Brighton and Hove Psychotherapy

Online Therapy
01273 921 355

by Leave a Comment

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 bi-polar 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 that is a key feature of PMDD and this raises the importance of tracking symptoms. Tracking symptoms provides 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

Facebooktwitter

by Leave a Comment

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.

Facebooktwitter

by Leave a Comment

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?

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Facebooktwitter

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?

Facebooktwitter

by Leave a Comment

“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

Facebooktwitter

by Leave a Comment

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.

 

Facebooktwitter

Copyright © 2020 – Brighton And Hove Psychotherapy – Privacy Policy
6 The Drive, Hove , East Sussex, BN3 3JA.