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November 5, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Are criticism and anger good or bad for a happy relationship?

Studies of happy marriages find that anger and criticism are expressed rather than repressed. However the way that they are expressed matters.

Most of us are uncomfortable with expressing anger and being critical. Anger and criticism generate rejection and everyone hates rejection. More often than not criticizing and complaining create a climate of negative energy before they create positive energy.

Why does criticism feel like attack?

Historically criticism could lead to ostracism that may in turn lead to death. To ostracise someone meant to not speak with them, trade, or engage with them in any way. Being the subject of criticism therefore could threaten one’s livelihood and reputation as well as that of one’s family. Our genetic heritage made it functional to kill the criticiser before the criticiser killed us.

Female vs Male anger

In a study on sex differences, when observers were told that the infant they were observing was a boy they were more likely to interpret “his” emotional expression as anger; observers told the identical infant was a girl were more likely to interpret “her” emotional expression as fear.

When we interpret a woman’s emotion as fear the instinct is to protect, when the same emotion expressed in a man is interpreted as anger the instinct is to fight or flee.

It may be that a double standard has lodged itself in our mindset and translates into our feelings about how to criticize a man vs. a woman. It is more often the case that a man’s criticism of a woman is met with disapproval whilst a woman’s criticism of a man is approved of and approximated with empowerment.

Most men have learnt to express anger and criticism toward other men, but have been socialised to protect women, to argue outside the home (with men) not inside the home (with women). Withdrawal is not the way men do battle with men. It is the way they do battle with women.

Genetic heritage

For millions of years, women have biologically selected men who were heroes. The word “hero” derives from the Greek “serow” from which we get our words for “servant” “slave” and “protector.” Servants and slaves were not expected to express feelings but to repress them, just like heroes.

Our genetic heritage, the socialisation process that led women to marrying killer/provider men and men marrying beautiful women, thus selecting genes from which the next generation of children were born is still with us.

With all this genetic and social baggage in tow, is it possible to create a safe environment in which to both give and receive criticism without fear of annihilation? Couples are often afraid to understand their partner’s point of view for fear it will diminish or discount their own and demand too much by way of compromise. This is understandable in an evolutionary context where survival was more dependant on combat than compassion.

Moving forward

Perhaps it is useful to understand relational dynamics as an art, to be engaged with and navigated without blame or shame. Especially so at a time when our relationships have become the organising principle of our lives and the couple the chief organising unit.

This is easy to say, but if communicating effectively were easy, we’d already be doing it! In my next blog I shall be considering what relationship tools, language and intelligence might look and sound like, such that anger and criticism may be expressed and received in ways that promotes relational growth.

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

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Filed Under: Gender, Gerry Gilmartin, Psychotherapy, Relationships Tagged With: conflict, couple counselling

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.’

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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Filed Under: Psychotherapy Tagged With: adolescent psychotherapy, Mental Health

October 8, 2018 by Brighton & Hove Psychotherapy 1 Comment

Crisis of Meaning

We live in a complex world which, for the most part, seems to demand that we achieve certain things to ‘be someone’ and have a successful and happy life. These ‘certain things’ are the obvious trappings of society – having a good education, getting that well-paid job or rewarding career, finding that perfect relationship, having the right house and the right car, and so on. While these can bring certain levels of happiness and contentment for some people, those feelings are usually transitory and once the excitement of the achievement dies down, it leaves us with the yearning for the next thing on the list, the next achievement that will bring us happiness.

Materialistic society

This, of course, is how our materialistic society works. It is based on continued consumption of good and products, a continued movement towards bigger and better things, with very little time to sit and wonder what it is all about. When we do find the time to do so, we are often left with the nagging feeling that there must be more to life than this. Do we really want to spend our days working really hard, burning ourselves out to earn more money, just to buy more stuff? Is the purpose of our life just to make money, achieve some social status, maybe raise a family and then die? Is this truly and deeply where we want to be in our life?

When these sorts of questions start to arise, we can quickly face a crisis of meaning, which is arguable the epidemic of our times. While we can avoid thinking about these deeper issues for a while by living a busy life and staying at the surface level, these deeper questions with the unsettling feelings they can bring with them will keep bubbling up again and again. For many people this can manifest in a lack of motivation, a lack of joy or excitement in life, and indeed in depression.

What is a crisis of meaning?

So what can we do when we face a crisis of meaning? While there is no easy and straightforward answer to this we can consider two distinct ways of finding meaning in life. The first is to create meaning – to invest our time an energy in something that seems meaningful to us. Being a parent for example, can give some people a meaning in life, or doing some voluntary work, engaging in something that spreads positivity in the world, writing a book etc – all of these can give people meaning. The key is to engage in something that is bigger than you, that propagates out into the world and helps people in one way or another. While creating a meaning can be very satisfying, for many there is a deeper level still to this, and they want to find their true meaning in life – to answer the deeper question of ‘what are we here for?’ In order to find our meaning in life (rather than create it), takes quite a different approach. We need to spend time being with ourselves, listening to our inner voice, spending time in quiet contemplation. For some this will naturally lead in a spiritual direction, as contemplating the deeper recesses of our psyche will invariably move us to transcendental thinking. Engaging with spirituality, whether in an organised way by attending a spiritual or religious group, or just reading and thinking about it, can go a long way to helping us find meaning in life. It is also worth mentioning that spending time in quiet contemplation can also entail facing some of our inner demons, as we come in touch with our deeper emotional side. Understanding and resolving our deeper feelings can be fundamental to living a more contented and meaningful life. 

Psychotherapy and meaning

Engaging in psychotherapy can be a very fruitful journey on the path to finding meaning in life. With your therapist you can find ways to face your inner fears, get in touch with your inner self and express the meaningful life that is yours.

Simon Cassar is an experienced integrative existential psychotherapist, supervisor and academic, providing long and short-term psychotherapy to both individuals and couples at our practices in Hove and Lewes.

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Filed Under: Psychotherapy, Simon Cassar Tagged With: existential psychotherapy

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.

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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Filed Under: Psychotherapy Tagged With: men's issues, mid-life crisis, Psychotherapy

September 10, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is loneliness?

Loneliness is an experience that people coming into psychotherapy often talk about struggling with. It is an uncomfortable and often painful state and usually linked with feelings of sadness, loss and emptiness.

But maybe loneliness isn’t necessarily just a bad experience. Below, I will explore possible causes and suggest there are some positive and helpful aspects to feeling lonely.

Loneliness through circumstances

Loneliness could be characterised as feeling disconnected from others and profoundly alone. This might well be circumstantial – for e.g. someone who has just moved to a new city and doesn’t know many people could reasonably be expected to feel lonely. Their loneliness might indeed help push and motivate them into making some social connections and friendships.

Feelings of loneliness can also be triggered by losing a significant other through separation or death. In these circumstances loneliness will feel bound up with the loss of this person and part of the experience of grieving.

In both these examples we would think a loneliness as a normal response to circumstances of being suddenly alone or losing someone close.

Loneliness and disconnection

Chronic loneliness is often caused by an intense and ongoing sense of disconnection from others. This may not necessarily bear any relation to the presence of other people. In fact, it is often reported that this kind of loneliness is most painfully felt in the company of others.

Becoming so disconnected and lonely is usually linked to a history of emotional withdrawal. Often this comes about originally as a form of self-protection. Self-isolation can be a way of avoiding the painful and difficult feelings that interactions with others can bring. This defensive strategy might start early in life and create its own momentum. It may be deployed all the time – leading to extreme isolation – or at certain times or in more nuanced ways.

In some people, this emotional withdrawal might be obvious, e.g. a literal keeping away from others. In many cases though the withdrawal is more of an internal distancing which may not be obvious at all, even to the person themselves. So, although the individual may have relationships, the quality of all or most of these relationships – i.e. the level of intimacy and genuine closeness – may not be enough to create or sustain feelings of real connection.

While this describes more entrenched or extreme experiences of chronic emotional disconnection and loneliness, it’s important to say that of course we can all find ourselves at times emotionally withdrawing from others and becoming lonely as a result.

Can loneliness be healthy?

Loneliness can be a horrible even desolating experience, but it can also be helpful to pay attention to it.

Earlier, I suggested it might motivate someone to seek out social connections in a new situation. On a socio-political level, a general state of loneliness can be generated by living in an, arguably, increasingly alienated and alienating world. Recognising our own experiences of social disconnection may move us to reach out to others in local and wider communities.

In my view, loneliness most importantly reveals a longing for greater intimacy and closeness and at the same time the absence or loss of this. Loneliness reminds us of our innate connectivity as human beings and its importance to our wellbeing. Where people have a pattern of disconnecting or withdrawing internally to deal with emotional pain, an awareness of lonely feelings can be a positive sign. It can mean the beginnings of a realisation that defensive distancing is no longer working.

Loneliness can indicate something needs to change, or is already starting to.

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

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Filed Under: Claire Barnes, Psychotherapy, Sleep, Society Tagged With: loneliness, Psychotherapy

August 20, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Object Relations Theory?


Object relations theory describes the development, structure and functioning of the human psyche. Although evolved from ideas earlier in the 1900’s, it came to fruition with British psychoanalytic thinking and practice in the 1940s and 50s. Its most notable proponent was Child Psychotherapist Melanie Klein, but further developed by others such as Ronald Fairbairn, Donald Winnicott and Harry Guntrip.  Understanding object relations remains central to understanding how psychotherapy works.

The theory describes how our infant and childhood experience of being cared for and interacted with by our primary carers (mother, father, siblings, grandparents, carers) and other formative figures, as well as situations and events shapes how we then relate to others and to situations throughout life.

Later experiences can to some degree reshape these early experiences. Aspects of relationships and experiences are taken in and absorbed and internalised to form ‘objects’. These exist at the core of our subjective experience, acting as dynamic templates that drive and inform how we think, interpret and perceive our world and expectations and responses towards others and situations.

Why do object relations matter?

If an infant has the experience of a punishing parent who put them down, figures they later encounter can activate memories of how they perceived and responded to that parent and cause them to behave in similar ways.

The theory describes how as babies we understand Objects by their function that relate to parts of a person (part-objects). Klein famously spoke of the “Good” and “Bad” breast; when available to provide comfort and sustenance the breast is perceived as good, while the unavailable breast can become depriving and persecuting in its absence. With their limited mental capacity babies use “splitting” to make sense of experience, with people and things existing in their mind as either good or bad, with no capacity to conceptualise more mixed feelings.

The good enough mother

Through “good enough” parenting (Winnicott) these “part objects” can gradually be understood to exist as “whole objects”. So the breast that provides food is the same breast that can frustrate or persecute in its absence. In the same way an understanding is reached that not only do they belong to the same mother but that the mother who stirs feelings of love in them is the same mother as the one that stirs more frustrated negative feelings. The working through of these processes allows us to be able to tolerate ambiguity, in other words, uncertainty and mixed feelings.

The objects we internalise are not necessarily based on reality but a mix of lived-experience and fantasy. Object Relations, especially those we internalise before we have developed verbal reasoning, become deeply ingrained within our psyche and tend to operate unnoticed by us at an unconscious level. To differentiate between fantasy and unconscious fantasy that takes place at an unconscious level, Klein changed the spelling to “phantasy”.

Psychotherapy helps us to explore our experience of our internalised primary relationships so they are better understood as part of understanding why we think and relate as we do. The therapeutic relationship can be of prime importance in exploring relational dynamics and in healing dysfunctional dynamics.

The deeper level of why we may operate and behave as we do does not cure all ills, but it can offer us a far greater degree of choice and understanding in terms of how we relate to others and situations and in how we perceive and construct our worlds.

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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Filed Under: Psychotherapy Tagged With: object relations, 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.

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Filed Under: Attachment, Brighton and Hove Psychotherapy, Mark Vahrmeyer, Psychotherapy Tagged With: body psychotherapy

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 supervisor, working in Hove and Lewes. Sam is also one of the founding partners of Brighton and Hove Psychotherapy.

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Filed Under: Brighton and Hove Psychotherapy, Psychotherapy, Sam Jahara Tagged With: Psychotherapy, transactional analysis

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.

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Filed Under: Brighton and Hove Psychotherapy, Gerry Gilmartin, Psychotherapy Tagged With: loneliness, Self-esteem

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

How do Transactional Analysts work with Anxiety?

In this blog I share my view 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.

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Filed Under: Brighton and Hove Psychotherapy, Psychotherapy, Sam Jahara Tagged With: anxiety, Psychotherapy, transactional analysis

June 22, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Existential Psychotherapy? An interview with Dr. Simon Cassar – VLOG

 

Recently Mark Vahrmeyer interviewed Dr. Simon Cassar on the topic of Existential Psychotherapy.  This is the first in a series of interviews and VLOGS into the topic of psychotherapy generally.  So, please check out the interview and we would welcome any feedback or suggestions for future VLOGS.

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 works from our Hove and Lewes practice.

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Filed Under: Mark Vahrmeyer, Psychotherapy, Simon Cassar Tagged With: existential psychotherapy, VLOG

April 23, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Is Psychotherapy about Questions or Answers?

People often arrive in therapy looking for answers to life’s difficulties. This might seem like a reasonable proposition. However, it pre-supposes that there might be such a thing as a simple answer to any of the thorny challenges life presents, and, indeed, that the therapist is an “expert” on life, uniquely qualified in their provision. Solutions are at best only ever partial and must always remain subject to review.  I believe that it is often more useful to attend to the nature and quality of our questions. A good question is generous and generative and often far more useful than a tidy answer, alluring as the latter might seem.

The Art of Listening

Remaining curious and open to the humanity of another which lies behind their words is an art to be cultivated through listening. Learning to listen is more than simply being quiet while another person speaks, waiting your turn to say your piece. Listening at its best is a willingness to be vulnerable, to be open to surprise, to relinquish assumption and to enter the realm of ambiguity.

Arguments so often have a quality of familiarity about them, in civic as well as personal life. Culturally, as is so prevalent in current political discourse, conversations polarise around notions of right and wrong and winning and losing. When we enter debate from the perspective of competing certainties, I believe that the conversations it is possible to have become immediately impoverished.

Modern Living

We may experience this dynamic of polarity most often in our intimate relationships. The pressures of work, of raising children, and of paying the bills, among other issues, often render us less than perfectly attentive versions of ourselves. The quality of our conversations with our loved ones often deteriorates under such duress. Managing and prioritising (triage style) the demands of modern life may leave intimate connection forced to the bottom of the pile. When we find ourselves enraged about whose turn it is to do the washing up or encounter one of the myriad incendiary touch points that can inflame separated parents, we know that we are between a rock and a hard place. We are (in part) caught in an inevitable existential bind, tethered between freedom and responsibility, yours and mine. We must find ways to catch ourselves and the conversation before it degrades into one of accusation and blame. If that happens, everyone is at once diminished and relegated to positions of victim-hood.

Opinion Versus Experience

While we may disagree with the opinion of another, we cannot disagree with their experience. When we get closer to understanding the experience of another, we enter a more relational dynamic. In this dynamic, we can be more open to complexity and more tolerant of difference. The quality of our listening changes. We become more generous, less defended and ultimately more compassionate.

Difference of opinion is something to celebrate and defend. After all, it is an expression of our human rights of free will and free speech. When we shut down, deny or disqualify the opinions of others, we enter dangerous totalitarian territory.

Back at the Kitchen Sink

When we find ourselves (as we all do) entrenched in our competing stories of reality, played out amid a greasy cast of pots and pans, perhaps this is a moment for a different kind of question. “What else might be going on for me/you right now?” “What am I /you not expressing/ hearing?” “What is the story we tell and believe about ourselves/ each other in this moment?” Generative questions are more likely to evoke answers in their image and serve to demonstrate our interest, curiosity and respect for each other.

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor who is available at our Hove practice.

Further reading

What is intimacy?

Aims and goals of couples’ therapy

Love, commitment and desire in the age of choice

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Filed Under: Gerry Gilmartin, Psychotherapy, Relationships Tagged With: communication, couple, Relationships

March 26, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Come and Join our Team

We Need You!

Brighton and Hove Psychotherapy is expanding thanks to consistently increasing demand across our Hove and Lewes practices.

We are seeking an experienced and motivated psychotherapist who has the clinical training and experiential background to work with individuals and couples, ideally splitting their practice between our clinics in Hove and Lewes.

This is an excellent opportunity for the right person to join our strong team of clinicians and to contribute to a cohesive practice whilst growing a vibrant private practice.

We are interested in hearing from UKCP registered psychotherapists or equivalent (BPS/BPC), who can bring additional skills to our practice.

This position would be on a self-employed, part-time basis.

If you are looking to be part of a clinical team, to contribute to blogs, reflective practice meetings and work as part of an integrated talking therapies clinic then please email mark@www.brightonandhovepsychotherapy.com.

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Filed Under: Mark Vahrmeyer, Psychotherapy Tagged With: Psychotherapy

March 19, 2018 by Brighton & Hove Psychotherapy Leave a Comment

The Truth of the Myth of Anti-Depressants

The Truth of The Myth of Anti-Depressants A Response to Johann Hari’s Book  – Lost Connections

As a psychotherapist, I welcome honest debates about mental health, as they can help reduce the stigma and isolation of many sufferers experience.  Recently, a book has been published by controversial author Johann Hari, that has created a bit of a storm,  in which he claims to dispel the myth of anti-depressants and provides us with the Nine Factors that lie at the root of anxiety and depression.  Here is my two-cents worth:

Do anti-depressants work for some people?

Yes they do.  And furthermore, they can be essential ‘life rafts’ for clients who simply cannot cope.

They are compatible with psychotherapy in as much that clients need to be thinking about and taking responsibility for choosing healthier ways of coping.

Are there ‘Nine Factors’ contributing to Anxiety and Depression?

This idea really concerns me.  It is less about whether Hari’s ideas or suggestions are valid (some are), but rather seems to be reminiscent of a reductionist trend of identifying and listing the problems of the human condition, with a view to us being fixed if we address the list.  The many causes of depression include biological, social, economic, genetic, epi-genetic, existential and more beyond.  And they are all interconnected.

The Problem of Being Human

Since the dawn of time, man and womankind have pondered the purpose of life.  Existential thought and theory has much to teach us on this matter and the many tomes published on the topic have never identified a specific number of causes.

Perhaps what we are ultimately left with is that anxiety and depression are part of the human condition.  Whether this is a random fluke of evolution, or brought about by us being (as far as we know) the only species who must live life knowing we shall die – existentially an unbearable proposition – or a combination of the two, I do not know.

My view is that being a successful human being is about learning to come to terms with the past and to learn to tolerate our feelings and then navigate by them.  If anti-depressants help us bear the unbearable for a while, they have a place and a role which can be lifesaving.

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes.  He is existentially informed and has a background of working in palliative care.

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Filed Under: Mark Vahrmeyer, Mental health, Psychotherapy Tagged With: anti-depressants, anxiety, Depression

March 12, 2018 by Brighton & Hove Psychotherapy Leave a Comment

The Menopause: Women of a Certain Age

For many women in the 21st century, the menopause leads to a sense of freedom, independence and creativity. Of course, I want to celebrate this, but I also want to talk about less welcome aspects. Culturally, the menopause is still somewhat feared and is something of a taboo. It is also open to derision and often referred to with euphemisms or jokes.

Sharing the experience

Things might be changing. Recently, a few women celebrities have used the media to share their physical and mental struggles through several years of the menopause. I believe that sharing these experiences publicly is especially important in a culture that does not take the reality of the menopause seriously. Think about the photographs of post-menopausal celebrities on the front pages of women’s magazines, looking glamorous with their obligatory bobbed and highlighted hair, subtle yet sexy make-up and carefully co-ordinated outfits. I do not want to dismiss women’s aspirations for wanting to look good at any age, but the demands for women to look sexually attractive can be punitive. The hostility Mary Beard received for appearing on television apparently unmade-up and with her hair worn long and grey is telling.

Physical symptoms and emotional wellbeing

Physiologically, the menopause is the cessation of menstruation and is medically defined as one year with no bleeding. Other physical symptoms include hot flushes, night sweats and insomnia, dry skin and hair and weight gain. We are likely to feel less sexually attractive, whatever our sexual orientation. There may be a drop in libido and physical changes in the vagina can make sex difficult or painful.

Fortunately, there are hormonal and medical interventions that can treat these physical symptoms with some, but not complete, success. Along with the physical changes in our bodies, psychological symptoms related to the menopause can affect our emotional well-being and leave us feeling vulnerable. Changes in how we experience ourselves, such as being unusually grumpy or depressed, voicing our frustrations or losing our temper can be disconcerting and make us wonder if we are going a bit crazy. This is especially so in a culture where women are rewarded for being nice, kind and caring.

The menopause, life events and relationships

The physiological and psychological effects of the menopause coincide with inevitable life events for women in their 40s and 50s. These include decreasing fertility and the end of child bearing or the hope of ever giving birth. In an age of increased life expectancy, the hope of having time in later to do what we have always wanted may vanish as we see ageing parents need care and support. It is also a stage in life when children leave home, another kind of painful loss that can throw the focus onto the dissatisfactions of a marriage or partnership. Long-held resentments towards a partner can be a factor in a lack of sexual desire. If both partners feel less interested in sex, a less active sex life is part of growing older together. However, clinical research tells us that a decrease or cessation of sexual desire and sexual activity is one of the most pressing and distressing concerns for menopausal women (Kolod 2009). It is probably the most difficult to talk about because of a sense of shame and a feeling the situation is hopeless. Depression is an understandable result. For women not in relationships or without children, or affectionate children, the menopause may be an acute reminder of the lack of an intimate or physically loving relationship.

How counselling and psychotherapy can help

Exploring these questions in a safe and supportive environment is a chance to think about and express the experience of the menopause without judgement. In this setting, losses, regrets and unrealised dreams can be grieved without recrimination. Working with a counsellor or psychotherapist can help us come to terms with these physical and social changes and lessen the emotional distress and negative impact on daily life. It is an opportunity to look at what getting older means for us and the choices and freedoms we have to live our own futures.

Reference: Susan Kolod (2009) Menopause and Sexuality, Contemporary Psychoanalysis, 45:1, 26-43, DOI: 10.1080/00107530.2009.10745985

 

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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Filed Under: Psychotherapy, Relationships, Sexuality Tagged With: Counselling, Menopause, Psychotherapy, Relationships

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