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Name That Tune

How can an old parlour game help us reflect on the way we communicate? Quite a lot it would seem.

Many of us will have played the game where we tap out the rhythm of a tune or song and ask our partner to guess the name of the piece. The challenge for the person doing the listening is that they have to use only limited information (the rhythm) to piece together something much more complicated in its whole. It is a different story for the person tapping out the rhythm. For them, the whole tune is in their head and it seems obvious that what they are hearing (in their head), is also what is being heard by the recipient.

In a study using the game to explore expectations in communication, over 90% of the people tapping the tune expected the recipient to guess correctly – some admitting to be dumbfounded that their recipients could not understand them. Sadly, this expectation was not matched by the results, where only 14% of recipients managed to guess the tune correctly. Imagine the frustration on both sides!

The fact that the large majority (over 9 in 10) of the tappers (as we will call them), felt they had supplied all the information required for their message to be understood, makes a useful reminder of the difference between the message we think we are communicating and the meaning that is created by the recipient. It is interesting that in the study of the exercise referred to above, the recipients did not just say they didn’t know the answer – over 8 in 10 of them named a tune they were sure was correct even though it was often some distance from the one in the head of the tapper. In other words, they created a meaning from the message which was quite different from the one being communicated by the tapper – which, of course, led to even more frustration: ‘How could you possibly misunderstand that? It’s so obvious!’ Worryingly, when it comes to communication, what seems just so obvious to us, can lead to confusion or misunderstanding for those on the receiving end.

The tapping game might also make us reflect on just how limited words can be when it comes to communicating the thoughts and feelings we carry. Like the complex melody, much of the nuance may be lost without access to the pitch, timbre and colours which make up the detail. As humans, we are meaning-seeking creatures. If there are gaps in our understanding, we will fill them in an effort to make sense. But in those fillers, we often go awry – gloriously so in many cases, which is why metaphor and symbolism can be such fun – but awry, nonetheless.

It takes a lot of work to be really understood and a great deal more to understand fully. But when we feel anger or frustration at others for not getting our message, or when we deal with similar feelings when our friends or partners never seem to appreciate our understanding, we would do well to remember that the gap between what is being communicated and what is being understood is considerably wider than what might at first appear.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

To enquire about psychotherapy sessions with Kevin, please contact him here, or to view our full clinical team, please click here.

 

Further reading by Kevin Collins –

I never thought my son would be addicted to pornography

Why is it hard to make decisions?

Communication, communication, communication

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Football, psychotherapy and engaging with male clients

I recently read that an English professional football team has a resident psychotherapist. Whilst the connection between clinical psychology and sporting outcomes is well established, having a team psychotherapist is something new. The therapist explained that they’re there to support the players, coaches and a team of staff through the emotional highs and lows of the professional game. Scoring goals isn’t the sole focus of the role, but it’s hoped that a happy and supported team will be more likely to score.

I read this not from a football supporter’s perspective, but from that of a therapist who is always mindful of how we engage with clients, especially men. There is no secret that men are less likely than women to engage with psychological services. Men are also more likely to hold gender based beliefs as to why they shouldn’t be sensitive to their own mental health.

The football team therapist spoke of how the engagement with players was less formal that traditional psychotherapy and could be anything from a few minutes chat to a longer session. It seems that being understanding and sensitive to the schedules of the players and being flexible around this, worked best for all parties.

Debating changing styles of therapy is a whole other discussion but it does make me question how greater engagement with men might be based on challenging concepts of masculinity whilst not taking men out of their own understood gender roles. In effect to reframe masculinity in a way that still feels masculine.

As a trainee therapist being in your own therapy is a requirement. The experience of being a client is something that shapes how we are as practitioners. The understanding of what it’s like to explore your own mind and how you can gain a deeper understanding of yourself can feel like a huge luxury. It can also feel like the most anxiety inducing and impossible task when you feel your own vulnerability in the face of another. As a trainee male practitioner this was the moment when I began to understand that I held many gendered views of what men did and didn’t do and how could I shift my perceptions without losing my own sense of my gender.

As therapists we are well aware of the challenges when clients begin to explore and think about their feelings. Knowing how that can feel for us we can empathise and think with them. When this is seen through a series of deeply held beliefs around gendered roles it can feel impossible. Here a myriad of gendered terms about ‘men not crying’ and being a ‘strong, silent type’ spring to mind. Is it any wonder that men can struggle to acknowledge, let alone engage with thoughts about mental health when there is so much messaging that it isn’t ‘masculine’?

Reading about a football club with a psychotherapist felt very positive. It wasn’t only an interesting article, but it very gently reminds us that attitudes towards men’s mental health, are changing. If the knowledge that a football team are supported and as a result successful by being sensitive to their own mental health it sends a subtle, yet positive, message. This can only be a good thing for helping men to think that being aware of their own mental health is not challenging their sense of their own masculinity, it is merely offering a different perspective.

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove and Lewes.

To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

When Home and Work merge

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Avoidance in therapy as the axe for the frozen seas between us

In this blog I will briefly discuss avoidant attachment strategies and how what can look like independence is actually a sort of suit of armour designed to protect and hide a locked box of vulnerability and need, preventing mutual dependency and intimacy.

The person who has developed the avoidant strategy has done so in order to cope with a lack of understanding and attunement to their needs from their caregivers, and have therefore had to deny their needs to themselves and make the decision (unconsciously) to repress or bury these needs and create an equilibrium for themselves where the pain, disappointments and griefs of these unmet needs are locked away. They can often find alternative ways to feel good about themselves and compensate for the shame of the disappointments and low self-esteem that they feel as a result of this lack of attunement. These alternative strategies can lead them to developing their intelligence as a way to circumvent their feelings and they are often very successful in their field of work. The problem of course is in their relationships, sometimes their relationship with themselves or parts of themselves.

The strategy seeks to enable them to have self-worth while keeping painful feelings of rejection at bay, they have found others unreliable and can therefore only trust themselves. They create an image of themselves that appears independent and strong but comes at the cost of denigrating others, especially those that are more comfortable with the parts of themselves that seek mutual reliance and inter-dependence on others. In extreme forms these others can stir up painful feelings of envy and hatred although these feelings too are disavowed. A calm state of coolness is sought that numbs any sort of emotional aliveness. However, this defence is often a fragile one and when a crisis occurs as it always does at some time or other in life then these defences can shatter, leaving the person distraught and desperate, unable to manage or deal with the emotions that now can’t be neutralized. Suicide can be one tragic outcome.

Brett Kahr, a British Psychoanalytic Psychotherapist, discusses the pain of this strategy which can be handed down generationally: – “Although many people inflict horrific cruelty upon their partners, the vast majority cause pain as a result of emotional unavailability, fuelled by avoidant attachment structures.”

Therapy takes time and requires an enormous amount of patience and keeping the patient in therapy is no easy task. However if they stay then perhaps the patient can slowly start to develop a more trusting relationship with the therapist, who can attune to them, who doesn’t need them to be other than who they are, who can accept their need for distance and who can digest their sometimes overt, but often covert denigrations, understanding them without retaliating or shaming them but not colluding either, calmly without judgment bringing to awareness what the patient is doing and the fear and pain behind these defences against relatedness.

The Author, Colum McCann, describes the work of literature, and I think his description also describes the therapeutic process.

“The job of literature is to acknowledge the heartbreak of the world and then to share that heartbreak in the hope that somehow you can find a little light, just a little, no matter how damaged and bruised. This light, then, must necessarily acknowledge the darkness. At the same time, it might just lift a portion of the dark, past the curtains, awaken us.”

He goes on to quote Kafka, “A book must be the axe for the frozen sea within us.”

So too must therapy.

 

To enquire about psychotherapy sessions with Paul Savage, please contact him here, or to view our full clinical team, please click here.

 

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

 

Further reading by Paul Salvage –

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

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Some existential musings from the sea

“Why do we like the frantic, the unmastered?” Asks Virginia Woolf,  in her diaries. This is a question I also return to time and time again as I look out to sea. Feeling the disquiet holds an edge of excitement for me, there is a thrill to its wild and unknown nature.
For me there is something quite awesome about being made to feel small, insignificant, vulnerable.
Something playfully cherishing about being sprayed by the sea and even more so when seeing the other’s surprise as they are splashed by the sea spray as they walk along the promenade.
Even more touching is when I am in the sea, bobbing around, apparently trusting its capacity to hold me, softly caressing my form, knowing its strength could take me over, its sometimes silent, sometimes roaring power could take away any sense of control I may feel I have, at any time.
For me that makes me feel free. For others I am aware that feels like the opposite of freedom. Perhaps it is the sense of disquiet that is not thrilling for the other. Of course that is completely understandable and perhaps very sensible.
The sea, our relationship, has taught me a lot.  Not just what was said above. Many other beautiful things too, some known, some still unknown.
It has deepened my capacity to feel, to reach into sensations, when to let go and when to push forwards. It has taught me how not to take things personally,  how to play and take risks, how to feel and experience joy, it has taught me, or at least invited me to be open even in the unknown and when I think I might be unsafe; not to judge or believe every thought that emerges from the reckless mind. It has taught me there is much I don’t know and that it is ok not to know. It has taught me lessons about connection,  intimacy and friendship.
It has inspired me, filled me with awe. It has provided beautiful gifts, delightful and magnificent gifts.   Whether seeing elusive pods of dolphins in the early dawn, as I witness the wonder of the full moon and the rising sun in unison.  Or the simple drama of playful young seagulls dipping and diving into the waters. It has yielded me a space to dive deeply into the unknown, into pleasure, and held me patiently on its voluptuous and flowing surface as I come up for air, breathing, resting and trusting.
And when its roaring form prevents me from entering its embrace it still teaches me much. It teaches me about patience, power, movement and change,  and it quietly, continually gives me permission to become. It invites me once more to come into contact with and enjoy the unmastered within me.
Even if one only feels a slight desire to see the sea, and not even consider entering it, there are many gifts to receive, lessons to learn. But if that desire increases I recommend dipping a humble toe into that vastness, you never know what might happen.

To enquire about psychotherapy sessions with Susanna Petitpierre, please contact her here, or to view our full clinical team, please click here.

 

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

 

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As we come out of lockdown, will a number of us be feeling socially anxious?

For the past year we have largely been confined to our homes, a lot of us working from home and only going out for regular exercise. Our social lives have been depleted, we’ve not been able to see friends and family and generally life may have become quite repetitive.

As we come out of lockdown there will be mixed feelings, some people may feel really ready to socialise again and are already filling their calendars with get togethers and events. For others, they might be more cautious and be worried about feeling anxious in group settings.

Perhaps you’ve always found social gatherings difficult and so the lockdowns gave you permission to not have to socialise. By having to keep ourselves to ourselves anxiety has not been triggered or challenged and so confidence in social settings may have reduced. The prospect of now going into situations where there are more than two people may feel quite daunting.

Because we’ve not had much going on in our lives we may start to worry that we have nothing to talk about. Or perhaps our appearance has changed a little, we’ve put on some weight, or we’re not as toned as we were or our hair is more grey than it was, and so we are worried we will not look physically good enough. Or perhaps we are worried whether our friends will still want to see us after all this time.

These are normal thoughts that we may experience but they aren’t helpful and we may have to work at keeping them in check. It’s worth reminding ourselves that thoughts are not facts and whilst we may have these thoughts about ourselves it doesn’t mean that others are having these thoughts about us.

We’ve all been socially deprived over the last year and when you haven’t done something for a while it can feel uncomfortable going back into it, its normal to feel some level of anxiety. Just as the more we avoid something the harder it becomes to do. Be kind to yourself, don’t expect yourself to be able to go straight into large social gatherings. It’s better to return to socialising in a graded way. If it feels too big it’s ok to say you’re not ready.

When we are feeling socially anxious we can start to worry about how we come across to others and feel like we’re in the spotlight. The more we focus on ourselves the more self conscious we can become and the more this happens the more we end up in our own head. The more we start to judge ourselves and the more difficult it becomes to interact with others. We can’t be concentrating on what is going on around us or what others are saying if we’re so busy in our heads judging ourselves. Try shifting your focus onto others, paying attention to what’s being said rather than your internal dialogue. By shifting your focus of attention outwards to others, from internal to external, you can keep more relaxed.

A common fear to have when socially anxious is thinking you should be interesting all of the time. How realistic is this? particularly given that none of us have had very interesting lives recently. Take the pressure off yourself to perform, it’s about being with others, not entertaining others. Share how bored you’ve been, I’m sure others will have been to. Try to reduce those high expectations of yourself.

Another fear is to think that others can see your anxiety however the research tells us that this is not the case. What feels magnified and obvious to you, such as shaking or sweating, isn’t visible to others.

It is also unhelpful to prepare things to talk about as this again puts pressure on yourself to perform and maintains self focus. If you’re so busy thinking about the list of things you’ve prepared you’re not going with the flow of conversation, you become more self focused and can appear uninterested in what’s being said or aloof.

Lastly don’t allow yourself to replay or dwell on what you said or did later. No one else will be giving a second thought to what you’ve said or done, they will have moved onto the next thing in their day. You’re the only one analysing yourself and giving yourself a hard time.

Remember social interactions are a two way street, it’s not all your responsibility. The more we can focus on the social event rather than ourselves the more we are likely to enjoy the social interaction.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

 

Further reading by Rebecca Mead –

New Year’s Resolutions

Making Changes

Social Connections

Back to ‘Bace’ics

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Why is Love Island so Popular? And why it’s not for the reasons we think

For those of you that don’t know, Love Island is a British ‘reality television’ concept that has become a global phenomenon. Arguably deriving from the first global reality programme, Big Brother, which launched in 1997 it is the latest incarnation of this genre.

The premise is one whereby a group of (young, physically attractive) singletons are isolated from the rest of the world in a luxury villa dotted with cameras throughout. The singletons then must avoid elimination (eviction) from the villa through coupling up with another contestant. And like Big Brother the public ‘votes’ to eliminate contestants who do not please them. The ultimate price? Love? Eternal happiness? No, a pot of money.

What is the appeal of watching reality television?
To answer this question we first have to define how reality TV differs from regular TV. Clearly, reality TV is (to a greater or lesser extent) unscripted. And a cynic may argue that it is cheap to produce as the ‘talent’ is free, however I am more interested in the viewers drive rather than the profit margins of the production company.

For the viewer, they are aware it is unscripted – anything could happen. And with offering the audience a piece of the action – the control to vote out contestants, the experience becomes seemingly interactive, almost relational in that viewers feel a form of connection to the contestants.

Reality TV is reminiscent of the Romans and their staged ‘fights’ between gladiators and prisoners, or between imprisoned wild animals and unfortunate humans. And whilst the humble Roman had no direct power over who survived, they could look to their Emperor who would decide with a simple thumb’s-up or -down whether to spare the life of the barely alive prisoner. In turn the Emperor would be guided by the furore of the crowd, hence the illusion of control and investment in the outcome. Fundamentally though, it was entertainment at the expense of an
other(s).

Now let’s consider how reality TV and regular drama such as soaps – Eastenders and the like – differ. Watching a soap opera is a narcissistic endeavour where the lives of fictitious characters are watched according to a script. All are aware of the ‘pretend’ quality. A performance is being given and the boundaries between real people and characters are clear.

Reality television invites the participants to ‘star’ in a version of life judged by the viewer. And the viewer rewards the contestant through sparing them or eliminating them dependent on how ‘entertained’ they feel. It is a game of exhibitionism and voyeurism. One can argue that unlike prisoners of the Romans who were ‘thrown to the lions’, reality TV stars enter into the ‘game’ with their eyes fully open and can be handsomely rewarded. On the face of it this is true, however, taking ‘Love Island’ alone, there has been significant media coverage of three suicides of people
connected to the show. Whether the latter is causation or correlation, my argument is that both the contestants and viewers of reality TV are being driven by something unconscious.

So what’s the appeal?
I believe that this genre of television has become so extraordinarily popular because it appeals to out innate need to feel part of a community. Unlike soap operas, we know that what happens is real – and even if it is not; both contestant and viewer believe it is so the fantasy is complete.

In reality TV we are invited into the intimate lives of a group of people and can exert influence over them – it creates a kind of pseudo-connection. Exactly the kind of pseudo-connection present in a collusive exhibitionistic/voyeuristic encounter. By definition therefore, it is a form of perverse relationship in that it is rigid and without emotional contact. It is a relationship based on power and control rather than real intimacy.

And like any pseudo-connection, whilst it may feel exciting and glamorous, it has the nasty habit of leaving us feeling less connected and thus more prone to feelings of depression, anxiety and loneliness when it all ends. And it always does. For the viewer, they can move onto the next reality TV series thereby keeping their need for authentic connection and vulnerability at bay; for the contestant, they can perpetuate the fantasy through building a career (brand) build on image, or they fall spectacularly from grace or fade away (both are equally devastating for the narcissist).

A loss of belonging
I therefore suggest that ultimately the rise of reality TV correlates with the erosion of community and a sense of belonging. It correlates with an increasingly individualistic world where narcissistic interactions are the norm.

Ultimately though, it speaks of our desire for contact and real relationship, something that can never be fulfilled through reality television or any other kind of perverse relationship where the premise is power and control.

Connection and belonging come from community and from real relationships where two people can take up space and each have their ‘real’ experience validated and understood by the other, rather than one having to be a performing (glamorous) monkey in order to manage to survive (elimination). The latter is pure and simply the definition of a deeply narcissistic and perverse relationship.

 

To enquire about psychotherapy sessions with Mark Vahrmeyer, please contact him here, or to view our full clinical team, please click here.

 

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

What is the purpose of intimate relationships?

Why ‘Cancel Culture’ is about the inability to tolerate difference

The Phenomenon of ‘Manifesting – The Law of Attraction’ and the inability to tolerate reality

Why does the difference between counselling and psychotherapy matter?

Love in the time of Covid

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When Home and Work Merge

The onset of national lockdowns in early 2020 (and subsequent restrictions) have made working from home the ‘new normal’. What was once seen as an ideal for many, free from commuting and office politics, suddenly became an enforced reality for all of us.

Our homes, which were previously separate, became our place of work, schoolroom or therapy room. The initial sense that being at home was an exciting new way of living and working, gave way, for many, to a sense that home and work were one and the same.

When home and work take place in the same space does it make us think about what function the workplace has? The workplace allows us to leave a lot of work-related stress there when we go home. Ad hoc chats with colleagues are part of how we manage some of the anxiety and challenges of working life. In short, the places that we work at and the people that we work with, hold a lot of our emotions.

This sense of something being held by a place and the people in it chimes with what Bion (1962) referred to as ‘containment’. Bion’s theory was based on the idea that it’s a person, invariably an early caregiver, who the infant looks to, to help them to process unbearable feelings. The infant cries and expels their feelings and the caregiver, through touch, facial expressions and sound makes these feelings more tolerable and, this in turn, calms the infant.

Bion felt that this cycle of learning what it is like to have feelings contained by another was part of how an individual learns to cope with their own feelings in later life. Once we learn this we can contain our own feelings and we can also trust others to contain them.

How does this translate to the impact on our lives of working and living in the same space? Bion spoke about the impact of the caring parent on a child. Might this sense of something being contained by another also relate to the place in which we work? This place forms it’s own sense of containment that may be lost with home working. It is somewhere that we engage with unconsciously as a space where we leave the challenging feelings that are evoked by the tasks carried out there. This place holds our feelings and leaves us free to go home and leave them behind.

Home working challenges us to find a way to manage this lack of separation and hold a boundary between what is work and what is not – and the anxiety that comes with that. How we do this is as individual as we are.

 

To enquire about psychotherapy sessions with David Work, please contact him here, or to view our full clinical team, please click here.
David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove and Lewes.

 

Reference:

Bion, W. (1962). Learning From Experience. London: Karnac Books.

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What is Transactional Analysis?

Transactional Analysis (TA) is a widely recognised form of modern counselling and psychotherapy, originally conceived by Eric Berne in the 1950’s and which is now used not only in therapy but also in education and organisational training and consultancy.

It is a theory of personality, behaviour and communication, and draws on tools and methodology from a wide range of psychological disciplines, including humanistic, psychodynamic, person centered and relational therapies.

It is therefore a flexible form of therapy that can be tailored to an individual’s needs to facilitate personal growth and change.

How is Transactional Analysis used in counselling and psychotherapy?

A Transactional Analysis counsellor or psychotherapist has a wide variety of theory to hand including the theory of personality, communication and child development.

Transactional Analysis theory has an emphasis on the therapy being contractual, with a negotiated agreement between the therapist and client on what will be explored in the therapy sessions with a view to an end goal or change. The agreement is not fixed but rather is a dynamic and fluid process where the agreement can be re-negotiated at any time. This enables an active participation, both by the client and the therapist, and an equal partnership which is built on the core values of clear communication, respect, and openness.

Transactional Analysis counselling and psychotherapy can be used for individuals, couples, and groups and for a wide range of issues, including anxiety, depression, bereavement, and other life changing issues.

Some key concepts of Transactional Analysis theory

Transactions– this looks at both the verbal and non-verbal messages we use to communicate with ourselves and others, which can give us an insight to how we think, feel and behave and how we view the world around us.
Unconscious Scripts – this is our life story or ‘script’ that we unconsciously write for ourselves when we are young, uniquely interpreting both internal and external events which influence our thoughts, feelings and behaviour. Transactional Analysis can help facilitate exploration of which of our thoughts, feelings or behavior is archaic and no longer serves us, and is therefore having an impact on how we want to live our lives in the ‘here and now’.
Ego States – Ego states theory relates to personality and is linked to which of our thoughts, feelings or behaviour has either been learnt from our caregivers and other significant people in our formative years (Parent ego state), from past experiences in our childhood (Child ego state) and which are direct responses to the ‘here and now’ (Adult ego state). It may be familiar to you that you play different ‘roles’ depending on the situation you are in, such as at work, or with friends or family and switch between these ‘roles’ many times during the day. In Transactional Analysis we see this as switching between ego states.

Transactional Analysis Counselling and Psychotherapy helps facilitate awareness of your life ‘script’ and its link to archaic perceptions and beliefs with exploration of how you would like to live in the ‘here and now’ to have a more fulfilling, enjoyable, and happier life.

 

Louise Herbert is a psychotherapeutic counsellor who is in the final year of specialist training in Transactional Analysis Psychotherapy. To get in touch with Louise, please contact us.

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Fear and hope in the time of Covid – part 2

I am writing a follow on from the wonderful blog written by Gerry Gilmartin back in August. 6 months on and here we are again, facing new Covid-related challenges with more restrictive measures in place, more infections and more deaths.

The theme of Gerry’s blog revolves around fear and hope, and how to work with these polarities which coexist in most of us. Psychotherapy is very much about learning to live with polarities within ourselves as well as acknowledge them in others. In psychotherapy we gradually increase our capacity to understand and be with complex human emotions, and to reduce polarised black-and-white thinking. Gerry writes:

“The uncontrollability of the corona virus may reflect something of the uncontrollability of a globalised world. Both highlight our mutual dependence and by implication our mutual vulnerability. At a time when a sense of universal unity might be prescient it is also a time at which it seems extremely unlikely. In a state of fear the instinct is to contract mentally and physically, to batten down the hatches against a real or imagined enemy. In a state of fear we may abandon our capacities for hope and for trust…. On a global as well as an individual level”.

Talking about what we are afraid of can be enlightening. It helps us separate fantasy from reality and to stay connected to ourselves and others. It can be difficult to ‘stay sane’ when we are constantly being bombarded with news items which are designed to retain our attention as much as possible by scaring us into remaining watchful and alert to yet more bad news, just in case we weren’t already frightened enough.

This process actives our fight or flight systems, sending us into survival mode which is never conducive to reflective states of mind required for conscious thought and creativity. In fact, the very type of thinking that is required for effective leadership and decision-making.

Part of our job is to help people to think when they have stopped thinking and are living in fear or in a state of hyperarousal. Of course, this isn’t always possible. However, it is possible in most cases and an outcome which is see in psychotherapy time and time again. People arrive contracted and fearful and leave feeling hopeful and with a more expansive and different mindset – each week, each month, each year this process deepens until it becomes second nature.

Through the establishment of a trusting relationship with another, we begin to create a microcosm of safety where difficult feelings can exist without the urgency to get rid of them. We learn to tolerate the intolerable, which may also result in setting limits, taking action, or even doing nothing. Whatever the choice, it will be one which emerges from a place of more awareness and hopefully lead to a more fulfilling life.

 

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

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.

 

Further reading by Sam Jahara

What shapes us?

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

Face to Face and Online Therapy Help Available Now

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New Year’s Resolutions

In my last blog I wrote about goals for change and linking these to our values. When someone decides to come into therapy it is often because they would like to make changes and it can help to set goals as a means of knowing when these changes have been achieved.

Given this is a time of year when we might have made New Year’s Resolutions it seems quite fitting to talk a little more about setting ourselves goals for change. It is often the case that at the start of the year we have all these wonderful ideas of what we want to achieve and we start off really motivated with all good intentions and then several months in we start to lose heart and give up.

A common goal at this time of year is dry January and this can quite often be successful because its time limited. We know that after a month we can return to our favourite tipple. However, for some this is difficult, particularly in the current situation with the stressors of Covid. Complete abstinence can be too challenging as its very all or nothing. It might be more helpful to consider cutting down and reducing frequency, e.g. limit to just one drink once or twice a week. In this way we can make the goal more achievable. Making our goals for change realistic and time limited is really important for achievement.

Another common goal for this time of year is to get fit and start exercising. To start with when we are motivated it goes well. It’s the trying to keep it up that’s difficult. Part of the battle is finding what exercise you enjoy. There’s no point pushing yourself to do something you don’t like. Often when people think of exercise they think they have to do something cardio related. However, there are lots of low impact workouts that are good forms of exercise, such as walking, yoga and pilates. Whatever choice you make its important to start small and build up. It’s the achievement that helps to maintain the motivation. So the first week or two you might aim to exercise for 20 minutes twice a week and then the third week, 3 times per week. Once you have comfortably achieved the first goal you set another, building on the first to push yourself that little bit further. All the time holding in mind where you want to be and this is where it can be useful to link goals to your values. In this example its values around physical well being and of course exercise is also great for our mental health.

Losing weight or eating healthier is another very common goal for people to set themselves at this time of year. And again is another that can be difficult to maintain. So rather than push yourself to go on a really restrictive diet or to cut out entire food groups consider aiming for a ‘better’ diet. Try reducing unhealthy food groups, reducing treats, and swapping to more healthy options. It can be more helpful to aim to eat healthily for 75% of the time or to eat healthily in the week and let yourself indulge a little at weekends. Again, it’s about trying to set more realistic goals for yourself. For example if your norm is to eat half a packet of biscuits with your cup of tea to allow yourself just 2 biscuits rather than going for complete abstinence.

Thinking about setting the right goals is really important and if you don’t achieve them, that’s o.k. There’s no such thing as a failed goal. If you don’t achieve your goal then there is still useful information – ask yourself why wasn’t I able to achieve this? What got in the way? What is the learning from this? What can I do differently next time? Are there any supports available to me to assist in this? Often we don’t achieve our goals because they are too big and need to be broken down further.

None of this is rocket science but we all to easily forget the basics. We can impose high expectations on ourselves and then become disheartened when we don’t achieve them. Our self critical voice kicks in and this can have a negative impact on our mood. Given the difficulties we are all facing currently its even more important to be kind to ourselves and realistic of what we can and can’t achieve.

To enquire about psychotherapy sessions with Rebecca Mead, please contact her here, or to view our full clinical team, please click here.

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

Making Changes

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

Face to Face and Online Therapy Help Available Now

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Why ‘Cancel Culture’ is about the inability to tolerate difference

What is Cancel Culture?

This seemingly new trend is one of promoting the ‘cancellation’ of people, brands or television shows as a result of what some (the cancellers) perceive to be some form of offensive comment, remark, view or behaviour. It has surged on social media with various derogatory hashtags, notably #RIP.

A recent high profile ‘celebrity’ who has been on the receiving end of social media trends to have her cancelled is J.K. Rowling for her, views on transgender issues that some find offensive.

Is it that new?

The term may be new and the platforms used may serve to whip up a storm of support against those who some wish to have cancelled, however the concept is by no means new at all. Cancel culture is essentially a form of social banishment whereby in traditional tribal communities one of the most severe punishments would be the banishment from the tribe: to be cast out.

To be cast out of ones tribe would mean more than social death; if not literal death through being vulnerable to attack from predators and other tribes, banishment most certainly meant the death of the sense of belonging, which in psychological terms, could potentially instigate a psychic collapse (going mad).

However, whilst this may seem primitive, historical and anthropological evidence shows that it would be a punishment of last resort and would be handed down by the elders of the tribe – in other words, there would be some form of judicial process in place that sanctioned the banishment.

This is where cancel culture differs profoundly from tribal banishment or ‘being cast out’. It is not a decree from wise elders or some sort of judiciary; it is generally used as an attack against the views, opinions or behaviours of others that some disagree with.

Why does it matter?

Put simply, it matters because there seems to be an ever decreasing array of opinions and voices allowed and cancel culture is an immature way of trying to ‘kill off’ anybody holding views or opinions that may not be comfortable for others to hear.

Feeling offended and causing offence

There is a difference between a person feeling upset or even offended by another’s views and with another trying to purposely hurt a person or group of people. The former is what we may experience when we encounter others and are confronted by a different perspective. The latter is when we encounter sadism.

Sadism is unacceptable and should not be tolerated, however the mark of being an adult is the capacity to tolerate a different perspective and a different mind. Even if we may feel offended.

On mergers and separation

Although separate from its mother, an infant, when born, cannot differentiate between their mother and themselves. In essence they believe that their mother is an extension of them. Of course, in reality, the mother in question is very much as separate entity, at least physically, and thus will eventually fail to meet the needs of her infant. This is extremely frustrating for the infant in question and the mind of the infant concocts an ingenious defence against the pain of separation – a good and a bad mother is created: the infant imagines it is the good mother who meets all their needs and the bad mother who frustrates them. It is a primitive psychological defence called splitting.

Infants split off the bad until through ‘good enough’ parenting they eventually integrate the two mothers and tolerate reality: mother is not part of them and frustrates them as she has a different mind and a different set of needs. However, mostly, she seems to meet their needs so on life goes and importantly, on psychological maturation goes. The child is on the path from mergers to a world where they can be in separate relationships with others and tolerate a different mind.

Why cancel culture is simply splitting by another name

To be unable to contain ones feelings when confronted by a different perspective and thus a different mind shows a lack of psychological maturity. The world is split into ‘good and ‘bad’ like in a child’s fairy tale. Bad must be killed off so good can live happily ever after. This is not how the real world works; it is how cancel culture works.

How does cancel culture relate to psychotherapy?

In essence, psychotherapy is about outgrowing cancel culture. It is about learning to be in a relationship where difference can be tolerated and acknowledged, without this needing to be threatening. For some this means they must learn for the first time to bring their needs ‘into the mix’ – something that can feel really confronting and may bring on fears of rejection and abandonment. For others it may mean the opposite which is to be able to cope with the separateness of their psychotherapist and tolerate this without throwing away ‘all the good’ – without ‘cancelling’ them, if you like.

Being an adult means tolerating the frustrations of the real world and the frustrations of the others who make up the real world. However, if this can be tolerated then real relationships are possible and people can locate substance and meaning thus moving them out of a fear/threat pattern into adult relating patterns.

If you would like to work on your own intolerances and relationships, get in touch with us to discuss whether psychotherapy may be appropriate for you.

 

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 does the difference between counselling and psychotherapy matter?

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Face to Face and Online Therapy Help Available Now

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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.)

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

 

Further reading by Kevin Collins –

Communication, communication, communication

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Fear and hope in the time of Covid

The coronavirus pandemic has interrupted our lives and disrupted the status quo – that which confers normalcy and (feels like) security. As we have in recent months reorganised and adapted our lives to halt the virus in its destructive tracks we have been derailed from our personal and collective sense of forward motion (progression). Forced sideways into new territories (socially, emotionally, physically and economically) some of us find our individual plans compromised and in many instances, in tatters. Confronted by an inescapable sense of uncertainty our coping mechanisms have been given a significant stress test. The covid ‘reset’ has demanded a refocusing of our priorities and our attentions.

Disrupted from our familiar rhythms and rituals and suddenly with multiple roles overlapping (and potentially conflicting) parent, teacher, partner, carer etc, most of us have experienced a significant blurring of more familiar boundaries. Under ‘normal’ circumstances different parts of our identity have different social settings, work, school, gym etc. Without the scope for differentiation that all these settings and contexts confer we may feel somewhat untethered, cast adrift. “Who am I now?”

The illusion of individualism

The comforting illusion that we may be masters of our own destiny is now creaking beneath the weight of new and uncomfortable evidence. Our interdependence and connectedness were never more clear. When we experience a loss of control and feel the fear that it evokes we are confronted by our best and worst selves. We have all witnessed (in recent weeks) and been moved by, acts of supreme neighbourliness, altruism and humanity. We may have experienced these capacities newly in ourselves and felt enlivened by our capacity to express them. More disquieting, lurking somewhere in the dark recesses of our individual and collective psyches (activated by the same fear) lives its shadowy xenophobic counterpart, suspicious, wary and often hostile…. to difference, to change, to ‘the other.’

The uncontrollability of the corona virus may reflect something of the uncontrollability of a globalised world. Both highlight our mutual dependence and by implication our mutual vulnerability. At a time when a sense of universal unity might be prescient it is also a time at which it seems extremely unlikely. In a state of fear the instinct is to contract mentally and physically, to batten down the hatches against a real or imagined enemy. In a state of fear we may abandon our capacities for hope and for trust…. on a global as well as an individual level.

The necessity of conversation

The truth (about anything) may only emerge at the end of a long conversation (always subject to review). That is to say, a genuine conversation, not a series of scripted monologues (in disguise) masquerading as conversation. A genuine conversation is one in which neither party is certain of knowing what the end will be, since in the process of conversation each party is shaped by the other.

This notion seems antithetical to current political discourse. At a time when our political leaders seem unable to agree on a path ahead how important it is that we steady ourselves in the face of such polarisation and uncertainty.

What are the conversations we need to begin having…..with ourselves, with our partners, our children, our families and our community? How might these conversations become fertile explorations of what matters now? Whilst the disruption caused by the virus has undoubtedly brought tragedy to many, perhaps (in spite of itself) it might also bring opportunity. Fear and hope are inextricably linked, each counterbalancing the other. When there is no easy path ahead how do we retain a sense of equanimity and trust? How might we stay open to the important conversations that need to be had without closing down… our minds and our hearts. How do we retain our humanity when we fear for our lives. How do we hold on to hope?

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

Relationships, networks and connections

Paying attention to stress

Why does empathy matter?

What is Intimacy?

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Psychiatry, Psychology and Psychodynamic Psychotherapy

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

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

Counselling Psychology:-A counselling psychologist will have first completed a degree in Psychology and then an additional counselling training. In theory their approach, or at least the ‘psychology part’,  will be based on theories resting on experiments and scientific deductions, for instance the British Psychological society states that “As a science psychology functions as both a thriving academic discipline and a vital professional practice, one dedicated to the study of human behaviour – and the thoughts, feelings, and motivations behind it – through observation, measurement, and testing, in order to form conclusions that are based on sound scientific methodology.”.

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

 

Psychodynamic Psychotherapy

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

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

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

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

 

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

 

Further reading by Paul Salvage –

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

The Therapeutic Relationship and the Unconscious

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