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Do you have Unrelenting Standards?

Put another way, is getting anything less than 100% not acceptable to you, and a trigger for uncomfortable feelings of failure, of not being good enough, of self-criticism, self-doubt and shame?

In my experience as a psychotherapist, a personal drive for perfection is often the root cause of distress in many of those seeking therapy. It can be a hard issue to resolve. After all, why would we not try our best?

An illustration of how much pressure unrelenting standards (US) can generate is a client I saw who, for ‘relaxation’ – as she saw it – became a triathlete. Nothing wrong with that, of course, but for this thirty-something woman, who for this blog I will call Caroline, her hobby required a series of log books and electronic aids to record every jog, every swim and every bike ride with painstaking notes about her heart rate, timings and much more (1).

It emerged in therapy that Caroline took any sign that her performance was not improving as a trigger of dismay. Was it because she was getting old? That she was physically too weak? Or that she was simply not good enough? She spoke about her ‘hobby’ almost as if it was a military exercise. The physical benefits were clearly being offset by that the effort involved was itself yet another source of worry. Worry about worry!

So how do unrelenting standards develop as a pattern of behaviour that can have maladaptive and counter-productive overtones? In a previous blog, I wrote about basic human needs, and pointed out that, according to US psychology researcher Caroline Dweck (2), in order to feel safe we need to come to feel that we exist within a secure base. How is this generated? Key elements are that we need to grow up feeling that the world is reasonably predictable, that we are accepted and loved (by those around us) and that we are sufficiently competent.

If that happens and we believe we are indeed broadly secure, the Dweck paper also says that we come to believe we can trust other people, we feel that we have a reasonable degree of agency and control over what happens to us in the world, and we develop a healthy and balanced sense of self-esteem.

Against that background, how do unrelenting standards develop? The current theory is that if we feel we have been abandoned in any way during our lives (for example by bereavement or as a result of divorce), and/or if we have been badly mistreated or abused, and/or if we come to believe we are basically defective, feelings that we are fundamentally unsafe develop. Our secure base is seriously compromised.

Those feelings are triggered in a part of the brain called the limbic system, which exists to monitor danger and to provide the tools for dealing with perceived threats. It is an extremely powerful and fast-acting structural network and if was not, we would soon be dead. Our fight-flight-freeze responses – all there to protect us – originate in the limbic system and they are activated by the five basic emotions: fear (through which we become aware of danger); anger (with which we can deal explosively and rapidly with threats); disgust (which, when triggered, prevents us ingesting poisons); sadness (loss of a loved one is perceived as a threat because we evolved as pack animals); and joy – the one positive emotion, which is an expression of the pleasure and sense of safety we feel when connected with the world and others.

The upshot of this is that if we feel we are in danger, the limbic system goes into overdrive.

We cannot relax. Any signal, however small, of abandonment, or abuse, or of defectiveness has to be countered by effort and that involves making sure that every aspect of what we do is ‘safe’.

How can this be treated? A vital step is to obtain an understanding of the root causes. In Caroline’s case, it gradually emerged that a significant factor was that her father – though otherwise very loving – never seemed satisfied with what she achieved. He regarded a ‘B’ grade in an exam as a failure and even an ‘A’ was not good enough unless she was also top of the class. Caroline often turned to her mum for reassurance, but instead, she sided with dad. The result was that Caroline first came to dread exams and then went into constant
overdrive to make sure she got the highest possible grades and left nothing to chance. She became locked in what felt like a desperate battle to prove she was not defective. A relentless drive towards perfection felt like the only way she could get love and affection from her parents.

Once Caroline became aware of the nature of the pressure involved, she could begin to see that as an adult, she could make her own choices about the amount of effort she wanted to expend on tasks, and could begin to experiment with dealing with day-to-day demands in a less stressful way, including that sometimes- and maybe even often – 70% is not failure.

Further information about unrelenting standards is contained in this You Tube video.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Resources –

(1) Details changed to ensure client cannot be identified.
(2) https://moodle2.units.it/pluginfile.php/358466/mod_resource/content/1/2017%20Dweck%20PR.pdf

 

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What Psychological Processes make us ‘Choke Under Pressure’?

It is a process whereby our bodies experience environmental stressors as a threat to our physical survival, thereby releasing stress hormones such as cortisol and adrenaline. This is an essential part of all mammal’s fear or threat response, which has become maladaptive in the modern world, as the threats we experience in modern life often do not require us to fight or flight, but rather be calm and think. The threat response, or ‘fight/ flight/ freeze’ responses draws on a more primitive part of the brain which shuts down all other systems to gather its energies and resources to survive danger. This means that our more evolved thinking and reflecting part can’t be accessed either.

Are some individuals more prone to ‘choking under pressure’? 

Some people have this survival system more activated than others. Usually this is linked to having experienced more emotional, psychological or physical threat and danger in childhood, when the brain is still developing. These individuals can end up perceiving life as dangerous a lot of the time. There are also certain triggers for chocking under pressure, such as a major past event or failure, a significant poor performance in a certain area which has led to loss of confidence, or certain negative associations. It could also be that a person is experiencing a lot of stress in their present life and therefore the resources for good performance just aren’t there.

How can we prevent ‘choking under pressure’?

Usually by gradually increasing exposure to situations which are perceived as threatening and checking these against reality. The idea is to challenge our false perception of certain situations. If your threat system is often activated, then I would suggest working with a psychotherapist on past traumas that are being re-activated by present events. Increasing self-confidence in certain areas, challenging negative self-belief and self-perception, and also teaching your body to relax through breathing and other activities that help regulate your emotional system. By increasing the focus on the task at hand, rather than on the outcome, takes focus and a calm state of mind. All of these tools can help either in isolation or in combination, depending on how bad the “chocking “ and how often it occurs.

 

On our website you can find more information about our counselling and psychotherapy services and how to contact our team.

 

Sam Jahara is a UKCP Registered Psychotherapist, Clinical Superviser and Executive Coach. She works with individuals, couples and groups in Hove and Lewes.

 

Further reading by Sam Jahara

Finding Contentment in the Age of Discontent

Having Healthy Conversations with Men about the Menopause

What causes low self esteem?

Online therapy: good for some but not everyone

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What Causes Low Self-Esteem?

Low self-esteem stems from beliefs that we have about ourselves, a negative self-evaluation which is usually rooted in childhood experiences. The way we were spoken to, treated, and made to feel as children has a significant impact on how we see and therefore relate to ourselves later in life. Some of us may also have grown up with parents who were not very confident and had low expectations of themselves and their children. Social class, culture, race, gender, sexuality, and disability are also societal and environmental contributing factors to how we self-evaluate.

Knowing where negative self-belief and low confidence comes from is the first step in effecting change. Feeling things that we don’t understand can be confusing and cause anxiety and depression, further perpetuating negative self-belief. The next step would be to begin challenging these beliefs and check them against the reality of your life and achievements, skills, etc. Many of the beliefs we carry are just that: thoughts about ourselves that do not match reality. This can lead to perpetual feelings of failure, regret or agonising about every small decision for fear of making mistakes. Some of these feelings can be debilitating and hold us back from moving our lives forward with confidence in our decisions.

Awareness of negative self-talk is also useful in that we can choose to gradually replace this self-talk with more positive inner dialogues. Sometimes people are surprised at how much time they spend being self-critical. The way we think has a direct impact on how we feel, therefore it is important to work on these issues.

How Relationships Affects Self-Esteem
Cultivating positive and healthy relationships is essential in gaining more confidence. A sense of belonging and acceptance comes from a variety of places, but the main place that it comes from is relationships. Therefore, being in relationships that don’t make you feel good about yourself, where you are badly treated, taken advantage of, etc is only going to make you feel worst about yourself. This includes both personal and professional relationships.

The definition of a healthy relationship is one where there is mutuality and exchange of support, ideas, validation, trust and honesty. The more we base our relationships on these principles, the stronger they will grow. Sometimes low self-confidence can get in the way of building relationships or seeking career opportunities for fear that others will think that we have little to offer. Again, challenging these beliefs and checking them against reality can help us to start to behave differently, take more risks and challenge ourselves in a good way.

In Psychotherapy we work with the root causes of low self- confidence, for instance how early relationships have contributed to the beliefs that we have about ourselves today, and then gradually replacing these with more helpful and realistic beliefs about who we are and what we are capable of. This usually leads to making better choices in life in the areas of work,  relationships and health.On our website you can find more information about our counselling and psychotherapy services and how to contact our team.

Sam Jahara is a UKCP Registered Psychotherapist, Clinical Superviser and Executive Coach. She works with individuals, couples and groups in Hove and Lewes.

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What is Belonging and Why does it Matter?

I was recently invited onto the Podcast ‘Conversations with Annalisa Barbieri’ to talk about the topic of ‘Belonging’.

The discussion centred around our mutual experience of growing up in cultures that were not of our families of origin. Annalisa is technically a ‘second culture kid’, and I am a ‘third culture kid’ – the latter meaning I spent my formative years in a country other that that of my parents or where I was born.

The focus of our conversation was on belonging and whilst a rich discussion, we were limited by time and the need to keep the discussion relevant to a broad audience.

In this blog I am going to (briefly) explain why I believe how ‘belonging’ is absolutely essential to not only our emotional and psychological health, but beyond that, critical to our very existence. And how it is under threat.

I have in previous blogs written about primary belonging which we refer to as attachment, and so I am now primarily approaching the topic from a more anthropological perspective.

My premise is that if we do not have a strong sense of belonging then there is an inverse correlation with the amount of (death) anxiety we are exposed to. At the extreme, this anxiety is unbearable and is the primary source of neurosis (and psychosis).

What is belonging?

Our first sense of belonging is derived from our family of origin. Belonging and attachment are inextricably linked for children and the main role of belonging in our family is, beyond immediate safety, as a means of deriving self-esteem.

As children we want to please our parents. We learn ‘right’ from ‘wrong’ and bit-by-bit form an understanding of the culture of the family – the rules and ways of being in that family. Through satisfying those rules, we derive self-esteem. So what is self-esteem?

Self-esteem is a combination of feelings whereby we feel valued and appreciated alongside feeling a sense of belonging. It is linked to meaning in that if we are embedded in a culture (a family) and are able to fulfil the expectations of that family – the cultural expectations – then we derive a sense of meaning from the process.

However, self esteem does not only come from ‘fitting in’. Healthy and psychologically robust children grow up in environments where the culture both supports them to derive self esteem from meeting expectations but also from forging their own path – expressing who they are.

As humans we are all somehow trying to find our personal balance between ‘standing out’ and ‘fitting in’, whether that be in the culture of our family of origin or later, in society.

What is Culture?

When I use the term Culture, I am referring to it on a macro level – in the context of society. If society is made up of the people with whom we share commonality, then culture is an expression of the values of that society.

Culture has two functions – it enables people to find mechanisms for generating self esteem (work, social groups, interests etc.) and secondly, and this part is entirely unconscious, it has an enormous symbolic function in assuaging death anxiety. Every culture on the planet provides its constituents with answers to cosmological questions, the four primary being:

Where do we come from (the story of our origin);
How to behave whilst we are alive (and derive self esteem);
What happens when we die (funeral rites etc.);
A myth of some sort of afterlife.

Culture is therefore in essence religious, and so are all human beings. However, as powerful as culture is, it remains symbolic and therefore cannot compete with the realities of death and so there remains residual death anxiety that we contend with. This in part gets expressed by an intolerance towards others who have a different culture as when we encounter difference it unconsciously increases our own anxiety as our cultural values are undermined and thus death anxiety encroaches upon us.

A currently example of the above is the war in Ukraine. The West thinks it can win on firepower – which it can technically – but what they fail to realise is that Putin is fighting a religious war – a war to restore the ‘myth’ – the culture – of Russia. Ergo, the war is unwinnable.

The role of myth

When we hear the word ‘myth’ many of us think of stories of old, perhaps extending back to the Ancient Greeks who had many a myth to tell. The truth, however, is that all cultures are comprised of myths. The answers to the aforementioned cosmological questions that each and every culture answers for its constituents are in essence myths. They are myths because they are stories rather than empirically provable.

Myths are stories that are held by the collective – by all, or at least most, constituents of a culture.

They may just be stories, but they are stories that hold great power in anchoring us to an identity and providing us with a sense of belonging.

Technology and the loss of myth

Joseph Campbell, the American writer and mythologist suggested that the world is changing too fast for us to cultivate and sustain myth. This matters significantly as, if myth forms the basis of culture, and culture functions as both a vehicle of deriving self esteem and in assuaging death anxiety, then the loss of myth renders us more anxious and less able to derive self esteem from our culture.

The deconstruction of Western Culture

We are living through a period of mass social change, much of which has been brought on my technology and some brought on by unexpected, but seismic events, such as The Pandemic.

In The West we are seeing long-standing cultural institutions and social structures being torn down at an alarming rate. The issue is not a moral one – some of these institutions and structures represent oppression and inequality and need to be challenged. However, we are at the stage of challenging virtually every construct that defines us right down to sex and gender. And yet have nothing collectively held to replace it with. There is nothing left to collectively believe in.

If all systemic meaning is removed and annihilated we will be left with nothing from which to derive our identity, sense of meaning and self-esteem. Perhaps this is already afoot as traditional ‘pillars’ of meaning collapse and people have little to replace them with, and certainly little of symbolic (religious) value, death anxiety comes rushing forward and manifests as both intolerance towards others (increasing culture wars), tribalism and ‘mental health problems’.

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

Can chatbot companions relieve our loneliness?

What are feelings anyway?

Client or patient; patient or client – does it matter?

The psychological impact of the recession

Why do people watch horror movies?

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Why we need a ‘Secure Base’

At the heart of the process of psychotherapy is trying to see more clearly what our basic needs as human beings are and how they can be met. Most clients seeking treatment are feeling uncomfortable because of difficulties in this domain.

The sense of discomfort is often compounded because, without help, it can be hard to unravel what our core needs actually are. There is no simple users’ manual telling us how our brains and emotions work. This article is an attempt to shed light in this important arena, based on recent pioneering research work.

Our understanding of this subject has undergone a major revolution since, Sigmund Freud – in the 1890s until his death in 1939 – led the way in creating a theoretical framework of the workings of our brain. He postulated that if libidinal needs – such as for food and sex – are not met, the result was neurosis, repression, unhappiness and anti-social behaviour.

In the 1940s, a British psychoanalyst originally trained in Freudian theory called John Bowlby developed a revolutionary alternative framework.

He came up with the idea that, above all, during our growing up period, we need what subsequently came to be called ‘a secure base’. He concluded that more important than Freud’s libidinal desires was the requirement to be looked after, to be connected with others, to be loved and accepted and to be made to feel safe.

Bowlby’s pioneering research was conducted during the Second World War among children orphaned during the Blitz. He believed they were distraught to the point of inconsolability and felt totally disconnected because they were missing their parents’ love and care.

A seminal piece of research which further supported Bowlby’s main ideas was conducted in 1958 using rhesus monkeys. It was found that a distressed monkey infant did not go first to a mother model dispensing food, but rather to one covered in fleecy material which felt warm and comforting (1).

Parallel research also showed that those who did not have a secure base became less likely to explore the world, less sociable and more prone to mental and physical problems.

In an ideal world, our individual needs are met during our childhood by our parents or principal care-givers. But of course, parents often can’t manage. In the vast majority of cases, that’s not because they want to upset or harm us, but rather because their own needs have not been met and their ability to be emotionally available has been compromised. They can struggle to be able to express the right level of ‘good enough’ care.

Bowlby’s ideas have been hugely refined and expanded since his first research papers were published during the Second World War. A distillation of latest thinking in relation to our core needs and the ‘secure base’ is contained in a paper published Stanford University psychologist Carol S. Dweck in 2017 (2).

She states: ‘. . . basic needs are present from very early in life and their criteria for inclusion include: irreducibility to other needs, universal high value from very early in life and importance for well-being and optimal development from very early in life’.

On the basis of her very wide research and reading, she postulates that three ‘basic needs’ – for predictability, acceptance and competence – are the primary components of the secure base:

competence acceptance predictability

To spell that out further, if we grow up feeling that the world is reasonably and broadly predictable – that we are looked after and loved, have food, that there is routine – then we feel fundamentally safe and secure; if we develop so that we believe we can do the tasks required of us, we feel able and equipped to deal with life’s challenges; and if it is communicated to us that we are accepted broadly for what we are in ourselves and in the family and in social settings, we feel comfortable in our interactions with the world and other people.

In turn, feeling ‘safe’ gives us the basis to be able to regulate our primary negative emotions – fear, anger, sadness and disgust – to a comfortable level.

Dweck further says that having such a ‘secure base’ generates further benefits.

  • We feel can control events in our lives as a result of experiencing at sufficient levels predictability and acceptance;
  • We develop self-esteem as a by-product of feeling that we are competent and broadly accepted for what we are;
  • We feel we can trust ourselves and others more easily if we have experienced predictability and the feeling that we are accepted.

Finally if all these pieces of the jigsaw are broadly in place, then we also develop a sense of self-coherence.

In future blogs, I will explain on the basis of latest research how emotional regulation can be achieved through the therapy process.

 

David Keighley is a BACP Accredited counsellor/psychotherapist offering short and long term therapy to individuals and couples using a variety of techniques such as EMDR, CBT and Schema Therapy. He is also a trained clinical supervisor.  He is available at our Brighton & Hove Practice.

 

Resources –

(1) https://positivepsychology.com/harlow-experiment/

(2) https://moodle2.units.it/pluginfile.php/358466/mod_resource/content/1/2017%20Dweck%20PR.pdf

 

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On Living as Becoming (Part Two)

We seem to be in a world slipping deeper into seeking safety, transparency and the need for power and control to sanitise life. All as an apparent response and remedy to pain and suffering. A desire for continued uninterrupted happiness and security. We seemingly long for the place where happiness is and will remain,  but as Nietzsche states-  

“the hunt for happiness will never be greater than when it must be caught  between today and tomorrow; because the day after tomorrow all hunting time may have come to an end altogether”. (Walter a. Kaufmann, Nietzsche. Philosopher, Psychological, Anti-Christ. Princeton: Princeton University Press, 1950, p.140.

I interpret Nietzsche’s quote as an ironic statement, one that is not validating the search for happiness but understanding it as a fleeting endeavour. I believe he is asking us not be distracted by it. To go deeper and face and live life in the knowledge of our impermanence.

Both Nietzsche and Kierkegaard (great influences in existential thought) were concerned by how humans repressed and avoided self enquiry. They both strived to understand human existence and used their own existences as a case study for analysis. They recognised how they, and others, would seek to protect themselves from reality and consequently suffer extreme symptoms and tensions, such as depression, guilt, anger, anxiety, obsessive behaviours and disconnection. They had not even considered the effects of social media as an escape on human experience when writing this.

What might get lost in avoiding these affects in terms of our potential and freedom?  Soren Kierkegaard (1844) felt without anxiety there would be no possibility and growth as a human being. He suggested anxiety is the ‘dizziness of freedom’ and ‘freedoms possibility’. He famously wrote,

“Whoever has learned to be anxious in the right way, has learned the ultimate…” (Kierkegaard S. The Concept of Anxiety. New York: Liverlight; 2014. p. 188.

They both emphasised the influence and importance of passions and the significance of commitment,  to take responsibility for their existence, to act, to create. They discussed in their own ways how our affects are significant for explorations (see more in a blog on Nietzsche’s magnificent monsters).  That attempts to avoid inner conflict and intensity and intellectualise and externalise struggles were in some way a defence against one’s own vitality. Anxiety was considered as a potent and necessary force for transformation. Potentially leading to an individual’s confrontation with their illusions and consequently a deeper awareness of how they are implicated via defences and rationalisations. As a dear friend and wise man recently said,

“without inner conflict, what chances do we have to give birth to ourselves. At the very least inner conflict is good for generating creative work”. 

Both Nietzsche and Kierkegaard died young (in the modern sense of the word). In that time they wrote prolifically and created great texts and thoughts, used to this day, that inform life and some types of psychotherapy in particular. In my mind both seemed to surrender generously their existences to creating and self enquiry (distanced from a need for notoriety or self preservation). They certainly left an enriched soil for those yet to come. There are many stirring and striking aspects to both of them and their writings.  However what moves me the most is their similarity to the eucalyptus tree’s surrendering of self-preservation as a dominant force: letting their passions, tensions, vulnerabilities, heartbreaks,  limitations and crises become a strength and force for creativity and transformation for those who are interested.

To end this piece, although more will come later about Nietzsche’s ideas about Will to Power’, I thought it might be fun to insert a quote kindly gifted from the aforementioned wise friend, where Nietzsche compares himself to a plant.

“It is absolutely unnecessary, and not even desirable, for you to argue in my favour; on the contrary, a dose of curiosity, as if you were looking at an alien plant with ironic distance, would strike me as an incomparably more intelligent attitude towards me”. (Nietzsche in a letter to Carl Fuchs, July 29, 1888)

 

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

 

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.

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Antidotes to Coercive, Controlling and Narcissistic Behaviour

There have been many more articles written on Narcissism in recent times, as it seems to be the age we are living in.

Narcissistic political, organisational, and religious leaders who lack accountability, manipulate information, and deny any wrongdoing has become a normal phenomenon across the world. This is not a new problem – narcissists have always existed and will continue to do so. In fact, every one of us has some degree of it, which is not necessarily a bad thing. A healthy degree of self-belief and self-confidence is in fact necessary. Narcissism of a more problematic kind exists on a spectrum, ranging from higher- than-usual degree of self-centredness to a deluded idea of omnipotence and specialness.

These characteristics are problematic because when the focus is on oneself only, the other simply becomes a means to an end, rather than a relationship between two human beings with differing needs. Clearly, relationships with narcissists can be very difficult. Unless the other is a good reflection of the narcissistic self and helps sustain their self-image, then the relationship will go smoothly. In fact, it can feel good to be a part of this ‘narcissistic bubble’. However, if the person disagrees, has their own opinion, or wants to assert their difference, then things can quickly take a turn for the worse.

The narcissistic character will do everything they can to maintain a good image of him/herself, which often involves projecting anything that is perceived as bad onto the other.

This is usually paired up with an inability to take responsibility, emotional immaturity, and the portrayal of a false sense of self-confidence. The key here is that the person is operating from a self that is idealised, inflated and false, rather than a real self which incorporates good and bad aspects, and is realistic about its limitations.

Deep down, the narcissist feels vulnerable but will do all it takes to protect themselves from this feeling. Unfortunately, people with a strong narcissistic disposition will prey on the vulnerable, using them to achieve their own gains, project uncomfortable feelings onto them, attack, undermine, and belittle them.

At this point you might be asking yourself “why would anyone choose to be in a relationship this bad?” Those in a relationship with a narcissist can go from feeling very special to feeling persecuted, manipulated, intruded upon, and objectified. A typical example would be a situation of domestic violence. It is usually very hard to leave because one is either kept in fear or hopes for the return to a time when things “felt really good”.

The Antidote

Building up self-esteem and self-confidence is an important aspect of making healthy relationship choices. We all have self-doubt, but excessive self-doubt leads to a vulnerability to manipulation and control. A healthy degree of self-belief and self-esteem can help in asserting needs and act as a protective mechanism against self-doubt that can feel paralyzing in the face of coercive, manipulative and controlling behaviour. It also sends a strong message out that your mind is your own and you are not vulnerable to control.

Setting strong boundaries is another vital antidote. Taking more ownership of your physical and psychological space, sending the message that you will not be intruded upon without consequences, and reasserting your boundaries again and again will go a long way towards self-protection. If this isn’t respected, then trusted others may need to become involved in helping you create a strong self-protective shield around you. In the extreme case of violent intrusions, criminal and abusive behaviour, reporting the crime might be the only way to set those boundaries. Even in less severe cases of manipulation and intrusion, it is going to be helpful to set strong boundaries and stick with them.

Don’t be seduced by an illusion of specialness. There are different ways to feel special – are you being seen and respected for who you really are, or because you conform with who the other wants you to be? Do you feel valued or seen for your own virtues, feelings and thinking? Are you being encouraged to be who you are, even if you disagree with them? Do you feel you can be different, separate, do your own thing? Are you often put down, belittled, or told that you are no good?

Psychotherapy can help with assertion, boundary setting and improving self-esteem. Most importantly, it is a space to examine the motivation for relationship choices and unhealthy beliefs about self and others.

 

Sam Jahara is a UKCP Registered Psychotherapist, Superviser and Tavistock Certified Executive Coach. Sam has recently been interviewed by Talk beliefs on the harmful impact that cults have on children, drawing from her personal and professional experience. See the link to Sam’s interview.

Further reading by Sam Jahara

An in-depth approach to leadership coaching

Demystifying mental health

Women and Anger

Why all therapists and mental health professionals need therapy now more than ever

Fear and hope in the time of Covid – part 2

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Pornography and the Online Safety bill

Having just come off a phone call with the Child Sexual Abuse and Exploitation Policy Lead, my thoughts have been drawn to the enormity of the problem we face with pornography and the ‘pornification’ of society, particular the world of young people.

Pornography use has become ubiquitous and normalised to the extent that increasingly the world of pornography seems to influence and infiltrate wider society through body shape, appearance, hair removal, sexual behaviour, dating, all the way through to the core of our identity.

From my perspective as a clinician, I have no particular moral take on what consenting adults do behind closed doors and indeed, it is my job to hold curiosity about this as with any other aspect of my clients’ lives.  It could be argued that pornography falls into this category.  However, whilst I have no particular moral take on (some) aspects of pornography (consumed by adults), I have a strong healthy perspective on the issue much like I do on the consumption of alcohol for example.

A person may choose to live their life drinking a bottle of wine per night.  Other than this they don’t negatively impact society, they maintain a job and pay their way in the world.  However, I would hold a health perspective on this issue and whilst as a lay person I am as aware as anyone else about the physical health risks of excessive alcohol consumption, I believe that in my role as a psychotherapist I can claim an expert position on the mental health impact of excessive alcohol use extending to the wider social context.  And so it is with pornography.

It is easier for anyone to access pornography via the internet than it is to buy alcohol.  At the very least, alcohol must be physically purchased and paid for whilst porn is free – in the monetary sense.  However, I believe that what seems free to consume is in fact a Faustian deal in which the consumer sells their soul – in this case their mental and emotional health.

It is also extremely disturbing and concerning that it is easier for children to access pornography of virtually any description than it is for them to be able to access alcohol.  Let’s be clear, I am not advocating children have access to alcohol, however surely it should be at least as well regulated and policed and the risks considered? To date, the impact of pornography use by children, teenagers and young people has been vastly underestimated and as a mental health professional, I and my colleagues see the fallout of this.

We face a pornification of society whereby the young now trade in sexual pictures of each other and sexual acts that would until very recently have been considered ‘fringe’ at best, have become normalised such as non-fatal strangulation.  The effects of this pornification of our young is leading to enormous self esteem issues, relational problems and mental health conditions such as eating disorders, depression and anxiety.

As a society we therefore need to safeguard children from child abuse – and to be clear, permitting children to view pornography constitutes child sexual abuse.  The online safety bill aims to do just this – it is imperfect and won’t solve the problem in that legislation can never solve social ills, however the first port of call is to safeguard children and then a more nuanced consideration of the insidious effects pornography is having on society can take place.

Psychotherapy is about relationships and at its core it is about helping clients to have a healthy relationship with themselves and others in a two-person world.  Pornography is by its very nature perverse – it is narcissistic and is about voyeurism and exhibitionism rather than relating.  It is therefore by its nature in conflict with the very essence of the psychotherapeutic journey and a healthy society.

 

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

 

Further reading by Mark Vahrmeyer

How much time should I devote to self care?

Why is Netflix’s Squid Game so popular?

Space: The Final Frontier of Manic Defence

Do Psychotherapists Need to Love Their Clients?

Unexpressed emotions will never die

 

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Making Changes

As well as working privately, I work within an NHS IAPT Service providing psychological therapy for depression and anxiety disorders and when a client comes into therapy, one of the first things we discuss is goals for treatment.

What is it the client is hoping to change by the end of treatment? Is there anything that the client is not able do now, because of their difficulties, that they would like to be doing in the next couple of months?

Goals help to focus the therapy. It’s quite common that the client will say they would like to increase their confidence or to improve their self esteem, to be less anxious or to be happy. These are very broad goals, would be difficult to measure and don’t tell us what the client would actually be doing differently if they were to be confident, have better self esteem, be less anxious or be happier. So we work together to work out what this might look like.

One way to help determine goals for change is to think of our values. When considering values we need to think about what is really important to us, what gives our life meaning and purpose. Values are what we care about and are different for everybody. They can change over time depending on where we are in our life. Meaningful activity is value driven. Values are fluid and don’t have an end point, they are how we want to live our lives, they help us to be the person we want to be.

We hold values in different areas of our life: intimate relationships / marriage / being a couple; family relations; friendships & social relationships; parenting; career / employment; physical wellbeing / healthy living; connecting with the community; spirituality; education / training / personal growth; mental wellbeing.

It can be useful to consider what values you hold in each of these areas and rate how important each domain is to you and where you are in achieving that domain. For example what kind of values do you hold in physical wellbeing? How do you want to look after yourself physically? Is it to take regular exercise, eat healthily, get enough sleep and rest? Are you achieving this as much as you would like to be? What sort of friend do you want to be and how would you like to act towards your friends? For example, loyal, trustworthy, to spend time with friends, to share, to listen, to have fun together. What kind of values might you want to model as a parent? For example, to be curios, have courage, be adventurous, have determination, gratitude kindness and have fun (to name but a few). Values can be described as compass directions in which we live our life.

If you feel that you are not where you would like to be within a particular domain, how can you bring this value further into your life? This is where goal setting comes in. Values are a direction we want to progress in. Goals can be set to help us achieve that direction. For example, if we place value upon exercise and physical health we might have the goal of going for a swim twice a week or we might have a goal of completing a qualification, which sits within the value of education and personal growth. Goals can be achieved and have an end point. You maybe familiar with the acronym SMART goals. This means goals are specific, measurable, achievable, realistic and time limited. So if we wanted to make the goal of ‘going for a swim twice a week’ into a really SMART goal we could add a set time period, i.e. ‘going for a swim twice a week for half an hour’. By setting SMART goals we break down the areas of change into manageable chunks.

Change is difficult and if we are feeling low or stressed and anxious we can often feel overwhelmed. It is likely that areas of our life that are important to us have become affected and we don’t know where to start to change this.

Setting ourselves small goals for change in line with our values is a useful starting place. It’s important to remember that there is no such thing as a failed goal. If we don’t achieve our goal it still give us useful information. Perhaps we set ourselves an unrealistic goal, in which case we might consider how we can break this down further into smaller, more manageable chunks. We can explore the process along the way whilst trying to achieve our goals and moving towards our values. In this way change takes place and has a positive impact on our mental wellbeing.

 

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

 

Rebecca Mead is an accredited, registered and experienced Psychotherapist offering Cognitive Behavioural Therapy (CBT) and Interpersonal Psychotherapy (IPT) to individuals adults.  Rebecca is available at our Brighton and Hove Practice.

 

Further reading by Rebecca Mead –

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

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Home is in my Head: Rediscovering your Identity in a New Culture

The urge to migrate twists through the marrow of our bones; the restless energy moving our ancestors across vast wastelands in search of a better life mirrors our journey to self-actualisation.  With global migration on the rise what happens to your relationship to yourself and to others when  you leave your birth country for a different life? How do you fit yourself to a culture that is both exciting and un-lived and yet as closed as an unread book?

Years ago my mother an economic migrant and native french speaker, studied French A Level at my school together with my peers. Back then I didn’t understand and was embarrassed by her presence in the school corridors.  Now I see how courageous and important it was to navigate, and excel in, a world of English teenagers (she achieved Grade A).  Undoubtedly she struggled with her inner voice that continues to taunt ‘you are a guest in this country’.  How much I ingested of her shame I can’t say. It is impossible to separate the hidden toxicity of shame from my identity – the me who lives, breathes and continually adapts to the pull of three different cultures: my parents’ and the British culture I was born into.

Whether through choice or forced migration the traumatic consequences of relocation can include rootlessness, alienation, difficulties in relating to others and disconnection to yourself – it requires emotional investment to redefine yourself in an alien culture, to start to fit in, to feel a sense of belonging.  Dislocation leads to a sense of disease, of being ill at ease with the person you thought you were, without a clear sense of yourself in relation to others. Says Gestalt theorist Yontef (1993)  ‘Living that is not based on the truth of oneself leads to feelings of dread, guilt and anxiety’.

You might ask who am I in this new place I inhabit, how do I move, talk, occupy this alien environment? Whose space is it? Am I allowed in? Will the other give up some of their space for me in the territorial dance between us?

“I can’t stay in one place, my home is in my head”* state A-wa, an Israeli pop group who sing in Yemeni as an homage to their grandparents.  This sentiment is felt as a spiritual and physical load, the burden of those who carry the heart and soul of their homeland with them wherever they go.

I hold inside me poignant stories of others’ longings for a secure base: the European man who seeks love looks for a woman who understands the food he used to eat at his mother’s table.  The woman whose future lies in repeated migrations – whose only home is her partner.

Perhaps a way to reorient yourself to a new country is in finding allies in people from your own culture or embracing your partner’s family. In the therapy room you may want to explore finding a way back to yourself, the you who hasn’t stood still but hasn’t yet found a way to fit in.  Therapy can support you to restore the sense of who you are, what you want to say, what you want to ask for.

By rooting yourself in your own identity, you can re-build self esteem and ultimately risk new and exciting relationships in the world around you – your colleagues, peers, future friends and family.

 

Resources: 

*  A-wa, (2019) from the album Bayti Fi Rasi

Yontef, G (1993) Awareness, Dialogue & Process: Essays on Gestalt Therapy. Highland. N.Y: The Gestalt Journal Press

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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When praise becomes harmful to children

Contrary to its intention, praise does not always make a child feel good.

Whilst we might typically think of praise as a gift, it is technically an evaluative judgement on the other person (e.g. “you’re a good girl” or “you’re a brilliant artist”), which for some children can be experienced as threatening or even dysregulating (Stephen Porges Polyvagal Theory).

This risk is particularly pronounced in children whose earliest relationships have not enabled them to trust in the safety of relationships and/or have caused them to develop negative core beliefs about themselves as inherently bad or unlovable. For these children, being told that they are “good” or “fantastic” at something, is so far removed from their own sense of themselves that they cannot make use of it. More likely, they will be put on high alert for when the other person will no longer see them as “good” and will see their true self. It also creates inevitable comparison – and therefore, competition, with other children. For very traumatised children, therefore, ‘global praise’ (or generalised, non-specific praise), can actually act to undermine their trust in the safety of their relationship with the person giving it to them (Hughes, Golding & Hudson, 2019).

Whilst not all children have experienced developmental trauma, however, it is still true that global praise is not helpful to children. This is because it contains too little information about what the giver is enjoying about the child, or what they are doing well, for them to make use of it. Indeed, a natural tendency (for any of us!) when offered global praise, is to immediately deny it (e.g. “I don’t always have gorgeous hair! You didn’t see me yesterday!”), to assume that the giver is lying or does not know what they are talking about (“As if I always sound intelligent!”), to focus on our weaknesses (e.g. “Clever! You should see me doing my times tables!”), to make us anxious (e.g. “I’ll never be able to hit the ball again now you’ve said I’m a good shot!”) or to assume that we are being manipulated (e.g. “What’s she after?”; Faber & Mazlish, 2001).

A healthier alternative to global praise is ‘descriptive praise’. That is, the act of actively looking for specific things that you appreciate, value or enjoy about your child (e.g. “You two have just sat there colouring for 20 minutes with no squabbling”, or “You picked up all your toys, thank you!”) In offering descriptive praise, parents and professionals should attend as much, if not more so, to the effort that a child is making as their achievements (e.g. “I can see you are putting so much hard work into revising your spellings”). They should also ‘own’ their opinions (e.g. “I really like what you’ve drawn there. I like the stripes on your zebra. I think that’s a great drawing!” rather than “you’re a brilliant artist!”).

Unlike global praise, descriptive praise helps to build children’s self-esteem. This is because it supports children to start to recognise the positives in themselves. This happens because having someone else point out specific things that they like or value about them, in a way that they actually can hear and accept it, enables children to give themselves the praise they deserve (e.g. “Yeah, I did draw that chimney well”). Descriptive praise can also be a wonderful way of building enjoyment, joy, trust and security in attachment relationships, for instance, building in a period of descriptive praise for the child before they go to sleep each night. Further, descriptive praise can help to build a child’s resilience, as parents can support their child to start to recognise all their strengths in the face of adversity (e.g. “I know you’re sad that you didn’t make the football team, but I was so impressed with how you went and congratulated the other players. I thought that was really kind”).

For descriptive praise to be effective, however, it should always be within the context of GENUINE heartfelt appreciation and gratitude for the child or their behaviour, as our non-verbal communication is always stronger than our verbal.

References:

Faber, A. & Mazlish, E. (2001). How to talk so kids will listen and listen so kids will talk. Piccadilly Press

Hughes, D., Golding, K. & Hudson, J. (2019). Healing Relational Trauma with Attachment-Focused Interventions: Dyadic developmental psychotherapy with children and families. W. W. Norton & Company.

Porges, S. (2019). Home of Dr. Stephen Porges. www.stephenporges.com; Accessed: 2019.06.07

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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On the Importance of Recognising Emotional Injury

If we could take a child’s logic and apply it to the arena of psychological injury we may be better equipped to deal with the emotional pain and suffering that is an inescapable part of being human.

None of us is immune to heart ache. We are relational beings and cannot help but be touched by the emotional connections and disconnections we have with others. We have clear methods and maps for understanding and navigating physical pain and disease. Physical injury is generally quite easy to identify. It is harder for us to acknowledge psychological dis- ease, even when ignoring it can drastically impact our lives.

Loneliness and self esteem

Loneliness is a case in hand. Research indicates a detrimental impact on health in the experience of chronic loneliness. It can elevate blood pressure and suppress immunity rendering people more vulnerable to disease. Indeed it has been estimated that that the likelihood of premature death may be increased by as much as 14% for those in the grip of chronic loneliness.

The experience of loneliness is subjective. We can feel lonely in the midst of a crowd, lonely in the context of our marriages and our families. When we feel lonely, we feel emotionally or socially disconnected from those around us. More often in this age of technological connectivity we may even feel a certain taboo about admitting our experience.

The disconnection we feel serves to alter our perceptions and our thinking about ourselves and those around us. It may lead us to believe that others care less about us than they actually do. When we think this way we are less likely to reach out. The stakes in so doing can seem high and we risk the additional pain of rejection. When our self- esteem is low, we are more vulnerable to stress and anxiety and when this is the case we are more likely to experience rejection, failure and loneliness as evidence of our inadequacies and shortcomings.

Rumination

When we ruminate we chew over, again and again, replaying upsetting or unpleasant events, we become slaves to our thoughts and our feelings and feel powerless to change. When trapped in this negative cycle we put ourselves at risk of developing depression and anxiety or of developing other unhealthy habits with food and alcohol for example. We harm ourselves.

Our thoughts and feelings are not always the reliable arbiters of reality we imagine them to be. More often the critic within will speak with the voice of an absolute authority whilst delivering the worst kind of propaganda. Rarely does our critical voice have something genuinely new to tell us.

Confusion and suffering may indeed be our birthright, but wisdom and well-being may also be available. When we recognise and attend to emotional injury and struggle, (by reaching out and finding out) we become pro-active, as opposed to reactive. Catching our unhealthy and unhelpful psychological habits puts us in with a chance of changing them.

Psychological health and resilience is the reward.

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor who is available at our Hove practice.  She works with individuals and couples.

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50 years on, how free are we from homophobia?

This year has marked the 50th anniversary of the (partial) decriminalisation of male homosexuality in the UK. This has been responded to with a slew of television and radio programmes exploring current and past personal and political experiences of LGBT individuals and communities in the UK and elsewhere. This output has been matched by a large number of broadsheet and online articles on this subject. Some of these commentaries have pointed out how in our celebration of social progress we shouldn’t overlook the social and state owned prejudices that have caused much harm and damage to LGBT people.

For those interested and sensitive to these matters, it is perhaps clear that trans-phobia is still very much alive in our society. However, increased acceptance of homosexuality could give an impression that homophobia may no longer be an issue for people with same-sex identities and orientations in the UK.

This blog focuses on the continual difficulties for specifically LGB identified people due to past and continued impact of homophobia. Prejudices have become more submerged and hidden. There is now an added challenge for therapists to continue to recognise how these might be interplaying and undermining their LGB clients’ social and internal worlds.

Homophobia today

While open hatred towards lesbians and gay men is now less widespread, as a recent BBC documentary testified, it still exists.

Violent attacks aside, people in same sex relationships will still scan their environment before doing something as natural as holding hands in public. In many parts of the UK, being affectionate in this way with a same sex partner is still not deemed either comfortable or even safe enough. In other parts of the world, being openly gay is still very problematic. In some places, it is criminalised and extremely dangerous.

Homophobia refers to hateful (and possibly fearful) feelings towards people with homosexual orientation. When we talk about homophobia, we perhaps think about it being overt. However, this kind of social discrimination operates on many levels. More subtle, and sometimes unconscious, expressions and feelings of homophobia can be harder to tackle, understand, and talk about.

Despite social and legal progress, people with homosexual identities and orientations continue to feel excluded, marginalised, and unseen in this society because relationships are still regarded in the mainstream as heterosexual. How this continues to operate on a social level is complex and often unconscious. This mechanism is known as ‘heteronormativity’, meaning the norm is assumed to be heterosexual.

These social processes are similar to ways in which other groups can be discriminated against, for example on the basis of gender, ethnicity, disability, etc. These prejudices operate in such a socially ingrained way that they are mostly only visible to those in the minority group (and not always to them.) This makes it very hard to challenge or change them.

Internalised homophobia

Broadly speaking, internalised homophobia refers to homosexual self-hatred in relation to sexual orientation. These feelings have been absorbed, like everybody else’s, by living in a homophobic, heteronormative world.

Many LGB people still struggle with overt negative feelings towards their sexual orientation. These feelings might be particularly heightened prior to or grappling with ‘coming out.’ However, feelings of self-hatred, self-disgust, inadequacy and low self-esteem in relation to sexuality can surface at any time in the lives of those with same-sex desires or identities.

Like homophobia, internalised homophobia often seems to be discussed in terms of overt feelings. It is important that we are able to think about these internal processes on a more complex level to understand the less visible ways in which they may continue to undermine the well-being and confidence of gay and bisexual people. LGB individuals living in our current society may well find themselves struggling with less conscious sources of self-hatred that they may not recognise as having any link to homophobia.

This level of internalised homophobia is very difficult to tackle, as it seems likely that it begins early in childhood. In contemporary psychoanalytic thinking about sexuality, theories have emerged that support the idea that our sexualities begin to shape and orientate very early on in our lives (Lemma, Lynch 2015). In this context, it is suggested that responses from parents will heavily influence how all individuals feel about their expressions of sexuality at a young age. These parental attitudes may well be unconscious and shaped by prevailing social prejudices which again can be covert.

Impact and trauma

For some journalists writing on this subject in recent months, the damage has already been done. While things have improved in this country, past state and social attacks through criminalisation, arrests, unequal legal rights, stigmatisation and verbal and physical abuse have left individuals and communities hurt, angry and traumatised. In this way, we might think about the post-traumatic distress that some LGB people may still be struggling with.

Even without these traumatic after-shocks of the past, the negative impact of being gay in a modern society which still consciously or unconsciously operates as if everybody is straight should not be underestimated. Living in a world that marginalises or ignores who you are and who you love can be stressful and tap into earlier experiences of feeling unseen and overlooked.

While ‘coming out’ is less obviously problematic for gay people than it used to be, the experience of many working in specialist services is that it continues to be a struggle for many. Acceptance of one’s self may or may not be echoed by acceptance of friends and family. Cultural and religious differences may also continue to make this more of an ordeal for some than others.

We also certainly know that young people who identify as gay continue to be a highly vulnerable group in relation to homophobic bullying. This can lead to an increased risk of  self-harm, suicide, and the misuse of drugs and alcohol.

LGB people who have accepted their sexual orientation and worked through overt negative feelings are not invulnerable to social forces of internalised homophobia working unconsciously. These internalised feelings can exacerbate and complicate other difficulties such as shame, anxiety, anger, problems around sexual drives and body image. It is widely thought that homophobia can also play an important part in difficulties for same-sex couples.

Therapists working with homophobia

It seems to me in these more liberal and sexually fluid times, therapists need to be even more alert to the ways prejudices and other repressive forces continue to undermine our LGB clients. Homophobia and hetero-normativity operate on multiple levels in our societies. The internalisation of past and current social scapegoating, marginalisation and hatred can be emotionally problematic for even the most confident individual.

An increasing number of lesbians and gay men who come for therapy these days do not regard their sexual identity or orientation as a major problem. However, it is important that we bear in mind the social context in which they are experiencing the difficulties they do bring. These social mechanisms need to be understood as operating both externally and internally and on complex and often unconscious levels. While they may not need to be the focus of therapeutic work, there are likely to be areas where their influence will need to be recognised and actively engaged with.

Many lesbians and gay men continue to feel caution about the potential sensitivity and understanding of therapists towards sexual difference when seeking psychotherapy. Of course, any therapist seeing clients with same-sex desires and identities needs to be very aware of the ways in which homophobia might operate within themselves – whatever their sexual orientation.

In my view, affirming and supporting an LGB client’s sexual identity is essential but insufficient without being also vigilant to the hidden and sophisticated ways that homophobic processes, outside and within the individual, might work to exacerbate or create obstacles to their emotional development and wellbeing.

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

Reference: Sexualities. Eds  Lemma, Lynch 2015

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Relaxing into Being

It is so rare in today’s world to give oneself permission to relax and do nothing. Yet our body and mind need those moments of relaxation in order to recover from the constant demands of a production-based society. Doing rather than being is how most of us are programmed to spend our time. Throughout our lives, doing is what we are rewarded for. And doing is mostly not enough. We also need to do things well…Achieve, do well, succeed! Our sense of identity is generally linked to the things we do, and not to who we are. Doing things well enough and being recognised for them plays a major role in one’s self-esteem and self worth.

The recognition or ‘strokes’ we strive for can be linked back to the parental love we much longed for as children. For most of us strokes weren’t given freely, but hard earned through what was culturally deemed as achievements and successes.

Are we ultimately still children striving for parental recognition, or are we adults making conscious choices in our lives?

Psychotherapy can help you discover what your life choices are driven by, and improve your self-esteem through self-exploration and understanding.

 

Sam Jahara

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