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Fear and hope in the time of Covid – part 2

I am writing a follow on from the wonderful blog written by Gerry Gilmartin back in August. 6 months on and here we are again, facing new Covid-related challenges with more restrictive measures in place, more infections and more deaths.

The theme of Gerry’s blog revolves around fear and hope, and how to work with these polarities which coexist in most of us. Psychotherapy is very much about learning to live with polarities within ourselves as well as acknowledge them in others. In psychotherapy we gradually increase our capacity to understand and be with complex human emotions, and to reduce polarised black-and-white thinking. Gerry writes:

“The uncontrollability of the corona virus may reflect something of the uncontrollability of a globalised world. Both highlight our mutual dependence and by implication our mutual vulnerability. At a time when a sense of universal unity might be prescient it is also a time at which it seems extremely unlikely. In a state of fear the instinct is to contract mentally and physically, to batten down the hatches against a real or imagined enemy. In a state of fear we may abandon our capacities for hope and for trust…. On a global as well as an individual level”.

Talking about what we are afraid of can be enlightening. It helps us separate fantasy from reality and to stay connected to ourselves and others. It can be difficult to ‘stay sane’ when we are constantly being bombarded with news items which are designed to retain our attention as much as possible by scaring us into remaining watchful and alert to yet more bad news, just in case we weren’t already frightened enough.

This process actives our fight or flight systems, sending us into survival mode which is never conducive to reflective states of mind required for conscious thought and creativity. In fact, the very type of thinking that is required for effective leadership and decision-making.

Part of our job is to help people to think when they have stopped thinking and are living in fear or in a state of hyperarousal. Of course, this isn’t always possible. However, it is possible in most cases and an outcome which is see in psychotherapy time and time again. People arrive contracted and fearful and leave feeling hopeful and with a more expansive and different mindset – each week, each month, each year this process deepens until it becomes second nature.

Through the establishment of a trusting relationship with another, we begin to create a microcosm of safety where difficult feelings can exist without the urgency to get rid of them. We learn to tolerate the intolerable, which may also result in setting limits, taking action, or even doing nothing. Whatever the choice, it will be one which emerges from a place of more awareness and hopefully lead to a more fulfilling life.

 

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

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

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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The Pandemic and the Emerging Mental Health Epidemic

There is a lot of talk about how Covid-19 and the resulting lockdown cycles are causing a mental health crisis in the UK. This blog aims to unpack and list some of the reasons why the response to the pandemic is also causing a mental health epidemic amongst us.

This year has been very hard on most of us, personally and professionally. I don’t think I have come across anyone who has not been negatively impacted by the pandemic and resulting lockdown cycles since last March. The pandemic and deaths resulting from Covid-19 are only one aspect of this crisis. The efforts to avoid death and transmission, not overwhelm the health service, and its resulting policies, in conjunction with how the Covid narrative is portrayed in the media, is what is driving the mental health crisis.

Before the pandemic hit, we were already living and dealing with normal day to day challenges linked with work, relationships, raising children, making decisions, caring for relatives, ageing and death, etc, etc. As psychotherapists, we listen to and work with these challenges everyday. The pandemic has added another layer to pre-existing issues in society, exacerbating them for everyone through the fear of death, loss, survival and health anxieties, to name a few issues which are both specifically linked to the pandemic but also issues to do with being human.

It has even become difficult to distinguish whether some of the difficulties experienced are linked to Covid or not. For instance, relationship issues which were pre-existing became exacerbated during lockdown and having to work together to home school children. Or someone with an already high level of health anxiety becomes even more anxious about becoming infected with Covid and isolates themselves even further from others.

There was a big drive to bring more awareness to mental health issues in UK society before any of us even heard of Covid-19. A large number of people were already experiencing pressures on their mental health through a variety of factors, which have now become more exacerbated through the fear of death and transmission, confinement at home, business closures, lack of outlet with entertainment venues, cafes, leisure and restaurants closed.

We have lost a large proportion of our social connections due to not being able to meet socially and professionally as we used to. Even small daily exchanges which used to make us feel more socially connected have been taken away, such as a visit to a local shop or the hairdresser.

The list is endless: Professionals who derive their identity and social contacts through work and running their businesses and had to close them, the elderly who were already lonely and have now become even more isolated, workers in the gig economy who were already struggling to survive and are now out of work, parents who were already under pressure and now have to home school as well. The list goes on…

It is vital that enough mental health support is available. In my work as a therapist, I acknowledge the collective impact in society yet focus on how it affects people on an individual level. We are all fighting our own battles at the moment, each one is dealing with a separate set of challenges pertinent to their life circumstances. It is vital for us to acknowledge and talk about what is troubling us and not just “get through”.

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

Sam Jahara is a UKCP Registered Psychotherapist, Transactional Analyst and Supervisor 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

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

Leaving the Family

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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What is Schema Therapy?

Schema Therapy (ST) is a flexible and comprehensive approach to therapy that focuses on understanding you as a person. It provides a helpful framework for us to make sense of some of the difficulties you might be experiencing. These might be difficulties with how you feel, your thought patterns, relationships, unhelpful behaviours, or a general dissatisfaction with your life.

ST was developed in the 1980s by psychologist Jeffrey Young and can be understood as an integrative model that draws on a number of therapeutic approaches, including cognitive behavioural (CBT), psychodynamic, gestalt, and person-centred.

CBT has a strong evidence base and because of this tends to be the treatment of choice for many common difficulties such as anxiety and depression; when delivering ST, I would be able to work with you to incorporate many of the effective components of CBT to support with the changes you make. In addition, ST goes deeper and puts more of an emphasis on understanding the links between childhood experiences and the development of patterns in thinking, feeling and behaving.

ST asserts that it is our schemas that link our past to our present. In ST, a schema can be understood as a deeply held belief which is often out of our conscious awareness. Schemas affect how we think, feel, and behave, and are sometimes described as our blueprints or software. They help us to make sense of the world, and are the patterns that run throughout our life. A goal of schema therapy is to help you to become more aware of your schemas and then to provide you with tools to change on an intellectual, emotional and behavioural level.

Another important part of ST is the focus on emotional needs. ST believes that schemas develop from experiences when our emotional needs were not met. One of the overarching goals of ST is to help you to develop an awareness of these needs and, over the course of therapy, develop a variety of ways of meeting them.

What happens in schema therapy?
In the early sessions of ST, we would work together to build an understanding of your current problems and how they developed. A crucial element of this is making links between your early life experiences and your current problems. The process of therapy is active, and, right from the start we would use different therapeutic techniques. These can be divided into: (i) emotion focussed strategies that aim to connect you with the emotional level of your experience, and include imagery and chair work; (ii) cognitive techniques that aim to promote flexible and compassionate thinking; and (iii) behavioural techniques that help you to challenge fears and break behavioural patterns.

What I like about schema therapy?
I really like the comprehensiveness and flexibility of ST. It provides a framework for understanding how we function on a deeper level and helps us to spot the common thinking and behavioural traps that we can all fall into. As a therapist I can be creative and draw on a number of proven techniques that aim to address problems on a variety of levels. ST also encourages therapists to play an active role in the therapy and to bring an authentic and open approach to the therapeutic relationship. This can help create a genuine connection, which is often the foundation for lasting change.

 

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

 

Dr John Burns  is an experienced Consultant Clinical Psychologist registered with the British Psychological Society, Health and Care Professions Council, and the British Association of Behavioural and Cognitive Psychotherapies.  He is available at our Brighton & Hove Practice.

Face to Face and Online Therapy Help Available Now

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What shapes us?

We all have key figures in our lives, people who either held or hold great importance because of their positive impact on our professional and personal lives. They may have been people who we are either personally or professionally connected to, such as parents, siblings, friends, family members, or teachers, bosses, coaches, therapists and work colleagues, to name a few.

These people become so important to us because we internalise their qualities and also their positive messages to us, whether they were implicit or explicit, verbal or non-verbal.

Therapists are keenly aware that some key elements need to be present in our work in order for a positive relationship to form. We know that many who come to therapy do so because of breakdown or absence of relationship early on, which we can also understand as a scarcity or total absence of some key elements listed below:

Interest and Curiosity

To feel seen, heard and to perceive sense of curiosity towards oneself from another, which is engaged, honest and encourages mutual trust. Delight, enjoyment and even surprise in the exchanges that take place.

Attunement

Usually used in the context of a parent-child relationship, but the word is also used in other contexts. Attunement is a quality where the other person ‘tunes in’ to another, almost as if trying to absorb and understand what the other is communicating on a deeper level. Attuning entails putting oneself aside to hear how the other views and experiences the world.

Consistency

Consistent love and care is something children need in order to feel emotionally and psychologically safe. This continues to be the case for adults, albeit in a different way. The consistency in the care of others is what gives us a sense of belonging and therefore a sense of safety in the world.

Commitment

To feel the commitment of another to a relationship is another form of consistency, but also one that affirms that “I am here for you” or “You can count on me”. This doesn’t not mean that the other won’t disappoint at times or will always be available. But they let you know that you can rely on their commitment to you as a friend, partner or in an ongoing professional relationship, such as the regular long-term commitment of psychotherapy, for instance.

Time

Related to the two above in that there needs to be a consistent time commitment in order for any relationship to work. The gift of time cannot be underestimated, especially in today’s world. With time, important conversations take place, people get to know one another and things are allowed to unfold. We feel valued and important when others make time to be with us.

Connection

Of course this can’t be forced. We either feel connected or we don’t. However, all of the qualities above are conducive to developing a connection with another. Some people are better than others at connecting, both to themselves and therefore to other people. But there are times when the chemistry between individuals exists in a way in which can’t be explained. Some of these formed connections stay with us for a very long time, if not forever.

What are other qualities that you see as essential to forming a positive bond with someone? I look forward to your thoughts.

 

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

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

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

Leaving the Family

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Why do ex-boarders find intimate relationships difficult?

This is a question I often ask couples who come to see me for couples therapy. Most cannot answer the question beyond the superficial. However, it is an important question to ponder: relationships are not easy for the most well-adjusted of us and so there has to be a fundamental reason why we (generally) choose to pair bond (be in a committed intimate and romantic relationship with one other person).

I believe that we choose to pair bond as on an unconscious level it is the closest that we can come as adult humans to replicating the ideal) experience of childhood where we had a parent who was there for us, who would listen to us and who, most importantly, would help us make sense of our feelings so that we knew we were not alone. This is essentially what strong functional couples do – they listen to each other and try and work out what feeling their partner is trying to convey to them. The general term for this is empathy.

I therefore believe that this explains what we all want and why we all go into relationships. And also why so many of us keep on trying to find ‘the right person’ even after so many disappointments.

What happens to boarders?
Ex-boarders also harbour hope of a good relationship, however, may be at odds in identifying one. The attachment damage they have sustained and the abandonment (couched in privilege) that they have experienced, leaves them unconsciously yearning for that idealised mother who will be there unconditionally for them. Of course, what they eventually find in any relationship with another adult is that they are not in an unconditional relationship (no such thing exists) and then they withdraw to avoid being hurt or disappointed.

What does it look like?
We are all different and so are ex-boarders, however, many have some traits in common which I shall list:

Ex-boarders tend to-

  • Withdraw emotionally from relationships in order to keep themselves safe and default to their indolence survival strategy;
  • Struggle to make sense of what their emotions are telling them and lack the ability to navigate them without becoming overwhelmed: ex-boarders are good under pressure until they are not;
  • Have an over-reliance on logic and rationality to make sense of the world – this does not work when confronted with a partner who is trying to share their emotions;
  • Regulate (read manage) their emotions by controlling their external world – exercise, career success, sex, alcohol, drugs etc. Some may be less harmful than others but all show an inanity to be in contact with their inner world;
  • Live a pseudo-life where they can never really allow themselves to feel alive as that can only happen through bringing themselves fully into relationships and navigating their needs through communicating boundaries.

What can be done?
The effects that the abandonment a child suffers from being sent to boarding school can be enormously significant. Often ex-boarders will only resent for therapy when they have ‘hit a wall’ in some way.

Psychotherapy can help and indeed is the only way to remap the brain and help ex-boarders come to life. As the damage is relational, the only remedy is a therapeutic relationship where the cut-off feelings of loss, abandonment and emptiness can be retrieved and experienced in the safety of a psychotherapeutic frame.

 

The term ‘Boarding School Syndrome’ was coined by Jungian analyst Professor Joy Schaverian around a decade ago. Since then, it has gained significant traction as a model for explaining the experiences and symptoms of adults who were sent away to boarding school as children.  Please refer to Mark’s previous blog.

 

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 ready by Mark Vahrmeyer –

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

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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Understanding Sexual Fantasy

The exploration of sexual preference and fantasy in therapy can be a portal to our inner psychological landscape. Unlocking the unconscious logic of sexual fantasy is one way of casting  a light on our internal world and of understanding the emotional and psychological difficulties that may have prompted us to seek therapy in the first instance.

Our sexual scripts are formed in infancy, long before the onset of mature sexual desire. Our early attachment experiences and the familial and cultural context into which we are born inform the psychological maps and templates for being (in the world) to which we both consciously and unconsciously refer as we develop and grow. We are evolutionarily wired and sensitively attuned to the moods and feeling states of our caregivers absorbing them all through a process of psychological osmosis.

The conflict of growing up

Whilst our lust and capacity for pleasure (according to the Freudian account) are instinctual, the road to pleasure is more often than not a complicated one. We are likely to experience myriad obstacles along the way (many that will later inform our sexual fantasies) guilt, shame, fear, rejection may all stand in the way of our experience of pleasure. We all (consciously or otherwise) feel guilty about something. Life is fraught with conflict – and from the get go. The conflict (for example) between our attachment to our families and to the developmental imperative to grow up, individuate and leave them is fraught with guilt and worry. We bring these unresolved and largely unconscious conflicts into our erotic lives.

The creativity of fantasy

The child of a depressed parent may grow up with a powerful sensitivity to and identification with the sadness of others. It may be hard for such an individual to fully connect to their own aliveness and vitality as sexual excitement is fundamentally incompatible with depression. In the imaginative realm of fantasy such an individual may be released from the burden of caring by populating their fantasies with dynamic carefree people, aroused, excited and turned on. It is not hard to understand, in this scenario, that when everyone is having a great time (and no one is depressed)  the fantasy serves as a creative permission to connect, without guilt or shame to one’s own desire.

An antidote to trauma

Many sexual fantasies can seem puzzling and hard to understand. One person’s turn on is another’s turn off after all. Arousal for some may come through being tied up and whipped, another’s from phone sex, group sex, sex with a stranger(s), etc, etc. All are plots of desire, many are attempts to draw on and transform past trauma. When someone is cruel or aggressive  in their sexual fantasy or practice it is not because they are inherently sadistic but rather that they are trying to solve a problem. It may be useful and illuminating to consider and understand why the normal pursuit of pleasure may require a particular imaginative scenario in order to be safely experienced.

Empathy and ruthlessness are important aspects of a healthy sexual relationship. Too much empathy (for the other) may be a dampener to our own desire and too much ruthlessness may render sex mechanical and devoid of emotion. Sexual fantasies can be attempts to counteract or transform beliefs and feelings that may interfere with sexual arousal and can provide an elegant ( if not always politically correct) solution to the problems of ruthlessness , guilt and shame.

When we  understand our sexuality we understand ourselves.

 

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

 

Further reading by Gerry Gilmartin

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

Why does empathy matter?

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 Therapy

There are many reasons why people seek out 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.


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Am I cracking up or is it my hormones? Pre-menstrual Dysphoric Disorder and the importance of tracking symptoms

It is not comfortable being told that you are feeling the way you do because of your hormones. This kind of biological reductionism is not helpful to any gender but the extremely severe symptoms of Pre-menstrual Dysphoric Disorder are completely aligned to the menstrual cycle. They manifest during the week before menstruation and end when or shortly after the start of menstruation. Like a switch going on and off.

There are a wide range of physical symptoms some not usually recognised as linked to pre-menstruation – changes in vision, heart palpitations, numbness and easy bruising – along with those that are familiar. In this post, I am concerned with the psychological symptoms.

The ones we might expect like irritability, confusion and weeping to excessive anxiety, deep depression and suicidal thoughts and feelings. It is the severity of these psychological symptoms, far more severe than normal pre-menstrual symptoms that make PMDD so disturbing and destructive.

Women suffering with PMDD can find themselves unable to cope with everyday life in the week or so leading up to their period. Ordinary tasks at home or at work can be insurmountable. Getting out of bed to dress and wash is impossible. The ‘personality changes’ put relationships under enormous duress. The sudden change in symptoms at the onset of a period is a relief but much of the next three weeks will be spent in repairing and picking up the pieces. It is not surprising that women can feel they are cracking up.

Unfortunately, many women are undiagnosed, incorrectly diagnosed and they can feel as if they are regularly in torment for a long time until their PMDD is recognised and treated. An example of misdiagnosis is a diagnosis of bipolar disorder. This is because the cyclical nature of mood swings is a feature of both conditions but it fails to recognise the correlation between emotional lability and the menstrual cycle. The predictability of the changes in thoughts and feelings is a key feature of PMDD and this raises the importance of tracking symptoms. Tracking symptoms provide information over time that may reveal a pattern, in this case, the menstrual cycle. Informed diagnosis leads to appropriate treatment, this means a woman will be treated for a severe problem with her endocrine system rather than a psychiatric illness. Sometimes it is your hormones.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

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Communication, communication, communication

Of all the problems presented by clients when they first attend therapy as a couple, communication difficulties are often to be found as the most pressing. However, our difficulties with communication is not just an issue within a relationship: it touches every aspect of our lives – which makes the effort of finding out how we communicate well worth the effort.

Our style of communication is based on how we learned to communicate in our families, culture, society, and with our peers.  It is important to understand that communication is a learned skill:  when we are born, we will be neither good nor bad communicators. However, since it is a learned skill, it means we can unlearn things that make communication a problem, and we can learn new ways to be more effective in the way we relate our ideas, opinions, thoughts and feelings.

What is your style of communication?

Read through a brief description of the four main types of communication and think through which style would be a best fit for you.

  1. Passive Communication       

Passive communicators fail to communicate to others what they think, want or need.  Sometimes they don’t even admit it to themselves. Passive communicators might believe that they are protecting others from their feelings, but in fact more often they are protecting themselves from potential conflict and/or rejection.

Example:

Your partner or friend asks you to do something you do not really want to do. You may feel you are under time pressure, already have too much to do, or already had something else planned for that time.

Passive response:

Agree to do what the partner/ friend asks (what feelings are involved here?)

Say, “Okay”

Pretend not to hear request

Passive communication includes:

  • Avoiding situations which might be uncomfortable
  • Avoiding conflict
  • Avoiding situations that feel emotionally risky
  • Not expressing feelings, thoughts or needs
  • Ignoring our own rights in a situation
  • Lying or making excuses in uncomfortable situations
  • Being apologetic or putting down self
  • Letting others make decisions for us

Feelings might include:

  • Relief (avoided conflict)
  • Resentment (of others for making decisions, having power)
  • Annoyed with self (didn’t say what felt/needed)

2. Aggressive Communication                

Aggressive communicators say what they think without taking into account the other person’s feelings, thoughts or needs.  Aggressive communication includes shouting, intimidating body language, sarcasm and violence. This form of communication aims to hurt, and is often a projection of the hurt and anger the person is feeling.

Example:

Your partner or friend asks you to do something you would rather not do.

Aggressive response:

Laughs at person and storms out of room. (note the ‘acting out’)

“Of course I can’t/ won’t do it!  What an idiotic suggestion.  Why would I want to do that now?  It’s stupid.”

“Yeah, right”

“You always do this.  Don’t you ever do things yourself?  Why me?  You never do things yourself: it is always left to someone else.”

“Why the xxxx did you ever become my partner/ friend?”

Aggressive communication includes:

  • Expression of feelings, needs and ideas at expense of others
  • Violating others’ feelings or rights
  • Dominating and belittling behaviour
  • Having a sense of power or control in the situation
  • Saying what you think without thinking about the outcome
  • Sarcastic remarks

Feelings might include:

  • Sense of power
  • Justified in what you have said
  • Pleased to get your way in the situation
  • May feel isolated (aggressive communication can distance people)
  • Frustration
  • Bitterness

3. Passive Aggressive Communication

People who use a passive aggressive communication style, indirectly say what they think or mean.  It often leaves the person receiving the remark feeling confused, as they have not been clear about what they really think or feel. Although the person speaking might believe they are being polite in communicating this way, both they and the recipient can often be left with unresolved feelings that linger.

Example:

Your partner/friend asks you to do something that is inconvenient for you.

Passive-aggressive response:

“Sure, no problem”…Then seeks out confidante and says, “I just talked to X, who asked me to do this. Can you believe it? He never does things himself, he’s so lazy… How did I get into a relationship with him.”

“I guess I can do that.  I am a bit busy, but I’ll probably be able to do it.  I missed something important the last time, but obviously you need me to do this so I will.”

“Whatever”

“I suppose that is one way to organise your life – getting others to do the work for you. Sure, I’ll do it.

Passive aggressive communication includes:

  • Being indirectly aggressive
  • Trying to control the situation while being ‘nice’
  • Manipulative behaviour
  • Being unclear about how you are truly feeling
  • Denying your feelings about a situation, when you are clearly aware of them
  • Making others feel guilty
  • Avoiding rejection and hurt
  • Getting what you want without facing conflict

Feelings might include:

  • Low self-esteem
  • Isolated because of distancing and confusing communication
  • Angry at self
  • Relief because person has made their point whilst avoiding conflict.

4. Assertive Communication    

People who communicate assertively, are clear and say what they mean. They accept their feelings, thoughts and ideas without judgement and express these in such a way that they don’t put the other person down.  When being assertive, they take into consideration timing, situation, feelings and thoughts.

Example:

A partner/ friend asks you to do something at short notice, when you have deadlines of your own.

Assertive response:

“I am unable to do this as I need to finish x by y.”

“I am unable to do this now, but I could do it by x.’

“I cannot do this now, but I would like to help. How about we meet at x and we can do it together?”

Assertive communication includes:

  • Expressing your feelings, needs and ideas, while maintaining respect for the other person
  • Knowing what you feel so that you can express it clearly
  • Standing up for your rights: saying “yes” or “no” when you mean it
  • Being honest with yourself and others
  • Saying what you mean (with persistence—sometimes you have to repeat yourself when being assertive)
  • Making own choices
  • Taking risks in communication
  • Facing potential conflict

Feelings might include:

  • Feeling good about self
  • Increased confidence
  • Increased self-esteem
  • Relief

Communicating assertively can make us feel anxious, but it often leaves us feeling empowered. It takes practice, but it can become habit. Think about your needs and feelings – and then consider the best way of articulating them.

It is also odd to think that to make ourselves assertive, we need to make ourselves vulnerable (by being honest and open about how we feel). If we fail to do this, and continue to communicate without the connection with feeling, we are likely to continue to ‘act out’ various defensive communication styles learned in our early family units.

How can Therapy Help?

Therapy will help you to understand your feelings better, which in turn will lead to a better understanding of your needs and the needs of those around you. You can then begin to make choices about how you wish to communicate those feelings and needs with clarity.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

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Fear and hope in the time of Covid

The coronavirus pandemic has interrupted our lives and disrupted the status quo – that which confers normalcy and (feels like) security. As we have in recent months reorganised and adapted our lives to halt the virus in its destructive tracks we have been derailed from our personal and collective sense of forward motion (progression). Forced sideways into new territories (socially, emotionally, physically and economically) some of us find our individual plans compromised and in many instances, in tatters. Confronted by an inescapable sense of uncertainty our coping mechanisms have been given a significant stress test. The covid ‘reset’ has demanded a refocusing of our priorities and our attentions.

Disrupted from our familiar rhythms and rituals and suddenly with multiple roles overlapping (and potentially conflicting) parent, teacher, partner, carer etc, most of us have experienced a significant blurring of more familiar boundaries. Under ‘normal’ circumstances different parts of our identity have different social settings, work, school, gym etc. Without the scope for differentiation that all these settings and contexts confer we may feel somewhat untethered, cast adrift. “Who am I now?”

The illusion of individualism

The comforting illusion that we may be masters of our own destiny is now creaking beneath the weight of new and uncomfortable evidence. Our interdependence and connectedness were never more clear. When we experience a loss of control and feel the fear that it evokes we are confronted by our best and worst selves. We have all witnessed (in recent weeks) and been moved by, acts of supreme neighbourliness, altruism and humanity. We may have experienced these capacities newly in ourselves and felt enlivened by our capacity to express them. More disquieting, lurking somewhere in the dark recesses of our individual and collective psyches (activated by the same fear) lives its shadowy xenophobic counterpart, suspicious, wary and often hostile…. to difference, to change, to ‘the other.’

The uncontrollability of the corona virus may reflect something of the uncontrollability of a globalised world. Both highlight our mutual dependence and by implication our mutual vulnerability. At a time when a sense of universal unity might be prescient it is also a time at which it seems extremely unlikely. In a state of fear the instinct is to contract mentally and physically, to batten down the hatches against a real or imagined enemy. In a state of fear we may abandon our capacities for hope and for trust…. on a global as well as an individual level.

The necessity of conversation

The truth (about anything) may only emerge at the end of a long conversation (always subject to review). That is to say, a genuine conversation, not a series of scripted monologues (in disguise) masquerading as conversation. A genuine conversation is one in which neither party is certain of knowing what the end will be, since in the process of conversation each party is shaped by the other.

This notion seems antithetical to current political discourse. At a time when our political leaders seem unable to agree on a path ahead how important it is that we steady ourselves in the face of such polarisation and uncertainty.

What are the conversations we need to begin having…..with ourselves, with our partners, our children, our families and our community? How might these conversations become fertile explorations of what matters now? Whilst the disruption caused by the virus has undoubtedly brought tragedy to many, perhaps (in spite of itself) it might also bring opportunity. Fear and hope are inextricably linked, each counterbalancing the other. When there is no easy path ahead how do we retain a sense of equanimity and trust? How might we stay open to the important conversations that need to be had without closing down… our minds and our hearts. How do we retain our humanity when we fear for our lives. How do we hold on to hope?

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

 

Further reading by Gerry Gilmartin

Relationships, networks and connections

Paying attention to stress

Why does empathy matter?

What is Intimacy?

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“Should I stay, or should I go?” What does easing the lockdown mean to you?

I have found the Clash’s song of this title playing over in my mind when thinking about the current easing of the social lock down in the UK. It seems to me that we all, to some degree or another, now face a dilemma whether to stay or go.

Straight away, it is important to acknowledge the relationship of this dilemma to levels of freedom and privilege. It is true that some people have little or no choice about whether to go back into their workplace.  We all face very differing health concerns, with those in the ‘extremely vulnerable clinical group’ likely to feel greatest levels of concern and anxiety about going outside.  There has also been concerning, though unsurprising, expositions of inequalities in terms of health risks, with poorer and BAME people having greater chances of fatality.

However, in my experience these will not prevent them from experiencing similar kinds of conflicts at this time. It is a reality that a great many of us will, to some degree or another, be starting to wonder about how or when or whether we return to ‘normal’.

I have been wondering myself about this dilemma but I am also interested in how it might tap into broader questions about how we think about ourselves in relationship to our worlds – both outside and inside.

There is no doubt this has been a strange and disturbing time and of course we are no way through it. The sudden exponential growth of the virus and pandemic was frightening, and many felt traumatised by the level of crisis and what felt like an intense threat to our mortality. The war metaphors and imagery referenced by our government, while perhaps intended to help rally a ‘blitz spirit’, in all likelihood, simply added to the terror already felt by many.

The orders to lock down came as a relief for many people. We had permission to retreat and protect ourselves against what had suddenly become a hostile world. This was and is a necessary response but one that also exacerbated the fear of the outside world engendered by the virus and the rhetoric used about it.

We all responded differently to the retreat and this of course varied at different times. There are those who found and continue to find the lock down liberating, others who found and find it oppressive.  Of course, we are also living in different circumstances which add or detract from the benefits of the protection it offers. For example, it has been widely reported that incidents of domestic violence and abuse have increased during this period. Many were able to work easily from home, many were not and there was, and is still, differences between the level of risk for those going into work. And many have lost work or continue to face this as an increasing prospect.

External factors aside, our relationship to the pandemic and the lock down response will also key into aspects of our own internal worlds. A reluctance to move out of lock down could arise for those of us who tend to use retreat as a defence. It makes sense that the bubble offered by the lock down could tap into and heighten historical ways of managing difficult realities through strategies of self-seclusion. At the same time, those of us who have particularly found the lack of purpose and activity in the lock down difficult may have developed defences around keeping busy as a means of warding away difficult or painful feelings.  This could lead to a manic response to the easing of restrictions – perhaps a rushing quickly back into the world and ‘normality’.

Of course, both states may be at play in us at different times, but I am wondering about our overall tendencies that will shape how we are likely to interpret, and respond to, this shift in government advice.

Reflecting on my starting title, I wonder now about the aptness of the Clash song. It seems the transition from lock down to ‘normality’ (whatever that means) is not going to be as either/or as staying or leaving a relationship. It looks likely anyway that we are going to experience further Covid outbreaks with many expert views suggesting the current easing as premature and a second wave imminent.  We can therefore most probably anticipate more lock downs, perhaps even soon.

So, it feels more appropriate to think about a dialectic in/out situation we find ourselves facing requiring complex navigations. How we proceed and find our way through these difficult and disturbing times and those ahead, will be dictated by many external factors but also our own internal worlds and their responses, conscious and unconscious, to the different experiences of this pandemic.

 

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

 

Further reading by Claire Barnes

Silences in Therapy

Sibling Rivalry – Part 1

Sibling Rivalry – Park 2e

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Magnificent Monsters

“The passions, these “magnificent monsters” (Nietzsche, 1967, p. 521), can we consider them a gift in which something valuable can be learnt?

Below is a consideration of the multiple, dynamic, creative and sometimes conflicting forces of energy that are often competing for dominance within us – what Fredrick Nietzsche sometimes described as ‘the passions’. Others may describe them as drives, passions and impulses. They are always present and seemingly are what constitutes and influences much of what is our lived experience. Despite their force and significance, they can often go unnoticed and our knowledge of them is always incomplete. They sometimes emerge into our conscious awareness when we are awakened into our existence, for instance when we are confronted by experiences such as uncertainty, grief and love.

Feeling passionate can be both enthralling and scary. Passions are sometimes encountered as other worldly, because they can appear out of nowhere and stir us and shake the ground beneath our feet. Passions can cross the many boundaries of our lived experience. They can symbolise our strong emotional states including joy and suffering. Perhaps many people can relate to the passions felt in the first stages of falling in love, or the sudden earthquake of loss.

At times, we may find ourselves running away from them. This is perhaps born out of a sense of needing to escape from what is being experienced. Perhaps this can be influenced by our conditioned beliefs, rooted in religious and philosophical beliefs, which might espouse that passions are dangerous, uncivilised and something that need to be tamed, and/or eradicated.

Other times we may run towards them, feeling that despite the fear they might cause within us, their intensity and irreducible form feels like an opportunity to live more vitally and come-into-being.

As time passes, human beings seem to be moving into spaces where connection and desire are dampened down by our addiction to technology, self-preservation and control. Even therapy can find itself, unwittingly perhaps, offering ways to master the ever-arising encounter with thoughts, emotions and sensations, so that we might never have to feel perturbed. Other times therapy may be seen as providing an opportunity to self actualise, by integrating all that we apparently are. Perhaps all of this in some way is a strategy to defend against feeling unsafe and uncertain.

But what if moving out of uncertainty is not possible or even necessary? What if these passions are revealing our possibilities, our strengths, our potential to move and become? What if we need them to create, to learn, to feel alive within our uncertain world. What if really feeling them slowly and subtly before acting on them or attempting to eradicate them is important? What if becoming intimate with them and patiently listening to them is what is necessary?

Perhaps this is where therapy can facilitate; by providing a space to feel, to explore, to experiment so that maybe we can change the relationship. What is perhaps significant to consider, for a while at least, are the desires and possibilities they are revealing within us. As Clarice Lispector (2012) wrote: “Life, my love, is a great seduction in which all that exists seduces.” (p 55).

Perhaps some passions must sometimes be tamed in order to live within a collective space. However, within any taming I feel it is equally, if not more significant, to understand what is being felt and moved within us with curiosity and kindness so that we may experience this brief encounter with life more deeply and compassionately.

Maybe letting go of a need to control, just for a while, and trusting our continually changing movements, just for a bit, is all that has to happen?

With gratitude and inspiration from Nietzsche (1967) and Clarice Lispector (2012).

 

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.

 

Further reading by Susanna Petitpierre –

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

Lispector, C (2012) The Passion According to G.H. Trans, Idea Novey. London, Penguin

Nietzsche, F. (1967) The Will to Power, trans. Walter Kaufman London: Weidenfeld and

Nicolson.

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Love in the time of Covid

I admit the shameless plagiarising of the title of Gabriel Garcia Marquez’ – ‘Love in the Time of Cholera’ as it fits as a Segway into considering the tresses and strains of both finding love, and holding onto in, in the current pandemic. 

The statistics

Disturbing statistics are emerging of surging rates of domestic violence, sadly predominantly perpetrated by men upon women, exacerbated by the circumstances brought about by the ‘lock-down’. A surge of somewhere between 25% and 35% in the rates of reported domestic violence hide all that goes unreported. 

Alongside the extremes of domestic violence lie other statistics such as the reality that many couples have suddenly been catapulted from spending a couple of hours per day together, to inhabiting the same space (indoors and out) for the entire of the day. A young couples dream has become many seasoned couples challenge (and for some a nightmare). 

On finding love 

The old rules of dating have gone through a revolution in recent years from what dating constitutes, through whom we date (gender fluidity) into how we date revolutionised by the internet. 

However, suddenly, the seemingly endless supply of opportunities to physically meet others has dried up with us being left with all the tools and little of the substance. We can swipe left or right, however, we cannot meet those we like (unless we risk social judgement and our own physical health – both of which may paradoxically make the whole encounter that much more exciting). 

Referring to statistics, there has been a surge in pornography use as those who are isolating alone seek out some virtual simulation and those isolating with partners seek out some sense of novelty. Throw into the mix the likely enduring requirements for ‘social distancing’ and it raises questions around what dating may look like going forward? 

On keeping love 

Coping with ‘lock-down’ can be challenging on any relationship whether new or old, robust or fractured. That is because relationships all rely on certain key ingredients that make relating possible – all of which have been outwardly challenged during lock-down.

Space 

It is abundantly obvious that for all of us, our physical worlds have shrunk down. Socialising, leisure trips and the distractions of shopping have all been taken away. And many of us find ourselves cooped up for 24 hours per day (bar the ubiquitous exercise sorle) with our partners. 

Negotiating physical space is always a part of a healthy relationship involving discussion, negotiation and compromise. The world of Covid lock-down has amplified this and with it the requirement to communicate effectively around personal space. In lieu of healthy communication, some couples find themselves acting out and reacting to what they perceive as intrusions by the partner, when their partner is probably trying to carve our a little space for themselves too. 

Boundaries 

Boundaries are similar to space though in this context I shall be referring to them as the management of internal space – emotional closeness and distance. In any relationship, no matter how healthy, it is very unlikely that the two protagonists (or more if you are polyamorous), have the same needs for emotional intimacy. This is inherently frustrating. More so now than ever, but remember, it is also a simple truth of being in an adult relationship with another adult (rather than regressing to the fantasy of a union between mother and infant). 

Boundaries need to be explicitly named and negotiated and naming how one is feeling (taking turns to do so) is a key foundation in managing boundaries: if we know what we are feeling then we can communicate it. 

Difference 

The two former headings bring me neatly onto the concept of difference. One of my pet hates is when couples refer to their partner as ‘my other half’ or some iteration of this fantasy merger. 

Being in an adult relationship with another adult means having to tolerate reality – the reality that our partner is different to us and therefore has different views, thoughts and feelings to us, irrespective of how odd we may find them. 

When tensions are heightened (cue the Covid lock-down), humans can find difference threatening and will seek out consensus and similarity. This happens of a national scale where many differences are (temporarily) put aside for the common good and presents itself in relationships too. The problem is – it is an illusion. 

Sure, we can all agree to put aside differences in challenging times in order to achieve a goal, however the differences remain. And in lock-down, those differences are far less likely to be ‘life or death’ issues between couples and far more likely to be around an opinion about a film, a meal, or some other triviality that when mixed with anxiety, becomes evidence that just perhaps our partner is rather mad and not the right person for us to continue our journey through life with in the post Covid landscape. 

Couple who genuinely fare well in daily life in terms of negotiating and compromising; in observing difference no mater how hard it is – the cornerstone of empathy – will fare better in this crisis. 

The third table leg 

We all know that in order to build a stable table a minimum of three legs is required: two leads to instability. The same goes for relationships – not that we need a third person in the relationship – just the spectre of a third. Let me explain: 

Relationships are a complex balance of wanting to be one with our partner and suffering the frustration of knowing that that cannot happen. To get too close kills the relationship as the couple can no longer see each other and the relationship becomes a merger – a fantasy re- enactment of the womb experience. Too distant an intimacy and connection is not possible – this the the couple dance. 

For many couples their partners interaction with the outside world makes them interesting and enables each to see the other as a separate person who has a life outside of the relationship. Couple work, play and socialise, at least in part, separately. And this is the way it has always been and remains in tribal communities such as, for example the Aboriginal communities of Australia where ‘men’s business’ and women’s business’ was culturally and ceremonially embedded so observe difference. 

Under Covid, many of us have lost jobs, are being paid to stay at home or are trying to work from a co-living space with our partner – we no longer have to wonder about the ‘mysteries’ of men’s and women’s business as we are exposed to it 24 hours a day. The third table leg has become decidedly wobbly. 

On kindness 

Just like ‘Love in the Time of Cholera’ is not actually about cholera, nor are the current relationship challenges really about Covid and the lock-down. They are about who we are and how we navigate adult to adult relationships sacrificing the certainly or a pseudo infant- adult relationship for one that is real and therefore difficult and frustrating. Marquez’ book is ultimately about the reality of relationships in all the glory and pain and that is what is being brought to the forefront in this crisis for many couples. Being kind to each other is harder than it sounds when so much of what we rely on externally to manage our relationships vanishes in a lock-down.

 

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 –

Coronavirus Lock-Down – Physical Health vs Mental Health

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

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Coronavirus Lock-Down – Physical Health vs Mental Health

As I write this blog, we are entering into the fourth week of so-called ‘lock-down’ across the UK. Despite daily speculation, nobody has any idea how long the restrictions on life will last for. 

Everything has changed and this has been hard to cope with in a society where stability and the ordinary continuity of life has been severely disrupted and curtailed; the UK population is currently in limbo, isolated from the wider community and possibly in closer physical contact with family than ever before. 

We know why we are doing this – we are reminded multiple times per day – to ‘save lives’ and ‘protect the NHS’. 

There has been much talk of the compelling priorities of the health of the nation vs the health of the economy. Arguably initially it was the later that took precedent in this country meaning we are now facing large numbers of fatalities. However, beyond the obvious economic costs of ‘lock-down’ and social distancing, the mental health impact seems to have been largely overlooked. 

Why start now? 

Despite a strong history and legacy of psychoanalysis and psychotherapy in the UK, mental health provision has long-since slipped from the forefront of policy-makers minds. Gone is the aptitude to be curious and instead a culture of symptoms has emerged increasingly oblivious to the fact that symptoms are communicating emotional and psychic distress. Depression has ceased to be seen as an inability to mourn and is instead an illness to be medicalised – as if it can be caught from the air like Coronavirus. 

So, in the midst of the pandemic, it is not surprising that any meaningful discussion on the impacts of quarantine, lock-down and social distancing will have on mental health, not to mention the ongoing rhetoric of how the socially interactive parts of our lives will be ‘changed forever’; today the WHO suggested that wearing a face-mask in public must become the long-term norm without the being any consideration to what the psychological impacts on self and others would be from such a policy. For example, where healthy development of an infant is contingent on them constantly scanning their care-givers face for reassurance and validation, what will the effect be of masking these quite literally behind a surgical mask? 

Compelling needs 

Whilst some of us may remain in denial, there is no question that social distancing is the only real means available at present to combat this pandemic. It is the oldest method in the book for dealing with epidemics and remains all we have (at present). 

However, for relational beings (which is what humans are) the strategy is psychologically and emotionally challenging (and for many catastrophic). 

Humans understand themselves and gain a sense of meaning through relationships with others. This is not a luxury – it is essential both as we develop and throughout our lives. Not only do humans needs to be able to communicate verbally, but we also require contact that is ‘non-verbal’. 

The mortality of isolation 

Isolation may keep us safe from the Coronavirus, however isolation is linked is not the cause of many mental health problems such as depression and anxiety and is fatal, particularly for the elderly (who, it would seem, are also being most impacted by Covid-19). Indeed, some studies have shown that loneliness is, indirectly, the biggest killer of the elderly. 

Virtual connections 

We live in an age where we can make use of virtual connections and video conference software to stay in touch with each other – my profession – psychotherapy – has overnight shifted to online working to ensure the continuity of therapy sessions. This is a positive, however, it will not migrate the tsunami of mental health and relationship problems that will arrive in the wake of the health crisis. 

Meaning making propositions 

For many, our daily lives, often revolving around work, provide us with a profound and anchoring sense of meaning and purpose. Not only has the ‘treadmill’ stopped, but with it much of the sense of purpose and meaning that many of us have. These two combined can be difficult to manage contributing to anxiety and depression – a literal crisis of meaning. 

Anxiety 

In the absence of meaning and purpose, and with the distractions of ‘ordinary’ life removed, anxiety can bubble up. It can leave us with a profound sense of unease and discomfort in our own skin and the wider world. And at present, it is hard to escape from. Of course, in reality anxiety can never be escaped from – it is part of us. It can, however, be faced and used to ask difficult questions about how we live our lives. 

Depression 

We are faced with a narrative from the media and politicians that ‘things will never be the same again’. I am unsure really what this means other than that it sounds like a warning or premonition of some kind. Being alive means accepting that things cannot remain the same and that we adapt. Change is hard and it forces us to be confronted with difficult emotions that many of us would rather run from. In the current climate of Covid, running from emotions has simply become harder. 

Whilst there simply cannot be a national or state managed balance between physical and mental health needs at present, this does not mean that as individuals we cannot be staying with our discomfort and asking ourselves what we ultimately want from this precarious life. 

 

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 psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

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

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