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CORONAVIRUS – How Psychotherapy can help you navigate your way through the crisis

I am writing this blog four days after the UK government imposed an effective ‘lockdown’ in response to the spread of the Covid-19 virus.  Inevitably this crisis will have a considerable impact on all of us be it emotionally, financially, physically, spiritually and psychologically. Depending on our character, disposition and ways of thinking we will experience the impact in specific and particular ways. We may be very aware of feeling lonely, anxious, frightened, overwhelmed, sick, vulnerable, frustrated, bored, angry and our unconscious fears almost certainly will be highlighted by this unprecedented situation.

From what my clients have been telling me over the last couple of weeks it seems to me that the most difficult aspect of this situation for people is the uncertainty.  We don’t how long the threat of the virus will stop us from leading our ‘normal’ lives.  We don’t know what life will be like at the end, how it will end and what the longer lasting effects will be on us, our families, our communities and the world at large.

As human beings we struggle with uncertainties and ‘not knowing’. We may not always be aware of it but the lack of certainty the ‘not knowing’ makes us feel afraid, ill at ease, out of control and so in order to protect ourselves from these uncomfortable feelings we unconsciously replace them with the illusion that we are in control and therefore we know exactly what will happen. Being certain, knowing what will happen narrows the mind, reduces the questions and makes life feel easier.  We usually forget to focus on the present moment and instead we make plans for the future, focussing on what we are going to do, where we’ll go, what we’ll buy, who we’ll see etc, confirming our illusion that we know what will happen and that we are in control.

Focussing on the future works until we are faced with a crisis or we are under threat then we focus completely on the present moment, it takes up all our thinking.  The present moment right now is frightening and for many people this is overwhelming.  Many people are struggling to bear the awfulness of it and the feelings of uncertainty they are having to cope with.

The reality is we cannot change what is happening, we cannot control outside forces we can only change the way we think about them and therefore how we feel in response to them.  In essence this is the work of psychotherapy.

Having a therapist to talk to at this time can help you bear the uncertainties of life and what feels overwhelming.  As therapists we are trained to work with the ‘not knowing’ and are therefore uniquely placed to help you face uncertainty and anxiety – it is our medium and what we work with all the time in our consulting rooms. Having a space where you can verbalise your anxieties and reframe your life so it becomes more bearable is invaluable right now.

 

Anna Reynolds is a UKCP registered Psychoanalytic Psychotherapist qualified to work with a broad range of psychological issues as well as more complex mental health conditions in adults.  Anna works with individuals and couples.  Anna is available at our Lewes Practice.

 

Further reading by Anna Reynolds –

The dangers of over medicalising

Attachment styles & how they affect relationships

The language of love: how couples communicate

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

Many self-employed psychotherapists, psychologists and counsellors have immediately felt the economic impact of the crisis brought by Covid-19. As our clients began to either loose their jobs or face increasing economic uncertainty, many had to either put their sessions on hold or stop coming all together. Many of us have either dropped our fees or continued seeing people with the uncertainty of getting paid. Unfortunately, some people have lost their support system when they need it the most.

Private Psychotherapy has always been enjoyed by many in the UK and around the world, as most national health services cannot offer the same level of professional service due to cost.

Psychotherapy practices have always offered a vital service to the community, whether through charities, low cost services or full paying clinics. Psychotherapy is a place where people’s deepest mental anguishes have a place to exist, to unfold and to be healed.

The health and consequent economic crisis brought by Covid-19 is already affecting people’s mental health in several ways, some of which have not yet come to light. This is being felt and will continue to be felt for a while to come at all levels of society.

An Existential Crisis

Covid-19 has highlighted our main vulnerabilities as human beings. It has hit many people at a very fundamental existential level as many have lost their jobs and their livelihoods overnight. In addition to this, as more people become infected and die of Coronavirus, we have become much more aware of our mortality and that of those we love.

Living in a globalised world, the spread of the virus had happened so rapidly that we have not had the time to process and digest the changes which we have been required to make as a result of the restrictions imposed to keep the virus from spreading. Never could we have imagined that something which started in China a few months ago could spread and reach our doorstep so rapidly and dramatically. This further highlighted our lack of immunity to world events.

Impacts of Lockdown

With people being asked to stay at home to protect the NHS, schools and businesses closing and people being asked to work from home (if they still have work), suddenly the home has become office, school, gym, social hub and place of relaxation. Whilst some families are feeling more crowded as a result of these changes, some people living on their own have become more lonely, isolated and vulnerable.

Some families trying to make life work under lockdown are finding that their relationships are being put under more strain, whilst children of unhappy and even abusive families are being made to stay at home more.

Of course, there are also positive stories emerging as a result of families spending more time together and solidarity between people. In times such as this, we are seeing the best and the worst of human nature.

Why is Psychotherapy vital during these times?

To put it simply, in times of crisis psychotherapy helps us to hold onto our thinking. When our survival is threated, our ‘reptilian brain’ takes over and we can act impulsively (panic buying for instance) often resulting in harm to self or others. Thinking makes us slow down and consider options. In times of crisis we sometimes need to think quickly and make decisions. However, buying time to think enables us to put things into perspective and to make wise rather than impulsive decisions.

Because this is both a health and economic crisis, it is hitting many of us at our very core. The British attitude to “keep calm and carry on” works to a degree. Of course, we need to keep calm, but we also need a place to acknowledge and talk about our fears, losses, despair, sadness, anger, etc if we are going to survive this crisis in good mental health.

 

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

 

Further reading by Sam Jahara

Leaving the Family

Psychotherapy and the climate crisis

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

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Spirituality and Mental Health

Spirituality is an often-used term these days, and around 20% of the population in the UK define themselves as spiritual, but not in the religious sense. So what does it mean to be spiritual?

There are many definitions of spirituality but generally we could say that it involves having a sense of something bigger than ourselves – a transcendental view of life where we start to realise that there is more to life that we see around us. This can include a sense that there is a God or creator, an intelligence in the universe, or maybe a deeper wisdom that we all carry. However we conceptualise it, spirituality often leads to a greater sense of purpose and meaning as we start to step back from the everyday world and see a bigger picture playing out before us. Spirituality also includes a sense of connectedness, which might be with others, ourselves or with something more transcendental. This feeling of connectedness can bring us a great deal of peace as we start to realise that perhaps we are not alone in the world. 

Spirituality is different from religion, but is linked to it. Religion is about adhering to a set of doctrines that define each particular faith. Religion will often have a spiritual component – a worldview that has an idea of something greater than us (God, for example) and may also involve a spiritual connection as part of the religious practice. However, you do not need to be religious to be spiritual, and indeed being religious doesn’t need to be spiritual!

So how important is spirituality to our mental health and wellbeing? There has been a lot of research over the past decade that considers this question. The findings show that engaging in spiritual practices have a positive impact on our mental health. Lower levels of depression can be found in those who are actively involved in spiritual communities. Levels of stress and anxiety can be lowered by engaging in spiritual practices, and spirituality can be instrumental in the recovery from trauma. Also, there can be a greater sense of purpose and meaning from having a spiritual perspective, which can have a positive impact on our wellbeing. 

Having a committed spiritual practice – whether it is mediation, prayer, or whatever feels right for you – reading spiritual philosophy and engaging with a spiritual or religious community can be hugely beneficial in improving and maintaining positive mental health. Even if you don’t consider yourself to be spiritual, it is worth spending a few moments thinking about life and the wonders that we see around us. It is easy to see that there is more to life than our own limited worldview and when we step back and consider this, our problems and daily issues can be put into perspective as we gain a more holistic view of life.

 

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

 

Further reading by Dr Simon Cassar –

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

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How do I choose a psychotherapist?

Deciding that you want or need psychological help can be a difficult position to arrive at.  Choosing the right practitioner to work with can feel like a daunting task with so many different fields of talk therapy, types of therapy and professional bodies overseeing the field.  This blog is a guide to helping you find your way to the right psychotherapist for you.

Counselling, psychotherapy or psychology?

Counselling, psychotherapy and psychology all broadly fall under the category of ‘talking therapy’.  They have much in common, yet are also very different.  I have previously written a piece on the difference between counselling and psychotherapy; the former being largely for shorter-term work and the latter being appropriate for deeper and long-term work on the personality.  We also have an in-depth page on psychology here so I shall not go into more detail about that here.

Depth of work

In choosing a psychotherapist, it can be helpful to have a sense of what it is you are seeking to gain from therapy.  Generally, psychotherapy is longer term than counselling and rather than working with one specific issue, is instead a relationship through which the client can work through relational patterns (with themselves and others), formed in childhood that they wish to change. Depth relational psychotherapy takes time – months to years – to understand and process relational, or attachment, losses. It is a commitment to a process of therapy and to oneself with sessions being as a minimum weekly, at the same time and on the same day each week.

Professional Body

There are a few professional bodies who offer voluntary registration to counsellors and psychotherapists – the BACP and UKCP. Whilst the BACP includes the ‘P’ for ‘psychotherapist in its acronym, the minimum training requirements of the BACP for someone to call themselves a psychotherapist are quite low. The UKCP, on the other hand requires all registered psychotherapists to undertake a minimum of four years of post-graduate training at an accredited training institution alongside a mental health placement and four years of personal therapy, before permitting applicants to join.  At Brighton and Hove Psychotherapy, all of our psychotherapists have trained at least to this standard and many far beyond.

Training

Psychotherapy training is long, challenging and requires the candidate to be in their own personal therapy throughout the training period.  Most training institutions are located in London, or further afield, and so a great deal of commitment is required to reach the necessary training standards. One of the main aspects that sets UKCP registered psychotherapists apart from counsellors is that they have been trained to ‘formulate’, which is another work for diagnose, or understand, more complex trauma and mental health issues.

First Appointment

If you have never previously been in therapy, then the prospect of the first appointment can be daunting. It is the job of your psychotherapist to set clear boundaries and create an environment that ‘feels safe, but not too safe’.  What does this mean?  Psychotherapy is about learning to tolerate difficult feelings and your psychotherapist is there to facilitate this process through their relationship with you.  They are not there to be liked, or to be your friend, as this would not be beneficial to you or to your process. If all goes well at the initial consultation then you and your psychotherapist may ‘contract’, or agree, to work together.  This means that they have assessed what work is required to facilitate change for you and you have decided that you are going to enter into an intimate relationship unlike one you have perhaps ever had before.

Length of Contract

How long is a piece of string?  Most psychotherapy can last for months or years, however little can be inferred from the duration.  For example, someone attending a year of therapy is not necessarily ‘healthier’ or ‘saner’ than someone who attends weekly for many years.  It is entirely dependent on the work required, how the client wishes to ‘use’ therapy and the relationship formed. Freud famously believed that therapy only begins when the client is no longer in a crisis.

Final Thoughts

Finding a good psychotherapist begins on paper but ends with a feeling, or a set of feelings.  As it is in the relationship that the unravelling of the past takes place, it is critical that as a client, you feel you can build a therapeutic relationship with your psychotherapist. The capacity to do this will hinge on their degree of training, clinical experience and therapeutic boundaries, as well as on it being a relationship that feels ‘safe enough’ – not too safe to not be challenging – within which the therapeutic process can unfold.  

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.

 

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A Dramatherapist at work in the sand tray

 

Dramatherapy is one of a group of therapies which are called Creative Arts Therapies, along with Music therapy and Art therapy. Today I am going to explore one aspect of Dramatherapy.

We usually come to therapy to talk.  Dramatherapy, has the capacity to go beyond the talking because it is creative.

Dramatherapy becomes useful in the therapy space when it is used as a way of illustrating  the talking which takes place between the client and therapist. This illustration provides another way (a container) for the client to find meaning in their experiences and in their sense of self.

How is this?

Mostly when we seek therapy we expect to be talking. As a dramatherapist I am always alert to opportunities within the talking,  opportunities to explore  those things for which there are no words-maybe those things that happened to us before we spoke,  or those painful experiences, things that we want to actively or unconsciously deny, or perhaps a dream, or an illness.  In other words those things that are not part of our everyday cognitive knowing.

And this is where creativity comes in. When we are creative we are tapping into the right side of our brain which is very different from the left side.  Simply speaking the right brain does not have the same rules of logical thought and sequential time. It receives and processes information and experience very differently. For us to be able to connect and communicate with the rich wisdom of the right brain we need to use a medium which represents (re-presents) our experience to us in a different way.

Sand tray is such a medium which can re-present a situation or experience. The placing of objects in the sandtray is intuitive, there is no right or wrong, only personal and individual interpretation.

In my work with a particular client who suffered from chronic anxiety, we explored her early pre-verbal experience as a way of understanding the roots of the anxiety.  She made sandtrays of her early years showing scenes of confinement, of heaviness, weight and pressure. Over the weeks she interpreted her created scenes to me, her witness. Through this witnessed process she was able to articulate her pain for the first time. As her feelings emerged and as she became more emotionally open her anxiety lessened.

In my experience this precious work continues outside of the therapy room, bringing a richness of new experience and self -understanding.  Through this work I see clients growing in self-confidence which I think is born from coming to know the self more fully and  profoundly.

If you are interested to know more about dramatherapy and how it may be of help to you, do contact me.

 

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and groups.

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