Simon Cassar Archives | Brighton and Hove Psychotherapy

September 23, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Online Therapy

We spend much of our lives online these days and increasingly more services are available online that traditionally would have been conducted face to face. This is the same with psychotherapy and counselling, and there is a growing availability of online therapy services around on the internet. So, is online therapy for you?

There are many ways to engage in therapy online, but for the purposes of this blog I’ll be considering online therapy that uses live video. This can be done with apps such as: Skype, Zoom, WhatsApp, FaceTime, BotIM etc. Whatever app is used, the most important thing to consider is the security. Only use an app that has a secure and encrypted connection.

There are many benefits to having therapy online and the most obvious might be the convenience of it. Rather than having to spend time travelling to a clinic, you can be at a location of your choice where you feel comfortable. This might be at home, in a private office at work during your lunch break, or anywhere where it is confidential and you won’t be overheard or disturbed. However, you will need to consider what you will do after the session has ended. Do you have time to compose yourself before you step outside the room and back to the office or family life?

Another benefit of working online is that you might have a greater choice of therapists available to you. Rather than having to choose those in your local area, you can work with the therapist of your choice wherever they are in the country. This can be particularly beneficial if you live in a remote area, or live abroad and want a therapist who speaks your native language. Additionally, if you travel around a lot, it can make it possible to access therapy wherever you might be.

Another advantage of online therapy is that it can make it easier to engage with therapy if you are anxious about going to a clinic in the first place, or have any difficulties with leaving home or accessing certain locations. Being able to engage with your therapist online can remove any of these potential barriers and you can get the support you need.

A lot of people wonder if online therapy is as good as face to face therapy, and that is an important point to consider. Certainly, there is a big difference. The rapport and connection you have face to face with a therapist will be different to what you build online. Some of the non-verbal clues to communication can be lost online so it’s important to be able to tell your therapist if they haven’t understood you, or if you don’t understand them. However, once you get used to working online with a therapist, the distance and technology can ‘disappear’ and you can feel very connected with your therapist.

Here are a few points you might want to consider if you want to access therapy online:

You will need to have a good, stable internet connection for the duration of your session.
It is best to have a few connection options available – such as wifi and data, and a couple of different options of apps – such as Skype and Zoom, to allow for tech difficulties.
You need to be comfortable working online and familiar with the tech you are using. It’s a good idea to turn off any notifications for the duration of your session as these are very distracting when you are trying to work with your therapist.
You need to ensure that the location you are in is private and confidential.
You should check the credentials and qualifications of your therapist before you engage in any online therapy. There is a growing number of people setting up online as ‘therapists’ with little or no training. Make sure your therapist is registered with a professional body such as UKCP.

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

Further reading by Dr Simon Cassar –

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

December 17, 2018 by Brighton & Hove Psychotherapy Leave a Comment

So what exactly is Mindfulness?

The term ‘mindfulness’ is much spoken about these days, especially in relation to mental health and wellbeing. But what does it really mean? Mindfulness generally relates to a meditation practice that has its origins in Buddhism. It is thought that the Buddha was practicing mindfulness when he gained enlightenment, and it is one of the key meditation practices for Buddhists.

However, the practice of mindfulness has been taken by psychologists out of its Buddhist origins and used as a technique to help with gaining better mental health and having a healthier and calmer outlook on life. Mindfulness is often used to help treat anxiety and depression, and is recommended by the NICE guidelines for people with depression to help prevent further depressive episodes.

How do I practice mindfulness?

To practice mindfulness is really quite simple. You just need to be aware of what is going on in your body, with your thoughts and emotions, and keep your focus trained on a meditative object such as your breath. Find a quiet place to sit, where you won’t be disturbed for a few minutes, close your eyes, and pay attention to your breathing. Notice the air coming in through your nose or your mouth. Notice how it feels, notice how your chest or abdomen rise and fall with each breath. Notice how your body feels different with each in-breath and out-breath. This seemingly simple practice is actually quite hard to do. You will notice that as you try to focus on your breath, your mind will start to wander. You’ll start thinking about things you need to be doing, planning your next activity, or wondering if you are doing it right. Also, you might start to notice feelings coming to the surface. Maybe you will feel anxious, or notice some sadness connected to an event that happened earlier in the day. When thoughts and feelings arise, all you need to do is to notice that they are there. Give them a label “I’m feeling sad” or “I’m planning” then bring your attention back to your breath. Do this gently and kindly. With regular practice, this will become easier, and you will find that your times of practicing mindfulness will become calmer and you will feel more peaceful. Also, you will start to notice how your mind wanders. You’ll notice the patterns of your thoughts and your emotions and you’ll become less entangled with them. After a while, you’ll start to realise that while you have thoughts and emotions, your are not your thoughts and emotions. They are part of you, but you don’t have to become consumed by them.

By having a regular practice of mindfulness, you can learn to regulate your emotions, and be able to tolerate more difficult emotions easier. You’ll also have more control over your thoughts and be able to step back from your thoughts when they are leading you to dark places. With time, mindfulness can help you become more compassionate to yourself and the others in your life.

And for how long?

It is often asked how often and for how long we should practice mindfulness meditation. The answer to this really depends on how much you want to commit to your wellbeing. A regular, daily practice is important. So try to practice every day if you can. In terms of duration, start small with about 5 – 10 minutes each day. Then start to work up to longer durations. Most people find that it will take about 20 minutes for the mind to really start to settle, and it is after that you will gain some of the deeper benefits of mindfulness. If you can, set aside 40-60 minutes each day to practice mindfulness. However, as we live in a busy world, setting aside this amount of time can be difficult, so if you can’t spare it, or just don’t want to do so much, stay with a smaller amount and keep your practice regular.

Mindfulness is a very important meditation practice that is accessible to all. The are many free videos and podcasts that will guide you in your practice, and many course available to teach it.

Combining mindfulness with psychotherapy is a very powerful way to understand your inner world and to make significant changes in your way of being in the world.

Simon Cassar is an experienced integrative existential psychotherapist and mindfulness practitioner providing long and short-term psychotherapy to both individuals and couples in Hove and Lewes.

October 8, 2018 by Brighton & Hove Psychotherapy 1 Comment

Crisis of Meaning

We live in a complex world which, for the most part, seems to demand that we achieve certain things to ‘be someone’ and have a successful and happy life. These ‘certain things’ are the obvious trappings of society – having a good education, getting that well-paid job or rewarding career, finding that perfect relationship, having the right house and the right car, and so on. While these can bring certain levels of happiness and contentment for some people, those feelings are usually transitory and once the excitement of the achievement dies down, it leaves us with the yearning for the next thing on the list, the next achievement that will bring us happiness.

Materialistic society

This, of course, is how our materialistic society works. It is based on continued consumption of good and products, a continued movement towards bigger and better things, with very little time to sit and wonder what it is all about. When we do find the time to do so, we are often left with the nagging feeling that there must be more to life than this. Do we really want to spend our days working really hard, burning ourselves out to earn more money, just to buy more stuff? Is the purpose of our life just to make money, achieve some social status, maybe raise a family and then die? Is this truly and deeply where we want to be in our life?

When these sorts of questions start to arise, we can quickly face a crisis of meaning, which is arguable the epidemic of our times. While we can avoid thinking about these deeper issues for a while by living a busy life and staying at the surface level, these deeper questions with the unsettling feelings they can bring with them will keep bubbling up again and again. For many people this can manifest in a lack of motivation, a lack of joy or excitement in life, and indeed in depression.

What is a crisis of meaning?

So what can we do when we face a crisis of meaning? While there is no easy and straightforward answer to this we can consider two distinct ways of finding meaning in life. The first is to create meaning – to invest our time an energy in something that seems meaningful to us. Being a parent for example, can give some people a meaning in life, or doing some voluntary work, engaging in something that spreads positivity in the world, writing a book etc – all of these can give people meaning. The key is to engage in something that is bigger than you, that propagates out into the world and helps people in one way or another. While creating a meaning can be very satisfying, for many there is a deeper level still to this, and they want to find their true meaning in life – to answer the deeper question of ‘what are we here for?’ In order to find our meaning in life (rather than create it), takes quite a different approach. We need to spend time being with ourselves, listening to our inner voice, spending time in quiet contemplation. For some this will naturally lead in a spiritual direction, as contemplating the deeper recesses of our psyche will invariably move us to transcendental thinking. Engaging with spirituality, whether in an organised way by attending a spiritual or religious group, or just reading and thinking about it, can go a long way to helping us find meaning in life. It is also worth mentioning that spending time in quiet contemplation can also entail facing some of our inner demons, as we come in touch with our deeper emotional side. Understanding and resolving our deeper feelings can be fundamental to living a more contented and meaningful life.

Psychotherapy and meaning

Engaging in psychotherapy can be a very fruitful journey on the path to finding meaning in life. With your therapist you can find ways to face your inner fears, get in touch with your inner self and express the meaningful life that is yours.

Simon Cassar is an experienced integrative existential psychotherapist, superviser and academic, providing long and short-term psychotherapy to both individuals and couples at our practices in Hove and Lewes.

June 22, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Existential Psychotherapy? An interview with Dr. Simon Cassar – VLOG

Recently Mark Vahrmeyer interviewed Dr. Simon Cassar on the topic of Existential Psychotherapy. This is the first in a series of interviews and VLOGS into the topic of psychotherapy generally. So, please check out the interview and we would welcome any feedback or suggestions for future VLOGS.

May 29, 2018 by Brighton & Hove Psychotherapy Leave a Comment

What is Bipolar Disorder?

Bipolar disorder, previously known and manic depression, is a mood disorder that is thought to effect about 1% of the UK population.

Typically, the onset of Bipolar disorder is at around 15-19 years, although some may develop it later on.

What are the symptoms of bipolar disorder?

The symptoms of Bipolar disorder are mood related, and range from feeling high (manic) and very low (depressed).

Manic phases

In the manic phases, you can feel euphoric, have a great sense of wellbeing, have racing thoughts, a feeling of being invincible or special and have increased sexual energy. A manic phase can last for a week or longer and during that time you may end up losing your social inhibitions, take serious risks with your safety and take on big projects with extensive time and financial commitments.

During a manic phase, you may also experience psychotic symptoms such as delusions and hallucinations. In a manic phase, your daily life is likely to be significantly disrupted and at the severe end, you may need hospitalisation. A lower threshold of mania, called hypomania, may also be experienced which is typical in Bipolar II disorder. This phase generally lasts less than a week and the symptoms are similar to those of mania, but to a lesser degree and without the psychotic features. Hypomanic phases can also be disruptive and there will be a noticeable change in your behaviour, but normally you can still continue your daily routine.

Depressive phase

The other side of Bipolar disorder is the depressed phase. In this phase, you can experience a lower self-esteem and lack self confidence.

You can feel hopeless, tearful and agitated, and sometimes feel suicidal. Often the depressed phase can feel harder to deal with than the manic phases, and the contrast between the two can make the depressed phase feel much worse.

There are three types of Bipolar disorder: Bipolar I, which is where you experience more manic episodes, Bipolar II, which is where you experience more depressive episodes and experience hypomania, and Cyclothymia which is where you experience both manic and depressive episodes, but at a lower threshold than you would if you had Bipolar I or II.

How to manage bipolar disorder

When given a diagnosis of Bipolar disorder, it is important to take some time to notice how you feel about it. Some people will reach with relief as it will give context and understanding to the difficultmood swings.

For others, the diagnosis can be hard to accept and indeed they might not agree with it. However you feel about the diagnosis, it is best to get informed about what the disorder means, how it can be managed, and to get some support.

Medication will often be offered in the treatment of Bipolar disorder to manage the depressive episodes, keep your moods stable and sometimes antipsychotics will be needed during manic phases. In addition to medication, psychotherapy can provide a very good way of coping with Bipolar disorder. It can help you gain insight into the triggers, and the warning signs that you are entering a manic or depressed phase and help you to deal with the complex and often painful emotions that can accompany them.

The supportive therapeutic environment can enable you to process and make sense of what you are feeling and to understand the affect it is having on you and those around you.