Therapy with Liz PSYCHOTHERAPY IN SOUTH MANCHESTER & ONLINE

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:

• Relief from emotional difficulties
  
• Identifying and working towards goals,
  
• Creating meanings
  
• Understanding lifestyle patterns and behaviours
  
• Changing relationships (with yourself and others)

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
2) Evaluation
3) Early treatment
4) Deepening
5)Working through
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:

'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:

Blog: Living Life Anxious

Being 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.

Courage and Vulnerability in Psychotherapy

It is often said that it takes courage to begin therapy, to begin to open up about personal material, and to reveal your innermost thoughts and feelings. It can feel frightening. Yet, in the context of a safe and supportive therapeutic relationship, particularly one like a relational transactional analysis approach, which believes that profound and deep change occurs in response to relational experiences, there is the opportunity for you to work through these fears.

To work through fears of criticism, of shame and even fears about exposing or revealing yourself. You might also fear feelings and be fearful about bringing into the open various aspects of yourself and your life.

Indeed, these fears may be so great that you might feel safer to stay with the difficulties that brought you to psychotherapy in the first place, rather than to take chances to reveal yourself. As Brene Brown described her fear ‘not knowing whether I could literally physically withstand the criticism’.

Fears and the Courage to be Vulnerable

Yet these fears can be worked through in psychotherapy. Here, in this safe space, there are opportunities for change. Opportunities for new beliefs to emerge and new stories to be created. The rewards are potentially great. However, relinquishing relational armour is necessary in order to reach them. Letting go of the urges or pulls to keep parts of yourself hidden and stepping into an arena (in this case a psychotherapeutic one) where you allow yourself to be seen.

Courage and the Possibility of Change

This is an act that provides possibilities to create new life stories (or scripts). Perhaps changing the story you tell yourself.