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Are our emotions shaped by our relationships?

This particularly influences us during infancy, childhood and adolescence.  These early experiences can be activated if they have led to the development of unhelpful defenses.  The lack of attunement in parental relationships can result in an infant developing an unhealthy attachment style, divorced from reality in the form of fantasy or withdrawal and detachment.  This initially protects the infant from the pain, emotion and feelings.  Later due to the blocking of the ability to connect emotionally the protector becomes the persecutor.

A chaotic attachment experience can impact on vital neurological developmental pathways leading to permanent damage to later functional performance. Hence the recent research on childhood services from pregnancy to five years of age. 

If a “good enough” environment is NOT available for one reason or another during a person’s childhood there will be aspects of this early experience that appear to act at an unconscious level, a shadow of the early object relationship. This can be brought into consciousness and worked with in the therapeutic process.   Forming a trusting relationship with a therapist or a stable relationship within a group to hold and contain feelings and emotions to be internalized, made sense of in order to be restored. However, we must not conflate this process by apportioning blame on the parent but as a means of unfolding the neurological pathways that block the capacity for integration.  This is re-experienced in the therapeutic alliance as an imago of the infant / child with an immature mind as the “unthought known”     

Our brain and therefore our mind can remain adaptable throughout our lives and given the right support can  make a conscious decision with a mature mind not that of the infant /child.  A similar process occurs in trauma.  It can respond making the shifts necessary to live a valued and happy life.

 

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

 

Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

Group Analytic Psychotherapy – the slow open group

It is never too late!

The Unconscious Mind

Groups for Mental Health

Group Psychotherapy in a post ‘Pandemic World’

 

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The Unconscious Mind

How do we bring to mind what is unconscious? Is it important to make this journey? These two questions are central to the therapeutic process of psychological therapy. When we are young we depend on our primary carer’s usually our parents, to hold and contain our emotional needs.

In childhood, none of us have a mature mind to guide us we rely on adults, siblings or our extended social network to help us grow into mature people. Siblings play an important role in our social development our place in the pecking order can determine how we deal later on with competition, rivalry our reaction to authority, etc. This effect can impact on us throughout our lives. Bringing to the conscious mind these experiences can help with regulation of our emotional responses as adults.

Our unconscious can exercise its influence on us leading to destructive patterns in our relationships with family, friends and work colleagues. This is often the primary motivation for people to seek out psychotherapy.

When we are grown up the experiences of childhood can exhort their influence on us leaving us bewildered at our difficulty in managing our emotional responses in everyday situations. It is as if a shadow is caste over us, we are driven by something beyond our control to act out.

Feelings, emotions and experiences from childhood or the accumulation of a long period of small daily undermining by family dynamics or bullying at school can lead to trauma. When we are traumatised, either by an event or the cumulative effect of oppression, our only escape is to detach. This may result in retreating into a fantasy world or addiction, compulsive behaviour or other psychological defenses in order to survive.

The work with the therapist or group on the unconscious allows us to revisit this hidden material. To experience in a safe environment the painful and disturbing events that triggered a defensive psychological response.

This blog to asks more questions than gives you answers. Its aim is to offer you whatever your age, ethnicity or orientation to consider looking at your own journey with greater understanding. You can follow-up this blog by watching a utube webinar “Three Ways of Connecting With Our Unconscious Mind” by Kirsten Heynisch’s, Clinical Psychologist’s description of accessing the unconscious and working with it. This can inform your work with the process of change in Individual or Group Psychoanalytic Psychotherapy.

 

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

 

Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  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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Unexpressed emotions will never die

Short sharp, to the point and written by Freud. His full quote is ‘Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways’. What does he mean and is he right? 

With this statement Freud is defining on the pillars of psycho-analysis and psychotherapy – to uncover repressed and unconscious memories and provide a relationship in which those ‘traumas’ can be expressed through language and contact. 

What evidence is there that unexpressed emotions don’t die, after all, is passage of time not a great healer as the popular expression goes? We know that unexpressed emotions don’t die because otherwise people with traumas would simply recover and live contented and fulfilling lives.  Instead we know that this is not the case and trauma gets ‘stuck’. 

And with regards to the glib statement that ‘time heals’, this is only true when feelings can be expressed – losses grieved – and reality come to terms with, otherwise the past will continue to repeat itself in unconscious ways in the present. After all, the unconscious has no concept of time. 

How do unexpressed emotions come forth?

Unexpressed emotions – in other words emotions that cannot be acknowledged for fear of their impact on the psyche – express through a variety of means and present in an infinite number of actual behaviours or presentations. For me it brings to mind a quote from a Woody Allen movie where a character (played by Allen) says ‘I never get angry …. I grow a tumour instead’. 

Some of what we see as clinicians with clients who are defending against expressing difficult feelings can be: 

Acting out – Engaging in behaviours that are destructive to self and or others the reasons for which the client is often unaware of; 

Mania – Frantically ‘doing’ to avoid being in touch with one’s inner world; 

Depression – A pervasive deadness and inability to be in touch with desire as a result of emotions  being unexpressed. Being dead is preferable to feeling; 

Repetition compulsion – The compulsion to repeat an event or behaviour over and over again without an ability to clearly think about and consider why that may be; 

Reaction formation – A defence against the anxiety produced by feelings towards something causing the person to over-compensate in the opposite direction – an example would be someone terrified of death who engages in dangerous sports or activities; 

Mental illness – This is a catch all phrase, a product of the medicalisation of psychiatry whereby clusters of ‘symptoms’ are given different diagnoses. Essentially, mental health diagnosis or not, the work remains the same. And psychosis can be seen as the mind protecting itself from unbearable feelings and emotions by ‘going mad’. 

Somatic (body) symptoms – Back to the Woody Allen quote – in lieu of feeling, many of us develop physical ‘pains’ far less dramatic than tumours, but chronic nonetheless. Examples could be  gastro-intestinal problems (IBS), migraines or other more obscure symptoms. 

Dissociation – We all dissociate, which broadly means to ‘zone out’, however dissociation can manifest in powerful and extreme ways whereby the person ‘splits’ their mind akin to ‘the left hand  not knowing what the right hand is doing’, however rather than it being about one hand not knowing what the other is doing, it is in reality one hand not knowing what is BEING DONE to the other. 

And this list is by no means exhaustive or conclusive. 

Expression vs repression – living vs dying 

Expression of emotion is essential, however, cruelly paradoxically, those who have needed to repress have done so because there has not been a sufficiently available adult (in chronological as well as psychological terms) to be in relationship with. This is the role of the therapeutic relationship. 

Without titrated expression of emotion – I am no fan of new-age catharsis – and done in the context of relationship, living is simply not possible; only existence is possible where the client is at the mercy of powerful unconscious forces and exposed to their repressed emotions coming forth later in uglier ways. 

Grieving is part of living 

Grieving is extremely painful – whether that is grieving a loss in the present, or grieving the loss of what never was. However, without grieving we cannot feel alive – we cannot be born. 

Being born in the biological sense means leaving the safety of the womb, but also the ‘nothingness’ of the womb. In the womb we cannot experience reality other that filtered through our mothers. And so it is psychologically too – being born through psychotherapy means to face losses and bear reality, however painful that may be, and through that to come alive. If loss can be borne then desire for life can emerge and emerge it will. 

Psychotherapy is about expressing what has previously been inexpressible and it is in the context of the therapeutic relationship and encounter using language that this takes place: language gives trauma shape and form.

 

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

 

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

 

Further ready 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?

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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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Magnificent Monsters

“The passions, these “magnificent monsters” (Nietzsche, 1967, p. 521), can we consider them a gift in which something valuable can be learnt?

Below is a consideration of the multiple, dynamic, creative and sometimes conflicting forces of energy that are often competing for dominance within us – what Fredrick Nietzsche sometimes described as ‘the passions’. Others may describe them as drives, passions and impulses. They are always present and seemingly are what constitutes and influences much of what is our lived experience. Despite their force and significance, they can often go unnoticed and our knowledge of them is always incomplete. They sometimes emerge into our conscious awareness when we are awakened into our existence, for instance when we are confronted by experiences such as uncertainty, grief and love.

Feeling passionate can be both enthralling and scary. Passions are sometimes encountered as other worldly, because they can appear out of nowhere and stir us and shake the ground beneath our feet. Passions can cross the many boundaries of our lived experience. They can symbolise our strong emotional states including joy and suffering. Perhaps many people can relate to the passions felt in the first stages of falling in love, or the sudden earthquake of loss.

At times, we may find ourselves running away from them. This is perhaps born out of a sense of needing to escape from what is being experienced. Perhaps this can be influenced by our conditioned beliefs, rooted in religious and philosophical beliefs, which might espouse that passions are dangerous, uncivilised and something that need to be tamed, and/or eradicated.

Other times we may run towards them, feeling that despite the fear they might cause within us, their intensity and irreducible form feels like an opportunity to live more vitally and come-into-being.

As time passes, human beings seem to be moving into spaces where connection and desire are dampened down by our addiction to technology, self-preservation and control. Even therapy can find itself, unwittingly perhaps, offering ways to master the ever-arising encounter with thoughts, emotions and sensations, so that we might never have to feel perturbed. Other times therapy may be seen as providing an opportunity to self actualise, by integrating all that we apparently are. Perhaps all of this in some way is a strategy to defend against feeling unsafe and uncertain.

But what if moving out of uncertainty is not possible or even necessary? What if these passions are revealing our possibilities, our strengths, our potential to move and become? What if we need them to create, to learn, to feel alive within our uncertain world. What if really feeling them slowly and subtly before acting on them or attempting to eradicate them is important? What if becoming intimate with them and patiently listening to them is what is necessary?

Perhaps this is where therapy can facilitate; by providing a space to feel, to explore, to experiment so that maybe we can change the relationship. What is perhaps significant to consider, for a while at least, are the desires and possibilities they are revealing within us. As Clarice Lispector (2012) wrote: “Life, my love, is a great seduction in which all that exists seduces.” (p 55).

Perhaps some passions must sometimes be tamed in order to live within a collective space. However, within any taming I feel it is equally, if not more significant, to understand what is being felt and moved within us with curiosity and kindness so that we may experience this brief encounter with life more deeply and compassionately.

Maybe letting go of a need to control, just for a while, and trusting our continually changing movements, just for a bit, is all that has to happen?

With gratitude and inspiration from Nietzsche (1967) and Clarice Lispector (2012).

 

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

 

Further reading by Susanna Petitpierre –

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

Lispector, C (2012) The Passion According to G.H. Trans, Idea Novey. London, Penguin

Nietzsche, F. (1967) The Will to Power, trans. Walter Kaufman London: Weidenfeld and

Nicolson.

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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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How body stability creates psychic stability

There is No Such Thing as a Baby

I frequently blog about the importance about including the body in the process of psychotherapy and how the unconscious resides in the body.  However, unlike many ‘body psychotherapists,’ I believe that the involvement of the body is more profound than identifying the presence of the body in the process. Let me explain using one of Donald Winnicott’s most famous quotes, “There is no such thing as a baby.”

Winnicott famously made this statement in 1947. On face value, it may seem somewhat absurd. After all, we have all seen babies and know they exist. However, the reality is far more complicated, because every baby that any one of us has ever seen is only visible because it is in a relationship with its primary carer (which for simplicity, I shall refer to as its mother).

A baby cannot exist alone but is essentially part of a relationship.  Babies exist in an absolute state of dependence, such that the infant (the word is taken from the Latin – ‘infans’ – not able to speak) has no knowledge of maternal care, as this would require the knowledge of ‘an other’ providing the care.  The baby therefore is essentially indivisible from its mother and thus cannot exist in its own right.  The infant’s experience relies on the mother’s ability to merge with, and adapt to, her baby.  Therefore, whenever we see a baby, we actually see a baby, its mother, the relationship between the two and also the wider social context within which that baby lives and has come to be.

There is No Such Thing as a Body

The same principle can be applied to a body.  There is no such thing as a body in its own right.  A body is created, shaped, moulded and exists within the relationship that the mother of the owner of the body has had with it.  In other words, the body and how it is experienced by the person in the body is contingent on the relationship that the baby has with the mother and the wider environment. This then dictates the relationship that the owner of said body, has with him or herself (if any.)

Why Does the Body Matter?

Psychotherapy is about many things, but one of the primary tenets is that it is a relationship within which the client/patient can, through relating to the therapist, establish a relationship with themselves. Having a relationship with ourselves includes having a relationship with our body. However, I believe that too many psychotherapists assume that such a relationship is necessarily experienced as helpful by the client at the outset of therapy, or even possible.

The Body as an Enemy

If we come to inhabit, or embody, our bodies through the relationship with our mothers and the wider social context, and our mothers were abusive to us, then the experience of our body can be one of ambivalence (‘I don’t really care about my body”) through to experiencing the body as dangerous, attacking or not our own.

Examples of where internalised abuse/hatred is expressed towards the body include cutting and burning the skin through to anorexia and bulimia, to name a few.

Risk of Trauma

Assuming a pre-existing, or even conceptually possible positive relationship between a client and their body on the part of the psychotherapist is naive. At worst, it risks re-traumatising the client.

If, for the client, all that is bad resides in their body, then they need to slowly find a way to ‘meet’ their body in a different context and to tentatively form a different relationship with their body – to reclaim it from the ‘bad’ parent. The therapeutic process involves creating a different relationship with ourselves, one in which we are able to leave the echoes of past formative relationships behind. At the very least, we need to learn to think about ourselves as players in those stories in a different way. In the same way, we need to learn to relate to our body as our own and as our friend, guide and an integral part of us.

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

Body psychotherapy

What is attachment and why does it matter?

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Student mental health – how to stay healthy at university

After the long summer, thousands of new students are heading to university. The start of the academic year is an exciting time for many, but it can also be a difficult, worrying time for some. Students today are subject to different pressures from earlier generations – financial, academic, social – that didn’t affect previous students to the same degree. Higher study costs means that an increasing number of students have to balance their study with part-time work. This means that they have less time to form and nurture close friendships and a social support network with their peers.

For those leaving home for the first time, it can be a stressful transition towards independent adulthood. If we look to wider society, the uncertain and competitive job market can put an inordinate amount of pressure on students to perform well as they face an uncertain future. In addition to this, many serious mental health conditions manifest themselves for the first time in young adulthood. The Higher Education Statistics Agency recently revealed that the number of students who drop out of university with mental health problems has more than trebled since 2009-10, with a record 1,180 university students with mental health problems abandoning their studies in 2014-15, the most recent year for which data was available.

It is important, therefore, to keep yourself healthy if you are heading off, or back to university. There are many good resources out there that will give good tips on how to look after your mental health while studying at uni, and here are a few tips that might point you in the right direction.

Physical health

Looking after your physical health is key, especially when you are entering a potentially stressful situation and experiencing big life changes. Having a regular routine of physical activity can be a great help in maintaining good emotional health. This could be team sports, the gym, walking rather than getting the bus – whatever works for you. Also, having a healthy diet and adequate nutrition will also help maintain the energy level that is needed when you are studying and partying hard!

Social health

Going to uni is a social experience. Creating new social networks is part of the attraction of studying in a new area. It can be a lot of fun, and a good social network is intrinsic to having good mental health. But don’t underestimate the impact of not being around your close friends. Keeping in contact with your existing friends who know you well is important too, as building deep friendships where you can open up about your inner world takes time.

Psychological and emotional health

Looking after your psychological and emotional health is obviously a key part in maintaining good mental health. Spend some time noticing your thoughts – what are you telling yourself? Notice also your emotions – how are you feeling on a day-day basis? Being able to identify your thoughts and feelings and to express them in some manner, whether through talking to friends or writing them down, can help you maintain a healthy inner world.

Spiritual health

People often forget about their spiritual health, but this is an important part of our lived experience. Looking after your spiritual health can be simple. You could spend some time alone on a regular basis, spend time in nature, or learn to meditate. Of course, if you are religious, then engage more with your religion. Spiritual health doesn’t need to be about religion, and can be just spending time by yourself and noticing the amazing world that is around us.

Staying healthy at university

Keeping these four areas in mind on a daily basis can go a long way to maintaining a healthy lifestyle. However, when things get a little more difficult, then use the support services that will be available at your university. There will invariably be counselling services and learning support services who will be able to help in your university journey.

Kate Connolly and Simon Cassar

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Grief – how to grieve?

Grief is often referred to in the context of intense feelings experienced with the loss of a loved one. The loss we experience is often caused through death. Grief is, therefore, synonymous with bereavement.

This, however, is nowhere near the whole story. In order to know how to grieve, we need to understand grief.

When we are told that someone is grieving, we may assume they are feeling intensely sad. Although this is often true, grief is comprised of a multitude of emotions, and sadness is only one. One of the early pioneers of grief work (yes, there is such a thing), was Elizabeth Kübler-Ross. She suggested grieving was an active process that required a “working through of emotions” broken down into five core groups: denial, anger, bargaining, depression and acceptance. Sadness would fall into the ‘depression’ group in this model.

Since Kübler-Ross, plenty of other models have been proposed. All of these have added something to the field. I will not directly elaborate on these in this blog, but further information can be found on the Internet.

Grief is, therefore, an umbrella term for a whole host of emotions, and it is a verb.  It is something that we must allow ourselves to experience and actively engage with.

 Why should I grieve?

Emotions exist within us, whether we consciously acknowledge them or not.  Where we are unable to feel them (through repression, which is always unconscious) these emotions will often express themselves as a conversion reaction. They will be expressed through the body such as in aches and pains. They may be expressed through even more obscure symptoms, such as a loss of physical movement.

Where we are aware that we are feeling grief, but actively suppress the feeling, emotions are likely to manifest as anxiety or depressive symptoms, which can persist for years.

Thus, there is no escaping it, grief must be felt and ridden out, like a storm. To complicate things further, it is not a linear process. We might have felt anger (perhaps with our loved one for leaving us) and moved onto bargaining (“If only I had done more for them…”) However, this does not mean that we will not return to anger again. And again…

We must grieve because we need to acknowledge what we feel.  If we do not (because we can’t or won’t) things get complicated.

How do I grieve?

Grieving (in the context of bereavement) used to be a socially prescribed activity which was both acknowledged by the wider community and defined as a process. Those who were bereaved would often wear symbols of their grief – black clothes or a black armband. Within their community, it was acknowledged that they would be grieving for a set period of time, often a year. This practice has largely been lost in northern Europe. However, in southern Europe, it remains common in more traditional communities to see widows wearing black for the remainder of their lives.

Religion

Love it or hate it, the one thing religion gave (or gives) us is a powerful story of what happens after we die.  From the Vikings with Valhalla to the Christians and Heaven, the concept of an afterlife can bring great solace to loved ones who are left behind.  The loss of socially prescribed ways of mourning, combined with a loss of religious beliefs, has made grieving more difficult.

Meaning making

A universal task in coming to terms with grief is to find some sense of meaning within it, and to weave this together into a narrative. We are no longer provided with cultural narratives in the way that we once were. This then becomes something that we need to do ourselves.

Why is grief hard for some people?

When I embarked on my own professional psychotherapy career, working directly with dying patients and their relatives, I imagined that the loss of the deceased would be felt most acutely where relationships had been close, connected and happy. However, the inverse was true. Where relationships had been difficult, strained, or even devoid of contact for long periods of time, the bereaved would often struggle to process the loss far more. This occurred particularly where the relationship was between a parent and their (adult) child.

The reason for this lies in attachment and in how we learn, through attachment, to feel.  For those of us lucky enough to grow up in homes where there is no abuse or neglect, and no unexpected losses, we find it relatively easy to move in and out of relationship – to say ‘hello’ and ‘goodbye’. With the security of the relationship comes an ability to feel emotions and make sense of what is being felt. Thus, the process of grieving, whilst hard, is something that can be actively undertaken.

In some parent/child relationships, the child has been significantly disappointed by the parent in the past. Parental neglect and/or abuse can lead to an accumulation of unacknowledged earlier losses in the relationship. In these cases, the final physical loss of the parent can make it very hard to come to terms with the enormity of all the losses that person represents. The loss is not only of the relationship and person, but also of hope. If the relationship between parent and child was strained or difficult, it is likely the bereaved will be poor at navigating his or her emotional states. This makes grieving terrifying, at best, or unthinkable, at worst.

Grieving is normal

As a clinician, I get a lot of fulfilment in helping clients to grieve. It is different from any other presenting issue they bring to me. Grief is the universal leveller. We will all experience it at some point in our lives. The way out and through grief is always the same – we have to feel the full range of emotions that our grief brings up.

Grief is not a mental health condition, and yet many people become stuck with their grief. When this happens, the secondary symptoms can mutate into more complex conditions such as anxiety, clinical depression and panic attacks.

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.

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Managing conflict for emotional and physical health

In our last blog, I discussed the correlation between expressed anger and cardiac problems and repressed emotion and back/muscle pain in warring couples.

The article gave some interesting insights into the correlation between couples who cannot fight healthily and the poor health they experience as a consequence. So should we avoid fighting? No, we need to be able to disagree with our partners and express our emotions. So how do we do this healthily?

Couples who manage conflict well are able to undertake four key tasks:

  • Listen
  • Accept difference
  • Validate
  • Repair

The idea of listening to our partner sounds like the easiest thing in the world. After all, we do it all the time. However, truly listening means hearing how they are feeling rather than focusing on the content or facts. The facts matter as context, but your partner’s feelings are what is key.

Accepting difference in our partner can be really hard, especially when we have learnt that difference threatens a relationship. For example, we may have learned that we were not allowed to have our own subjective experience of the world when we were growing up. Perhaps our parent(s) expected us to enjoy what they enjoyed or they simply told us we were wrong when we expressed a negative or strong emotion. If this is the case, then it is likely that we will experience a difference in opinion with a partner as threatening.

Validation is a behaviour and state of being requiring empathy. To validate our partner means seeing them as separate to us and letting them know that we can accept their experience. It does not mean making them right and us wrong. This is often where couples stumble as they subscribe to the idea that there can only be one correct perspective.

Lastly, healthy and happy couples are really good at repairing their relationship and nurturing themselves and their partner after a fight. The health of the couple unit can often be gauged by how soon a couple moves through the four tasks, ending in repair. Couples who do this within an hour or two of a fight generally have better communication and are emotionally healthier than those who take days or weeks to repair their relationship.

These four tasks may seem simple, but the reality is that many couples simply never master them without support and guidance.

To discuss how couple therapy could benefit your relationship, please contact us for an initial consultation in Hove or Lewes.

Mark Vahrmeyer is a UKCP Registered Psychotherapist working in private practice.

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How fights with our partner influence our health

I write a lot about how the mind and body are connected and that our emotions originate in our bodies. I also write about how change happens through learning to be aware of our emotions and being able to feel them without becoming overwhelmed or needing to suppress them.

Recently I came across a blog in the New York Times which considered a study conducted in the 1980s at the University of California, Berkeley, which aimed to show the impact that how we fight with our partners has on our health. It makes for interesting reading.

The researchers took a group of married heterosexual couples and asked them to first talk about their day together for 15 minutes (the control conversation) and then to shift to discussing a contentious issue between them. The study participants were filmed and their bodily cues were studied to establish the emotions they were feeling. As all emotions are embodied and many of us are unaware of what we are actually feeling moment to moment, this was a very accurate way of establishing what emotion the participants’ bodies were experiencing. For example, anger is expressed in the body with a lowering of the eyebrows, a widening of the eyes, flushing of the skin and an increase in the pitch of the voice.

The researchers then focused on two defence strategies that participants seemed to adopt when they were fighting – anger and stonewalling. The latter would be termed suppression or repression in the language of psychotherapy.

The results showed that those who expressed their anger had a predisposition to developing cardiac problems, while those who stonewalled (repressed their feelings) were more likely to experience back and muscular problems. What’s more, the study participants who reacted angrily seemed to never experience the muscular and back pains of the stonewallers, and vice-versa.

The finding makes sense in that uncontained anger will manifest in higher blood pressure, leading to possible cardiac problems, and what we repress is ‘held’ in the body.

The conclusion seems to be that poor relationships are literally bad for your health.

What the study and blog did not discuss is how to fight healthily, as all couples fight (and conflict can be healthy, not only in ensuring we are getting our needs met, but also in keeping the relationship alive). It also implies that anger is detrimental to our health, which it most definitely is not, provided we can experience and communicate it healthily.

In our next blog we will discuss some tools for managing healthy conflict in relationships. Or if you want help with your relationship or managing your emotions, please contact us for either individual or couple therapy in Lewes or Hove.

Mark Vahrmeyer is a UKCP Registered Psychotherapist working in private practice.

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Who to tell that you’re in therapy? And why?

Alice Ayres

Sitting on the Tube with a relatively new friend, I suddenly found myself feeling awkward in the middle of an anecdote. “And on a Thursday evening, I…I…”

I cast a sideways glance at him. How would he react? Could I trust him not to judge me negatively? In the heat of the moment, I came up with a compromise.

“I see a therapist. For, like, general life direction stuff, you know?”

I waved an airy hand. He nodded understandingly. I sat back in my seat and breathed a sigh of relief, feeling rather pleased with myself. Not only had I negotiated the tricky subject, I had portrayed myself as a forward-thinking career woman. I was going places and seeking direction! I certainly wasn’t sitting at home in my dressing gown every Friday night eating Maltesers and talking to my cat. I don’t believe my friend was taken in for one second, but there you go. In my mind, I got away with it.

Who can you trust?

If you’re going through a tough time and seeking help for it, it can be hard to know who in your life you can trust to talk about it. Despite the excellent work being done by several charities to reduce stigma, to me, personally, it still feels like a risk. That’s one reason I write this blog under a pseudonym, after all, although I’m experimenting with being more open. Encouragingly, I haven’t yet had a single negative reaction (although neither has anyone said “Anxiety and depression? You? But you’re always so positive and upbeat!” Perhaps I look naturally morose.)

It’s a hugely personal decision, and everyone will be different. For example, despite (or perhaps because of) my strong family history of mental illness, I would rather do almost anything than talk to my family about it. Work is the other big issue, and here’s another great reason to write under a pseudonym.

To disclose or not to disclose?

I have never willingly disclosed any form of mental health difficulties I have experienced to any employer I have had, even though doing so might have meant that I could have accessed additional support. I simply don’t trust them not to treat me less favourably, despite legislation and everything else that might protect me. I am envious of people who can be open with their employers, but for me, it has never felt like an option.

Fortunately, my work has rarely been affected, although I’ve had a number of close shaves. At the start of this year, when things were really bad for me, I went through a period of waking up every single night at 3am. When it was time to get up and go to work, I experienced severe stomach cramps and crippling headaches, which never troubled me at the weekends.

My boss never spoke to me about my sickness absence record, although I remember one time when I was sitting in her office, pale and hollow-eyed from lack of sleep, staring at her, hoping she would ask me if I was OK. But she never did, and I staggered back to my desk like a dutiful zombie to fight my way through another day. I could make tea, crack jokes and just about do my job properly, but I felt numb inside. I remember thinking, “Why can’t any of these people tell how bad I feel?” But of course, depression is invisible. Nobody really knows unless you tell them, but having these conversations can be incredibly difficult.

In an ideal world, everyone would be able to be open about experiencing difficulties with mental health. It’s getting better, but we’re not there just yet. In the meantime, though, there are people who can be trusted. If all else fails, there are always Maltesers, and my cat.

The writer of this blog is not a current or past client of any therapist presently or formerly practising at Brighton & Hove Psychotherapy. Alice Ayres is a pseudonym.

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Transition

This is a transitional period, a transition from an old to a new way of being, thinking, living and working. For the past 3 years my life has felt like hard work – physically, emotionally and intellectually. It feels like I have been walking into the depths of a forest, dense with trees and devoid of sunlight. In Jungian psychology this dense and dark place is called the shadow.

In her book ‘The Expressive Body in Life, Art and Therapy’, Daria Halprin writes:

‘The personal shadow from which no person can escape contains the collection of qualities and feelings that were not allowed- the negative emotions, the not-so-nice characteristics, the disorderly and chaotic, or any other aspect of our person that might jeopardize the well-constructed façade of the ego. Along with all the of the “not allowed stuff”, the undeveloped talents, gifts and potential, as well as the ability to connect with and communicate our actual feelings and experiences, get inadvertently thrown into the bag as well.’ (2003, p.177)

Immersing oneself in the shadow is a process in which one either enters into voluntarily, is thrown in it by external life circumstances, or both. The shadow represents the part of ourselves which have been wounded early on. This wounded self, when unexamined, becomes a neglected and split off aspect of us which wants to be seen, manifesting itself in the way we relate to others and ourselves.

Working with the wounded self can feel like an incredibly arduous process at times, but also one which leads us into the depth of who we are. This process involves acknowledging that parts of our emotional world are wounded and bleeding and need to be healed. Once the healing journey begins, new possibilities open up, creative energy is released and change becomes possible. Knowing yourself means letting the disowned and wounded parts of the self lead us to the hidden treasures of who we are (Halprin, 2003).

It feels like the past 3 years have been marked by an intense love-hate relationship with my shadow. Once I started loving it more than hating it, real inner-transformation began. Learning to love my shadow was learning to love and be compassionate with myself; and I believe this has led to an increased ability to love and be compassionate towards others.

Watch this space for more on working in therapy with the shadow aspects of ourselves.

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