Brighton and Hove Psychotherapy

01273 921 355
Online therapy In the press

by 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?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Online relationship counselling

There are many reasons why people seek out online 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 at 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-judgmental environment to help you face any difficulty in your relationship. Though practically identical to face-to-face therapy, online therapy offers the option of receiving counselling or psychotherapy remotely through a secure platform for greater accessibility, convenience and approachability.

The Difference Between Online Relationship Counselling and In-Person Relationship Counselling

Our psychotherapists are trained to provide a supportive and non-judgmental environment to help you face any difficulty in your relationship. Though practically identical to face-to-face therapy, online therapy offers the option of receiving counselling or psychotherapy remotely through a secure platform for greater comfort, 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 couples 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. Couples counselling or psychotherapy can be an incredibly rewarding experience that can make a marked difference to your partnership. Through choosing to work online, you can access to our highly skilled team from anywhere in the country.

Contact us today if you want to talk to an expert about your relationship or if you need any advice.

How Online Relationship Counselling Works

There are many reasons why people seek out online relationship counselling and psychotherapy, from ongoing conflicts and communication challenges to infidelity, bereavement and grief, or family-related issues that are causing a rift. Whilst it may feel like 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. By choosing to work with a trained counsellor remotely, you will benefit from a confidential and safe space to discuss any issues, past or present, to help you improve your relationship.

Our Online Relationship Therapists

Brighton and Hove Psychotherapy is home to a talented team of counsellors and psychotherapists with decades of experience. Take a look at Our Practitioners to learn more and find a practitioner who is right for you.

Areas We Cover

At Brighton and Hove Psychotherapy, we have two physical practices, one in Hove and one in Lewes, where we offer a full range of psychological therapies.

Alternatively, we also offer online therapy services.

Why Choose Brighton and Hove Psychotherapy?

Brighton and Hove Psychotherapy provides high quality psychotherapy and consultancy services in Brighton and Hove, Lewes, and online. With over a decade of experience and a talented team of skilled associates, we have built a solid reputation for excellence.

Unlike so many directory sites that purport to be clinics, or large operations comprising of a high number of clinicians, we have purposefully kept our team small enough to ensure we can all work together on a personal basis, whilst being large enough to cater to the diverse needs of our client base.

To find out more about how Brighton and Hove Psychotherapy can help you through online relationship therapy, get in touch with us today to arrange your initial consultation.

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


Frequently Asked Questions

How do I know if we are having relationship problems?

Every relationship has conflict. In fact, conflict can be healthy and certainly the frequency of conflict is no measure of the health of a relationship. Some people simply have more ‘fiery’ relationships than others. However, if your relationship is either too turbulent or eerily calm and you feel anxious or depressed in your relationship, it may be time to work with a skilled relationship therapist.

How can relationship therapy help a relationship?

A good relationship has, at its core, good communication, which relies on each member of the relationship being able to give space to the other and see their perspective.

A skilled couples therapist acts as a stabilising element in the relationship whereby the couple do not regress in the same way during conflict as they do when alone. They can use the mind of their relationship therapist to understand their partner and the underlying process between them.

Couples therapy is not necessarily about the couple staying together.  Rather, it is about facilitating a dialogue and helping the couple reach their own conclusions.

How do I know if I am working with the right psychotherapist?

Effective therapy should feel safe, but not too safe; an appropriate therapeutic relationship is one where you, the client, can learn to take risks, express yourself relationally in ways that perhaps have never felt safe to before, and work at the edge of your comfort zone, without becoming overwhelmed.

Do you offer couples or group sessions?

We offer counselling and psychotherapy for individuals, couples, families and groups. To find out about the types of session we can offer, get in touch with us today. We will find a date and time that works best for everyone involved and we will make sure everyone feels as comfortable as possible.

What happens in the first session?

The first session with one of our practitioners is an opportunity for you both to work out whether you feel able to work together. Your psychotherapist or psychologist will likely ask you a variety of questions relating to what has brought you in and explain the process of therapy to you. The first session is a two-way process where you have the opportunity to ask questions and to decide whether you feel safe and supported with your therapist.

How long will it take for me to see a practitioner?

We aim to respond to all enquiries within twenty-four hours.  You may either contact one of our practitioners directly via their profile page or you can contact us directly and we will assist you in finding the right person as soon as possible. If the practitioner you wish to see has space, an appointment can usually be arranged within a week or sometimes much sooner.

Do you offer evening and weekend sessions?

We offer sessions every day of the week including Saturdays and sessions are available into the evening.

by 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.)

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by 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.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by 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.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Counselling and therapy for organisations

Whether you run or work in a large organisation spanning multiple countries and many offices, or you are part of a business with a small team, mental health is critical. It plays a major role in making sure staff are healthy and happy but also in productivity, working relationships, staff turnover, sick days and more. We offer corporate counselling and therapy services for businesses and their staff covering a wide range of issues from depression and anxiety to managing stress, relationships and confidence issues.

EAP – employee assistance programme

EAPs are offered by many larger organisation to assist and support staff during challenging times be that work-related or personal issues. We are able to work with existing EAP programmes to supply therapy and counselling services. Employee assistance programmes can have many levels from internal HR support, annual mental health reviews and discussions, to specific personal help.

Therapy and counselling services for businesses

Our workplace counselling and other services do not have to be part of an EAP. We are able to offer bespoke help to any organisation whether it is to help and support single staff members and managers or to roll out more general support for teams and departments through individual or group sessions. Our highly experienced practitioners are on hand to deliver first class support for staff ranging from entry level team members to board level support.

Counselling for employees

We support many employees using our range of therapy and counselling services. Whether you’re a business owner looking for therapy services for your employees, or you’re an employee looking for ideas for support to take to your boss, we have a range of corporate services to suit you.

Stress management for business owners

Running a business can be rewarding, but if you’re a business owner, putting your mental health at the top of your priority list can help you run your business more efficiently. Talking to a therapist can be a positive step if you don’t know where to start with your stress and anxiety levels. At Brighton and Hove Psychotherapy, we will work with you to manage the stress of running a business.

Take an HR initiative

Many HR managers are taking action to provide mental health support for employees. We establish long-term relationships with professionals and work closely with HR representatives to provide expert therapy to those in the business who need it.

What is corporate counselling?

Corporate counselling and therapy can take many forms but is generally a process by which employees are able to access mental health services, from CBT and bereavement counselling to executive coaching and much more. It can be a very important part of the overall wellbeing processes for a business with many benefits to staff and the organisation as a whole.

Bereavement counselling for businesses

Bereavement can have a huge impact on the emotional and psychological wellbeing of a person. The death of a loved one – whether a parent, a partner or, unthinkably, a child – is an experience no one can be fully prepared to deal with. However, alongside this, it is something we will all experience at some point in our lives – grief through bereavement, which is the universal leveller. The feelings associated with grief are similar to the feelings of depression, and it can make continuing with normal tasks, such as going to work, a huge struggle.

Common mental health issues in corporate environments

The modern workplace can be a very stressful place. Sales targets, revenue goals, working relationships with other team members and workload can all be factors that cause a range of issues. Stress is common, but stress can often lead to other issues including depression and anxiety. The pressure to achieve on a personal level and dealing with promotion related concerns can also play a very big role in the mental health of anyone in the organisation. Businesses must also be aware of personal issues around money and relationships, family deaths and more, while they may not be a business or work issue they can have a huge impact on the individual and the business as a result. Counselling for business is becoming more and more common and for good reason.

Depression, anxiety, panic attacks, stress, anger issues, addiction and obsessive behaviours are all common in the workplace and can all have a serious impact on individuals, people who work alongside them and the business as a whole. We are able to offer corporate counselling and therapy services to businesses to allow them to support their staff and help improve their mental health as well as deal with crisis issues.

Why is staff mental health important?

Companies are far more reliant on the mental wellbeing of their staff than many realise. When a member of a team is in crisis or suffering long term chronic issues like anxiety it can have a profound impact on the business. The individual’s performance will be impaired, they may avoid certain situations like a sales pitch when they would otherwise have won the business. Depression, for example, can lead to long periods off work, it may prevent some team members working together in a productive way and so damages productivity in the organisation. Often mental health issues can lead to other behaviours, anger issues in the workplace can not only affect the individual suffering but also those around them, which in turn can lead to further mental health issues.

Corporate mental health is as, if not more, important than physical health when it comes to looking after staff and running a functioning business. We offer workplace and employee counselling services as well as more in-depth services around psychotherapy.

Making your team and organisation aware there is mental health support is a very positive thing for any business to do. To discuss our services more and how we can help your business function, grow and be more productive please get in touch to book an initial high level consultation.

We have practices in Lewes and Hove and have clients from right across Sussex as well as London and further afield. To find out about the help Brighton & Hove Psychotherapy can offer get in touch with us today.

by Leave a Comment

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.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

Psychiatry, Psychology and Psychodynamic Psychotherapy

It’s easy for psychiatry, psychology and psychodynamic psychotherapy to be confused, so in this article, we will provide definitions and distinctions between them all. As the psychodynamic model is what we do, we may be biased. However, there is research that suggests the effectiveness of therapeutic approaches is pretty equal, and that the relationship with your therapist is more important than the model of therapy.

Psychiatry

Psychiatry isn’t necessarily a therapy, but focuses on the diagnosis, treatment and prevention of mental disorders. It takes a scientific, biological pathway to the treatment of mental disorders with the main treatment being medicine or drugs like anti-depressants or anti-psychotics.

In psychiatry, mental disorders are seen through chemical imbalances known as biological psychiatry. People seek psychiatry for many reasons such as panic attacks, hallucinations, suicidal thoughts or hearing voices. In psychiatry, there are other areas like social psychiatry which challenge the typical view that mental illnesses are caused by abnormal thoughts as well as biological and social factors.

Counselling Psychology

Counselling provides a safe space for you to talk to a trained professional about your issues and your concerns. You will work with your therapist to explore your thoughts, feelings, and behaviours to help you develop a better understanding of yourself. During counselling psychology, a counsellor will not give you their opinions, advice or prescribe medications, they will help you come to your own solutions. Whether that be making changes to your life or finding coping mechanisms.

Counselling psychologists use a broad range of treatments to help people who are struggling with stress, anxiety, emotional crises, or behavioural disorders. 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, to form conclusions that are based on sound scientific methodology.”.

Although counselling psychology helps many people, there are critiques surrounding the scientific methods. For example, scientists at Amgen, the biotechnology company, set out to replicate 53 landmark studies that ended up being accepted as fact. However, they were only able to replicate 11% of the time. This proves that science is fundamentally flawed when carried out by humans as it is often driven by unconscious bias.

Psychodynamic Psychotherapy

Psychodynamic therapy is a type of therapy that helps you understand your current feelings and behaviours are shaped by your past experiences. It is important during this therapy to have a good relationship with your therapist that is accepting, trusting and open. This encourages you to talk freely about topics like your childhood and your relationship with your parents.

A downfall to psychodynamic psychotherapy is that it is often unfocused with no clear goals. Barnaby Barrat, a radical psychoanalyst defines psychodynamics as “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’”.

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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 benefited 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?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

by Leave a Comment

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, UKCP accredited, 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.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

by Leave a Comment

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.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Hove clinic
49 Church Road, Hove, East Sussex, BN3 2BE

Lewes clinic
Star Brewery, Studio 22, 1 Castle Ditch Lane, Lewes, BN7 1YJ

Copyright © 2025