Psychotherapy Archives | Brighton and Hove Psychotherapy

February 11, 2019 by Brighton & Hove Psychotherapy Leave a Comment

A Couple State of Mind

This is the first in a series of blog posts about couples therapy. In this post I want to talk about what Mary Morgan from Tavistock Relationships calls a ‘couple state of mind’.

Why if our partner is ‘right’ for us don’t they understand us completely? There are limits to how much we can ever fully understand or know another person. As we move from away from the early stages of being in love or infatuation it can be disappointing when our partner doesn’t live up to our expectations, ‘You aren’t the person I married!” or “You’ve changed since we first met.”. What we mean is “You haven’t become the partner I imagined you would be.”

When we become a couple we are two separate people with our own ideas of what it means to be a couple and what each of us should be prepared to offer and can expect to receive. These ideas are likely to be based on how we experienced our parents’ or carers’ relating to each other, as well as the community and culture we grew up in. As a couple we will inevitably be sharing psychic space as well as physical space, the tension between wanting to be held and close and wanting our own space and freedom can be challenging.

At times we might find our sense of our self and our reality is threatened by our partner’s version of what is happening. For example, we might feel our frequent phone calls and texts show how attentive and caring we are but our partner may feel overwhelmed and claustrophobic. One of us may feel it is important to regularly spend time apart to not become tired of each other, but this might make our partner might feel rejected and isolated. These polarised positions highlight the difficulties of holding two perspectives on what it means to be in a couple relationship.

Couples coming to therapy often do not have a sense of themselves as a couple. Thinking about what your relationship needs is not the same as thinking about what you need. This may sound obvious but it is easy to lose sight of when you are finding life is a struggle. One role for the couples therapist is to help partners contain or tolerate their differences long enough to create a shared space to think, a couple state of mind. A couple state of mind can be understood as a third perspective, a position which gives a couple a chance to step back, look at their relationship and explore what they could hope for and create together.

Couples therapy also gives each of us the chance to see our partner relating to the therapist, showing ways that two people can think together in a close and trusting way. Seeing someone as familiar as your partner connecting with another person can be surprising, they can be revealed in a different light. The therapist offers a safe and supportive environment where a couple can think together and explore a couple state of mind, to see if they can continue to develop as individuals whilst enjoying the closeness and intimacy of being a couple.

Morgan, M. (2018) A Couple State of Mind: Psychoanalysis of Couples and the Tavistock Relationships Model. London. Routledge.

Angela Betteridge is a couple and family therapist working at our private practice in Lewes. She is available to see adolescents individually or with parents /carers.

January 7, 2019 by Brighton & Hove Psychotherapy Leave a Comment

How Psychotherapy Taught me to Live Life

This piece is written by a ‘fictional’ client who is a composite of three real-life clients who have shared their experience of psychotherapy with me. Some details have been changed to ensure confidentiality, however, the thoughts feeling and experiences expressed are those of three very real clients:

When I came to psychotherapy I did not even really know what it was. I knew I needed something because I knew I was struggling but whether that something was counselling, psychotherapy or what I simply had no idea.

As well as not having much of an idea about what to expect from my psychotherapy, I also had no idea about how long it would take. And I was impatient! It is therefore with a surprise that I look back upon my two-year journey of weekly one-to-one psychotherapy with some degree of awe with regards to how little I really understood what I needed and for how long; from my initial impatience, a sense of appreciation and security developed from knowing that on Tuesdays, at 5pm, I would be seeing my psychotherapist.

Where I say that psychotherapy taught me how to live life, I mean this in the sense of courageously living rather than existing.

Prior to psychotherapy I approached life and relationships from a default fear position. Not that I knew that at the time – the way I was all seemed perfectly normal to me. Normal is, after all what we are familiar with.

However, part of me also know that I felt unfulfilled and lacking in purpose and meaning. Meaning in terms of my own desires and meaning in terms of what relationships could offer me.

It has been through a slow process of learning to be in relationship with my psychotherapist that I have slowly learnt to have a healthy relationship with myself. Through being held in mind, I have learnt to hold myself on mind. And through trusting that the relationship with my psychotherapist was and is genuine, I have come to accept that just perhaps, relationships with others have something to offer me.

I am now two years into my ‘ongoing’ psychotherapy relationship. It has been hard, frustrating, frightening, constructive, containing and life enhancing all in equal measure. The only commitment: we both show up each week for the session.

How have I changed

Most of all I have let go of the past. My experiences still happened, of course. There is no magic to undo that. However I have accepted that I can still have a life without having gotten what I needed as a child. And through this have come to accept that I can treat myself differently to how I experienced my parents treating me.

My relationship with myself

‘Has psychotherapy made you happy?’, people I know sometimes ask me. No. But then happiness is not the purpose of life. I do, however, at times feel content and even happy. More importantly, I am able to feel the full range of human emotions without running away from them. I can navigate my emotional world using my mind in a way I simply could not before psychotherapy and instead would use all sorts of distractions to avoid feeling.

My relationship to others

I have far deeper and more authentic relationships with others – something I now realise I avoided in the past for fear of them really seeing me and then rejecting me.

Relationships have become important to me and I am far more able to tolerate difference in those around me – to accept that they have different minds.

In summary

Put simply, my life now has substance. I know more about who I am, who I have been and how I spent much of my life hiding from myself and others because of not feeling accepted; I now have compassion for this part of me.

Mark is an integrative psychotherapist primarily informed by attachment theory and object relations psychotherapy. He works relationally and sees individuals and couples in Hove and Lewes.

December 17, 2018 by Brighton & Hove Psychotherapy Leave a Comment

So what exactly is Mindfulness?

The term ‘mindfulness’ is much spoken about these days, especially in relation to mental health and wellbeing. But what does it really mean? Mindfulness generally relates to a meditation practice that has its origins in Buddhism. It is thought that the Buddha was practicing mindfulness when he gained enlightenment, and it is one of the key meditation practices for Buddhists.

However, the practice of mindfulness has been taken by psychologists out of its Buddhist origins and used as a technique to help with gaining better mental health and having a healthier and calmer outlook on life. Mindfulness is often used to help treat anxiety and depression, and is recommended by the NICE guidelines for people with depression to help prevent further depressive episodes.

How do I practice mindfulness?

To practice mindfulness is really quite simple. You just need to be aware of what is going on in your body, with your thoughts and emotions, and keep your focus trained on a meditative object such as your breath. Find a quiet place to sit, where you won’t be disturbed for a few minutes, close your eyes, and pay attention to your breathing. Notice the air coming in through your nose or your mouth. Notice how it feels, notice how your chest or abdomen rise and fall with each breath. Notice how your body feels different with each in-breath and out-breath. This seemingly simple practice is actually quite hard to do. You will notice that as you try to focus on your breath, your mind will start to wander. You’ll start thinking about things you need to be doing, planning your next activity, or wondering if you are doing it right. Also, you might start to notice feelings coming to the surface. Maybe you will feel anxious, or notice some sadness connected to an event that happened earlier in the day. When thoughts and feelings arise, all you need to do is to notice that they are there. Give them a label “I’m feeling sad” or “I’m planning” then bring your attention back to your breath. Do this gently and kindly. With regular practice, this will become easier, and you will find that your times of practicing mindfulness will become calmer and you will feel more peaceful. Also, you will start to notice how your mind wanders. You’ll notice the patterns of your thoughts and your emotions and you’ll become less entangled with them. After a while, you’ll start to realise that while you have thoughts and emotions, your are not your thoughts and emotions. They are part of you, but you don’t have to become consumed by them.

By having a regular practice of mindfulness, you can learn to regulate your emotions, and be able to tolerate more difficult emotions easier. You’ll also have more control over your thoughts and be able to step back from your thoughts when they are leading you to dark places. With time, mindfulness can help you become more compassionate to yourself and the others in your life.

And for how long?

It is often asked how often and for how long we should practice mindfulness meditation. The answer to this really depends on how much you want to commit to your wellbeing. A regular, daily practice is important. So try to practice every day if you can. In terms of duration, start small with about 5 – 10 minutes each day. Then start to work up to longer durations. Most people find that it will take about 20 minutes for the mind to really start to settle, and it is after that you will gain some of the deeper benefits of mindfulness. If you can, set aside 40-60 minutes each day to practice mindfulness. However, as we live in a busy world, setting aside this amount of time can be difficult, so if you can’t spare it, or just don’t want to do so much, stay with a smaller amount and keep your practice regular.

Mindfulness is a very important meditation practice that is accessible to all. The are many free videos and podcasts that will guide you in your practice, and many course available to teach it.

Combining mindfulness with psychotherapy is a very powerful way to understand your inner world and to make significant changes in your way of being in the world.

Simon Cassar is an experienced integrative existential psychotherapist and mindfulness practitioner providing long and short-term psychotherapy to both individuals and couples in Hove and Lewes.

November 26, 2018 by Brighton & Hove Psychotherapy Leave a Comment

‘Where Should I Start?’ – On the flow of a psychotherapy session

Starting psychotherapy can be a daunting prospect. Researching the right psychotherapist; making contact; booking the appointment; finding the practice; waiting in the waiting room; and then…. you are invited in.

You enter and sit down. Water is on the table. Perhaps you help yourself as you are suddenly unexpectedly thirsty. Or perhaps, unconsciously, the thirst delays the awkwardness of starting the session. Eventually that moment arrives and you are unsure where to begin and so ask ‘ where should I start?’.

In fact, my experience is that this is a question that, for some clients, will repeat over and over again in the relationship and it becomes a significant part fo the work: how to work out where to begin each week.

On taking space

Whilst it is conceivable that someone with a perfectly good childhood should choose to enter into psychotherapy, it is in practice highly unlikely. Especially if we differentiate between short-term counselling or psychology, and open-ended psychotherapy.

All of us can fall victim to the uncertainties of life and can find ourselves struggling to make sense of a difficult event – perhaps a divorce or an accident. These would be perfect examples of events that may require a period of focused counselling. However, as troubling as these experiences can be, it is only if they throw our whole existence into doubt or bring down the edifices of our defences, that psychotherapy would be required.

Therefore whilst it is possible that someone with a good childhood would come into psychotherapy, most of those who do are coming (unconsciously or not) to work-through and repair attachment damage, neglect and trauma in their early relationship(s).

And for children who have been neglected, and thus not held in mind, it can then be hard to suddenly find themselves in an environment where the Other (the psychotherapist) is fully holding them in mind and is interested in everything they have to think and say. Where in the world should they start and how can they learn to feel comfortable taking up the space for themselves? Being truly seen when one has not been seen can feel very exposing.

Knowing where to start, is all about desire

When a client asks me where they should start a session I will mostly hand this back to them in a gentle manner. I invite them to be curious about how they might work out where they want to start.

I then quite often get a relaying of the week’s events, if the client is one I have seen before. Once again I will hand this back and ask them what it is that they want me to know about how they are feeling about their week. Often this is then met with a blank stare and then we can perhaps address the issue at hand: how can they work out what they want to share with me as someone they are in relationship with?

Knowing where to start is all about desire. It is about having a relationship with ourselves and working out what we would like to think about in the therapeutic relationship. It is akin to choosing what to eat off a menu – in order to know what we want to eat, we need to get in touch with what we ‘feel like eating’. We try the different dishes on in our mind and then choose which we will focus on – which becomes the dish we will order and eat. Therefore desire tells us about what matters to us – what is important to us.

And yet choosing were to start has a further complexity – we must choose what we want to talk about and then bring this onto the relationship which means acknowledging that our psychotherapist will have thoughts, feeling and perhaps judgements about what we tell them. That can bet very confronting!

From a duet for one to a dance of two

Psychotherapy is a relationship and as in all relationships, they are not static. They follow a trajectory of, if the relationship is positive, deepening over time. It shifts and moves, develops and cements as a relationship, where two people are in dialogue with each other and who matter to each other.

Where we start a session then is about allowing ourselves to accept that we are in a relationship with someone who not only holds us in mind and to whom we matter, but crucially, letting our psychotherapist matter to us. The question of where to start then simply becomes, ‘what do I want Mark to know about me?’.

Mark Vahrmeyer is a UKCP registered psychotherapist and co-founder of Brighton and Hove Psychotherapy. He works with couples and individuals using an psychoanalytically informed integrative approach and sees clients in Hove and Lewes.

September 24, 2018 by Brighton & Hove Psychotherapy Leave a Comment

Does the male mid-life crisis exist?

The Man’o’Pause

Much has been depicted of the male ‘mid life crisis, most of it mocking. However in my experience as a Psychotherapist, I wholly agree with author Marian Keyes, who notes, “no one really goes through a midlife crisis without experiencing real despair, real fear and real soul-searching about ‘what have you done with your life?’.

I suspect much of the mocking relates to the often-painful consequences of the acting out of this pain, in searches for ways to make this manageable. Most recognizably perhaps in the breakdown of relationships and families.

Gender specific?

Of course, a mid-life crisis is not gender specific.

It can be, a pause to take stock of a life, where the initial manic scramble to achieve goals has been fulfilled and once that finish line has been to some extent crossed, another, much more frightening one appears, that of the inevitability of our own death, sometimes brought home by loss of people close to us from older generations.

How can psychotherapy help?

Psychotherapy offers the opportunity to assess this in detail, to explore what values and ways of being are chosen for their merits and what are perhaps inherited unconsciously, driving on, the acting out of old unconscious roles. In order for a role to be chosen, the unconscious roles being played need to be made conscious in order to allow comes more choice about which future roles we decide to take or leave.

The Psychoanalyst Donald Meltzer, suggested that most adults have an adolescent personality structure until mid-life when either a struggle toward greater integration commences or a return to latency period rigidity which he described as ‘settling into middle age’.

This ‘crisis’, then is also an important and vital opportunity to assess and evaluate what kind of life is to be chosen for this second half, where the existential reality of death, brings into sharper focus the decisions and choices we make.

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. Paul is available in our Brighton and Hove practice.