Brighton and Hove Psychotherapy

Online Therapy
01273 921 355
  • Home
  • Therapy Services
    • Fees
    • How Psychotherapy Works
    • Who is it for?
    • Individual Psychotherapy
    • Child Therapy
    • Couples Counselling and Therapy
    • Marriage Counselling
    • Family Therapy and Counselling
    • Group Psychotherapy
    • Corporate Services
    • Leadership Coaching and Consultancy
    • Clinical Supervision for Therapists and Trainees
    • FAQs
  • Types of Therapy
    • Acceptance Commitment Therapy
    • Analytic Psychotherapy
    • Body Orientated Psychotherapy
    • Private Clinical Psychology
    • CBT – Cognitive Behaviour Therapy
    • CFT – Compassion Focused Therapy
    • Coronavirus (Covid-19) Counselling
    • DBT – Dialectical Behaviour Therapy
    • Divorce & Separation Therapy
    • Eye Movement Desensitization and Reprocessing
    • Existential Therapy
    • Group Analytic Psychotherapy
    • Integrative Therapy
    • IPT – Interpersonal Psychotherapy
    • Non-Violent Resistance (NVR)
    • Family and Systemic Psychotherapy
    • TA – Transactional Analysis
    • Trauma Psychotherapy
  • Types of Issues
    • Abuse
    • Addiction
      • Gambling Addiction Therapy
      • Porn Addiction Help
    • Affairs
    • Anger Management
    • Anxiety
    • Bereavement Counselling
    • Coronavirus Induced Mental Health Issues
    • Cross Cultural Issues
    • Depression
    • Family Issues
    • LGBT+ Issues and Therapy
    • Low Self-Esteem
    • Relationship Issues
    • Sexual Issues
    • Stress
  • Online Therapy
    • Therapy for Anger Management
    • Online Anxiety Therapy
    • Online Therapy for Bereavement
    • Online Therapy for Depression
    • Online Relationship Counselling
  • Practitioner Search
    • Our Practitioners
  • Work with us
  • Blog
    • Ageing
    • Attachment
    • Child Development
    • Families
    • Gender
    • Groups
    • Loss
    • Mental Health
    • Neuroscience
    • Parenting
    • Psychotherapy
    • Relationships
    • Sexuality
    • Sleep
    • Society
    • Spirituality
    • Work
  • Contact Us
    • Contact Us – Brighton & Hove Practice
    • Contact Us – Lewes Practice
    • Contact Us – Online Therapy
    • Contact Us – Press
    • Privacy Policy

February 24, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Living with Borderline Personality Disorder

Borderline Personality Disorder (BPD), also know as Emotionally Unstable Personality Disorder, is a thought to affect between 0.7 and 2% of the general population. While estimates vary, it is considered that the disorder is predominantly diagnosed in women (75%).

So what is BPD? On a generic level, BPD is characterised by having difficulties in how you feel and think about yourself and other people. This can manifest in feeling insecure in relationships and consistently worrying that people will abandon you. This can bring about intense feelings that are very painful and difficult to mange, and they can last anything from a few hours to many days. This can make it hard to make and maintain stable relationships as the intense emotions and abandonment fears can push other people away. People with BPD often don’t have a strong sense of self and will try to change who they are depending on the person they are relating to.

The difficult feelings that are associated with BPD can often lead people to act impulsively, have strong feelings of anger that are hard to control and often self-harming or suicidal feelings. At the most difficult times, they may also experience paranoia or dissociation.

The causes of BPD aren’t clear, but there are some factors that appear with most people that can lead to a diagnosis of BPD. These are environmental factors when growing up, such as feeling unsupported, afraid or upset, with little validation. Family difficulties such as addictions in the parents or any kind of neglect or abuse can also lead to BPD. In additions to these factors, having an inherent emotional sensitivity can also be a factor that can lead to BPD.

So what should you do if you have been diagnosed with BPD? The first thing to consider is whether or not the diagnosis is correct. BPD is a controversial diagnosis as in itself it is hard to diagnose. The disorder shares a lot of commonalities with other personality disorders, and also with other conditions such as depression, bipolar-disorder and PTSD. For some people the diagnosis is a relief as the difficult feelings they experience now start to make sense. For others, having the label of BPD is unhelpful and doesn’t seem to capture their experience. Whatever way you feel about your diagnosis, it is important to get help so you can learn to manage your difficult emotions.

While there are a few treatments available for BPD, the one that is recommended by the NICE guidelines is Dialectical Behaviour Therapy (DBT). In DBT therapy, you will focus on acceptance and change. Accepting yourself is a fundamental part of building a sense of self, and leads the way to making positive changes in how you experience life. You will also start to learn emotional regulation skills so you are not swamped by difficult emotions, but instead learn to accept them and let them go. One of the key tools for this is mindfulness, as this allows you to really see what you are thinking and feeling, and allows you to distance yourself from these thoughts and feelings and stay rooted in the present moment. DBT therapy does take commitment to change, but it can allow you experience life in a more positive and balanced way.

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 –

Online Therapy

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

What is an integrative existential therapist?

What is Existential Psychotherapy – Video

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Simon Cassar Tagged With: bipolar, Depression, mind and body

November 11, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Don’t just do something, sit there! On the role of manic defences

We have all heard the phrase.  Often shouted at a moment of crisis on a television programme or film: “Don’t just sit there, do something!”  As if ‘doing something’, anything at all, will make a difference.  Of course, the reality is that doing something does make a difference, if not to the outcome of the crisis, then at least to how the protagonists in the crisis feel.

Doing something – anything – at a moment of crisis or even simply at a moment of inner discomfort, can be a common way of avoiding uncomfortable feelings.  Doing something can convert those feelings into an external activity whereby they, at least for the duration of the ‘doing something’ do not need to be consciously experienced.

We call defences, such as these manic defences, as their purpose is to rigorously protect us from having to be in touch with uncomfortable feelings.

Is manic defence linked to depression?

Most people associate the term manic defence, or ‘mania’ with depression and in particular bipolar disorder.  And whilst it is correct that some sufferers from bipolar disorder experience acute manic episodes which may or may not include psychosis, all of us use manic defences as an unconscious way of protecting ourselves against psychic pain.

The clinical bit

Manic defences arise developmentally sometime between the age of six months and a year.  This stage is when the infant is starting to come to terms with the fact that his/her primary carer (I shall use the term mother here for simplicity) is separate to them.  In other words, the mother is not a ‘part’ of the infant and that therefore she will frustrate and anger the infant in not being perfect in meeting their needs.  Manic defences protect the infant against painful feelings of control, contempt and triumph, according to Melanie Klein.  Manic defences, therefore, protect the infant against their own uncomfortable feelings and protect the mother, from the infant’s rage.

How do we use manic feelings?

Manic defences come into play to stave off a whole range of difficult feelings from boredom, through to rage and anger – often feelings where we feel impotent, helpless or fear our own strength of emotion.

An example could be to go shopping after a tough day at work.  And, with the advent of the internet, ‘shopping’ is invariably always at our fingertips.

What’s the problem?

The developmental process of growing up is one in which we should all learn to be able to face our emotional and mental discomfort and then use it in a growth-orientated manner to move forwards in our life.

Without this, we remain at the mercy of early, primitive defences that stop us engaging with who we are and how we feel and severely limit our capacity to become an integrated whole person.

How can psychotherapy help?

In order to grow up in a methodical way using our wisdom to make sense of our internal and external world, we must rely on others to teach us what is required.  This is ideally the role of a parent, however, if we have a parent who has been unable to truly separate from their parents and relies on manic defences to navigate the world, then we cannot learn this from them.

Psychotherapy offers and represents a relationship in which our inner worlds can be understood and tolerated.  This is not an easy process, but it is a fulfilling one: when the going gets tough, the tough go to therapy.

Returning to the title of this piece, perhaps the challenge for us all is in being able to resist doing anything, and to simply sit there and observe our internal process and acknowledge our feelings.  This is the mature response, but does not make for dramatic television!

 

Mark Vahrmeyer is a UKCP registered integrative psychotherapist who draws strongly on existential thoughts and theory to help clients make sense on an increasingly senseless world.  He sees clients in Hove and Lewes.

 

Further reading by Mark Vahrmeyer –

Can Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

How do I choose a Psychotherapist?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Mark Vahrmeyer, Society Tagged With: bipolar, Depression, Psychotherapy

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

What is Bipolar Disorder?

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

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

What are the symptoms of bipolar disorder?

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

Manic phases

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

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

 Depressive phase

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

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

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

How to manage bipolar disorder

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

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

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

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

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 sees clients from our Hove and Lewes practices.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Brighton and Hove Psychotherapy, Simon Cassar Tagged With: bipolar, Mental Health, Psychotherapy

Find your practitioner

loader
Wordpress Meta Data and Taxonomies Filter

Locations -

  • Brighton
  • Lewes
  • Online
loader
loader
loader
loader
loader

Search for your practitioner by location

Brighton
Lewes

Therapy services +

Therapy services: 

Therapy types

Therapy types: 

Our Practitioners

  • Mark Vahrmeyer
  • Sam Jahara
  • Gerry Gilmartin
  • Dr Simon Cassar
  • Claire Barnes
  • David Work
  • Angela Rogers
  • Dorothea Beech
  • Paul Salvage
  • Susanna Petitpierre
  • Sharon Spindler
  • Kevin Collins
  • Rebecca Mead
  • Georgie Leake
  • Fiona Downie
  • Chris Horton

Search our blog

Work with us

Find out more….

Subscribe to our Newsletter

Charities we support

Hove Clinic
6 The Drive, Hove , East Sussex, BN3 3JA.

Copyright © 2022
Press Enquiries
Privacy Policy
This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish.AcceptReject Privacy Policy
Privacy & Cookies Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Non-necessary
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
SAVE & ACCEPT