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January 11, 2021 by BHP Leave a Comment

Love and family

The family is our first social group. It is the crucible in which our passions are born and our capacities to love and to live are shaped – and mis-shaped. The family imbues its members with its own specific culture, habits and attitudes.

As an organism it too is shaped by the cultural moment and the social environment, the hopes, fears and attitudes of the day. It is the bedrock of our most durable and intense emotions and the fertile soil of our satisfactions and discontents. The family reconfigures with each new life that enters and exits. Constantly changing, constantly staying the same it is both dynamic and flexible, coded and predictable. We are all indelibly touched, one way or another by its authority. We learn to love in the context of ‘family’, each in our own idiosyncratic way. Every family has its own cast of characters ((step)parents, grandparents, (step) siblings, aunts, uncles etc). All players in a unique drama. Family is a stage where universal themes are navigated, power, sex and money, hierarchy and democracy, passion and ambivalence, in all their dark, tumultuous, devastating and innocuous glory.

Universal themes

From Greek myth to Shakespearean tragedy, the depths and breadth of family relations provide a turbulent, brooding backdrop to moral, ethical and philosophical considerations of a universal scale. So often in these epic tales we are reminded what an unruly emotion love is, indeed how uncomfortably close it resides to its shadowy counterpoint hate. Disowning his most beloved youngest daughter Cordelia, King Lear in a fit of vanity and rage is consumed by a vengeful hate, abdicating love and reason in its wake he casts her out. Her failure to satisfy his insatiable need for flattery and primacy, to go against her own nature, disrupts their bond, unleashes chaos and eventual tragedy. This is an epic tale of family conflicts, of power, love and greed. Most family dramas do not play out on such a grand scale, but remain hidden in the shadows of secrecy, shame and trauma, creating a legacy that can trickle (or cascade) down through generations to come.

Changing Families

Whilst the major human themes endure in families across generations, the architecture of family life and living is continually changing with the socio political and economic tides. Every generation spawns its own raft of experts on the family and its constituent members, from the institutions of religion, state, medical and social science and philosophy. The current moment in particular is one in which the couple is the central organising pillar upon which the success of the family depends. Bred in ever smaller numbers, the modern child is also a major focus of scrutiny and opinion. As the birth rate has decreased so children’s value has increased. Parents invest heavily in their offspring financially, emotionally, educationally etc. We dedicate ourselves to their health and happiness, often discounting our own in the process. As an antidote to our high tech fast moving, demanding lives we create a utopia of childhood and perhaps (without knowing) locate many of our own unmet hopes and passions in our beloved and precious innocents.

Love them or hate them (and indeed it is within our families that we learn about both) idealise or reject them it is within the context of family that we learn about the social world and our place in it. It is in this original grouping that we have our first experience of grief and loss, it is where we learn to trust (or not) and to express (or inhibit) our desires. Family life is fraught with misunderstandings and pain and is the vessel in which our virtues are forged, kindness, loyalty generosity and fortitude. Interestingly, even when we grow up and leave them we will, most often seek out another with whom we wish to form a family. At this very particular COVID moment we are all forced to reconsider what family means to us.

 

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

 

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

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Families, Gerry Gilmartin, Parenting Tagged With: Family, family therapy, Parenting

October 26, 2020 by BHP Leave a Comment

Helping children to ride the waves of big emotions

Quite a few people this week have asked me about tips for supporting children at times of high emotional stress (e.g. anger, rage or anxiety). For this reason, I thought I would share with you some generic pointers for parents that I use in clinic, but which could apply to most children. These are predominantly drawn from the principles of Dialectical Behaviour Therapy (DBT) and Dyadic Developmental Psychotherapy (DDP), which you may have heard of.

1. When a child is calm, help them to understand that emotions (of any kind) are a bit like waves… they rise, they peak and they fall. They come and they go, but they DO eventually end.

2. When a child (or their parent) notices that they are starting to become distressed (or to ‘fall out of their window of optimum arousal’), they can be supported to try the TIPP approach:

T = TEMPERATURE
Helping a child to change their body temperature (e.g. by splashing the face with cold water or eating or drinking something cold) can help them calm, as the body naturally gets hotter when distressed or aroused.

I = INTENSE EXERCISE
Engaging in intense exercise to match the level of emotional arousal (e.g. star jumps or running) provides a healthy outlet for anxious tension. – Ideally this should be a rhythmic exercise as it is more likely to activate a child’s earliest neural pathways of feeling soothed from when they were rocked as babies.

P = PACED BREATHING
Slow breathing, concentrating on their breath and (importantly) breathing out for longer than they breathe in, helps children to regulate the bodies. This is because longer exhalation naturally slows their heart rate and activates the Parasympathetic Nervous System (PNS), which in turn helps the body to calm.

PAIRED MUSCLE RELAXATION
Supporting a child to tense and then relax parts of their body, supports muscles to release tension. Relaxed muscles require less oxygen, so heart rate and breathing naturally start to slow down.

3. Having a calm box – Supporting a child to develop a pre-prepared box of all their favourite textures, smells, photos, games, sensory toys, etc., can be a lovely way to start to talk about emotions with a child and help them to feel a sense of self-efficacy in managing their own emotions. As time goes on, a child might start to ask for their box before becoming overly distressed.

4. Parental matching of the affect – When a child’s brain is distressed, it regresses to a much earlier developmental form of itself, whereby it does not register language or logic in the same ways. For this reason, a parent needs to ‘match’ the emotional intensity of the child in their non-verbal behaviours (e.g. when a child is shouting: using a loud (but not angry) voice, using BIG physical gestures, maintaining intense eye contact, etc.). The very act of ‘mirroring’ a child to themselves helps them to feel held and contained. The parent can then gradually lower their voice and soften their gestures, which the child will match in turn. I think of this as ’emotional hand holding’.

5. Having a cuddle – Following an emotional outburst, close physical connection instigated by a safe adult, is one of the most soothing and regulatory activities to do with a child to bring them back into a state of optimum arousal. It also enables them to learn that no matter what they have done or said, they are still loved, which is so important for developing a secure and healthy attachment. Once they are physically and emotionally calm, you might then want to talk about the actual behaviour if this needs to be addressed, however, the key is…’Connection before Correction!’!

I hope that you find some of these tools helpful. It is of course important to note, however, that what causes (and maintains) emotional distress in children can vary hugely from child to child. It is also important to note that for some children, what causes and maintains their distress can be very hard to determine. In such cases, parents should feel empowered to seek professional advice regarding a targeted assessment of their children’s specific needs.

Happy surfing everyone…!

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families Tagged With: child therapy, childhood developmental trauma, family therapy

October 12, 2020 by BHP Leave a Comment

Helping Children With Loss Through Story Books

Children, like all of us, encounter loss in their lives, temporary and permanent. They may lose a treasured possession, a loved one who dies, a parent who leaves or is imprisoned, a friend who moves away, or a valued teacher in the transition between year groups or schools. Some are unlucky enough to lose their health or abilities they once took for granted. Others lose their home or their country and there are those who lose their innocence through exploitation and with it perhaps their sense of self and any respect and trust they had for the world.

With loss comes associated feelings, held in the conscious or unconscious mind or both. Support in processing losses may or may not be available and the degree to which children show lasting difficulties will vary accordingly. Stories are just one tool which can help children connect with and work through internal emotional conflicts associated with experience of loss.

Like art, stories help us to take new perspectives and understand ourselves, others and the world differently. They can offer comfort or challenge, enliven or unsettle us. By engaging the imagination, not only can stories transport us to another time and place but they can also open up a rich emotional landscape which might otherwise be off limits to the defended conscious mind.

Most children speak and understand the language of play and they live stories, in their everyday playful interactions with food, sounds, textures, objects, animals and people. And, of course most are introduced to and love books, from a young age. Well-told children’s stories tap into a child’s thirst for make-believe, for adventure and for powerful emotive themes such as love and hate, despair and hope, failure and redemption.

For this blog, I have selected 6 story picture books which I will briefly summarise:

Amos And Boris by William Steig (1971)
This beautifully written tale of enduring friendship focuses on the unlikely alliance of a mouse (Amos) and a whale (Boris), who become acquainted when Amos falls off the boat he has made (which is sadly lost forever) and Boris rescues him. The two travel together, learn about their differences, survive a falling-out, share ideas and develop “a deep admiration for one another”, becoming “the closest possible friends”. Coming one from land, one from sea, the time comes for them to separate: “. . . we can’t be together . . . I’ll never forget you though.” Years later, Boris is beached by a hurricane and Amos, aided by elephants, is then able to save his life. The wrench of what may be
their final parting is sad and tender yet secure in the knowledge that each will continue to be remembered in the other’s heart and mind.

Badgers Parting Gifts by Susan Varley (1984)
This story opens with the inevitability of the ageing Badger’s death and his awareness of the loss his friends will feel after he’s gone. When he dies, Badger is sorely missed by all the animals but especially Mole, who feels “lost, alone and desperately unhappy.” The friends’ sadness is intensified by Badger’s absence, as it was he who had always been there for them in times of trouble. And in missing him, they start to come together and share memories. This, in turn, highlights to them the gifts which Badger has left behind, skills he taught each of them when he was alive which they can now remember him by and use to support each other. Gradually, sadness gives way to a comforting and emboldening remembrance and gratitude.

The Red Tree by Shaun Tan (2001)
This story tells of a girl who loses her sense of purpose and place in the world, and with it any sense of hope. Through unique, extraordinary, incredibly crafted images, and condensed, graphic text, we travel into the girl’s mind, inhabited by surreal, exaggerated and often frightening forms and scenes which overwhelm her. She is not seen, heard or understood and oscillates between these worlds of chaos and a relentless nothingness. A happy, colourful life is out of reach and all seems doomed and irresolvable. She has lost everything and become lost herself. And then, suddenly, life returns (thankfully!) and with it hope and joy. This speaks to the immense value there is in sitting alongside and fully taking in the realities of another person’s bleak experience. As the reader, we witness the
girl’s pain, perhaps helping her to mourn her losses and then re-discover herself.

The Day The Sea Went Out And Never Came Back by Margot Sunderland (2006)
Eric the sand dragon lives on a beach and adores the beautiful sea beyond, which in its daily rhythm comes and goes predictably, with the tides. One day the sea goes out and does not return. This is devastating for Eric who waits and longs for the sea to come back and is then overwhelmed with the pain of his loss. He becomes trapped and isolated inside himself. Eventually, attracted to the vulnerability of a dying wild flower, which he then saves, Eric is drawn back into life himself. He saves more flowers and a rock pool garden is created. Eric starts to feel safe enough to fully mourn his loss and in so doing discovers that remembering his beloved sea builds a treasure store in his mind which
he can keep forever.

The Lonely Tree by Nicholas Halliday (2006)
Set in the New Forest, this original book uses the seasons to chart the forest life-cycle through the friendship between an old, story-telling oak tree and a young, curious evergreen. As the oaks sleep for the winter, the evergreen becomes acutely lonely and, when spring finally comes, all hope is cruelly crushed when his oak-tree friend fails to wake up, his long life ended. The evergreen cannot comprehend what has happened but holds onto his cherished memories, through the sadness. Hope returns as a fallen acorn germinates and a new oak is born, destined to form a new friendship with the evergreen. Stories of the forest are retold and, as they are, the trees’ roots go “deeper and
deeper into the ground”, reminding us that with companionship we can endure and process the pain of loss and live a more enriched life.

The Heart And The Bottle by Oliver Jeffries (2010)
Beautiful illustrations alongside a concise narrative makes for great dramatic effect, telling the story of a delightfully curious and creative little girl who experiences the apparently abrupt and unexplained loss of an adored grandparent, with whom she had discovered and shared many wonders. She puts her heart into a bottle for safe keeping but as she grows up becomes limited and encumbered by its seclusion, which she finds she is unable to reverse. It is only through connecting with her own daughter’s zest for life that she allows her heart to be freed and re-discovers treasured memories of her beloved grandparent who she can now enjoy remembering. Her inner-child, in league with her actual child become the unwitting healers.

These books, like many others, model that feelings are okay, they are a normal response to loss and are to be expected. This is an important message to our children, particularly given that many of us are still filtering cultural and familial influences in our own lives which would have us discount feelings in order not to rock the boat or blow other people’s stiff-upper-lip cover. Children are expert at tuning into our sensitive pressure points and while they may push our anger buttons quite readily, they may avoid talking about sadness if they sense we may be uncomfortable and find it hard to hear and hold them. In turn, to avoid burdening others or being alone with pain, their own natural defences against connecting with sadness can become strengthened and entrenched.

A story book can serve as a helpful third party, a neutral but enriching messenger, able to venture into forbidden territory within the safety of metaphor. Connection with characters breeds understanding and empathy for one’s own pain. We can read the story exactly as it is or go off piste, filling in blanks with a child, co-creating a personalised narrative, re-writing the ending and reflecting all the while. Repetition can work wonders, enabling a child to use pictures as prompts and retell the story from memory. Each retelling can add meaning and a layer of digestion for the child, outside of his/her awareness, whether or not any overt life parallels are drawn.

All 5 of these books also convey a sense of hope, always integrated into the experience of loss. Again, this is a powerful lesson in a world which all too often splits artificially the good from the bad. We might not long for loss or wish it upon anyone else, but when it comes we, alongside our children, can do what we can to to feel it, to know it, to share it and to find new life somewhere within it.

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

 

Michael Reeves is a Psychotherapist working with children and young people aged 4-18 and/or their parents/carers. He is available as a clinical supervisor for training or practising therapists and counsellors, whose work is primarily focused on children/ families/ parents. He is available at our Lewes Practice.

 

Further reading by Michael Reeves –

Supporting children and young people with stress and anxiety

Educational Psychotherapy (2) – developing empathy, mind-mindedness and self-discovery

Educational Psychotherapy (1): supporting social-emotional development and learning

Curiosity: how can children’s behaviour help us understand what they need from us?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Child Development, Families, Michael Reeves, Parenting Tagged With: child therapy, childhood developmental trauma, family therapy

May 6, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Educational Psychotherapy (2) – developing empathy, mind-mindedness and self-discovery

In Educational Psychotherapy (1), I explain how Educational Psychotherapy first evolved and how, as an approach, it can help promote social and emotional development as well as the thinking skills required for learning.  This was illustrated through the aspects of a child’s first six months in therapy. Here, I highlight three areas of further progress over the next 12 months of work with the same child. Again, this account is disguised and anonymised.

Empathy and feeling understood

One of the most exciting benefits of Sammy’s becoming more emotionally literate was the opening it allowed for me to make connections between his experiences with family and friends and his feelings and then providing empathy for Sammy’s felt experience.  This enabled Sammy both to feel held and understood by me at an emotional level and to experience his feelings as making sense. Over time, Sammy came to welcome this and it seemed to encourage him to actively seek openings to make further connections between his experiences past and present and his thoughts, feelings and behaviours.

Mind-mindedness and social connection

Early on in the therapy, Sammy found it difficult to engage in wondering about his own mind or about others’ minds, in either imaginary or real contexts.  There were times when he seemed to think I should have already known what he was thinking. Things began to shift when trust developed and Sammy allowed himself to become more openly curious about me, what my life might be like and how I might perceive him.  He grew increasingly accepting of the idea that I had a mind separate to his and that learning about each other involved a shared process. He started to wonder about my own mental state and thoughts, perhaps partly in response to my modelling of a mentalising approach with him.  This capacity to be “mind-minded” was also reflected in Sammy’s accounts of social interactions at school when he openly wondered about various students’ motivations for particular actions and how they might have been feeling about a situation.  This included an understanding that people might have mixed feelings at times.

Therapeutic journey

It was Sammy’s journey of mental-emotional-social self-discovery which came to shape the bulk of our sessions and it was an encouraging and rewarding journey to be a part of.  The significance to Sammy of this work became increasingly evident as I began to talk about the sessions coming to an end several months before the final session.  Sammy found this very hard and would avoid or deny the subject in various ways.  However, in time, we were able to talk more about what this avoidance meant and Sammy moved into a period of some weeks when, unprompted, he became highly reflective about what the sessions had meant to him, bringing in memories of particular activities and commenting on changes which he felt had taken place within himself.  He also made reference to ways in which our working relationship had changed.  He spoke with confidence and resilience and a certain assurance that his memory would remain in my mind after our sessions had come to an end – and it has!

Michael Reeves is a Psychotherapist working with children and young people aged 4-18 and/or their parents/carers. He is available as a clinical supervisor for training or practising therapists and counsellors, whose work is primarily focused on children/ families/ parents. He is available at our Lewes Practice.

 

Further reading by Michael Reeves –

Educational Psychotherapy (1): supporting social-emotional development and learning

Curiosity: how can children’s behaviour help us understand what they need from us?

Acceptance – What does it have to do with managing children’s difficult behaviour?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Child Development, Families, Michael Reeves, Society Tagged With: adolescent psychotherapy, child therapy, family therapy

April 8, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Educational Psychotherapy: (1) supporting social-emotional development and learning

Educational Psychotherapy was developed by Irene Caspari in the 1970s, an Educational Psychologist working at the Tavistock Clinic in London.  She was interested in understanding learning difficulties from a psychoanalytic and attachment perspective. In order to address both learning needs and emotional difficulties together, she pioneered a method of blending structured (educational) tasks and free expression within a 50-minute weekly therapy session.  Treatment usually lasts 1-2 years but some work continues for longer or is adapted for shorter periods or extended assessments. Trainees are typically experienced teachers or learning support staff and undergo their own therapy during training. Many continue to work in schools and adapt their learning to therapeutic teaching and attachment-aware, trauma-informed practice.  

What follows is an anonymised, disguised case study which illustrates how Educational Psychotherapy can begin to support social-emotional development and learning.

11-year-old Sammy was referred for therapy by his key worker on account of difficulties he was having with relationships, expressing and understanding emotions and understanding the world. An earlier Educational Psychology assessment had suggested that high levels of anxiety were impacting on Sammy’s capacity to make full use of learning.  Therapy took place over 18 months.  

Sammy soon engaged with a variety of word, number and drawing games and activities, offered within the context of a supportive relationship.  Tasks which combined cognition, physical activity and relational connection proved an effective way to build trust, stimulate thought and enliven Sammy’s felt experience in the room.  Shared story writing and the free use of paint and clay facilitated expression and imagination. Conversation also had a significant place, at the point of checking in, within and around activities and, over time, for sustained periods.

Over the first 6 months of therapy, progress became evident in the following foundational areas:

Sense of self and reciprocal interaction
Sammy came to enjoy the process of co-creation with craft activities and solving problems together, including making up physical word and number games and negotiating the rules between us.  He became more comfortable with what he didn’t know  and embraced the opportunity to find things out, explore new skills and introduce me to new areas of learning.  Sammy also started to talk more about himself and grew comfortable with the routine of checking in at the start of a session, when he would share a happy achievement or discovery or an experience of frustration, disappointment or confusion.

Tasks and learning

Persevering at a challenging task requires the use of Executive Function skills, such as being able to monitor and evaluate where the difficulty lies, use problem solving skills to work out and plan the next steps, use working memory, inhibit distracting thoughts and so on.  Young people like Sammy, who have difficulties in these areas, require considerable “scaffolding” to help them develop and practice skills and tools for thinking. To begin with, Sammy found it hard to take instruction or support from me but as trust grew he became a little more comfortable with not knowing and clearly more curious.  My sense was that a space for thinking opened up in his mind which enabled him not to panic but to consider what was required next in order to proceed. 

Thinking about and talking about feelings

The development of a language for feelings was a significant area of development.  In early sessions, Sammy would habitually say that everything was “fine” or “normal”, almost seeming oblivious to the relevance of emotional experience or reflection.  After a time, Sammy disclosed that he had been getting into rages at home and taking out his feelings on objects which had sometimes become broken.  He acknowledged that this was confusing, upsetting and problematic for him and that he wanted help with it.  Activities like squeezing paint directly onto paper or working with clay enabled Sammy to express himself viscerally and then reflect on how he connected with the images created.  We also thought about activities Sammy could do at home to self-regulate.  

In time, thinking about feelings became an area that Sammy would actively seek.  He talked about experiencing fear and how this had caused him to adopt particular behaviours as an avoidance mechanism.  It seemed that the naming of these fears was enough to create some distance and enable Sammy to make a choice about how he wanted to act.  Sammy also talked about sadness and acknowledged that he had grown used to keeping his feelings to himself.  He started to voluntarily make links between his expressive material in artwork and his own thoughts and feelings inside.  

 

In part, these conversations involved psycho-education, helping Sammy to understand more about how feelings work, that it is normal to experience a wide range of feelings and that it can help to be self-aware and to share some of what we feel with trusted others.  At times, we were able to do this through playing board games or through role-play with miniatures.  Sammy showed that he could recognise the difference between actions held in mind and actions lived and that he could think hypothetically about possible future consequences of taking a particular course of action.  

This phase of the work paved the way for more profound developments which were to follow.  Sammy was now ready to take more risks. (Read more about this in Educational Psychotherapy (2) – article will be published shortly).

 

Michael Reeves is a Psychotherapist working with children and young people aged 4-18 and/or their parents/carers. He is available as a clinical supervisor for training or practising therapists and counsellors, whose work is primarily focused on children/ families/ parents. He is available at our Lewes Practice.

 

Further reading by Michael Reeves –

Curiosity: how can children’s behaviour help us understand what they need from us?

Acceptance – What does it have to do with managing children’s difficult behaviour?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Child Development, Michael Reeves, Parenting Tagged With: adolescent psychotherapy, child therapy, family therapy

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We would like to reassure all our clients that Brighton and Hove Psychotherapy is operating as normal despite the current situation.

Our working practices have fully incorporated online therapy in addition to a re-opening of our Hove and Lewes practices for face-to-face psychotherapy in accordance with Government guidelines and advice on safe practice and social distancing.