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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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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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What’s wrong with good advice?

Often, the people who engage in therapy with me will ask for advice, tips on managing anxiety, what to do about a relationship situation, how to manage a tricky situation at work. Sometimes someone might ask for general ‘life advice’. Of course, mostly what they want is some sort of reassurance and although its not true that therapists never give advice I tend not to offer reassurance. Why not?

Well to start with, the problem is rarely not knowing what the right thing to do is. If someone wants ‘tips’ on sleep or anxiety strategies, I might advise them to look on the internet, there’s plenty of it out there and its free and of course generally sound. Eat your greens, go to bed at a regular time, do some exercise, especially yoga and don’t take too many or too much, mind altering substances.

This reminds me of a joke, –

‘Doctor, If I stop drinking alcohol altogether, eat my greens and give up sex, will I live longer?

Dr – Well I can’t tell you with any certainty whether you’ll live any longer, but one thing I do know, it will certainly seem much longer!’

Of course, what people struggle with is not, not knowing, what the healthy thing to do is, it’s doing it and the reason for this is that they/we are conflicted.

Many clients may come saying they want to stop, whatever it is, that is causing them problems. So I ask why don’t they then? and they say I don’t know. Well the answer is simple, another part of them doesn’t want to stop, whatever it is there doing, is serving some purpose, even if the consequences of continuing to do it are grave. Of course, in many cases this can indeed be tragic, people find themselves compulsively doing things that they know hurt themselves or others, damage, destroy or put important, sometimes essential relationships at risk.

Therefore, advice on stopping the behaviour rarely works as the addiction or compulsion is a solution to another, sometimes, -unconscious problem., as Depache Mode noted, they’re, “looking for love in all the wrong places”.

– “in the woods of anguish, it’s easy to lose your way”. (George Nash 7.9.2020)

The difficulty in a way is in beginning therapy, as the client and therapist needs to come to a together about what the problem is and what the contract of work is.

I have had many clients come with problems and basically say, well, I’ve told you the problem, now over to you to give me the right advice to fix it. Needless to say, these client’s often leave before the work starts. For instance, someone I saw with a destructive addiction was clearly harbouring a long festering repressed grief about an abandonment by his father, however this wound was so repressed that any interpretation of mine that it might be important to look at this just didn’t work and we were immediately at a stalemate.

Of course, my job is to be as tactful as possible, to not push the client beyond where they are ready to go and to be as patient as possible, BUT, destructive behaviour is always the result of past hurts and unless we do find a way together to think about these, a stalemate or premature ending will be the result.

 

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 –

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

Face to Face and Online Therapy Help Available Now

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The Pandemic and the Emerging Mental Health Epidemic

There is a lot of talk about how Covid-19 and the resulting lockdown cycles are causing a mental health crisis in the UK. This blog aims to unpack and list some of the reasons why the response to the pandemic is also causing a mental health epidemic amongst us.

This year has been very hard on most of us, personally and professionally. I don’t think I have come across anyone who has not been negatively impacted by the pandemic and resulting lockdown cycles since last March. The pandemic and deaths resulting from Covid-19 are only one aspect of this crisis. The efforts to avoid death and transmission, not overwhelm the health service, and its resulting policies, in conjunction with how the Covid narrative is portrayed in the media, is what is driving the mental health crisis.

Before the pandemic hit, we were already living and dealing with normal day to day challenges linked with work, relationships, raising children, making decisions, caring for relatives, ageing and death, etc, etc. As psychotherapists, we listen to and work with these challenges everyday. The pandemic has added another layer to pre-existing issues in society, exacerbating them for everyone through the fear of death, loss, survival and health anxieties, to name a few issues which are both specifically linked to the pandemic but also issues to do with being human.

It has even become difficult to distinguish whether some of the difficulties experienced are linked to Covid or not. For instance, relationship issues which were pre-existing became exacerbated during lockdown and having to work together to home school children. Or someone with an already high level of health anxiety becomes even more anxious about becoming infected with Covid and isolates themselves even further from others.

There was a big drive to bring more awareness to mental health issues in UK society before any of us even heard of Covid-19. A large number of people were already experiencing pressures on their mental health through a variety of factors, which have now become more exacerbated through the fear of death and transmission, confinement at home, business closures, lack of outlet with entertainment venues, cafes, leisure and restaurants closed.

We have lost a large proportion of our social connections due to not being able to meet socially and professionally as we used to. Even small daily exchanges which used to make us feel more socially connected have been taken away, such as a visit to a local shop or the hairdresser.

The list is endless: Professionals who derive their identity and social contacts through work and running their businesses and had to close them, the elderly who were already lonely and have now become even more isolated, workers in the gig economy who were already struggling to survive and are now out of work, parents who were already under pressure and now have to home school as well. The list goes on…

It is vital that enough mental health support is available. In my work as a therapist, I acknowledge the collective impact in society yet focus on how it affects people on an individual level. We are all fighting our own battles at the moment, each one is dealing with a separate set of challenges pertinent to their life circumstances. It is vital for us to acknowledge and talk about what is troubling us and not just “get through”.

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, Transactional Analyst and Supervisor 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

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

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

Leaving the Family

Face to Face and Online Therapy Help Available Now

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Five Top-Tips for Surviving Christmas – And one Extra Thanks to Covid-19

This blog is a re-post with some further reflections in it to account for not only Christmas is a challenging time, but that Christmas during a pandemic may be a particularly challenging time.  Original blog post from 25 December 2017:

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 fails to deliver on the ‘winter wonderland’ scenes on the TV adverts, for many of us, our family experience often falls far short of the loving idyllic family reunions depicted in those same snowy adverts. With 202 having been the ‘mother’ of all challenging years and with Covid and the accompanying restrictions remaining firmly in place, Christmas 202 promises to be one like no other.

What makes Christmas particularly difficult – and Christmas 2020 especially so?

Aside from the expectations we put upon ourselves, it has all the classic ingredients of being either an explosive disappointment or a damp squib. With the pandemic where many of us have been starved of contact with family, expectations for the perfect Christmas may be running particularly high and yet we may find that friends and family are unable or unwilling to take the risks to visit us or allow us to visit.

Family of choice versus family of origin

Christmas is often a time when we get together with family members we would only ever see on other festive days or, as the saying goes, weddings and funerals. Often, we have a little close relationship with these family members. Yet somehow we expect to feel a close bond with them on this day in particular.

Many families are now what is referred to as blended families.  Nowadays, it is normal to grow up with step-parents, step-siblings and half-brothers and sisters. While this does not necessarily lead to conflict, it can make the delicate balance of Christmas Day complicated and fractious. Compromise is often the order of the day.

Christmas is often a difficult time thanks to the ghost of Christmas past. Many relationships break down over Christmas and can leave us with tainted childhood memories of parental feuds and the accompanying grief.  This then plays out in the present, potentially contributing to conflict with family members – the trauma repeats.

And then there is the one extra ingredient that can make things seem so much worse than they are; the explosive charge in many Christmases – alcohol. Consuming alcohol in and around Christmas is normalised and we can often feel under pressure to ‘join in’. Many of us also use alcohol as a way of coping with the day, the family members who descend upon us, the expectations, unhealed rifts and so on. However, when it comes to managing emotions and conflict, alcohol has never been a solution.

Five top tips to surviving Christmas Day and an extra one thanks to the pandemic!

  • Support through relationship

If you are in a relationship, talk to your partner.  Explain to them that you may find the day hard and agree how you will ask for support when needed, or how you will support each other. Examples may be anything from starting the day together and connecting through to holding each other in mind. You can demonstrate this through small reassuring gestures such as visually checking in with one another.

  • Reality Testing

Christmas is only a day. The expectations we feel in relation to it are largely in our own head.  By pausing and accepting that there is no such thing as a ‘fairy-tale Christmas’ (except perhaps for some fortunate children) we can gain a little space to see it for what it is.

  • The past is not the present

Memories of past Christmases, while present, need not dominate our experience in the here and now. Accept that it is a difficult time for you, know that it is for many others, 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 have the power to create something different.

  • Alcohol 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.

  • Hold Yourself in Mind

One of the traps people often fall into is that they imagine that they have no choices on the day; they simply have to do what is expected. Doing what is expected is a choice in itself!  Even if you do feel that there is little on offer for you during the day, a change of perspective and holding in mind why you are choosing to make these choices can be helpful. For example, rather than framing it as “I have to go see X person, or Y will be disappointed”, you can rethink it as “I choose to see X person as I want to give that as a gift to Y’.

  • Hold the Future in Mind

The pandemic will pass.  And whilst things will not ‘go back to normal’ in the sense that we can never go back, restrictions on our lives will ease and we will find new and creative ways of finding meaning and connection in our lives.  The only certainty in life is a change which for all of us is anxiety-provoking.  Connection is the antidote to anxiety and that is fundamentally the opportunity/challenge that Christmas presents.

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. See my blog on avoiding panic attacks for a simple but effective practice to calm yourself and return to the here and now – particularly helpful during the pandemic.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

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?

 

Face to Face and Online Therapy Help Available Now

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Holiday Blues in the time of Covid-19

This blog was originally posted in 2015 in the lead up to Christmas.  As this Christmas period is particularly challenging for so many due to the Covid-19 pandemic, I am reposting it with further thoughts on how you can get through this holiday period:

This time of year can evoke a range of feelings in most of us from anticipation of being with loved ones, through to the dread of Christmas past revisiting us either literally or figuratively. Whilst some of us may have a festive and positive outlook on Christmas and look forward to spending time with friends and family, for many it is a time filled with conflicting emotions. Some of us have difficult memories associated with Christmas and family gatherings.

The pandemic and associates restrictions – unthinkable a mere 12 months ago – have impacted all of our lives and undoubtedly will impact on all of our Christmas’. Many of us will be unable to see friends and family, travel or celebrate in the ways we wish.  And for many, the feelings of loneliness and isolation will be amplified.

Going through sad and difficult times without ignoring or suppressing feelings can be a challenge. When working with my clients around grief, loss and relationship issues I tend to be curious and ask questions about what they are experiencing and really honour those feelings, after all, they are there for a reason. In the absence of an experienced professional to guide you through this process, here are some ideas to help you not only cope, but make the most out of a challenging time.

Listen to your body

This doesn’t mean act impulsively. It is more about listening for what the vulnerable part of your 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.

Challenge Expectations

This matters more this year than ever before. The ‘traditional’ idea of what Christmas should be is largely absent this year and we are all being made to challenge our expectations about what Christmas 2020 will be for us. However, even in the midst of the pandemic, the restrictions, anxiety, fear and frustration, we all have the opportunity and the choice to consider what will make Christmas and this holiday period meaningful for us.

Spend Time Reflecting

The end of the year can be a good opportunity to review and reflect on the past year. Reflections on your present life in terms of what is going well and what could be improved on is a good starting point. Are you following your dreams and aspirations? How are you contributing to causes that you care about? What are some of your wishes for the future? Where would you like to see yourself this time next year?

Make Positive Decisions

Many people come to psychotherapy to reflect on and improve their lives with the support of an impartial other. It is never too late to become more self-aware and make significant changes in the areas of your life that you are not happy with. Whether you are experiencing grief, going through relationship issues, depression, anxiety or feeling stuck in your life, an experienced counsellor or psychotherapist will explore those feelings with you in a supportive, interested and non-judgemental way.

Wishing all a relaxing holiday and a fruitful year ahead with an eye on this pandemic ending and us all being able to come together freely once again.

 

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

Cultural Identity and Integration – Feeling at Home in your own skin

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

Click Here to Enquire

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Making Changes

As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.

What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?

Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.

One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.

We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.

It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.

If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.

Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.

Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.

 

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 –

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Online Anxiety Counselling

There are various symptoms of anxiety, including an overwhelming feeling of fear, panic or worry, as well as physical signs such as sweaty palms, dizziness and palpitations. For those struggling with an anxiety disorder, these feelings can occur on a frequent basis and are isolating and distressing.

Anxiety is a problem that can be exacerbated if stressors are allowed to build. It’s important to get help and support if you’re finding yourself struggling with anxious thoughts on a regular basis. By speaking to someone about what you’re dealing with, you can understand what’s causing the negative reactions to your thoughts to be better equipped to tackle them.

How Can Online Psychotherapy Help?

Anxiety can be debilitating for many people but having specialist support in the form of psychotherapy can be effective in helping relieve the worry associated with this condition and encourage recovery. Our trained therapists can help you develop effective coping strategies and resolve the issues that are causing anxiety in your life, as well as help you identify the triggers for your anxiety.

There can be various reasons why your anxiety has developed, from stressful work or school environments to difficult relationships, your health or social interactions. By talking through your issues and the causes for your anxiety, you can increase your self-awareness to manage your feelings and thoughts more effectively. Removing yourself from the situations that cause anxiety isn’t always possible but having an arsenal of techniques makes dealing with it easier, which can be a great comfort. And in a supportive and therapeutic relationship, you will no longer face your anxiety alone.

Online anxiety psychotherapy is just one form of treatment but talking to a trained professional can help you in many ways, from understanding your condition and what may be causing it, to learning techniques to deal with the symptoms. Online psychotherapy enables you to benefit from the advantages of face-to-face sessions but from the comfort of your home for a more convenient and accessible solution. It also ensures you have access to our highly skilled team from anywhere in the country.

If you want to discuss online anxiety counselling with us, contact us today or take a look at our practitioners.

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


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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

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

What is ‘Manifesting’ and The Law of Attraction?

Recently a client, somewhat younger than me, described a phenomenon they called “Manifesting”. They felt excited and disappointed in themselves in equal measure that they seemed to be failing in using this ‘secret’ method of working with ‘the universe’ to bring them whatever their heart desired.

Curious, I investigated.

Manifesting is a verb used to describe the active process of using positive thoughts, and a degree of self-hypnosis, to draw ‘good things’ to oneself. Based on the many Youtube videos on this topic, these good things seem to be consumer products or monetary wealth, rather than contentment and tolerance, but then the latter two are really not as enticing as ones own private island.

Manifesting is not new and nor is the concept original. It seems to have been re-hashed in a 2006 ‘documentary’ and book entitled ‘The Secret’ which explains the mystical process of using the ‘Law of Attraction’ to get what you want in life. What a great concept – if only it were true.

Fate and Destiny
I have previously written about the concepts of fate and destiny and how I do not believe that any idea of fate has a place in psychotherapy – or indeed in the outcome of psychotherapy, which is in essentially becoming an adult who can tolerate reality.

To recap, the concept of fate posits that there is some sort of external force, entity or deity that decides what happens to us. This can be very unhelpful in the therapeutic process as clients can often use the idea of fate to reinforce that what is happening (or not) to them is simply how things are supposed to be.

Destiny, though not a word I personally favour, can be translated to being thought of as taking some degree of ownership of one’s life whilst remaining firmly rooted in reality. Therefore it is possible for most free people to experience a change in their lives, or perception of their lives, whist acknowledging their reality.

Destiny and death
Some years back I spent four years working on the front lines of death – as a psychotherapist in the field of palliative care. Whilst the usual issues around meaning, relationships and mental health problems presented themselves, they were all within the context of death and dying: I worked with patients who had terminal illnesses, were actively dying or with their bereaved relatives. It certainly redefines the concept of ‘psychotherapy’ when sitting beside the bedside of a patient who has hours to live and is engaging with you through a cocktail of opiates!

Despite the confronting nature of death and dying – the patients’ ‘fate’ was sealed – nonetheless, many of the people I worked with were able to find purpose and meaning in their predicament and to mourn losses not previously addressed. They were engaged in changing their destiny.

Magical thinking
We can all, at times, make use of magical thinking. It can be a way of assuaging anxiety and giving us the illusion of being in control. The practice is as old as human beings and embedded in a language such as in the saying ‘touch wood’ or in the belief that walking under ladders brings bad luck. Human beings are symbolic creatures who make the unreal real. This is perhaps how we cope with our knowledge of finitude – death. However, we also confuse the symbolic with the real.

Whilst touching wood and avoiding ladders is relatively harmless, subscribing wholeheartedly to fantasies that there is some ‘secret’ method or means of ‘manifesting’ objects into ones life is dangerous and deluded. In psychological terms, it is a way of avoiding growing up and being born. A way of believing that the world can be just how we want it if only we imagine it hard enough – a sort of womb, in essence.

The power of magic
The reality of being in weekly or more frequent psychotherapy is that it is not very magical at all.  In fact, it is the opposite. Psychotherapy generally takes place in a fairly ordinary consulting room (or online), you see the same face week after week and often find yourself going over the same ground. Clearly, promises of Ferraris and private islands are far more enticing. However, the consistency and regularity, along with having someone there who holds us in mind and helps us think can be life-changing. If we are thought about, just perhaps we can learn to think our own
thoughts about ourselves rather than follow a script on who we are. If we are not alone then we can learn to bear reality, however hard that may seem.

Psychotherapy does not promise magic. It is, in fact, the opposite in that often our job as psychotherapists is to help clients and patients lift the veils of illusion and see life and their history for what it was – only then can the mourning begin. And it is only through mourning that eventually, desire can emerge – a sense of self and a sense of what that self wants.

Desire
When desire emerges it is rarely if ever about Ferraris or private islands. It is not about consumer products period. It is about a deeper recognition of what will bring contentment and peace in the context of the realities in which that person lives. And that can be achieved even on a death-bed.

Of course, as a final blow, unlike manifesting, psychotherapy also has science on its side. And a long studied evidence base. It may not get the Youtube hits but then real life was never to be found in movies.

 

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

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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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Supporting children and young people with stress and anxiety

Stress is caused by an existing stress-causing factor or stressor. Stress can be ‘routine’, related to everyday activities or ‘sudden’, brought about by a change or transition, or ‘traumatic’, in relation to an overwhelming event.

During stressful events our adrenal glands release adrenaline, a hormone which activates the sympathetic nervous system, our body’s defence mechanism which causes our heart to pound, blood pressure to rise, muscles to tense, and the pupils of our eyes to dilate. Historically, this prepared us to respond to attackers with one of three responses – fight, flight or freeze.

This stress response can still be helpful to us today. It provides a burst of energy which can help us to stay safe when suddenly facing a speeding car, for example. Or, it might help us meet deadlines and goals through increased efficiency and focus. Our stress response ceases to be helpful if it is activated too easily or at a level which is too intense or if it goes on for too long, preventing us from returning to a relaxed state.

Anxiety is stress that continues after that stressor is gone. When we are anxious, fear can take over whenever there is worry and apprehension. This can lead to irritability, low mood, social withdrawal, lack of motivation, poor concentration and nervousness, as well as physical symptoms like chest pains, disruption to eating routines, dizziness, shortness of breath, fatigue and panic attacks.

There are multiple triggers for stress and anxiety in young people today. Those most commonly reported include school, exams and future prospects; social difficulties including peer pressure, social media issues and bullying; family concerns such as conflict or financial problems; and major world events. For some, these factors can become overwhelming.

A good place to start when helping children and young people with stress and anxiety is to be aware of what we are thinking, feeling and doing ourselves. This will help us to tune in to kids and look after ourselves so that we can stay calm, alert and responsive. There are many routes to self-care – the 5 Ways to Wellbeing is one of them – How are you doing right now? What steps might help you to build your own self awareness and take care of your own support needs?

Secondly, psychotherapeutic work is naturally based on a belief that by talking and thinking about difficulties we create space for creative exploration, digestion/ processing, increased understanding and new perspectives/ opportunities. It can be helpful to take a moment to consider where you stand yourself with regards to talking about feelings.

And do you think your child/ teenager believes it is okay to have feelings? Whether the answer is yes or no, how might he/she have picked up this message? What do we think is likely to help give a message that it is okay to feel feelings and to talk about them?

We can begin by making time to notice how young people are doing, listen to their concerns without judgement and then take them seriously. In ‘How To Talk So Teens Will Listen’ and ‘Listen So Teens Will Talk’, Faber and Mazlish (2006) advocate: “Identifying thoughts and feelings . . . Acknowledging feelings with a word or sound . . . Giving in fantasy what you can’t give in reality . . . and . . . Accepting feelings as you redirect behaviour.” (p31).

To make the above possible, it helps if we can stay calm and avoid becoming either frustrated or overwhelmed with our own worries about the child’s worry. We also want to steer clear of trying to fix things too quickly as this can seem like we’re not really interested in a child’s felt experience.

Being listened to can start to give shape to what might often feel like a formless mass of uncontrolled emotion. Feeling understood can, in itself, help to bring anxiety under control. It then becomes more possible to actively build self-awareness through tools like a stress-graph or diary, which maps stress intensity across a day, week or year. Other visual systems using scales and colours can be helpful too. A 0-5 scale, for example, can enable children to identify the difference between a slight glitch, a small/ medium/ large problem, and a situation which feels quite huge or even like an emergency. Other systems like the ‘Zones of Regulation’ or the similar ‘Just Right State Program’ (widely used in Brighton and Hove schools) help young people to notice their emotional/arousal state at any given time and to learn what helps them either to up-regulate or down-regulate in those moments in order that they can relate and learn effectively.

Specific calming approaches can be taught such as deep belly-breathing or simple, unobtrusive techniques for the classroom like hand-breathing or square breathing. Positive self-statements can also help – in place of an ‘all or nothing’ catastrophic approach (“I’ve messed up this essay, I may as well give up”) the young person might say to herself, “I’ve done it before, I can do it again” or “this feeling will pass”. Others may benefit from being helped to express thoughts and feelings through writing or drawing. Others might need to move around, take sensory breaks, do Yoga, make a mess with clay, cook a meal together, make a special den, imagine a calm place, complete a puzzle, make a list or listen to a favourite story or a book about anxiety, like ‘The Huge Bag of Worries’ by Virginia Ironside. Lots of helpful ideas for activities can be found in Karen Triesman’s ‘Treasure Deck of Grounding, Soothing, Coping and Regulating cards’.

Young people who are feeling sufficiently safe and regulated might also be able to consider the bigger picture of how their thoughts, feelings, body sensations and behaviour all inter-relate and where they might be able to make one small change which could then have a beneficial knock-on effect. Read more on these approaches in books like ‘Starving the Anxiety Gremlin’ (Kate Collins-Donnelly) and ‘Overcoming your child’s fears and worries’ (Cathy Cresswell).

For young people who are specifically stressed about exams, the following links may be helpful:

– The #NoStressSuccess series of video clips on Youtube about a wide range of opportunities for education and training post-16, made by Brighton Met College students.
– The ASAP Science Youtube clips: 9 Best Scientific Study Tips and 7 Tips to Beat Exam Anxiety.

As supporters of children and young people, one challenge we have is to be regulated in the way that we offer help and ideas. If we overload with strategies and things to ‘do’ to make the stress go away, we can be in danger of increasing pressure rather than decreasing it. If we can remember to be accepting of our children and if we model self-acceptance ourselves, we might go a long way towards helping them effectively manage stress in their lives. Dan Millman has said: “Resistance creates suffering. Stress happens when your mind resists what is. The only problem in your life is your mind’s resistance to life as it unfolds.” And in a similar vein, the following Chinese Proverb tells
us that: “Tension is who you think you should be. Relaxation is who you are.”

 

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

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Sleep and Mental Health

We all need sleep, and it is a natural part of our life. On average, most adults need around 8 hours of sleep per night although this can vary from person to person. While no one is entirely sure why we need to sleep, we do know that it is significant for brain development, and maintains normal levels of cognitive skills such as memory, speech and flexible thinking. Indeed, if have as little as 15 minutes less than our normal level of sleep this can have measurable effects on our cognitive functioning.

While sleep is a very natural and important part of our lives, many people can struggle with sleep and this can have a serious impact on their mental health. A lack of sleep can lead to daytime tiredness and this lowers our resilience and ability to cope with everyday life. This, in turn, can lead to a lowering of self-esteem and we can start to feel more worried or stressed about life. This leads to more difficulties getting to sleep or staying asleep and the cycle continues. When we have problems sleeping, we are more likely to feel irritable, anxious or depressed. In more extreme cases, it can lead to psychosis or paranoia.

There are many types of sleep disturbances – difficulties getting to sleep, difficulties staying asleep, night-time panic attacks, waking up too early etc. To the opposite of these can also be sleeping too much which might be the case with someone who is depressed. There are also sleep disorders such as Narcolepsy or Sleep Apnoea which can have a significant effect on sleep and physical health. If you think you have a sleep disorder, it is important to get this checked out by your GP.

So what can we do if we can’t sleep?

There are some obvious and easy changes that we can make to help our sleep habits:

  • Establish a sleep routine – going to be at the same time every night and waking up at the same time. Setting a habit can help your body get into a routine and make sleep come easier.
  • Make your bedroom a relaxing environment, and if you can, only use your bedroom for sleep and not for watching movies or working.
  • Establish a bedtime routine that allows you to wind down gently.
  • Avoid any caffeine before bedtime, and of course avoid electronic devices an hour or so before bedtime – so switch that mobile phone off!
  • Get regular exercise, but try not to exercise just before bedtime.

If you find you are waking up in the night and unable to sleep try not to worry about it. Laying in bed worrying about not sleeping and how you will function the next day can be torturous. It is better to get out of bed and if you have lots of thoughts, then write these down until your mind is a bit clearer. You could also read for a while to help you relax a little more, and keep a compassionate focus on yourself – getting annoyed with yourself for not sleeping will only make it worse!

Of course, if your sleep problems persist, you should consult your GP as they may be able to offer some medical help. You could also consider psychotherapy if you are finding that worries, stress and anxiety is keeping you awake.

During these challenging times that we are all in, it is vital to get a good night’s sleep, so look after your night-time routine so you are better equipped to face the days ahead.

 

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

 

Further reading by Dr Simon Cassar

Spirituality and mental health

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

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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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Why behavioural approaches do not work for all children

One of the most frequently asked questions put to me in clinic, is why some children do not respond to traditional reward/punishment based behavioural strategies. The answer is simple – because, contrary to popular opinion, these strategies do not work for all children in all situations.

This is because the ability to make a mental link between a behaviour and a punishment, and to then be to be subsequently less motivated to use that behaviour again, actually involves quite sophisticated cognitive processes. It also requires specific parts of the brain to be functioning well. Difficulties with this may apply to children with learning disabilities or neurological conditions. It may also apply to children who are anxious, fearful or traumatised. This is because anxious or fearful children are often operating from a very primitive part of their brain that physically impedes their ability to access more developed parts of their brains. This in turn makes it harder for them to make cause and effect links, to generalise, to suppress their impulses, to make rational decisions, to maintain empathy for others and, in some cases, even to trust in the motivations of others. Punishing these children without supporting them to understand what is happening for them, therefore, is actually more likely to increase their fearful behaviours and further undermine their trust in those around them. For some children, it can also exacerbate feelings of shame.

A second concern with an overly heavy reliance on behaviourist principles when applied to children, is the theoretical and research origins upon which these principles are based. Behaviourism was largely developed in the 1950s and 1960s in laboratories with small mammals such as dogs, cats and rats – animals with significantly less developed brains than our own. Whilst these experiments can teach us a lot about how to shape behaviour in its purist sense therefore (i.e. classical and operant conditioning), they offer nothing in terms of how we build children’s self-esteem, build their intrinsic motivation, or even how to protect their attachment relationships. For instance, classically conditioning young babies to sleep by ignoring their attachment-seeking behaviours, can have detrimental effects on a child’s subsequent relational security and internal regulation skills. Similarly, a heavy reliance on operantly conditioning ‘good behaviour’ in young children with external motivators (e.g. star charts) has been shown to undermine a child’s natural desire to problem solve, be creative and to keep building on their successes when these external motivators are later removed.

Whilst some behavioural principles within a parenting repertoire can undoubtedly be helpful, therefore, when used to excess, and particularly when used in the absence of a broader context of sensitive, loving and developmentally appropriate care, they can quickly become damaging. This is because human children have brains that require so much more from the parent-carer relationship than simple behavioural conditioning.

Part of my role as a Clinical Psychologist, therefore, is to help parents, carers and professionals, to find new and more effective ways of supporting children to reach their full potential.

 

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