Psychotherapy Archives | Brighton and Hove Psychotherapy

July 16, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What does Integration mean in Psychotherapy?

Psychotherapy is many things, but on a fundamental level it is about the integration of split-off parts of ourselves.

This cannot be achieved without the integration of psyche and soma (body), which is the function of the mind. We need the mind of another to grow a mind and this is what happens in the relationship children have with their parents, if all goes well. Emotional and psychological integration cannot happen outside of the context of a secure object relationship and it is this that is the function of psychotherapy.

Far too many ‘modalities’ of psychotherapy operate in ‘silos’, possibly reflecting the medical approach to the body and mind. This makes them limiting and we end up with ‘infighting’ around “my modality is better than yours”, or “this modality is NICE approved whereas that one isn’t”…. All of this in unhelpful to clients and to the profession. Without an integrated approach to helping clients to grow and use their minds to form a relationship with their whole being, little change is likely.

Going back to psychoanalysis

The old analysts, from Freud through Winnicott, understood integration and Winnicott wrote extensively about the ‘Mind Object’: where a mind becomes an external ‘object relationship’ for the patient/client, to compensate for a lack of secure primary object, but then persecutes the individual for having an emotional world (as it cannot process and contain emotion).

In the absence of a ‘good enough’ parent, the child projects his or her mind out of the body and uses it to navigate the world, however, this is a precocious mind that cannot help the client process emotion and attacks the client for their emotions.

The function of a mind is to make sense of the psyche and soma and be an ally to the individual. Integration in psychotherapy involves the client/patient growing a mind; learning to navigate their feelings and making sense of their thoughts, all whilst accepting reality and being in relationship to others. To do this requires and integration of approaches, not least Object Relations (psychoanalysis), Attachment Theory, Neuroscience, Embodiment and Existential Givens, all held within a relational therapeutic context.

Integration vs eclecticism

Being a potent psychotherapist means therefore being able to adapt our language and thoughts processes to those of the client in order to help them grow their mind and discover how they become integrated. It relies on the ability to move between languages (therapeutic, class, gender, culture, religious/spiritual) as well as being able to move between the client’s experience and our own. This is the true meaning of integration and the difference between integration and eclecticism.

Mark Vahrmeyer is a UKCP-registered integrative psychotherapist working in private practice in Hove and Lewes. He is integrates psychotherapeutic approaches with neuroscience and the body in his work.

July 16, 2018 by Brighton & Hove Psychotherapy Leave a Comment

On rushing towards answers

Take the following situation: a client seeks psychotherapy to deal with anxiety and other related physical symptoms such as heart palpitations, ABS, stomach pains, etc.

They are used to a solution-focused approach and can want quick answers from me.

I feel rushed and pulled to meet them in their anxious place – to offer solutions, set goals, etc. I can easily see the how therapy session could quickly turn into a business meeting.

I take a breath, check in with myself and see how I am feeling (pushed, rushed, slightly anxious to give solutions).

I pause and offer the following:

“It seems you want me to give you more work in addition to what you already have. This seems to be exactly what is stressing you out. What would it be like for us to slow down and focus on your experience right now?”

We both look at one another for a moment and there is a sense of confusion: “I’m not sure what I’m supposed to DO.”

The DO bit is of importance here. Everything seems to be about doing in this person’s life. I imagine most of us can relate to this way of being.

This is because many of us have not learnt to pay attention to our experience. As children we are taught to do well, achieve, win, etc. in order to be loved and recognized. However, real recognition comes from validation of experience. This means paying attention to feelings, thoughts and responses,

Through a focus on doing and achieving, we loose connection to our bodies and our feelings. This means we end up a little bit like performance machines, ticking lists and meeting deadlines. In this process we tend to forget who we are, why we do what we do and how we feel about it.

One of the goals of therapy is to facilitate this process of coming back to oneself and understanding what drives us for good or bad. We then look at what behaviours and ways of being serve you and which really don’t.

Sam Jahara is a Relational Transactional Analysis psychotherapist and superviser, working in Hove and Lewes. Sam is also one of the founding partners of Brighton and Hove Psychotherapy.

July 9, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Demystifying Psychotherapy. An interview with Magdalena Whitehouse – VLOG

Recently Mark Vahrmeyer interviewed psychotherapist and drama therapist Magdalena Whitehouse on the topic of Demystifying Psychotherapy to help viewers understand some of what it means to consider going into therapy, how to choose a psychotherapist and more. So, please check out the interview and we would welcome any feedback or suggestions for future VLOGS.

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and groups. She works from our Hove and Lewes practices.

July 2, 2018 by Brighton & Hove Psychotherapy Leave a Comment

On The Importance of Recognising Emotional Injury

If we could take a child’s logic and apply it to the arena of psychological injury we may be better equipped to deal with the emotional pain and suffering that is an inescapable part of being human.

None of us is immune to heart ache. We are relational beings and cannot help but be touched by the emotional connections and disconnections we have with others. We have clear methods and maps for understanding and navigating physical pain and disease. Physical injury is generally quite easy to identify. It is harder for us to acknowledge psychological dis- ease, even when ignoring it can drastically impact our lives.

Loneliness and self esteem

Loneliness is a case in hand. Research indicates a detrimental impact on health in the experience of chronic loneliness. It can elevate blood pressure and suppress immunity rendering people more vulnerable to disease. Indeed it has been estimated that that the likelihood of premature death may be increased by as much as 14% for those in the grip of chronic loneliness.

The experience of loneliness is subjective. We can feel lonely in the midst of a crowd, lonely in the context of our marriages and our families. When we feel lonely, we feel emotionally or socially disconnected from those around us. More often in this age of technological connectivity we may even feel a certain taboo about admitting our experience.

The disconnection we feel serves to alter our perceptions and our thinking about ourselves and those around us. It may lead us to believe that others care less about us than they actually do. When we think this way we are less likely to reach out. The stakes in so doing can seem high and we risk the additional pain of rejection. When our self- esteem is low, we are more vulnerable to stress and anxiety and when this is the case we are more likely to experience rejection, failure and loneliness as evidence of our inadequacies and shortcomings.

Rumination

When we ruminate we chew over, again and again, replaying upsetting or unpleasant events, we become slaves to our thoughts and our feelings and feel powerless to change. When trapped in this negative cycle we put ourselves at risk of developing depression and anxiety or of developing other unhealthy habits with food and alcohol for example. We harm ourselves.

Our thoughts and feelings are not always the reliable arbiters of reality we imagine them to be. More often the critic within will speak with the voice of an absolute authority whilst delivering the worst kind of propaganda. Rarely does our critical voice have something genuinely new to tell us.

Confusion and suffering may indeed be our birthright, but wisdom and well-being may also be available. When we recognise and attend to emotional injury and struggle, (by reaching out and finding out) we become pro-active, as opposed to reactive. Catching our unhealthy and unhelpful psychological habits puts us in with a chance of changing them.

Psychological health and resilience is the reward.

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor who is available at our Hove practice. She works with individuals and couples.

June 25, 2018 by Brighton & Hove Psychotherapy Leave a Comment

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

In this trio of blogs, three of our therapists – a psychologist and two psychotherapists – of differing modalities will be sharing their views on how to work with a fictitious client. The “client” James, is a high achieving barrister in his mid-thirties presents with severe anxiety. He has recently started a new relationship and they are thinking of moving in together.

Client background

The “client” James, is a high achieving barrister in his mid-thirties presents with severe anxiety. He has recently started a new relationship and they are thinking of moving in together.

He comes from an upper-middle class background where there was a family culture of not talking about feelings and difficulties. He was sent to boarding school ages 6 – 13. He is eldest of 3 children and his parents divorced when he was 13. There’s has been other traumatic childhood incidents that he is yet to disclose.

He presents well dressed, competent, practical and wants quick solutions. He is very busy and wants to know what therapy can do for him and how long it will take

A transactional analysis / psychodynamic approach

I’m interested in James’s past, present and hopes for the future. Also relevant here is James’s attitude towards emotions. What has he learnt from his parents or caregivers about the role of feelings and emotions? Here, clearly there is a culture of not talking about feelings. I would imagine there was little encouragement for James to develop a relationship with his inner-world, given academic achievement was the main focus and what James would have been rewarded for.

In boarding school there is usually a culture of suppression of emotions, including suppressing the distress of leaving home at such an early age. The developmental stage of 6-13 years is also relevant. It is a transitional period for both girls and boys linked with identity development and moving from dependence to independence. Without a ‘secure base’ (parental presence, support and encouragement), this is likely to be compromised.

Why now?

Starting a new relationship can trigger feelings around early bonding and attachment. Inner conflicts to do with dependence versus independence will likely resurface, causing anxiety about the future of their relationship.

The divorce of his parents at age 13, followed by years in boarding school would have invariably shaken his world. Early separation from parents is traumatic for children, and so is divorce. We don’t know yet about the other traumatic events of his childhood, which will no doubt emerge as the therapy progresses.

I would be led by the person’s telling of their story. The process of telling one’s story and being heard by a present and supportive other can be transformative in itself. This might be an alien concept to James and something that he may find both pleasant and strange.

Wanting quick solutions is part of the driven environment of his family, profession and background. A therapist who is willing to be both understand and challenge his worldview, whilst exploring healthier ways to relate to himself is needed here.

Working relationally in the ‘here-and-now’

I would encourage James to begin paying attention to his experience, rather than on the demands he is likely to impose on himself and others. I imagine that James has never been allowed to experience his feelings and receive comfort and support when distressed, sad, angry, etc.

Unprocessed feelings usually manifest in anxiety and or depression. These will also resurface at key moments in life, such as new relationships, crisis, having children, etc.

The above are just initial thoughts based on a limited amount of information given about a fictitious client. Although the information presented here will be familiar to quite a few readers.

In therapy, client and therapist will work together in defining their therapeutic work. This usually happens in a spirit of collaboration and mutuality which, albeit challenging, can also be an enjoyable and incredibly rewarding experience.

Sam Jahara is a UKCP Registered Psychotherapist and Certified Transactional Analyst with a special interest in cross-cultural and intergenerational influences. She works from our Lewes and Hove practices and sees individuals and couples as well as offering clinical supervision.