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June 2, 2025 by BHP Leave a Comment

Why do boundaries matter in psychotherapy groups?

The importance of boundaries in psychotherapy

I think it’s probably fair to say that all models of psychotherapy view boundaries as important. Analytic therapies particularly emphasise the role of boundaries and see them as integral to the psychotherapeutic process.

There are many ways of understanding why boundaries are crucial. When I reflect on my work as a therapist, I particularly think about how boundaries seem to offer containment, safety and consistency. These conditions seem vital for many reasons, not least because many people who enter therapy have not had them met sufficiently in their childhood.

In one-to-one therapy, it is the therapist who is responsible for holding the boundaries and keeping the work feeling safe and contained. For example, you can reasonably expect that the therapist will be on time to sessions, will aim to give plenty of notice for cancelled sessions (except obviously for emergencies like sickness), will keep the things you share and your identity confidential. It would also be reasonable to expect that the therapist will not be eating food or drinking anything other than water in the session and not be under the influence of drugs or alcohol. Most models disapprove of therapists making any physical contact with you – so no hugging or touching. And of course, essentially, the therapist must not confuse or abuse the relationship by becoming, or trying to become, something else, for example a sexual or romantic partner, friend, confidante or fellow patient.

Not only do boundaries offer a particular containment to the therapeutic work, how a patient might respond to them will also provide information and insights. This can prove useful for helping to understand ways in which they might struggle in the present or how boundaries (or perhaps lack of) were experienced as a child. Sometimes when people challenge boundaries in therapy, they are really trying to check that they will hold.

While therapists will regularly find boundaries pushed in individual work, overall, those who have had sufficient training and are working ethically, and in a patient-centred way, are generally able to keep the boundaries intact and the work secure and contained.

Boundaries in psychotherapy groups

In a group, keeping the therapy and members feeling contained becomes more complicated and the role of holding the boundaries can’t just reside with the therapist.

Before joining a group, potential members are asked to consider and commit to maintaining the group’s therapeutic boundaries. These are pretty much the same as those outlined earlier. In addition, keeping relationships safe and protected is helped by an explicit boundary of not having contact outside. Sometimes this isn’t possible for various reasons. In this situation, members need support and help from the group and therapist to maintain enough personal distance outside the group so they can keep themselves and the group feeling safe.

These boundaries are not rules for group members (there are no consequences to breaking them – within reason at least), but it is understandable that they can feel like it. Some of these boundaries are more obvious and easier to adhere to than others. For example, I have rarely experienced a group member under the influence of alcohol or drugs during a session and my experience is members are also very respectful of the need to protect each other’s confidentiality.

Where the boundaries become harder to maintain is more likely to be around repeated cancellations or lateness, or leaving the group without the required notice period. Also drinking coffee, tea or juice in the session, as opposed to just water, is in my experience not an uncommon boundary flouting. It’s harder perhaps to register the importance of these kinds of boundaries being held and to see why it matters. It can feel difficult for group members to question when they are being pushed by someone in the group. It’s easy perhaps to feel that they are making a fuss or doing something that is really the therapist’s ‘job’.

Because in group therapy there is more than one patient, there are multiple possibilities of boundary reactions and breaches, sometimes simultaneously. The group can feel the unsteadiness this creates at times. The therapist and the group members need to hold firm to help the group feel safe enough. The best way to do this is to name and talk about those times when members might test or push at the boundaries and explore the impact on the group, as well as the meaning for the individuals.

The aim, however, is not for members to never push boundaries (although it is a reality that some group members feel less compelled to than others). A group situation with no boundary challenges is unrealistic and, given what can be learned, not necessarily always helpful.

The theory underlying group analysis sees problems as belonging to the group, not just located in the individual member, and so anyone shaking the group boundary will be viewed as not just acting something out on their own behalf but also – more unconsciously – on behalf of the group. The culture of the group analytic therapy group, which includes being curious, means there is rich and therapeutic potential in thinking about the meaning of a boundary push on several levels – what it means for the individual, for the other group members and for the group as a whole.

 

Claire Barnes is an experienced UKCP registered psychotherapist and group analyst offering psychodynamic counselling and psychotherapy to individuals and groups at our Hove practice.  She also offers couples therapy at BHP.

 

Further reading by Claire Barnes –

What is transference and why is it important?

What happens in groups: free-floating discussion

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

Filed Under: Claire Barnes, Mental health, Psychotherapy Tagged With: containment, ethical therapy, group analysis, group therapy, Mental Health, Psychotherapy, safe space in therapy, therapeutic frame, therapeutic relationship, therapy boundaries, transference

March 31, 2025 by BHP 1 Comment

Why staying in your chair is the key to being a good psychotherapist

When working with trainees and supervisees, I frequently refer to the need for a psychotherapist to ‘stay in their chair’. Let me explain.

Psychotherapy is a relationship. It is a very intimate and unique relationship between the clinician and their patient, which is principally about the needs of the patient. This, however, does not mean that the psychotherapist acquiesces to every whim or request a patient may have. On the contrary.

The key to any successful relationship, whether a friendship, a romantic relationship or a parent-child relationship, is that there are clear boundaries. Often, if not always, when a patient comes into therapy it is because they have grown up in an environment where the boundaries were poor, inappropriate or non-existent. In other words, they grew up with relational deficiencies.

Poor boundaries create a psychological and at times physical environment, where there ceases to be a differentiation between self and other. This is often referred to as a merger. Where children grew up with a parent or parents with poor boundaries, the experience can be hugely impactful on their psychological and emotional development and, in attachment language, leads to insecure or disorganised attachment styles. In simple terms, it makes it very difficult for these individuals, once adults, to have healthy boundaries in two-person relationships; they are either at the mercy of the other, or conversely, make everything about themselves and fail to recognise the needs of the other.

As a psychotherapist with fifteen years of experience, I have yet to meet a single patient who crossed my threshold, who did not have issues with relationships and thus had attachment damage. It’s the work.

One of the primary roles of the psychotherapeutic relationship is to have a caring, loving relationship with the patient, that is in their best interests. It therefore is boundaried by definition.

One of the tenets of working as a psychotherapist is that it is always in the best interest of the patient for the clinician to hold the boundaries. Even if the patient pushes against these – and they will. Just as it is a parent’s role to hold the boundary with their child and hold their best interests in mind, since they cannot.

So, now we are coming to the meaning of ‘stay in your chair’ which I mean both literally and figuratively. Put simply it means stay in your role and hold the boundaries, because without boundaries, the psychotherapy ends.

Patients who have not grown up with clear and supportive boundaries will unconsciously try and recreate a familiar dynamic, generally stemming from their childhood, in the psychotherapy. Us clinicians refer to this as transference, which is a form of projection from the patient onto the clinician. The difference between projection and transference is that the role of the psychotherapist is to think about and understand the projection onto them, and within this to recognise the relational blueprint of the patient and whom the psychotherapist represents for the patient. In simple terms, the patient will attempt to ‘play out’ the most influential relational patterns from their childhood with their psychotherapist. And if this is not caught and thought about, then the therapy simply becomes a repeat of the patient’s childhood experience.

Whether a patient attacks or seduces, our role is to stay in our chair – to remain consistent and constant and to hold the boundaries. Patients will invariably ‘act out’, which is to say that they will embody and play out dynamics that are counter-productive to the therapy, but familiar to them. Our role as a clinician is to survive these acting outs and to protect the therapy at all costs, Sadly, the concept of psychotherapy has become increasingly diluted in the UK, in part due to a lack of differentiation between counselling and psychotherapy and a general ‘race to the bottom’ amongst training institutions. The result is that therapists increasingly have no concept of ‘staying in their chair’ and either move towards the patient when seduced into a collusion, or back away and abandon when attacked.

Lastly, this is not to say that as psychotherapists we should accept or ‘put up with’ attacks from patients. On the contrary, the boundaries are there to protect us too, and if a patient verbally attacks and cannot return to think alongside their therapist, then they may simply be unsuitable for the work, which is also a boundaried position to hold.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further reading by Mark Vahrmeyer –

What do dreams mean?

Is starting psychotherapy a good New Year’s resolution?

Twixtmas – surviving that dreaded time between Christmas and New Year

How to minimise Christmas stress if you are hosting

How do you get self esteem?

Filed Under: Mark Vahrmeyer, Psychotherapy, Relationships Tagged With: acting out in psychotherapy, insecure attachment and therapy, psychotherapy boundaries, psychotherapy supervision, psychotherapy training UK, staying in the chair, therapeutic relationship, therapist role and limits, therapist-patient dynamics, transference in therapy

January 13, 2025 by BHP Leave a Comment

The therapeutic journey: a pilgrimage to the soul?

As a psychotherapist, I’ve come to understand healing as a profound journey—not unlike the transformative experience described in the photo of the welcome sign below, sent to me by a colleague who has recently walked the Camino de Santiago.

Just as pilgrims leave behind their familiar comforts to venture into the unknown, therapy invites you to embark on an equally courageous inner expedition.

Imagine therapy as a sacred space—much like Beilari—where ‘we share rooms with strangers’ and strip away the protective layers we’ve constructed. In our therapeutic alliance, we challenge the ‘lives of comfort and privacy’ that have insulated us from our deeper truths. We step away from the ‘habitual rush accelerated by lists of obligations and the interest of our agitated minds’ and create a different sense of time—a healing time where introspection and self-discovery take precedence.

Just as Beilari invites pilgrims to ‘divest ourselves of the character we have believed we are’, therapy offers a similarly profound opportunity. Here, you’re not defined by your social roles, professional identities, or family expectations. Instead, we sit metaphorically at the same table, creating a space of radical authenticity where your essence can emerge.

The therapeutic journey is about understanding that the ‘unknown parts’ of yourself are not to be feared but explored. Like the pilgrim’s path, this route is not always comfortable. It demands courage — the courage to look deeply, to accept what you discover, and to transform. We seek ‘discernment in difficulty’, learning to see challenges not as obstacles but as gateways to deeper self-understanding.

In our work together, we’ll explore the illusion of separation. Just as Beilari suggests that an ‘unknown person is really a part of ourselves’, therapy helps you recognise the interconnected nature of your experiences, emotions, and inner landscapes. We are not isolated beings but part of a larger, more complex human narrative.

This journey requires an ‘open heart’ and a willingness to be vulnerable. Like a pilgrim stepping into an unfamiliar landscape, you’ll be invited to exchange profound glances with your inner self — to share the essence of who you truly are, beyond the masks and defenses.

I offer you a therapeutic space that is ‘unconditional, non-judgmental, non-transactional’. This means our work together is not about fixing or changing you, but about accompanying you as you uncover your most authentic self. We walk together, but you are the pilgrim of your own soul’s journey.

‘Buen Camino’ as they say — good journey. Every step you take in therapy is an act of courage.

We’ll work to cultivate ‘lightness in every step’, openness to what emerges, and the strength to strip down to your most alive, human self — ‘vibrating in Divinity’.

Your therapeutic pilgrimage awaits. Are you ready to take the first step?

 

Shiraz El Showk is a Training Member of the Association for Group and Individual Psychotherapy (AGIP) and a registered Training member of the UKCP, She is experienced in Psychodynamic counselling and Psychoanalytic Psychotherapy work with individuals, on both long and short term basis. Shiraz works from our Brighton and Hove practice, Lewes practice and online.

 

Further reading by Shiraz El Showk –

Surviving family festivities: a psychoanalytic journey through the twelve days of Christmas

Parents – the ghosts and angels of our past

Is an AI therapist as good as a human one?

What is the unconscious? (part one)

Why is three the magic number? Third spaces, secure bases and creative living (part two)

Filed Under: Brighton and Hove Psychotherapy, Psychotherapy, Shiraz El Showk Tagged With: Mindfulness, pilgrimage, therapeutic relationship

March 25, 2024 by BHP Leave a Comment

No space to be heard?

When life feels like it’s getting on top of us, it can feel like there’s no space for our thoughts and feelings to be heard. This can make us feel isolated, and the problems we’re trying to deal with seem a lot worse. This points to the core of what therapy offers: physical and psychological space where you can voice your problems and feel meaningfully heard and understood.

This article aims to introduce some of the different types of space we use in therapy and how they might help.

Trusted space

The consulting room where the therapy takes place is separate from your everyday life, free from interruptions and what’s said there is confidential. This aims to provide a safe, non-judgemental space you can have faith in.

Coupled with this, you will have chosen a therapist who you believe to be a skilled and empathic professional. Feeling comfortable and confident with your therapist is key to a successful outcome. As this understanding between you develops, you will increasingly feel open to discuss in-depth the problems that brought you to therapy.

Space to explore

From this foundation, therapy is able to move into an exploratory space, where you and your therapist work together to listen with curiosity and compassion to the feelings and experiences that you’ve often kept hidden.

As the work deepens, you are likely to connect more fully with your current emotional difficulties, and also with earlier, often buried experiences. It’s common to start feeling heard and understood in a new and profound way. This alone can have a powerful impact.

Potential space

Old patterns, often learned deep in the past, start to show themselves. There can be a sense of more space opening up between you and previously overpowering feelings.

This often brings emotional and psychological relief, while showing different ways of seeing problems and understanding how you might approach them.

The British psychoanalyst, Donald Winnicott, coined the concept ‘potential space’ to refer to a transitional area that lies between fantasy and reality in therapy, where therapist and client start creatively considering new and different options. Not only does this enable fresh insights and understanding but it starts opening up new possibilities for the future.

Space to take away

The course of therapy not only provides a space once a week for the therapy itself, but increasingly develops an internal space – within you. Through your experience of therapy, you develop the capacity of internalising not only your new understanding of the problem you’re working on, but also how to understand yourself in the face of problems you may encounter in the future.

Therefore, this internal space not only gives you more understanding of your patterns, relationships and needs, and the ability to manage feelings and respond more constructively in the present, but you get to take this internal space away with you, to refer to and use whenever it is helpful to hear yourself, know what you think and feel, and envision what might be the way forward. This is perhaps therapy’s biggest gift.

Opening a space

With our lives putting ever-growing demands on us, we can be under pressure to act unconsciously and repeat unhelpful patterns. Therapy offers us the opportunity to do something different: to give ourselves a moment to pause, to listen to what we really think and feel, and see how we might adapt to be more in line with ourselves, and feelmore fulfilled.

Viktor Frankl, the existential psychotherapist and Holocaust survivor, wrote in his book Man’s Search for Meaning: ‘Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.’

 

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

Thad is an experienced psychotherapeutic counsellor and a registered member of the British Association for Counselling and Psychotherapy (BACP). He works long-term with individuals in our Lewes and Brighton and Hove practices.

 

Further reading by Thad Hickman

Does your life story make sense?

When something has to change

Filed Under: Mental health, Psychotherapy, Thad Hickman Tagged With: Psychotherapy, therapeutic relationship

September 12, 2022 by BHP Leave a Comment

What Can Couples Counselling Help With?

Couples Counselling or Couples Therapy can help the couple communicate better, look at past influences on present behaviour and help the individuals within the couple understand themselves and their partner better. Depending on approach to couples therapy, the therapist will either work with the here-and-now issues and provide the couple with tools to better communicate and relate to one another, and/or look at the dynamics stemming from each person’s family of origin and what each brings into their relationship.

In a sense, the role of the therapist is to introduce the individuals in the couple to one another. There are sides of ourselves that might be difficult to show to our partners without the help of a third party who is “looking in” the relationship.

Observation

The couples counsellor acts as an observer of the couples existing communication style, noticing how they interact both verbally and non-verbally. This information assists the therapist and the couple in helping to identify unhelpful patterns and difficulties in getting important messages across. Communication involves speaking, listening and other vital non-verbal cues.

The aim is to achieve greater awareness of how we come across by slowing things down, reflecting on what was said and noticing how things are received by our partner. Patterns of communication usually stem from how we were taught to communicate in our family of origin, therefore what comes naturally may not be what is needed to improve a relationship.

Mediation

Some couples work involves mediation between parties, especially in situations of conflict and impasse. When the couple gets stuck in recurring patterns of behaviour, a skilled third party can assist in calming things down when exchanges get heated, keep track of certain dynamics, and suggest new and different ways of dialogue that are more conducive to conflict resolution. Ideally, in time, mediation is no longer needed and the couple will eventually learn to slow things down themselves and reflect on their style of relating without the help of a professional.

Education

The therapist’s role is also that of an educator in the art of relating and communicating better. People who are very skilled in other areas of their lives can get stuck when it comes to their relationship. There is no shame in being a master communicator in your job but completely fail when it comes to your relationship. This is because there is so much more at stake. The closer we are to someone, the more difficult it is to see things clearly. Some people may feel resistance to coming to couples therapy because they don’t want to be taught to do something that they think they should know themselves. However, a certain degree of humility when it comes to improving your marriage or partnership, can go a long way. Afterall, we are all learning new things all the time.

Final Thoughts

It might feel daunting for couples to talk about the difficulties in their relationship to a total stranger. It can also feel exposing to talk to a stranger about your feelings in front of your partner. However, this very exposure is what enables us to lower our defences and put us in a more receptive and reflective frame of mind. Individuals within a couple often, over the course of their relationship, built walls around themselves as a protection against emotional
hurt and pain. Within a safe space and with a trusted therapist, the couple can hopefully begin to talk about and understand the origins of these feelings. This usually leads to partners getting to know each other better and feeling closer as a result. With more tools and healthier patterns of relating learnt during the sessions, the couple should feel more equipped to continue working on their relationship even after the therapy has ended.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

Filed Under: Psychotherapy, Relationships Tagged With: relationship, Relationship Counselling, therapeutic relationship

March 8, 2021 by BHP Leave a Comment

Relax: Watching people using their hands

Stuck at home I don’t always want to chat with friends and family or listen to any more news, podcasts or watch TV drama or read a book. Yet I want to be taken out of myself. I want to be elsewhere and with my own thoughts at the same time.

Being engaged in an activity that uses our hands is recognised as having therapeutic benefits. During the privations of Covid-19 lockdowns making and baking have become popular. You can find numerous examples of famous faces presenting the results on social media. For example, the Olympic diver Tom Daley says he took up knitting to help him relax and he has knitted clothes for his husband and child. Finding no knitting patterns for men’s swimwear he adapted a pattern for bikini bottoms and produced a pair of crocheted speedos for himself.

There is also a therapeutic effect when we watch someone else using their hands. Think about the close-ups on hands in cooking programmes. Might this satisfaction in watching be something to do with mirror neurones. Discovered in the 1990s, mirror neurones fire in the brain of observers whilst watching or listening to another person performing an activity. The neurones that fire in the brain of the person performing the activity are mirrored in the observer. That is, the same neurones fire in the brain of the observer. It seems we can experience what another is experiencing at the same time. This has led to research investigating the role of mirror neurones in how empathy operates and how we learn.

Whilst watching the gardener raking the Zen garden in this video clip, I find I can sense his body movements, almost feel the weight of the rake and the resistance and flow of the gravel. And then I watch it again. I can be there in that garden and at the same time sitting at home relaxing into my own thoughts and imagination.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch. Online therapy is available.

Filed Under: Psychotherapy, Spirituality Tagged With: Covid-19, hands, relaxation, therapeutic relationship

December 21, 2020 by BHP Leave a Comment

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

Filed Under: Families, Relationships, Sam Jahara Tagged With: Mental Health, Relationships, therapeutic relationship

January 9, 2017 by Brighton & Hove Psychotherapy Leave a Comment

What is narcissism?

Narcissism is a Freudian term that has become perhaps more ubiquitous in the social lexicon than any other derived from psychoanalysis.

It is a term that seems to define a generation in the eyes of the media – the Millennials, and one that we use disparagingly to describe celebrities before following them via social media, emulating them or electing them to the highest public office.

Narcissism in psychotherapy

In psychotherapy, narcissism is on a continuum from healthy to pathological. For example, it is entirely possible for a client or patient to lack enough healthy narcissism, in which case, the work is to strengthen their ego accordingly.

The sort of folk who get labelled as ‘narcissists’ – those who crave celebrity status, fame and live up to legend in seeking their reflection in the mirror that is society – rarely presents themselves for therapy. After all, why would they? They don’t have a problem – the problem is everyone else!

When we psychotherapists talk about narcissism and narcissistic defences and structures, it is rarely these people we are referring to. So how can we better understand narcissism as it presents in psychotherapy treatment?

What causes unhealthy narcissism?

Unhealthy narcissism is a defence.  Generally, it comes about through the young infant learning through relational patterns with his or her caregivers that he or she cannot rely on them, leading to a ‘turning away’. This turning away marks the beginning of a defensive structure built around self-sufficiency. However, this is not a self-sufficiency born out of healthy confidence, but one born out of emotional neglect.

Narcissistic structures are often well hidden in clients and patients and difficult to treat. Narcissistic patients and clients tend to treat all relationships, the therapeutic one included, as things that are there to be used and thus discarded when no longer of use. Relationships (in the truest sense of the word) are threatening at a core level to people who rely on narcissistic defences, as any true relating will open them up to a whole host of unbearable feelings and mental pain. The latter lies at the crux of the function of the narcissistic defence; the inability to cope with, endure and make sense of mental pain.

Is working with clients and patients exhibiting narcissistic defences a lost cause? Not if they willingly enter the therapy room and not if they are able to think about their vulnerable side and how they needed to develop a disdain for this part of themselves in order to survive. Without a doubt though, it will be a lively journey, because as the charming, likeable and self-sufficient façade starts to crack, rage, envy and mental pain will emerge and present themselves in the therapeutic relationship. This is often where the therapy can end, as the therapist is unable or unwilling to engage with the enactments that invariably will play out. If, however, these can be worked through, then there is genuine hope.

Mark Vahrmeyer is a UKCP Registered psychotherapist working in private practice in Hove and Lewes, East Sussex.  He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

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Filed Under: Attachment, Mark Vahrmeyer, Psychotherapy Tagged With: attachment, Narcissism, Psychotherapy, therapeutic relationship

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49 Church Road, Hove, East Sussex, BN3 2BE

Lewes clinic
Star Brewery, Studio 22, 1 Castle Ditch Lane, Lewes, BN7 1YJ

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