significant part of the therapy.  There is also talking involved, but people do not necessarily have to share all the details of their traumatic story if they prefer not to.

EMDR is an advanced therapy and should only be delivered by highly skilled, trained therapists.  In order to become an accredited EMDR therapist there is a significant amount of training and then supervised therapy work with clients.

The website of the EMDR Association UK and Ireland has more information on EMDR, finding a therapist and some stories of people who have benefitted from EMDR therapy – www.emdrassociation.org.uk

 

Dr Emma Stevens, HCPC Registered, Clinical Psychologist, is currently undergoing the training process to become an accredited EMDR therapist and is able to offer EMDR, under specialist supervision.   She has an integrative approach drawing on Cognitive Behavioural, Systemic and Psychodynamic models, as well as Attachment Theory. Emma sees individuals primarily for short-term work. Emma is available at our Lewes Practice.

 

Further reading by Dr Emma Stevens –

Emotional Well-being

 

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How do I choose a psychotherapist?

Deciding that you want or need psychological help can be a difficult position to arrive at.  Choosing the right practitioner to work with can feel like a daunting task with so many different fields of talk therapy, types of therapy and professional bodies overseeing the field.  This blog is a guide to helping you find your way to the right psychotherapist for you.

Counselling, psychotherapy or psychology?

Counselling, psychotherapy and psychology all broadly fall under the category of ‘talking therapy’.  They have much in common, yet are also very different.  I have previously written a piece on the difference between counselling and psychotherapy; the former being largely for shorter-term work and the latter being appropriate for deeper and long-term work on the personality.  We also have an in-depth page on psychology here so I shall not go into more detail about that here.

Depth of work

In choosing a psychotherapist, it can be helpful to have a sense of what it is you are seeking to gain from therapy.  Generally, psychotherapy is longer term than counselling and rather than working with one specific issue, is instead a relationship through which the client can work through relational patterns (with themselves and others), formed in childhood that they wish to change. Depth relational psychotherapy takes time – months to years – to understand and process relational, or attachment, losses. It is a commitment to a process of therapy and to oneself with sessions being as a minimum weekly, at the same time and on the same day each week.

Professional Body

There are a few professional bodies who offer voluntary registration to counsellors and psychotherapists – the BACP and UKCP. Whilst the BACP includes the ‘P’ for ‘psychotherapist in its acronym, the minimum training requirements of the BACP for someone to call themselves a psychotherapist are quite low. The UKCP, on the other hand requires all registered psychotherapists to undertake a minimum of four years of post-graduate training at an accredited training institution alongside a mental health placement and four years of personal therapy, before permitting applicants to join.  At Brighton and Hove Psychotherapy, all of our psychotherapists have trained at least to this standard and many far beyond.

Training

Psychotherapy training is long, challenging and requires the candidate to be in their own personal therapy throughout the training period.  Most training institutions are located in London, or further afield, and so a great deal of commitment is required to reach the necessary training standards. One of the main aspects that sets UKCP registered psychotherapists apart from counsellors is that they have been trained to ‘formulate’, which is another work for diagnose, or understand, more complex trauma and mental health issues.

First Appointment

If you have never previously been in therapy, then the prospect of the first appointment can be daunting. It is the job of your psychotherapist to set clear boundaries and create an environment that ‘feels safe, but not too safe’.  What does this mean?  Psychotherapy is about learning to tolerate difficult feelings and your psychotherapist is there to facilitate this process through their relationship with you.  They are not there to be liked, or to be your friend, as this would not be beneficial to you or to your process. If all goes well at the initial consultation then you and your psychotherapist may ‘contract’, or agree, to work together.  This means that they have assessed what work is required to facilitate change for you and you have decided that you are going to enter into an intimate relationship unlike one you have perhaps ever had before.

Length of Contract

How long is a piece of string?  Most psychotherapy can last for months or years, however little can be inferred from the duration.  For example, someone attending a year of therapy is not necessarily ‘healthier’ or ‘saner’ than someone who attends weekly for many years.  It is entirely dependent on the work required, how the client wishes to ‘use’ therapy and the relationship formed. Freud famously believed that therapy only begins when the client is no longer in a crisis.

Final Thoughts

Finding a good psychotherapist begins on paper but ends with a feeling, or a set of feelings.  As it is in the relationship that the unravelling of the past takes place, it is critical that as a client, you feel you can build a therapeutic relationship with your psychotherapist. The capacity to do this will hinge on their degree of training, clinical experience and therapeutic boundaries, as well as on it being a relationship that feels ‘safe enough’ – not too safe to not be challenging – within which the therapeutic process can unfold.  

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.

 

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What is ‘Blocked Care’ as it applies to parenting?

The phenomenon of parental ‘blocked care’ is a term coined by eminent Clinical Psychologists Dan Hughes and Jonathon Baylin and Psychiatrist Dan Siegal. It represents a central feature of the Dyadic Developmental Psychotherapy (DDP) approach to treating children and young people with a history of developmental trauma and attachment disruption.

Advancements in the areas of attachment, trauma and neurobiological development, teach us that children’s brains are shaped on a neurological level by their earliest caregiving experiences. Indeed, we now know that an infant’s brain is primed, even in utero, to adapt to the type of care that it anticipates receiving from its primary caregivers in order to maximise its chances of survival. What is perhaps less known however, is that parents’ brains are also neurologically influenced by their experience of caring for their child. When things are going well, five main areas or ‘care systems’ in the parental brain are optimally functioning. These are:

  1. The Approach System: The system that enables us to fall in love with our children, to crave to be with them and to become completely absorbed in them. Not surprisingly, this system is associated with the release of oxytocin (the ‘love hormone’).
  2. The Reward System: The system that enables mutual delight and attunement when a parent interacts with their child. This system is associated with the release of dopamine (the ‘addictive hormone’).
  3. The Child Reading System: The system that enables parents to positively interpret our child’s behaviours and motivations and to remain interested in their unique qualities.
  4. The Meaning-Making System: The system that enables parents to think positively and meaningfully about their relationship with their child.
  5. The Executive System: The system that enables us to physically care for our children.

For some parent-child dyads however, things do not go so well. Some parents may face unmanageable levels of stress whilst caring for their infants, which may be exacerbated by their own poorly developed care and emotional-regulation systems. Others may be offering reparative foster parenting to children who, owing to previous experiences of abusive or neglectful parenting, now fear, mistrust and reject the care they are being offered, which can be extremely painful for their new carers to bear.

The real risk when things go wrong however, is that parents may enter (chronic or acute) periods of ‘blocked care’. When this happens, the first four systems listed above start to shut down. The parent no longer experiences joy or fulfilment of being with their child. They do not get the rushes of oxytocin and dopamine that other parents get, and they do not seek to be with their child. They also become much more likely to interpret their child’s behaviours and motivations with a negative bias (e.g. “he is manipulating me” or “she is a spiteful child”) as well as their relationship with the child (e.g. “I am a rubbish parent”).

A stressed-out parent is in survival mode. They are no longer able to remain open and engaged to the child’s emotional and developmental needs. Rather, they are liable to become extremely rigid, defensive and behaviorally-focused in their approach to parenting. Sadly, however, without support, the final care system, the executive system, may also start to shut down. This is the point when we start to see abusive or neglectful parenting emerge.

The growing evidence-base for blocked care, therefore, highlights the crucial need for psycho-education, as well as early and non-judgmental support to parents and carers who are most vulnerable to entering it.

References:

Hughes, D. & Baylin, J. (2012). Brain-Based Parenting: The Neuroscience of caregiving for healthy attachment. Norton

Hughes, D. & Baylin, J. (2016). The Neurobiology of Attachment-Focused Therapy: Enhancing Connection & Trust in the Treatment of Children & Adolescents. Norton

Siegal, D. & Hartzell, M. (2003). Parenting from the Inside Out. Tarcher/Penguin

 

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes practice.

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Why does empathy matter?

When you begin therapy you enter into a particular (perhaps peculiar) type of relationship, one with well defined boundaries and ethics. Beyond its method and structure, at the very heart of this relationship lies empathy.

As a therapist empathy means doing all you can to understand your client from inside their own experience. It requires an ability to communicate this understanding in ways that are sensitive, meaningful and useful, both verbal and nonverbal.

It is a powerful experience to feel understood, listened to, cared for and respected. Over time it can make it easier to have empathy for yourself, to take your own personal pain and suffering seriously, to judge it less, as trivial, stupid or simply a product of your own personal weakness.

When we begin to take our own struggles seriously, we gain access to another layer of empathy: compassion for the child that we were, often a child who made sense of what troubled them by deciding that there must be something wrong with them – that they were the problem. In the context of an authentic and empathic connection with another human being the shame or disgust or guilt that has become so entangled in our sense of self can begin to make way for new feelings. Sadness (perhaps) for what was lost and loving regard for the child who did the best they could at the time.  When there is more space in our imaginations for the reality of our own struggle, we can begin to see other people differently too. When we experience the power of feeling understood we may also experience greater internal space for new thoughts and feelings, both about ourselves and about others.

The therapist as client

All psychotherapists have had their own experience of being a client in therapy. Sharing the most intimate and often painful moments of someone’s life is made possible when you have felt and expressed your own. It is not that as a therapist you become an expert on life (not even your own) but that having undergone your own therapy you will be more equipped with the clarity to differentiate your separate self and experience from that of another.  To understand whose feelings are whose and to have the versatility  and flexibility to step into and out of another person’s shoes.

The circuitry of empathy

Empathy is a complex system of mutual cues and responses that regulates each persons experience of self and other. We observe this very clearly in parent/ infant interactions. How attuned a parent is to the (myriad/micro) communications of an infant will inform the infants reciprocal response to the parent.

It is not that in an ideal world infants and young children would be perfectly attuned to at all times. Over-attunement can be stifling and intrusive. What’s more important is the experience of an ongoing relationship in which misunderstandings and mis-attunements can be repaired.

Emotional neglect and emotional intrusion are flip sides of the same coin. Anyone who has suffered either will have good reason to believe that they may never be understood.

As a therapist we cannot “know it all” for our clients, we cannot tell someone how it is they feel or what is true for them. What we can provide is an open ended, respectful curiosity for our clients and a willingness to share in the important project of “getting it.”  Paying close attention to the unique form of connection that exists with each client means understanding empathy as a mutually influencing system. From this perspective, the communication of empathy becomes much more a mystery to engage with than a tool to master.

 

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.

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