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How Psychotherapy can help shape a better world

In Psychotherapy people learn how to reflect more on their lives, choices, behaviours and feelings. This more thoughtful and reflective mode translates into how one sees her or his world and their place within it.

We learn to feel more connected to ourselves and others, and to behave in more thoughtful ways as a result of greater self-awareness. This ‘looking inwards’ has sometimes been mistaken for individualistic or self-indulgent. However, what it does is exactly the opposite – we can only relate better to others and the world around us when we have first developed a better relationship with ourselves. Qualities which are usually seen as altruistic, selfless, and giving usually stem from a place of gratitude and generosity. Whilst some have it in themselves already, others will need to learn it.

Psychotherapy is also about congruence and authenticity. The more out of touch we are with our true values, needs and wishes, the more we suffer. Psychotherapy puts us back in touch with those values, needs and wishes, through a complex process of working through barriers which we have put in place early in our lives.

These needs and wishes are not material or superfluous, but are universally felt needs for connection, love and belonging. The more we diverge from these needs, the more alone and isolated we become. Admitting the need for connection and love can sometimes be painful and even shameful. This is because our fundamental early needs for connection, attunement and love have not been met in the past – to varying degrees.

Only through realising our early wounds, can we begin to heal and move past them into a different way of being in the world which entails connectedness, support, caring and giving. In essence, some of us will need to learn how to feel and give love.

Learning how to love others is the most fundamental quality needed during any crisis. If we can’t love, we harm – ourselves and others. When we love, we can extend ourselves to others, empathise and feel with others. When we truly see someone else’s pain, we see them as a ‘real other’. This applies not just to human beings, but also animals and nature.

In Psychotherapy we can work on lessening this ‘disconnect’ between who we want to be and how we currently live. People discover new ways of being and living as a result of this work. Therefore, in key times such as these, let us move consciously into shaping a better world for everyone and the planet we live in.

 

Sam Jahara is a Psychotherapist and Co-founder of Brighton and Hove Psychotherapy. She has a special interest in how Psychotherapy can influence social change.

 

Further reading by Sam Jahara

Making the most of your online therapy session

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Leaving the Family

Psychotherapy and the climate crisis

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Love in the time of Covid

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

The statistics

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

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

On finding love 

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

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

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

On keeping love 

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

Space 

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

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

Boundaries 

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

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

Difference 

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

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

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

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

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

The third table leg 

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

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

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

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

On kindness 

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

 

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

 

Further reading by Mark Vahrmeyer –

Coronavirus Lock-Down – Physical Health vs Mental Health

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

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Educational Psychotherapy (2) – developing empathy, mind-mindedness and self-discovery

In Educational Psychotherapy (1), I explain how Educational Psychotherapy first evolved and how, as an approach, it can help promote social and emotional development as well as the thinking skills required for learning.  This was illustrated through the aspects of a child’s first six months in therapy. Here, I highlight three areas of further progress over the next 12 months of work with the same child. Again, this account is disguised and anonymised.

Empathy and feeling understood

One of the most exciting benefits of Sammy’s becoming more emotionally literate was the opening it allowed for me to make connections between his experiences with family and friends and his feelings and then providing empathy for Sammy’s felt experience.  This enabled Sammy both to feel held and understood by me at an emotional level and to experience his feelings as making sense. Over time, Sammy came to welcome this and it seemed to encourage him to actively seek openings to make further connections between his experiences past and present and his thoughts, feelings and behaviours.

Mind-mindedness and social connection

Early on in the therapy, Sammy found it difficult to engage in wondering about his own mind or about others’ minds, in either imaginary or real contexts.  There were times when he seemed to think I should have already known what he was thinking. Things began to shift when trust developed and Sammy allowed himself to become more openly curious about me, what my life might be like and how I might perceive him.  He grew increasingly accepting of the idea that I had a mind separate to his and that learning about each other involved a shared process. He started to wonder about my own mental state and thoughts, perhaps partly in response to my modelling of a mentalising approach with him.  This capacity to be “mind-minded” was also reflected in Sammy’s accounts of social interactions at school when he openly wondered about various students’ motivations for particular actions and how they might have been feeling about a situation.  This included an understanding that people might have mixed feelings at times.

Therapeutic journey

It was Sammy’s journey of mental-emotional-social self-discovery which came to shape the bulk of our sessions and it was an encouraging and rewarding journey to be a part of.  The significance to Sammy of this work became increasingly evident as I began to talk about the sessions coming to an end several months before the final session.  Sammy found this very hard and would avoid or deny the subject in various ways.  However, in time, we were able to talk more about what this avoidance meant and Sammy moved into a period of some weeks when, unprompted, he became highly reflective about what the sessions had meant to him, bringing in memories of particular activities and commenting on changes which he felt had taken place within himself.  He also made reference to ways in which our working relationship had changed.  He spoke with confidence and resilience and a certain assurance that his memory would remain in my mind after our sessions had come to an end – and it has!

Michael Reeves is a Psychotherapist working with children and young people aged 4-18 and/or their parents/carers. He is available as a clinical supervisor for training or practising therapists and counsellors, whose work is primarily focused on children/ families/ parents. He is available at our Lewes Practice.

 

Further reading by Michael Reeves –

Educational Psychotherapy (1): supporting social-emotional development and learning

Curiosity: how can children’s behaviour help us understand what they need from us?

Acceptance – What does it have to do with managing children’s difficult behaviour?

 

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Coronavirus Lock-Down – Physical Health vs Mental Health

As I write this blog, we are entering into the fourth week of so-called ‘lock-down’ across the UK. Despite daily speculation, nobody has any idea how long the restrictions on life will last for. 

Everything has changed and this has been hard to cope with in a society where stability and the ordinary continuity of life has been severely disrupted and curtailed; the UK population is currently in limbo, isolated from the wider community and possibly in closer physical contact with family than ever before. 

We know why we are doing this – we are reminded multiple times per day – to ‘save lives’ and ‘protect the NHS’. 

There has been much talk of the compelling priorities of the health of the nation vs the health of the economy. Arguably initially it was the later that took precedent in this country meaning we are now facing large numbers of fatalities. However, beyond the obvious economic costs of ‘lock-down’ and social distancing, the mental health impact seems to have been largely overlooked. 

Why start now? 

Despite a strong history and legacy of psychoanalysis and psychotherapy in the UK, mental health provision has long-since slipped from the forefront of policy-makers minds. Gone is the aptitude to be curious and instead a culture of symptoms has emerged increasingly oblivious to the fact that symptoms are communicating emotional and psychic distress. Depression has ceased to be seen as an inability to mourn and is instead an illness to be medicalised – as if it can be caught from the air like Coronavirus. 

So, in the midst of the pandemic, it is not surprising that any meaningful discussion on the impacts of quarantine, lock-down and social distancing will have on mental health, not to mention the ongoing rhetoric of how the socially interactive parts of our lives will be ‘changed forever’; today the WHO suggested that wearing a face-mask in public must become the long-term norm without the being any consideration to what the psychological impacts on self and others would be from such a policy. For example, where healthy development of an infant is contingent on them constantly scanning their care-givers face for reassurance and validation, what will the effect be of masking these quite literally behind a surgical mask? 

Compelling needs 

Whilst some of us may remain in denial, there is no question that social distancing is the only real means available at present to combat this pandemic. It is the oldest method in the book for dealing with epidemics and remains all we have (at present). 

However, for relational beings (which is what humans are) the strategy is psychologically and emotionally challenging (and for many catastrophic). 

Humans understand themselves and gain a sense of meaning through relationships with others. This is not a luxury – it is essential both as we develop and throughout our lives. Not only do humans needs to be able to communicate verbally, but we also require contact that is ‘non-verbal’. 

The mortality of isolation 

Isolation may keep us safe from the Coronavirus, however isolation is linked is not the cause of many mental health problems such as depression and anxiety and is fatal, particularly for the elderly (who, it would seem, are also being most impacted by Covid-19). Indeed, some studies have shown that loneliness is, indirectly, the biggest killer of the elderly. 

Virtual connections 

We live in an age where we can make use of virtual connections and video conference software to stay in touch with each other – my profession – psychotherapy – has overnight shifted to online working to ensure the continuity of therapy sessions. This is a positive, however, it will not migrate the tsunami of mental health and relationship problems that will arrive in the wake of the health crisis. 

Meaning making propositions 

For many, our daily lives, often revolving around work, provide us with a profound and anchoring sense of meaning and purpose. Not only has the ‘treadmill’ stopped, but with it much of the sense of purpose and meaning that many of us have. These two combined can be difficult to manage contributing to anxiety and depression – a literal crisis of meaning. 

Anxiety 

In the absence of meaning and purpose, and with the distractions of ‘ordinary’ life removed, anxiety can bubble up. It can leave us with a profound sense of unease and discomfort in our own skin and the wider world. And at present, it is hard to escape from. Of course, in reality anxiety can never be escaped from – it is part of us. It can, however, be faced and used to ask difficult questions about how we live our lives. 

Depression 

We are faced with a narrative from the media and politicians that ‘things will never be the same again’. I am unsure really what this means other than that it sounds like a warning or premonition of some kind. Being alive means accepting that things cannot remain the same and that we adapt. Change is hard and it forces us to be confronted with difficult emotions that many of us would rather run from. In the current climate of Covid, running from emotions has simply become harder. 

Whilst there simply cannot be a national or state managed balance between physical and mental health needs at present, this does not mean that as individuals we cannot be staying with our discomfort and asking ourselves what we ultimately want from this precarious life. 

 

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 –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

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Anxiety, Fear states, Trauma

Why do we get anxious and fearful?

The anxiety /fear response is the brain’s way of trying to keep us safe and healthy. Anxiety serves as a faithful reminder of things which the brain assesses need to be avoided, based on past experience. Most of this experience is past or learned experience. This is important in understanding the role of anxiety and fear states.

Firstly anxiety and fear are natural emotions which are built into our biochemistry in order to ensure survival. The fright flight fight response takes place in the lower ‘old brain’ and is vital to promote survival. This is the area of the brain which we probably all have had some experience of in recent days and weeks with the Corona virus pandemic. This response is what we are seeing with a frightened population stockpiling food and resources and even fighting over supplies.

Secondly alongside the biochemical response of the old brain, we each have individual mental and emotional responses which are very variable

Understanding that the brain is a pattern seeking machine is really helpful here in understanding these variable responses. The brain simply reproduces a response based on past similar experience.

In order to treat anxiety we need to look at these patterns.

Different schools of therapy  have different approaches.

Behavioural  therapy looks at how thinking influences feelings and how to interrupt that pattern.

Psychodynamic therapy seeks to understand and connect past experience (which may be outside of our awareness) with the current response. A therapist can help the client to decontaminate, to understand, and process those experiences which may be outside of our awareness.

Creative psychotherapies such as Dramatherapy, Art Therapy and Music Therapy specialise in helping the client to access, process and release, out of awareness experience in very safe non directive ways. These therapies are especially indicated where there is trauma, neglect and attachment issues which are causing or contributing to anxiety and fear states.

Mindfulness therapy is very beneficial for anxiety,  fear states and panic attacks. It works by showing the client how to learn to place awareness in the body, the feelings, sensations- to  notice the thinking and then to return to body awareness. It becomes possible to observe thoughts passing as if watching a video, and then to return to the calm still space within the body.

Over time in mindfulness therapy, a new awareness begins to develop which interrupts the fear response. The mind develops an ability to dis -identify with the thinking, the feelings and the sensations which create and support the anxiety fear response. The ability to return to the still quiet space within is a skill that can be developed with practice both within and outside of sessions.

 

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and  groups. Magdalena is available at our Brighton and Hove Practice.

Further reading by Magdalena Whitehouse –
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