Brighton and Hove Psychotherapy

01273 921 355

by Leave a Comment

The Therapeutic Relationship and the Unconscious

Therapy is often referred to in terms of it being relational, or as a relationship, albeit a particular type of relationship, one that has very specific parameters, particularly around money, time, touch, and about whose inner life is there to be explored.

Despite this, in some ways, very one-way relationship, an awful lot of what goes on is a kind of relating. The therapist will encourage the client to speak as freely as possible and through a careful listening to the client’s words and to what is evoked in themselves, through this listening, they will try and relate as closely as possible to the clients experience and will feed this understanding back via their own comments, or interpretations.

What makes this different from other listening conversations, is that the therapists understanding and feedback will be influenced by the therapists training, specifically their own therapy and their learning of theories, which provide maps of mental structures and types of human experience and distress.

The therapist as well as listening to the stories, will also listen for patterns, for words, they will try and be attuned to what is going on emotionally for the client and also pay attention to the actions of therapy, to the how the client goes about relating to the therapist. When the therapist feels something useful has been understood, they will share this.

Sometimes this may not have been consciously known by the client, and this is why it can be useful. However, it can also be unnerving, as we like to believe we are the masters of our own houses, independent and not in need of the help of another.

Freud said there have been three great blows to man’s ego, the Copernican discovery that the solar system didn’t revolve around the earth, Darwin’s discovery that we are descended from animals, and share an essentially mammalian brain structure and Freuds own discovery that we have a dynamic unconscious, that the rational beings we like to believe ourselves to be is only one part of the story.

Part of this unconscious is the repressed unconscious, the place where we store the things we don’t want to know about ourselves, however these things are known at some level and we can expound a great deal of energy trying not to know them.

Getting to know and understand these parts of ourselves although often frightening to begin with, can actually be a huge relief as we come to know and accept these parts of ourselves, parts of ourselves that may seem like monsters under the bed and cast scary shadows but are usually essentially human characteristics.

 

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

A Nation Divided

Adolescence: the trials and tribulations

Does the male mid-life crisis exist?

Facebooktwitter

by Leave a Comment

How do I choose a psychotherapist?

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

Counselling, psychotherapy or psychology?

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

Depth of work

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

Professional Body

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

Training

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

First Appointment

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

Length of Contract

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

Final Thoughts

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

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

 

Facebooktwitter

by Leave a Comment

Being Embodied in Therapy: feeling and listening to your body

Therapy is often called a ‘talking therapy’ but what is talking exactly?

Generally speaking, what someone says is what therapists consider and explore in session. Body psychotherapies are often the exception because language and thought are understood as different aspects of being in and as the body. The rise of mindfulness-based therapies that explore therapeutic change via awareness of the body as a whole could suggest that the focus on talking therapy is changing.

Despite this, what someone says remains a significant focus in therapy. Other than words, what could be important to pay attention to in therapy and beyond?

Existential therapy is rooted in philosophy. Merleau-Ponty (1962) has been deeply influential in how existential therapy considers the embodied being. Merleau-Ponty illustrated how our embodied nature is our primary experience of the world and how we communicate.

He also emphasised the importance of our existential sexuality (which I will discuss in more depth in a later blog) and embodiment to how we feel and how we react to everything we encounter. This understanding seems fundamental to how we open and close ourselves to the world. Merleau-Ponty reminded us that however we are perceiving experience in our own way, we are always in an interpersonal encounter “like an atmosphere” (p. 168)  .

Perhaps this atmosphere is most readily felt when we open and connect to something that generates sensation, for instance when doing yoga, meditating, making love. Or perhaps when we feel ourselves with others deeply, whether it is in an intimate and caring moment or perhaps feeling a difficult and challenging emotion. This ‘atmosphere’ is incredibly useful to consider both in therapy and in the moment when we feel the cluster of sensations that reveal our ‘being-ness’.

For instance, this atmosphere can point to how we are relating with others. It provides information for us personally but can also highlight how we feel in our relationships. Breaking through repetitive patterns in relationships can be tricky. However, a quick way to cut through stuck narratives is to stop and feel. Pausing the story telling and easing into the direct experience of being with another can sometimes reveal a deeper more intimate layer of being. We may notice we feel more open, or perhaps we may feel more closed. Defences may drop while a sense of feeling exposed becomes more prevalent.

In this moment, we may feel more deeply the sensations which illuminate the connecting space between all we encounter. We may understand more clearly whether we want to move towards or away from something or someone. This understanding can be a hugely significant when we are feeling confused intellectually.

Gendlin’s (1993) writes the “… living body always implies its right next step” (p.32). His commentary about being and focusing in the body seems to support Merleau Ponty’s ideas and suggests that it can be a guiding force to orient and anchor us. Even simple movements, such as feeling the pattern of breath and its impacts, can ground us and bring us into intimately present being. Paying attention to feeling sensations may encourage new understanding to arise. By broadening how we understand ourselves we may find more possibilities emerge where we once felt stuck.

These notions and an openness to experience it directly for yourself can be incredibly helpful in therapy. It is also a significant understanding and experience for anyone interested enough to pay attention to what is actually happening in your body, in any moment.

So, despite therapy often being considered a talking therapy there is much useful information that happens beyond this. Paying attention to what is actually happening in and as the body can be a fantastic starting point. This enquiry does not have to be difficult or complicated. For instance, next time you are out walking or sitting down just notice what it feels like. How do your feet and hands feel? Are they relaxed or tense? Do you feel any tension in your tummy? Let go of any judgement or speculation about it and just feel what is actually happening. If you feel like it, try sensitively easing into the tension. Relax, be curious and see what happens.

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice and Lewes Practice.

 

Disclaimer: some of the content of this blog was originally part of an essay for a doctoral programme at NSPC. It has been amended.

1)          Merleau-Ponty, M. (1962). Phenomenology of Perception. Trans. C.                     Smith London: Routledge.

2)         Gendlin, E.T (1993). ‘Three Assertions about the Body’. The Folio 12                      (1): 21–33.

 Facebooktwitter

by Leave a Comment

How to find a Therapist

I’m in agreement with Brett Kharr who argues that unfortunately we have a strange situation in therapy where there are an almost innumerable different types of therapies to choose from.  I think this reflects the consumerist, swipe right, swipe left age we live in and actually makes starting therapy more confusing for clients.

Richard Chessick, a Psychoanalyst, writes that;

“It is the experience of the therapists personality and the encounter with the therapist as a human who is truly present, rather than any verbal exchange, that makes the fundamental difference in therapy. It forms a link, that brings the patient in consistently over years of treatment, even at times when the patient is very angry or upset. (85).”

If, as a client, you are serious about wanting to change things and about wanting to engage in therapy then it does pay to think a bit about which therapist and therapy may be a good match for you. Sometimes you may feel comfortable with the first therapist you meet after perhaps doing some online research or obtaining a personal recommendation. Sometimes you may want to have a few initial consultations with different therapists. As a therapist I would always be more than happy for you to do this. As a client I would advise on being as honest as possible with the therapists you meet about this, as it’s a good chance to gage their reaction. A therapist where you feel you might have to worry about hurting their feelings, may not be the best choice.

When I began my training the course leader, in one of our first seminars, talked about the therapists needing to have personal therapy and how to choose and get the most out of therapy, said one thing that has stuck with me –

“Make sure to give your therapist hell”.

I have often thought about that statement and have come to appreciate, that I think at essence, its saying how important it is to be as honest as possible in therapy, especially about the things you don’t want to say and especially about the things you don’t want to say to your therapist.

This may feel strange. You may feel your therapist is annoying, a disappointment, etc.  What’s useful about this and I believe unique to therapy is that the therapist who has had a thorough therapy themselves won’t take it personally, they will be able to reflect on the bits that may be true, but also may be able to help you think about the bits you may be bringing that you may also bring to other areas of your life. Is the experience of finding your therapist annoying/boring/uncaring or whatever, something you experience in other areas of your life in relation to other people? If so the special circumstances of the therapeutic relationship can be a unique chance gain insight into these recurring patterns as they are happening, not just in an intellectual way but also at a deeper more affective level. It is at that level that I believe change can really occur.

Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

Facebooktwitter

by Leave a Comment

An Interview with Mark Vahrmeyer – Viva Lewes March ’19

Mark Vahrmeyer was recently approached by Viva Lewes for an interview on ‘Mending the Mind.  Below is a scanned copy of the full interview:

 

Mark 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.

 

 Facebooktwitter

Copyright © 2019 – Brighton And Hove Psychotherapy – Privacy Policy
6 The Drive, Hove , East Sussex, BN3 3JA.