Brighton and Hove Psychotherapy

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The End

Just as what goes up must come down, so whatever begins must end.

Each of us comes to deal with this existential reality imposed on our own lives and all the living beings that we care for. As truly relational creatures we humans encounter the inescapable fact of death in those who die before us and we experience the pain of loss and bereavement.

And grief work itself is a common reason for people to seek therapeutic support. But whether it is through debilitating loss, or one of the many other reasons that spur people to commit to regular therapy, it is a fact that once therapy has begun, an ending of some sort will surely follow in the fullness of time.

Indeed the business of deciding when and how to end therapy is not straightforward.

Aspects that might make it easier to recognise when work is coming to an end can sit within the very beginnings of the work. Sometimes we go to therapy with a higher level of self knowledge about where our difficulties lie. With the help of our chosen therapist we can identify a working goal that will help us to recognise desirable change and a means of measuring how we will know when this has been achieved.

Through this means an ending may well present itself. In some senses this work might be likened to sailing whilst keeping the shoreline always in view.

Perhaps more often than not though, we can approach therapy with a less clear picture of who we are in our lives at that particular point in time, maybe even feeling unsure about quite what is ailing us or why.

In this case the beginnings of therapy can require a willingness to tolerate uncertainty. To deepen our self awareness, we might contract with our therapist to explore more deeply how we are in the world and this might come with a commitment to developing skills for new ways of being. We might compare this approach with setting sail beyond coastal waters to the open sea in search of new horizons.

When client and therapist first meet one question swirls for each of them: how is this for me to meet in relationship with this new person? And when the time comes to end therapy the question’s twin will arrive: how is this for me to end my relationship with this person I have known? An attuning therapist will process both these questions in the service of her client. For the client these valuable questions offer a way to better understand themselves and to evaluate any differences they experience in who they were back then at the beginning and who they feel they are now, at ‘the end’.

Much has been written about endings in therapy in terms of how this might relate to the ways in which both client and therapist have processed loss and bereavement in their own lives. Some family systems therapists have proposed that we can conceive other contexts to finishing therapeutic work than (1) ‘ending as loss’. Their framings suggest to me some useful additional questions for both client and therapist to consider:

• Ending as cure: does the client feel ‘better’ in relation to the way they originally felt ‘bad’?
• Ending as transition: how has this therapy supported the client to grow developmentally?
• Ending as release: does either client or therapist feel relief in this ending and if so, what might this mean?
• Ending as metamorphosis: how have both client and therapist changed through this relationship?

Reviewing these questions here reminds me of the vital importance of beginnings and endings in shaping the content of therapy and the emerging relationship between practitioner and client. Thus therapeutic beginnings and endings always invite our special attention.

As it is ultimately the client who decides to finish in therapy one final question becomes theirs alone: having begun, how much time and space will I allow myself to end?

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

Chris Horton is a registered member of the British Association for Counselling & Psychotherapy (BACP) and a psychotherapeutic counsellor with experience in a diverse range of occupational settings. He works with individuals (young people/adults) in private practice.  He is available at our Lewes and Brighton & Hove Practice.

 

Further reading by Chris Horton –

I’m the problem – It’s me!

Making sense of our multiple selves

Let’s not go round again – how we repeat ourselves!

How are you?

Out of Sight, Out of Mind

 

Resources –

Fredman G. & Dalal C. (1998) Ending discourses: implications for relationships and action in therapy. 1
Human Systems: The Journal of Systemic Consultation & Management. Vol 9 (Issue 1)

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Collective Grief

Recent Events: The Death of Queen Elizabeth and COVID

The recent death of Queen Elizabeth has drawn people together in grief in a ways both individual and shared. Having been Queen and a globally public figure for 70 years, her death felt like the loss of what had been a constant and stable presence in our lives.

The COVID pandemic forced us to engage with mortality in a way that many people hadn’t ever had to. We found ourselves experiencing emotions and feelings in ways that were unexpected and unsettling. We had to find a way to feel safe, in the face on what could feel like an invisible threat. Sharing the vulnerability of COVID became a way of coping with our feelings when so much felt unknown and uncertain.

Both of these events gave rise to feelings of loss and grief that were public and shared, yet they felt very different.

Contrasting experiences of grief

The experience of loss is something that no one can assume to avoid in life. It is part of human existence and can be the most obvious way in which we experience grief. The experience of grief is subjective and effects people in ways as individual as we are. Whilst some people appear unmoved and stoic, others can feel intense and uncontrollable emotions. Grief can be present in life in ways that can be hard to explain, either at the time, or at points in the future.

The death of a public figure and our sense of grief gives us an understanding of how we related to that person. Do we feel the loss of someone that we felt a closeness to, or do we find ourselves having ambivalent feelings? How does the loss affect our lives and what does it mean for us? Answers to these questions show us how unique our grief can be.

Sharing our grief over the death of Queen Elizabeth can feel as if it gives us permission to mourn and experience our own grief. We can attribute our emotions to an event that is shared and understood. We find comfort in sharing grief with others with a similar lived experience.

Looking back at the pandemic it could be hard to find ways in which to express feelings of grief, when everyone was trying to make sense of what was going on. Why we felt the way that we did wasn’t always easy to understand.

The pandemic also challenged us to experience death in ways that were far from what anyone would want. The absence of the ability to share grief at collective events like funerals and memorials left a sense of something unfinished and denied us the opportunity to find ways to understand our grief.

Comparable experiences of grief

Comparing the experience of loss and grief between the COVID pandemic and the death of Queen Elizabeth might seem rather obtuse. Both are joined by the collective nature of the events and how there felt like something inescapable about being aware of a collective sense of grief.

There is some comfort in the shared nature of what has happened and the sense that ‘we’re all in this together’ offers some reassurance, yet grief is still an individual experience

Grief and Psychotherapy

Loss and grief are parts of our existence, yet they can affect us in ways that can be unpredictable and unsettling. Being able to think with a therapist about how one is experiencing loss and grief can help to give understanding and a sense that what can at times can feel overwhelming can become less acute.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove .

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

 

Further reading by David Work –

The challenge of change

Thinking about origins

Bridging Political divides

Save? Edit? Delete?

Football, psychotherapy and engaging with male clients

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Loss

You can hold yourself back from the sufferings of the world, that is something you are free to do and it accords with your nature, but perhaps this very holding back is the one suffering you could avoid.”? Franz Kafka

Loss is a feature in almost every encounter we experience as psychotherapists. It’s a common part of being human. In this article, we will look at what loss is and what we can do with it.

What Is Loss?

Loss is a term we use to describe many experiences and not just death. Although bereavement is what we associate with loss, more everyday losses that we experience include loss of identity, the loss of childhood experiences, the loss of friendships or relationships or simply the loss you feel from a change in situations. Loss can be experienced in a range of different ways, and if not properly processed, it can have a profound impact on your life and mental well-being.

How To Cope with Loss

Experiencing a loss can make you feel like you have a lack of control. It’s therefore helpful to look at the things you do have control over and do things to make you feel more in control. Breaking things down into smaller, more manageable pieces ensures you don’t overwhelm yourself. For example, maintaining a routine and slowly introducing smaller goals can give you a sense of purpose.

Therapy is also a great tool for working through your loss, whatever that loss may be.

How Therapy Can Help With Loss

Talking to a professional psychotherapist can help you understand your feelings of loss and support you in overcoming them. As therapists, we reflect mentally through our own experiences and mirror them onto our clients, so they feel understood. Grief and loss cause pain, and this must be managed to ensure a healthy life.

This reflective process helps clients understand what they are doing to manage their grief. We’re not here to judge, but to bring awareness to it so it can be looked at more in-depth. Over time, through exploration of these survival strategies, the frightening experience of grief will pass. Sometimes, a loss must be examined from different angles to be able to move forward.

As therapists, we don’t judge. We provide a safe, calm space to listen to you. We understand that people who have experienced loss have so much going on in their lives and can struggle to make sense of it. We help you reflect on what is happening and help you to navigate through it.

Darian Leader’s book, The New Black, revisits Freud’s concepts of Mourning and Melancholia and explores the more subtle experience of loss and argues that modern life holds pressure to treat loss with medication. However, this adjusts the chemicals within the brain which has led to complex and unconscious causes of depression. Although drugs can be helpful, they rarely resolve the underlying cause of loss and depression.

Leader while praising Freud’s new thinking about depression, argues that he misses a vital element of mourning, its communal aspect and looks at various cultures and how they share the process of mourning.

In the book, Darian Leader argues that Freud missed a vital element in mourning: its communal aspect. In different cultures, many share the process of mourning, and mourning should be shared whether it’s a death or more everyday loss.

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. Online therapy is available.

 

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Holiday Blues?

This time of year can evoque a range of feelings in most of us. 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. For me, this season was always associated with positive memories of my grandmother. After she recently passed away, Christmas became a reminder of her absence.

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 you 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

There are many ways to spend your holidays. If you rather be on your own or spend it some place else, then why not? Just because it’s tradition for many families to gather at Christmas, it doesn’t mean you have to! If you fear that saying ‘no’ to family gatherings will upset or disappoint family members, explain that you are making a different choice this year and that you hope they will be supportive of your decision.

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.

Sam Jahara

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