Relationships Blogs | Brighton and Hove Psychotherapy

November 23, 2020 by BHP Leave a Comment

Understanding Sexual Fantasy

The exploration of sexual preference and fantasy in therapy can be a portal to our inner psychological landscape. Unlocking the unconscious logic of sexual fantasy is one way of casting a light on our internal world and of understanding the emotional and psychological difficulties that may have prompted us to seek therapy in the first instance.

Our sexual scripts are formed in infancy, long before the onset of mature sexual desire. Our early attachment experiences and the familial and cultural context into which we are born inform the psychological maps and templates for being (in the world) to which we both consciously and unconsciously refer as we develop and grow. We are evolutionarily wired and sensitively attuned to the moods and feeling states of our caregivers absorbing them all through a process of psychological osmosis.

The conflict of growing up

Whilst our lust and capacity for pleasure (according to the Freudian account) are instinctual, the road to pleasure is more often than not a complicated one. We are likely to experience myriad obstacles along the way (many that will later inform our sexual fantasies) guilt, shame, fear, rejection may all stand in the way of our experience of pleasure. We all (consciously or otherwise) feel guilty about something. Life is fraught with conflict – and from the get go. The conflict (for example) between our attachment to our families and to the developmental imperative to grow up, individuate and leave them is fraught with guilt and worry. We bring these unresolved and largely unconscious conflicts into our erotic lives.

The creativity of fantasy

The child of a depressed parent may grow up with a powerful sensitivity to and identification with the sadness of others. It may be hard for such an individual to fully connect to their own aliveness and vitality as sexual excitement is fundamentally incompatible with depression. In the imaginative realm of fantasy such an individual may be released from the burden of caring by populating their fantasies with dynamic carefree people, aroused, excited and turned on. It is not hard to understand, in this scenario, that when everyone is having a great time (and no one is depressed) the fantasy serves as a creative permission to connect, without guilt or shame to one’s own desire.

An antidote to trauma

Many sexual fantasies can seem puzzling and hard to understand. One person’s turn on is another’s turn off after all. Arousal for some may come through being tied up and whipped, another’s from phone sex, group sex, sex with a stranger(s), etc, etc. All are plots of desire, many are attempts to draw on and transform past trauma. When someone is cruel or aggressive in their sexual fantasy or practice it is not because they are inherently sadistic but rather that they are trying to solve a problem. It may be useful and illuminating to consider and understand why the normal pursuit of pleasure may require a particular imaginative scenario in order to be safely experienced.

Empathy and ruthlessness are important aspects of a healthy sexual relationship. Too much empathy (for the other) may be a dampener to our own desire and too much ruthlessness may render sex mechanical and devoid of emotion. Sexual fantasies can be attempts to counteract or transform beliefs and feelings that may interfere with sexual arousal and can provide an elegant ( if not always politically correct) solution to the problems of ruthlessness , guilt and shame.

When we understand our sexuality we understand ourselves.

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

Further reading by Gerry Gilmartin

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

Why does empathy matter?

Online Relationship Therapy

There are many reasons why people seek out relationship counselling and psychotherapy, from ongoing conflicts and communication challenges to infidelity, bereavement and grief, or family-related issues that are causing a rift. By working with a trained counsellor remotely from your own home, you’ll benefit from a confidential and safe space to discuss any issues, past or present, to help you improve your relationship.

What is Online Relationship Counselling and Psychotherapy?

While it may seem in the moment that your relationship is at breaking point, a trained psychotherapist can help you talk through your problems to help you find a solution and to see each other’s point of view. Many couples imagine that relationship counselling means sitting in a therapy room with a clinician, however, there is also the option to talk with a trained professional in the comfort of your own home with online sessions.

Our psychotherapists are trained to provide a supportive and non-judgemental environment to help you face any di?culty in your relationship. Though practically identical to face-to-face therapy, online therapy o?ers the option of receiving counselling or psychotherapy remotely through a secure platform for greater accessibility, convenience and approachability.

How Can Relationship Counselling or Psychotherapy Help My Relationship?

For some couples, just a few sessions of counselling can help them resolve their problems while for others, it’s the beginning of a long process of discovery in order to make a breakthrough. Your clinician will be able to help you in setting out expectations. Whether you’ve been struggling with the same argument for years or it’s a new issue that has arisen, a couple’s psychotherapist can help you work through the problem in a healthy way.

Communication is such a vital component of any relationship and finding new ways to talk through issues can help you move past rough patches and restore your relationship or amicably go your separate ways – an essential consideration where children are involved. Couple’s counselling or psychotherapy can be an incredibly rewarding experience that can make a marked di?erence to your partnership. Through choosing to work online, you can access to our highly skilled team from anywhere in the country.

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

November 9, 2020 by BHP Leave a Comment

Social Connections

“Social connection can lower anxiety and depression, help us regulate our emotions, lead to higher self-esteem and empathy, and actually improve our immune systems. By neglecting our need to connect, we put our health at risk.”
JS House, KR Landis, D Umberson (2019)

Social connection can be difficult to do right now as we find ourselves amidst the Covid-19 Pandemic. We have been told we must socially distance, limit our social connection with others to no more than 6 people at any one time and stay in our established support bubbles. We are now told that we are at risk of a ‘second wave’ and socially connecting can seem even more frightening and confusing.

As we continue to live amidst global uncertainty, we may have found our social connections inadvertently diminishing.

So how do we stay socially connected to maintain our mental wellbeing?

Rather than discussing the various means which we are now using to stay connected, such as Zoom, Facebook, What’s App, etc, I would like to explore how we might identify the people in our lives that can help support us through these difficult times. It is very easy to get caught up in our daily lives, trying to get a balance between work, children, school, hobbies, self-care and more. All too easy our social connections fall by the way side and this can have a detrimental impact to our wellbeing.

I would like to draw upon the Interpersonal Psychotherapy (IPT) approach to help explore this. IPT is based on the premise that there is a relationship between the way people interact with others and their psychological symptoms. The focus of IPT is to improve the quality of a person’s interpersonal relationships and social functioning to help reduce distress. Part of the process in doing this is to identify a person’s interpersonal inventory. This is an exploration of the relationships in a person’s life and identifying ways in which these relationships can contribute to a person’s recovery from emotional distress.

What can be useful in the first instance is to consider all your relationships in your life, in particular those that make you feel better. It’s important to remember no relationship is perfect and no one person can meet all your needs so try to be as inclusive as possible. It is also helpful to consider what support is available to you? When we consider support it is not just emotional support that is important, it can also be social, motivational, practical, educational and even financial. Finally, how available are these relationships to you? This doesn’t have to physically be in person. Not everyone is available all of the time and it can be helpful to identify when different people are likely to be available, e.g. in the evenings or at weekends.

Identifying all the people in your life enables you to have an overview of your relationship world – the overall itself might tell you something important, e.g. that you have few people in your life but they are all very close to you and provide a lot of support.

You can draw a diagram of all the people in your life using concentric circles this allows you to show how close you feel to each person (don’t forget to write yourself in the middle). The most immediate circle to yourself would include those that you are closest to – this would typically be the people that you spend most time with and that are emotionally involved with. Just because these are your closest relationships doesn’t mean they are perfect but they are likely to be your most significant.

Try to ensure that you include everyone, i.e. those that you see in your daily lives, family, children, friends, work colleagues, neighbours, those that you don’t see very often but still regard as friends, those that you may share interests or hobbies with, children’s school friend’s parents, your extended family, even pets.

This exercise enables you to identify who is in your life and how close you feel to them, to consider the support those in your life provide and to consider how available they are or when they would be available.

By having a visual reminder of who we have in our lives we can begin to work at reaching out to our social network – Who haven’t we been in contact with for a while? Who can we pick up the phone to or go for a walk with? Who can we arrange a Zoom meet up with or create a What’s App chat with? We might need to set ourselves weekly goals to pick up that phone or send a message to stay connected, or to reach out for support in these difficult times. Just having a chat with someone can have a positive impact on how we are feeling or being in someone else’s company.

It’s important to remember we are not alone and by reaching out to others for support we will also be helping others to feel more connected and supported. Staying connected is fundamental in maintaining our mental wellbeing now more than ever.

(Reference: Chapter 9, Your Interpersonal Inventory – Rosalyn Law, Defeating Depression.)

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults. Rebecca is available at our Brighton and Hove Practice.

Further reading by Rebecca Mead –

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

October 5, 2020 by BHP Leave a Comment

What is Andropause and what happens to men when their testosterone levels decline?

Schools will soon have menopause on the curriculum. Largely due to the efforts of psychotherapist Diane Danzebrink and her #MakeMenopauseMatter campaign. In 2019 Education Secretary Damian Hinds confirmed menopause will
become part of the Sex and Relationships curriculum for teenagers in the UK in Autumn 2020 alongside periods and pregnancy.

With the recognition that menopause needs to be better understood in the broader context of sex and relationships perhaps now we can begin to talk about men’s experience of changes in their hormones. Testosterone is the main sex
hormone (androgen) in men and the symptoms that men can experience as a result of reduced testosterone are called andropause. The hormone testosterone plays a role in the production of sperm, in the drive to have sex, in building muscle and bone mass, in the way fat is deposited around the body, in the facial and body hair patterns found in males and their deeper voices.

Men will experience hormonal changes as they age, levels of testosterone will start to decline from around 30 at approximately 10% every decade. It is important to note that testosterone reduction can also be affected by other
factors such as injury, cancer treatments, medication and chronic conditions including diabetes, obesity, kidney and liver disease. Symptoms include a lower sex drive, loss of body muscle and an increase in body fat, decrease in bone
density, fatigue, insomnia and difficulty attaining and maintaining erections*.

From research by the Centre for Men’s Health Clinic in Manchester, looking at men over 50 in the UK, Dr Malcolm Carruthers says: “Of the ten thousand men surveyed actually 80 per cent had moderate or high levels of symptoms suggesting they had testosterone deficiency. This shows that its not the rare condition that some doctors claim but actually its very common and almost totally untreated.”

Symptoms described by two patients attending the clinic and suffering from low testosterone, defined as Testosterone Deficiency Syndrome, share features with women’s accounts of menopause.

“Well I was 55 or there abouts and I was getting perspiration in my shirt and was getting really wet, I’m talking serious perspiration, tiredness and I had a lot of muscle aches particularly in my legs”.

“I was a fishing skipper for 23 years and was the type of person that woke up in the morning and rolled out of bed and was on the job, something to do” … Then when I reached the age of 55 I began to feel that I was flagging and I got all sorts of strange to me symptoms, aches, pains, horrendous sweats and uncontrollable temper.”

What about the mental and emotional aspects of andropause? We need to acknowledge and better understand andropause and the impact on men and their lives and relationships. Symptoms of andropause include mood swings,
irritability, low-self esteem, memory and concentration problems and depression. These are familiar menopausal symptoms for women, however it may be harder for men to acknowledge these symptoms and to ask for help
because they are associated with female menopause.

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

References –
Diane Danzebrink
https://twitter.com/hashtag/makemenopause

Centre for Men’s Health Clinic
Associated Press Television 11.3.2011
https://youtu.be/33aCzR4U9l4

*See an earlier blog about men’s use of Viagra here.

September 28, 2020 by BHP Leave a Comment

Why is it hard to make decisions?

‘It’s not about making the right choice.
It’s about making a choice and making it right.’

J.R. Rim

Making a decision can be very difficult. Sometimes it doesn’t matter how big or small a decision is: it is the fact that one has to be made at all which engenders an anxiety that can feel crippling at times.

Why is it so difficult to make a decision?

For well-known psychoanalyst, thinker and writer, Irwin Yalom, decision making is linked to one of his ‘Four Givens’ – one of the four underlying anxieties from which all other anxieties spring. Having to make a decision, suggests Yalom, means we have to take responsibility for our own actions – something he feels we all seek to avoid. If only we can pass the decision off to someone else, we will not have to take responsibility for the outcome. Imagine – we might even have someone else to blame if the outcome fails to go as planned.

There are other impediments to decision making. One of the most common is inertia – our natural reluctance to change our state or position. Put bluntly, it is very difficult to make the effort to move. If you need a banal example of this inertia in action, then ask yourself why so many of us choose to stay with our utility providers, mortgage or banking firms, when we know (for certain!) that we would be far better off with a new provider? Our bias towards the status quo keeps us where we are – or, as Yalom would no doubt point out – allows us to use the ‘where we are’ as a useful excuse for us not to have to make a decision at all.

Research also shows that decisions are easier when there are fewer choices. There are many studies available that demonstrate this bias in our thinking. Shoppers, for example, will buy more when presented with fewer options. As the amount of choice grows, it would seem we become burdened with the weight of the process – and end up buying nothing at all (or maybe everything!) as a response to the sense of being overwhelmed.

Finally, we should also think about the condition of decision fatigue, a condition that can feature significantly in people who are suffering burn out in work or domestic environments. If such a role or lifestyle demands that we make many, serial decisions, there may come a point where we just cannot face making another. You can understand this on a domestic level if you have been in the position where you have asked your friend or partner ‘What shall we have for dinner/ What shall we do at the weekend?’ only to hear the reply ‘I don’t mind: whatever you want.’ Having been in a position where you take decision after decision, sometimes even the most trivial (in this case, ‘what’s for tea?’) can feel like the last – and heaviest of straws.

So what can we do?

We do need to separate the decision-making process from the outcome. The latter is out of our control. In a world which currently seems to be driven by hindsight, it is a wonder how any decisions get made. But we should try to understand that good decisions can lead to poor outcomes.

For example: I toss a coin. I offer you a bet as follows: if the coin falls as ‘Heads’, I will pay you £10; if it falls as ‘Tails’, you pay me £1. Do you take the bet? Fairly easy decision, but imagine you lose ten bets in a row, do you still take the next bet? Although it would seem still an excellent decision (if your aim is to increase your funds), a concern over outcome will often emerge as a major brake on the decision-making ability. It can even collude with the bias towards inertia which we carry (spoken of above), providing a useful excuse to remain risk averse and avoid the decision entirely.

If we can put outcome to one side and concentrate on the decision itself, there are a number of practical strategies we might employ to help to make up our minds. From pros and cons list-making, to identifying our highest priorities and values in the various options, to listening to the voices of third parties, or studying the experiences of others – all of which might well bring a sense of perspective to an area which seems to be drowning in the waters of confusion and distortion. Remember, though, that there will any number of unconscious forces working to prevent that decision being made, so we have to keep in mind that by thinking these things through so carefully, we don’t provide scope to put any decision off – and thus to avoid the responsibility.

It’s only a simple decision!

If only this were true. As Yalom points out, and as our own experience confirms, the matters which lie beneath ‘a simple decision’ are complex and linked to many of the fears and anxieties we all carry as a consequence of our life experience. Lists and balance sheets may help to some degree, but if we really want to understand how to make decisions more effectively – how to take responsibility for what we want – we need to reach a better understanding of ourselves.

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

Further reading by Kevin Collins –

Communication, communication, communication