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Is starting psychotherapy a good New Year’s resolution?

Most of us make some sort of New Year’s resolution, whether overtly or covertly.  The new year can feel like an opportunity to put the past behind us and to start afresh.

Whether or not we actively name and own our New Year’s resolutions, most of us can also attest to the best held intentions for change slipping away. There are plenty of good reasons why New Year’s resolutions don’t work. We are often too unspecific in what would constitute change, and it can be hard to make change on our own.

Psychotherapy is about change.  However, the start of all change comes from inside. To make change, we need to understand ourselves and accept why we have made the decisions we have. Nothing is random.

Psychotherapy is first and foremost about learning to have a relationship with ourselves and to learn to hold ourselves in mind, often in ways others failed to do when we were growing up. When we hold ourselves in mind, we can objectively evaluate if something is helpful or in our best interests.

We learn to hold ourselves in mind through others holding us in mind. This is one of the main roles of a psychotherapist. Holding a client in mind is far broader and deeper than simply making notes and remembering what they told us. It is about having a relationship with them and helping them to understand their blind spots, their relational patterns to themselves and to others. Helping them work through this is the therapeutic encounter.

Psychotherapy is often hard. Keeping to a weekly day and time when we meet with our psychotherapist can feel like a slog. Unlike a New Year’s resolution, the process is held relationally. Your psychotherapist makes the time and space available to hold you in mind and expects you to show up for the weekly dialogue. Even if you do not attend, your therapist is there to hold you in mind.

Perhaps the question is not so much whether psychotherapy is a good New Year’s resolution. Rather, it may be whether you are committed to having a deeper and more meaningful relationship with yourself, and through this, learning to hold yourself better in mind. The latter will lead to long-lasting changes on a profound level which may or may not include more frequent trips to the gym!

 

Happy New Year from all of us at Brighton and Hove Psychotherapy.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further Reading by Mark –

AI psychosis: why depth therapy cannot be automated

All depth psychotherapy is trauma therapy – and the rest is marketing

Why there is no such thing as a patient

How AI tools between sessions are undermining the therapeutic relationship

Masochism and the impossibility of desire

 

Face to Face and Online Therapy Help Available Now

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The psychology of shyness: what it reveals about the self

Do you experience anxiety in social situations that can be overwhelming or even debilitating?  Is it affecting your social life, work, relationships – your everyday happiness?  If so, this article is for you. 

Asking what the function of your shyness is might seem a strange question – you didn’t choose it, right?  Yet exploring the function of shyness can open up new ways of understanding and, ultimately, relieving it.  

First, let’s consider the experience of shyness.  

Before a social event with friends or family, do you feel intense anxiety and find yourself making any excuse not to go?

Or if you do go, maybe you experience symptoms such as a racing heart, sweaty palms, a mind teetering on all-out panic?  When asked to speak, do you freeze or stumble, then blush and feel humiliated?  And all the while, is your internal critic attacking you for being a failure?  For many people, these symptoms are a daily reality.

At the heart of shyness lies the fear of being judged by others.  This fear often shows up as self-consciousness, low self-esteem, self-defeating comparison to extroverts, and hypervigilance – constantly scanning the environment for potential threats.  

A word about introversion, which shyness is often confused with.  At a surface level, the two can seem similar: being quiet in the company of others or preferring time alone.  However, just as extroverts seek company to feel energised, introverts feel overstimulated by social interaction and therefore recover their energy through spending time alone.  Shyness, in contrast, is rooted in fear of judgement.

How shyness develops: cause and function

Two factors typically contribute to the development of shyness: biological and environmental. 

Although people who suffer from shyness may have more sensitive temperaments, this is only a contributing factor.  The deeper origins are often environmental – rooted in childhood experiences of judgement and criticism – whether from parents, teachers, or peers.  When the environment fails to provide emotional safety, children can internalise the belief that connection is dangerous or unattainable.  This creates a damaging cycle of seeking connection while, at the same time, believing connection is impossible.

Growing up in a hostile or critical environment, you are likely to have unconsciously developed shyness as a self-protective strategy.  Its function was to keep your vulnerable self safe and away from those you feared might harm or humiliate you.  You stayed hidden, kept a low profile, avoided speaking first, were cautious about what you revealed.  This defensive strategy partly worked by keeping you out of harm’s way, but it also came with significant costs.

The cost of the shyness: shame and disconnection

A major cost of shyness is the impact on your self-image.  Conditioned to expect negative judgements, you may feel fundamentally ‘less than’ others, deficient in some deep, unconscious way.  This difficult-to-bear wound can be referred to as ‘relational shame’: learned in early relationships, this is a feeling of unworthiness that you’ll do anything to avoid.  And unfortunately, this relational pattern is likely to be re-triggered in present-day social interactions, again and again.

The other significant cost is disconnection.  We humans need connection with others just as we need food to survive.  Yet the very defence that seeks to protect you also blocks you from the very relationships you long for.  Now, as an adult, this historic pattern continues to cut you off from nourishing, validating connections with others, often leaving you feeling unseen and isolated.

How therapy might help

Because shyness originated in relationship, relational psychotherapy is a natural setting to understand and change the patterns that maintain it.  Therapy offers a safe space where past wounds can be explored and understood, enabling a more open and confident way of relating to others to develop.

Self-esteem is another key focus: uncovering childhood messages that conditioned your expectation of negative judgement.  Through compassion and curiosity, you can begin to see how you sought the approval of others while fearing them at the same time.  Through therapy, you gradually build a stronger sense of self and a greater trust in your self-worth.

Originally an unconscious protection against hostile judgement, shyness can be therapeutically worked with and transformed.  You can unlearn relational patterns that have held you back, as you meaningfully connect with others and a more authentic and self-accepting version of yourself emerges.

 

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

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman –

The cost of hiding your vulnerability: why emotional strength begins with openness

When life shifts without warning: finding your way through unwanted transitions

What is the role of creativity in psychotherapy?

No space to be heard?

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In therapy the past repeats until it can be let go of

A foundational principle of depth therapy is that until mourned, the past is never truly past. It lives on in the present in our relationships shaping how we see others, how we see ourselves and in how others see us. In the consulting room, this process plays out much the same way as it does in our regular lives but here it can be thought about and worked with. We call it transference.

Transference defined?

Transference is the unconscious repetition of early relationships in the present. The patient unwittingly re-enacts old relational patterns with the therapist which gives the skilled therapist an insight and understanding of how the patient learnt to navigate their relationships as an infant and from there onwards. Put simply, these relational patterns were once necessary in order for the infant to get their needs met (to varying degrees) but over time they have harden into fixed ways of relating that restrict emotional freedom.

Freud saw this phenomenon as both the greatest obstacle to therapy and its most powerful tool describing transference as “the prototype of all love.” Transference shows how the mind repeats what is familiar, even when it causes suffering. The therapeutic relationship becomes the arena in which these repetitions can be recognised, thought about, and over time different relational patterns experimented with whereby the patient comes to see the therapist as someone who is different to those in their past.

Why do we repeat relational patterns?

The repetition of the past in the present is not accidental. We repeat what we cannot yet remember or think about with the unconsciously hope that we may eventually get a different outcome. The patient unconsciously assigns to the therapist the role of the critical parent, the unavailable caregiver, or the idealised rescuer, depending on where their relational trauma lies. And these roles cannot be mentalized until they are lived through in the therapeutic dyad.

In this way, the therapeutic relationship becomes both a mirror from the past and an opportunity for change. It reflects the patient’s inner world while providing a new relational context in which that world can evolve.

Working with the transference

A common misunderstanding is that the therapist’s role is to correct the patient’s distortions of reality, however this is unlikely to lead to any relational change as simple insight rarely does. Relational depth psychotherapy instead takes the view of observing what unfolds in the relationship, as a vital indictor of what has unfolded in the patient’s early primary relationship. But, instead of reacting to how they, the psychotherapist, feel in response to the transference, they instead use what is known as their counter-transference to work but the patient’s projections and to name the pain and grief locked within those relational patterns.

Freud called this process working through. It involves returning to these patterns again and again in the therapeutic relationship until their meaning becomes clear to the patient.

The aim is not insight for its own sake, but the gradual loosening of the grip that the past exerts on the present through mourning.

The therapist as separate to the patient

Over time, the work is such that the patient begins to experience the therapist not as a figure from their past, but as a real person with a separate mind. This marks a crucial developmental step which didn’t happen when the patient was growing up and has kept them relationally stuck. It is the developmental step of recognising that others exist independently of one’s own needs and projections.

Analytical psychotherapists call this capacity the two-person world. In this world, the therapist is neither idealised nor devalued but experienced as a whole separate person. The patient’s growing ability to recognise separateness opens the possibility of genuine relatedness in all their relationships.

The emotional demands of change

Transference is not an intellectual concept but an emotional event that is worked with leads to developmental change and psychological maturity. The feelings it stirs can be intense, confusing, and often painful and throughout he therapist’s task is to stay present, holding onto their thinking mind and to use these emotional currents to help the patient understand what happened to them.

For the patient, the process invariably involves mourning. Old hopes of finally being loved or rescued must give way to the reality that the past cannot be undone as its only by grieving what was not possible that a person becomes free to live differently in the present – the past can be let go of.

Why transference matters

Transference provides a living picture of the patient’s inner world and defines how they do relationships. It brings into the open what might otherwise has remained hidden in repetition throughout the patient’s life. Without transference, depth therapy is imply not possible and the therapeutic encounter remains insightful at best.

The goal therefore is not to eliminate transference but to firstly understand it and then help the patient work through it. This is not easy work for the therapist as they must not only be asking themselves ‘who do I represent in the transference?’ But must also survive the patient’s idealisation and hate. Resolution means recognising these patterns for what they are: echoes of earlier life and not the reality of the therapeutic relationship.

Relational freedom

When the transference has been worked through, the patient no longer needs the therapist to embody old roles and this becomes a felt experience in the encounter. The patient can tolerate the therapist as separate to them and neither perfect nor dreadful. The therapist can be disappointing to them in an ordinary way. This is what psychoanalysis calls relational freedom. The patient becomes able to love, to hate, to desire, and to depend, all while knowing that both self and other remain distinct.

Psychotherapy is not an intellectual exercise. It is a living relationship that requires both participants to learn to feel and to think together. The transference provides the raw material for transformation IF the therapist is skilled enough to hold it and work with it.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further reading by Mark Vahrmeyer –

AI psychosis: why depth therapy cannot be automated

All depth psychotherapy is trauma therapy – and the rest is marketing

Why there is no such thing as a patient

How AI tools between sessions are undermining the therapeutic relationship

Masochism and the impossibility of desire

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The two faces of shame: how this powerful feeling shapes our lives

In the therapy room, shame – which we often hide, almost at any cost – frequently hinders progress. Clients sometimes conceal aspects of their behaviour they fear are shameful, such as viewing pornography, taking class A drugs, or losing their temper.

This is because it is perhaps one of the most intense and complex feelings we experience as human beings. Unlike embarrassment or guilt, shame often goes straight to the core of who we are. It can make us feel exposed, small, or defective – as if we are unworthy of love or belonging.

We hide it, push it away, or defend against it. But as psychotherapist and author Dr Joseph Burgo argues in his mould-breaking 2018 book “Shame: Free Yourself, Find Joy, and Build True Self-Esteem”, shame is not only inevitable; it also serves an essential positive function. Understanding the good and bad faces of shame can help us work with it more consciously, rather than being imprisoned by it.

Modern neuroscience, particularly the work of Allan Schore, adds another layer of understanding. Schore shows us that shame is not just psychological but deeply biological: it emerges in the earliest attachment relationships, shaped by how infants and caregivers connect. To understand shame fully, we need to see it both as a developmental survival mechanism and as a potential source of lifelong suffering.

From an evolutionary perspective, shame is a social emotion. In early human groups, survival depended on belonging and cooperation. To be excluded from the tribe was to face near-certain death. The hot flush of shame evolved as a kind of internal alarm system, warning us when our behaviour risked rejection.

It is no accident how shame is experienced in the body: downcast eyes, flushed cheeks, slumped posture. These physical signals were ways of showing submission and appealing for re-inclusion. Shame helped regulate social life by curbing selfish impulses and motivating cooperation.

In this sense, shame is not inherently destructive. It has kept us alive as a species by binding us to one another.

The distinguished neuropsychologist Allan Schore has shown, over the past 30 years, in a pioneering series of books about the workings of the human mind, how shame arises at a very early stage of life, before language, as part of the developing attachment bond between infant and caregiver.

When a baby seeks connection — through eye contact, smiling, or reaching out — and the caregiver responds warmly, the baby’s nervous system is regulated. The infant learns that it is safe, lovable, and worthy of attention.

But when a caregiver consistently (in Schore’s language) ‘misattunes’ — looking away, showing irritation, or failing to respond — the infant experiences what Schore calls a ‘rupture in attunement’. This leads to an abrupt shift in the child’s state: the body deflates, the gaze drops, energy collapses. In other words, the infant experiences a proto-form of shame.

This early shame response is not yet cognitive. It is a bodily state of withdrawal, rooted in the developing right brain. Schore’s research highlights that:

  • Shame is hardwired into the nervous system as a survival response to misattunement.
  • Repeated experiences of empathic repair (when the caregiver re-engages after a rupture) teach the child that shame can be survived and soothed.
  • But repeated misattunement without repair can embed toxic shame deep in the developing self, leading to lifelong vulnerabilities in self-esteem and affect regulation.

In this way, shame is not only evolutionary but developmental. It is built into the earliest interactions between parent and child, shaping how we later relate to others — and to ourselves.

The positive face of shame

Burgo, for his part, identifies four ‘faces’ of shame that, in their healthier forms, can guide us towards growth and connection. These are:

  • Unrequited love – the pain of rejection teaches us about limits, boundaries, and the importance of loving reciprocity in relationships.
  • Exclusion – the sting of being left out motivates us to adjust behaviour to stay connected with others.
  • Unwanted exposure – the discomfort of being ‘seen’ can trigger the growth of humility and self-awareness.
  • Disappointed expectation – failing to meet social goals or standards can motivate us to try harder and achieve mastery.

When shame operates in these ways, it functions almost like an inner compass. It points us towards empathy, accountability, and integrity. It helps us remain bonded to our communities and attentive to the impact we have on others.

Think of the flush of shame when you realise you’ve spoken harshly to someone you care about. That painful signal may prompt you to apologise, repair the relationship, and do better next time. Without shame, we might lose the motivation to reflect on our actions or take responsibility for their consequences.

The dark side of shame

The positive face of shame turns destructive when it becomes overwhelming, chronic, or linked to distorted beliefs about the self. Toxic shame is not about ‘what we’ve done’ but about ‘who we are’. It whispers:

‘I am defective.’

‘I am unlovable.’

‘If people really knew me, they would reject me.’

This toxic shame often originates in early experiences of neglect, rejection, criticism, or abuse. When children are repeatedly shamed without repair, they internalise the belief that their very self is flawed.

Burgo shows how toxic shame underpins many psychological difficulties:

  • Depression – the inward collapse of energy and self-worth.
  • Addiction – attempts to numb or escape unbearable feelings of defectiveness.
  • Perfectionism – striving endlessly to counter a sense of unworthiness.
  • Eating disorders – using control over the body to manage feelings of shame

In these cases, shame is no longer adaptive. It doesn’t guide us toward growth but traps us in cycles of avoidance, withdrawal, or self-punishment.

Shame in the body

One of the most striking aspects of shame is its embodied nature. It is felt physically:

  • The heat rising in the cheeks.
  • The desire to avert the gaze or hide.
  • The collapse of posture, as if trying to shrink away.

Schore’s work shows that these reactions are part of the autonomic nervous system. They happen faster than conscious thought, rooted in right-brain processes that regulate emotion and social connection.

Because shame is so deeply embodied, it often resists purely cognitive approaches. This is why therapies that integrate imagery, experiential work, and body awareness — such as schema therapy, EMDR, or somatic approaches — can be particularly powerful in working with shame.

Working with shame in therapy

Therapy offers a unique space to explore shame, often for the first time without judgement. Some of the key tasks include:

  • Naming shame – many clients don’t use the word ‘shame’ at all. They may describe feeling ‘not good enough’, ‘invisible’, or ‘like a fraud’. Helping clients put words to shame begins to loosen its grip.
  • Tracing its origins – understanding where shame came from — whether in early misattunement (Schore), painful childhood experiences, or later relational traumas — helps clients see that shame is not proof of defectiveness but a learned response.
  • Differentiating helpful vs harmful shame – clients learn to recognise when shame is signalling a need for repair or growth, versus when it is simply punishing the self without cause.
  • Developing compassion – the antidote to toxic shame is not pride but compassion. Building an inner voice that soothes rather than attacks allows clients to comfort the vulnerable parts of themselves.
  • Repairing in relationship – shame is relational in origin and relational in healing. The therapeutic relationship provides a model of attunement and repair, offering experiences of being seen and accepted even in moments of exposure.

Living beyond shame

Working with shame does not mean eliminating it. As Burgo and Schore both suggest, shame is a fundamental part of being human. The goal is to:

  • Soften toxic shame, loosening its hold over our sense of self.
  • Harness healthy shame, allowing it to guide us toward integrity, humility, and empathy.
  • Develop resilience, learning that moments of shame can be survived, reflected upon, and repaired.

When this happens, shame becomes less of a prison and more of a teacher. We stop living in fear of exposure and start living with greater authenticity. Relationships deepen, the inner critic softens, and life feels freer, more connected, and more real.

Conclusion

Shame has two faces. One binds us together, keeps us accountable, and helps us grow. The other isolates, silences, and convinces us we are unworthy.

By understanding its evolutionary roots, its developmental origins in early attachment (as Allan Schore so powerfully describes), and its psychological impact (as Joseph Burgo outlines), we can begin to approach shame differently.

Shame is not evidence of our defectiveness. It is part of being human. And when we bring it into the open — with honesty, compassion, and support — shame can transform from a source of suffering into a guide towards healing and wholeness.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Further reading by David Keighley –

Rewiring the past: EMDR demystified

Do we need to do homework during psychotherapy?

The dynamic maturation model: a new way of understanding how to cope with distress and create happier relationships

The empty chair in therapy

How therapy can help with anger issues

 

 

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The issue with online therapy platforms

Two key issues with large online therapy platforms

One of the first things I tend to ask new patients in a consultation is about their previous experience of therapy. Increasingly, I’m hearing that somewhere along this journey they have tried an online therapy platform – such as BetterHelp or Talkspace. 

This isn’t surprising. The advertising budgets of these large online platforms are enormous with promotions appearing across TV, podcasts, radio and social media. Having looked further into the way these platforms operate and present themselves, there are a number of issues I have with how they advertise their services and facilitate therapy. 

In this blog, I’ve outlined two of these concerns and offered some reflections on how psychotherapy might approach them differently. 

Therapist switching

Many of these online platforms promote the idea that if you don’t like your therapist, you can switch immediately, at no extra cost to you. In addition, some adverts even highlight users who switched five or six times before finding the ‘right fit’ – as though this should be a normal practice for someone looking for a therapist. 

For someone relatively new to therapy, this might sound like a real benefit. It fits neatly into a culture of swiping or upgrading at the first sign of disappointment. Whilst I do believe it’s true that not every therapist is the right fit for every patient, frequent switching is somewhat uncommon. And having a strong dislike towards – or discomfort with – someone very quickly, could more likely suggest there’s something within you that’s bringing out that emotion. Perhaps they remind you of a parent who you find dismissive or disinterested, for instance. This could become one of the key themes of your therapeutic work with them. And more broadly, doing so could be beneficial in helping you to address the reasons you have come to therapy. 

Alternatively, if your reaction isn’t so much dislike but uncertainty of the therapist, it’s possible that by cycling through different practitioners, what is unconsciously taking place is an avoiding of building a deeper connection with any of them individually. As you find yourself hopping between therapists, it’s possible that there’s something unconscious at play—perhaps an avoidance of forming deeper connections. This may perhaps reflect your dating history or difficulties with relationships or friendships, where you keep others at a distance to protect yourself from vulnerability or rejection.

Of course, it is important to feel comfortable with your therapist. But sometimes, feeling too comfortable can be more about avoiding vulnerability than creating real safety. Therapy is not always about liking your therapist, but rather gradually building a trusting relationship that can contain and explore your inner world; the good, the bad and the ugly. By constantly switching therapists, we risk reinforcing the very patterns that therapy is supposed to help us identify. And yet, the promotional messaging from these online subscription platforms seems to encourage it.

Messaging outside sessions

Large online therapy platforms also enable users to message their therapist outside of sessions, or schedule sessions as and when they want them, rather than having consistent appointment slots like in psychotherapy. These features are promoted as positives – encouraging users to reach out whenever they feel the need.

Again, this might sound like a plus – offering emotional support within a relationship where the other is available to you entirely on your terms, without any risk. However, psychological change rarely happens without some level of vulnerability and risk. 

Psychotherapy involves two people mutually coming together within the conditions agreed by each of them, in a consistent and reliable framework. It is set up in this way, as this is how life works. The therapy room becomes reflective of the wider world. The therapeutic relationship offers a place to to reflect on how we relate to others, and what we expect of from them, as well as how we manage disappointment and uncertainty. How can these relational patterns be seen or understood if the platform denies the user of these challenges?

In addition, many of the difficulties we bring to therapy involve struggling with frustration or boundary-setting. Having a therapist constantly on-call might feel soothing in the short term, but it risks bypassing the vital therapeutic work of sitting with discomfort, unmet needs, and complex feelings – until they can be thought about together in the next session. The space between sessions matters just as much as the sessions themselves, as it allows for internal processing and for unconscious material to surface. If we take away the frustration and boundaries within the therapy, these emotions have little opportunity to be expressed and explored. 

The illusion of risk-free change

The therapeutic relationship is not meant to be entirely free from tension or challenge and the discomfort that sometimes emerges can be some of the most important and useful material to explore for insight and growth. What these Silicon Valley type corporations seem to have done, is apply a customer service model to therapy, which risks taking these very experiences out of the therapy altogether.

While these online platforms may offer greater accessibility and immediacy, it’s important to be thoughtful about what kind of help we are seeking. There is therapeutic value in speaking about our difficulties with another person, but without a consistent framework, it’s unlikely to address these issues in a deeper and more meaningful way. 

That said, I return to what I said at the beginning: many people start their therapy journey after going through a process of trying different types of therapy, including online therapy platforms. There is no shame in this. These services can be a helpful entry point into thinking about one’s emotional world. And whilst the safety and convenience offered might not necessarily lead to long-term change, it can provide a gateway to something deeper and more sustaining.

For some, the anxiety around starting therapy can be significant, and perhaps requires a dipping the toe in before fully testing the water. And perhaps these subscription platforms do provide this. But if it’s insight, understanding and change that you’re looking for, I believe that the work of psychotherapy provides a more reliable framework to achieve this. 

 

Joseph Bailey is a psychodynamic psychotherapist, offering analytic therapy to individual adults in Brighton and Hove. He is registered with both the British Psychoanalytic Council (BPC) and the British Association for Counselling and Psychotherapy (BACP). Joseph is available at our Brighton & Hove Practice and online.

 

Further reading by Joseph Bailey – 

Why do we repeat past failures again and again?

 

 

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How to meet negative thoughts with compassion

We all experience negative thoughts and sometimes these thoughts can be painful, undermining and leave us feeling worthless. Some people simply try to tolerate them, and others might feel they are deserved – or even criticise themselves for having them in the first place. But is there another way to work with negative thoughts?

What if, instead of battling or pushing away our difficult thoughts, we gently turned toward them with compassion and understanding?

This idea is central to a therapeutic approach called Compassion-Focused Therapy (CFT). CFT is based on the understanding that many of us, particularly those with histories of trauma, shame, or harsh self-criticism, struggle to generate feelings of safety, warmth, and care toward ourselves. The goal of CFT is to help people develop an inner compassionate voice, a way of relating to themselves that is kind, wise, and courageous, especially in the face of suffering.

One of the most powerful ways we can use compassion is in how we respond to our negative thoughts.

Why we have negative thoughts in the first place?

Before diving into how to be compassionate to negative thoughts, it’s helpful to understand why we have them. From a CFT perspective, our minds are shaped by evolution. Our brains developed to keep us safe in a world that was often dangerous and unpredictable. That means we’re wired with threat-detection systems that are constantly scanning for danger, internally and externally.

This system is brilliant at spotting potential threats, but not so great at distinguishing real danger from perceived threat. As a result, we may experience critical, fearful, or shaming thoughts even when no actual danger is present. These thoughts are not your fault, they’re your brain’s way of trying to protect you. If we look deeply into our negative thoughts, and track them back to our formative experiences, we can often see that they protected us in difficult or hostile situations. With the limited faculties we had in our early childhood, these thoughts were our prime defense against difficult situations. Their purpose in many ways was to keep us out of danger.

As we get older, these thoughts continue and become a habit – we constantly criticise ourselves to keep us safe in the way we learnt in our childhood. Over time, these thinking patterns become habitual. Unfortunately, we often respond to these thoughts with yet more internal threat: shame, suppression, or judgment which can further exacerbate the problem. 

Meeting your inner critic with compassion

Let’s say you make a mistake at work and immediately think, “I’m such an idiot. I always mess things up.” A typical reaction might be to argue with the thought, try to block it out, or to agree with it which can take us into a shameful spiral.

From a compassionate perspective, we do something very different: we turn toward the thought with curiosity and kindness.

This shift doesn’t mean you agree with the negative thought or indulge it. It means you create space to understand it, soothe it, and decide how to respond from a place of wisdom and calm rather than fear or judgment.

Three emotion systems and why balance matters

CFT describes three core emotional systems that govern how we experience life:

  1. The threat system – focuses on survival, reacts with fear, anger, or disgust.
  2. The drive system – motivates us to achieve goals and seek rewards.
  3. The soothing system – promotes feelings of safety, calm, and connection.

Many of us live with an overactive threat system (negative thoughts, anxiety, self-criticism) and an overused drive system (always chasing goals or perfection), while the soothing system is underdeveloped. Compassion helps activate the soothing system, bringing balance to the other two.

When you respond to a negative thought with compassion, you’re essentially saying:
“I see you, I hear you, and I choose to respond with care, not fear.”

Practical steps to cultivate compassion toward negative thoughts

Here are several accessible strategies to begin meeting your negative thoughts with compassion: 

  1. Label the thought, not yourself
    Instead of saying, “I’m a failure,” try saying, “I’m having the thought that I’m a failure,” or even “I’m having a negative thought.” This creates distance and allows space for reflection and care.
  2. Use a soothing voice
    Speak to yourself as you would to a friend or a child in distress. You might say:
    “This is hard. You’re feeling overwhelmed right now, and that’s okay. Let’s take a breath and slow down.”
  3. Get curious
    Ask yourself:
    “What is this thought trying to protect me from? What does it need?”
    Often, negative thoughts stem from past wounds or unmet emotional needs.
  4. Practice compassion imagery
    We can also use visualisation to help access compassion. Imagine a compassionate figure—real or fictional—who sees your suffering and responds with love and understanding. Imagine what they would say to you right now?
  5. Anchor in the body
    Physical gestures, like placing a hand on your heart or face, can help signal to your brain that you are safe. Pair it with a calming breath and a kind phrase like,
    “May I be kind to myself in this moment.”

Compassion is a practice, not a quick fix

Meeting your inner critic with compassion won’t erase negative thoughts overnight. But it does change your relationship with them. You gradually stop being at war with yourself and start becoming a caring presence in your own life. While this practice may seem simple, it can be challenging to carry out, and we may not be fully aware of the scope of our negative thoughts. Working with a psychotherapist can help to understand our negative thoughts and aid in bringing more compassion to our inner worlds.

It’s important to remember that you are not your thoughts. You are the awareness behind them—the one with the power to choose how to respond. When you choose compassion, you create a more grounded, kind, and resilient space within yourself

That’s where healing begins.

 

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 at our Lewes clinic and also works online.

 

Further reading by Dr Simon Cassar –

Understanding exercise addiction

Can Buddhist thinking help with our emotions?

Exercise and mental health

Are you too sensitive?

Is spirituality an escape from reality?

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Beyond the label: Rethinking assessment and diagnosis in psychotherapy

The rise in diagnosis

Talking therapies are a well-established means by which we think about and work with mental health. They don’t sit in a traditional clinical framework where we think of consultation, diagnosis and treatment. They offer a much more nuanced approach which breaks down the dynamic of specialist and patient. It is more about being able to reflect and think together, than being diagnosed and offered a treatment pathway.

The insight that we all now have into health and wellbeing means that we can have a much greater awareness of what is going on for us. This crosses over into mental health and raises the notion that we can explain, by diagnosis, what we think, feel and observe in ourselves as a category of medical disorder. For example, we see depression described as being due to low levels of serotonin, as opposed to a reflection of life experiences. We seem to be both biologising and pathologising mental health and behavioural disorders in ways that are more clinical and definite.

The increase in mental health awareness has corresponded with a rise in the number of people being diagnosed with a mental health condition. According to The Journal of Child Psychology and Psychiatry, between 1998 and 2018 the rate of diagnosis of autism rose by 787% (Russell et al., 2021). This is not a reflection of a rise in the numbers of people with autism, more that we are much more likely to consider such conditions.

In psychotherapy, some individuals are interested in mental health assessments. The hope that what we feel and experience and how we behave, can be explained by a diagnosis.

How we feel, think and behave can be both the thing that makes us feel connected to others and ourselves, or the reason why we feel separate and ‘othered’. Not being able to make sense of this and the feelings that this gives rise to, is a strong motivation to explore.

What would a diagnosis feel like?

What do we want from this exploration? Are we looking for a diagnosis or just some more understanding? In  thinking about this, we need to ask what a diagnosis would feel like. Does being diagnosed with a clinically recognised condition help to make sense of how one feels, or is there a fear of such knowledge? In knowing that we have a recognised condition, do we feel labelled? If one were to find that a condition that fit with your own experiences and feelings, what would that knowledge be used for? It would be easy to attribute one’s feelings and behaviour to the diagnosis. In other words, ‘I do this, because I am…’.

As in a clinical model where diagnosis is followed by a curative process, surely, we should be seeing any  identification of a condition in the same way? The diagnosis is treated as the beginning of a way of learning how to live with the condition.

Psychotherapy after a diagnosis

Psychotherapy offers an opportunity to go beyond the confines of a diagnosis and focus on the individual as a whole. While clinical diagnosis often categorises and characterises someone’s experience in terms of symptoms and behaviours, psychotherapy focuses on understanding the emotional, psychological, and social factors that contribute to a person’s mental health. It creates a space for individuals to explore their feelings, thoughts, relationships, and behaviours.

One of the strengths of psychotherapy lies in its ability to complement clinical diagnosis. While a diagnosis can provide a concrete framework for understanding a person’s mental health, psychotherapy allows for the exploration of how that diagnosis plays out in the person’s life. For example, a person with a diagnosis of depression may benefit from understanding how their past relationships, family dynamics, and personal beliefs have contributed to the development of their depressive symptoms.

In therapy, individuals can work through the impact of their diagnosis in a way that feels developmental rather than limiting. By reflecting on themselves and examining their perspective, individuals can start to consider how to live with their diagnosis.

Psychotherapy is about self-reflection, distinguishing it from treatments like medication that primarily focus on alleviating specific symptoms.

It’s not uncommon for people to feel anxious, overwhelmed, or even ashamed after learning that they have a mental health condition. Therapy provides a space to process these feelings and move forward with a deeper sense of how we relate to ourselves and others.

 

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

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

 

Further reading by David Work 

Wearable tech: when is there too much data?

In support of vulnerability

Trauma and the use of pornography

Reflections on bereavement

Compulsive use of pornography

 

References –
Russell, G., Stapley, S., Newlove-Delgado, T., Salmon, A., White, R., Warren, F., Pearson, A. and Ford, T. (2022), Time trends in autism diagnosis over 20 years: a UK population-based cohort study. J Child Psychol Psychiatr, 63: 674-682.

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When life shifts without warning: finding your way through unwanted transitions

After many years of hard work, when life was finally falling into place, does it feel like everything is suddenly changing? That you’re blinking into a life transition you neither asked for nor saw coming?

In this article we’ll be discussing life transitions: how they can challenge us at a deep and even existential level, how our natural response can be to resist at all costs, the opportunities this process offers that we don’t necessarily see, and how we might better navigate this process.

The shock of change – even when expected

Many of life’s transitions are a common and known feature of the human experience, whether in middle-age, as we approach retirement or, in fact, at any other time across a lifespan. However, this logical view doesn’t really help us understand how we ourselves experience these seismic shifts.

The lived experience of a transition is often unexpected, if not a shock, arriving when we’re focused on something entirely different. Many of the fundamental building blocks we’ve nurtured and lovingly grown in our lives can suddenly feel threatened: our relationships, our work, our identity, our health. Each transition is different and unique, but at their most extreme they can feel like everything we’ve built is suddenly being washed out to sea – and all we can do is stand on the shore and watch it unravel.

Resisting the tide: why we push back against change

It’s therefore not surprising that these unplanned-for life changes can make us feel giddy and fearful. Instead of enjoying the fruits of all our life’s work, we’re desperately trying to hold onto what hasn’t already been swept away, worried about where it will all end.

The truth is that we’re being confronted with the need to accept that the life we’ve known is now changing course, as if it had a mind of its own. And the future we thought we knew, we now realise we don’t. And as our worries deepen, our daily life can drain of colour. So, it’s not therefore surprising that we throw everything at stopping this uninvited invader; we dig in to resist change at all costs.

And yet, building up high walls to defend ourselves from change doesn’t work either, and will only cause us more pain. We simply can’t stop the transition happening, no more than we can stop the incoming tide. It therefore serves us better to work with and not against transitional change, though this can feel counterintuitive initially.

This isn’t to diminish the difficulty you’re currently experiencing, but the reality is that by engaging with the process you’ll waste less energy fighting it, and you’ll be more likely to benefit from its opportunities. It’s just difficult to see these opportunities when you’re crouched down in your bunker.

As fearsome as the transition might look to you right now, by working with it, it becomes easier to manage and more easily offers up its insights. Such as starting to see what’s really happening to you, seeing past the fears that preoccupy you, understanding yourself in new and deeper ways, and better equipping yourself for what lies ahead.

The role of psychotherapy when life shifts without warning

The aim therefore is to take an active part in navigating this vital transition. By breathing in and stepping into the process it is more likely to open up to you and present its riches. And there will be riches. Yes, there will also be difficulties to deal with, but it is through working with them that they will lessen and dissipate, enabling you to move forwards. This might sound easier said than done but this is where psychotherapy can play a crucial part.

The role of the psychotherapist is to be alongside you through this process, as you start to navigate your way, keeping you steady in choppier waters, and open to receive and make sense of what emerges. In this way, a transition is about learning to engage with where you are now, understand your experience in ways that better
help you, see the options available to you, and decide how you want to proceed.

Therefore, an active engagement with this vital process can enable you to steer your own course as you enter this new chapter in life.

 

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

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman

What is the role of creativity in psychotherapy?

No space to be heard?

Does your life story make sense?

When something has to change

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Why do boundaries matter in psychotherapy groups?

The importance of boundaries in psychotherapy

I think it’s probably fair to say that all models of psychotherapy view boundaries as important. Analytic therapies particularly emphasise the role of boundaries and see them as integral to the psychotherapeutic process.

There are many ways of understanding why boundaries are crucial. When I reflect on my work as a therapist, I particularly think about how boundaries seem to offer containment, safety and consistency. These conditions seem vital for many reasons, not least because many people who enter therapy have not had them met sufficiently in their childhood.

In one-to-one therapy, it is the therapist who is responsible for holding the boundaries and keeping the work feeling safe and contained. For example, you can reasonably expect that the therapist will be on time to sessions, will aim to give plenty of notice for cancelled sessions (except obviously for emergencies like sickness), will keep the things you share and your identity confidential. It would also be reasonable to expect that the therapist will not be eating food or drinking anything other than water in the session and not be under the influence of drugs or alcohol. Most models disapprove of therapists making any physical contact with you – so no hugging or touching. And of course, essentially, the therapist must not confuse or abuse the relationship by becoming, or trying to become, something else, for example a sexual or romantic partner, friend, confidante or fellow patient.

Not only do boundaries offer a particular containment to the therapeutic work, how a patient might respond to them will also provide information and insights. This can prove useful for helping to understand ways in which they might struggle in the present or how boundaries (or perhaps lack of) were experienced as a child. Sometimes when people challenge boundaries in therapy, they are really trying to check that they will hold.

While therapists will regularly find boundaries pushed in individual work, overall, those who have had sufficient training and are working ethically, and in a patient-centred way, are generally able to keep the boundaries intact and the work secure and contained.

Boundaries in psychotherapy groups

In a group, keeping the therapy and members feeling contained becomes more complicated and the role of holding the boundaries can’t just reside with the therapist.

Before joining a group, potential members are asked to consider and commit to maintaining the group’s therapeutic boundaries. These are pretty much the same as those outlined earlier. In addition, keeping relationships safe and protected is helped by an explicit boundary of not having contact outside. Sometimes this isn’t possible for various reasons. In this situation, members need support and help from the group and therapist to maintain enough personal distance outside the group so they can keep themselves and the group feeling safe.

These boundaries are not rules for group members (there are no consequences to breaking them – within reason at least), but it is understandable that they can feel like it. Some of these boundaries are more obvious and easier to adhere to than others. For example, I have rarely experienced a group member under the influence of alcohol or drugs during a session and my experience is members are also very respectful of the need to protect each other’s confidentiality.

Where the boundaries become harder to maintain is more likely to be around repeated cancellations or lateness, or leaving the group without the required notice period. Also drinking coffee, tea or juice in the session, as opposed to just water, is in my experience not an uncommon boundary flouting. It’s harder perhaps to register the importance of these kinds of boundaries being held and to see why it matters. It can feel difficult for group members to question when they are being pushed by someone in the group. It’s easy perhaps to feel that they are making a fuss or doing something that is really the therapist’s ‘job’.

Because in group therapy there is more than one patient, there are multiple possibilities of boundary reactions and breaches, sometimes simultaneously. The group can feel the unsteadiness this creates at times. The therapist and the group members need to hold firm to help the group feel safe enough. The best way to do this is to name and talk about those times when members might test or push at the boundaries and explore the impact on the group, as well as the meaning for the individuals.

The aim, however, is not for members to never push boundaries (although it is a reality that some group members feel less compelled to than others). A group situation with no boundary challenges is unrealistic and, given what can be learned, not necessarily always helpful.

The theory underlying group analysis sees problems as belonging to the group, not just located in the individual member, and so anyone shaking the group boundary will be viewed as not just acting something out on their own behalf but also – more unconsciously – on behalf of the group. The culture of the group analytic therapy group, which includes being curious, means there is rich and therapeutic potential in thinking about the meaning of a boundary push on several levels – what it means for the individual, for the other group members and for the group as a whole.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.  She also offers couples therapy at BHP.

 

Further reading by Claire Barnes –

What is transference and why is it important?

What happens in groups: free-floating discussion

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

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Is starting psychotherapy a good New Year’s resolution?

Most of us make some sort of New Year’s resolution, whether overtly or covertly.  The new year can feel like an opportunity to put the past behind us and to start afresh.

Whether or not we actively name and own our New Year’s resolutions, most of us can also attest to the best held intentions for change slipping away. There are plenty of good reasons why New Year’s resolutions don’t work. We are often too unspecific in what would constitute change, and it can be hard to make change on our own.

Psychotherapy is about change.  However, the start of all change comes from inside. To make change, we need to understand ourselves and accept why we have made the decisions we have. Nothing is random.

Psychotherapy is first and foremost about learning to have a relationship with ourselves and to learn to hold ourselves in mind, often in ways others failed to do when we were growing up. When we hold ourselves in mind, we can objectively evaluate if something is helpful or in our best interests.

We learn to hold ourselves in mind through others holding us in mind. This is one of the main roles of a psychotherapist. Holding a client in mind is far broader and deeper than simply making notes and remembering what they told us. It is about having a relationship with them and helping them to understand their blind spots, their relational patterns to themselves and to others. Helping them work through this is the therapeutic encounter.

Psychotherapy is often hard. Keeping to a weekly day and time when we meet with our psychotherapist can feel like a slog. Unlike a New Year’s resolution, the process is held relationally. Your psychotherapist makes the time and space available to hold you in mind and expects you to show up for the weekly dialogue. Even if you do not attend, your therapist is there to hold you in mind.

Perhaps the question is not so much whether psychotherapy is a good New Year’s resolution. Rather, it may be whether you are committed to having a deeper and more meaningful relationship with yourself, and through this, learning to hold yourself better in mind. The latter will lead to long-lasting changes on a profound level which may or may not include more frequent trips to the gym!

 

Happy New Year from all of us at Brighton and Hove Psychotherapy.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further Reading by Mark –

How do you get self esteem?

Why is psychotherapy generally weekly?

Why we should be disappointed

What is a growth mindset?

Don’t tear down psychological fences until you understand their purpose

 

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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What is the role of creativity in psychotherapy?

In this article, I discuss creativity as foundational to being human, how it enables an emotionally and psychologically fulfilling life, and its relationship with psychotherapy.

Everyday creativity

When we think of creativity we tend to think of world-renowned artists such as Leonardo da Vinci, Picasso, Mozart. This, however, is a very narrow interpretation of creativity and perhaps illustrates an unfortunate common belief: that only a select few people are creative. This is simply not true. Though not everyone follows the path of the professional artist, all humans are nevertheless creative. This is powerfully illustrated by observing children at play, where curiosity and imaginative make-believe are both instinctive and joyful.

As we develop into adults, however, our relationship with creativity changes. Instead of playing inside a castle we’ve made out of bedsheets, our creativity often focuses on more practical issues, such as ideas for dinner using what’s in the fridge, how to find a holiday in the sun we can afford, how to deal with a friend we’ve fallen out with. This means that we spend much of the day using what we might call ‘everyday creativity’ to navigate the problems and opportunities we encounter.

And yet, even though we rely on this intrinsic creative ability, we often don’t see the crucial role it plays in getting us through the day and its influence on our fulfilment in life, which in turn often means we don’t fully explore our creative potential.

Self-understanding

To respond creatively in a way that enables us to thrive, we first need to understand ourselves: our experience, our needs, our problems. For example, how to make sense of challenging experiences we’ve tried hard to hide from ourselves? The confusing difficulty with an important relationship? Issues we repeatedly struggle with?

Without this self-understanding, we can try to respond creatively, but as we don’t know what need we’re trying to fulfil and we don’t know how we’ve been going wrong to date, we’re likely to keep trying new solutions which don’t make us feel better.

This has the mistaken side-effect of making us believe that our creativity doesn’t provide the answers we need.

Creativity enabled

But if we develop self-knowledge, our innate creativity can start to work better for us and get our needs met. For example, we might start creatively exploring deeper questions such as childhood trauma. This in turn could change our relationship with the trauma and its impact on our lives now. Or we might come to understand what we’re not happy about in a long-term relationship and creatively explore ways of improving or changing that relationship.

How therapy can help

Psychotherapy embraces creativity in two fundamental ways. Firstly, it aims to help you understand yourself better – to connect with your authentic, creative self. This is the inherent part of you that makes you you, and enables you to respond to life in ways that are aligned with what you believe or feel to be true.

Secondly, psychotherapy develops creativity through its own creative process: where you learn to explore and be open to your own internal world of experience, thoughts, and feelings. And you learn to be open to new possibilities within yourself, developing into a new self-understanding.

It is from here that deeper resources of creativity often come online: seeing experiences and relationships in fresh ways, being more open to emerging experience, responding spontaneously to the moment, being less held back by habitual fears and more prepared to try something new.

The potential impact

The impact of being more tuned into and aware of your own experience and more connected to your creative self are significant and multiple. You will likely be more resilient to problems you encounter, know more about what is and isn’t working for you, and trust and listen to your own internal creative responses. This can positively affect your relationships, your own mental health and wellbeing, and your own fulfilment in life as you positively engage with the creative process of personal change and growth.

What’s the takeaway?

Psychotherapy aims to help you establish and deepen a connection with your creative self which enables you to be more you, to use your own powerful and innate creative resources, which in turn enables you to respond to life in a way that better meets your needs.

 

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

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman – 

No space to be heard?

Does your life story make sense?

When something has to change

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Is an AI therapist as good as a human one?

Two articles, one written by a human therapist and the other by a chatbot – can you tell which is which?

Part one: The human touch: why a human therapist outshines an AI therapist

In today’s rapidly evolving world, technology continues to reshape various aspects of our lives, including mental health care. With advancements in artificial intelligence (AI) and machine learning, AI therapists are increasingly being developed to offer therapeutic support. However, despite the technological strides, there are fundamental reasons why a human therapist remains irreplaceable and superior in many aspects. Let’s delve into why the human touch in therapy is invaluable.

Empathy and emotional connection
One of the cornerstones of effective therapy is the therapeutic relationship built on empathy and emotional connection. Humans possess a unique ability to empathise deeply with others, understanding their emotions, experiences, and struggles on a profound level. A human therapist can provide genuine empathy, validation, and support that AI, with its algorithms and data processing capabilities, cannot replicate.

Individualised and flexible approach
Every person is unique, with distinct backgrounds, experiences, and complexities. Human therapists tailor their approach to meet the specific needs of each client, adapting their methods based on individual personalities, cultural backgrounds, and therapeutic goals. This personalised approach allows for flexibility in therapy sessions, accommodating the ever-changing dynamics of human emotions and circumstances.

Complex emotional understanding
Human emotions are intricate and multifaceted, often defying straightforward algorithms or predefined responses. A human therapist possesses nuanced emotional intelligence and intuition honed through years of training, experience, and personal growth. They can navigate the complexities of human emotions, such as grief, trauma, or existential crises, offering nuanced insights and interventions that resonate deeply with clients.

Contextual understanding and judgment
Therapeutic interventions often require a deep understanding of the client’s life circumstances, relationships, and societal contexts. Human therapists can contextualise their therapeutic insights within broader social, cultural, and ethical frameworks, ensuring that interventions are not only effective but also culturally sensitive and ethically sound. They exercise professional judgment in guiding clients through ethical dilemmas, moral
quandaries, and complex decision-making processes.

Collaborative and reflective process
Therapy is a collaborative journey between the therapist and the client, characterised by open dialogue, reflection, and mutual exploration. Human therapists engage clients in meaningful conversations, encouraging introspection, self-discovery, and personal growth.

They facilitate a safe and non-judgmental space where clients can explore their thoughts, emotions, and identities, fostering profound transformative experiences that extend beyond mere symptom relief.

Conclusion
While AI therapists have their merits in providing accessible and immediate support, they lack the essential qualities that make human therapists indispensable in the field of mental health care. The human touch—embodied in empathy, emotional connection, personalised care, and nuanced understanding—enriches the therapeutic experience and enhances therapeutic outcomes. As we continue to embrace technological advancements, let us recognise and celebrate the enduring value of the human therapist in promoting healing,
resilience, and well-being in individuals and communities worldwide.

In your experience, what qualities do you value most in your interactions with a human therapist? Share your thoughts and reflections in the comments below—I look forward to hearing from you!

 

Part two: Would you rather have a human therapist or an AI therapist?

What is AI?
My limited understanding of AI, or machine learning, is that it is basically binary code developed into software commands, engineered to perform a function. This function operates to access as much digitised linguistic content as exists on the internet, based on the capacity or server space available. It collates the collection of words, then follows a process of arranging them in such a way that can simulate or mimic meaning and
understanding. Parrots can do this well, mimicking human words. Cats and dogs also do this, albeit their vocalisations are less human sounding, but I would argue they can still effectively convey meaning and emotion.

What is a human?
A human operates in spatial, biological, physical and psychological dimensions. We collect sense data from our environment, sight, sound, touch, scent, taste. Our nervous systems are linked to the world around us not via words, but by virtue of having a myriad of experiential, physical interactions. These interactions in real life present our nervous system with immense data, that we live as senses, feelings, emotions in a process that inspires language, thought, relationship and communication. We absorb them in our memories, our unconscious, our souls, our psychology, our sensing bodies. We are infinitely more varied, intricate and experienced in the process and function of our sensing, feeling and thinking than any simple programme which has appropriated, without any experiential capacity, the poor currency of language.

What is therapy?
Therapy is an art, a craft and a science. It is what happens in the relationship between two humans, the client and the therapist. Therapists train for up to eight years and whilst in training have to undertake their own therapeutic journey, often meeting their therapists up to three times a week for the duration of their training. In a letter to Carl Jung, Freud wrote: ‘psychoanalysis in essence is a cure through love’. In the book A General Theory of Love, the authors write: ‘Psychotherapy changes people because one mammal can restructure the limbic brain of another… The person of the therapist will determine the shape of the new world a patient is bound for; the configuration of his limbic attractors fixes those of the other. Thus, the urgent necessity for a therapist to get his emotional house in order. His patients are coming to stay, and they may have to live there for the rest of their lives’.

Where would you rather reside, lost in a remote, binary, virtual cyberspace, or secure in the hearth of a human soul capable of resonating with the depth of your experiential humanness?

Therapists simply act as the guardians of your process, choose yours wisely.

 

Shiraz is a Training Member of the Association for Group and Individual Psychotherapy (AGIP) and a registered Training member of the UKCP. She is experienced in Psychodynamic counselling and Psychoanalytic Psychotherapy work with individuals, on both long and short term basis.

Shiraz works from our Brighton and Hove practice, Lewes practice and online

Further reading by Shiraz El Showk –

What is the unconscious? (part one)

Why is three the magic number? Third spaces, secure bases and creative living (part two)

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Why is psychotherapy generally weekly?

All forms of psychotherapy, from the classically analytical, through to humanistic, evolved from psychoanalysis and thus Freud. The cadence of psychoanalysis has changed very little over the years, with sessions taking place between three and five times per week, generally at the same time each day.

Psychotherapy evolved directly from analysis but is also quite different. For example, those who are suited to psychotherapy may not need analysis, and in cases of more troubled or disturbed patients, weekly psychotherapy may not be sufficient and psychoanalysis is recommended. However, despite the frequency difference, the consistency remains the same.

Those who are trained in-depth and adhere to the principles of the psychotherapeutic framework, which is to say all the non-verbal factors that enable the process of psychotherapy to take place, will also subscribe to seeing their clients or patients on the same day, at the same time each week. But does it have to be this way?

There are psychotherapists who see their patients less frequently than weekly and that includes those who work at depth, and/or analytically. The most obvious example is those who work with couples where the frequency of sessions is less critical, or tapers off towards the end of the work.

There are, of course, therapists who see individual clients on a less than weekly basis, however, with one or two possible exceptions, this is not something I or most colleagues would advocate.

There is significant emotional and psychological benefit to sessions being consistent, and something the patient comes to rely on in terms of where it sits in the week. In the same way the clinician makes space in their diary, and time in their mind, available for that patient, the session being on the same day and time each week allows the patient to do two things – start to hold themselves in mind, and start to bridge the gap between sessions.

Psychological change is slow and it is hard. This is not the same as behavioural change which may be tough but is something that can in simple cases be achieved through working on a superficial level. However, behavioural change, whilst important, says little about the underlying reasons why a person ‘does what they do’ – the unconscious process. And it is in the unconscious that the trauma lies.

Bridging the gap between therapy sessions can be hard for patients – to be able to hold on to not only the content of what was discussed, but more importantly the relationship between their therapist and themselves. Bridging the gap means being able to hold on to the experience of ‘being held in mind’ and therefore not falling back into feeling hopeless and alone in the world. For some patients this is a particular challenge and a more frequent schedule of psychotherapy is agreed, such as twice-weekly sessions.

For the patient, the regularity of the session being on the same day and time each week is something that becomes a part of their weekly routine – something that they can rely on and expect. That is not to say that patients look forward to sessions each week, but simply that come rain or shine, they are something that happens and is consistent.

An analogy I like when thinking about the cadence of psychotherapy sessions is that the weekly session is like keeping the kettle gently on the boil – any less and the kettle goes cold.

Each clinician works differently and tailors their approach to each patient, which is also why the concept of an ‘approach’ is something of red herring. A clinician is either trained to work at depth and with the unconscious, or not. With me, psychotherapy is at a minimum weekly and on the same day and time each week. And it is open-ended, meaning that it goes on for as long as it is clinically appropriate for it to go on for, which is generally many months and often years.

 

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

 

Further reading by Mark Vahrmeyer –

Why we should be disappointed

What is a growth mindset?

Don’t tear down psychological fences until you understand their purpose

How do I become more assertive?

I worked as a psychotherapist with death. Here’s what I learnt

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When a solution is not the answer

Often people come to therapy in some kind of emotional pain. This might be acute or chronic or both. Understandably, they want to feel better. Sometimes, for some, this desire can feel very urgent. Reassuringly, many people find their distress dissipates with surprising speed almost as soon as they start therapy. Bringing your upset to someone who can listen and engage with it attentively and compassionately can impact quickly as a pain relief. Work can then begin in untangling the difficulties that have led to the painful situation the person finds themselves in.

For some, however, the pain stirs up so much anxiety (or, high levels of anxiety are driving it, or both) that it feels difficult to allow this process to take its course. In my experience this dynamic often manifests as a desire for solutions above all other help. These ‘solutions’ can often be seen, consciously or unconsciously, as a means of getting rid of feelings that are deeply lodged internally. What almost always accompanies the desire for a solution is the desire for it to be speedy. The ‘solution’ in this sense seems to be a quick fix that side-steps painful feelings and thoughts. Often, it seems, it is experiences and memories from the past that must be avoided.

It is of course true that some people do come with problems that can be and are addressed in a short time frame. For example, an acute experience, such as a bereavement or other kind of adult trauma, can often be simply and quickly contained and processed, providing that there is no underlying complexity created by earlier losses or traumas. Or, some people come to therapy for help with a difficult dilemma or needing help in making sense of things as they go through an upsetting experience, such as a break-up or redundancy. For young people, learning how and when to assert independence is very important and so short-term therapy, for many, can be the best intervention at this life stage. There are many, many examples where short-term work*, that has a clear aim, is the most appropriate help to offer.

However, there are also many examples where it is not.

When someone approaches me as a psychotherapist, I initially assess what they might need and if I am able to help. A key factor in working this out is deciding what seem to be the underlying traumas and complexity to their issue/s. I also ask myself to what extent (or not) is their current problem a symptom of something deeper and more complicated and/or part of an emotional pattern. Thinking about these elements contributes to my assessment about whether the problem/s may be addressed in a short time frame or may need longer term help. Sometimes, of course, I will misjudge or something changes and a long-term piece of work finds a natural conclusion early on or in short-term therapy, something emerges which indicates longer term help is needed.

Earlier in this blog I described how I see wanting a solution through therapy as potentially a defence against painful feelings. There are also other ways it is problematic. Firstly, it supposes a neatness to life that is rarely borne out. This is very much the case where emotional and relational problems are concerned. Secondly, most therapies centre on a journey of some form around self-discovery and exploration, and this process is an essential aspect of the work. Skipping steps and jumping ahead to a solution is not only often impossible but can be countertherapeutic and counterproductive.

Many of us live in a world where it has become increasingly possible to find solutions to problems quickly and this has become a valued aspect of our modern life. This has perhaps normalised an expectation that our emotional lives and difficulties should be dealt with the same immediacy and solution focus. This is of course also understandable when those problems leave us feeling distressed and overwhelmed. Some difficulties can be met within shorter time frames but, in many cases, they are manifestations of deeper, complicated and longstanding difficulties and trauma. At these times, finding a quick solution is not the answer.

* I define short-term work as anything between four to six weeks and three months.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.  She also offers couples therapy at BHP.

 

Further reading by Claire Barnes –

When a solution is not the answer

What happens in groups: free-floating discussion

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

A new psychotherapy group

 

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No space to be heard?

When life feels like it’s getting on top of us, it can feel like there’s no space for our thoughts and feelings to be heard. This can make us feel isolated, and the problems we’re trying to deal with seem a lot worse. This points to the core of what therapy offers: physical and psychological space where you can voice your problems and feel meaningfully heard and understood.

This article aims to introduce some of the different types of space we use in therapy and how they might help.

Trusted space

The consulting room where the therapy takes place is separate from your everyday life, free from interruptions and what’s said there is confidential. This aims to provide a safe, non-judgemental space you can have faith in.

Coupled with this, you will have chosen a therapist who you believe to be a skilled and empathic professional. Feeling comfortable and confident with your therapist is key to a successful outcome. As this understanding between you develops, you will increasingly feel open to discuss in-depth the problems that brought you to therapy.

Space to explore

From this foundation, therapy is able to move into an exploratory space, where you and your therapist work together to listen with curiosity and compassion to the feelings and experiences that you’ve often kept hidden.

As the work deepens, you are likely to connect more fully with your current emotional difficulties, and also with earlier, often buried experiences. It’s common to start feeling heard and understood in a new and profound way. This alone can have a powerful impact.

Potential space

Old patterns, often learned deep in the past, start to show themselves. There can be a sense of more space opening up between you and previously overpowering feelings.

This often brings emotional and psychological relief, while showing different ways of seeing problems and understanding how you might approach them.

The British psychoanalyst, Donald Winnicott, coined the concept ‘potential space’ to refer to a transitional area that lies between fantasy and reality in therapy, where therapist and client start creatively considering new and different options. Not only does this enable fresh insights and understanding but it starts opening up new possibilities for the future.

Space to take away

The course of therapy not only provides a space once a week for the therapy itself, but increasingly develops an internal space – within you. Through your experience of therapy, you develop the capacity of internalising not only your new understanding of the problem you’re working on, but also how to understand yourself in the face of problems you may encounter in the future.

Therefore, this internal space not only gives you more understanding of your patterns, relationships and needs, and the ability to manage feelings and respond more constructively in the present, but you get to take this internal space away with you, to refer to and use whenever it is helpful to hear yourself, know what you think and feel, and envision what might be the way forward. This is perhaps therapy’s biggest gift.

Opening a space

With our lives putting ever-growing demands on us, we can be under pressure to act unconsciously and repeat unhelpful patterns. Therapy offers us the opportunity to do something different: to give ourselves a moment to pause, to listen to what we really think and feel, and see how we might adapt to be more in line with ourselves, and feelmore fulfilled.

Viktor Frankl, the existential psychotherapist and Holocaust survivor, wrote in his book Man’s Search for Meaning: ‘Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.’

 

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

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman

Does your life story make sense?

When something has to change

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