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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.

 

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 with us by telephone or email.

 

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

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Filed Under: Mental Health, Psychotherapy, Sam Jahara Tagged With: Mental Health, Psychotherapy, psychotherapy services

October 19, 2020 by BHP Leave a Comment

Why does the difference between counselling and psychotherapy matter?

What a difference a year makes. For all of us the world is an inconceivably different place to a year ago. Not only are we all living with greater uncertainty, we have all had to enormously adapt to living, socialising, relating working, and not least, having therapy in a different way.

Almost exactly a year ago I wrote a blog on entitled ‘The Difference Between Counselling and Psychotherapy’, which has received some traction. More recently, the age old question pertaining to the difference between these to related disciplines has come bursting forth through a collaborative project SCoPEd project which seeks to set out training requirements and practice standards for counselling and psychotherapy. This project is receiving a lot of attention
(accompanied by fierce criticism) by many in the ‘talking therapies’ field. I have no wish to get drawn into the intricacies and politics of the actual project but do firmly believe that from a client’s perspective, standardisation of training requirements and robust practice standards that differ between counsellors and psychotherapists can only be a good thing. More so, I believe that they are essential.

Many of my clients come to be after trying some form of ‘talk therapy’ which may or may not have been helpful. Many come because they are unclear about why they don’t feel better and have ‘stumbled’ across me and my practice via a search engine. Few really understand that there is a difference between counselling and psychotherapy and few understand what they may need and why that may be a psychotherapist.

The fact few understand this has nothing to do with the fact that there is a fundamental difference and put simply, the more I have trained and the more years of experience I have, the more cognisant I have become not only of the differences, but also of how to assess what someone needs and whether they are in fact suitable for therapy.

I have written extensively about the differences between psychotherapy and counselling in my blog a year ago and if you are interested, you can read them here. My blogs are aimed predominantly at lay people who may be considering entering into therapy, rather than at the counselling and psychotherapy community.

Why do clients need to understand the difference between counsellors and psychotherapists?           

At present the distinction (in the minds of many) is blurry. Many counsellors believe the two terms to be interchangeable and are thus aggrieved by any proposed framework that should distinguish between the two disciplines: most counsellors think they are psychotherapist; few psychotherapists consider themselves counsellors.
The distinction matters from a duty of care perspective. Deeper work with clients dealing with complex trauma, personality disturbance and psychiatric disorders requires an in-depth understanding of how to identify these issues and an assessment of our ability to work with such clients and the client’s ability to ‘make use’ of the therapy, their robustness.

Turning clients away

My practice is generally full as my work is long-term, however, when considering taking on a new client I undertake a clinical assessment of their suitability for therapy. I aim to answer the question: ‘can I help this person?’ It may seem counter-intuitive, however, I am far more likely to turn down clients pre- or post-assessment now than when I first started out as a counsellor.

Why? Because I now know what I do not know and where my limitations lie.

A GP will not undertake surgery as they have been trained in general practice. They can, however, recognise that a patient needs to see a specialist who can offer an expert opinion and in-depth complex treatment. A GP is invaluable precisely because they are aware of what they do and don’t know and work within their limitations.

This is the ethical responsibility that I believe all counsellors and psychotherapists would carry at the forefront of their minds, however, without training in formulating (our word for diagnosing) how can a clinician know what they don’t know? Herein lies the problem.

Do no harm

The Hippocratic Oath, subscribed to by medical professionals the world over applies to us too.  In trying to help (rescue, fix, therapise, relate to) a client, unless we are acutely aware of what we are dealing with, we can do more harm than good.

Is there a place for counselling?

Unequivocally yes. Counselling is enormously beneficial and most psychotherapists started their careers as counsellors in some capacity. Counselling is often all a client needs and it can bring about enormous change for many. However, it is not appropriate for more complex or serious relational or personality disturbances.

In turning clients way it is not solely or even frequently because their requirements lie beyond my abilities; I often suggest to prospective clients that counselling may be more appropriate for them, especially if they have no prior experience of ‘talking therapy’ and are wanting to work through a time-limited issue.

And beyond psychotherapy?

The clients I do turn away as their requirements lie either beyond my knowledge base or holding capacity, I do so from a position of ‘doing no harm’ and making an often tough ethical decision. It may be that that person requires psychiatric support but it may also be that their level of disturbance is best treated by a multi-disciplinary team. And then there is, of course, psychoanalysis.

Inaccessible for many – sadly as Freud saw Analysis as being something that should be accessible for the general population – provides something that psychotherapy cannot: the ability and framework within which to work at depth with powerful regression.

To summarise, the difference simply must be acknowledged and accepted between the professions for the safety and well-being of clients and patients. To do otherwise is plain hubris.

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

 

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

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Why psychotherapy sessions should end on time

Face to Face and Online Therapy Help Available Now

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Filed Under: Mark Vahrmeyer, Mental Health, Psychotherapy Tagged With: Counselling, Psychotherapy, psychotherapy services

April 13, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Why psychotherapy sessions should end on time

Boundaries are critical not only to a psychotherapeutic relationship, but, as many clients learn through therapy, are essential to healthy adult-to-adult relationships.

In a good psychotherapeutic relationship, there is a solid contract between client and therapist such that clients know what to expect and when.  And part of this knowing by the client is knowing what time the session ends; most psychotherapy sessions last for a ‘therapeutic hour’ or 50 minutes.

Door-stop moments

Every clinician has encountered what are known as ‘door-stop moments’ with clients – they happen in the moments leading up to the end of a session where a client suddenly blurts out something emotive and important that can throw the therapist and lead them to extend the session by some further minutes.

Unconsciously, door-stop moments have much significance and represent a relational process between the client and therapist.  Yes, the content may be important, however, why is it being brought into the room (and relationship) in the final moments?

The client may unconsciously want to control the session by ensuring their therapist has no time to explore the content in detail; they may wish to ‘leave’ something difficult with their therapist to hold for a week; and they may be testing whether the therapist will hold the boundaries.  Or all of the above and more.

On hiding an being found

Donald Winnicott, esteemed 20th Century British analyst famously said “it is a joy to be hidden, and a disaster not to be found”.  Winnicott was making reference to the children’s game of hide and seek, which, is only enjoyable if we imagine that someone is looking for us.  If the other game participants give up and leave, we are left hiding with nobody holding us in mind – a disaster.  In this quote, Winnicott is talking about many concepts, but amongst others he is making reference to boundaries and holding others in mind.

Even though in the game of hide and seek the winner triumphs by not being found, they paradoxically only win if the other(s) are still searching for them – the game therefore is profoundly relational and based on an agreed set of rules.

Psychotherapy is also relational at its core and based on a set of rules (boundaries).  One of these is that sessions end on time.  Clients will find all sorts of ways to ‘hide’ from their psychotherapist, however, this is only ‘joyful’ if they believe that they will be found (seen and contained).

When a client presents a door-stop moment to us, it cannot be allowed to derail the boundaries of the relationship or the rules of the game.  Otherwise the client gets what they think they want (more time) but feels omnipotent and thus unsafe with their psychotherapist – in other words, the client has hidden so well the psychotherapist has forgotten about them.

It is never about the client even though it seems it is

Extending a session due to a door-stop moment is never about the client’s needs and always about the psychotherapist’s.  The client relies on their psychotherapist to ‘hold them in mind’ and thus hold their best interests in mind.  It is the latter that gets lost when a session is extended.

How can it be in the psychotherapists interests to extend a session?

Unconsciously the psychotherapist has also ‘got lost’ and is unable to remain separate from the client’s needs.  They thus extend the session to try and ‘please’, or appease the client, which fundamentally is about avoiding the client’s anger’ rage and disappointment.  And the job of a psychotherapist is precisely to survive these feelings in their client and what it makes them feel.

Don’t become a psychotherapist if you want your clients to like you

Psychotherapy is only happening when a client feels either positive or negative feelings towards their psychotherapist (and vice-versa).  If the relationship is neutral, nothing is happening.

It is easy to bask in the glow of a client’s adoration but beware, a fall will come.  And so it should.  As psychotherapists we are not there to be liked – we are there to remain constant in the face of our client’s emotions.

And being constant means ending the session on time.

 

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 –

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Can Psychotherapy or counselling be a business expense?

The difference between Counselling and Psychotherapy

Face to Face and Online Therapy Help Available Now

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Filed Under: Brighton and Hove Psychotherapy, Mark Vahrmeyer, Psychotherapy Tagged With: Counselling, Psychotherapy, psychotherapy services

February 10, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Silences in Therapy

Silences are an inevitable and potentially helpful part of the therapeutic process. However, a number of people I see as a therapist express a feeling that they are not getting something right when a silence arises in our work together. The psychotherapy world (in particular the psychoanalytic and group analytic fields) has also had some difficulties historically with accepting the value of silence.

A few years ago, I wrote about silence in relation to group analysis (Barnes, 2015) I felt compelled to do this as I had been working with a psychotherapy group that was gripped for some time by long, crippling silences. These silences affected the whole group and were intensely paralysing – for the group members and for me. I found it hard to help the group but also wasn’t helped myself by the general absence of clinical literature on this subject.

In my paper I made a case for the value and role of silence in therapy and specifically therapy groups. I explored how silence is a part of speech and that all speaking relies on pauses and breaks for our communications to make sense (this is, perhaps, most obviously understood in music). These rhythms and patterns in our communications are particularly important and central to the processes of therapy.

By just seeing silences as unhelpful we lose the opportunity to be curious about the different kinds of silences and what they might mean.  Below are some of the kinds of silences that can come up in the therapy relationship.

  • A common silence in therapy arises when both therapist and patient, or members of a therapy group, pull away from verbal interaction and retreat into a more internal space. Often, in my experience, this is when a discussion then moves onto a deeper level.
  • Sometimes silences are used to protect from scrutiny. Using silence as a defense can be bound up with early experiences of intrusion or a difficulty in asserting one’s self in interpersonal relations – the only protection then is to withdraw.
  • Then there is the paralysed silence, like the one that seemed to incapacitate my group for so long. People often say they can’t think in this kind of silence. When we’ve explored it more it seems they feel increasingly self-conscious in the silence and under pressure to break it – like it’s all too much responsibility. This seems to me bound up with shame.
  • But sometimes words just fail and just don’t feel enough. Silence can be used to convey this. Or to show a respect for the enormity of what is being felt.

In thinking about silence and speaking it’s also important to bear in mind the thoughts of French psychoanalyst Andre Green who pointed out how “behind the noise of words speech can be silent” (Green 1972). At times we talk in order to silence something uncomfortable, or just too painful.

Holding a silence can be a way – perhaps sometimes the only way – of staying with what feels difficult and communicating this.

References –

Barnes 2015 ‘Speaking with Silence. An Exploration of Silence and its Relationship to Speech in Analytic Groups’, Group Analysis, Vol 48 number 1

Green 1972’ On Private Madness,’ reprint Hogarth Press 1986

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.

 

Further reading by Claire Barnes

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2

What is loneliness?

50 years on, how free are we from homophobia?

If you don’t like groups, could it be time to join one?

Face to Face and Online Therapy Help Available Now

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Filed Under: Claire Barnes, Groups, Mental Health Tagged With: group psychotherapy, group therapy, psychotherapy services

March 18, 2019 by Brighton & Hove Psychotherapy Leave a Comment

What is Relational therapy?

A central idea of relational psychotherapy is that our thoughts, feelings and behaviours (healthy and unhealthy) are directly related to our interpersonal relationships. It is therefore about our self-with-other experience. We are all creatures of familial, social and political contexts, continuously formed (and forming) through our interactions with others.

Relational therapy can be an effective treatment for a whole range of psychological and emotional problems, understanding as it does that so many of them are rooted in troubled relationships past and present. Telling one’s own relational story in the presence of a carefully attuned empathic listener can be a powerful experience, generating shifts in self-understanding and ultimately in symptoms.

Not a medical model.

A relational therapist is not a doctor, there to administer a cure to someone’s emotional pain. This may seem disappointing to some clients. Rather s/he is a fellow human being, ready to engage with and understand the longings and the losses, the hopes, fears and struggles that might have brought a client into therapy.

Not individualism.

Relational therapy does not hold with the notion that each of us is responsible for our own happiness. It rejects the tyranny of self-help models that suggest that it is only by “working” on ourselves will we claim our power, increase our self-esteem, become fully evolved etc.

Instead it believes that we all need good connections with others in order to feel good about ourselves. Individual power, agency and wellbeing are only achieved in the context of healthy interpersonal connections.

Not Rationalism.

Relational therapy does not subscribe to rational, linear, cause and effect explanations of how change happens. We are complex systems of thoughts, feelings, beliefs, self-states and energies, all interconnected. Relational therapy takes a systemic, non-linear view of change. Having a new experience of oneself in the context of the therapeutic relationship may lead to new experiences of self and others outside of therapy as well.

Who needs Relational Therapy?

Anyone who has questions like “How do others see me?” “Am I good enough for them?” “Am I worthy enough?” might consider seeking a relationally oriented therapeutic approach. When your own answers to the questions above aren’t good, you feel bad about yourself and when you feel bad about yourself you are diminished.

A relational therapy will look at your everyday relationships with people in your life right now and seek to understand what it is that happens there that leaves you feeling bad about yourself.

Understanding the (repetitive) patterns of feeling bad in your life might be a reminder of earlier relationships. Consideration of these earlier relationships may help in developing an understanding of the sense you made of them, the sense of who you are and what you’re worth.

The here and now relationship between therapist and client is also kept in mind and attended to as part of a relational approach. As a relational practitioner I am always noticing the subtle shifts within and between myself and my client(s). The moments when a client might feel misunderstood or judged by me are important to “catch.” Understanding what goes on between “us” might be useful in understanding what goes on “out there” with “them.”

Therapy offers the possibility to reflect on what forms us and to make room for the changes we hope for. A relational approach understands the relationship itself between client and therapist to be a fundamentally important element in realising such change.

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

Face to Face and Online Therapy Help Available Now

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Filed Under: Brighton and Hove Psychotherapy, Gerry Gilmartin, Mental Health, Psychotherapy Tagged With: couples therapy, psychotherapy services, relational therapy, therapy rooms Brighton and Hove

December 13, 2013 by Brighton & Hove Psychotherapy 1 Comment

Counselling and Psychotherapy Services in Brighton & Hove

0101_B & H Psychotherapy_0001lrA Good Year for Brighton and Hove Psychotherapy

As we approach the end of another busy year it is time to look back at both the achievements and challenges of 2013. This has been our practice’s first year and a fruitful one so far. I attribute this to a close partnership of dedicated therapists who have a vision of providing high quality counselling and psychotherapy services to clients in the Brighton & Hove area.

We were also pleased to welcome very skilled practitioners who joined our practice as associates. Our valued associates work from our lovely premises on The Drive in Hove and offer individual, couples and group therapy.

I would like to most of all thank our clients who teach us so much each and every day. We hope this year has been a fruitful one for you too, on a personal, professional and spiritual level.

Wishing you a good holiday break and looking forward to seeing you in the New Year.

Sam Jahara and Mark Vahrmeyer

Face to Face and Online Therapy Help Available Now

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Filed Under: Brighton and Hove Psychotherapy, Mental Health, Psychotherapy Tagged With: Brighton & Hove, counselling services, psychotherapy services, therapy rooms

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COVID-19 (CORONAVIRUS) Important Notice

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

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