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Communication, communication, communication

Of all the problems presented by clients when they first attend therapy as a couple, communication difficulties are often to be found as the most pressing. However, our difficulties with communication is not just an issue within a relationship: it touches every aspect of our lives – which makes the effort of finding out how we communicate well worth the effort.

Our style of communication is based on how we learned to communicate in our families, culture, society, and with our peers.  It is important to understand that communication is a learned skill:  when we are born, we will be neither good nor bad communicators. However, since it is a learned skill, it means we can unlearn things that make communication a problem, and we can learn new ways to be more effective in the way we relate our ideas, opinions, thoughts and feelings.

What is your style of communication?

Read through a brief description of the four main types of communication and think through which style would be a best fit for you.

  1. Passive Communication       

Passive communicators fail to communicate to others what they think, want or need.  Sometimes they don’t even admit it to themselves. Passive communicators might believe that they are protecting others from their feelings, but in fact more often they are protecting themselves from potential conflict and/or rejection.

Example:

Your partner or friend asks you to do something you do not really want to do. You may feel you are under time pressure, already have too much to do, or already had something else planned for that time.

Passive response:

Agree to do what the partner/ friend asks (what feelings are involved here?)

Say, “Okay”

Pretend not to hear request

Passive communication includes:

  • Avoiding situations which might be uncomfortable
  • Avoiding conflict
  • Avoiding situations that feel emotionally risky
  • Not expressing feelings, thoughts or needs
  • Ignoring our own rights in a situation
  • Lying or making excuses in uncomfortable situations
  • Being apologetic or putting down self
  • Letting others make decisions for us

Feelings might include:

  • Relief (avoided conflict)
  • Resentment (of others for making decisions, having power)
  • Annoyed with self (didn’t say what felt/needed)

2. Aggressive Communication                

Aggressive communicators say what they think without taking into account the other person’s feelings, thoughts or needs.  Aggressive communication includes shouting, intimidating body language, sarcasm and violence. This form of communication aims to hurt, and is often a projection of the hurt and anger the person is feeling.

Example:

Your partner or friend asks you to do something you would rather not do.

Aggressive response:

Laughs at person and storms out of room. (note the ‘acting out’)

“Of course I can’t/ won’t do it!  What an idiotic suggestion.  Why would I want to do that now?  It’s stupid.”

“Yeah, right”

“You always do this.  Don’t you ever do things yourself?  Why me?  You never do things yourself: it is always left to someone else.”

“Why the xxxx did you ever become my partner/ friend?”

Aggressive communication includes:

  • Expression of feelings, needs and ideas at expense of others
  • Violating others’ feelings or rights
  • Dominating and belittling behaviour
  • Having a sense of power or control in the situation
  • Saying what you think without thinking about the outcome
  • Sarcastic remarks

Feelings might include:

  • Sense of power
  • Justified in what you have said
  • Pleased to get your way in the situation
  • May feel isolated (aggressive communication can distance people)
  • Frustration
  • Bitterness

3. Passive Aggressive Communication

People who use a passive aggressive communication style, indirectly say what they think or mean.  It often leaves the person receiving the remark feeling confused, as they have not been clear about what they really think or feel. Although the person speaking might believe they are being polite in communicating this way, both they and the recipient can often be left with unresolved feelings that linger.

Example:

Your partner/friend asks you to do something that is inconvenient for you.

Passive-aggressive response:

“Sure, no problem”…Then seeks out confidante and says, “I just talked to X, who asked me to do this. Can you believe it? He never does things himself, he’s so lazy… How did I get into a relationship with him.”

“I guess I can do that.  I am a bit busy, but I’ll probably be able to do it.  I missed something important the last time, but obviously you need me to do this so I will.”

“Whatever”

“I suppose that is one way to organise your life – getting others to do the work for you. Sure, I’ll do it.

Passive aggressive communication includes:

  • Being indirectly aggressive
  • Trying to control the situation while being ‘nice’
  • Manipulative behaviour
  • Being unclear about how you are truly feeling
  • Denying your feelings about a situation, when you are clearly aware of them
  • Making others feel guilty
  • Avoiding rejection and hurt
  • Getting what you want without facing conflict

Feelings might include:

  • Low self-esteem
  • Isolated because of distancing and confusing communication
  • Angry at self
  • Relief because person has made their point whilst avoiding conflict.

4. Assertive Communication    

People who communicate assertively, are clear and say what they mean. They accept their feelings, thoughts and ideas without judgement and express these in such a way that they don’t put the other person down.  When being assertive, they take into consideration timing, situation, feelings and thoughts.

Example:

A partner/ friend asks you to do something at short notice, when you have deadlines of your own.

Assertive response:

“I am unable to do this as I need to finish x by y.”

“I am unable to do this now, but I could do it by x.’

“I cannot do this now, but I would like to help. How about we meet at x and we can do it together?”

Assertive communication includes:

  • Expressing your feelings, needs and ideas, while maintaining respect for the other person
  • Knowing what you feel so that you can express it clearly
  • Standing up for your rights: saying “yes” or “no” when you mean it
  • Being honest with yourself and others
  • Saying what you mean (with persistence—sometimes you have to repeat yourself when being assertive)
  • Making own choices
  • Taking risks in communication
  • Facing potential conflict

Feelings might include:

  • Feeling good about self
  • Increased confidence
  • Increased self-esteem
  • Relief

Communicating assertively can make us feel anxious, but it often leaves us feeling empowered. It takes practice, but it can become habit. Think about your needs and feelings – and then consider the best way of articulating them.

It is also odd to think that to make ourselves assertive, we need to make ourselves vulnerable (by being honest and open about how we feel). If we fail to do this, and continue to communicate without the connection with feeling, we are likely to continue to ‘act out’ various defensive communication styles learned in our early family units.

How can Therapy Help?

Therapy will help you to understand your feelings better, which in turn will lead to a better understanding of your needs and the needs of those around you. You can then begin to make choices about how you wish to communicate those feelings and needs with clarity.

 

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.

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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.

 

Dr Emma Stevens, HCPC Registered, is an experienced Clinical Psychologist. She has an integrative approach drawing on Cognitive Behavioural, Systemic and Psychodynamic models, as well as Attachment Theory. Emma sees individuals primarily for sort-term work. Emma is available at our Lewes Practice.

 

Further reading by Dr Emma Stevens

So what actually is a Psychologist?

Using the body to calm the mind

Emotional Well-being

What is EMDR?

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Psychiatry, Psychology and Psychodynamic Psychotherapy

I am aware that these terms often get confused, so will use this blog to offer some very brief definitions and distinctions. Full disclosure – I’m biased, the psychodynamic model is ‘my bag’, however it’s also really important to point out that, the research suggests a pretty equal efficacy between therapeutic approaches and that the working relationship with the therapist is more important than the particular model of therapy they practice. 

Psychiatry: – which isn’t a therapy but the branch of medicine that seeks to treat ‘mental disorders”. As its part of medicine, it seeks to take a scientific, biological view of the disorders and its main source of treatment is ‘medicine’ or psychiatric drugs, such as anti-depressants or anti-psychotics. These ‘disorders’ are seen primarily through the prism of chemical imbalances and this is what is known as biological Psychiatry.  However, within Psychiatry there are differences, for instance, – Social Psychiatry. Social psychiatry, challenges the traditional psychiatric view that mental illness is caused by abnormal thoughts and actions relating to biological imbalances and stresses the importance of social factors, such as relationships, and the wider contexts of a person’s life. 

Counselling Psychology:-A counselling psychologist will have first completed a degree in Psychology and then an additional counselling training. In theory their approach, or at least the ‘psychology part’,  will be based on theories resting on experiments and scientific deductions, for instance 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, in order to form conclusions that are based on sound scientific methodology.”.

A critique of this would be around the critique of scientific methods, for instance A few years back, scientists at the biotechnology company Amgen set out to replicate 53 landmark studies that went on to be widely accepted as fact. They were able to replicate the findings of the original research only 11 percent of the time. This proves a general critique of science, which is that is inherently flawed as it is undertaken by humans and therefore always, although often subtly and perhaps unconsciously, driven by unconscious subjective and paradigmatic factors. 

 

Psychodynamic Psychotherapy

Johnathan Shedler, working in America, contrasts the psychiatric and psychodynamic approach, arguing that, “a psychiatric diagnosis alone is a poor and limiting way of understanding a person” as it, “fosters the fiction that we can treat emotional pain as encapsulated illness separate from the person having the pain.” 

In my experience many patients have adopted this split way of viewing themselves, it’s very seductive, the idea we are in control and can pick and choose between our emotions rather than having to surf whatever waves they may throw up,  this can appear comforting, however its isn’t because it’s a fallacy. A recent humorous Instagram, post suggests: – “1. Avoid emotional burnout by never experiencing emotions in the first place.” 

Shedler describes the difference between having therapy and having meaningful therapy; – If someone has had meaningful therapy, they will be able to describe the relationship with their therapist, what it was like and what they learnt about themselves, some patients can have had lots of therapy but not be able to describe these aspects as they and the therapist have seen therapy, as a “provider of techniques. “

A critique of Psychodynamic Psychotherapy is that it is often unfocused, that it has no clearly defined goals and no clear direction, which is a fair point but one that is an inherent part of a truly analytic approach. Barnaby Barratt, author of ‘Beyond Psychotherapy-Radical Psychoanalysis’,  defines Psychodynamics as relating to, “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’”, I.e. is interested in the dynamic interplay of these aspects of being human without taking sides, but simply in allowing the conflicts inherent in being human to be explored and brought to consciousness so that whatever uneasy peace may be possible, can be facilitated, and that folks in relation to being human in my opinion  is as good as it gets. 

 

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

The Therapeutic Relationship and the Unconscious

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What is it like being in a Psychotherapy Group? Case study – Joe

In my experience, when exploring joining a therapy group, people often ask what it will be like. I thought it might be helpful to write a fictional narrative to give a flavour of the therapeutic experience of being in a group. This ‘case’ is not based on a real individual although some of the conflicts and difficulties will undoubtedly feel familiar to many. To keep this blog as a short read, I have simplified the details, and have focussed on just one aspect of a person’s history, difficulties, and group experience.

Joe

Joe would always say his childhood was fine. Nothing bad or traumatic happened. No real problems. As an adult, however, Joe felt increasingly alienated in his life and relationships.  In particular, he had struggled to maintain long-term relationships, which was causing him pain, disappointment and worry about the future. 

After his last relationship ended in a familiar way, Joe came into therapy with a sense of loneliness and emptiness. Through discussing this with the therapist, Joe came to feel that a group might be helpful for his difficulties.

Early stages

Once in the group, Joe found that by listening to the way others talked about their experiences, and hearing their feedback to his own, he could start to formulate some different perspectives on himself. 

Particularly new for Joe, was an insight into the ways he had felt neglected as a child. Joe began to connect old memories and recall new ones which gave a picture of a lonely child overlooked by two busy and distracted parents. It was a shock to recall this vulnerable and neglected younger self.

Joe was immediately struck by the supportive and open atmosphere in the group. At first, he found the curiosity and empathy that other group members showed towards him strange. Over time the other members pointed out how often he dismissed his emotional experiences, and the ways that he avoided being taken care of in the group.  Joe realised this was the first time in his life where he felt his emotional needs might be important. 

New Insights

Accepting that his early experiences might have been difficult and impactful was the first step for Joe. He began to realise how he had developed an emotional independence as a means of survival and had therefore set out to deny the needy part of himself. Keeping his needs at bay also required creating a distance between himself and others. Joe was desperately fearful of this defensive system falling apart, and of being thrown back into the loneliness of his childhood. 

A few months in to being in the group, Joe had an important insight that his relationships often began to fall apart around the same time that he started to feel an emotional commitment. Joe’s break-through was heightened by being able to link this to what he was discovering about himself and the feedback he was getting about the way he pushed people away in the group.

As time went on, Joe was able to open-up more in the group. He explored the patterns of relationships failing and was also able to learn from others who also reflected on their own historical and current relationship struggles, as well as developments and successes. 

Making External Changes

After about 18 months Joe was feeling settled in the group. He had started a new relationship, and with the support of the group was more conscious of what was getting stirred up in him and mindful of his impulses to escape the intimacy this person offered him. 

Crisis

The group had helped Joe get in touch with the painful experiences of his childhood that he had tried to deny and avoid. He found himself increasingly in touch with emotional needs that he had not had sufficiently met as a child. This made it harder to tolerate the times in the group where he felt unheard or overlooked. The more Joe opened himself up to his need, the more he felt wounded and frustrated when it was not met. 

Joe announced very suddenly that he was going to leave the group. The group members questioned the timing of this decision and Joe agreed to give it more time and thought.

The group and therapist helped Joe to think about the parallels with the times in his life where he tended to finish a relationship just as it was beginning to be. Joe realised that the frustration and upset he had been feeling in the group was bound up with intimacy. He started to see that leaving at this point was another way of avoiding the frustrations of having intimate relationships. Being able to make a link between what was happening to him in the group and his pattern of relationships helped Joe to properly understand himself on a profound and deeper level. 

3 years on, Joe is still in the group. Last week the other members and therapist were delighted when he told them he and his partner have decided to get married. 

Discussion

Joe benefitted enormously from the therapy group from the outset and had been able to make significant progress and changes in his life, However it was when his ‘problem’ manifested in such a live way in the group that something was able to transform on a deeper level. Joe’s frustration with the group was a turning point in his therapy as he had to confront pain reminiscent of his childhood and see how his habitual strategies of ‘ending’ relationships was a way of avoiding the reality of intimacy. 

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

 

Further reading by Claire Barnes

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

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Cultural Identity and Integration – Feeling at Home in your own skin

I feel lucky to live and work in a place where I am in contact with people of diverse cultural backgrounds. Many seek me out as a therapist to talk about their personal struggles with cultural identity and belonging. Difference is something which is deeply felt in one’s skin and bones and living in a different culture to one’s own can feel like being a fish out of water – permanently. Everyone goes through their own unique set of issues depending on circumstances linked to upbringing, race, gender, immigration status, class, age, sexuality, and disability.

Sense of Belonging

Cultural and psychological integration go hand in hand, given culture is an intrinsic part of one’s identity which is linked to a sense of belonging, safety, and mirroring. All of these are associated to early childhood experiences; for instance, hearing our parents or carers speak in a certain language or with a particular accent, and sensory experiences – smell, taste, sound, and touch. Most of us can recognise the familiarity which transports us ‘home’ through hearing a piece of music, eating certain foods, or hearing our language. Other familiar experiences can include literature and art, nature and wildlife, and weather.

The True Meaning of ‘Cultural Integration’

Migration, whether through choice or not, can result in the loss of everything that has once felt familiar. These losses need to be felt and mourned, so we can better accept and embrace the new culture we are living in. I have come across individuals from other cultures who had on the surface integrated very well in the UK, but on the other hand carried a deep melancholia about their cultural past, preventing them from ever fully ‘arriving’ here. Leaving one’s country and culture for another means reinventing oneself to a certain degree. Whilst this may sound appealing to some, the other side of it is that it can feel that you must constantly explain yourself. The lack of familiar cultural references, working harder to understand and be understood, and the constant feeling of being different are aspects of a migrant’s daily experience which remains invisible to others. We understand cultural integration more superficially as whether one can speak the language fluently, settle and adapt to a new environment. This is only the beginning.

The Role of Psychotherapy

We can think of Psychotherapy as integration of the different parts of the self which conflict with one another. This usually involves mourning losses, accepting reality, and learning to live with (or even embrace) paradox and uncertainty.  This is not about leaving your culture behind – quite the opposite. The more we process and integrate experiences, the more we learn to accept who we truly are. As you can imagine, this will not happen in just a few sessions. Preferably seek a culturally aware psychotherapist who has been through this process themselves or is at least far enough along the journey to take you through it.

 

Sam Jahara is a UKCP Registered Psychotherapist with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Blogs by Sam Jahara

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

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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