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Online anxiety therapy

There are various symptoms of anxiety, including an overwhelming feeling of fear, panic or worry, as well as physical signs such as sweaty palms, dizziness and palpitations. For those struggling with an anxiety disorder, these feelings can occur on a frequent basis and are isolating and distressing.

Anxiety is a problem that can be exacerbated if stressors are allowed to build. It’s important to get help and support if you’re finding yourself struggling with anxious thoughts on a regular basis. By speaking to someone about what you’re dealing with, you can understand what’s causing the negative reactions to your thoughts to be better equipped to tackle them.

How can online psychotherapy help?

Anxiety can be debilitating for many people but having specialist support in the form of psychotherapy can be effective in helping relieve the worry associated with this condition and encourage recovery. Our trained therapists can help you develop effective coping strategies and resolve the issues that are causing anxiety in your life, as well as help you identify the triggers for your anxiety.

There can be various reasons why your anxiety has developed, from stressful work or school environments to difficult relationships, your health or social interactions. By talking through your issues and the causes for your anxiety, you can increase your self-awareness to manage your feelings and thoughts more effectively. Removing yourself from the situations that cause anxiety isn’t always possible but having an arsenal of techniques makes dealing with it easier, which can be a great comfort. And in a supportive and therapeutic relationship, you will no longer face your anxiety alone.

Online anxiety psychotherapy is just one form of treatment but talking to a trained professional can help you in many ways, from understanding your condition and what may be causing it, to learning techniques to deal with the symptoms. Online psychotherapy enables you to benefit from the advantages of face-to-face sessions but from the comfort of your home for a more convenient and accessible solution. It also ensures you have access to our highly skilled team from anywhere in the country.

If you want to discuss online anxiety counselling with us, contact us today or take a look at our practitioners.

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


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

What is ‘Manifesting’ and The Law of Attraction?

Recently a client, somewhat younger than me, described a phenomenon they called “Manifesting”. They felt excited and disappointed in themselves in equal measure that they seemed to be failing in using this ‘secret’ method of working with ‘the universe’ to bring them whatever their heart desired.

Curious, I investigated.

Manifesting is a verb used to describe the active process of using positive thoughts, and a degree of self-hypnosis, to draw ‘good things’ to oneself. Based on the many Youtube videos on this topic, these good things seem to be consumer products or monetary wealth, rather than contentment and tolerance, but then the latter two are really not as enticing as ones own private island.

Manifesting is not new and nor is the concept original. It seems to have been re-hashed in a 2006 ‘documentary’ and book entitled ‘The Secret’ which explains the mystical process of using the ‘Law of Attraction’ to get what you want in life. What a great concept – if only it were true.

Fate and Destiny
I have previously written about the concepts of fate and destiny and how I do not believe that any idea of fate has a place in psychotherapy – or indeed in the outcome of psychotherapy, which is in essentially becoming an adult who can tolerate reality.

To recap, the concept of fate posits that there is some sort of external force, entity or deity that decides what happens to us. This can be very unhelpful in the therapeutic process as clients can often use the idea of fate to reinforce that what is happening (or not) to them is simply how things are supposed to be.

Destiny, though not a word I personally favour, can be translated to being thought of as taking some degree of ownership of one’s life whilst remaining firmly rooted in reality. Therefore it is possible for most free people to experience a change in their lives, or perception of their lives, whist acknowledging their reality.

Destiny and death
Some years back I spent four years working on the front lines of death – as a psychotherapist in the field of palliative care. Whilst the usual issues around meaning, relationships and mental health problems presented themselves, they were all within the context of death and dying: I worked with patients who had terminal illnesses, were actively dying or with their bereaved relatives. It certainly redefines the concept of ‘psychotherapy’ when sitting beside the bedside of a patient who has hours to live and is engaging with you through a cocktail of opiates!

Despite the confronting nature of death and dying – the patients’ ‘fate’ was sealed – nonetheless, many of the people I worked with were able to find purpose and meaning in their predicament and to mourn losses not previously addressed. They were engaged in changing their destiny.

Magical thinking
We can all, at times, make use of magical thinking. It can be a way of assuaging anxiety and giving us the illusion of being in control. The practice is as old as human beings and embedded in a language such as in the saying ‘touch wood’ or in the belief that walking under ladders brings bad luck. Human beings are symbolic creatures who make the unreal real. This is perhaps how we cope with our knowledge of finitude – death. However, we also confuse the symbolic with the real.

Whilst touching wood and avoiding ladders is relatively harmless, subscribing wholeheartedly to fantasies that there is some ‘secret’ method or means of ‘manifesting’ objects into ones life is dangerous and deluded. In psychological terms, it is a way of avoiding growing up and being born. A way of believing that the world can be just how we want it if only we imagine it hard enough – a sort of womb, in essence.

The power of magic
The reality of being in weekly or more frequent psychotherapy is that it is not very magical at all.  In fact, it is the opposite. Psychotherapy generally takes place in a fairly ordinary consulting room (or online), you see the same face week after week and often find yourself going over the same ground. Clearly, promises of Ferraris and private islands are far more enticing. However, the consistency and regularity, along with having someone there who holds us in mind and helps us think can be life-changing. If we are thought about, just perhaps we can learn to think our own
thoughts about ourselves rather than follow a script on who we are. If we are not alone then we can learn to bear reality, however hard that may seem.

Psychotherapy does not promise magic. It is, in fact, the opposite in that often our job as psychotherapists is to help clients and patients lift the veils of illusion and see life and their history for what it was – only then can the mourning begin. And it is only through mourning that eventually, desire can emerge – a sense of self and a sense of what that self wants.

Desire
When desire emerges it is rarely if ever about Ferraris or private islands. It is not about consumer products period. It is about a deeper recognition of what will bring contentment and peace in the context of the realities in which that person lives. And that can be achieved even on a death-bed.

Of course, as a final blow, unlike manifesting, psychotherapy also has science on its side. And a long studied evidence base. It may not get the Youtube hits but then real life was never to be found in movies.

 

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

 

Further reading by Mark Vahrmeyer

Why does the difference between counselling and psychotherapy matter?

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Face to Face and Online Therapy Help Available Now

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Why does the difference between counselling and psychotherapy matter?

What a difference a year makes. For all of us the world is an inconceivably different place to a year ago. Not only are we all living with greater uncertainty, we have all had to enormously adapt to living, socialising, relating working, and not least, having therapy in a different way.

Almost exactly a year ago I wrote a blog on entitled ‘The Difference Between Counselling and Psychotherapy’, which has received some traction. More recently, the age old question pertaining to the difference between these to related disciplines has come bursting forth through a collaborative project SCoPEd project which seeks to set out training requirements and practice standards for counselling and psychotherapy. This project is receiving a lot of attention
(accompanied by fierce criticism) by many in the ‘talking therapies’ field. I have no wish to get drawn into the intricacies and politics of the actual project but do firmly believe that from a client’s perspective, standardisation of training requirements and robust practice standards that differ between counsellors and psychotherapists can only be a good thing. More so, I believe that they are essential.

Many of my clients come to be after trying some form of ‘talk therapy’ which may or may not have been helpful. Many come because they are unclear about why they don’t feel better and have ‘stumbled’ across me and my practice via a search engine. Few really understand that there is a difference between counselling and psychotherapy and few understand what they may need and why that may be a psychotherapist.

The fact few understand this has nothing to do with the fact that there is a fundamental difference and put simply, the more I have trained and the more years of experience I have, the more cognisant I have become not only of the differences, but also of how to assess what someone needs and whether they are in fact suitable for therapy.

I have written extensively about the differences between psychotherapy and counselling in my blog a year ago and if you are interested, you can read them here. My blogs are aimed predominantly at lay people who may be considering entering into therapy, rather than at the counselling and psychotherapy community.

Why do clients need to understand the difference between counsellors and psychotherapists?           

At present the distinction (in the minds of many) is blurry. Many counsellors believe the two terms to be interchangeable and are thus aggrieved by any proposed framework that should distinguish between the two disciplines: most counsellors think they are psychotherapist; few psychotherapists consider themselves counsellors.
The distinction matters from a duty of care perspective. Deeper work with clients dealing with complex trauma, personality disturbance and psychiatric disorders requires an in-depth understanding of how to identify these issues and an assessment of our ability to work with such clients and the client’s ability to ‘make use’ of the therapy, their robustness.

Turning clients away

My practice is generally full as my work is long-term, however, when considering taking on a new client I undertake a clinical assessment of their suitability for therapy. I aim to answer the question: ‘can I help this person?’ It may seem counter-intuitive, however, I am far more likely to turn down clients pre- or post-assessment now than when I first started out as a counsellor.

Why? Because I now know what I do not know and where my limitations lie.

A GP will not undertake surgery as they have been trained in general practice. They can, however, recognise that a patient needs to see a specialist who can offer an expert opinion and in-depth complex treatment. A GP is invaluable precisely because they are aware of what they do and don’t know and work within their limitations.

This is the ethical responsibility that I believe all counsellors and psychotherapists would carry at the forefront of their minds, however, without training in formulating (our word for diagnosing) how can a clinician know what they don’t know? Herein lies the problem.

Do no harm

The Hippocratic Oath, subscribed to by medical professionals the world over applies to us too.  In trying to help (rescue, fix, therapise, relate to) a client, unless we are acutely aware of what we are dealing with, we can do more harm than good.

Is there a place for counselling?

Unequivocally yes. Counselling is enormously beneficial and most psychotherapists started their careers as counsellors in some capacity. Counselling is often all a client needs and it can bring about enormous change for many. However, it is not appropriate for more complex or serious relational or personality disturbances.

In turning clients way it is not solely or even frequently because their requirements lie beyond my abilities; I often suggest to prospective clients that counselling may be more appropriate for them, especially if they have no prior experience of ‘talking therapy’ and are wanting to work through a time-limited issue.

And beyond psychotherapy?

The clients I do turn away as their requirements lie either beyond my knowledge base or holding capacity, I do so from a position of ‘doing no harm’ and making an often tough ethical decision. It may be that that person requires psychiatric support but it may also be that their level of disturbance is best treated by a multi-disciplinary team. And then there is, of course, psychoanalysis.

Inaccessible for many – sadly as Freud saw Analysis as being something that should be accessible for the general population – provides something that psychotherapy cannot: the ability and framework within which to work at depth with powerful regression.

To summarise, the difference simply must be acknowledged and accepted between the professions for the safety and well-being of clients and patients. To do otherwise is plain hubris.

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

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Why psychotherapy sessions should end on time

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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We are recruiting

Thanks to ever increasing demand for our services, we are now recruiting new associates to join our vibrant and busy practice.

Established in 2008, Brighton and Hove Psychotherapy is a practice offering high-quality face-to-face psychology and psychotherapy across the Brighton & Hove area, as well as online therapy to clients nationally.

We are interested in hearing from experienced Psychotherapists (UKCP or BPC registered) and Clinical Psychologists, who are looking to be part of a cohesive practice and who are hungry to grow their private practice as part of our brand.

We offer a broad range of psychological specialities to individuals, couples, families and groups, across all age groups from infant to adult. We are offering you the opportunity to take your private practice to the next level through our service and brand. With a full page profile on our website, referrals made through our administrative team, high-quality consulting rooms with online bookings as well as all the benefits of being a part of a clinical team with regular practice and reflective meetings, and cross-referrals.

If you are a clinician who has been practising for at least 5 years post-qualification and can work with a variety of client groups, we would like to hear from you.

For further information or an informal chat, please contact us.

For more information about Brighton and Hove Psychotherapy, visit our website:
www.brightonandhovepsychotherapy.com

Face to Face and Online Therapy Help Available Now

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Why read Nietzsche?

Nietzsche reflected on and wrote much about the lived experience of human beings. He discussed many things that were seemingly in conflict with the last thing he wrote. I have sometimes heard this used as a reason not to read Nietzsche. This apparent paradoxical nature might sometimes leave you confused and resistant to look again.  However, I feel he is always worth returning to, especially if we are curious about life.

According to Kaufman (2004) Nietzsche depicted himself in Ecce Homo as “a psychologist without equal and many consider his philosophical work to have a deeply psychological understanding of the human experience.”  [1]

Freud apparently discussed the level of introspection Nietzsche reached as being greater than anyone else past or potentially in the future. [2]

When I began to read Nietzsche, I was actually surprised at how engaged I became, despite how little I seemed to understand. He inspired me then and continues to each time I return to his texts, often seeing it from a different perspective each time.  I feel his rhythmical and metaphorical offerings were made to stimulate exploration and awaken emotional responses rather than offer conclusive truths. He was purposely ambiguous and contradictory. For me, Nietzsche was on the side of experiencing and embracing the significance of creativity, music and dance. He
welcomed understandings about fluidity, multiplicity, becomings and going beyond. I feel he invited us to see that we are so much more than we have dreamed of thus far, and there are many dimensions to be explored.

My understanding of Nietzsche is that he was not one to be dogmatic, and he challenged scientific reductionism. Bazzano (2019) discusses how Nietzsche did not see science as able to explain life, only describe it. He challenged people to see how structures and systems were filled with our attempts to the bring natural dynamic and conflicting forces (both internal and external) into order and control [3] .

Or sometimes, perhaps, as a way to avoid taking responsibility.  In fact, Nietzsche was often suspicious of the systematisation of life, “I mistrust all systematizers and I avoid them. The will to a system is a lack of integrity.” [4]   (Part 2, sec 26)

Nietzsche welcomed the dance of life. His writings pointed to the multiple dynamic perspectives and interpretations that direct human experience, and the oscillating movements between chaos and structure that we all seemingly exist within on a macro and micro level. He championed understandings and explorations that focused on active over reactive forces. He centred the ‘need to know’ that can monopolise human thought and perhaps gave consciousness and intellectual knowledge its origins and apparent semblance of supremacy as, in fact, secondary
to the primacy of the body. The latter being a direct experience of active forces experienced through feeling the body’s affects. [5]

Nietzsche has both inspired and disturbed me. He manages to shake the ground beneath you, leaving you adrift at times. Equally he evokes a desire to live this opportunity to exist and experience more fully, within all facets presented. I feel he provokes a desire to feel, listen and move. To take responsibility for this existence we are living in all its uncertainty, intensity and affect and utilise creatively their influence in our transformations. [6]

Sadly, his thinking can be overlooked and dismissed due to his fall into apparent madness. I feel that is a fruitful encounter missed. He is worth reading if only to find out if any gems touch and inspire something within you.

Susanna Petitpierre, UKCP accredited, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

 

Further reading by Susanna Petitpierre –

Magnificent Monsters

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

1 Kaufman (2004). Nietzsche, Heidegger and Buber- discovering the mind vol 2. New York: transaction publishers.

2 ibid

3 Bazzano, M, (2019) Nietzsche and Psychotherapy. London: Routledge

4 Nietzsche, F. (1888/1969) Twilight of the Idols, trans, R. J. Hollingdale, Harmonsworth: penguin.

5  Bazzano, M, (2019) Nietzsche and Psychotherapy. London: Routledge

6 ibid

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Taking therapy ‘online’

When Covid-19 started spreading, I didn’t instantly move away from working with people directly in the room.  Up until that point I had only provided limited online sessions, usually when people moved away from the area or travelled for work.  I was slightly apprehensive about that as an option.  However, as things continued and lockdown measures were looming, I decided to only offer online sessions, and of course it got to a point where this was all we were able to do.

As lockdown measures have eased there has been lots of discussion (and concern) amongst Clinical Psychologists regarding at what point is it ‘safe’ to return to working with people in the same room again.  As I write this, in early July, I do not feel that it is quite time yet, which is to do with a variety of factors.  One factor that is informing this decision is that I am actually (surprisingly) finding online working ok.  In fact more than ok.  There are of course some disadvantages, and it has taken some getting used to.  However, in terms of the feedback from my clients and the reflections I have made myself, I feel that online working is a very viable option.

Over this lockdown period, I have completed work with clients who I have solely worked online with and therefore will never meet in person.  If online working weren’t an option, these clients, instead of having completed a course of therapy, would still be waiting.  I reflected today on how online working doesn’t necessarily have to impact negatively on the therapeutic relationship, as perhaps I had previously anticipated that it would.  The therapeutic relationship is of utmost importance to me:  it is essential that people are able to foster a good therapeutic relationship with their therapist, and this has been proved to be essential in determining whether work is effective.  I have learnt that it has been possible to foster some really strong therapeutic relationships with clients through online working.

In some instances, online therapy might actually be easier for some people, as clients may feel more comfortable and relaxed in their own surroundings rather than in a clinic space.  This may mean that people feel more able to open up and allow themselves to be more vulnerable than they previously might have done.  It may even be about practical factors; people may find it easier to engage in therapy when there are competing demands on time as it can take just an hour out of the day when no travel time is required.

Of course, online options are not going to suit everyone.  For some people accessing therapy via an online platform will not be comfortable or even possible.  However, I am keen that once I am again in a position to offer ‘in room’ therapy again, that I will continue to offer online sessions to those who might want it, or indeed a combination of the both.  For anyone who is considering therapy, but unsure whether they feel online therapy is for them, I would encourage them to get in touch.  I offer a free 15 minute consultation, which can be conducted online in order to get a ‘feel’ for how online therapy might work.

 

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.

Face to Face and Online Therapy Help Available Now

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Psychiatry, Psychology and Psychodynamic Psychotherapy

It’s easy for psychiatry, psychology and psychodynamic psychotherapy to be confused, so in this article, we will provide definitions and distinctions between them all. As the psychodynamic model is what we do, we may be biased. However, there is research that suggests the effectiveness of therapeutic approaches is pretty equal, and that the relationship with your therapist is more important than the model of therapy.

Psychiatry

Psychiatry isn’t necessarily a therapy, but focuses on the diagnosis, treatment and prevention of mental disorders. It takes a scientific, biological pathway to the treatment of mental disorders with the main treatment being medicine or drugs like anti-depressants or anti-psychotics.

In psychiatry, mental disorders are seen through chemical imbalances known as biological psychiatry. People seek psychiatry for many reasons such as panic attacks, hallucinations, suicidal thoughts or hearing voices. In psychiatry, there are other areas like social psychiatry which challenge the typical view that mental illnesses are caused by abnormal thoughts as well as biological and social factors.

Counselling Psychology

Counselling provides a safe space for you to talk to a trained professional about your issues and your concerns. You will work with your therapist to explore your thoughts, feelings, and behaviours to help you develop a better understanding of yourself. During counselling psychology, a counsellor will not give you their opinions, advice or prescribe medications, they will help you come to your own solutions. Whether that be making changes to your life or finding coping mechanisms.

Counselling psychologists use a broad range of treatments to help people who are struggling with stress, anxiety, emotional crises, or behavioural disorders. the British Psychological Society states that “As a science psychology functions as both a thriving academic discipline and a vital professional practice, one dedicated to the study of human behaviour – and the thoughts, feelings, and motivations behind it – through observation, measurement, and testing, to form conclusions that are based on sound scientific methodology.”.

Although counselling psychology helps many people, there are critiques surrounding the scientific methods. For example, scientists at Amgen, the biotechnology company, set out to replicate 53 landmark studies that ended up being accepted as fact. However, they were only able to replicate 11% of the time. This proves that science is fundamentally flawed when carried out by humans as it is often driven by unconscious bias.

Psychodynamic Psychotherapy

Psychodynamic therapy is a type of therapy that helps you understand your current feelings and behaviours are shaped by your past experiences. It is important during this therapy to have a good relationship with your therapist that is accepting, trusting and open. This encourages you to talk freely about topics like your childhood and your relationship with your parents.

A downfall to psychodynamic psychotherapy is that it is often unfocused with no clear goals. Barnaby Barrat, a radical psychoanalyst defines psychodynamics as “an understanding of the human condition that is non-manipulatively interested in the meaning of life’s events for the participant and one that is holistically interested in ‘mind, body and spirit’”.

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.

Face to Face and Online Therapy Help Available Now

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A Primary Task

This is second of eight short blogs exploring the elements of therapeutic change as proposed by Dr Sebastian Kramer.  Click here to read the first one – ‘A Desire to Change‘.

2.  A primary task, a goal . . .

When a client enters therapy they give us permission, to help them with an initial task or goal.  This goal may change throughout the therapy so it can be discussed and the ‘therapeutic sat nav’ can be reset. 

It is important that both of therapist and client understand and agree with what is being worked towards. 

We call it a ‘therapeutic contract’. It helps to keep our talking on subject and the last thing a therapist wants is for a client to walk out of the room thinking that the session had not been useful, that the conversation may have drifted around too many subjects or they had not been asked the questions they were hoping to be asked.  

In systemic psychotherapy it is not unusual for us to ask for feedback from our clients a little way into the session to help us understand if the session feels on track and useful so we can change direction to recalibrate the conversation.

When I was training I thought it was the therapist’s job to solve all of the client’s problems and dilemmas – this was an overwhelming and crippling thought.

I now understand that therapy can exist in chapters, in segments and in episodes.  You can move in and out of therapy with different goals.   

Therapy is an on-going dialogue with the therapist’s job being facilitate, encourage, cajole, challenge, question, celebrate and witness the reflection, insights and successes that our clients experience.

 

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 Psychotherapy can help shape a better world

In Psychotherapy people learn how to reflect more on their lives, choices, behaviours and feelings. This more thoughtful and reflective mode translates into how one sees her or his world and their place within it.

We learn to feel more connected to ourselves and others, and to behave in more thoughtful ways as a result of greater self-awareness. This ‘looking inwards’ has sometimes been mistaken for individualistic or self-indulgent. However, what it does is exactly the opposite – we can only relate better to others and the world around us when we have first developed a better relationship with ourselves. Qualities which are usually seen as altruistic, selfless, and giving usually stem from a place of gratitude and generosity. Whilst some have it in themselves already, others will need to learn it.

Psychotherapy is also about congruence and authenticity. The more out of touch we are with our true values, needs and wishes, the more we suffer. Psychotherapy puts us back in touch with those values, needs and wishes, through a complex process of working through barriers which we have put in place early in our lives.

These needs and wishes are not material or superfluous, but are universally felt needs for connection, love and belonging. The more we diverge from these needs, the more alone and isolated we become. Admitting the need for connection and love can sometimes be painful and even shameful. This is because our fundamental early needs for connection, attunement and love have not been met in the past – to varying degrees.

Only through realising our early wounds, can we begin to heal and move past them into a different way of being in the world which entails connectedness, support, caring and giving. In essence, some of us will need to learn how to feel and give love.

Learning how to love others is the most fundamental quality needed during any crisis. If we can’t love, we harm – ourselves and others. When we love, we can extend ourselves to others, empathise and feel with others. When we truly see someone else’s pain, we see them as a ‘real other’. This applies not just to human beings, but also animals and nature.

In Psychotherapy we can work on lessening this ‘disconnect’ between who we want to be and how we currently live. People discover new ways of being and living as a result of this work. Therefore, in key times such as these, let us move consciously into shaping a better world for everyone and the planet we live in.

 

Sam Jahara is a Psychotherapist and Co-founder of Brighton and Hove Psychotherapy. She has a special interest in how Psychotherapy can influence social change.

 

Further reading by Sam Jahara

Making the most of your online therapy session

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

Leaving the Family

Psychotherapy and the climate crisis

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Why psychotherapy sessions should end on time

Boundaries are critical not only to a psychotherapeutic relationship, but, as many clients learn through therapy, are essential to healthy adult-to-adult relationships.

In a good psychotherapeutic relationship, there is a solid contract between client and therapist such that clients know what to expect and when.  And part of this knowing by the client is knowing what time the session ends; most psychotherapy sessions last for a ‘therapeutic hour’ or 50 minutes.

Door-stop moments

Every clinician has encountered what are known as ‘door-stop moments’ with clients – they happen in the moments leading up to the end of a session where a client suddenly blurts out something emotive and important that can throw the therapist and lead them to extend the session by some further minutes.

Unconsciously, door-stop moments have much significance and represent a relational process between the client and therapist.  Yes, the content may be important, however, why is it being brought into the room (and relationship) in the final moments?

The client may unconsciously want to control the session by ensuring their therapist has no time to explore the content in detail; they may wish to ‘leave’ something difficult with their therapist to hold for a week; and they may be testing whether the therapist will hold the boundaries.  Or all of the above and more.

On hiding an being found

Donald Winnicott, esteemed 20th Century British analyst famously said “it is a joy to be hidden, and a disaster not to be found”.  Winnicott was making reference to the children’s game of hide and seek, which, is only enjoyable if we imagine that someone is looking for us.  If the other game participants give up and leave, we are left hiding with nobody holding us in mind – a disaster.  In this quote, Winnicott is talking about many concepts, but amongst others he is making reference to boundaries and holding others in mind.

Even though in the game of hide and seek the winner triumphs by not being found, they paradoxically only win if the other(s) are still searching for them – the game therefore is profoundly relational and based on an agreed set of rules.

Psychotherapy is also relational at its core and based on a set of rules (boundaries).  One of these is that sessions end on time.  Clients will find all sorts of ways to ‘hide’ from their psychotherapist, however, this is only ‘joyful’ if they believe that they will be found (seen and contained).

When a client presents a door-stop moment to us, it cannot be allowed to derail the boundaries of the relationship or the rules of the game.  Otherwise the client gets what they think they want (more time) but feels omnipotent and thus unsafe with their psychotherapist – in other words, the client has hidden so well the psychotherapist has forgotten about them.

It is never about the client even though it seems it is

Extending a session due to a door-stop moment is never about the client’s needs and always about the psychotherapist’s.  The client relies on their psychotherapist to ‘hold them in mind’ and thus hold their best interests in mind.  It is the latter that gets lost when a session is extended.

How can it be in the psychotherapists interests to extend a session?

Unconsciously the psychotherapist has also ‘got lost’ and is unable to remain separate from the client’s needs.  They thus extend the session to try and ‘please’, or appease the client, which fundamentally is about avoiding the client’s anger’ rage and disappointment.  And the job of a psychotherapist is precisely to survive these feelings in their client and what it makes them feel.

Don’t become a psychotherapist if you want your clients to like you

Psychotherapy is only happening when a client feels either positive or negative feelings towards their psychotherapist (and vice-versa).  If the relationship is neutral, nothing is happening.

It is easy to bask in the glow of a client’s adoration but beware, a fall will come.  And so it should.  As psychotherapists we are not there to be liked – we are there to remain constant in the face of our client’s emotions.

And being constant means ending the session on time.

 

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 –

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Can Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

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Making the most of your online therapy sessions

During the recent challenges brought about by Covid-19, we all had to make significant changes to our lives and adapt quickly to a new reality. This is also true for therapists and clients who shifted quickly from the safety and familiarity of their consulting rooms to video or telephone meetings. I would like to acknowledge the impact of these changes on both clients and therapists on a separate blog. But first, to help remove some of the anxiety of involved in this transition I want to outline how you can make the most of your online therapy sessions.

  1. Spend some time setting up

Although most of us are familiar with video technology in our personal and professional lives, meeting online for therapy requires some preparation. Not just in terms of tech but also allowing a psychological transition into the therapy space, especially if you are shifting from a different activity in your home.

Give some thought to the room you wish to use, making sure that it is private and quiet, and that you will be sitting comfortably for the duration of the session. Make sure your devices are fully charged or plugged in and well positioned, so that you can see and hear your therapist well. Preferably wear headphones for a better sound quality and experience. Have a phone available in case one of you encounter issues with your tech and need to continue your session over the phone.

Finally, make sure the lighting in the room is positioned so you can also be seen well. Seeing and hearing you well will enable your therapist to ‘tune in’ much better to you, reading nuances in your facial expressions and tone of voice.

  1. Avoid all distractions

Make sure your notifications are switched off and all distractions are put away, such as work and study materials. Most therapy rooms are deliberately thoughtfully furnished in order to offer a calming, comfortable and uncluttered environment.  Ideally try to replicate this in your home where possible. If you live with others, schedule your session at a time when no one will hear or interrupt you.

  1. Communication queues

Psychotherapy and counselling usually take place face to face because it important for both the client and therapist to be able to communicate well with one another. This communication is largely non-verbal and often ‘felt’ rather than spoken. Video can be an additional of barrier to communication, despite advances in technology and video quality. Therefore, it is important that both client and therapist flag up missed queues or gaps in connection as it can be the case with delays or frozen images. Voice any frustrations you are experiencing in relation to this and work with your therapist to try and improve them where possible.

  1. Transitioning into and out of your appointment

As in number 1., give yourself space before and after your session. The travel journey to and from a meeting can help with processing, reflecting and thinking. In the absence of this, allow yourself some quiet time before and after your therapy session. Dealing with difficult emotions and discussing sensitive topics can leave us feeling vulnerable for a little while. If you are using your therapy to work on relationship difficulties with someone you live with, engaging with them straight after your appointment might not be a good idea. Go for a walk, take a bath, or just ask for some quiet time on your own. Equally, moving from a therapy session straight into dealing with work emails might not be such a good plan.

  1. Remember the positives

With Covid-19, we have moved our face to face meetings online because of circumstance rather than out of choice. However, people have been offering online therapy for quite a few years now. Although my preference remains meeting people in person, I am beginning to appreciate some of the advantages of online working. For instance, it is nice to be able to use headsets and adjust the volume if I can’t hear someone well. Because I no longer need to travel to and from work, I now have more time to do things I used to have no time for. It has also given me much more flexibility to see clients at times I previously couldn’t. There are advantages and disadvantages of working at home and working online. It will take us sometime to get used to our new reality. If we can’t change our new predicament, we may as well make the most of it!

 

Sam Jahara is a Psychotherapist and Supervisor in private practice working with individuals and couples. She is also the co-founder of Brighton and Hove Psychotherapy, a multi-approach clinic, offering Psychotherapy, Psychology and Counselling to all client groups, both face-to-face and online.

 

Further reading by Sam Jahara

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

Leaving the Family

Psychotherapy and the climate crisis

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

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

Many self-employed psychotherapists, psychologists and counsellors have immediately felt the economic impact of the crisis brought by Covid-19. As our clients began to either lose their jobs or face increasing economic uncertainty, many had to either put their sessions on hold or stop coming altogether. Many of us have either dropped our fees or continued seeing people with the uncertainty of getting paid. Unfortunately, some people have lost their support system when they need it the most.

Private Psychotherapy has always been enjoyed by many in the UK and around the world, as most national health services cannot offer the same level of professional service due to cost.

Psychotherapy practices have always offered a vital service to the community, whether through charities, low-cost services or full paying clinics. Psychotherapy is a place where people’s deepest mental anguishes have a place to exist, to unfold and to be healed.

The health and consequent economic crisis brought by Covid-19 is already affecting people’s mental health in several ways, some of which have not yet come to light. This is being felt and will continue to be felt for a while to come at all levels of society.

An Existential Crisis

Covid-19 has highlighted our main vulnerabilities as human beings. It has hit many people at a very fundamental existential level as many have lost their jobs and their livelihoods overnight. In addition to this, as more people become infected and die of Coronavirus, we have become much more aware of our mortality and that of those we love.

Living in a globalised world, the spread of the virus had happened so rapidly that we have not had the time to process and digest the changes which we have been required to make as a result of the restrictions imposed to keep the virus from spreading. Never could we have imagined that something which started in China a few months ago could spread and reach our doorstep so rapidly and dramatically. This further highlighted our lack of immunity to world events.

Impacts of Lockdown

With people being asked to stay at home to protect the NHS, schools and businesses closing and people being asked to work from home (if they still have work), suddenly the home has become office, school, gym, social hub and place of relaxation. Whilst some families are feeling more crowded as a result of these changes, some people living on their own have become more lonely, isolated and vulnerable.

Some families trying to make life work under lockdown are finding that their relationships are being put under more strain, whilst children of unhappy and even abusive families are being made to stay at home more.

Of course, there are also positive stories emerging as a result of families spending more time together and solidarity between people. In times such as this, we are seeing the best and the worst of human nature.

Why is Psychotherapy vital during these times?

To put it simply, in times of crisis psychotherapy helps us to hold onto our thinking. When our survival is threatened, our ‘reptilian brain’ takes over and we can act impulsively (panic buying for instance) often resulting in harm to self or others. Thinking makes us slow down and consider options. In times of crisis, we sometimes need to think quickly and make decisions. However, buying time to think enables us to put things into perspective and to make wise rather than impulsive decisions.

Because this is both a health and economic crisis, it is hitting many of us at our very core. The British attitude to “keep calm and carry on” works to a degree. Of course, we need to keep calm, but we also need a place to acknowledge and talk about our fears, losses, despair, sadness, anger, etc if we are going to survive this crisis in good mental health.

 

Sam Jahara is a Psychotherapist and Supervisor in private practice working with individuals and couples. She is also the co-founder of Brighton and Hove Psychotherapy, a multi-approach clinic, offering Psychotherapy, Psychology and Counselling to all client groups, both face-to-face and online.

 

Further reading by Sam Jahara

Leaving the Family

Psychotherapy and the climate crisis

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

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Online Therapy

We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?

There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.

There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?

Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.

Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.

A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.

Here are a few points you might want to consider if you want to access therapy online:

  • You will need to have a good, stable internet connection for the duration of your session.
  • It is best to have a few connection options available – such as wifi and data, and a couple of different options of apps – such as Skype and Zoom, to allow for tech difficulties.
  • You need to be comfortable working online and familiar with the tech you are using. It’s a good idea to turn off any notifications for the duration of your session as these are very distracting when you are trying to work with your therapist.
  • You need to ensure that the location you are in is private and confidential.
  • You should check the credentials and qualifications of your therapist before you engage in any online therapy. There is a growing number of people setting up online as ‘therapists’ with little or no training. Make sure your therapist is registered with a professional body such as UKCP.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

Further reading by Dr Simon Cassar –

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

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COVID-19 (CORONAVIRUS) Important Notice

We would like to reassure all our clients that Brighton and Hove Psychotherapy, including The Barn, in Lewes,  is operating as normal despite the current situation. 

We are coordinating our response to the virus to ensure we can continue to deliver sessions to our clients, look after the welfare of our associates and maintain the continuity of our practices.

Psychotherapy sessions do not involve physical contact and a boundaried physical working distance of more than a metre between clinician and client is maintained in sessions as general good practice.

Should clients or clinicians need to self-isolate, regular sessions will continue using video call or telephone as an alternative means of working, until face-to-face sessions can be resumed.

We are monitoring the situation closely, guided by appropriate health organisation advice (PHE) and relevant government guidelines.

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So what actually is a Psychologist?

It’s important to note that the term ‘psychologist’ is not actually a protected title.  So, anyone can technically call themselves a psychologist.  If someone claims to be a psychologist, then the question to ask is, what kind of psychologist are they, and perhaps more importantly, what qualifications do they have.

Undergraduate degrees may be undertaken as either a Bachelor of Science or of Arts.  Completing an undergraduate degree in psychology gives a good basic introduction to a wide range of psychological theories and applications, but not necessarily expertise in any one area.

The British Psychological Society describes psychology as:

‘the scientific study of the mind and how it dictates and influences our behaviour, from communication and memory to thought and emotion.  It’s about understanding what makes people tick and how this understanding can help us address many of the problems and issues in society today.’

There are many areas of both theory and application within psychology; health, educational, forensic, counselling, occupational, clinical, sports and exercise, and neuro.  Becoming qualified in one of these fields requires post-graduate study.

In the example of Clinical Psychology; the current route for training is a 3 year doctoral degree (after the undergraduate degree) which involves both university teaching days and days on placement with the NHS.  In order for someone to call themselves a Clinical Psychologist, they must have completed an approved training course, and be registered with the Health and Care Professions Council (HCPC).

The HCPC regulates all applied psychologists within the areas above. The below are protected titles, which means people can only use them if they have completed an approved training course and complete ongoing appropriate Continuing Professional Development.

  • Practitioner psychologist
  • Registered psychologist
  • Clinical psychologist
  • Forensic psychologist
  • Counselling psychologist
  • Health psychologist
  • Educational psychologist
  • Occupational psychologist
  • Sport and exercise psychologist

Any other titles, such as Media Psychologist, Celebrity Psychologist or TV Psychologist, such as are often seen in the media, say nothing about the qualifications or expertise of the individual.  Understandably this is often misunderstood by the public.  As a Clinical Psychologist it concerns me that people may put their trust in, or even pay for services delivered by, unqualified people.  In addition it is concerning that the reputation or credibility of the profession may be damaged by unqualified people providing a poor service.

It is a very confusing area, however, probably the most important thing to remember is if you are considering working with a psychologist in any of the fields above check that they are registered with the HCPC on www.hcpc-uk.org

 

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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Hove clinic
49 Church Road, Hove, East Sussex, BN3 2BE

Lewes clinic
Star Brewery, Studio 22, 1 Castle Ditch Lane, Lewes, BN7 1YJ

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