Mental Health Archives - Brighton and Hove Psychotherapy

Mental health problems in Brighton

August 29, 2022 by BHP Leave a Comment

What is Psychotherapy?

Psychotherapy is a method of treating mental health issues through psychological, rather than medical means.

Known as ‘the talking cure’ a psychotherapist’s role is to work with patients or clients, generally on a minimum of a weekly basis, over a period of months or years. The work takes place within what is called a ‘therapeutic relationship’, characterised by the psychotherapist listening and thinking carefully about the client’s experience and working with them to make sense of it. Thus, whilst known as the talking cure, it could be more accurately described as the listening cure.

Psychotherapy developed from psycho-analysis, which is similar in nature, but involves multiple weekly sessions (up to five) and can often last for up to a decade. Freud referred to (psycho) analysis as a ‘cure through love’ and this applies to psychotherapy in much the same way. The relationship between psychotherapist and client is unique and one in which all the focus, attention and thought is about the client’s process. The closest example to this type of relationship is between mother and child, or primary-caregiver and child, and it is often due to failings in this primary attachment relationship that clients seek out psychotherapy in later life.

Do I need to have a mental illness to go into therapy?

Whilst it is very common for people to seek out the assistance, support and expertise of a psychotherapy due to them feeling like they are in a crisis in their life, the crisis is often only the catalyst that brings a client into psychotherapy. Indeed, it was once again Freud who said that psychotherapy (analysis) only begins once the patient’s crisis has passed. What did he mean by this?

One of the goals of psychotherapy is to bring space and contemplation into a person’s life so that they feel less at the mercy of their emotions and more able to hold themselves in mind. Once a crisis has passed, clients can often start to focus on using the therapeutic relationship and space to examine why they think and feel the way they do and to develop a construct or idea about who they would like to be. Psychotherapy is thus about getting in touch with our appetite, or passions.

Whilst most people access psychotherapy due to an issue covered by the term ‘mental health’, most remain for months or years in order to learn to have a better relationship with themselves and others.

How does psychotherapy work?

Human beings are relational beings, meaning that we are, from the moment we are conceived, in relationship to another. Relationships shape not only our worldview and our relationships to others in our life, but also shape our relationship to ourselves.

If we have learnt through early relationship(s) that others are unsafe and/or that we are not worthy of love then this shapes our worldview of all our relationships going forward. If we have been wounded in relationship then it takes another (therapeutic) relationship to work through all the hurt and to discover a new way of relating through how we are related to.

What training do psychotherapists have?

In the UK, the terms of psychotherapist and counsellor are not legally protected meaning that virtually anybody can use these terms with impunity.

Whilst some clinicians use the terms of counsellor and psychotherapist interchangeably, the UKCP (United Kingdom Council for Psychotherapy) is the largest professional body for psychotherapy clinicians and lays out its training and membership expectations for clinical psychotherapist very clearly.

Psychotherapists in the UK (who are UKCP members) train for a minimum of four years at post-graduate level, undergoing their own psychotherapy throughout this period, obtain at least 450 clinical hours of experience and undertake a mental health placement. Most UKCP psychotherapists will therefore have a minimum of a Masters degree in the field.

What’s the difference between psychotherapy and counselling?

There is much disagreement about the differences between counselling and psychotherapy and this is something I have previously addressed here. Fundamentally, psychotherapists are trained to work at a deeper level than counsellors and have been trained to formulate – our word for diagnose.

How do I find a psychotherapist?

Finding a psychotherapist can feel daunting. Brighton and Hove Psychotherapy is a physical clinic comprised of a group of skilled clinicians offering psychotherapy across the greater Brighton and Hove area and Lewes. You can use our search function to find a psychotherapist near you.

Alternatively, the UKCP holds a directory of all registered UK based psychotherapists which can be found here.

Further reading by Mark Vahrmeyer –

How to improve mental health

How do I find the right psychotherapist?

How do I find the right psychotherapist?

August 15, 2022 by BHP Leave a Comment

How to Improve Mental Health

Mental health is constantly in the news and not a day goes by without an article, blog post or news piece on the topic.

The great contradiction is that whilst we know more about mental health now and how to manage it, the busy, chaotic and plugged-in world we live in does little to help our mental health. Nor is it often that clear what exactly is meant by the term ‘mental health’.

Mental health is a ‘catch-all’ phrase that encompasses our emotional, psychological and social wellbeing. It therefore includes our mind, our emotional system and our social world. It stands to reason that good mental health means attending to all three, but I would argue that there is a fourth – the body – which is intrinsically connected to good mental health.

When people refer to their mental health, what are they really saying?

As I write this article, the media will have us believe that mental health is currently under crisis in the UK. Waiting times to see a mental health practitioner are at an all time high, people are increasingly struggling to cope with high stress levels and many folks remain isolated or fearful for social contact following the numerous and lengthy Covid lockdowns.

Poor mental health can manifest in a range of symptoms from low level depression and anxiety through to diagnosable psychiatric illnesses. For most people concerned about their mental health, the latter is fortunately not very common and therefore we can think about how you can take responsibility for improving your mental health.

Steps you can take

Sleep is crucial to good mental health and it is no coincidence that many of us struggle with poor sleep which ever time can have a very detrimental impact on our mental health (as well as our physical health).

Establish a sleep routine and stick to it – going to bed at a set time and avoiding stimulants such as caffeine before bed can be very helpful. Another stimulant that you would do well to avoid is watching the news prior to bed – whilst informative, the news impacts significantly on our nervous system and can leave us feeling ‘activated’ exactly when we need to get to sleep.

Exercise is good for the body, but also the mind. Many folks are put off exercise as they see it as something that involves strenuous exercise in a gym, however, this need not be the case.

Exercise does not need to cost anything and can be a way of combining being in nature with moving the body. A brisk walk or sea swim (in the midst of this heatwave) are both good forms of exercise.

Eating sensibly is another activity associated with physical health but which can also have a significant impact on our mental wellbeing. Stimulants such as coffee and sugar impact on moods and with this can in turn impact on sleep patterns, so be aware of when you consume stimulants and avoid eating anything late into the evening.

Socialising is not only enjoyable but is also good for our mental health. Human beings are relational, meaning that we are born into relationship and require relationship(s) to develop. Even when we are alone, in a psychological sense we are in relationship to someone – we call this an internal object – and constitutes how we hold ourselves in mind and make the ‘best’ choices for ourselves.

The mind body connection

All of our emotions stem from the body. They start as sensations and we then notice them and group them into emotions; feelings are the words we use to describe emotions.

Each feeling, or set of emotions, has its own somatic (body) blueprint, which means to say that each feeling is made up of a unique set of sensations in the body. For example, anger, whilst ‘feeling’ different for everyone has the in-common body sensations of tight stomach, tight jaw, clenched or tightened fists and a narrowing of the eyes. Conversely, joy, is felt in the body as an openness and moving towards something or someone. Joy tends to bring a smile to our face and it is as if our whole body opens to receive more of what we are enjoying.

Everyone has a different shaped and sized body and everyone has a body that can perform different tasks depending on fitness, ability, age and (dis)ability. However, unless a person has a ‘good enough’ relationship with their body, it is simply not possible to have good mental health.

Hence why the body must be included in psychotherapy and feelings stemming from the body attended to.

Practicing gratitude towards your body for what it can do and how it looks after you, getting curious about what your body needs and wants and treating your body with respect, are all significant pathways to good mental health.

Talk to someone

When things get too much it can be good to talk and whilst a social and support network is important, some things need to be thought about with a mental health professional such as a psychotherapist.

A psychotherapist is someone who has trained at postgraduate level for a minimum of four years and undergone their own journey of analysis or psychotherapy throughout their training and ideally well beyond. In the UK, psychotherapists are registered with the UKCP who hold a directory of qualified clinicians or you can search for one using the search function on our own website.

People generally enter in psychotherapy because of a crisis of some sort in their life, however, they tend to stay because they find the therapeutic relationship so invaluable in not only improving their mental health but in developing an appetite for their lives. As Freud said, psychotherapy (analysis) begins after the crisis has passed.

Further reading by Mark Vahrmeyer –

Mental health problems in Brighton

August 8, 2022 by BHP Leave a Comment

How do I find the right Psychotherapist?

Finding a psychotherapist can feel like a daunting task. For starters, the difference between a counsellor and psychotherapist may not immediately be apparent. Then there are the different modalities, or approaches to therapy. And lastly, there are the different professional bodies to make sense of.

The term ‘psychotherapist’, unlike ‘clinical psychologist’, is not a legally protected term in the UK. This means that there is very little to stop anyone claiming that they are a psychotherapist, without having undergone an accredited psychotherapy training (or indeed any training at all).

There is also, as of yet, no agreement across the different professional bodies as to what exactly constitutes a psychotherapist, which further muddies the water for anyone seeking psychotherapy.

If a client is wishing to go into therapy then my advice would be first and foremost to seek out a professional registered with either the UKCP or BACP and who can evidence significant clinical experience in the field. Both of these professional bodies have helpful websites which enables users to search for clinicians based on location, as well as other criteria.

Once you have a list of accredited psychotherapists, you may wish to consider which approach, or modality, in which the clinicians in question have been trained. Whilst this may seem confusing, it is important to remember that research has shown that it is the quality of the therapeutic relationship combined with the approach, that leads to the most successful outcomes in therapy. Therefore, look for a clinician who is able to explain how they think and work in clear and understandable language – remember, it is their job to help you understand how they can assist you, rather than you needing to figure it out by wading through complex jargon yourself.

Many people make the decision to seek out a psychotherapist when in a crisis. Whilst this is common and the sense of urgency strong, it is important to take the time to find the right ‘fit’ and this may mean contacting various clinicians, as well as attending potentially more than one initial consultation. When new clients come for an initial consultation with me, I always set a goal with them at the start of the session in suggesting that it is their job to work out whether they feel comfortable enough (but not too comfortable) working with me, and my job to work out if I believe that clinically, I can help them. This often comes as a surprise to new clients in that they are there to make a judgement and choice in relation to working with me, however, therapy needs to be a co-created and collaborative process from the outset.

How do I know if my therapist is right for me?

If you find that you are working with a therapist and it does not feel like you are getting what you hoped for or are feeling uncomfortable then raise this. As I stated earlier, psychotherapy is ‘work’ that two people undertake and a big part of the work is in establishing a particular kind of relationship – a therapeutic relationship – or alliance.

If your psychotherapist is unwilling to hear your concerns and to discuss these with you, then that is a strong warning sign that the person you are working with is not a good fit (and arguably not a very good clinician).

I suggested earlier that psychotherapy should be a process that feels supportive and comfortable, but not too comfortable – you have sought out a psychotherapist because you have a problem and want support. Your psychotherapist is not there to be your friend.

They are equally not there to collude with you, but to appropriately and mindfully challenge you.

I previously referenced the different approaches to psychotherapy – the methods. These can seem confusing – and even cause a fair bit of infighting amongst the therapeutic community! One way of thinking about these approaches is to consider them as ways of conceptualising, of thinking, about your inner world. It may be that after a period of time you discover the way your psychotherapist thinks simply does not ‘fit’ with the way you think. Remember, psychotherapy is about understanding the human mind and nobody has veer seen or touched a mind – it is a concept, a construct, and as such is shaped and brought to life by language.

What is ‘good’ psychotherapy?

There are many answers to the question – ‘what is psychotherapy?’ – which is another way of asking the question ‘what is good therapy?’. As there are so many ways of helping people make sense of their inner world, there are an equal number of answers as to the goals of therapy, however, there is commonality.

Rather than ‘good therapy’ being one thing, it can be better expressed as a formula: A solid frame combined with a containing relationship. Let me explain: Us psychotherapists frequently reference ; ‘the frame’ in psychotherapy and this refers to all the elements that enable a solid ‘containing’ relationship to form between the client and their therapist. The frame consists of a regular meeting day and time, a stable and unchanging consulting room, sessions that start and end on time, a therapist who is ready and attentive – these are some examples.

By ‘containing relationship’ we are talking about the very unique role that we, as psychotherapists, must play for our clients. We are there to think about the client every second of the encounter and must not make the relationship or sessions about us.

Therefore, when in psychotherapy, if you ask your psychotherapist a question – something such as ‘how was your weekend?’ – they will likely explore with you what lies behind the question before answering.

A containing psychotherapist is also one who can ‘survive’ their client – in other words, the client is free to express themselves how they wish and the job of the therapist is to be able to hold the boundary no matter what. When the frame and container are solid, that is a good starting point for successful therapy.

Can it be dangerous to see the wrong psychotherapist?

Let us assume that by ‘wrong’ therapist we are assuming a poor fit rather than any kind of abusive relationship, as clearly the latter presents significant risks to the client and would constitute a breach of the psychotherapist’s (BACP or UKCP) code of conduct.

Psychotherapy is, amongst other things, about helping client to understand their wants and needs and to help them put appropriate boundaries in place in relationships. If a client is continuing to see a psychotherapist where they are getting little to nothing from the sessions and feel that they cannot raise this, then this is only going to further undermine their self esteem and confidence which is utterly counter-productive to the process. This would be an example of the client’s experience in their relational world repeating in the therapy.

How important is it that my therapist is accredited and what should I look for?

As I have previously highlighted, psychotherapy remains largely formally unregulated in the UK. Membership of the various professional bodies is voluntary and for clients, it can be hard to distinguish between them.

As a UKCP registered psychotherapist I am acutely aware of the rigorous training standards of my professional body and understand the level of training that other psychotherapists, irrespective of their modality, have received who are fellow members.

Anyone crossing the threshold of a psychotherapist’s consulting room has been on the receiving end of some degree of neglect or abuse in their childhood. This makes them susceptible to further relational injury from working with someone who either is misrepresenting themselves, or has received inadequate training to understand their
limitations.

Mark Vahrmeyer is available at our Brighton and Hove practice and the Lewes Practice.

Further reading by Mark Vahrmeyer

Mental health problems in Brighton

The limitations of online therapy

July 25, 2022 by BHP Leave a Comment

Making Sense of our Multiple Selves

How many people are you? Personally, I know I’m quite a few and always will be.

Some years ago at a conference on ways of treating trauma a speaker was challenged from the audience to define what ‘mental health’ was. She paused for a moment and then replied that a mentally healthy person was ‘comfortable with self, comfortable with others’.

I admired the way she met this challenging question with a clear definition that describes a state of true wellbeing. At the same time I wondered, which ‘self’ are we referring to here?

Being in Relationship

Underlying that speaker’s definition of mental health is the notion of relationship and the recognition that to be a person is to always be in relationship with others and, most especially, with ourselves. In fact this learning how to be with ourselves is a process intricately linked to how we come to be ‘our selves’ in early development through relationships with our primary caregivers and other family members.

This notion that each of us appears to have multiple selves – or at least multiple parts of our ‘self’ – chimes with the reported experience of most people. This sense can be most acute when we face a life situation where we cannot decide on something, as though different parts of us are conflicting with each other to determine what is best for us as a ‘whole’ self.

The Parent, Adult & Child Model of the Self

A radical and deceptively simple idea for accounting for our different selves first emerged in the 1960s in the modality of Transactional Analysis (TA) (1) . This proposed that we naturally relate to ourselves and to others through a constant interplay between three different ways of thinking, feeling and behaving.

We first learn how to be from our close observation of the all-powerful others we meet in infancy.

We borrow aspects of how they behave towards us and incorporate these into our own way of being. This has been termed our ‘Parent’ ego state, of which we can have many different ‘borrowings’ from the authoritative figures of our early years. Borrowing these parental ways of being is useful when it allows us to provide ourselves with parental comfort and structure to safely navigate the world, such as soothing ourselves by rubbing a bruised knee or remembering to stop and hold hands at the kerb. This becomes unhelpful when any borrowed forms of the parenting we received prevent us fully accepting and loving ourselves.

We also learn by actively storing as separate ‘Child’ ego states within us our earliest intense aspects of previous emotional experiences and imaginings about the world. By replaying these old experiences in different situations, they give us guiding models for expressing our innermost impulses or adapting in order to successfully maintain relationships with others. This is less helpful to us when previous fears overwhelm us in the present or we over adapt to the demands of others at the expense of our own needs.

Our third and probably most common way of being is to operate in the here and now – or our ‘Adult’ ego state – where we use our accumulated knowledge of the world to solve daily challenges and get our needs met. Problems can arise when our ability to function in the moment is compromised by us bringing our more unhelpful Parent or Child ways of being into our present.

Making sense of our multiple selves

So when we face times in our lives when we do become ‘uncomfortable’ or worse, it can be instructive to use this powerfully simplified model to explore how aspects of our Parent, Adult or Child ego states might now be limiting our capacity to live well.

TA Psychotherapy

Part of the process of TA Psychotherapy is to focus with compassion on how our borrowed and previous selves continue to serve us and to explore with care and curiosity those aspects of ourselves that are now no longer helping us to change or grow. For example, we might identify the origins of self-critical voices and practise liberating new nurturing parts of ourselves. Or we might explore those moments in our lives when we seem to be suddenly incapacitated by childhood vulnerabilities and work to resolve why this is so.

To return to our speaker, if the definition of mental health is indeed to be ‘comfortable with self, comfortable with others’, then I would like to suggest that the vitally important process towards this healthy state is of one of ‘compassion for self, compassion for others’, a process that TA and many other forms of psychotherapy can very effectively support.

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 –

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

How are you?

Out of Sight, Out of Mind

Resources –

(1) Berne, E. (1961). Transactional analysis in psychotherapy: A systematic individual and social psychiatry. New
York: Grove Press.

June 20, 2022 by BHP Leave a Comment

Are People with Mental Health Problems Violent?

The stigmatisation of mental health and mental illness is nothing new and can be traced back through the centuries and across cultures.

Despite much improvement in the treatment of mental illness and an increasingly open dialogue about the effects of mental illness from sufferers and professionals, the evidence shows that paradoxically increasing numbers of the general public fear violence from those who are mentally ill.

What is mental illness?

Whilst the term mental illness is ubiquitous, it is a ‘catch all’ term which fails to differentiate between people struggling with their general mental health, people who struggle to regulate their emotions and the tiny minority who have an actual illness as defined in psychiatric terms.

In its most extreme form, mental illness is an inability to ‘hold’ onto reality and is a terrifying experience for the sufferer – this would be the definition of psychosis. However, as terrifying as this is, there is simply no correlation between violence and mental illness.

Where does this fear come from?

The fear of mental illness seems to be profoundly primal. Human beings pride themselves on the rationality and intellect and to be exposed to someone who has ‘lost their mind’ triggers fear – if it can happen to them, can it happen to me? Losing ones mind can feel like losing the connection with what makes us human.

Periodically these fears are brought back to the surface, often as a direct result of some unfathomable act such as the recent school shooting in Texas where 19 children and two adults were murdered by an 18 year old gunman. How can something like this happen? Who would do such a thing?

Human beings seek to ‘fit in’. We all to a greater or lesser extent abide by the rules and laws laid down by our culture and society. Where we abide by the rules and perform well, society tends to reward us. The rewards are multiple, but are generally related to social standing and financial payment which propels us to continue to do well: fitting into culture affords us self esteem.

Many people who suffer from mental health problems have experienced trauma during their lives – it can be argued all of them. We now know, in no small part thanks for the 1998 ACE study (Adverse Childhood Experiences) conducted by the CDC-Kaiser Permanente, that the more adverse childhood experiences a child is exposed to, the higher the likelihood that they will suffer from mental illness.

However, whilst striking, it was not only their mental health that was likely to be affected, the higher the number of ACE’s, the higher the risk of emotional and cognitive impairment, physical disease, poverty, criminality, social problems and substance abuse problems, all culminating in a higher likelihood of an early death. Trauma therefore impacts on a person in every facet of their future life. Trauma is not caused by poor mental health – poor mental health comes about through trauma, accompanied with the long list of symptoms above.

All human beings harbour thoughts and feelings that we consider to be in conflict to how we see ourselves and how we wish to be seen. Psychoanalysis was the first discipline to start to talk about how we all have sadistic drives, harbour murderous thoughts and take glee in the suffering of others. Psychotherapy seeks, amongst other things, to help people know themselves and to integrate these parts of their character.

However, where this integration has not happened people can ‘split’ these parts of themselves off – as if it simply is not a part of themselves – and ‘project’ them into others: I am ‘good’, you are ‘bad’, or in this case, I am ‘sane’ you are ‘mad’.

I would therefore suggest that much of what drives the stigma around mental illness and the association between the latter and violence is driven by fear leading to the psychological defence called projection. ‘Mental illness’ or ‘mental health’ is a convenient scapegoat for the parts of ourselves that we disavoy.

What can be done to challenge the misconceptions around mental health and violence?

In order to challenge the misconception that people with mental health problems are violent, we need to be able to have a mature and complex conversation about society, trauma and how we are all collectively responsible for ‘othering’: scapegoating and ostracising certain groups of people who are vulnerable. There is correlation between childhood trauma and violence, but violence is not caused by mental illness.

Alongside this we need to use factual statistic to show that simply having a psychiatric diagnosis or ‘suffering from depression’ makes a person no more likely to be violent or to commit a crime than anyone else. What does significantly increase the possibility is childhood trauma, contributing to feelings of low self esteem, a lack of belonging in society, poverty and feelings of disempowerment.

The effects of stigmatising those with mental health problems

Through engaging in an open and honest debate around mental health and mental illness, we can not only support those who are suffering to talk about their experiences and seek help, but also acknowledge to ourselves that we are all in no small part likely to be affected by a mental health issue at some point in our lives. This makes it ‘our’ problem rather than ‘theirs’.

Where people with mental health problems are stigmatised it further alienates them from mainstream society and the opportunity to ‘contribute’ to that society and feel a sense of belonging, purpose all leading to greater
self-esteem.

Stigma and scapegoating leads to shame and shame makes it even harder for people to access help. People with mental health issues need support, compassion (not sympathy) and a pathway to belonging in society. It is no more helpful to pretend that they have no problems than it is to demonise them.

Mental illness is a social problem

As discussed earlier, trauma – particularly childhood developmental trauma – impacts on every aspect of a persons ability to lead a fulfilling, healthy life. And trauma begets trauma, meaning that it is passed from generation to generation. Therefore, rather that scapegoating those with mental health problems, perhaps we need to collectively pause, reflect and look in the mirror to see what sort society we are all contributing to.

Further reading by Mark Vahrmeyer

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

June 13, 2022 by BHP Leave a Comment

Mental Health Problems in Brighton

Brighton and Hove Psychotherapy, as the name would suggest, is an applied psychology practice located in central Brighton and Hove in operation since 2014. Whilst many of our clients travel from further afield to see and be seen by our clinicians, and whilst we offer online therapy, most of our clients over the years have been from the Brighton and Hove area. As such we are in a privileged position to have a good insight into the specifics of the state of mental health amongst the general population of this city.

Do different cities have specific mental health trends?

There is much in the media being published about the poor state of mental health (and mental health provision in England) at the moment. Years of austerity, the pandemic and soaring addiction problems are fueling a national mental health crisis across the nation. This is no different in Brighton and yet some of the issues that people present for therapy within Brighton will also be an expression of the demographic and culture of the city.

The demographics of Brighton

Brighton is a vibrant city on the south coast of England, within easy reach of London. It has a relatively young, highly educated population, many of whom move here for the lifestyle or have graduated from one of the two universities in the city and made the city their home.

It boasts both the highest proportion of small and medium sized enterprises in the country as well as the most start-ups per capita; both these are testimony to the young, highly educated population many of whom are liberally minded and self-starters.

Brighton considers itself not be ethnically diverse though statistically this is not reflected in the figures with 87% of the population being white. Brighton also markets itself as a ‘hip and happy’ city that is the epicentre of the LGBTQ community, though again, the statistics and perception may mask certain realities.

Millennials and mental health

As Millennials have come of age and are now approaching their thirties and beyond, we are noticing increasing numbers of them presenting for therapy. This is a national trend, however due to the large numbers of young people living in Brighton coupled with their education and entrepreneurial spirit, we see many Millennials presenting for open-ended psychotherapy to use as a relational tool to get deeply curious about who they are and what they want from their lives.

Whilst everyone who crosses the threshold of a psychotherapy practice has a ‘presenting issue’, these Millennials will often stay in therapy for a long time to engage in a depth relationship in with to get in touch with their deeper desires. They are often extremely bright as a population group and well-versed in psychological concepts. This in contrast to my own generation – Generation X – who consume the most alcohol and drugs of any generational group and will often only present for therapy once they reach crisis point (a generalisation, but true nonetheless).

Drug and alcohol use

There is a saying in Brighton that nobody who lives here is actually from Brighton. Of course this is a complete exaggeration, however, the city does attract a lot of ‘migrants’ from other parts of the UK as well as beyond. It is liberal and open at heart and, as already discussed, has a young demographic. It is therefore not surprising that drug and alcohol use and misuse is at the highest rate for the South-East of England and one of the highest for the UK. Indeed, back in 2011, Brighton held the disconcerting record for being the drug-death capital of the UK.

Another saying that seems to go some way to defining Brighton is that it is a ‘Peter Pan Town’ where nobody wants to grow up. This would be the ‘shadow side’ of its fun, hip culture in that the city and its culture can draw people into an ongoing cycle of ‘living for the moment’ and avoiding the realities of life.

Psychotherapy has many goals but one is that it is about growing up psychologically – working though past losses and moving with purpose towards what you want. Peter Pan, beneath his boyish charm, was someone who was frightened of the future and of adult responsibility, but unlike Peter Pan we all must grow up as otherwise life simply passes us by.

The LGBTQ community and feelings of not belonging

Brighton prides itself on inclusivity and this is reflected in the size of the LGBTQ community. However, as with everything, there is also a shadow side here and over the years myself and colleagues have worked with individuals who identify as LGBTQ but feel no sense of belonging in the Brighton community, or worse still, feel ostracised.

There is prejudice everywhere and some research has shown that minority communities can unconsciously exhibit higher levels of prejudice towards others who do not meet the criteria of ‘their community’. This is not unique to the LGBT community nor to Brighton and has been observed in racial minorities who have been seen to express higher levels of racism towards other minorities that is present in the general population.

To what extend the above is ubiquitous in Brighton lies beyond the scope of this piece, however, I have had numerous clients over the years who felt that they ‘did not belong’ in the Brighton LGBTQ scene and who found this enormously difficult and painful as it had been one of the reasons why they moved here. They felt that the way they were ‘gay’ or ‘lesbian’ was not accepted.

We all need a sense of community and belonging and it can be extremely painful if we intentionally move to a place to be a part of a wider community with whom we identify on a profound level, only to find that the way we are in that identity is not accepted.

Cities are communities and communities are collectives of people who, through their unconscious process, create a collective unconscious that’ has an identity to it – so it is with Brighton.

Psychotherapy is a relational process embedded in culture and thus practicing as a psychotherapist in Brighton, the specifics of the community will both be expressed and need to be worked with.

Further reading by Mark Vahrmeyer

The limitations of online therapy

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

May 30, 2022 by BHP Leave a Comment

An In-Depth Approach to Leadership Coaching

Coaching in organisations has become increasingly popular over the past 20 years as workplaces become less hierarchical and organisations seek a more sophisticated approach to leadership. The more recent shift linked to the pandemic has sped-up changes already on the horizon.

Leaders are feeling an increasing sense of pressure and responsibility, alongside a collective shift towards a more balanced life. The two positions are difficult to reconcile leading to more pressure on the leadership as employees demand more empathy and flexibility, alongside added pressures on organisations linked to global uncertainty, supply chain issues and political instability.

We are living in times where things are constantly shifting and adapting quickly is a must. We want better relationships and a better work-life balance. Technology is connecting and isolating us at the same time – online meetings demonstrates this paradox well. Those in positions of leadership require an ever more empathic and sophisticated approach to their role, alongside being one-step ahead in an already fast-moving world.

The Role of Leadership Coaching

The role of Leadership Coaching is to be alongside leaders through these challenging times. An exploration of the challenges and opportunities within a person’s role requires more than a behavioural and goal-oriented approach. A more psychological approach to leadership coaching requires a coach who can think ‘outside the box’ and work with what lies beneath the surface. This entails understanding what motivates and drives the client, the demands of the organisation, the story behind the client’s career choices or trajectory, their resources and pitfalls.

An exploration of the story behind an individual’s career choice and understanding of their relationships at work speaks volumes. This exercise can be very interesting for both coach and coachee and lead further understanding some of the issues at hand. Given that success is linked to relationships – to self, others and the organisation – exploring these is an essential aspect of leadership coaching.

Finally, it is vital for leaders to have a place to discuss their anxieties, worries, and fears. Leaders must learn to know their vulnerabilities, and not deny or bury them. Facing and understanding these emotions is what leads to change. It is also through exploration that these anxieties and fears begin to lessen, and the client can start to focus their energies on more creative pursuits rather than constantly firefighting.

With space for reflection, a better understanding of one own emotions and relationships, and energies freed up for more important tasks and creativity, work starts to become more enjoyable. With better self-awareness leaders can enjoy their role and stand in uncertainty with more confidence.

Sam Jahara is a UKCP Registered Psychotherapist and Tavistock Certified Coach. She coaches individuals and groups in organisations as well as those who are self-employed or run their own business.

Further reading by Sam Jahara

Demystifying mental health

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

April 25, 2022 by BHP Leave a Comment

“I’m interested in therapy but isn’t it a bit self-indulgent?”

Many people believe that they don’t have a justified reason to go to therapy. They may feel they haven’t had anything ‘bad enough’ happen to them, or feel it is too self-indulgent. They may not think they are worthy of the attention they will receive. The truth is everyone is worthy of therapy. Therapy can help us look at our painful experiences and use them to adopt a different approach to living and engaging with ourselves and others.

Mental Health Imposter Syndrome Is Real

We’ve heard time and time again how clients feel they aren’t suffering enough to deserve mental health support. Following the pandemic, it’s more important than ever before to ensure you’re taking care of yourself.

Melanie Klein, an Austrian-British psychoanalyst, theorised a key early and ongoing development task is the realisation that others and different from us with their own needs rather than as extensions of our own. This forces us to realise the loss of what we want other people to be. However, this loss enables us to move on to a more realistic life.

Many feel that they don’t feel ‘that bad’ right now, however, it’s a common misconception that you much be going through some sort of crisis to be a good candidate for therapy. It’s easy for people to compare themselves to others or brush off their pain because it’s ‘a stressful time of year’.

Why We Need Therapy

Everyone’s experiences are valid, and many of us will benefit from therapy. A lot is going on in the world, especially following the pandemic. So, we must take time out for ourselves and work on what makes us feel good to be able to function to the best of our abilities.

The French philosopher and writer, Voltaire, tells the story of travellers who have suffered various trials and tribulations. These travellers hear of a murder at the Ottoman court. They pass an old man calmly tending to his garden and ask him if he’s heard about the murder. The old man doesn’t know anything about it and explains how he doesn’t concern himself with the affairs there. Voltaire uses this example for the idea that to live a good life, we should put more effort into the tasks that make us feel good and less about other worldly affairs.

Many of our therapists relate to this in the sense that many clients like to express their feelings and opinions on politics or activism, which, don’t get us wrong, is very important. However, we find that hidden within these opinions are parts of the client’s self that they are unable to face such as feelings of hopelessness, insecurities, despair, rejection and more.

Therapy Is Not Self-Indulgent

Rather than being self-indulgent, therapy is one of the best things we can do for ourselves and the world. By trying to understand ourselves, we don’t project our own pain onto the world. Through therapy, we can explore what is happening inside ourselves and utilise this new self-awareness to accept and understand ourselves better.

Voltaire argues in his book that cannot escape suffering, since the world is a brutal place. But rather than getting lost in these feelings of despair, we can accept them as part of the human condition. We must do our best to be honest about our feelings and cultivate what we can. Like tending a garden, the work is never complete.

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.

March 21, 2022 by BHP Leave a Comment

Demystifying Mental Health Issues

In the last few years there has been increased awareness of mental health issues in the media, way before the pandemic hit. Mental health professionals are seeing a growing mental health epidemic which has become significantly worse due to the human and financial cost of Covid-19, prolonged lockdowns, and a general shift in how people live, work and study. Nowadays, most of us know someone with a mental health issue or have experienced it ourselves.

Mental Health Issues are Human Issues

The language used in the mainstream media to describe mental health does not adequately portray the issues people present with in therapy. Terms such as trauma, anxiety and depression are often overused and do not describe their full meaning. Most of us experience fear, grief, sadness, and fluctuation in emotions. Whether we choose to acknowledge it or not, most of us have been through a challenging life event(s) or loss(es) with significant emotional and psychological impact.

Anxiety and Depression – An Emotional Accumulation

I often hear people say that they or someone else “suffers with” anxiety or depression, or “has a mental health issue”. My first thought is: what does this mean? Though these terms have been fed to us through both clinicians and the media, I believe there are much better ways of describing someone’s experience in a less diagnostic, medical and all-encompassing way.

Although some of us may say “I feel anxious” or “I feel depressed”, anxiety and depression are not actual feelings but a cluster or accumulation of many things. Feelings and emotions when undealt with (supressed) and poorly understood, can result in what we currently describe as depression or anxiety.

For instance, a prolonged period of low mood which we call depression can ensue as a response to anything from prolonged grief to suppressed anger, feelings of powerlessness and helplessness, just to name a few. Depression can range from low mood to intense depressive episodes, depending on cause and other psychological and biological factors.

A prolonged or chronic state of high alert resulting in unpleasant feelings of fear or dread which we call anxiety, often manifests when we are responding internally to a certain situation that we perceive as a threat of some description, either actual or imagined. Like depression, anxiety symptoms range from generalised anxiety to panic disorder, depending on the level of accumulation of emotions, life circumstances, personal resilience, previous trauma, etc.

Finally, our mood is also impacted by environmental and physiological factors such as sleep, hormones, mood altering substances such as caffeine, alcohol and drugs (illegal or prescribed), exercise, fresh air and sunshine, screen time, etc.

The Role of Psychotherapy

Is to help people make sense of why they feel the way they do. To understand what is behind the symptoms that people label as anxiety or depression because they do not know what they are experiencing and why. Uncovering the ‘why’ is a big part of the process of getting better – the more we know why, the more we know ourselves.

Elsewhere on this website we list the issues that people commonly seek therapy for. Anyone who comes to therapy seeking help with a particular issue or issues, also brings with them a rich context and personal history. Making links between symptoms and experience (past and present) is an essential part of understanding, accepting and therefore overcoming some of the barriers we face in feeling mentally well and more at ease with ourselves.

Sam Jahara is a UKCP Registered Psychotherapist and Clinical Supervisor and Executive Coach. She works with individuals in Hove and Lewes.

Further reading by Sam Jahara

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

The Pandemic and the Emerging Mental Health Epidemic

What shapes us?

February 22, 2021 by BHP Leave a Comment

Why all therapists and mental health professionals need therapy now more than ever

I don’t know about you, but I have been riding the Covid-19 emotional roller coaster since March 2020 with very little roadmap, whilst trying to guide those who I work with like “the blind leading the blind”.

I also see my own psychotherapist and supervisers in the exact same boat. They are supposed to know more than me, but actually I get the sense that we are all struggling together.

Nonetheless, as a mental health professional, business owner and with all my family living in different countries, I have been dealing with my own set of challenges as a result of Covid-19, as well as trying to be the best support I can for my clients. I have also felt grateful for the support of a therapist throughout this period and couldn’t imagine a better time to be in therapy other than now.

All helping professionals are going through their own predicaments throughout this crisis whilst trying to help others as well. This can be both rewarding and also incredibly taxing. I noticed feeling more tired than ever at the end of last year – an exhaustion which felt both familiar and entirely new. Self-care has become more important than ever.

We all had to adapt to new working practices and navigate the unknown over past months. This has been both unsettling and reassuring in that most of us have survived and gotten through in our own way. There have been losses for sure and they have taught us that we can survive them too.

Professionals in support roles have been working through the pandemic feeling mostly under-resourced themselves. Under such unusual set of circumstances this can only be expected. It has been humbling.

Having weekly psychotherapy sessions has helped and continues to help me enormously. Therapists need their own therapy now more than ever. If we are to continue to be of help to our clients, first we need to have the support ourselves.

Sam Jahara is a UKCP Registered Psychotherapist and clinical Superviser. She works with individuals and couples in Hove and Lewes.

Further reading by Sam Jahara

What shapes us?

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

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

Face to Face and Online Therapy Help Available Now

A consideration of some vital notions connected to Existential Therapies

December 28, 2020 by BHP Leave a Comment

Nietzsche and the body

Here I reflect, a little, on a few of Nietzsche’s words on and as the body. These reflections are not conclusive or comprehensive. The only agenda is inspired by Nietzsche, to perhaps stimulate the reader’s curiosity and desire to experiment and explore. Please do read my previous article – ‘Why read Nietzsche?‘

“The body is a great intelligence, a multiplicity with one sense, a war and a peace, a herd and a shepherd.” (1)

Nietzsche felt many philosophers, including Plato and Descartes, failed to grasp the significance of the corporeal nature of human beings and the pivotal role of affect.

In much of his writing he explored the impossibility of pure thinking, reminding us that we are embodied thinkers, and our senses and emotions are as much a part of this reasoning as thought, if not more so.

Nietzsche treasured being and walking in nature. In fact, Nietzsche (1967) seemingly suggests physical movement was necessary for a thought to be accepted as plausible when he said –

“Give no credence to a thought that was not born outdoors while one moved about freely”. (2)

He depicted how the air we breathe, the food we eat, the place we live and what we ingest through reading, writing and talking all have an impact on our physiology and philosophy and vice versa. Nietzsche (1974) even advised:

“Our first questions about the value of a book, of a human being, or a musical composition are: Can they walk? Even more, can they dance?” (3)

Nietzsche wrote a poem called ‘Writing with one’s feet’. It emphasised the principle of embodiment through metaphor and description of the anatomy of his writing.

“Not with my hand alone I write:

My foot wants to participate.

Firm and free and bold,

my feet Run across the field – and sheet”(4)

I understand Nietzsche as a passionate defender of the embodied lived experience. His philosophy is one that elevates both known and unknown instincts and drives that interplay with our bodily lived experiences. In fact, Nietzsche seems to suggest the self is the body.

“Behind your thoughts and feelings… there stands a mighty rule, an unknown sage – whose name is self. In your body he dwells; he is your body”(5)

Nietzsche was not defining the body in a conventional way, such as a physical body or a single unit. He viewed it more metaphorically as a collection of corporeal and psychic forces, including emotions and instincts which are in a continual and often conflictual interplay. He saw the self as a plurality of forces, or more precisely a plurality of (relational) affects. These relational affects each express a viewpoint and seek domination. Affects, for Nietzsche, are dynamically and continually interpreting and creating perspective. (6)

This multiplicity can sometimes create confusion and conflict, especially if one gets stuck in thinking there is a such a thing as supremacy, or the right way, or the truth. Perhaps the key is to recognise that they all say many things at once. Rather than seeing this multiplicity of meaning and often unknown elements as something to fear, one could be curious and trust there is something to be listened to in all aspects. This exploration and experimentation is something that therapy can be helpful for. A potential space to sit in the unknown for a while, exploring, experimenting and experiencing, and see what might emerge.

Perhaps as Nietzsche suggests this very experience of conflicting affect can dislodge the notion that there is one way to be and create an opportunity for us to be guided into new, more fluid and creative ways of becoming. It can show us there are no limits to novel forms and there is always potential for transformation even within the limitations, obstacles and challenges that we may face. It also tells me that the idea of a rational pure thought that can somehow ignore or overcome the influence of emotions, physical sensations and those forces that reside in the unknown or unreflected, is unlikely. For Nietzsche it seems, nothing is, or needs to be, left behind in this often enigmatic embodied endeavour we might call lived experience.

As I conclude I feel a pressure to tie this short piece up into a nice and neat bow, so that it feels complete and reassuring somehow. However, I also feel the desire to swim. Perhaps the former would be missing the entire point of Nietzsche and the latter highlights his case in point.

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

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.

Further reading by Susanna Petitpierre

Why read Nietzsche?

Magnificent Monsters

Death Anxiety

References –

1) Nietzsche, F. (1883/2010) Thus Spoke Zarathustra (Ed. B Chapko),Ebook.

2) Nietzsche, F. (1967) Ecce Homo, in On the Genealogy of Morals and Ecce Homo, trans. and ed. by Walter Kaufmann. New York: Vintage Books, 1967

3) Nietzsche, F. (1882/1974), The Gay science. With a Prelude in Rhymes and an Appendix of Songs, trans. W Kaufmann, New York: Random House

4) Nietzsche, F. (1882/1974), The Gay science. With a Prelude in Rhymes and an Appendix of Songs, trans. W Kaufmann, New York: Random House

5) Nietzsche, F. (1883/2010) Thus Spoke Zarathustra (Ed. B Chapko), Ebook.

6) Bazzano, M., (2019) Niezsche and Psychotherapy. London: Routeledge.

Face to Face and Online Therapy Help Available Now

How Psychotherapy can Help Shape a Better World

December 21, 2020 by BHP Leave a Comment

What shapes us?

We all have key figures in our lives, people who either held or hold great importance because of their positive impact on our professional and personal lives. They may have been people who we are either personally or professionally connected to, such as parents, siblings, friends, family members, or teachers, bosses, coaches, therapists and work colleagues, to name a few.

These people become so important to us because we internalise their qualities and also their positive messages to us, whether they were implicit or explicit, verbal or non-verbal.

Therapists are keenly aware that some key elements need to be present in our work in order for a positive relationship to form. We know that many who come to therapy do so because of breakdown or absence of relationship early on, which we can also understand as a scarcity or total absence of some key elements listed below:

Interest and Curiosity

To feel seen, heard and to perceive sense of curiosity towards oneself from another, which is engaged, honest and encourages mutual trust. Delight, enjoyment and even surprise in the exchanges that take place.

Attunement

Usually used in the context of a parent-child relationship, but the word is also used in other contexts. Attunement is a quality where the other person ‘tunes in’ to another, almost as if trying to absorb and understand what the other is communicating on a deeper level. Attuning entails putting oneself aside to hear how the other views and experiences the world.

Consistency

Consistent love and care is something children need in order to feel emotionally and psychologically safe. This continues to be the case for adults, albeit in a different way. The consistency in the care of others is what gives us a sense of belonging and therefore a sense of safety in the world.

Commitment

To feel the commitment of another to a relationship is another form of consistency, but also one that affirms that “I am here for you” or “You can count on me”. This doesn’t not mean that the other won’t disappoint at times or will always be available. But they let you know that you can rely on their commitment to you as a friend, partner or in an ongoing professional relationship, such as the regular long-term commitment of psychotherapy, for instance.

Time

Related to the two above in that there needs to be a consistent time commitment in order for any relationship to work. The gift of time cannot be underestimated, especially in today’s world. With time, important conversations take place, people get to know one another and things are allowed to unfold. We feel valued and important when others make time to be with us.

Connection

Of course this can’t be forced. We either feel connected or we don’t. However, all of the qualities above are conducive to developing a connection with another. Some people are better than others at connecting, both to themselves and therefore to other people. But there are times when the chemistry between individuals exists in a way in which can’t be explained. Some of these formed connections stay with us for a very long time, if not forever.

What are other qualities that you see as essential to forming a positive bond with someone? I look forward to your thoughts.

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

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

Further reading by Sam Jahara

Getting the most of your online therapy sessions

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

Leaving the Family

Face to Face and Online Therapy Help Available Now

Interpersonal Therapy (IPT) explained

December 7, 2020 by BHP Leave a Comment

Making Changes

As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.

What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?

Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.

One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.

We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.

It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.

If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.

Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.

Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.

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

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

Further reading by Rebecca Mead –

Social Connections

Back to ‘Bace’ics

Face to Face and Online Therapy Help Available Now