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What are Feelings Anyway?

Everyone knows what a feeling is, right? Well, it turns out that this is not the case and many of us are either unable to experience feelings at all, or get thoughts and feelings mixed up.

Early on in my training I had a tutor who would tell us ‘when in doubt, hunt the feeling’. It is arguable that this is the purpose of the therapeutic interaction that enables both empathy and relational understanding to take place.

So what is a feeling?

Feelings are emotional responses that we experience which can then be thought about and communicated using language. Let’s delve deeper and understand how feelings operate.

When we have a physiological response to stimuli – this can be external or a thought process – the cluster of physical responses are called ‘affect’. Affect is primal and is something we find across all mammals. Broadly, affect is a proto-emotion and expresses itself through what we would describe in words as:

Seeking;
Rage;
Fear;
Panic;
Play;
Lust
Care.

Affect is not relational, meaning it neither functions nor is used to communicate feelings to another.

Above affect we have our emotions, which are more sophisticated and nuanced and whose function is to let both us and those with whom we are in relationship know about what is going on for us. Emotion is the link between mind and body, and, affect and feeling. Our primary emotions are:

Fear;
Anger;
Sadness;
Joy;
Disgust;
Surprise.

Emotion defies language in that it can be felt and communicated through relationship and experience. However, effect is communicated using projection and projective identification – the ‘putting’ of feelings into another.

Feelings sit at the highest level and are behavioural and cognitive. They can be thought about and defined in language and conceptualised by another.

How can things go wrong?

Infants do not have the ability to use language and nor do they think using words. They experience affect in their body and communicate their emotions to their primary carer using projection. With early trauma where the primary carer (the mother) has not been adequately internalised, the infant projects their affect out into the universe, rather than into the other. They can neither make sense and soothe themselves nor locate soothing in another and are adrift with overwhelming emotions.

In psychotherapy

In relational psychotherapy, feelings are communicated through verbal and non-verbal cues but are also present in the transference in the shape of emotion. By receiving the patient’s projections and giving shape and form to them in the therapy, the therapist assists the patient in digesting their emotions and converting them into feelings.

When is a feeling not a feeling?

Often people will talk about feelings when these are actually thoughts. In language this is expressed as ‘I feel that…’. As soon as the word ‘that’ follows the word ‘feeling’, you know you are dealing with a thought.

Why does all this matter?

Integrating thinking and feeling lies at the heart of the therapeutic process. If unexpressed and crucially, unexpressed in a relationship, then a person is likely to remain stuck experiencing the world and their current relationships clouded by past experiences. In the words of Freud: “Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways.”

 

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 – 

Client or patient; patient or client – does it matter?

The psychological impact of the recession

Why do people watch horror movies?

How to minimise Christmas stress if you are hosting

Can couples counselling fix a relationship?

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Why we need a ‘Secure Base’

At the heart of the process of psychotherapy is trying to see more clearly what our basic needs as human beings are and how they can be met. Most clients seeking treatment are feeling uncomfortable because of difficulties in this domain.

The sense of discomfort is often compounded because, without help, it can be hard to unravel what our core needs actually are. There is no simple users’ manual telling us how our brains and emotions work. This article is an attempt to shed light in this important arena, based on recent pioneering research work.

Our understanding of this subject has undergone a major revolution since, Sigmund Freud – in the 1890s until his death in 1939 – led the way in creating a theoretical framework of the workings of our brain. He postulated that if libidinal needs – such as for food and sex – are not met, the result was neurosis, repression, unhappiness and anti-social behaviour.

In the 1940s, a British psychoanalyst originally trained in Freudian theory called John Bowlby developed a revolutionary alternative framework.

He came up with the idea that, above all, during our growing up period, we need what subsequently came to be called ‘a secure base’. He concluded that more important than Freud’s libidinal desires was the requirement to be looked after, to be connected with others, to be loved and accepted and to be made to feel safe.

Bowlby’s pioneering research was conducted during the Second World War among children orphaned during the Blitz. He believed they were distraught to the point of inconsolability and felt totally disconnected because they were missing their parents’ love and care.

A seminal piece of research which further supported Bowlby’s main ideas was conducted in 1958 using rhesus monkeys. It was found that a distressed monkey infant did not go first to a mother model dispensing food, but rather to one covered in fleecy material which felt warm and comforting (1).

Parallel research also showed that those who did not have a secure base became less likely to explore the world, less sociable and more prone to mental and physical problems.

In an ideal world, our individual needs are met during our childhood by our parents or principal care-givers. But of course, parents often can’t manage. In the vast majority of cases, that’s not because they want to upset or harm us, but rather because their own needs have not been met and their ability to be emotionally available has been compromised. They can struggle to be able to express the right level of ‘good enough’ care.

Bowlby’s ideas have been hugely refined and expanded since his first research papers were published during the Second World War. A distillation of latest thinking in relation to our core needs and the ‘secure base’ is contained in a paper published Stanford University psychologist Carol S. Dweck in 2017 (2).

She states: ‘. . . basic needs are present from very early in life and their criteria for inclusion include: irreducibility to other needs, universal high value from very early in life and importance for well-being and optimal development from very early in life’.

On the basis of her very wide research and reading, she postulates that three ‘basic needs’ – for predictability, acceptance and competence – are the primary components of the secure base:

competence acceptance predictability

To spell that out further, if we grow up feeling that the world is reasonably and broadly predictable – that we are looked after and loved, have food, that there is routine – then we feel fundamentally safe and secure; if we develop so that we believe we can do the tasks required of us, we feel able and equipped to deal with life’s challenges; and if it is communicated to us that we are accepted broadly for what we are in ourselves and in the family and in social settings, we feel comfortable in our interactions with the world and other people.

In turn, feeling ‘safe’ gives us the basis to be able to regulate our primary negative emotions – fear, anger, sadness and disgust – to a comfortable level.

Dweck further says that having such a ‘secure base’ generates further benefits.

  • We feel can control events in our lives as a result of experiencing at sufficient levels predictability and acceptance;
  • We develop self-esteem as a by-product of feeling that we are competent and broadly accepted for what we are;
  • We feel we can trust ourselves and others more easily if we have experienced predictability and the feeling that we are accepted.

Finally if all these pieces of the jigsaw are broadly in place, then we also develop a sense of self-coherence.

In future blogs, I will explain on the basis of latest research how emotional regulation can be achieved through the therapy process.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Resources –

(1) https://positivepsychology.com/harlow-experiment/

(2) https://moodle2.units.it/pluginfile.php/358466/mod_resource/content/1/2017%20Dweck%20PR.pdf

 

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The Psychological Impact of the Recession

So we are officially in a recession in the UK. And not just any recession, but ‘the longest ever recession’ is predicted ‘since records began’. The word ‘recession’ is one that fills most working-age adults with a sense of dread, only further exacerbated not only by the suggestion that it will be ‘longer’ than ever before, but that it comes off the back of a couple of extremely anxiety provoking years thanks to the global pandemic. Will there be any respite for us all?

Our nervous systems have evolved to protect us from threat and very good they are at it too! We experience increased levels of anxiety and vigilance when our nervous system locates anything in our surroundings that may be threatening to our existence. For centuries, this would involve the literal threat to life resulting from the risk of becoming food for a wild animal or the victim of an attack by a neighbouring tribe. However, the world that most of us now live in is, fortunately, not punctuated by wild animals prowling around us or a neighbouring tribe mounting an attack. This is not to say that there are not dangers around us, but the risk of imminent death has unequivocally reduced as a result of multiple factors such as the rule of law, healthcare and our dominance over nature. Our nervous systems just don’t seem to have gotten the news.

Anxiety, which is the predominant emotion we feel when initially under threat is unlike other emotions in that it seeks to attach to an external event (rather than always being triggered by an external event). Thus, our ancestors would have an underlying level of anxiety they would navigate the world with and invariably when they felt a threat their anxiety levels would shoot up and they could appropriately respond to the threat. The same process happens with modern humans, however, the anxiety we feel is now often unhelpful when facing ‘modern threats’ as these, whilst real, are not imminently life threatening and even if they do represent a sort of existential threat – like a recession may – they are not something we can run from, fight, freeze up against or fawn; these are the four options our nervous system presents us with when we feel under extreme threat.

The psychological impact of the news of a recession can be similar to that of the psychological impact our ancient cousins would face when confronted with a sabre tooth tiger. And this stops us being able to think things through calmly. We then become reactive rather than able to take action.

What can you do?

I am no financial adviser and it is important to remember that each and every one of us will be impacted differently by economic events such as a recession, just as we are all impacted differently by all other events happening around us. But what I do understand is the human nervous system and anxiety.

Firstly, remember that ‘The News’ irrespective of the outlet, is designed to grab your attention – much like that sabre tooth tiger sticking its head out of a bush and into our face. News headlines are designed to sell newspapers, or in the modern world, to get ‘clicks’. This does not mean that it is ‘fake news’ but the devil is in the detail, not the headline. Take time to read the whole article and digest what it means. Think about whether you will actually be directly impacted and if so in which ways. Then you can take the time to take action methodically.

Remember that recessions are a part of the ordinary cycle of an economy and that each time one has arrived, it has once again passed and followed by a period of growth. People are affected but again, like the headlines, the news will report these effects from a ‘newsworthy’ perspective, rather than as a balanced view or perspective on society as a whole.

Limit your exposure to too much ‘news’ even though you will likely be drawn to ‘consume’ more.

This is human nature – your nervous system has signalled that this is a threat and so you are inclined to gather as much information as you possibly can. However, a recession, unlike a marauding tribe, is something that is approaching slowly and will also unfold slowly in relative terms – you do not need to get into a panic.

Focus on helpful ways of managing your anxiety such as taking time in nature, sharing your feelings with friends, practicing mindfulness, doing exercise or anything else that both brings you into your body, into the ‘here and now’, and calms your nervous system. Why is this important? It’s not about denying reality – on the contrary, it is about calming you enough so that you can once again think and if you can think you can make plans, rather than simply react to the news.

It is also worth bearing in mind that at present, what you are reading about the recession is a prediction. In other words, not may not be as bad as predicted or pan out quite as predicted.

We have all, collectively, got through the pandemic and coped with the anxiety of the unknown – the virus – that we all faced. This is likely to be the same.

 

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 – 

Can couples counselling fix a relationship?

How to get a mental health diagnosis

What is psychotherapy?

How to improve mental health

How do I find the right psychotherapist?

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I’m the Problem – It’s Me!

Are you curious to know the most popular song in the world right now? Of course, you might not have been able to miss it.

This autumn, a musical milestone was achieved by Taylor Swift, who has become the first musician to claim all ten top slots of the US Billboard Top 100. Of her ten conquering songs the one that’s found most popularity with streamers is Anti-Hero, with its choral refrain, ‘I’m the problem, it’s me’.

And this phrase has been reported as being rapidly taken up in social media trends almost as an anthem for our times. The promotional video accompanying the song depicts multiple versions of Swift portraying a character riven by internal conflict, struggling to relate to others and self-medicating with alcohol to cope.

Clearly, apart from its evident musical catchiness, something in the central message of this song is resonating with fans of an artist whose online followers number more than 100 million, mostly young, people. Is it that the singer’s conflation of her very identity with her problem seems to fit their own experience?

So what’s ‘the problem’?

The word ‘problem’ has been defined as ‘a situation, person, or thing that needs attention and needs to be dealt with or solved’. Just to speak the word involves compressing the lips twice to form the first syllable with its explosive ‘p’ and ‘b’ in a verbal stumble, almost expressive of something being expelled. It’s derived from the Greek ‘proballein’, a combination of ‘pro’ meaning ‘before’ and ‘ballein’ meaning ‘to throw’. And perhaps there is an ancient wisdom in the root of this word in its suggestion that we experience the need to ‘throw’ a perceived problem out of us.

Working with ‘the problem’ in therapy

This has recalled me to thinking about the uses of therapy as a means for practitioner and client to work purposefully together in addressing the recurrent phenomena of ‘the problem’.

Narrative therapy offers a framework for supporting families and individuals who present accounts of their life experience as ‘problem saturated’. Where someone has concluded they are the problem, in locating the problem inwardly in this way, they have formed what is called a ‘dominant story’ about themselves, one that could become powerfully restricting in narrowing possibilities for them to uncover other meanings or perspectives on their lives. It’s argued that this way of seeing only supports and sustains the presenting problem.

Linked with the original meaning of the word as ‘throwing’ something away from us, narrative therapy invites us to separate the person from the problem. Therapist and client engage in a collaborative search for an ‘alternative story’ that will challenge a person’s dominant story through techniques of ‘problem externalisation’. This starts with the contention that ‘the problem is the problem’ and focuses instead on the relationship between the person and the problem.

In therapeutic practice, fruitful ways of externalising any problem often involve using language creatively in naming it and even placing the problem where it may be visualised in the room and personified in its own right as an entity with its own curious qualities. So depending on the nature of the difficulty, practitioner and client might be working together to discover more about what the client them self names as, for example, the ‘Anxiety Wave’, the ‘Constant Conflict’ or even, in the case of Taylor Swift’s Anti-Hero, the ‘Monster On The Hill’.

This is an approach that honours the deep distress experienced by many individuals for whom a problem has become an inextricable and debilitating part of themselves. Through supporting them to separate from their problem, alternative stories can emerge that surface previously unacknowledged – or discounted – personal skills and competencies, revealing new capacities for agency.

Arguably Taylor’s song has done a service for those who most identify with her protagonist’s dominant story of problem internalisation. I hope it leads them to ways in which they might find their own alternative stories to effect preferred positive change in their own lives.

 

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

Chris Horton is a registered member of the British Association for Counselling & Psychotherapy (BACP) and a psychotherapeutic counsellor with experience in a diverse range of occupational settings. He works with individuals (young people/adults) in private practice.  He is available at our Lewes and Brighton & Hove Practice.

 

Further reading by Chris Horton – 

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

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Why do People Watch Horror Movies?

Horror as a genre of ‘entertainment’ has, I would suggest, always been a part of the human experience, as it is through this collective narrative that we give shape and form to a world in which we have very little control. Long before movies existed and extending back to before the written word, our early ancestors would ‘invent’ super-natural beings with whom they would do battle in story and ritual. Why?

Anxiety

Human beings are inherently anxious beings. One can argue that this anxiety has come about as a result of two facts: the first being that until very recently we had good reason to be anxious as much of nature and the animals and plants in it posed an existential threat to us – only the anxious survived.

Secondly, and perhaps more psychologically relevant, is the suggestion that humans are the only animal who is conscious, self conscious, hyper conscious. What fundamentally makes us stand out from other animals is our ability to project our minds into the future which renders us capable of planning and achieving great feats, however, also brings us into brutal contact with the knowledge that we are destined to die. We are therefore in the impossible position of being able to largely shape our destiny (providing we don’t get eaten by a wild animal) only to face a certain death at the end of life (if we are lucky), or potentially at any moment. This renders us anxious in nature.

Humans use all sorts of methods and means as individuals and in groups to manage their underlying anxiety such as having children and building a career, through to subscribing to a culture (being British), that provides constituents with shared answers to cosmological questions – where have I come from, what happens after I die? So how may this apply to horror?

It has been noted that more than half the population enjoys watching horror as a genre. What is specific to this group is that they tend to score high on neuroticism which, amongst other characteristics, is denoted by high levels of anxiety.

When we think of anxiety as being the price we pay for our consciousness, and we consider that humans are always trying to somehow manage their anxiety, the draw to horror movies becomes a little clearer, particularly when considered in conjunction with the events of the past couple of years.

Why are we collectively watching more horror movies?

As a collective global society, any notions of safety and security were suddenly taken from us in early 2020 by the emergence of a virus that swept the world. We were all required to remain at home, stay away from work and consider friends and loved ones as ‘high risk’ and potentially contagious. For our nervous systems this represents a horror movie in itself! The problem is that it unfolded far too slowly for us to ‘attach’ our anxiety to it and then let it play out over 90 minutes.

Watching horror as a locus of control

I would suggest that one of the prime reasons that horror has become so popular over the last couple of years is that it represents a vehicle onto which those who already have a disposition to using horror as a means of evacuating their anxiety through projection, to do so by ‘projecting’ the anxiety of the unknowns generated by the fallout of the pandemic, into something tangible – a movie.

Psychologically horror movies may also function in a pseudo-ritualistic manner, in the way a dance or group ritual may have worked for our ancestors to gain mastery over their world – even if only in fantasy. The themes in horror movies are primal and archetypal in nature – they represent what lurks in the deepest recesses of our minds – and what we once imagined lived behind every tree out in darkness as we cowered by our campfires with mere sticks and stones to protect us.

Horror movies represent the ultimate battle of good versus evil and as it is a battle that plays out on screen we feel activated in the way our ancestors did when facing real and imagined dangers, however, it provides a locus of control to the viewer in that they are choosing to feel anxious and embark on the quest they experience playing out in front of them.

I therefore do not believe that horror films represent a conscious desire on the viewers part to confront their fears about the real world ‘head on’ but rather that it is a displacement activity whereby anxiety can be expelled in a socially sanctioned and safe manner. It is a method and means of gaining mastery over unbearable feelings through experiencing them safely.

Life imitates art, as the expression goes, however art is first and foremost an expression of the collective experience (the collective unconscious), and so as long as our collective experience is dominated by the horror of the pandemic and war and other existential threats, then I think it likely that horror, as a genre of art, will continue to be made and consumed at a higher rate as a way of us coping with our anxiety.

 

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

Can couples counselling fix a relationship?

How to get a mental health diagnosis

What is psychotherapy?

How to improve mental health

How do I find the right psychotherapist?

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How to Minimise Christmas Stress if you’re Hosting

Christmas can be an emotionally challenging and difficult time for many of us. There is such expectation on how Christmas ‘should’ be, yet like the weather, it often fails to deliver on the ‘winter wonderland’ scenes on
the TV adverts. For so many of us our family experience often falls far short of the loving idyllic family reunions depicted in those same snowy adverts. And if you are hosting, this can bring with it an added pressure to deliver the ‘perfect Christmas’.

There is lots of advice available on how best to organise yourself practically in advance in the big day, such as food prep hacks, however, I wonder if there is another way of not only coping but getting something
from the day for yourself?

Think about your own needs first

An example that I often use in clinical practice when illustrating to patients how it is vital that they think of their own needs, is the pre-flight safety briefing that happens before a plane takes off.

Anyone who has flown has sat through at least one of these and there is a particular point in the briefing where the cabin crew explain what you should do if the cabin loses pressure, the oxygen masks drop down and
you are travelling with a dependent. The correct approach is to attend to your own mask first and then your dependent, however, it is surprising how many people think that they should help their dependent fit their
mask first, before attending to their own. Why is it this way around? Because if you try and help your dependent first and have not tended to your own needs, there will be two people in distress rather than one.
And yet for so many of us the inclination is to ignore our own needs and attend to those of others.

Applying the same logic to Christmas, before deciding whom to invite and having any conversations with family and friends about the day itself, first think about your own wants and needs. What are your physical limitations and needs? What can you and can’t you do? How many people can you host without feeling overwhelmed? Who’s company do you enjoy and who is draining? What do you want to get from the day?

The next step is to think about what is negotiable and what is a firm boundary. For example, it may be that you are willing to cater for an additional number of people if you have help or support from others with
cooking. Or, it may be that you are willing to tolerate the presence of someone you find contentious, if another member of the family assures you that they will help you manage that person. However, a firm boundary may be that you have a certain time by when you request everybody leaves (stated in advance).

Wants vs needs

The nature of Christmas combined with the pressure to host, can often mean that any consideration of what you may want from the day gets lost and the focus shifts to being one of ‘surviving the day’. What if it
does not have to be like this? What if you could take some time to calmly consider how you would like not only to ‘host’ the day and cater for everybody, but to play an active role in creating the day that you would like? In other words, what if you were to value your own needs as much as you value everybody else’s?

Hosting does not mean sacrificing yourself

Consider how you do not need to sacrifice yourself in order to host an event for others. People who are worth being in relationship with (and therefore arguably worth spending Christmas with), should be people who are interested in your well-being and needs and will therefore be open to hearing about not only what you can and can’t offer on the day, but also what you would like from it. If they aren’t, then perhaps question whether they are really wanting to celebrate with you as a person, or are simply making use of what you can provide.

Support through relationship

Putting your needs into the mix can feel daunting if it is not something that you are used to doing. And it is generally only possible if we can rely on having an ally, or allies, by our side who are encouraging – this is
often our partner or a close friend. If you are in a relationship, talk to your partner about your needs and wants of Christmas well before the day arrives.  Explain to them how you wish to approach hosting Christmas and risk asking for support – emotional as well as practical. This is something you can do with a friend, or friends too.

It can also be really helpful to agree up front how you will ask for support on the actual day and how you would like your partner or friend(s) to support you. Examples may be anything from starting the day together and connecting, through to specific practical requests. You can demonstrate support for each other throughout the day through small reassuring gestures such as visually checking in with one another or making physical contact.

Reality Testing

Christmas is only a day and that is really worth bearing that in mind. However the day goes, the world will keep on turning and in all likelihood, the relationships that matter will still be there for you. The expectations we feel in relation to Christmas are largely in our own head and can therefore be challenged.  By pausing and accepting that there is no such thing as a ‘fairy-tale Christmas’ we can gain a little space to see it for what it is. It does not have to be perfect nor is it likely to be. Is the goal a ‘picture perfect’ Christmas, or one in which you feel like you are connecting with loved ones and friends?

The past is not the present

For many, memories of past Christmases are difficult and they can reappear like ghosts. However, these ghosts need not dominate your experience in the here-and-now. Accept that it is a difficult time for you and know that it is for many others too, be compassionate with the feelings that the season evokes and remember it is only a day. Sometimes we feel strong emotions on particular days that are simply reminders of the past – echoes – and we actually have the power to create something different. The more you are able to anticipate your wants and needs ahead of Christmas, the less likely the ghosts of the past are to appear and dominate the day.

Alcohol generally makes things worse

Nobody is telling you not to drink on Christmas Day. However, if it is a day that evokes sadness or anxiety, alcohol will not improve these feelings for long. Once it wears off, they will be back with a vengeance and accompanied by a hangover. The opposite of using alcohol to self-soothe is to soothe through relationship. Even if you are not in a relationship with another, you are in a relationship with yourself and can hold yourself in mind.

Even if the day feels full and focused on others, it is always possible to take a few minutes out to calm yourself. You can breathe, come back to the here and now and remind yourself –  Christmas is only a day.

Listen to your body

This doesn’t mean act impulsively. It is more about listening for what the vulnerable part of you needs. This may be a hot bath with a good book, a warm drink by the fire, a nice home cooked meal or spending time with a supportive friend. It could also be a long run, or a dance or yoga class. Whatever self-care tool helps you feel well and connected should form part of your preparations for the day and be in place after the day.

 

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 – 

Can couples counselling fix a relationship?

How to get a mental health diagnosis

What is psychotherapy?

How to improve mental health

How do I find the right psychotherapist?

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In Support of Being Average

Ask yourself if you would like to be described as being ‘average’ and it might not be your first choice. Average might feel like a vague insult, a reflection on yourself that you’d rather not have. When we use the term ‘average’ we don’t see much that is positive about it.

What is ‘average’?

By definition ‘average’ speaks of a central or typical value across a data set. Average comes with connotations of mediocrity, not setting a very high standard, lacking motivation or even having given up. Average has little to make it feel desirable, but that doesn’t mean that we should write it off.

Perfection: The opposite of average?

Modern society, especially in the world of social media, seems to have no time for average. We are encouraged to seek perfection, to rise above what is seen as average and to strive and compete for a perfect existence. Flaws and defects wont do, only achieving a level that cannot be exceeded is acceptable.

In writing this we are presented with the thought that perfection is very subjective and is also very hard to achieve. We all carry a sense of who we are and the pursuit of perfection is something that we mostly define for ourselves.

Our sense of what is perfect is tied to our sense of self. Early messaging that one isn’t good enough and the associated feelings of inadequacy can make perfection feel appealing. By being perfect we compensate for our inadequacies and are beyond reproach. One becomes insulated from the feelings of judgement from oneself and others. Perfection and the pursuit of it become the solution to challenging feelings.

To always want to be perfect means that we never have to consider what failure feels like. Part of being human is that we are sentient beings and not merely machines carrying out limited functions in a repetitive fashion. To be simplistic we aren’t and can’t be all-knowing and therefore we are flawed and failure is possible.

The pursuit of perfection can impact our personal relationships and deny us the opportunity to explore and be curious. If perfection becomes a motivating factor how can be relate to others when we are managing our own anxiety around feelings of being judged. If it feels unbearable to think of failure how do we learn and develop?

Thoughts of being ‘average’ and psychotherapy

Considering how thoughts of being perfect can impact our life and relationships we might think of how we can move away from this high standard. To be less than perfect, we have to consider how we tolerate what has previously felt unbearable. The thought that it’s ok not to be perfect is a challenge and can expose one to questions of self critical, judgemental feelings that have been defended against. Psychotherapy offers the opportunity to think with a therapist and explore what is behind such feelings. Can we challenge this unconscious sense that anything other than perfection is bearable? Can we be ‘average’ and be happy with that?

Being an advocate for ‘average’ is not about promoting mediocrity, it’s a reaction to the rigour of perfection and a way of finding a more compassionate sense of self that can be at ease with and maybe even enjoy.

 

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

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 –

The challenge of change

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

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Understanding Feelings of Guilt

Guilt can be a particularly tortuous feeling and, for some, a chronic state of mind. Below, I will think about different aspects of this complicated emotion.

Origins of Guilt

For Melanie Klein (1), guilt is part of a small child’s normal development, when they realise that they can hate and feel aggressive towards those they also love. The guilt arises out of fear that the infant is responsible for the potential or actual damage and loss of their mother/caregiver – on whom they absolutely depend.

These early experiences will be made better or worse by several factors, including the love and stability given to the child as it grows. Future events, particularly those early on in life, may help to relieve or compound the individual’s more complex or unresolved relationship to guilt.

Function and Dysfunction of Guilt

While painful, particularly when we are consumed by it, it’s important to realise that guilt is a normal part of our emotional lives. When it functions, it is helpful for us as individuals and societies. It is strongly connected, for example, with morality and conscience.

Being able to feel guilt is a healthy capacity and is connected to remorse. Guilt can lead us to accept our responsibility and take action, if necessary, to make reparation. This can take often place in ordinary ways, for example, saying sorry to someone we feel we’ve hurt.

However, when the awful and terrifying feelings of guilt in childhood have not been resolved enough, they can persist into adulthood in chronic and acute ways, and for some people becomes a regular place in their minds to go to. Feeling perpetually guilty can lead to, and be bound up with, intense feelings of anxiety and persecution.

Guilt can get located into all kinds of irrational parts of oneself and can become a way of avoiding other difficult feelings. For example, guilt can be bound up with unresolved feelings around regret and loss or can be a response to uncomfortable feelings of anger. Or it can be used as a way of cushioning against feelings of a loss of control – for e.g. following an external trauma.

Defences against Guilt

For some people, feelings of guilt are so hard to bear they find different ways to get rid of them.

For example, they may become extreme in their efforts to ‘make reparation’, like compulsively putting others first. This is problematic for several reasons, not least of all because underlying this dynamic is often – and understandably – growing resentment which cannot be acknowledged. Inevitably this can simply perpetuate further cyclical feelings of guilt.

Fearfulness around feeling guilt can also lead to a difficulty in taking ownership and another way of avoiding guilt can involve being critical and blaming of others. This is often unconscious and a defensive way of managing guilt by projecting it out – so that others will hold all the guilty feelings.

How to get help with Guilt

If we think back to Klein’s ideas of development, it is the acceptance of responsibility that can lead to repair and resolution. In adult life it is similarly important to be able to bear our guilt without fear and attack (on ourselves or others). Taking responsibility for our actions is so important to our psychological health, and allows us, at times, to repair and this will also feed back into our sense of self and confidence.

Chronic and more compulsive feelings of guilt however are problematic and likely to be bound up with complex childhood (and, also, sometimes adult) losses and traumas. These can be worked through in therapy or counselling.
Group therapy can be particularly useful in tackling pervasive feelings of guilt as the individual can gain a great deal from the reassurances of other members. Also, seeing others grapple with familiar emotions around guilt can be powerfully therapeutic in thinking about one’s own relationship to it.

Therapy can encourage and support people in coming to terms with responsibility, regret, and remorse where this is helpful and appropriate, while still questioning and exploring more chronic and corrosive feelings of guilt.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

A new psychotherapy group

The process of joining a therapy group

What is ‘othering’ and why is it important?

How psychotherapy groups can help change our internalised family systems

Is a Therapy Group Right for Me? Am I Right for a Therapy Group?

 

Reference – 

(1) Melanie Klein (Psychoanalyst) b1882 – d1960. Love, Guilt and Reparation (1937)

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Collective Grief

Recent Events: The Death of Queen Elizabeth and COVID

The recent death of Queen Elizabeth has drawn people together in grief in a ways both individual and shared. Having been Queen and a globally public figure for 70 years, her death felt like the loss of what had been a constant and stable presence in our lives.

The COVID pandemic forced us to engage with mortality in a way that many people hadn’t ever had to. We found ourselves experiencing emotions and feelings in ways that were unexpected and unsettling. We had to find a way to feel safe, in the face on what could feel like an invisible threat. Sharing the vulnerability of COVID became a way of coping with our feelings when so much felt unknown and uncertain.

Both of these events gave rise to feelings of loss and grief that were public and shared, yet they felt very different.

Contrasting experiences of grief

The experience of loss is something that no one can assume to avoid in life. It is part of human existence and can be the most obvious way in which we experience grief. The experience of grief is subjective and effects people in ways as individual as we are. Whilst some people appear unmoved and stoic, others can feel intense and uncontrollable emotions. Grief can be present in life in ways that can be hard to explain, either at the time, or at points in the future.

The death of a public figure and our sense of grief gives us an understanding of how we related to that person. Do we feel the loss of someone that we felt a closeness to, or do we find ourselves having ambivalent feelings? How does the loss affect our lives and what does it mean for us? Answers to these questions show us how unique our grief can be.

Sharing our grief over the death of Queen Elizabeth can feel as if it gives us permission to mourn and experience our own grief. We can attribute our emotions to an event that is shared and understood. We find comfort in sharing grief with others with a similar lived experience.

Looking back at the pandemic it could be hard to find ways in which to express feelings of grief, when everyone was trying to make sense of what was going on. Why we felt the way that we did wasn’t always easy to understand.

The pandemic also challenged us to experience death in ways that were far from what anyone would want. The absence of the ability to share grief at collective events like funerals and memorials left a sense of something unfinished and denied us the opportunity to find ways to understand our grief.

Comparable experiences of grief

Comparing the experience of loss and grief between the COVID pandemic and the death of Queen Elizabeth might seem rather obtuse. Both are joined by the collective nature of the events and how there felt like something inescapable about being aware of a collective sense of grief.

There is some comfort in the shared nature of what has happened and the sense that ‘we’re all in this together’ offers some reassurance, yet grief is still an individual experience

Grief and Psychotherapy

Loss and grief are parts of our existence, yet they can affect us in ways that can be unpredictable and unsettling. Being able to think with a therapist about how one is experiencing loss and grief can help to give understanding and a sense that what can at times can feel overwhelming can become less acute.

 

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

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 –

The challenge of change

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

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Why is Mental Health Important?

Mental Health has become a hot topic in the last few years. We often hear about it in the media, and because of more public awareness about mental health issues, more employers are adopting mental health policies and offering employees more support. Whilst mental health used to be seen as something related to mental illness, nowadays people are talking more about the importance of mental health as a part of their overall wellbeing, such as exercise and healthy eating.

But what is mental health?

Mental health is dependent on a certain degree of emotional, psychological, and social equilibrium. It impacts thinking, feeling and behaviour and therefore our capacity to handle stress, maintain good relationships and make decisions, amongst other things.

Good mental health is a vital aspect of us being able to function well in the world, hence it’s importance. There are environmental, social and psychological factors that can affect our mental state, such as:
– Ongoing real or perceived threat or danger to one’s life and livelihood
– Traumatic experiences/ events, recent or historical
– A physical or mental health diagnosis/ symptoms
– Bereavement and loss
– Breakdown in relationship(s)
– Major life change or life crisis
– Financial problems/ stressors
– Work stress
– Loneliness and isolation
– Discrimination and bullying
– Poor sleep and/ or diet
– Sedentary lifestyle/ lack of exercise
– Lack of light and/ or fresh air
– Noise and pollution

It is only human to have experienced one or several of the list above, therefore mental health is of relevance to everyone.

How to Look After your Mental Health?

Environmental and lifestyle factors:
Many people underestimate the impact of sleep, diet, exercise and sunlight on their mental wellbeing. With the increase in the use of screens and less time spent outdoors, especially in the case of children, these very basic factors are not being attended to, with often drastic impact on quality of life. Poor diet, poor sleep and lack of exercise and natural light are interacting factors. Lack of natural light and fresh air affects our sleep, as does the consumption of certain foods such as sugar and caffeine. Exercise can help improve sleep quality and lead us to want to eat better. Good sleep quality helps combat sugar cravings and when we feel rested need to consume less caffeine, etc. Good habits feed other good habits – it’s a cycle.

Social factors:
We all live in society and in communities within society. A sense of belonging paired with a sense of purpose and meaning are significant factors in our sense of mental wellbeing. We all need social connections and to feel a part of something. This became very apparent during the Covid pandemic when we saw many people’s mental health decline because of social isolation. Good relationships and good support systems make us feel safer and cared
about. Helping others, sharing interests, exchanging ideas and working towards common goals helps create a positive social loop where we feel that our life is meaningful and our contributions matter.

Psychological factors:
Most of us have gone through a crisis, a loss or even suffered significant traumatic event(s). Many of us have also experienced challenges growing up in dysfunctional families or under challenging circumstances. These issues when not attended to psychologically, can easily become cumulative and affect our lives in negative ways, often leading to depression or chronic anxiety. Feeling alone with our problems further exacerbates these issues, creating
a negative cycle that is self-perpetuating.

How Psychotherapy can Help

Psychotherapy can help you get and remain mentally healthy in several ways. A skilled therapist will help you address psychological issues such as the ones listed above. Therapy can be very effective in helping people deal with past traumas, life crisis, relationship issues and process loss, amongst many other things. In psychotherapy you can also explore how certain behaviours are affecting your mental health and how to change or improve them.

Sometimes bad habits tell us something about how we were looked after, and therefore how we end looking after ourselves. Finally, it can also help us get to a better place within ourselves and therefore make better decisions. Sometimes issues are multi-faceted, layered, and complex. Being able to distinguish, pick apart and navigate a seemingly hopeless situation is empowering and puts us back in control of our lives.

 

Sam Jahara is a UKCP Registered Psychotherapist, Superviser and Tavistock Certified Executive Coach.

 

Further reading by Sam Jahara

What makes us choose our career paths?

Antidotes to coercive, controlling and narcissistic behaviour

An in-depth approach to leadership coaching

Demystifying mental health

Women and Anger

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What makes us choose our Career Paths?

In both coaching and psychotherapy I am always fascinated by the reasons people choose certain career paths or lines of work. It is also interesting to see how career paths develop and change because of personal choices and how people’s personalities interact within organisations and changes in the job market.

These explorations can be vital to our personal fulfilment and sense of satisfaction, after all most of us spend a significant amount of our lives in work.

For instance, a surgeon may have chosen to go into medicine because this was what was expected of them. However, on further exploration it turns out that the demands of being a medical doctor in a public hospital, combined with the repeated reward of saving lives and a certain clinical detachment are very all significant factors in further exploring this choice of career.

Working hours and shift patterns, type of work, setting and level of responsibility, employment status (self-employed, employed, or unemployed), relationship to work, etc can generally be traced back to the weight of status and education in the family, sibling hierarchy, types of relationship, life-changing or traumatic events, gender and sexuality, level of family support, parent’s line of work, and family expectations, just to name a few.

There are other environmental and biological factors as well such as migration, displacement, political and societal influences, personality traits, life circumstances and opportunities, etc.

The role of psychotherapy and coaching can be helpful and exploring one’s motivations and drivers for following a career path, realising when that path no longer suits or making necessary changes to one’s work life. For instance, gaining more self-confidence to take more risks or becoming more aware of one’s personal desires and wishes, rather than following the path that was expected by others.

I see this as a maturing process, a way of becoming more in touch with oneself and making choices that are more in line with who one is rather than being restricted by self-limiting beliefs. To live according to our beliefs and values is a great thing to do, if we know what they are in the first place.

To find out more about leadership coaching or psychotherapy get in touch with us.

 

Sam Jahara is a UKCP Registered Psychotherapist, Superviser and Tavistock Certified Executive Coach.

 

Further reading by Sam Jahara –

Antidotes to coercive, controlling and narcissistic behaviour

An in-depth approach to leadership coaching

Demystifying mental health

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

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Why do people get the birthday blues?

Birthdays are generally depicted in the media as happy events that should be celebrated. However, for no small number of people birthdays can be complicated and evoke difficult feelings such as sadness, listlessness and even feelings of depression. Why is this?

The ‘birthday blues’ is a term used to capture the range of difficult emotions that some people experience around birthdays. They often come on in the lead up to a birthday, peaking on the actual day and then quickly dissipating, at times with a sense of relief.

There is no single clinical reason why people may feel down or depressed on their birthday and nor is it a pathology but rather a combination of association and arguably somatic memory. Let me explain.

Whilst we all have seen images heard stories or seen films depicting ‘the perfect birthday’ for children, for most of us this was not the case, but overall we enjoyed the day because we were allowed to celebrate it with those we love. However in many cases this simply is not so. For example, for children of divorced parents birthdays can be difficult as the loss of one of the parents may be highlighted on that ‘special day’. As a clinician this is something I encounter often with clients whose parents divorced acrimoniously – they wanted nothing more than to spend the day with both parents but can’t. Worse still I have encountered stories whereby my clients as children had to choose between their parents as to with whom they were going to spend their birthday. The outcome was that birthdays become something to dread rather than eagerly anticipate.

So, birthdays can represent a marker date (not dissimilar to Christmas) – a reminder – of a painful event which is compounded by the societal expectation of how a person should feel. This creates an internal conflict between the felt reality and how that person actually feels, which exacerbates the problem and can lead to symptoms of depression.

Why are birthdays so important to so many people?

Human beings are defined by time. We did not invent it as it passes whether we are aware of it or not, however, we structure our lives around time and use it not only as an important guide in terms of the passing of the seasons but also in measuring our time on this earth.

Birthdays are seen as something to celebrate as an achievement which may seem somewhat arbitrary in the modern world, however in a world in which infant mortality was rampant and few people lived beyond their forties – which constituted much of human existence – there was arguably much to celebrate in living another year.

However, I believe that there is something else that sits beneath this explanation that operates on an unconscious level and that is how birthdays represent an overcoming of death. It could be argued that becoming yet another year older is nothing to have a party about – especially once we have passed our youth. Birthdays mark the passage of time and bring us ever closer to death – something us humans have a hard time dealing with. So by marking birthdays and celebrating them, we are perhaps avoiding contemplating our mortality. They function in part as a form of
death denial.

Like the actual new year, birthdays are psychologically and thus symbolically representative of an opportunity for renewal – we can put the bad or mediocre of the past year behind us and start another year with good intentions. Sadly, like new year’s resolutions, little generally changes following birthdays as we take our old selves with us into the ‘new year’.

Is there any physical reason why people would feel differently on their birthday?

From a medical perspective, there is no reason why anyone would feel differently on their birthday, however, as noted earlier, birthdays can evoke powerful memories that may be pleasant, difficult, or a combination of both.

We know from neuroscientist and Professor of Psychiatry Steven Porges’ work on Polyvagal Theory that our neural network extends to our gut and that we receive significantly more ‘data’ from our gut to our brain via the vagal nerve than the other way around. It therefore stands to reason that where we have powerful memories associated with a significant date, that we will feel and possibly experience those memories in our body too. How may these manifest?

Some people may feel lethargic or achy and others may have headaches or migraines in lieu of experiencing the actual feelings – and this is particularly likely in cases where there is a conflict between how the person feels, and how they believe they should feel based on social or family expectations.

How can people start to think differently about their birthday?

When I was a trainee psychotherapist, one of my tutors would say ‘if you feel stuck with a client, find the feeling’. Ultimately psychotherapy is about grieving – what clients grieve will vary, but they are coming to grieve whether they know it or not.

If birthdays have in the past been difficult and remain so in the present then there is something that has not been grieved. For example, where a client began to dislike their birthday or even dread it due to a family event such as parental divorce, and that feeling repeats in their adult life, then I would suggest that there are feelings relating to that loss of the parental unit that remain unresolved. Once these have been worked through, birthdays will be ‘freed up’ so a different meaning and set of memories can be ascribed to them.

So, the first step is in grieving whatever needs to be grieved and then the second step is in recognising that a birthday is largely symbolic and that as an adult we can take control of them and take responsibility for creating of them what we wish. The latter is critically important as it may be that one person’s idea of a ‘good’ birthday is a full-on bash with friends whilst another is a quiet walk in the woods. Both are equally valid.

Are birthdays as important as people think?

Human beings are symbolic and are unique (as far as we know) in world of mammals in that we are the only creatures that inhabit a symbolic world. The majority of what we do, create and celebrate has no pragmatic purpose, however that does not mean that it is not important.

The symbolic is the basic fabric of culture and we all subscribe to a culture, as it is through culture that we gain our sense of belonging and self esteem. Culture (whichever one you happen to belong to) gives us three fundamental stories which enable us to cope with death anxiety according to psychoanalyst Otto Rank, who was one of Freud’s acolytes – culture tells us where we came from, how to behave whilst we are alive and lastly, it tells us what happens to us when we die. Without culture, we have very little.

Birthdays are symbolic and embedded in culture thus they are important in us being a part of the world in which we live. However, particularly in Western Culture where we subscribe to individualism, we are free to create of our birthday whatever we wish.

I would therefore suggest that birthdays are important as all cultural markers are important, however, that does not mean that we should be indentured to them.

Are the birthday blues real?

Anything that a person feels is real, as it is their felt experience. This does not mean, however, that that feeling or set of feelings belong in the present. Nor does it mean that the ‘birthday blues’ are a pathology but rather a term that helps us makes sense of what someone may be experiencing.

If people are habitually getting the ‘birthday blues’ which is a set of difficult feelings akin to depression, then something from the past has got ‘stuck’ and is repeating as an experience each year.

A psychotherapist would work with you to uncover what it is that brings on these ‘blues’ around the time of your birthday and to work with you to resolve the underlying grief or address what it is in your appetite for life that is being suppressed.

Can birthday blues ever be a good thing?

Whilst it may seem counter-intuitive, it can be helpful to be curious about how we really feel around our birthday and to work out whether those feelings are perhaps telling us something important.

It’s no secret that in my profession the peak time for couple’s therapy enquiries is in early January (the same is true of a family solicitor friend of mine). This I believe is in no small part to the pressures of family Christmas being combined with a new year and a desire for new beginnings.

Birthday blues can also be a sign that something in a person’s life needs addressing and perhaps changing. Birthdays are a reminder of the passage of time and can increase feelings of anxiety when deep down a person knows they are not really living the life they want to.

If we can be curious about them, birthday blues can tell us important information about what we may want or what is missing from our life. And if you can’t make sense of it, it can be really helpful to talk to a psychotherapist who can help you unpick what the blues might mean – whether that is a loss that needs to be grieved or an appetite that needs to be expressed.

 

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

Are people with mental health problems violent?

Mental health problems in Brighton

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

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The Importance of Generosity and Forgiveness in a Hostile World

As human beings we have evolved to connect. However sophisticated we have become over time though, our capacities for clear communication are enduringly mired in complication. Our inclinations are tilted toward a negativity bias whereby, when in doubt we will tend to assume the worst of an(other)s intent. One negative comment will more often make a far greater impression upon us than ten positive ones. To assume the worst may be our default position but cultivating a degree of generosity in interpreting the remarks of others may be a calling to our better selves. At the particular cultural moment that we find ourselves in this seems particularly pertinent.

We live in the same society as people with whom we don’t get along and with whom we don’t share the same views. When we are unable to listen respectfully (and generously) to those whose views might differ from our own we are in danger of confining ourselves to the trenches of tribalism. It is hard to avoid or ignore the increasingly polarising and toxic nature of current debate. This new reality may well have something to do with a loss of faith and trust in our institutions, religious, political and social and a subsequent (if subtle) loss of meaning. The postmodern era has accelerated this mistrust with its defining suspicion of all grand narratives. Into the breach we have witnessed the exponential rise of social media, dramatically increasing our abilities to connect but doing little to expand our capacities to communicate effectively and compassionately.

The impact of social media on communication

In fact social media may actively diminish our communication skills, pulling us, as it does away from face to face encounters. When you don’t have to meet the person with whom you are in disagreement, it is far easier to dehumanise them….to reduce, diminish and wilfully misunderstand them. When we don’t have to encounter someone, face to face, we don’t need to consider the impact we might have on them and their lives. From the comfort of the echo chamber there is far more scope for righteousness and outrage and far less for generosity and nuanced understanding.

In the age of social media, the boundaries between private and public language have collapsed. This is problematic in many ways, some of which we may not yet even be aware of. When the line between public and private is breached so too is the significant matter of context. When we lose context we also lose sight of the matter of intent. In the minefield of  todays identity politics these things matter, holding people to account in the court of social media for an expression of the “wrong view” is no justice at all. We all know something of the experience of misrepresentation or misinterpretation in our online communications…albeit more often with others within our own group. How many of us have taken exception or offence to a text message without even stopping to question whether any was actually intended?

We are more than our google history

In a fast changing and increasingly atomised world we need more than ever to find ways of getting along with each other. Of talking and listening generously and respectfully, the absence of which simply takes us one treacherous step closer to a moral abyss. We build confidence in our relationships when we encounter each other  face to face through personal interaction. This is the baseline from which generosity can flourish. It is harder to be generous when we fear abuse and it is so much easier to be unkind when there is no attempt to meet. We must not confuse knowing someone with knowing their google history.

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

 

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Are People with Mental Health Problems Violent?

The stigmatisation of mental health and mental illness is nothing new and can be traced back through the centuries and across cultures.

Despite much improvement in the treatment of mental illness and an increasingly open dialogue about the effects of mental illness from sufferers and professionals, the evidence shows that paradoxically increasing numbers of the general public fear violence from those who are mentally ill.

What is mental illness?

Whilst the term mental illness is ubiquitous, it is a ‘catch all’ term which fails to differentiate between people struggling with their general mental health, people who struggle to regulate their emotions and the tiny minority who have an actual illness as defined in psychiatric terms.

In its most extreme form, mental illness is an inability to ‘hold’ onto reality and is a terrifying experience for the sufferer – this would be the definition of psychosis. However, as terrifying as this is, there is simply no correlation between violence and mental illness.

Where does this fear come from?

The fear of mental illness seems to be profoundly primal. Human beings pride themselves on the rationality and intellect and to be exposed to someone who has ‘lost their mind’ triggers fear – if it can happen to them, can it happen to me? Losing ones mind can feel like losing the connection with what makes us human.

Periodically these fears are brought back to the surface, often as a direct result of some unfathomable act such as the recent school shooting in Texas where 19 children and two adults were murdered by an 18 year old gunman. How can something like this happen? Who would do such a thing?

Human beings seek to ‘fit in’. We all to a greater or lesser extent abide by the rules and laws laid down by our culture and society. Where we abide by the rules and perform well, society tends to reward us. The rewards are multiple, but are generally related to social standing and financial payment which propels us to continue to do well: fitting into culture affords us self esteem.

Many people who suffer from mental health problems have experienced trauma during their lives – it can be argued all of them. We now know, in no small part thanks for the 1998 ACE study (Adverse Childhood Experiences) conducted by the CDC-Kaiser Permanente, that the more adverse childhood experiences a child is exposed to, the higher the likelihood that they will suffer from mental illness.

However, whilst striking, it was not only their mental health that was likely to be affected, the higher the number of ACE’s, the higher the risk of emotional and cognitive impairment, physical disease, poverty, criminality, social problems and substance abuse problems, all culminating in a higher likelihood of an early death. Trauma therefore impacts on a person in every facet of their future life. Trauma is not caused by poor mental health – poor mental health comes about through trauma, accompanied with the long list of symptoms above.

All human beings harbour thoughts and feelings that we consider to be in conflict to how we see ourselves and how we wish to be seen. Psychoanalysis was the first discipline to start to talk about how we all have sadistic drives, harbour murderous thoughts and take glee in the suffering of others. Psychotherapy seeks, amongst other things, to help people know themselves and to integrate these parts of their character.

However, where this integration has not happened people can ‘split’ these parts of themselves off – as if it simply is not a part of themselves – and ‘project’ them into others: I am ‘good’, you are ‘bad’, or in this case, I am ‘sane’ you are ‘mad’.

I would therefore suggest that much of what drives the stigma around mental illness and the association between the latter and violence is driven by fear leading to the psychological defence called projection. ‘Mental illness’ or ‘mental health’ is a convenient scapegoat for the parts of ourselves that we disavoy.

What can be done to challenge the misconceptions around mental health and violence?

In order to challenge the misconception that people with mental health problems are violent, we need to be able to have a mature and complex conversation about society, trauma and how we are all collectively responsible for ‘othering’: scapegoating and ostracising certain groups of people who are vulnerable. There is correlation between childhood trauma and violence, but violence is not caused by mental illness.

Alongside this we need to use factual statistic to show that simply having a psychiatric diagnosis or ‘suffering from depression’ makes a person no more likely to be violent or to commit a crime than anyone else. What does significantly increase the possibility is childhood trauma, contributing to feelings of low self esteem, a lack of belonging in society, poverty and feelings of disempowerment.

The effects of stigmatising those with mental health problems

Through engaging in an open and honest debate around mental health and mental illness, we can not only support those who are suffering to talk about their experiences and seek help, but also acknowledge to ourselves that we are all in no small part likely to be affected by a mental health issue at some point in our lives. This makes it ‘our’ problem rather than ‘theirs’.

Where people with mental health problems are stigmatised it further alienates them from mainstream society and the opportunity to ‘contribute’ to that society and feel a sense of belonging, purpose all leading to greater
self-esteem.

Stigma and scapegoating leads to shame and shame makes it even harder for people to access help. People with mental health issues need support, compassion (not sympathy) and a pathway to belonging in society. It is no more helpful to pretend that they have no problems than it is to demonise them.

Mental illness is a social problem

As discussed earlier, trauma – particularly childhood developmental trauma – impacts on every aspect of a persons ability to lead a fulfilling, healthy life. And trauma begets trauma, meaning that it is passed from generation to generation. Therefore, rather that scapegoating those with mental health problems, perhaps we need to collectively pause, reflect and look in the mirror to see what sort society we are all contributing to.

 

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

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

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Mental Health Problems in Brighton

Brighton and Hove Psychotherapy, as the name would suggest, is an applied psychology practice located in central Brighton and Hove in operation since 2014. Whilst many of our clients travel from further afield to see and be seen by our clinicians, and whilst we offer online therapy, most of our clients over the years have been from the Brighton and Hove area. As such we are in a privileged position to have a good insight into the specifics of the state of mental health amongst the general population of this city.

Do different cities have specific mental health trends?

There is much in the media being published about the poor state of mental health (and mental health provision in England) at the moment. Years of austerity, the pandemic and soaring addiction problems are fueling a national mental health crisis across the nation. This is no different in Brighton and yet some of the issues that people present for therapy within Brighton will also be an expression of the demographic and culture of the city.

The demographics of Brighton

Brighton is a vibrant city on the south coast of England, within easy reach of London. It has a relatively young, highly educated population, many of whom move here for the lifestyle or have graduated from one of the two universities in the city and made the city their home.

It boasts both the highest proportion of small and medium sized enterprises in the country as well as the most start-ups per capita; both these are testimony to the young, highly educated population many of whom are liberally minded and self-starters.

Brighton considers itself not be ethnically diverse though statistically this is not reflected in the figures with 87% of the population being white. Brighton also markets itself as a ‘hip and happy’ city that is the epicentre of the LGBTQ community, though again, the statistics and perception may mask certain realities.

Millennials and mental health

As Millennials have come of age and are now approaching their thirties and beyond, we are noticing increasing numbers of them presenting for therapy. This is a national trend, however due to the large numbers of young people living in Brighton coupled with their education and entrepreneurial spirit, we see many Millennials presenting for open-ended psychotherapy to use as a relational tool to get deeply curious about who they are and what they want from their lives.

Whilst everyone who crosses the threshold of a psychotherapy practice has a ‘presenting issue’, these Millennials will often stay in therapy for a long time to engage in a depth relationship in with to get in touch with their deeper desires. They are often extremely bright as a population group and well-versed in psychological concepts. This in contrast to my own generation – Generation X – who consume the most alcohol and drugs of any generational group and will often only present for therapy once they reach crisis point (a generalisation, but true nonetheless).

Drug and alcohol use

There is a saying in Brighton that nobody who lives here is actually from Brighton. Of course this is a complete exaggeration, however, the city does attract a lot of ‘migrants’ from other parts of the UK as well as beyond. It is liberal and open at heart and, as already discussed, has a young demographic. It is therefore not surprising that drug and alcohol use and misuse is at the highest rate for the South-East of England and one of the highest for the UK. Indeed, back in 2011, Brighton held the disconcerting record for being the drug-death capital of the UK.

Another saying that seems to go some way to defining Brighton is that it is a ‘Peter Pan Town’ where nobody wants to grow up. This would be the ‘shadow side’ of its fun, hip culture in that the city and its culture can draw people into an ongoing cycle of ‘living for the moment’ and avoiding the realities of life.

Psychotherapy has many goals but one is that it is about growing up psychologically – working though past losses and moving with purpose towards what you want. Peter Pan, beneath his boyish charm, was someone who was frightened of the future and of adult responsibility, but unlike Peter Pan we all must grow up as otherwise life simply passes us by.

The LGBTQ community and feelings of not belonging

Brighton prides itself on inclusivity and this is reflected in the size of the LGBTQ community. However, as with everything, there is also a shadow side here and over the years myself and colleagues have worked with individuals who identify as LGBTQ but feel no sense of belonging in the Brighton community, or worse still, feel ostracised.

There is prejudice everywhere and some research has shown that minority communities can unconsciously exhibit higher levels of prejudice towards others who do not meet the criteria of ‘their community’. This is not unique to the LGBT community nor to Brighton and has been observed in racial minorities who have been seen to express higher levels of racism towards other minorities that is present in the general population.

To what extend the above is ubiquitous in Brighton lies beyond the scope of this piece, however, I have had numerous clients over the years who felt that they ‘did not belong’ in the Brighton LGBTQ scene and who found this enormously difficult and painful as it had been one of the reasons why they moved here. They felt that the way they were ‘gay’ or ‘lesbian’ was not accepted.

We all need a sense of community and belonging and it can be extremely painful if we intentionally move to a place to be a part of a wider community with whom we identify on a profound level, only to find that the way we are in that identity is not accepted.

Cities are communities and communities are collectives of people who, through their unconscious process, create a collective unconscious that’ has an identity to it – so it is with Brighton.

Psychotherapy is a relational process embedded in culture and thus practicing as a psychotherapist in Brighton, the specifics of the community will both be expressed and need to be worked with.

 

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

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

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