Brighton and Hove Psychotherapy

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The limitations of online therapy

Online psychotherapy is not a new concept; it was around before the pandemic and successfully used as a medium for delivering psychotherapy, counselling and coaching. However, what is new is how nearly all of us were obliged to work online to maintain continuity of sessions for our patients and clients during lockdown and how ubiquitous it remains. It is clearly here to stay but does that mean that in-person psychotherapy is a thing of the past?

Online psychotherapy brings with it some advantages over seeing a psychotherapist ‘in the flesh’ such as:

  • Access to a wider pool of clinicians;
  • Less time consuming as no travel is required;
  • Some people may find it easier to ‘open-up’ online rather than in person.

Like many psychotherapists, during the pandemic I had to abruptly move my whole practice online and together with my clients adapt to virtual sessions. Now at the tail-end of the pandemic the world is a different place and yet I have found that the vast majority of my clients have of their own volition decide to return to in-person sessions. I have explored this with them and below is a synthesis of some of the limitations of online psychotherapy and why, I believe, it will never replace in-person face-to-face sessions.

Psychotherapy is a body to body communication

Though often referred to a ‘talking therapy’ psychotherapy is much more a ‘listening therapy’ and the clinician is trained to listen in a very particular way – to what the client says as well as how they say it.

More than half of our communication is non-verbal and is a combination of tone and delivery in conjunction with body language. With online therapy much of the latter is lost due to the limitations of what can be seen on screen. But there is another reason why it gets lost – online psychotherapy is ever so slightly ‘out of synch’. It is almost imperceptible (most of the time) but there is a slight lag between the delivery of the sound and the delivery of the image which makes for a disconnect between the spoken and unspoken. And whilst almost imperceptible to the conscious mind, it gets registered by the emotional system.

Psychotherapy as re-parenting

Everyone who crosses the threshold of a psychotherapist’s consulting room is bringing with them unresolved experiences and patterns from their childhood. Many of the patterns are laid down in the formative years of bonding and dictate our attachment style. And because they were laid down between birth and around 2 years of age, they are non-verbal (and unconscious).

Psychotherapy is about working with these patterns – often referred to as ‘working in the transference’ – to understand how the client ‘does’ relationships; in this sense it is a process of re-pare helping the client to feel safer and more secure in relationships and in expressing boundaries.

The transitional space – travelling to therapy

Travelling to sessions in person can be time consuming and with today’s fuel prices, expensive. However, the travelling aspect has an important psychological function as it operates as a transitional space between the ordinary world and the unique world of introspective psychotherapy.

In online sessions I have often found that clients can be distracted as they have literally just ‘left work’ and entered my virtual consulting room – they have no given themselves time to make the journey to psychotherapy and it can then often take a significant part of the sessions for them to arrive.

Likewise, I have had clients who have scheduled work meetings immediately after their online therapy which can act as a powerful prohibitor to allowing themselves to ‘be in therapy’ as “I don’t want to get upset because I have a meeting with my boss”.

Lastly, when clients visit my consulting room in person, I am responsible for most of the physical boundaries. Clients know where they will be sitting, where the furniture will be positioned and this will remain the same week after week – it is part of be providing a consistent experience. Seeing a psychotherapist from home may mean that the space feels less safe with other members of the family in the same home or just simply having daily distractions around such as a picture of the family on the desk next to the monitor.

Psychotherapy is about making contact

Starting psychotherapy in any realm can feel like a daunting prospect. Coming into a consulting room, which is the domain of the psychotherapist, is a brave step.

Clients have often sat on my couch and mused or fretted about what to talk about. I generally sit in silence as they try and find their words as, to me, what they say is often less important than why they are telling me. If a client tells me anything they are telling me something about themselves that they feel is important and that they want me to see as important – often we need to figure out together why it is important but we generally get there in the end.

Therefore, psychotherapy is about ‘coming into contact with another’ – taking a risk to be seen and heard. Whilst this can be achieved to some extent online, nothing can be a substitute for in person contact where two bodies are in the same room and in communication and contact with each other.

Until we start raising babies and infants over virtual connections and can do so successfully – which is neither desirable nor remotely possible due to our physiological and psychological make-up – face-to-pace in person psychotherapy is not going anywhere.

 

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 –

Pornography and the Online Safety Bill

Does the sex of my counsellor or psychotherapist matter?

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Parental Alienation and the impact on children

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Does the sex of my counsellor or psychotherapist matter?

A question I have often either been asked or has come up up is whether the gender of the clinician matters (or should matter) to the client?

The answer, as with most questions relating to the intricacies of psychotherapy is not categorically ‘yes’ or ‘no’.  However, the question opens up other questions which may themselves be more interesting such as, what are your beliefs about psychotherapy and why should the sex matter?

To start with, there are clearly cases and instances where it is entirely appropriate for a patient or client to want or need to work with a therapist of a particular gender.  Aside from the fact that this may simply be the wish of the client (and therefore to be respected) valid reasons may include a history of sexual abuse by one gender leading to the client feeling safe with the other gender (often their own).

However, if we drop beneath the obvious, the question takes on more of a philosophical slant and how it is answered gives much insight into what a clinician believes about psychotherapy – let me explain.

There are many ‘schools’ of psychotherapy and many methods, however most of these have more in common than they don’t and secondly, most clinicians are to a greater or lesser extent ‘integrative’ in that they use different models in their clinical work.  The greatest distinction, or divide, perhaps lies in whether or not a method, and thus a practitioner, believe in unconscious process or not (and spoiler alert – I do profoundly).

As a psychoanalytically informed psychotherapist, I work with the unconscious which means to say that I take very little on face value and work with my clients to understand why they think, behave and act in the way they do; in other words, how is their past experience influencing their perception of the present without their knowledge.  Through therapy the past can be uncovered, worked through, grieved and its hold on the present reduced.  This frees clients up to make informed and thought through choices based on their reality as it really is now rather than where they were previously stuck.

Those who don’t believe in the unconscious (namely behaviourists or person-centred therapists to name a couple) take things on face value.  They do not believe in unconscious process and work very much in the ‘here and now’.

How does the unconscious link to the sex of the therapist?

Those of us who work with the unconscious will, to a greater or lesser extent, work with transference – that is, work with whom we represent to the client in the room.  And whom we represent will invariably be one of the client’s caregivers, usually a parent.

Transference is very similar to projection, which is something we all do at times – we ascribe values to a person based on prior assumptions rather than on the reality of who they are.  The difference with transference is that the clinician, if trained well enough, will receive the client’s projections and be thinking about who they are (represent) for the client.

Freud believed (and rightly so) that transference occurs irrespective of gender/sex.  We will therefore ‘transfer’ our unfinished business relating to either or both parents onto the therapist.  This too is my experience as I work in the transference and so recognise that how the client relates to me tells me something important about how they learnt to relate as a child and I can represent their mother just as easily as their father in the transference.

Therefore, whilst in some cases the sex of the therapist may matter, in most, it does not.  And I believe that has also been my clients’ experience over the years whereby they may have had a preference in working with a female, have ‘ended up with me’ and we have done excellent work.

 

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

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Parental Alienation and the impact on children

Space: The Final Frontier of Manic Defence

Do Psychotherapists Need to Love Their Clients?

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Executive Coaching, Psychotherapy, or both?

Executive or Leadership coaching is nowadays widely offered in organisations. Employers know the benefits of investing in developing their leaders and employing a coach is one of the best ways of doing this. 

What Makes a Good Leader?

Good leaders need to be self-aware, emotionally intelligent and have excellent interpersonal skills. The leaders who develop such qualities fair far better than those who have risen to the top due to high performance in their respective fields, but do not have the qualities needed to lead a team. Leaders of people need to know how to do relationships. This includes setting boundaries, being assertive and knowing how to communicate well with their peers and staff.

Psychotherapy is all about relationships – to self, others and the world. In psychotherapy, we learn to understand ourselves on a deeper level. This translates into knowing how we impact and are impacted by others. The aim of self-knowledge is to become more perceptive about patterns we repeat that are unhelpful or even harmful to ourselves and those around us. This extends to relationships at work, where the leader has a responsibility to shape the culture of an organisation and create an environment where people have the best chance to perform well. 

The leader and their staff‘s performance directly impacts the success of an organisation, which brings us back to the importance of good interpersonal relationships, communication and self-knowledge, especially when what is required is seeing and working with what lies beneath the surface.

What is the Difference Between Psychotherapy and Coaching?

Psychotherapy and leadership coaching are two distinct professions, each with a with their own set of skills and training. However, coaches with psychotherapy training under their belt are in a good position to coach executives due to their in-depth training in psychological theories and processes. Psychotherapists are trained on what makes people think, feel and behave the way they do. This knowledge can be directly applied to organisational and team dynamics. 

However, this does not in itself make any psychotherapist into a skilled leadership coach. Coaching leaders in the context in which they are working requires training, knowledge and experience in the field of business and as well as psychology. It also requires an ongoing interest in both, and the drive to constantly learn.   

Psychotherapists who work as coaches also need to know how the two differ and where they overlap. No one wants to engage in coaching and end up receiving psychotherapy instead, or vice-versa. Executive coaching is work focused, usually time-limited and takes place less frequently than psychotherapy. People engage in coaching usually to work through challenges they are experiencing at work, to develop themselves in their role or to explore changes in their career. Finally, psychotherapy and coaching can take place alongside one another, with two different professionals who will support the client in distinct but possibly overlapping areas of the person’s life. 

 

Sam Jahara is a UKCP registered Psychotherapist and Tavistock trained Executive Coach. She has a special interest on the impact of unconscious dynamics at work. She was born in Brazil and lived in Germany, The Netherlands and Australia. Sam currently lives and works in the UK and sees clients from her Lewes and Hove offices as well as online. You can get in touch with Sam directly via her profile.

 

Further reading by Sam Jahara

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What makes Psychotherapy Different?

“The Patient who will not suffer pain fails to suffer pleasure.” Wilfred Bion 1970.

I’ve been a therapist for over ten years now and one of the things I love about the job is how demanding it is of me to stay awake and stay alive. The training never stops and development is always a work in progress.

After many years of various work and an enduring interest in self-development and study, encompassing Eastern thoughts and practices and various experiential group experiences, I started my formal Psychotherapy training in 2008 and finished in 2014. However, what I didn’t realise was that this was the beginning much more than the end of something.

What makes Psychotherapy so important to me is that it requires one to become a psychotherapist rather than to do psychotherapy. The non-behavioural psychotherapeutic interaction is not one where I teach someone strategies, but one where I seek to on a sustained, regular and meaningful way to contact another human being, always in service of them and focusing on them but using my own present being to help make sense and bring to awareness what is going for them. I do this with all that I have available my mind, my senses, my bodily feelings, my intuition, to try and get a felt sense of what things are like for them.

Jonathon Shedler, the American Psychotherapist and researcher, says “don’t ask what model your therapist practises but how much therapy they have had.”

For me this is what makes psychotherapy truly interesting, of course learning about different theories of the mind and the way it functions and disfunctions is hugely important but it is in our own therapy that we truly learn the ‘praxis’, (practice) of psychotherapy. This involves being challenged to reflect deeply on our own internal processes, our own avoidance and defence mechanisms all human difficulties are on a spectrum and that if we look deeply enough all of us can relate to our patients through our own reflecting selves.

 

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

 

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 –

What’s wrong with good advice?

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

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Do Psychotherapists Need to Love Their Clients?

Freud is an extraordinary and greatly misunderstood individual (and mental health practitioner).  Many believe we have ‘evolved’ beyond his ‘outdated’ theories and indeed, there are views and  theories of his that are no longer literally relevant. However, to dismiss him on this basis is myopic and superficial in that Freud’s writing has taken us to where we are today in the world of  psychotherapy; and so many of his theories are increasingly becoming ‘evidenced’ through technology and our understanding of brain plasticity and the need for relationship to grow a mind.  So, with this in mind, I shall now start my piece with a Freud quote: 

‘Psychoanalysis is in essence a cure through love’ Freud, S. (1906) correspondence with  Jung. 

What is love? 

The first question that must be considered in Freud’s statement is the question of what love is? 

Clearly Freud is not talking about Eros, or erotic love; he is referring to Agape, love towards fellow human beings. However, I believe Freud is saying something significantly more profound and more important: By using the terminology ‘love’ Freud is drawing a comparison to the role of the analyst (or psychotherapist) in the transference – the role of the parent who has let the child in the client down. 

Parents should love their children and most do. However, loving a child is complex as it means to allow and encourage that child to have their own experience – emotional and psychological – separate to the parent. It is about being able to encourage and tolerate difference and then celebrate it in own’s child. 

Children who have been let down – neglected, abused or abandoned – have learnt that their survival depends on ‘keeping their parent happy’ – they sacrifice their own separateness and own experience in order to hold on to a parent. This is not a child who is ‘loved’. But a child who is owned. 

Love therefore in Freud’s sense of the word is about true empathy – to be able to understand and accept another’s experience without becoming threatened by it, without collapsing and without colluding with it. And without sacrificing our own experience. 

Does loving a client mean accepting their behaviour? 

Behaviour, when driven unconsciously by effect (emotion) is termed ‘acting out’ and ‘acting out’ is mindless. Furthermore it is an attack on the therapy and an attack on the therapist. 

Much like a good parent will have empathy for a child’s fear of the dentist, or a child’s desire for sweets placed next to the till, this does not mean that the child gets what they want – the avoidance of the dental appointment or the indulgence of sweets. A ‘good enough’ parent is able to empathise with the child’s feelings but withstand their demands. In short, a parent’s job is to hold their child in mind and advocate for their best interests rather than the child’s self interests (or their  own self interests). 

Is Psychoanalysis in essence the same as a Person-Centred Approach? 

Now we have established what Freud probably means by love, we can consider whether the analytical approach is in essence the same as a person-centred approach – one of unconditional positive regard. Is this not love? 

To a point it is, however, in my view (and that of analytically minded clinicians) the person-centred approach leaves the whole idea of ‘the unconscious’ just there – in the unconscious: in other words it does not exist. What you see is what you get.

Without working with the unconscious and in the transference, a clinician cannot really ‘love’ their client as they are oblivious to the drives and projections that are paying out in the room – the meaning behind the strength of emotion from the client. And they remain oblivious to whom they represent for the client and thus where the loss or trauma resides relationally. 

An analytical clinician will work to understand whom the client is projecting onto them – the transference – and will work within the context of that to provide the client with a different experience of relationship 

Evicting the bad parent 

We all ‘internalise’ our parents – working models of how we experienced them. If this process of internalisation goes ‘well enough’ then we can draw on a solid sense of sense that is supportive of us taking up space in the world and in other relationships: we can bear our inner world However, if it goes awry somehow, then that working model can be punitive, critical and unsupportive and we avoid contact with our inner world at all costs. The process of analytical therapy is to ‘evict’ the bad  parent and offer the client an alternative object (person) to introject through the consistent therapeutic relationship. 

How to ‘love’ our clients 

Loving our clients is a hard thing to do not because they are unlikable or unlovable, but because it  means consistently offering the client a different experience of relationship that they will be unconsciously trying to sabotage in subtle ways. Freud also spoke of our fear of change and suggested that in order to mitigate against change, going forward we always seek to replicate the past. Abused and neglected children feel unconsciously ‘safe’ in abusive and neglectful relationships as then the ‘world makes sense’ and they can simply use their old defensive  mechanisms to carry on surviving. They also don’t need to feel vulnerable. 

Loving a client means holding appropriate boundaries, offering them support and understanding whilst resisting either being seduced or offended by attacks. And as with real life evictions, the internal parents will protest and fight back to stay put. 

Ultimately loving our clients means to hold them in mind in ways they never were – their best interest rather than self interests. 

 

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 –

What is the purpose of intimate relationships?

Why ‘Cancel Culture’ is about the inability to tolerate difference

The Phenomenon of ‘Manifesting – The Law of Attraction’ and the inability to tolerate reality

Why does the difference between counselling and psychotherapy matter?

Love in the time of Covid

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Is it ever too late to start psychotherapy?

Is it too late to consider going into therapy once we reach a certain age? As I walked through the gardens on an early spring morning, this was the question going through my mind. I intended to get down to writing this blog, an unfamiliar task, when I got back to my office.

We seem to have heard all year about mental and physical decline as we age so it was refreshing to read Levitin (see below) that the brain retains plasticity or the capacity to learn and change through out life. And if we are not taken down by dementia, brain injury or stroke, we can in fact retain a lively and flexible mind throughout life. We have to do the obvious things like follow a balanced diet, exercise, not give up purposeful activity (work) and maintain a good and diverse social network.

Throughout life, our close friends and family are important to our wellbeing. These relationships take enormous strain in a world where change is the only hope for survival. And they need looking after even if this means we might end a relationship, if we have children developing and sustaining a healthy connection can help our children to adjust to the world with a healthy out look.

Transitional periods, retirement, divorce, bereavement, empty-nest syndrome, can benefit from psychotherapy for one or both partners providing the space for increased awareness of ourselves, an opportunity for gaining insight and change.

Considering the later years are often filled with opportunities for reflection on a life lived there is always plenty material to explore in the therapy room. David Levitin, an American Neuroscientist, sees this period of life as an opportunity to see life afresh. His premise is the brain retains its capacity to change through out life, at its greatest in childhood and old age.

 

To enquire about group sessions with Thea Beech, please contact her here, or to view our full clinical team, please click here.

 

Dorothea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

The Unconscious Mind

Groups for Mental Health

Group Psychotherapy in a post ‘Pandemic World’

Termination and endings in Psychotherapy

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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.

 

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

Click Here to Enquire

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What’s wrong with good advice?

Often, the people who engage in therapy with me will ask for advice, tips on managing anxiety, what to do about a relationship situation, how to manage a tricky situation at work. Sometimes someone might ask for general ‘life advice’. Of course, mostly what they want is some sort of reassurance and although its not true that therapists never give advice I tend not to offer reassurance. Why not?

Well to start with, the problem is rarely not knowing what the right thing to do is. If someone wants ‘tips’ on sleep or anxiety strategies, I might advise them to look on the internet, there’s plenty of it out there and its free and of course generally sound. Eat your greens, go to bed at a regular time, do some exercise, especially yoga and don’t take too many or too much, mind altering substances.

This reminds me of a joke, –

‘Doctor, If I stop drinking alcohol altogether, eat my greens and give up sex, will I live longer?

Dr – Well I can’t tell you with any certainty whether you’ll live any longer, but one thing I do know, it will certainly seem much longer!’

Of course, what people struggle with is not, not knowing, what the healthy thing to do is, it’s doing it and the reason for this is that they/we are conflicted.

Many clients may come saying they want to stop, whatever it is, that is causing them problems. So I ask why don’t they then? and they say I don’t know. Well the answer is simple, another part of them doesn’t want to stop, whatever it is there doing, is serving some purpose, even if the consequences of continuing to do it are grave. Of course, in many cases this can indeed be tragic, people find themselves compulsively doing things that they know hurt themselves or others, damage, destroy or put important, sometimes essential relationships at risk.

Therefore, advice on stopping the behaviour rarely works as the addiction or compulsion is a solution to another, sometimes, -unconscious problem., as Depache Mode noted, they’re, “looking for love in all the wrong places”.

– “in the woods of anguish, it’s easy to lose your way”. (George Nash 7.9.2020)

The difficulty in a way is in beginning therapy, as the client and therapist needs to come to a together about what the problem is and what the contract of work is.

I have had many clients come with problems and basically say, well, I’ve told you the problem, now over to you to give me the right advice to fix it. Needless to say, these client’s often leave before the work starts. For instance, someone I saw with a destructive addiction was clearly harbouring a long festering repressed grief about an abandonment by his father, however this wound was so repressed that any interpretation of mine that it might be important to look at this just didn’t work and we were immediately at a stalemate.

Of course, my job is to be as tactful as possible, to not push the client beyond where they are ready to go and to be as patient as possible, BUT, destructive behaviour is always the result of past hurts and unless we do find a way together to think about these, a stalemate or premature ending will be the result.

 

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

 

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 –

Psychiatry, Psychology and Psychodynamic Psychotherapy 

Analytic Therapy for Addictions

Loss

Post Natal Depression in Mothers & Fathers

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Holiday Blues in the time of Covid-19

This blog was originally posted in 2015 in the lead up to Christmas.  As this Christmas period is particularly challenging for so many due to the Covid-19 pandemic, I am reposting it with further thoughts on how you can get through this holiday period:

This time of year can evoke a range of feelings in most of us from anticipation of being with loved ones, through to the dread of Christmas past revisiting us either literally or figuratively. Whilst some of us may have a festive and positive outlook on Christmas and look forward to spending time with friends and family, for many it is a time filled with conflicting emotions. Some of us have difficult memories associated with Christmas and family gatherings.

The pandemic and associates restrictions – unthinkable a mere 12 months ago – have impacted all of our lives and undoubtedly will impact on all of our Christmas’. Many of us will be unable to see friends and family, travel or celebrate in the ways we wish.  And for many, the feelings of loneliness and isolation will be amplified.

Going through sad and difficult times without ignoring or suppressing feelings can be a challenge. When working with my clients around grief, loss and relationship issues I tend to be curious and ask questions about what they are experiencing and really honour those feelings, after all, they are there for a reason. In the absence of an experienced professional to guide you through this process, here are some ideas to help you not only cope, but make the most out of a challenging time.

Listen to your body

This doesn’t mean act impulsively. It is more about listening for what the vulnerable part of your needs. This may be a hot bath with a good book, a warm drink by the fire, a nice home-cooked meal or spending time with a supportive friend. It could also be a long run, or a dance or yoga class. Whatever self-care tool helps you feel well and connected.

Challenge Expectations

This matters more this year than ever before. The ‘traditional’ idea of what Christmas should be is largely absent this year and we are all being made to challenge our expectations about what Christmas 2020 will be for us. However, even in the midst of the pandemic, the restrictions, anxiety, fear and frustration, we all have the opportunity and the choice to consider what will make Christmas and this holiday period meaningful for us.

Spend Time Reflecting

The end of the year can be a good opportunity to review and reflect on the past year. Reflections on your present life in terms of what is going well and what could be improved on is a good starting point. Are you following your dreams and aspirations? How are you contributing to causes that you care about? What are some of your wishes for the future? Where would you like to see yourself this time next year?

Make Positive Decisions

Many people come to psychotherapy to reflect on and improve their lives with the support of an impartial other. It is never too late to become more self-aware and make significant changes in the areas of your life that you are not happy with. Whether you are experiencing grief, going through relationship issues, depression, anxiety or feeling stuck in your life, an experienced counsellor or psychotherapist will explore those feelings with you in a supportive, interested and non-judgemental way.

Wishing all a relaxing holiday and a fruitful year ahead with an eye on this pandemic ending and us all being able to come together freely once again.

 

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

 

Further reading by Sam Jahara

Cultural Identity and Integration – Feeling at Home in your own skin

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

Click Here to Enquire

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Why ‘Cancel Culture’ is about the inability to tolerate difference

What is Cancel Culture?

This seemingly new trend is one of promoting the ‘cancellation’ of people, brands or television shows as a result of what some (the cancellers) perceive to be some form of offensive comment, remark, view or behaviour. It has surged on social media with various derogatory hashtags, notably #RIP.

A recent high profile ‘celebrity’ who has been on the receiving end of social media trends to have her cancelled is J.K. Rowling for her, views on transgender issues that some find offensive.

Is it that new?

The term may be new and the platforms used may serve to whip up a storm of support against those who some wish to have cancelled, however the concept is by no means new at all. Cancel culture is essentially a form of social banishment whereby in traditional tribal communities one of the most severe punishments would be the banishment from the tribe: to be cast out.

To be cast out of ones tribe would mean more than social death; if not literal death through being vulnerable to attack from predators and other tribes, banishment most certainly meant the death of the sense of belonging, which in psychological terms, could potentially instigate a psychic collapse (going mad).

However, whilst this may seem primitive, historical and anthropological evidence shows that it would be a punishment of last resort and would be handed down by the elders of the tribe – in other words, there would be some form of judicial process in place that sanctioned the banishment.

This is where cancel culture differs profoundly from tribal banishment or ‘being cast out’. It is not a decree from wise elders or some sort of judiciary; it is generally used as an attack against the views, opinions or behaviours of others that some disagree with.

Why does it matter?

Put simply, it matters because there seems to be an ever decreasing array of opinions and voices allowed and cancel culture is an immature way of trying to ‘kill off’ anybody holding views or opinions that may not be comfortable for others to hear.

Feeling offended and causing offence

There is a difference between a person feeling upset or even offended by another’s views and with another trying to purposely hurt a person or group of people. The former is what we may experience when we encounter others and are confronted by a different perspective. The latter is when we encounter sadism.

Sadism is unacceptable and should not be tolerated, however the mark of being an adult is the capacity to tolerate a different perspective and a different mind. Even if we may feel offended.

On mergers and separation

Although separate from its mother, an infant, when born, cannot differentiate between their mother and themselves. In essence they believe that their mother is an extension of them. Of course, in reality, the mother in question is very much as separate entity, at least physically, and thus will eventually fail to meet the needs of her infant. This is extremely frustrating for the infant in question and the mind of the infant concocts an ingenious defence against the pain of separation – a good and a bad mother is created: the infant imagines it is the good mother who meets all their needs and the bad mother who frustrates them. It is a primitive psychological defence called splitting.

Infants split off the bad until through ‘good enough’ parenting they eventually integrate the two mothers and tolerate reality: mother is not part of them and frustrates them as she has a different mind and a different set of needs. However, mostly, she seems to meet their needs so on life goes and importantly, on psychological maturation goes. The child is on the path from mergers to a world where they can be in separate relationships with others and tolerate a different mind.

Why cancel culture is simply splitting by another name

To be unable to contain ones feelings when confronted by a different perspective and thus a different mind shows a lack of psychological maturity. The world is split into ‘good and ‘bad’ like in a child’s fairy tale. Bad must be killed off so good can live happily ever after. This is not how the real world works; it is how cancel culture works.

How does cancel culture relate to psychotherapy?

In essence, psychotherapy is about outgrowing cancel culture. It is about learning to be in a relationship where difference can be tolerated and acknowledged, without this needing to be threatening. For some this means they must learn for the first time to bring their needs ‘into the mix’ – something that can feel really confronting and may bring on fears of rejection and abandonment. For others it may mean the opposite which is to be able to cope with the separateness of their psychotherapist and tolerate this without throwing away ‘all the good’ – without ‘cancelling’ them, if you like.

Being an adult means tolerating the frustrations of the real world and the frustrations of the others who make up the real world. However, if this can be tolerated then real relationships are possible and people can locate substance and meaning thus moving them out of a fear/threat pattern into adult relating patterns.

If you would like to work on your own intolerances and relationships, get in touch with us to discuss whether psychotherapy may be appropriate for you.

 

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 does the difference between counselling and psychotherapy matter?

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Online Relationship Counselling

There are many reasons why people seek out online relationship counselling and psychotherapy, from ongoing conflicts and communication challenges to infidelity, bereavement and grief, or family-related issues that are causing a rift. By working with a trained counsellor remotely from your own home, you’ll benefit from a confidential and safe space to discuss any issues, past or present, to help you improve your relationship.

What is Online Relationship Counselling and Psychotherapy?

While it may seem in the moment that your relationship is at breaking point, a trained psychotherapist can help you talk through your problems to help you find a solution and to see each other’s point of view. Many couples imagine that relationship counselling means sitting in a therapy room with a clinician, however, there is also the option to talk with a trained professional in the comfort of your own home with online sessions.

Our psychotherapists are trained to provide a supportive and non-judgemental environment to help you face any difficulty in your relationship. Though practically identical to face-to-face therapy, online therapy offers the option of receiving counselling or psychotherapy remotely through a secure platform for greater accessibility, convenience and approachability.

How Can Relationship Counselling or Psychotherapy Help My Relationship?

For some couples, just a few sessions of counselling can help them resolve their problems while for others, it’s the beginning of a long process of discovery in order to make a breakthrough. Your clinician will be able to help you in setting out expectations. Whether you’ve been struggling with the same argument for years or it’s a new issue that has arisen, a couple’s psychotherapist can help you work through the problem in a healthy way.

Communication is such a vital component of any relationship and finding new ways to talk through issues can help you move past rough patches and restore your relationship or amicably go your separate ways – an essential consideration where children are involved. Couple’s counselling or psychotherapy can be an incredibly rewarding experience that can make a marked di?erence to your partnership. Through choosing to work online, you can access to our highly skilled team from anywhere in the country.

Contact us today if you want to talk to an expert about your relationship or if you need any advice.

All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.


Online Therapy for Depression

Depression is like a whole-body illness that affects not just your mood and thoughts but also your physical self, such as your appetite and sleep patterns, and how you view yourself, your capabilities and your emotions.

The symptoms of this condition vary from person to person, as well as in severity, but they can range from a feeling of helplessness and sadness to anxiety, insomnia, a loss of appetite, irritability and even suicidal thoughts.

How Can Psychotherapy Help?

There are several types of treatment available for depression, but the most effective is talking therapy in the shape of counselling or psychotherapy. Depression can be thought of as a ‘stickiness’ related to unexpressed emotion. A clinician trained in working with depression will listen to you without judgement, in a confidential and safe space to offer you the support you need to work through the problems that are troubling you. They can offer suggestions of strategies to deal with your depression and techniques to help you during the darker times.

Online depression counselling and psychotherapy makes it easier to speak with a trained professional, with sessions held remotely to make them more convenient and accessible. Depression can often make tasks feel insurmountable, so being able to speak to someone from your own home can also make therapy more approachable for many people.

Self-acceptance is fundamental in overcoming the destructive thoughts and beliefs one holds about themselves when they are depressed. Psychotherapy can help you recover trust in yourself and develop a better relationship with yourself through being in a relationship with your therapist.

Seeing a counsellor or psychotherapist work through depression enables you to learn a new approach in expressing your thoughts and feelings in the presence of another. Our clinical team are skilled in helping people deal with negative thoughts and feelings, as well as in providing objective advice and guidance to help you overcome the challenges related to this condition.

If you’re feeling depressed or want to talk to someone about how you’re feeling, get in touch with our team today and talk to someone.

All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.


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The Phenomenon of ‘Manifesting – The Law of Attraction’ and the inability to tolerate reality

What is ‘Manifesting’ and The Law of Attraction?

Recently a client, somewhat younger than me, described a phenomenon they called “Manifesting”. They felt excited and disappointed in themselves in equal measure that they seemed to be failing in using this ‘secret’ method of working with ‘the universe’ to bring them whatever their heart desired.

Curious, I investigated.

Manifesting is a verb used to describe the active process of using positive thoughts, and a degree of self-hypnosis, to draw ‘good things’ to oneself. Based on the many Youtube videos on this topic, these good things seem to be consumer products or monetary wealth, rather than contentment and tolerance, but then the latter two are really not as enticing as ones own private island.

Manifesting is not new and nor is the concept original. It seems to have been re-hashed in a 2006 ‘documentary’ and book entitled ‘The Secret’ which explains the mystical process of using the ‘Law of Attraction’ to get what you want in life. What a great concept – if only it were true.

Fate and Destiny
I have previously written about the concepts of fate and destiny and how I do not believe that any idea of fate has a place in psychotherapy – or indeed in the outcome of psychotherapy, which is in essentially becoming an adult who can tolerate reality.

To recap, the concept of fate posits that there is some sort of external force, entity or deity that decides what happens to us. This can be very unhelpful in the therapeutic process as clients can often use the idea of fate to reinforce that what is happening (or not) to them is simply how things are supposed to be.

Destiny, though not a word I personally favour, can be translated to being thought of as taking some degree of ownership of one’s life whilst remaining firmly rooted in reality. Therefore it is possible for most free people to experience a change in their lives, or perception of their lives, whist acknowledging their reality.

Destiny and death
Some years back I spent four years working on the front lines of death – as a psychotherapist in the field of palliative care. Whilst the usual issues around meaning, relationships and mental health problems presented themselves, they were all within the context of death and dying: I worked with patients who had terminal illnesses, were actively dying or with their bereaved relatives. It certainly redefines the concept of ‘psychotherapy’ when sitting beside the bedside of a patient who has hours to live and is engaging with you through a cocktail of opiates!

Despite the confronting nature of death and dying – the patients’ ‘fate’ was sealed – nonetheless, many of the people I worked with were able to find purpose and meaning in their predicament and to mourn losses not previously addressed. They were engaged in changing their destiny.

Magical thinking
We can all, at times, make use of magical thinking. It can be a way of assuaging anxiety and giving us the illusion of being in control. The practice is as old as human beings and embedded in a language such as in the saying ‘touch wood’ or in the belief that walking under ladders brings bad luck. Human beings are symbolic creatures who make the unreal real. This is perhaps how we cope with our knowledge of finitude – death. However, we also confuse the symbolic with the real.

Whilst touching wood and avoiding ladders is relatively harmless, subscribing wholeheartedly to fantasies that there is some ‘secret’ method or means of ‘manifesting’ objects into ones life is dangerous and deluded. In psychological terms, it is a way of avoiding growing up and being born. A way of believing that the world can be just how we want it if only we imagine it hard enough – a sort of womb, in essence.

The power of magic
The reality of being in weekly or more frequent psychotherapy is that it is not very magical at all.  In fact, it is the opposite. Psychotherapy generally takes place in a fairly ordinary consulting room (or online), you see the same face week after week and often find yourself going over the same ground. Clearly, promises of Ferraris and private islands are far more enticing. However, the consistency and regularity, along with having someone there who holds us in mind and helps us think can be life-changing. If we are thought about, just perhaps we can learn to think our own
thoughts about ourselves rather than follow a script on who we are. If we are not alone then we can learn to bear reality, however hard that may seem.

Psychotherapy does not promise magic. It is, in fact, the opposite in that often our job as psychotherapists is to help clients and patients lift the veils of illusion and see life and their history for what it was – only then can the mourning begin. And it is only through mourning that eventually, desire can emerge – a sense of self and a sense of what that self wants.

Desire
When desire emerges it is rarely if ever about Ferraris or private islands. It is not about consumer products period. It is about a deeper recognition of what will bring contentment and peace in the context of the realities in which that person lives. And that can be achieved even on a death-bed.

Of course, as a final blow, unlike manifesting, psychotherapy also has science on its side. And a long studied evidence base. It may not get the Youtube hits but then real life was never to be found in movies.

 

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 does the difference between counselling and psychotherapy matter?

Love in the time of Covid

Why am I feeling more anxious with Covid-19?

Coronavirus Lock-Down – Physical Health Vs Mental Health

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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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

Click Here to Enquire

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A Primary Task

This is second of eight short blogs exploring the elements of therapeutic change as proposed by Dr Sebastian Kramer.  Click here to read the first one – ‘A Desire to Change‘.

2.  A primary task, a goal . . .

When a client enters therapy they give us permission, to help them with an initial task or goal.  This goal may change throughout the therapy so it can be discussed and the ‘therapeutic sat nav’ can be reset. 

It is important that both of therapist and client understand and agree with what is being worked towards. 

We call it a ‘therapeutic contract’. It helps to keep our talking on subject and the last thing a therapist wants is for a client to walk out of the room thinking that the session had not been useful, that the conversation may have drifted around too many subjects or they had not been asked the questions they were hoping to be asked.  

In systemic psychotherapy it is not unusual for us to ask for feedback from our clients a little way into the session to help us understand if the session feels on track and useful so we can change direction to recalibrate the conversation.

When I was training I thought it was the therapist’s job to solve all of the client’s problems and dilemmas – this was an overwhelming and crippling thought.

I now understand that therapy can exist in chapters, in segments and in episodes.  You can move in and out of therapy with different goals.   

Therapy is an on-going dialogue with the therapist’s job being facilitate, encourage, cajole, challenge, question, celebrate and witness the reflection, insights and successes that our clients experience.

 

Sharon Spindler is an experienced Systemic Family Therapist with twelve years experience within the NHS and private practice.  Sharon is available at the Brighton & Hove Practice.

 

Further reading by Sharon Spindler –

A Desire to Change (part 1)

Covid 19 – Talking with children in uncertain times

Family Therapy for Beginners

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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