I write..... occasionally
I write blog posts and articles which sometimes are featured in psychotherapy and counselling publications. Details are listed below with PDFs for download for the articles.
How Psychotherapy Helps
How does psychotherapy help?
This is a big question of course. Beginning psychotherapy and counselling is a significant and potentially life-changing decision to make.
In order to help you with this decision, here I outline some of the ways in which psychotherapy and counselling is known to have helped, and also some of the components of psychotherapy and counselling that are known to contribute to a successful outcome.
Ways in Which Psychotherapy and Counselling Are Known to Be Helpful
First, I list a number of typical ways in which psychotherapy is known to be helpful. Perhaps items in this list are similar to the kinds of help you feel you need?
Psychotherapy and counselling can help in a number of different ways and on a number of different levels. These include:
What Really Works in Therapy
Next is the issue of how psychotherapy helps. Research on effective therapy has found that there are four common factors in successful therapy. Consideration of these may also help your decision about seeking therapy:
Overall Benefits of Therapy
So, by taking into account both the ways in which psychotherapy is known to be helpful and how psychotherapy helps, a range of benefits can be experienced:
Furthermore, it can do this with the greatest effect if you have the personal resources, the right therapist (for you) and the expectancy of success.
To end this post, perhaps the words of Marianne Williamson express why people most often turn to psychotherapy and counselling:
Psychotherapy can help. If you really want to discover how, please contact me
Hubble, M.A., Duncan, BL., and Miller, S.D. (eds.) Heart and Soul of Change: Delivering What Works in Therapy . American Psychological Association: Washington DC
Finding the Right Therapist
“Oh that’s easy, I just google and I can easily find the right therapist” you might say.
Of course, that is true.
A psychotherapist can easily be found that way. That is the finding part.
However, what about choosing the right therapist for you at this moment in your life? What is really important if you are to be able to work through your difficulties or concerns with your therapist?
Well, one of the keys to successful therapy is finding that therapist with whom you can have a relationship which includes:
Another central component to successful therapy is whether your psychotherapist’s way of working is a good fit for you:
All of these concerns can be addressed at an initial consultation – a first meeting where you have the chance to explore in conversation what you need from therapy
I may be the right therapist for you but equally I may not. If not, then the session will have helped you in your discovery process – you will have a clearer vision of what you need from your therapy and the kind of therapist that you want to work with.
Of course, if it turns out that I am the right therapist for you, then we can begin to work through your difficulties and concerns together.
Why not contact me today to arrange a no-obligation initial exploratory session. It may well be the first step towards life feeling a whole lot better?
'Not Another Headache'
The pain of migraine is physical. It is a sensation that ravages and incapacitates.
Does your day often begin with you saying to yourself 'Not another headache!' Do you perhaps take painkillers? Often? Every day even?
Perhaps you find that sometimes they help and sometimes not. For many people their headache is diagnosed as chronic daily headache. For others frequent migraine is the bug bear.
Yet medication is not always the answer. Frequent use of pain-killing medication can lead to overuse headache (rebound headache) and perhaps even make your headache pain worse. You may also wonder whether your problem is really a biochemical one.
Is taking a pill really the answer? Might your problem be more than a physical one?
In fact, it has been known for hundreds of years that emotional distress triggers headaches. Being angry or sad. Even being happy or excited can trigger a headache.
In 1743. Junkerius talked of migraine being caused by suppressed anger. Other, less common reactions, linked to emotions have also been identified as root causes for headaches, such as resentments, dissatisfaction and anxiety.
There are many factors which may combine to give an embodied experience of an emotion or feeling. The 'real' pain is perhaps an emotional one, which is hidden, or embedded within an experience of headache or migraine. This can be due to some, or all, of the factors in the following short list:
An alternative way of describing these kinds of headaches, then, is as a conversion headache, the explanation being that psychological distress is 'converted' into a more manageable physical symptom
So whether headache can be attributed to the inability to manage difficult emotions (such as anger or anxiety), or to alexithymia (the inability to identify emotion), what seems to happen often is that some sort of converted, or embodied emotional experience lies at the root of chronic headache and migraine
The good news is that these experiences can be unravelled in psychotherapy or counselling. Headaches can be investigated. Emotions can be explored.
If you have tried all of the medications and still are in intense pain on a frequent basis from your migraine, it may be time to explore the root of your migraine as being not only biochemical but also psychological and emotional.
If you would like to begin to explore migraine and work through the pain of migraine in psychotherapy please contact me using this form or by calling 07891 613580
Face-to-Face and Online Therapy - How to Know Which To Choose?
There are a number of factors to consider when deciding on what kind of therapy works for you. When thinking about the mode - whether to visit your therapist in an actual therapy room or to do some kind of online therapy there might be several different things to think about.
Firstly, are you someone that can easily ‘talk’ over the internet, whether by video or text, or do you feel more comfortable with face-to-face contact. Seeing the person, feeling their presence.
Or maybe you like to get to know people in-person first and then are comfortable with talking over the internet, but you don’t like using the internet to talk to people before getting to know them first.
Therapy can work like this too. You can begin by meeting your therapist and having some sessions face-to-face and then move to online therapy if that is more convenient. Sometimes, when you have got to know your therapist by visiting her in person first, online sessions can feel very similar because you have an established relationship.
You might have a need for online sessions because of your personal circumstances or because the therapist you want to work with does not live local to you, but this might not necessarily make it the right choice for you if you are somebody who needs to see the person they are sharing precious and perhaps anxiety-provoking information with. Psychotherapy is an interpersonal process at its heart and not everyone can re-create the relational aspect of therapy online.
Alternatively, because sometimes when you haven’t met your therapist in person it may feel more difficult to talk about what is troubling you and what is bringing you to therapy in the first place. That is not to say that online therapy couldn’t work for you but just that this kind of difficulty may mean that getting started may feel a bit on the slow side, while the work is done of forming a connection with your therapist.
Finally, it is important to consider that while some aspects of online therapy can feel challenging - such as sharing emotions, or not having facial expressions as a guide in text-based work, there can also be aspects of distance which make the therapy feel easier - being in the comfort of your home with the therapist in their office can feel safe and there can still be a sense of presence - being with your therapist that supports the expression of what can feel difficult.
So, what format of therapy you prefer is a very individual choice. Neither is better than the other. Both can be effective but which is right for you is dependent to some extent on how relationships generally work for you.
Different Kinds of Benefits from Therapy
An article I was reading recently addressed a myth of psychotherapy and counselling. In essence, whether everyone can receive benefits from psychotherapy.
The author held a personal belief that most people can benefit in some way or another but I think that whether this is an accurate statement will depend on what “benefit” is taken to mean, and also on what form of therapy an individual experiences.
The author of the article I read seemed to presume that all therapy is the same. It isn’t.
There are variations in terms of focus, depth, intensity, duration, as well as in terms of support versus exploration.
Considering one of these criteria, that of depth, it is often said that psychotherapy is a deeper, longer-lasting, more intense form of therapy, while counselling tends to be more problem-focused, focused on the present and on practicalities and also shorter-term.
In this blogpost, I will be talking mainly about psychotherapy, so those therapy experiences which are experienced as deeper, more intense and longer-lasting. In these cases, can everyone benefit?
I think that the answer here will depend on what people are benefiting from? What are the components of therapy? What do people expect from the therapy process?
There are many answers to these questions but some generalizations can be made. People enter therapy because they want to feel better about something, or to change something (either externally or internally). Often both.
The therapist helps the person to meet these goals in various ways but the process may be conceptualized as involving several stages:
1) Initial contact
3) Early treatment
6)Termination or Ending.
In short-term therapy there may not be a deepening stage, but otherwise irrespective of whether feeling better or changing something is the desired outcome from therapy, there tends to be something of a multi-stage process.
In terms of what happens in therapy, perhaps the words of Jung about when therapy can be effective or ineffective can help here:
Achieving benefits from psychotherapy, then, comes about from being willing to develop and maintain a rapport with the therapist, a rapport which feels safe enough to be willing to challenge conscious awareness. Of course for this to happen choosing a therapist who is a good fit is fundamental. See my blogpost on Finding the Right Therapist for help with this.
Assuming that you have found the right therapist for you, however, and that you have an enduring and close rapport with your therapist, what can be achieved then? If we return to the main question here, about whether everyone can receive benefits from psychotherapy, it seems that the core issue is about whether everyone is willing to take the step of confronting their internal reality. This can be challenging, scary and unsettling at times. So for some people, different kinds of benefits from therapy might be preferable, or even enough.
Not everyone may be ready to confront their realities, or feel that it is necessary, but there may be certain other benefits or outcomes of psychotherapy which can be made use of in daily life:
ability to listen. They know differently how to pay attention.
greater empathy. New insight has been gained about other people’s issues and concerns. There is a different way of understanding and
making sense of.
So, can everyone benefit from therapy? Well, yes and no. It depends. It depends on the meaning of “benefit”, and the kind of therapy you are seeking.
As I hope that I have highlighted here, there are different kinds of benefits to be had from psychotherapy.. Exactly which kind you experience, though, will depend on the depth of the process as well as the nature of your desires for change.
Howes, R. (2013) Four Unexpected Benefits of Therapy. Available from http://www.goodtherapy.org/blog/four-unexpected-benefits-of-therapy-0924137. Accessed 28 September 2014.
Seeman, G. (2005). Getting the Most Out of Psychotherapy. Available from http://drgaryseeman.com/resources/writing/getmost/. Accessed 28 September 2014.
Answers to Questions about Jungian Psychotherapy. Available from: http://www.thejungiantraining.org.uk/jungian_psychotherapy.html
Accessed 28 September 2014.
Blog: Living Life Anxious
Being anxious can be described in many different ways: as tension, feeling on edge, nervous, insecure, or worried.
Other words used to describe anxiety include uncertainty, vulnerability, and feeling apprehensive, scared or insecure.
Describing the experience of anxiety, a fairly common expression is “Anxiety is an inevitable part of life”. Or, there might even be some comfort taken from a diagnosis of anxiety. A feeling of reassurance may be provided by a certainty of having an “anxiety disorder” Yet, there might also be a normality to being anxious. Erich Fromm, for example says that: The experience of separateness arouses anxiety; it is, indeed, the source of all anxiety.
The Emergence of Anxiety
Taking Fromm’s view, we might consider how feeling anxious can begin at birth with an experience of a primal separation from our mother. Being attached to her feels safe and secure, and separated from her as danger and threat. Later in life, the polarities between separation and attachment, and being at risk, insecure, or under threat may lead to a constant sense of danger. But danger of what exactly? Melanie Klein, according to this line of thought, considers that anxiety signals danger in the relationship with our internal maternal object (the internalised image of mother). The loss of this object, this image, or relationship is feared.
Perhaps there is also fear of a more generalised loss – loss of control, of all relationships, of identity. Fear of a ripping apart, perhaps, because while anxiety may begin at birth it also may have many triggers, arising not only from internal sources, but external ones too – our own neurobiological makeup on the one hand and our life experiences on the other.
So, we might say that anxiety reflects our state of self, the extent of development of our internal structure, the state of our relationships, and our sense of security and satisfaction. Perhaps when anxiety is present and overwhelming there may be deficiency in one of these areas.
Yet, anxiety is not simply a thing that exists. It is dynamic – both a signal of danger and an initiator of a defensive response. It may signal danger to our sense of self, of wholeness, or of completion. We may fear destruction, engulfment or fragmentation and we may seek to control or to avoid a range of circumstances or situations.
Psychotherapy for Anxiety
The good news is that psychotherapy can help.
It can do so by, first of all, by understanding the individual history of each person’s anxiety. If we take the view that who we are, and who we are becoming, emerges from our anxieties, then the first task is to understand each person’s history of anxiety. Then, acknowledging and understanding the protective role of anxiety may be important. To see anxiety as the best strategy for coping with what has been felt as scary or uncertain. Then, perhaps to work through, or re-work through early relational histories, and the insecurities (feelings of not being safe) that may have emerged in these. All of this is possible when the therapeutic environment is felt as safe, and is experienced as a place for curiosity and exploration. A space can then emerge for new feelings, new reactions and responses, and a reframing of the lens through which life is experienced. It may not then be one of psychological danger, but instead one of safety and security.
If you feel ready to begin therapy for anxiety, or want to explore the possibility, please visit the anxiety page on my website for information about how to get started.
Book Review: Freud and the Spoken Word
For the Autumn 2016 issue of Private Practice, I reviewed a book by Ana-Maria Rizuto. The idea that nothing takes place between client and therapist except that they talk to each other is explored by considering the development of all of Freud's theories, with On Aphasia: A critical Study (1891) and The Interpretation of Dreams (1900) given particular prominence. In my review I comment on how fascinating I find Freud's various understandings of the use of words in the therapy room and how the book provides an insight into Freud the man as well as his theories.
Book Review: We Are Our Brains
Another Book Review I wrote for the BACP Magazine Private Practice, this one published in the Winter 2015 issue. This is a book which takes as its central thesis the idea that by the time of birth are brains are fixed. Our anatomy defines us and neuroplasticity is limited to development in utero. Environmental influence on development is limited, the author argues, to the chemical environment within the womb. In my review I consider how persuaded I am by this line of argument and how useful it is when considering the processes of psychotherapy and counselling.
Book Review: The Body Bears the Burden
A book review I wrote for the BACP Magazine Private Practice which was published in the Winter 2014 issue.
Article: Portfolio Approach
Published in The Transactional Analyst in Summer 2013, this is an article advocating a portfolio approach to Transactional Analysis training. The article’s full title (not shown in this publication) is Negotiating the Frame in Transactional Analysis Psychotherapy Training. With this title the idea of trainees choosing the frame of therapy is highlighted. There is the possibility of a containing, stable space on the one hand (in an integrated four-year programme) and on the other hand, for those people for whom this may represent a limiting and restricting environment, there is the portfolio approach which, I suggest, provides a less limiting and restrictive environment for the training process.
Article: Wounding the Healer or Healing the Wounded
Published in The Transactional Analyst, in Autumn 2012, this piece of writing explores the value of personal therapy for psychotherapy trainees. In it I consider the potential benefits for trainees (insight into personal conflicts, sensitivity to experiences, learning effective therapeutic procedures and demonstrating a personal belief in the efficacy of therapy) as well as the opportunity to learn about personal limitations, and to experience deep emotions. I also present my personal view of why personal therapy for trainees should be separate from training programmes, and not integrated into it, citing the avoidance of dual relationships as a primary concern.