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Group Analytic Psychotherapy – the slow open group

The name ‘Slow Open Group’ was adopted to reflect the nature of the psychological process of opening ourselves to our collective experience in our families, culture and social milieu. Slow, because it takes time, Open because people will come and go over time as they do in our lives.

The global pandemic has demonstrated, in a terrible way, the potential harm we are doing to our environment. It has reminded us of our connectiveness with others both at the level of our community and globally. The vaccine and getting it is both a personal act of protection whilst at the same time a civic duty protecting others.

The extraordinary benefits of our connectedness via social media and technology has raised our knowledge of the worldwide suffering from this disease. At the same time we are both informed and sharing in the emotional fallout of so many losses and bewildered at our personal suffering.

Therefore we seek psychotherapy or psychoanalysis in order to understand our emotional reactions; the implicit and explicit meaning of our lives. The implicit, what is going on in our mind and body. The explicit what is happening around us in our world and intimate relationships that triggers influence our responses. The act of choosing to enter therapy is a willingness to begin a journey that will continue throughout our lives.

 

To enquire about group sessions with Thea Beech, please contact her here, or to view our full clinical team, please click here.

Thea Beech is a Psychotherapist and Group Analyst. A Member of The Institute of Group Analysis and Registered with the UKCP. She now works in Private Practice after a long career in Healthcare related industries in the UK. She later taught in Universities South Africa on Group Work and Eating Disorders. She has written on Group Analysis and Eating Disorders. She was part of a small team who developed the Centre for Group Analysis in Cape Town. Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

Groups for Mental Health

Group Psychotherapy in a post ‘Pandemic World’

Termination and endings in Psychotherapy

What is Social Unconsciousness?

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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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When Home and Work Merge

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

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

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

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

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

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

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

 

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

 

Reference:

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

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Relax: Watching people using their hands

Stuck at home I don’t always want to chat with friends and family or listen to any more news, podcasts or watch TV drama or read a book. Yet I want to be taken out of myself. I want to be elsewhere and with my own thoughts at the same time.

Being engaged in an activity that uses our hands is recognised as having therapeutic benefits. During the privations of Covid-19 lockdowns making and baking have become popular. You can find numerous examples of famous faces presenting the results on social media. For example, the Olympic diver Tom Daley says he took up knitting to help him relax and he has knitted clothes for his husband and child. Finding no knitting patterns for men’s swimwear he adapted a pattern for bikini bottoms and produced a pair of crocheted speedos for himself.

There is also a therapeutic effect when we watch someone else using their hands. Think about the close-ups on hands in cooking programmes. Might this satisfaction in watching be something to do with mirror neurones. Discovered in the 1990s, mirror neurones fire in the brain of observers whilst watching or listening to another person performing an activity. The neurones that fire in the brain of the person performing the activity are mirrored in the observer. That is, the same neurones fire in the brain of the observer. It seems we can experience what another is experiencing at the same time. This has led to research investigating the role of mirror neurones in how empathy operates and how we learn.

Whilst watching the gardener raking the Zen garden in this video clip, I find I can sense his body movements, almost feel the weight of the rake and the resistance and flow of the gravel. And then I watch it again. I can be there in that garden and at the same time sitting at home relaxing into my own thoughts and imagination.

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

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

What is Andropause and what happens to men when their testosterone levels decline?

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric and the importance of tracking sysmptons

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

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Fear and hope in the time of Covid – part 2

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

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

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

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

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

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

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

 

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

Sam Jahara is a UKCP Registered Psychotherapist with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

What shapes us?

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

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

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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

Click Here to Enquire

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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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Social Connections

“Social connection can lower anxiety and depression, help us regulate our emotions, lead to higher self-esteem and empathy, and actually improve our immune systems. By neglecting our need to connect, we put our health at risk.”
JS House, KR Landis, D Umberson (2019)

Social connection can be difficult to do right now as we find ourselves amidst the Covid-19 Pandemic.  We have been told we must socially distance, limit our social connection with others to no more than 6 people at any one time and stay in our established support bubbles.  We are now told that we are at risk of a ‘second wave’ and socially connecting can seem even more frightening and confusing.

As we continue to live amidst global uncertainty, we may have found our social connections inadvertently diminishing.

So how do we stay socially connected to maintain our mental wellbeing?

Rather than discussing the various means which we are now using to stay connected, such as Zoom, Facebook, What’s App, etc, I would like to explore how we might identify the people in our lives that can help support us through these difficult times.  It is very easy to get caught up in our daily lives, trying to get a balance between work, children, school, hobbies, self-care and more.  All too easy our social connections fall by the way side and this can have a detrimental impact to our wellbeing.

I would like to draw upon the Interpersonal Psychotherapy (IPT) approach to help explore this.  IPT is based on the premise that there is a relationship between the way people interact with others and their psychological symptoms.  The focus of IPT is to improve the quality of a person’s interpersonal relationships and social functioning to help reduce distress.  Part of the process in doing this is to identify a person’s interpersonal inventory.  This is an exploration of the relationships in a person’s life and identifying ways in which these relationships can contribute to a person’s recovery from emotional distress.

What can be useful in the first instance is to consider all your relationships in your life, in particular those that make you feel better.  It’s important to remember no relationship is perfect and no one person can meet all your needs so try to be as inclusive as possible.  It is also helpful to consider what support is available to you?  When we consider support it is not just emotional support that is important, it can also be social, motivational, practical, educational and even financial.  Finally, how available are these relationships to you? This doesn’t have to physically be in person.  Not everyone is available all of the time and it can be helpful to identify when different people are likely to be available, e.g. in the evenings or at weekends.

Identifying all the people in your life enables you to have an overview of your relationship world – the overall itself might tell you something important, e.g. that you have few people in your life but they are all very close to you and provide a lot of support.

You can draw a diagram of all the people in your life using concentric circles this allows you to show how close you feel to each person (don’t forget to write yourself in the middle).  The most immediate circle to yourself would include those that you are closest to – this would typically be the people that you spend most time with and that are emotionally involved with.  Just because these are your closest relationships doesn’t mean they are perfect but they are likely to be your most significant.

Try to ensure that you include everyone, i.e. those that you see in your daily lives, family, children, friends, work colleagues, neighbours, those that you don’t see very often but still regard as friends, those that you may share interests or hobbies with, children’s school friend’s parents, your extended family, even pets.

This exercise enables you to identify who is in your life and how close you feel to them, to consider the support those in your life provide and to consider how available they are or when they would be available.

By having a visual reminder of who we have in our lives we can begin to work at reaching out to our social network – Who haven’t we been in contact with for a while? Who can we pick up the phone to or go for a walk with? Who can we arrange a Zoom meet up with or create a What’s App chat with?  We might need to set ourselves weekly goals to pick up that phone or send a message to stay connected, or to reach out for support in these difficult times.  Just having a chat with someone can have a positive impact on how we are feeling or being in someone else’s company.

It’s important to remember we are not alone and by reaching out to others for support we will also be helping others to feel more connected and supported.  Staying connected is fundamental in maintaining our mental wellbeing now more than ever.

(Reference: Chapter 9, Your Interpersonal Inventory – Rosalyn Law, Defeating Depression.)

 

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

 

Further reading by Rebecca Mead –

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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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“Should I stay, or should I go?” What does easing the lockdown mean to you?

I have found the Clash’s song of this title playing over in my mind when thinking about the current easing of the social lock down in the UK. It seems to me that we all, to some degree or another, now face a dilemma whether to stay or go.

Straight away, it is important to acknowledge the relationship of this dilemma to levels of freedom and privilege. It is true that some people have little or no choice about whether to go back into their workplace.  We all face very differing health concerns, with those in the ‘extremely vulnerable clinical group’ likely to feel greatest levels of concern and anxiety about going outside.  There has also been concerning, though unsurprising, expositions of inequalities in terms of health risks, with poorer and BAME people having greater chances of fatality.

However, in my experience these will not prevent them from experiencing similar kinds of conflicts at this time. It is a reality that a great many of us will, to some degree or another, be starting to wonder about how or when or whether we return to ‘normal’.

I have been wondering myself about this dilemma but I am also interested in how it might tap into broader questions about how we think about ourselves in relationship to our worlds – both outside and inside.

There is no doubt this has been a strange and disturbing time and of course we are no way through it. The sudden exponential growth of the virus and pandemic was frightening, and many felt traumatised by the level of crisis and what felt like an intense threat to our mortality. The war metaphors and imagery referenced by our government, while perhaps intended to help rally a ‘blitz spirit’, in all likelihood, simply added to the terror already felt by many.

The orders to lock down came as a relief for many people. We had permission to retreat and protect ourselves against what had suddenly become a hostile world. This was and is a necessary response but one that also exacerbated the fear of the outside world engendered by the virus and the rhetoric used about it.

We all responded differently to the retreat and this of course varied at different times. There are those who found and continue to find the lock down liberating, others who found and find it oppressive.  Of course, we are also living in different circumstances which add or detract from the benefits of the protection it offers. For example, it has been widely reported that incidents of domestic violence and abuse have increased during this period. Many were able to work easily from home, many were not and there was, and is still, differences between the level of risk for those going into work. And many have lost work or continue to face this as an increasing prospect.

External factors aside, our relationship to the pandemic and the lock down response will also key into aspects of our own internal worlds. A reluctance to move out of lock down could arise for those of us who tend to use retreat as a defence. It makes sense that the bubble offered by the lock down could tap into and heighten historical ways of managing difficult realities through strategies of self-seclusion. At the same time, those of us who have particularly found the lack of purpose and activity in the lock down difficult may have developed defences around keeping busy as a means of warding away difficult or painful feelings.  This could lead to a manic response to the easing of restrictions – perhaps a rushing quickly back into the world and ‘normality’.

Of course, both states may be at play in us at different times, but I am wondering about our overall tendencies that will shape how we are likely to interpret, and respond to, this shift in government advice.

Reflecting on my starting title, I wonder now about the aptness of the Clash song. It seems the transition from lock down to ‘normality’ (whatever that means) is not going to be as either/or as staying or leaving a relationship. It looks likely anyway that we are going to experience further Covid outbreaks with many expert views suggesting the current easing as premature and a second wave imminent.  We can therefore most probably anticipate more lock downs, perhaps even soon.

So, it feels more appropriate to think about a dialectic in/out situation we find ourselves facing requiring complex navigations. How we proceed and find our way through these difficult and disturbing times and those ahead, will be dictated by many external factors but also our own internal worlds and their responses, conscious and unconscious, to the different experiences of this pandemic.

 

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

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2e

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Corona Virus …… is in my garden!

Early in lockdown I turned  to my garden for the first time in a long time and my thoughts took an interesting turn which I wanted to share with you.

I spotted the jasmine shrub which had overgrown and was ‘invading’ my garden!  It had put deep star shaped roots all over the garden which were impossible to pull out. It was a ‘threat’, ‘invasive’, ‘runaway’, ‘contagious’.

I felt a mixture of feelings as I contemplated the consequences of my gardening neglect…..

….. overwhelm –it’s everywhere,

….. I’m not strong enough to beat it,

….. It’s spreading to my neighbours,

….. It will overpower and kill everything………maybe it will kill me…….

Kneeling on the infected earth,   demoralised, defeated and sweaty,  I  reflected awhile.

My garden had become a metaphor for the Coronavirus.

I wondered how I could make use of this metaphor to help me to come to terms with this unprecedented shocking world situation which was turning mine and others’ lives upside down and inside out.

I realised that although I couldn’t personally make any inroads into conquering the Corona virus, my humble garden would be a  much smaller and more manageable project.

Renewed hope reconnected me to resilience and perseverance. I hacked and chopped, I cut and cleared,  I dug and dug with a fervour ignited by my hatred of this virus, this ‘C ‘ word.

I cleared, I sorted, I ordered.  I took a longer view.  I wouldn’t manage to clear this weed today but if I kept at it I might succeed. Onward.

And magically as my garden was transforming, becoming clear and free from jasmine chaos, so my mind was becoming  clear and free.  Clear spaces of rich brown fertile earth reappeared in my mind.

And in this clear space Creativity bloomed.  I began to imagine possibilities for planting, for creating a lush healthy future for my garden.  My garden became a visible and experiential  dis-confirmation of the prevailing world crisis. Where the news was predicting death doom and disaster, my garden foretold of  renewal, regeneration and growth.

My garden remains undeterred by Covid-19 and lockdown.  Ever since March 23rd it  has behaved exactly the same as it always has. Spring arrived as usual, the leaves unfurling from trees and shrubs, new life shooting up from the ground apparently back from the dead.  This absolute predictability, regularity, repetition, this infinite miracle of nature has offered comfort and connection for me in this time of isolation and powerlessness.

As a Dramatherapist I seek  to work with Metaphor, Symbol, Image as a way of re-presenting reality.  I seek to connect, those things which are held inside of us with those things which are on the outside.

 

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. Online therapy is available.

 

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Covid-19 – talking with children in uncertain times

How do we contain our children’s anxiety in such uncertain times, when we too feel anxious and unsure ourselves?

When children are nervous we may notice them continually searching for reassurance – the usual advice would be to acknowledge this but keep reassurances to a minimum, modelling to them that fundamentally the adults in their life believe that the world is a safe place.

However, here we are – smack bang – in the middle of unprecedented times where it may be difficult for us, ‘the grown ups’, to keep level heads ourselves around our families health and economic future.

Our most important job is to manage our own anxiety whilst engaging with our children honestly and openly about the developing situation. Their worlds of home and school have been thrown into orbit; they had to say a hastened, brutal goodbye to friends and teachers not knowing when they would see them again.  The novelty of not being is school has now probably faded a little – time at home with parents is usually pleasurable but sometimes not.  Relationships can be put under extraordinary pressure when we are in lockdown with an unclear future.

Whilst we need to talk to children openly and find out their understanding of the pandemic, our responses should contain reassurances aplenty but we must to be careful not to give absolute guarantees.

It is within human nature to endeavour to provide an environment for our children in which they feel safe. Maybe we can begin to appreciate how these trying times can be viewed as an opportunity for us to model kindness, resilience and compassion.  We can hope that our children will remember these formative times as a period in which they learnt important life lessons along with resilience for their futures.

 

Sharon Spindler is an experienced Systemic Family Therapist with twelve years experience within the NHS and private practice.  Sharon is available at the Brighton & Hove Practice.

 

Further reading by Sharon Spindler –

Family Therapy for Beginners

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Coronavirus Lock-Down – Physical Health vs Mental Health

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

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

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

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

Why start now? 

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

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

Compelling needs 

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

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

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

The mortality of isolation 

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

Virtual connections 

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

Meaning making propositions 

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

Anxiety 

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

Depression 

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

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

 

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

 

Further reading by Mark Vahrmeyer –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

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

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Making the Most of your Online Therapy Sessions

During the recent challenges brought about by Covid-19, we all had to make significant changes to our lives and adapt quickly to a new reality. This is also true for therapists and clients who shifted quickly from the safety and familiarity of their consulting rooms to video or telephone meetings. I would like to acknowledge the impact of these changes on both clients and therapists on a separate blog. But first, to help remove some of the anxiety of involved in this transition I want to outline how you can make the most of your online therapy sessions.

  1. Spend some time setting up

Although most of us are familiar with video technology in our personal and professional lives, meeting online for therapy requires some preparation. Not just in terms of tech but also allowing a psychological transition into the therapy space, especially if you are shifting from a different activity in your home.

Give some thought to the room you wish to use, making sure that it is private and quiet, and that you will be sitting comfortably for the duration of the session. Make sure your devices are fully charged or plugged in and well positioned, so that you can see and hear your therapist well. Preferably wear headphones for a better sound quality and experience. Have a phone available in case one of you encounter issues with your tech and need to continue your session over the phone.

Finally, make sure the lighting in the room is positioned so you can also be seen well. Seeing and hearing you well will enable your therapist to ‘tune in’ much better to you, reading nuances in your facial expressions and tone of voice.

  1. Avoid all distractions

Make sure your notifications are switched off and all distractions are put away, such as work and study materials. Most therapy rooms are deliberately thoughtfully furnished in order to offer a calming, comfortable and uncluttered environment.  Ideally try to replicate this in your home where possible. If you live with others, schedule your session at a time when no one will hear or interrupt you.

  1. Communication queues

Psychotherapy and counselling usually take place face to face because it important for both the client and therapist to be able to communicate well with one another. This communication is largely non-verbal and often ‘felt’ rather than spoken. Video can be an additional of barrier to communication, despite advances in technology and video quality. Therefore, it is important that both client and therapist flag up missed queues or gaps in connection as it can be the case with delays or frozen images. Voice any frustrations you are experiencing in relation to this and work with your therapist to try and improve them where possible.

  1. Transitioning into and out of your appointment

As in number 1., give yourself space before and after your session. The travel journey to and from a meeting can help with processing, reflecting and thinking. In the absence of this, allow yourself some quiet time before and after your therapy session. Dealing with difficult emotions and discussing sensitive topics can leave us feeling vulnerable for a little while. If you are using your therapy to work on relationship difficulties with someone you live with, engaging with them straight after your appointment might not be a good idea. Go for a walk, take a bath, or just ask for some quiet time on your own. Equally, moving from a therapy session straight into dealing with work emails might not be such a good plan.

  1. Remember the positives

With Covid-19, we have moved our face to face meetings online because of circumstance rather than out of choice. However, people have been offering online therapy for quite a few years now. Although my preference remains meeting people in person, I am beginning to appreciate some of the advantages of online working. For instance, it is nice to be able to use headsets and adjust the volume if I can’t hear someone well. Because I no longer need to travel to and from work, I now have more time to do things I used to have no time for. It has also given me much more flexibility to see clients at times I previously couldn’t. There are advantages and disadvantages of working at home and working online. It will take us sometime to get used to our new reality. If we can’t change our new predicament, we may as well make the most of it!

 

Sam Jahara is a Psychotherapist and Supervisor in private practice working with individuals and couples. She is also the co-founder of Brighton and Hove Psychotherapy, a multi-approach clinic, offering Psychotherapy, Psychology and Counselling to all client groups, both face-to-face and online.

 

Further reading by Sam Jahara

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

Leaving the Family

Psychotherapy and the climate crisis

Psychotherapy can change your life – but you may not want it to

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