Relationships Archives | Brighton and Hove Psychotherapy

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.

How body stability creates psychic stability

There is No Such Thing as a Baby

I frequently blog about the importance about including the body in the process of psychotherapy and how the unconscious resides in the body. However, unlike many ‘body psychotherapists,’ I believe that the involvement of the body is more profound than identifying the presence of the body in the process. Let me explain using one of Donald Winnicott’s most famous quotes, “There is no such thing as a baby.”

Winnicott famously made this statement in 1947. On face value, it may seem somewhat absurd. After all, we have all seen babies and know they exist. However, the reality is far more complicated, because every baby that any one of us has ever seen is only visible because it is in a relationship with its primary carer (which for simplicity, I shall refer to as its mother).

A baby cannot exist alone but is essentially part of a relationship. Babies exist in an absolute state of dependence, such that the infant (the word is taken from the Latin – ‘infans’ – not able to speak) has no knowledge of maternal care, as this would require the knowledge of ‘an other’ providing the care. The baby therefore is essentially indivisible from its mother and thus cannot exist in its own right. The infant’s experience relies on the mother’s ability to merge with, and adapt to, her baby. Therefore, whenever we see a baby, we actually see a baby, its mother, the relationship between the two and also the wider social context within which that baby lives and has come to be.

There is No Such Thing as a Body

The same principle can be applied to a body. There is no such thing as a body in its own right. A body is created, shaped, moulded and exists within the relationship that the mother of the owner of the body has had with it. In other words, the body and how it is experienced by the person in the body is contingent on the relationship that the baby has with the mother and the wider environment. This then dictates the relationship that the owner of said body, has with him or herself (if any.)

Why Does the Body Matter?

Psychotherapy is about many things, but one of the primary tenets is that it is a relationship within which the client/patient can, through relating to the therapist, establish a relationship with themselves. Having a relationship with ourselves includes having a relationship with our body. However, I believe that too many psychotherapists assume that such a relationship is necessarily experienced as helpful by the client at the outset of therapy, or even possible.

The Body as an Enemy

If we come to inhabit, or embody, our bodies through the relationship with our mothers and the wider social context, and our mothers were abusive to us, then the experience of our body can be one of ambivalence (‘I don’t really care about my body”) through to experiencing the body as dangerous, attacking or not our own.

Examples of where internalised abuse/hatred is expressed towards the body include cutting and burning the skin through to anorexia and bulimia, to name a few.

Risk of Trauma

Assuming a pre-existing, or even conceptually possible positive relationship between a client and their body on the part of the psychotherapist is naive. At worst, it risks re-traumatising the client.

If, for the client, all that is bad resides in their body, then they need to slowly find a way to ‘meet’ their body in a different context and to tentatively form a different relationship with their body – to reclaim it from the ‘bad’ parent. The therapeutic process involves creating a different relationship with ourselves, one in which we are able to leave the echoes of past formative relationships behind. At the very least, we need to learn to think about ourselves as players in those stories in a different way. In the same way, we need to learn to relate to our body as our own and as our friend, guide and an integral part of us.

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

Further reading

Body psychotherapy

What is attachment and why does it matter?

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

Couples Therapy In Practice

Couples can often get into familiar and fixed patterns of relating which can be deeply unsatisfying to both parties. This style of relating is one which can eventually seriously threaten the health and longevity of a relationship. In this brief blog, I open a window onto a session which explores a particular dynamic which I frequently encounter in couples work.

Take the following anonymised example:

A domestic crisis had arisen. The wife responded in her typical style : hurried, worried and outwardly emotional.

The husband responded in his typical style: slow and detached.

The wife read his response as insensitive and abandoning.

The husband read her response as over-the-top and reactive.

The outcome was that he withdrew from the situation, while his wife became more distressed and demanding. This was an unsatisfactory outcome for both.

Swapping Roles

I asked if they would be willing to replay the event exactly as it happened. Then I suggested that they swap roles and again replay the event.

This is what we discovered together. The wife would typically become highly reactive as a way of getting her husband’s attention, of which she was uncertain. The outcome was exactly opposite to that which she wanted. Her husband would withdraw and she would again experience feeling abandoned by him.

The husband would typically become unreactive as a way of protecting himself from his wife’s emotional expression, which he feared. The outcome was exactly opposite to that which he wanted. His wife became more emotional resulting in him feeling overwhelmed and needing to withdraw.

I chose this intervention as a way for each of them to experience the trigger point which propelled them into their typical ways of relating to each other when under stress. In other words they both got to not only see, but to feel the ‘game’ which they typically re-played together.

Therapy and Real Life

Research shows us that what is experienced in the therapy space can become real in our outside lives, (Gersie, A., 1995). My experience of working in this active way with clients is that can bring powerful and surprising insights. These insights into our typical ways of behaving, facilitated by a skilled therapist, can lead couples to experimenting with healthier and therefore more mutually satisfying ways of being in relationship.

If you would like to explore how couples therapy can help your relationship, please contact us.

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and groups.

Lady Bird: a Psychotherapist’s Perspective on Key Themes

Ladybird

Warning – This article contains spoilers for anyone who has not seen the movie Lady Bird.

A critical success, this film about a mother and daughter relationship falls into the ‘coming of age’ genre, however it is also so much more than this in considering the systemic and unconscious processes at work that make this film both poignant and painful to watch.

There are many key themes present relating to those clients bring to psychotherapy, however I would like to pick out a couple that stood out for me which are perhaps better posed as questions we can imagine that Lady Bird (Christine), the protagonist, is grappling with unconsciously:

What is my desire?

How do I leave my family?

These two questions are in reality interconnected, as it is through desire that we leave the family. However, in a family where the roles are blurred, and for a young woman whose desire has always had to be curtailed to cope with her mother’s envy, the two questions are complex and the unconscious conflict immense.

From the opening scenes, we see a mother who struggles to see her daughter as separate to her. She clearly loves her, but also invests her own unfulfilled desires in her daughter. This is suffocating for Lady Bird, to the extent that in an early scene, she flings herself from the car to escape the literal confines of being with her mother: existence is impossible with her mother and hurling herself from a moving vehicle is less a thought-out action of leaving, than a murderous gesture – self destructive to her and to her mother.

As the film unfolds, the usual twists and turns of teenage experience are interspaced and amplified by the complexities of Lady Bird’s family. Her father is impotent – he loses his job and cannot separate mother and daughter. However, what he does know is that Lady Bird must leave, and he facilitates this through making financial arrangements for her university education, without involving his wife to whom he seems to be unable to stand up against (or to come alongside). This arrangement is pragmatically what Lady Bird needs, however, psychically it further undermines her autonomy and blurs any clarity of who she is in the family and who she is in relation to her mother.

An Envious Mother

Lady Bird understands, like so many of us who have had envious mothers, that she needs to ‘split off’ (disavow) her desire and get it met secretly, if at all. Or she can turn it into something destructive. Both choices aim to protect her relationship with her mother.

She gets in with the exciting, but bad crowd and swaps her boyfriend (who it turns out is gay) for an aloof boy who, like his friends, is nihilistic in his outlook on life. Neither her gay boyfriend nor her disinterested one will help her leave her family, as neither contain her true desire. Here Lady Bird seems to be asking herself less about her own desire and more about that of others: who am I for others and what do they want from me? A question she asks herself repeatedly in the relationship to her mother.

Owning her Desire

There are two scenes in the film which fill us with hope for Lady Bird: the first when she owns her wish to go to the school prom and be with her old friends, thereby stepping away from her less nihilistic friends who are ‘too cool’ for school, but who in reality actually have no idea about what they want, other than to rebel.

The second scene of hope is at the end of the film where Lady Bird is at an unnamed university in New York. Lady Bird’s father has slipped a pile of discarded attempts at a letter her mother tried to write to her into her suitcase which she finds. This is significant as Lady Bird’s father is finally able to help mother and daughter separate: he encourages his daughter to leave but provides her with the evidence her mother loves her; he assumes his rightful position as his wife’s husband by consoling her at the airport when she, as a result of her struggle to let her daughter have her own desire and individuate, misses her daughter’s departure.

To Individuate or Rebel?

Towards the finale, there is a perfectly ordinary scene with Lady Bird, at what me must assume is her first party in New York, she drinks, meets a guy and they end up at his or hers. She then becomes ill and the next scene is at a hospital where we learn she has drunk far too much. This scene is a reminder of the powerful unconscious forces at play in Lady Bird – whether she can find a way to individuate and own her desire or create distance from her internalised mother through self-destructive acts (think back to the hurling herself from the car).

Ultimately the viewer is left with hope as she seems to have enough psychic distance to claim her birth name – Christine – and to find ways to be like her parents (visiting a local church), without having to be defined by being them, or not being them.

Christine makes a call home to speak to her mother but she gets the answerphone. The message here? That her mother and family can survive her going and that they can too move on with their lives. She is free.

Sam Jahara is a UKCP registered psychotherapist, certified transactional analyst and clinical supervisor. She works with clients and supervisees in Hove and Lewes.

Image copyright: A24

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

The Menopause: Women of a Certain Age

For many women in the 21^st 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

Angela Rogers is an Integrative Psychotherapeutic Counsellor working with individuals in Lewes and Hove.