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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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Group Psychotherapy in a post ‘Pandemic World’

I wonder how you have coped with the forced isolation imposed on all of us during the corona virus.  Has the weekly hand clapping made you feel more part of your local community providing some small contact with others during the week? Or have you been part of a family meeting on Zoom or with friends?

Now, that we are beginning to return to more familiar routines you may be wondering if joining a psychotherapy group might help with the re-adjustment to the ‘new norm.’

Our relationships with family, friends and fellow workers can be a source of inspiration and support; however, often it is these relationships that baffles us.  Joining a group can offer a space for you to share experiences and gain an understanding of yourself.

 

Why should you join a group?  Ask yourself, what are the difficulties I need to address?  These usually fall into one of two groups:

Emotions and feelings – which disrupt life including general performance of daily living skills. You may be taking medication to treat the affects of a disorder.  Common symptoms include anxiety and depression, obsessive-compulsive disorders, eating disorders and social anxiety.

Relational Challenges – we are dependent on our relationships with others to live a happy and secure life.  However, these often challenge us in ways we do not understand. The signs and symptoms above are often caused or cause problems in relationships both personal and at work.

 

What happens next?  When you contact Brighton & Hove Psychotherapy, your enquiry will be passed onto me.  I will then contact you via your chosen method of contact to discuss your concerns.  We will then set up an appointment to meet.

The initial Session – at this first meeting, you and the psychotherapist will have a discussion in order to get to know you. If you both feel joining a group would be helpful another session will be set up.  A questionnaire will be sent to you to complete.

Follow-up – at the next session, we will use the questionnaire to follow-up your history, which will have formed the bulk of the first session. What are you hoping for by joining the group? Depending on your needs for preparation prior before starting the group will be agreed.  I will ask your permission to share your name with the group in order to check out whether there are any boundary issues i.e. you do not know personally anyone in the group already.

Usually there will be at least one more session before you join the group.

The first Session – joining the group for the first time is always a challenge, you already know the psychotherapist and the names of the group members.

There is no set agenda, the group runs using free association.  The boundaries of the group are – (1) always start and finish on time, (2) it will meet in the same venue, (3) it is a confidential space which each person agrees to before joining the group and (4) the members of the group do not have contact outside of the group. It provides a predictable space and time every week for a minimum of 40 to 42 weeks a year.

 

FAQ’s

Can I be in a group and continue with my individual psychotherapy?

No, the group is the primary therapy for the whole time the person is in the group.  A process called splitting can occur if group members are attending psychotherapy outside of the group.

How does Group Psychotherapy work?

The group provides a space to explore relationships in action.  As we all come from families or experiences of care in our young life, these influences stay with us and shape how we are later on as adults.  The small group offers a space to reconnect with that experience and re-work, often-traumatic events, in a safe and secure environment.  In addition to making connections to the past, we can explore current relationships in our families, couples, social and work life. Change of this sort takes time therefore you will need to make a commitment of time for processing and integration.

How confidential is the group?

The group is a confidential space where members of the group are asked not to have contact outside of the group or to share what happens in the group outside of the group space.

How many people are in the group?

A small group has a maximum of 8 members, 9 with the conductor.

Why is the Group Psychotherapist called a Conductor?

This relates to the role of the psychotherapist in the group.  As the group matures the group members become familiar with each other; they know each other’s stories and begin to see the patterns each one may be playing out in their lives.  The role of the psychotherapist will be to bring together the voices much the same way as the conductor in an orchestra brings in various instruments during a performance.

 

Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

Termination and endings in Psychotherapy

What is Social Unconsciousness?

Crossing Borders – Group Analytic Society Symposium, Berlin 2017

What is a Psychotherapy Group?

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Magnificent Monsters

“The passions, these “magnificent monsters” (Nietzsche, 1967, p. 521), can we consider them a gift in which something valuable can be learnt?

Below is a consideration of the multiple, dynamic, creative and sometimes conflicting forces of energy that are often competing for dominance within us – what Fredrick Nietzsche sometimes described as ‘the passions’. Others may describe them as drives, passions and impulses. They are always present and seemingly are what constitutes and influences much of what is our lived experience. Despite their force and significance, they can often go unnoticed and our knowledge of them is always incomplete. They sometimes emerge into our conscious awareness when we are awakened into our existence, for instance when we are confronted by experiences such as uncertainty, grief and love.

Feeling passionate can be both enthralling and scary. Passions are sometimes encountered as other worldly, because they can appear out of nowhere and stir us and shake the ground beneath our feet. Passions can cross the many boundaries of our lived experience. They can symbolise our strong emotional states including joy and suffering. Perhaps many people can relate to the passions felt in the first stages of falling in love, or the sudden earthquake of loss.

At times, we may find ourselves running away from them. This is perhaps born out of a sense of needing to escape from what is being experienced. Perhaps this can be influenced by our conditioned beliefs, rooted in religious and philosophical beliefs, which might espouse that passions are dangerous, uncivilised and something that need to be tamed, and/or eradicated.

Other times we may run towards them, feeling that despite the fear they might cause within us, their intensity and irreducible form feels like an opportunity to live more vitally and come-into-being.

As time passes, human beings seem to be moving into spaces where connection and desire are dampened down by our addiction to technology, self-preservation and control. Even therapy can find itself, unwittingly perhaps, offering ways to master the ever-arising encounter with thoughts, emotions and sensations, so that we might never have to feel perturbed. Other times therapy may be seen as providing an opportunity to self actualise, by integrating all that we apparently are. Perhaps all of this in some way is a strategy to defend against feeling unsafe and uncertain.

But what if moving out of uncertainty is not possible or even necessary? What if these passions are revealing our possibilities, our strengths, our potential to move and become? What if we need them to create, to learn, to feel alive within our uncertain world. What if really feeling them slowly and subtly before acting on them or attempting to eradicate them is important? What if becoming intimate with them and patiently listening to them is what is necessary?

Perhaps this is where therapy can facilitate; by providing a space to feel, to explore, to experiment so that maybe we can change the relationship. What is perhaps significant to consider, for a while at least, are the desires and possibilities they are revealing within us. As Clarice Lispector (2012) wrote: “Life, my love, is a great seduction in which all that exists seduces.” (p 55).

Perhaps some passions must sometimes be tamed in order to live within a collective space. However, within any taming I feel it is equally, if not more significant, to understand what is being felt and moved within us with curiosity and kindness so that we may experience this brief encounter with life more deeply and compassionately.

Maybe letting go of a need to control, just for a while, and trusting our continually changing movements, just for a bit, is all that has to happen?

With gratitude and inspiration from Nietzsche (1967) and Clarice Lispector (2012).

 

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

 

Further reading by Susanna Petitpierre –

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

Lispector, C (2012) The Passion According to G.H. Trans, Idea Novey. London, Penguin

Nietzsche, F. (1967) The Will to Power, trans. Walter Kaufman London: Weidenfeld and

Nicolson.

 

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Love in the time of Covid

I admit the shameless plagiarising of the title of Gabriel Garcia Marquez’ – ‘Love in the Time of Cholera’ as it fits as a Segway into considering the tresses and strains of both finding love, and holding onto in, in the current pandemic. 

The statistics

Disturbing statistics are emerging of surging rates of domestic violence, sadly predominantly perpetrated by men upon women, exacerbated by the circumstances brought about by the ‘lock-down’. A surge of somewhere between 25% and 35% in the rates of reported domestic violence hide all that goes unreported. 

Alongside the extremes of domestic violence lie other statistics such as the reality that many couples have suddenly been catapulted from spending a couple of hours per day together, to inhabiting the same space (indoors and out) for the entire of the day. A young couples dream has become many seasoned couples challenge (and for some a nightmare). 

On finding love 

The old rules of dating have gone through a revolution in recent years from what dating constitutes, through whom we date (gender fluidity) into how we date revolutionised by the internet. 

However, suddenly, the seemingly endless supply of opportunities to physically meet others has dried up with us being left with all the tools and little of the substance. We can swipe left or right, however, we cannot meet those we like (unless we risk social judgement and our own physical health – both of which may paradoxically make the whole encounter that much more exciting). 

Referring to statistics, there has been a surge in pornography use as those who are isolating alone seek out some virtual simulation and those isolating with partners seek out some sense of novelty. Throw into the mix the likely enduring requirements for ‘social distancing’ and it raises questions around what dating may look like going forward? 

On keeping love 

Coping with ‘lock-down’ can be challenging on any relationship whether new or old, robust or fractured. That is because relationships all rely on certain key ingredients that make relating possible – all of which have been outwardly challenged during lock-down.

Space 

It is abundantly obvious that for all of us, our physical worlds have shrunk down. Socialising, leisure trips and the distractions of shopping have all been taken away. And many of us find ourselves cooped up for 24 hours per day (bar the ubiquitous exercise sorle) with our partners. 

Negotiating physical space is always a part of a healthy relationship involving discussion, negotiation and compromise. The world of Covid lock-down has amplified this and with it the requirement to communicate effectively around personal space. In lieu of healthy communication, some couples find themselves acting out and reacting to what they perceive as intrusions by the partner, when their partner is probably trying to carve our a little space for themselves too. 

Boundaries 

Boundaries are similar to space though in this context I shall be referring to them as the management of internal space – emotional closeness and distance. In any relationship, no matter how healthy, it is very unlikely that the two protagonists (or more if you are polyamorous), have the same needs for emotional intimacy. This is inherently frustrating. More so now than ever, but remember, it is also a simple truth of being in an adult relationship with another adult (rather than regressing to the fantasy of a union between mother and infant). 

Boundaries need to be explicitly named and negotiated and naming how one is feeling (taking turns to do so) is a key foundation in managing boundaries: if we know what we are feeling then we can communicate it. 

Difference 

The two former headings bring me neatly onto the concept of difference. One of my pet hates is when couples refer to their partner as ‘my other half’ or some iteration of this fantasy merger. 

Being in an adult relationship with another adult means having to tolerate reality – the reality that our partner is different to us and therefore has different views, thoughts and feelings to us, irrespective of how odd we may find them. 

When tensions are heightened (cue the Covid lock-down), humans can find difference threatening and will seek out consensus and similarity. This happens of a national scale where many differences are (temporarily) put aside for the common good and presents itself in relationships too. The problem is – it is an illusion. 

Sure, we can all agree to put aside differences in challenging times in order to achieve a goal, however the differences remain. And in lock-down, those differences are far less likely to be ‘life or death’ issues between couples and far more likely to be around an opinion about a film, a meal, or some other triviality that when mixed with anxiety, becomes evidence that just perhaps our partner is rather mad and not the right person for us to continue our journey through life with in the post Covid landscape. 

Couple who genuinely fare well in daily life in terms of negotiating and compromising; in observing difference no mater how hard it is – the cornerstone of empathy – will fare better in this crisis. 

The third table leg 

We all know that in order to build a stable table a minimum of three legs is required: two leads to instability. The same goes for relationships – not that we need a third person in the relationship – just the spectre of a third. Let me explain: 

Relationships are a complex balance of wanting to be one with our partner and suffering the frustration of knowing that that cannot happen. To get too close kills the relationship as the couple can no longer see each other and the relationship becomes a merger – a fantasy re- enactment of the womb experience. Too distant an intimacy and connection is not possible – this the the couple dance. 

For many couples their partners interaction with the outside world makes them interesting and enables each to see the other as a separate person who has a life outside of the relationship. Couple work, play and socialise, at least in part, separately. And this is the way it has always been and remains in tribal communities such as, for example the Aboriginal communities of Australia where ‘men’s business’ and women’s business’ was culturally and ceremonially embedded so observe difference. 

Under Covid, many of us have lost jobs, are being paid to stay at home or are trying to work from a co-living space with our partner – we no longer have to wonder about the ‘mysteries’ of men’s and women’s business as we are exposed to it 24 hours a day. The third table leg has become decidedly wobbly. 

On kindness 

Just like ‘Love in the Time of Cholera’ is not actually about cholera, nor are the current relationship challenges really about Covid and the lock-down. They are about who we are and how we navigate adult to adult relationships sacrificing the certainly or a pseudo infant- adult relationship for one that is real and therefore difficult and frustrating. Marquez’ book is ultimately about the reality of relationships in all the glory and pain and that is what is being brought to the forefront in this crisis for many couples. Being kind to each other is harder than it sounds when so much of what we rely on externally to manage our relationships vanishes in a lock-down.

 

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

 

Further reading by Mark Vahrmeyer –

Coronavirus Lock-Down – Physical Health vs Mental Health

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

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

The medical definition of sexual dysfunction in women is hypoactive sexual desire disorder (HSDD) that is low or no libido. Like men, women’s desire for sex is effected by all sorts of factors such as relationship issues, bereavement, physical illness and the side effects of medication, job loss or work stress, depression and anxiety, recreational drugs, hormonal changes through aging and pregnancy, child birth, miscarriage.

There are conditions such as vaginismus where penetration is too painful for women to have sex but for the moment I want to look at chemical attempts to address women’s loss of sexual desire.

Unlike Viagra which treats the mechanics of erectile dysfunction, new pharmaceutical treatments in the US that aim to improve women’s sexual problems act on the brain rather than the genitals because blood flow has nothing to do with sexual function in women. At the moment there are no licensed treatments for women’s sexual dysfunction in the UK, but two in US are available for pre-menopausal women, these are Flibanserin (Addyi) and Bremelanotide (Vyleesi). They work by enhancing the neurotransmitters in the brain that support sexual arousal, reducing inhibition and encouraging sexual excitement.

These medications demand some commitment from users. Filbanserin is taken orally every evening whether you plan to have sex or not and Bremelanotide is injected into the thigh or stomach about 45 minutes before sex, no more than once every 24 hours or 8 times in a month. There are side effects such as tiredness, nausea, headache, dizziness dry mouth and these medications should not be taken with alcohol or grapefruit juice, as this may lower blood pressure to a risky level.

HSDD treatments do not claim to make sex any better rather they claim to promote an increase in women’s desire to have sex. The research determines a positive result as a limited increase in sexual activity measured as one more sexually significant event per month.

I have looked at the anecdotal experience of US women posting online. HSDD medication is extremely expensive costing several hundreds of dollars and the jury is out on its efficacy. Many women commented on the side effects, for some there was no improvement and/or the side effects were intolerable but others were extremely grateful for the difference it had made to their sex lives.

In the UK Prelox, a herbal supplement, is marketed as improving sexual function for late reproductive and post-menopausal women. There were no adverse effects during the trials but there it was noted that any improvements maybe due to a placebo effect.

 

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

 

Further reading by Angela Rogers –

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

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