Brighton and Hove Psychotherapy

01273 921 355
Online therapy In the press

by Leave a Comment

How to minimise Christmas stress if you’re hosting

Christmas can be an emotionally challenging and difficult time for many of us. There is such expectation on how Christmas ‘should’ be, yet like the weather, it often fails to deliver on the ‘winter wonderland’ scenes on the TV adverts. For so many of us our family experience often falls far short of the loving idyllic family reunions depicted in those same snowy adverts. And if you are hosting, this can bring with it an added pressure to deliver the ‘perfect Christmas’.

There is lots of advice available on how best to organise yourself practically in advance in the big day, such as food prep hacks. However, I wonder if there is another way of not only coping but getting something from the day for yourself?

Think about your own needs first

An example that I often use in clinical practice when illustrating to patients how it is vital that they think of their own needs, is the pre-flight safety briefing that happens before a plane takes off.

Anyone who has flown has sat through at least one of these and there is a particular point in the briefing where the cabin crew explain what you should do if the cabin loses pressure, the oxygen masks drop down and you are travelling with a dependent. The correct approach is to attend to your own mask first and then your dependent, however, it is surprising how many people think that they should help their dependent fit their mask first, before attending to their own. Why is it this way around? Because if you try and help your dependent first and have not tended to your own needs, there will be two people in distress rather than one. And yet for so many of us the inclination is to ignore our own needs and attend to those of others.

Applying the same logic to Christmas, before deciding whom to invite and having any conversations with family and friends about the day itself, first think about your own wants and needs. What are your physical limitations and needs? What can you and can’t you do? How many people can you host without feeling overwhelmed? Who’s company do you enjoy and who is draining? What do you want to get from the day?

The next step is to think about what is negotiable and what is a firm boundary. For example, it may be that you are willing to cater for an additional number of people if you have help or support from others with cooking. Or, it may be that you are willing to tolerate the presence of someone you find contentious, if another member of the family assures you that they will help you manage that person. However, a firm boundary may be that you have a certain time by when you request everybody leaves (stated in advance).

Wants versus needs

The nature of Christmas combined with the pressure to host, can often mean that any consideration of what you may want from the day gets lost and the focus shifts to being one of ‘surviving the day’. What if it does not have to be like this? What if you could take some time to calmly consider how you would like not only to ‘host’ the day and cater for everybody, but to play an active role in creating the day that you would like? In other words, what if you were to value your own needs as much as you value everybody else’s?

Hosting does not mean sacrificing yourself

Consider how you do not need to sacrifice yourself in order to host an event for others. People who are worth being in relationship with (and therefore arguably worth spending Christmas with), should be people who are interested in your wellbeing and needs and will therefore be open to hearing about not only what you can and can’t offer on the day, but also what you would like from it. If they aren’t, then perhaps question whether they are really wanting to celebrate with you as a person, or are simply making use of what you can provide.

Support through relationship

Putting your needs into the mix can feel daunting if it is not something that you are used to doing. And it is generally only possible if we can rely on having an ally, or allies, by our side who are encouraging – this is often our partner or a close friend. If you are in a relationship, talk to your partner about your needs and wants of Christmas well before the day arrives.  Explain to them how you wish to approach hosting Christmas and risk asking for support – emotional as well as practical. This is something you can do with a friend, or friends, too.

It can also be really helpful to agree up front how you will ask for support on the actual day and how you would like your partner or friend(s) to support you. Examples may be anything from starting the day together and connecting, through to specific practical requests. You can demonstrate support for each other throughout the day through small reassuring gestures such as visually checking in with one another or making physical contact.

Reality testing

Christmas is only a day and that is really worth bearing that in mind. However the day goes, the world will keep on turning and in all likelihood, the relationships that matter will still be there for you. The expectations we feel in relation to Christmas are largely in our own head and can therefore be challenged.  By pausing and accepting that there is no such thing as a ‘fairy-tale Christmas’ we can gain a little space to see it for what it is. It does not have to be perfect nor is it likely to be. Is the goal a ‘picture perfect’ Christmas, or one in which you feel like you are connecting with loved ones and friends?

The past is not the present

For many, memories of past Christmases are difficult and they can reappear like ghosts. However, these ghosts need not dominate your experience in the here-and-now. Accept that it is a difficult time for you and know that it is for many others too, be compassionate with the feelings that the season evokes and remember it is only a day. Sometimes we feel strong emotions on particular days that are simply reminders of the past – echoes – and we actually have the power to create something different. The more you are able to anticipate your wants and needs ahead of Christmas, the less likely the ghosts of the past are to appear and dominate the day.

Alcohol generally makes things worse

Nobody is telling you not to drink on Christmas Day. However, if it is a day that evokes sadness or anxiety, alcohol will not improve these feelings for long. Once it wears off, they will be back with a vengeance and accompanied by a hangover. The opposite of using alcohol to self-soothe is to soothe through relationship. Even if you are not in a relationship with another, you are in a relationship with yourself and can hold yourself in mind.

Even if the day feels full and focused on others, it is always possible to take a few minutes out to calm yourself. You can breathe, come back to the here and now and remind yourself –  Christmas is only a day.

Listen to your body

This doesn’t mean act impulsively. It is more about listening for what the vulnerable part of you needs. This may be a hot bath with a good book, a warm drink by the fire, a nice home cooked meal or spending time with a supportive friend. It could also be a long run, or a dance or yoga class. Whatever self-care tool helps you feel well and connected should form part of your preparations for the day and be in place after the day.

 

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 do you get self esteem?

Why is psychotherapy generally weekly?

Why we should be disappointed

What is a growth mindset?

Don’t tear down psychological fences until you understand their purpose

by Leave a Comment

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

As the holiday season descends upon us like a glittering, tinsel-laden avalanche, many find themselves navigating the tricky or sometimes treacherous emotional landscape of family gatherings. Fear not, dear reader, for psychoanalytic psychotherapy could offer a guiding star, a beacon of hope to lead you through the holiday chaos to that peaceful Nativity scene, stable and all.

On the first day of Christmas: recognising your inner child

Imagine the family Christmas as a complex psychological drama where every interaction is laden with unconscious meaning. Your mother’s passive-aggressive comment about your table decorations, cooking, Christmas jumper choice – a manifestation of unresolved childhood dynamics? Your father’s awkward attempt at connection and endless ‘dad jokes’ – a deep-seated need for validation?

Psychoanalytic therapy teaches us to unwrap these emotional presents, glimpsing beyond the shiny exterior to try to read or understand the deeper psychological mechanisms at play. Each family member arrives with a lifetime of unprocessed experiences, creating a psychological minefield more intricate than the most complicated Christmas light display.

On the second day of Christmas: projection and family dynamics

Watch as Uncle Bob projects his professional disappointments onto you, criticism masquerading as concern. Your sister’s seemingly innocent comments carry the weight of childhood rivalries. Psychoanalysis aims to help you recognize these projections, transforming you from a passive recipient of family narratives to an active interpreter of emotional scripts.

On the third day of Christmas: the unconscious holiday script

Your family gathering is not just a meal; it’s a carefully choreographed psychological performance. Each member plays a role established decades ago – the peacemaker, the black sheep, the golden child, the wise men, the angels and the shepherds. Psychoanalytic therapy can provide script analysis, helping you identify and grasp the inference in these deeply ingrained patterns.

On the fourth day of Christmas: transference and family interactions

Every interaction becomes a window into your unconscious processes. That tension with your mother… It’s rarely about the overcooked turkey. Is it perhaps related to those early attachment experiences, unresolved conflicts, and deep-seated emotional patterns that have been simmering in the realm of the unconscious since childhood, with a hint of the aroma of boiled sprouts?

On the fifth day of Christmas: breaking defensive mechanisms

Family gatherings trigger our most sophisticated psychological defence mechanisms. Humour becomes a shield, sarcasm a weapon, silence a fortress. Psychoanalysis can help you to recognise these hidden defences, encouraging an authentic emotional engagement beneath the festive veneer.

On the sixth day of Christmas: the unconscious holiday narrative

Your family’s holiday story is more complex than any Netflix drama. Unspoken traumas, generational patterns, and collective family myths create a narrative far more compelling than any Christmas special. Psychoanalytic therapy offers you the opportunity to re-write the director’s cut, helping you illuminate the deeper subtext of the storyline.

On the seventh day of Christmas: emotional archaeology

Each family interaction is an archaeological dig into your psychological landscape. Old wounds, repressed memories, unacknowledged traumas – they all resurface during the holidays. Psychoanalysis can provide the tools to gently excavate these emotional artefacts with as much care and compassion as you employ to slice and serve that extra special Christmas pavlova.

On the eighth day of Christmas: navigating emotional boundaries

Learn to establish psychological boundaries more robust than a gingerbread iced fortress. Psychoanalytic therapy empowers you to differentiate between your emotions and those projected onto you, creating a healthy emotional ecosystem amidst family chaos. A breadcrumb trail through the forest of the unconscious.

On the ninth day of Christmas: understanding repetition compulsion

Why do we find ourselves repeating the same family dynamics year after year? Psychoanalysis can reveal the unconscious drives which compel us to recreate familiar emotional landscapes, even when they’re painful and seemingly unavoidable. An Alka-Seltzer for those undigested issues.

On the tenth day of Christmas: the gift of self-awareness

Your greatest present this Christmas is self-understanding. Addressing and processing the unconscious elements we bury like a tangerine in the toe of our Christmas stocking, Psychoanalytic therapy can transform family gatherings from potential emotional minefields into opportunities for growth, insight and hopefully a family game of Uno that doesn’t descend into World War III.

On the eleventh day of Christmas: integrating the shadow

Embrace the parts of yourself and your family history you’d prefer to keep wrapped up. True healing comes from acknowledgment, not denial. Set a place at the table for all the ghosts of your Christmas’ past.

On the twelfth day of Christmas: transformation

As the holiday dust settles, you may emerge not just surviving, but psychologically transformed. Armed with insights from the psychoanalytic journey, you’ve navigated the complex emotional terrain of family dynamics, Prancer and Dancer would be most impressed!

Remember, dear reader: this Christmas, your most valuable gift is the journey of self-discovery.

 

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 –

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)

by Leave a Comment

What is the role of creativity in psychotherapy?

In this article, I discuss creativity as foundational to being human, how it enables an emotionally and psychologically fulfilling life, and its relationship with psychotherapy.

Everyday creativity

When we think of creativity we tend to think of world-renowned artists such as Leonardo da Vinci, Picasso, Mozart. This, however, is a very narrow interpretation of creativity and perhaps illustrates an unfortunate common belief: that only a select few people are creative. This is simply not true. Though not everyone follows the path of the professional artist, all humans are nevertheless creative. This is powerfully illustrated by observing children at play, where curiosity and imaginative make-believe are both instinctive and joyful.

As we develop into adults, however, our relationship with creativity changes. Instead of playing inside a castle we’ve made out of bedsheets, our creativity often focuses on more practical issues, such as ideas for dinner using what’s in the fridge, how to find a holiday in the sun we can afford, how to deal with a friend we’ve fallen out with. This means that we spend much of the day using what we might call ‘everyday creativity’ to navigate the problems and opportunities we encounter.

And yet, even though we rely on this intrinsic creative ability, we often don’t see the crucial role it plays in getting us through the day and its influence on our fulfilment in life, which in turn often means we don’t fully explore our creative potential.

Self-understanding

To respond creatively in a way that enables us to thrive, we first need to understand ourselves: our experience, our needs, our problems. For example, how to make sense of challenging experiences we’ve tried hard to hide from ourselves? The confusing difficulty with an important relationship? Issues we repeatedly struggle with?

Without this self-understanding, we can try to respond creatively, but as we don’t know what need we’re trying to fulfil and we don’t know how we’ve been going wrong to date, we’re likely to keep trying new solutions which don’t make us feel better.

This has the mistaken side-effect of making us believe that our creativity doesn’t provide the answers we need.

Creativity enabled

But if we develop self-knowledge, our innate creativity can start to work better for us and get our needs met. For example, we might start creatively exploring deeper questions such as childhood trauma. This in turn could change our relationship with the trauma and its impact on our lives now. Or we might come to understand what we’re not happy about in a long-term relationship and creatively explore ways of improving or changing that relationship.

How therapy can help

Psychotherapy embraces creativity in two fundamental ways. Firstly, it aims to help you understand yourself better – to connect with your authentic, creative self. This is the inherent part of you that makes you you, and enables you to respond to life in ways that are aligned with what you believe or feel to be true.

Secondly, psychotherapy develops creativity through its own creative process: where you learn to explore and be open to your own internal world of experience, thoughts, and feelings. And you learn to be open to new possibilities within yourself, developing into a new self-understanding.

It is from here that deeper resources of creativity often come online: seeing experiences and relationships in fresh ways, being more open to emerging experience, responding spontaneously to the moment, being less held back by habitual fears and more prepared to try something new.

The potential impact

The impact of being more tuned into and aware of your own experience and more connected to your creative self are significant and multiple. You will likely be more resilient to problems you encounter, know more about what is and isn’t working for you, and trust and listen to your own internal creative responses. This can positively affect your relationships, your own mental health and wellbeing, and your own fulfilment in life as you positively engage with the creative process of personal change and growth.

What’s the takeaway?

Psychotherapy aims to help you establish and deepen a connection with your creative self which enables you to be more you, to use your own powerful and innate creative resources, which in turn enables you to respond to life in a way that better meets your needs.

 

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 – 

No space to be heard?

Does your life story make sense?

When something has to change

by Leave a Comment

In support of vulnerability

What does vulnerability mean to you? Is it part of being human, something to acknowledge and embrace, or do you find ourselves shying away from it?

Vulnerability is part of what connects us to others. By being open, revealing something of ourselves and seeing that in others, we build connections. It’s not a given and we all have to feel that it’s appropriate to be open and vulnerable. We can all think of a time when we have been vulnerable, and it has felt challenging.  Whether we felt physically or emotionally unsafe, we know that it is something that we wouldn’t chose to return to and might find it hard to think about.

When it is hard to be vulnerable

From an early age we know what it is to feel vulnerable, because we depend on others for our safety and wellbeing. These formative relationships are how we develop a sense of how we allow ourselves to be vulnerable. Do we learn that we connect through being vulnerable, or that is it is to be avoided? Are we able to feel safe, when we feel vulnerable, or does it feel that being vulnerable isn’t possible or acceptable? Being vulnerable and it not feeling safe or acceptable, builds the sense that it is best avoided. The fear of being vulnerable, stops us.

The case for vulnerability

The awareness that we build relationships with others through vulnerability means that finding it hard to express our vulnerability can impact our capacity to connect. Do we let people see us or are we wary and therefore feel less connected? Building trust between people is about the interplay between them, allowing openness when it feels safe. By understanding that we can be vulnerable, we can build closer and deeper connections to others. We can be open with them, and they with us.

Being vulnerable in relation to others is about being able to share our emotions. When we have developed a sense that being vulnerable isn’t possible how do our emotions get expressed? Do we hold them in, deny their existence, hope that they go dormant, or act them out through behaviour? Holding on to our emotions, in effect a defence against feeling vulnerable, is challenging. It is hard to feel full of emotion and feel unable to express it. At this point vulnerability feels impossible, however desirable it might be.

Being able to express one’s emotions and form deeper connections with others can feel beyond the realms of possibility. It can be desirable, yet unthinkable, leaving the feeling that one is stuck in a pattern that repeats throughout life. The development of the capacity to be vulnerable is part of how these patterns can be challenged. Old habits and ways of being can shift, and one can feel able to experience both one’s own emotions and those of others.

Being vulnerable in psychotherapy

In talking therapy there is an understanding that one is going to be exploring emotions and that this can bring with it strong feelings of being vulnerable. The challenge that this presents is understood and as therapists it is about building a working relationship with a client that can make being vulnerable possible. The therapeutic relationship is one in which vulnerability is always possible, and that the thoughts that make it feel difficult can be explored. The therapist is not only bringing their knowledge and experience to the relationship, but is also invested in the individual.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove . To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

Trauma and the use of pornography

Reflections on bereavement

Compulsive use of pornography

Mental health in retirement

Subjective perception, shared experience

In support of being average

 

by Leave a Comment

Trauma and the use of pornography

I explored the use of pornography and its presence in society in previous blog. In thinking about pornography, there is the question of why some people might become habitual users. What part might childhood trauma play in the development of compulsive use of pornography?

Trauma, attachment and anxiety

The experience of trauma in formative years can have a marked impact on the individual when they become sexually active and might be using pornography. Trauma can take various forms and can lead to feelings of difficulty expressing emotions and in forming close relationships.

The connection between trauma and the difficulty in forming close relationships, originates in how the child who experiences trauma is related to. The experience that the caregivers are not able to hear and support the child in expressing and exploring their emotions, shapes the child’s sense of the bond that exists between them. When this bond, or attachment, is not good and secure, the child feels that they are not worthy of care, love and attention and of being ‘attached’. This is when they learn that close relations are not reliable and so are to be avoided. In the sexually active adult, the expression of this may well be that sexual intimacy feels difficult.

The vulnerability that is present when being sexually intimate can feel overwhelming and make such encounters difficult, if not impossible. The desire is there, but the anxiety that it induces makes it something to be avoided.

Pornography: the reliable relationship

Looking at the adult who has experienced trauma in childhood and finds close relationships difficult, how might we conceptualise their relationship with pornography? Against the background of trauma and the resulting poor attachment do we seek out reliable relationships? Looking for something that meets the need for sexual intimacy, yet doesn’t have associated anxiety about that comes with closeness?

Pornography could be seen to meet that need. It is intimate, yet it is impersonal. One can be sexually potent, engaged and satisfied without the anxiety that closeness brings. Pornography becomes the reliable and safe relationship. It meets the demands of libidinous urges, without demanding more of the individual. The use of
pornography also relates with the feelings of low self-esteem, that this might be the only form of sexual interaction that the individual deserves. Feelings of guilt, shame and unworthiness all get acted out in the use of pornography. It is secretive, private, personal and can controlled by the user. Pornography ultimately becomes the way in which anxiety is managed.

Psychotherapy and pornography

When thinking about the compulsive use of pornography from a therapeutic perspective, we are considering both the idea that its use can be a choice, but also exploring the origins of the compulsion. Can we be curious about what has happened in the past? How experiences that might have been traumatic and disruptive to the attachment to others, shaped the relationship with pornography. The capacity to imagine oneself as someone who can make choices around the use of pornography and feel more able to be form intimate relationships. All of this is present when working with the compulsion to use pornography and in helping the client to change their relationship with it.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove . To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

Reflections on bereavement

Compulsive use of pornography

Mental health in retirement

Subjective perception, shared experience

In support of being average

Collective grief

by Leave a Comment

What is transference and why is it important?

Transference is a complicated process and concept. This article attempts to describe it in simple terms, focussing on a basic understanding and highlighting why it is felt to be so important in analytic psychotherapies. I will end by thinking about how it can emerge and be used in both individual and group therapy.

What are the origins of transference?

The idea of ‘transference’ arose through Freud’s discovery that his patients projected early feelings about their parents onto him in the therapeutic work. Since Freud’s time, there have been developments in the field, furthering our understanding and recognising the complexity of the concept of transference, counter-transference and other similar processes. For the purposes of this article, I will not be exploring these later developments.

What is transference?

The fundamental meaning of transference can be found in the word. We ‘transfer’ feelings from an early relationship or experience onto someone or something in the present.

One way of thinking about transference is that it is one of the levels on which we all communicate with each other. Transference goes on all the time and between everyone.

Why is transference important in therapy?

It is thought that our transferences date back to childhood and adolescence. These early experiences are internalised and unconsciously become repeated in adulthood.

These unconscious ways of relating and communicating drive our more problematic life patterns. Our relationships (and therefore relationship problems) are thought to be shaped by our transferences. So, in psychotherapy, particularly in analytic approaches, working with the transference is a key part of the therapeutic process. The therapist will be very curious from the outset about what transference or transferences the patient/client is experiencing towards them.

Part of the therapist’s task is to think beyond which figure from the past is being transferred onto them, but also the dynamic and feeling associated with this past relationship. For example, perhaps they are experienced as an angry father, or a depressed mother, or a disapproving mother, or a withdrawn father.

In individual therapy, where there are only two people in the relationship, the focus is on the patient/client’s transference towards the therapist. The nature of the therapeutic process (the therapist offering care and attention, and holding more power) means the transference feelings elicited often originate with one or both parents. However, the therapist can also stand-in for sibling relationships, early friendships and other important relationships from the past (for example teachers or grandparents).

In individual therapy the transference can be explored in detail and depth. If the relationship with the therapist feels safe enough, the patient/client can allow early feelings to emerge powerfully in the therapy, exposing past experiences that might be buried and so elucidating unconscious ways that past relationships continue to be repeated.

In group therapy, the therapist, who is also called the conductor, is likely to be experienced as an important ‘transference figure’ in the group. Like individual therapists, they will tend to receive transference feelings drawn from parental experiences though, again, not necessarily so. Group members will also have transference feelings towards each other. These often seem to be drawn from sibling relationships or other early peer relationships but can also be from past parental experiences.

Group members can also experience transferences to what is called the total group situation. This means the group as a whole, including structural aspects such as the setting, boundaries etc. The group can be experienced as powerfully reminiscent of the family or classroom or other early groups. These transferences to the total group situation at times can be shared by the whole group.

Groups offer a multitude of transference feelings that are likely to be aroused in a simultaneous and complex way. Transferences to the therapist/conductor, the group and other group members can reveal the complexity of roles in the person’s early life. This means not just their individual relationship to early figures but what was also experienced as relationships and communications between others such as parents, siblings etc. In other words, re-experiencing the original family and other early group relationships. In this way, groups provide rich multi- dimensionality for understanding the complex network of internalised relationships and dynamics that can become unconsciously re-enacted in adulthood.

Conclusion

Unlike many other ways of relating, transference is usually unconscious at the point it is being experienced. However, being able to experience and reflect, such as in therapy, can allow us to become aware of our transferences. Through this work we can become increasingly familiar with them and how they shape our patterns and difficulties. This can have a therapeutic and potentially transformative effect on our lives and our relationships.

 

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 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

A new psychotherapy group

The process of joining a therapy group

by Leave a Comment

What is self-care?

Sometimes it is much easier to recognise the signs of lack of self-care in other people, than it is to see it in ourselves. What do we mean by self-care? The expression sounds self-explanatory, but do we know what it involves?

Most people recognise signs of depletion when they begin losing energy, passion and creativity. Signs of stress generally manifest in the body in the form of colds, flu and tiredness.  There might be a lack of engagement with life or even depression.

Things begin to feel dull or quickly overwhelming.

Physical self-care

Attending to our bodies is usually the easiest way to begin self-caring. Body and mind are invariably interlinked, therefore if something isn’t right in our bodies it is a sign that it demands our attention. Paying attention and getting to the bottom of things isn’t a linear process. Whether medical intervention is required or not, it does not change the fact that our body is going through something which needs to heal.

Listening to our bodies requires presence, discipline, and willingness. It is worth investing time and effort in finding out what our body needs and what is best for it.

Emotional self-care

The link between stress and physical illness is estimated at 75-90% depending on the source, which is why attending to our emotional well-being is vital in the treatment of many physical conditions. Movement or lack thereof is mostly dictated by thoughts and feelings. Our bodies constantly react and respond to emotional and
mental stimulus. How we interact with over- and under-stimulation is often the key to how we live, and as a result, to how we feel. Learning emotional self-care entails learning to pay close attention to our thoughts, feelings, and behaviours. Many of our emotional responses are unconscious and therefore making them conscious helps us understand what we are responding or reacting to and make more informed choices.

Self-care in relationships

Relationships are both fulfilling and challenging because we interpret the world and place ourselves in it through the approval and acceptance of others. Loving and being loved is vital for human beings because we depend on it for our survival. The balance between attending to self and attending to others is something which we learn early in life and consolidate throughout adulthood. When the balance is ‘off’ we can end up losing ourselves by placing too much value on relationships, or not valuing enough the relationships which are most vital to us. We live in a complex web of give and take, constantly negotiating or prioritising our needs and the needs of others. Giving or taking too much or too little says something about ourselves and determines how we feel.

Spiritual self-care

I use spirituality as a broad term for anything which looks beyond our immediate need for survival and safety, towards higher meaning, purpose, and fulfilment. These aren’t distractions or entertainment, but activities which enhance our emotional, psychological, and physical relationship with ourselves and other people. It is also ultimately about relationship to self and our place in the world. Some people find this through spending time in nature, physical activities, and/or religious and spiritual practices. Spirituality is deeply personal and something we all should care about because meaning and purpose is what makes life worthwhile.

In summary, true self-care is about engaging with ourselves on a physical, emotional and spiritual level and managing our personal boundaries within the relationships which matter to us. Psychotherapy can be a place to learn to self-care on a deep level and hopefully create an imprint which is sustainable in the long-term.

Sam Jahara is a UKCP registered Psychotherapist, Supervisor and Executive Coach. She is also the co-founder of Brighton and Hove Psychotherapy. Sam works with individuals and couples from Hove and Lewes.

 

Further reading by Sam Jahara –

What is love? (part two)

Radical self care as an antidote to overwhelm

The adult survivor of neglect and abuse – lifelong considerations

There are no shortcuts to growth

5 good reasons to be in therapy

by Leave a Comment

What is love? (part two)

Transference

Love is the unconscious expression of longings, desires and hopes onto a person who ‘fits’ because of who they are and who you are to them. This mutuality of hoped for experiences, combined with sexual attraction, results in a powerful combination of emotions and physical desire which we call falling in love. In simple terms, transference is a repetition of old feelings, desires and fantasies onto someone in our present life. Therefore, love will always have a transferential element to it.

We fall in love not only with the other person but also with what they mirror back to us about ourselves. Lovers mimic many of the early experiences of mother and baby, such as the loving gaze, facial expressions, sounds and touch, as we once again experience the bond in which we felt loved and safe. If we didn’t, then the longing is for the experience we never had.

Lovers merge as they become highly attuned to one another in a natural process of forming an attachment bond. The other becomes the most important person in our world and we become completely immersed and preoccupied with them. This goes back to how humans live, survive and procreate, and therefore the process of forming a bond becomes the most powerful drive. This is why love can be so intoxicating, all-consuming and painful at the same time. The early stages of falling in love are fragile. Both parties are open, vulnerable and full of hope. But because of such fragility, there is a parallel experience of being out of control and deep uncertainty. Will this feeling last? Will they keep loving me, being attracted to me? Am I a loveable person? Can I hold their interest? Etc. These are questions about potential loss, and fear of disappointment and hurt.

Falling in love and loving

The initial stages of a relationship often start with an idealisation of the other, followed by gradually getting to know the other for who they really are, rather than the idealised version. This process of getting to know each other takes a long time and is more realistic.

Partners will either stay together or separate based on their compatibility, life circumstances and desire to continue the relationship.

Over time, love grows, changes or dies, depending on many factors at play in relationships. How we were loved and taught to love in childhood will have a major impact in our adult relationships. And whilst upbringing and attachment style matter a great deal, how we grow and develop in adulthood carries a lot of weight in how we do relationships. For instance, someone may come from a family which was dysfunctional and decide that they do not want to repeat this dysfunctionality in their lives. They are determined to work on the relationship with their partner and their children, as opposed to sleepwalking into repeating their family history.

Loving is intentional. The decision to stay in a relationship needs to be made again and again throughout its life cycle.

Loving more than one person

Fortunately, or unfortunately, love does not constrain itself to our social rules of marriage, monogamy and ideas of romance. It is possible to fall in love and be attracted to more than one person or multiple people, either in succession or at the same time. The capacity for multiple types of love, or loving more than one person at once, can also be linked to the family environment and upbringing. Some children grow up with multiple attachment bonds, whilst others grow up with one or two primary carers. Parents, extended family and siblings all influence our capacity to form bonds and love. The beliefs and values we grow up with also impact our view of multiple love bonds and the extent to which we will allow ourselves to love more than one person at once.

Love in long-term relationships

Helping love to continue and flourish in long-term relationships can be a challenge. It requires ongoing effort and intention. Couples need to cultivate positive habits that nurture the bond they have. Everyone does this differently and some unfortunately not at all. As couples drift apart and become habitual in their way of relating, the relationship can die a slow death.

Sex and non-monogamy

Sex and sexuality can be used as expressions of our aliveness and our relationship with self and other. The ability to feel pleasure and desire says a lot about our ability to engage with life and our capacity to feel alive. Partners may differ in their sexual preferences, levels of desire (for one another and other people), and capacity for pleasure.

As partners levels of desire and preferences change over time, they must navigate these changes within the relationship and find new and creative ways of living a sexually and emotionally satisfying life. Some couples choose to open their relationship and experiment either alone or together with other people. Although affairs continue to be treated as taboo, humans have always found ways of meeting their sexual and emotional needs
through illicit or open extramarital relationships. There are many and complex reasons for engaging in sex outside committed relationships. This can range from a step towards leaving an unhappy marriage/partnership or wanting to inject life into one which has become stagnant.

Falling in love, being in love and learning to love

Whichever of the three phases you are experiencing or wanting to experience right now, couples or individual psychotherapy can be a good place to explore these feelings. Some of the common reasons people seek relationship therapy are:

  • Beginning a new relationship and not wanting to repeat old patterns.
  • To explore early family relationships which impact present ones.
  • Marriage counselling or couples therapy to help couples who are struggling to communicate and/or keep their relationship alive.
  • To discuss non-monogamy and explore differences in sexual preferences and levels of desire.
  • To discuss life transitions and their impact on relating.
  • To learn to love, stay in love or even fall in love.

 

Sam Jahara is a UKCP Registered Psychotherapist, Clinical Superviser, Leadership Coach and BHP Co-founder. She works with individuals and couples in Lewes and Hove.

Further reading by Sam Jahara –

Radical self care as an antidote to overwhelm

The adult survivor of neglect and abuse – lifelong considerations

There are no shortcuts to growth

5 good reasons to be in therapy

The psychological impact on children who grow up in cults

by Leave a Comment

Emotions: hardwired tools from our evolutionary past

Since the dawn of humanity, emotions have been integral to our survival, guiding our ancestors* through a world filled with imminent threats. Fear prompted quick reactions to danger, joy encouraged behaviours that strengthened social bonds, and disgust helped prevent contact with harmful substances.

These primitive emotional responses are hardwired into our brains, offering rapid, instinctual reactions to our environment. While these responses remain invaluable in critical situations, such as encountering a wild animal or reacting to sudden threats like fires, modern challenges often involve complex social and personal dynamics. These can include managing academic demands, coping with interpersonal conflict, navigating work-related stress, dealing with health issues, and striving for personal growth amidst societal pressures.

When triggered by modern challenges, our innate emotional responses can make us feel unequipped and overwhelmed. Viewing these reactions as abnormal only amplifies our distress. It is essential to recognise their natural and instinctive nature. By understanding their manifestation in our brain and body, and recognising their intended functions, we can learn to accept, welcome, and use them.

Far from being flaws, emotions help us cope and take necessary action to address the challenges we face.

Let’s delve deeper into each emotion and explore its practical applications:

FEAR

Fear initiates a series of neurological events, primarily engaging the amygdala, the brain’s fear centre. This activation orchestrates physiological changes, preparing the body for fight-or-flight responses to optimise survival chances. This mechanism is observed across species, underscoring its fundamental role in ensuring survival in threatening situations.

Consider a scenario from prehistoric times, where early humans encountered a predatory animal while hunting. In such moments, fear would surge through their bodies, prompting quick instinctual responses enabling them to confront the danger or flee to safety. This instinctual reaction allows for rapid assessment and adaptive actions to maximise survival chances. Over time, these innate survival mechanisms would have been refined through natural selection, contributing to the evolutionary success of early human populations.

Today, fear, when experienced moderately, can foster adaptive behaviours and resilience in navigating life’s challenges. The urgency and attention to detail prompted by anxiety can lead to increased preparation, alertness, focus, organisation, and productivity. These factors empower individuals to effectively respond to situations and achieve success in reaching their goals.

Implementable strategies: When facing fear, evaluate the reality of the threat and distinguish between immediate threats and potential future concerns. Determine if the fear relates to a current, tangible problem or abstract scenario. Practise calming techniques like mindfulness exercises, grounding techniques, or guided visualisation to manage the fight-or-flight response and navigate stress. These practices can cultivate a sense of security, enabling fear to serve as a tool for cautious, informed decision-making rather than an overwhelming obstacle.

ANGER

Anger indicates perceived violations of personal boundaries or unfair treatment. It serves as a signal for issues requiring attention or resolution and may prompt assertive behaviours aimed at defending one’s rights to gain recognition and respect.

In prehistoric times, a member of an early human tribe might have experienced anger when perceiving a threat to their territory or resources. This anger could have prompted assertive actions aimed at establishing dominance and preserving access to vital resources, ensuring the group’s survival.

Today, anger remains a potent indicator of issues necessitating attention or resolution, such as workplace injustices or interpersonal conflicts. Constructive expression of anger and addressing underlying issues can lead to advocacy and positive resolutions, although uncontrolled anger may result in destructive behaviours and strained relationships.

Implementable Strategies: Upon experiencing anger, pause to identify its root cause. Practise constructive communication by using ‘I’ statements to express feelings without assigning blame, and actively listen to the other party’s perspective. This approach fosters healthier resolutions and mutual understanding, transforming anger into a catalyst for positive change.

DISGUST

Disgust acts as a protective mechanism against harmful substances and behaviours, signalling individuals to avoid potential threats to physical or social well-being and safeguarding them from harm.

Consider a scenario from prehistoric times where our ancestors encountered spoiled food or contaminated water sources. The feeling of disgust would deter them from consuming these substances, preserving their health and preventing illness or disease.

In modern society, disgust continues to protect our health and influence our social behaviours. It shapes our perceptions of others and guides our interactions by prompting us to distance ourselves from offensive or inappropriate behaviour, thereby maintaining social norms and upholding cultural values.

Implementable Strategies: Recognise the triggers of your disgust and utilise this awareness to assert your personal boundaries and values. Communicate your boundaries to others clearly and respectfully when necessary.

SADNESS

Sadness is characterised by reduced activity in brain regions associated with reward processing, signalling a need for social support and introspection. The amygdala, refrontal cortex, and insula play pivotal roles in processing sadness, and facilitating adaptive responses to emotional distress. Crying often accompanies sadness, serving as a physiological release by triggering tear production to alleviate emotional tension.

Additionally, crying can function as a form of communication, conveying distress and potentially eliciting support from others. Research suggests that crying may have a cathartic effect, aiding individuals in processing and managing their emotions.

Imagine a scenario in a prehistoric community where a beloved member passes away. The tribe is overwhelmed with profound sadness and grief, mourning the loss of a cherished individual. Recognising the signs of sadness, the tribe comes together to offer support, empathy, and solace to those affected, strengthening bonds of kinship and collective responsibility. Through communal rituals and gatherings, they navigate this period of grief, drawing strength from their unity and fostering resilience and cohesion even in adversity.

Today, sadness continues to serve as a signal of the need for social support and introspection, prompting individuals to seek comfort, assistance and guidance during challenging times. By acknowledging and processing feelings of sadness, individuals can engage in self-reflection and adapt their strategies for survival, ultimately leading to more effective decision-making and increased chances of overcoming adversity.

Implementable Strategies: Recognise sadness as a natural, valid response to loss or disappointment. Seek comfort through healthy means, such as connecting with supportive friends or family, engaging in creative outlets like writing or art, or spending time in nature.

Consider exploring alternative solutions or perspectives that may help alleviate your sadness. This could involve challenging negative thought patterns, seeking professional guidance, or trying new activities that bring you joy.

JOY

Joy, intricately connected with the brain’s reward circuitry, orchestrates behaviours geared towards enhancing overall well-being. Dopaminergic pathways within the brain play a central role in the experience of joy, reinforcing behaviours associated with positive outcomes.

In prehistoric times, successful hunts or bountiful harvests elicited feelings of joy and satisfaction among individuals, strengthening social bonds as they shared their bounty with fellow tribe members. This communal joy fostered cooperation and ensured the collective well-being of the group.

Today, joy remains a driving force in goal pursuit, providing a sense of purpose and meaning. When we find joy in our aspirations—whether career-related, personal, or relational—we are motivated to invest time and effort into achieving them. Sharing joyful experiences strengthens social connections, fosters a sense of belonging, reduces conflicts, and promotes group stability.

Implementable Strategies: Take time to explore sources of genuine happiness and fulfilment in your life, recognising that they may evolve over time. Identify your core values, passions, and sources of joy, consciously prioritising them in your choices to enhance well-being. Additionally, create opportunities for shared experiences of joy with loved ones to deepen bonds and cultivate a greater sense of connection and belonging within your family and social circle.

Emotions are fundamental components of the human experience, woven into the DNA of our species. By understanding their biological mechanisms and functional roles, we gain valuable insight into our own physical experiences, behaviours, and decision-making processes. While some emotions may feel uncomfortable, ignoring or suppressing them can lead to negative consequences such as anxiety, depression, or even physical health problems.

Taking an evolutionary perspective on emotions can shift our view, recognising them as valuable tools for growth rather than obstacles to overcome. By actively understanding and accepting our emotions, we empower ourselves to navigate life’s challenges more effectively. Practices like mindfulness and effective communication help us manage emotions constructively, fostering resilience and positive outcomes.

For those grappling with overwhelming emotions, seeking professional help from a therapist can offer valuable support in developing healthy coping mechanisms and achieving emotional well-being.

 

Lucie Ramet is an experienced Chartered Psychologist and CBT & ACT Therapist offering short and long-term individual support to adolescents (16+) and adults. She works in English and French. She works Mondays and Fridays from our Brighton and Hove practice, She also offers online sessions.

*Ancestors: the people from whom we are descended. When referring to human evolution, “ancestors” specifically refers to hominids, a group of bipedal primates that includes early humans like Homo erectus and Homo habilis.

by Leave a Comment

Compulsive use of pornography

More people now identify as being compulsive users of pornography that at any other time, due in large part to the ease of access to pornography through online platforms. Such a compulsive use, or ‘addiction’ as it is often termed can have a damaging impact on the individual and those around them. The negative effects on quality of life or general functioning can include guilt, shame, isolation, damaged relationships, reduced performance at work or school, potential job loss and financial expenses. Whilst this list is not exhaustive, it illustrates that like other ‘addictions’, the compulsion to use pornography can be a hugely challenging experience.

Is it all about sexual desire?

Compulsive use of pornography on first examination is easily viewed as an expression of excessive sexual desire. That’s like saying that an alcoholic likes to drink. Meeting the sexual desires of users only partially explains the pattern of behaviour. When it becomes clear that the user has little or no capacity to limit their use of pornography it points to this being more than just sexual desire. What can we consider might be the unconscious motivations behind such behaviour?

Unconscious motivation

The compulsion to use pornography might not have any one clear motivation. It can be claimed that any compulsive behaviour has its origins in a need to manage and regulate difficult emotions. Over time we learn that certain behaviour helps us to negotiate and manage these challenging feelings and through this process of adaptation we find the behaviour gratifying. Pornography is no different and this is where it moves from purely meeting sexual desire into something more rooted in emotional regulation.

The reliable relationship

The origins of the need to manage difficult emotions through compulsive behaviour are rooted in developmental experience. As stated above, the behaviour is the way in which one learns to manage emotions, but also to meet unmet needs. Use of pornography is more obviously a relational activity in that it is about the imagined connection with another individual or individuals. The sexual desires are met, and the need for intimacy with another, but in a way that does not illicit strong anxious responses. Pornography effectively becomes the relationship that feels safe and reliable. There is no emotional demand on the individual and they have a higher degree of control over the relationship.

Can we talk about pornography?

Compulsive users of pornography, like any compulsive behaviour, can find talking about their behaviour difficult. Pornography is no different and has the added challenge that its use can be highly stigmatised and not deemed acceptable. Finding a way to talk about it opens the possibility that the compulsion can be managed and can become a choice. A sensitive, non-judgemental therapist can help the compulsive user to move towards feeling that they have a choice over how and when they use pornography.

 

David Work is a BACP registered psychotherapist working with adults, offering long term individual psychotherapy. He works with individuals in Hove . To enquire about psychotherapy sessions with David , please contact him here, or to view our full clinical team, please click here.

 

Further reading by David Work –

Mental health in retirement

Subjective perception, shared experience

In support of being average

Collective grief

The challenge of change

by Leave a Comment

What is the unconscious? (part one)

We use the words unconscious and subconscious quite frequently, but what do they really describe?

The unconscious and its processes are an integral aspect of exploration and discovery in psychoanalytic therapy, but what do we mean and understand when we refer to this unseen and unknowable territory? There may be as many answers to this, as there are individuals who wonder about the question. Perhaps the process of wondering is an end in itself and a definitive answer should always elude us.

What do the theory books tell us?

A monumental and encyclopaedic book, “The Discovery of the Unconscious” was published in 1970 by Henri Ellenburger, that describes our human fascination with developing an understanding of the nature and revelations of this unknown realm of our inner being. Tracing the evolutionary path of this long-standing interest, he describes the functions of: shaman, as magical guides to spiritual realms; priests, as confessors and exorcists; and the mesmerists and hypnotists that emerged as we entered the cultural eras of the scientific and rational. This lineage culminates with the domains of psychiatric and psychological systems – the talking therapies used today to reach a deeper understanding of ourselves. Pioneers engaged in mapping this exploration range across sociological, anthropological, philosophical, esoteric, psychological and neuroscientific fields.

First expeditions of the pioneers of psychoanalysis

From the psychoanalytic field, Sigmund Freud and Carl Jung were not the first, but possibly two of the most prominently remembered, who attempted to describe this unknowable territory.

What did Sigmund Freud find on his journey?

Freud imagined the unconscious as an isolated phenomenon, hidden in the individual psyche of each person. He proposed a shape for this territory consisting of three spaces, we can see these as layers or depths. He named these the unconscious, the pre-conscious and the conscious.

Freud understood humans to have two basic energetic forces, similar to the impulses that fire across neurons. These he described as ‘drives’: a libidinal or life drive, and a death drive, destructive and the opposite of the libidinal drive. He imagined these drives acting across and between the realms of our psyche or mind – conscious and unconscious, and believed this system favoured an economy of action and affect. These can direct our thoughts, actions and behaviours without our being conscious of them. So, when we experience a free-flowing movement of these impulses we are in a healthy psychological state, or we can experience ill health as a result of resistance, blockages, imbalance and repression of these drives. Freud believed that the working of these drives in the unconscious could be revealed and analysed under the guidance of a psychotherapist. The therapists work was to illuminate these processes, identified by observing the retelling of dreams, free association (authentic, undirected expression of thoughts and feelings), misdeeds or mis-sayings, or by placing the client under hypnosis.

How were Carl Jung’s findings different?

Jung’s mapping of these territories was quite different from Freud’s. He imagined the conscious and unconscious as both individual and collective spaces, ‘an extremely fluid state of affairs… encompassing everything that ever was or will be’ (1954). For Jung our individual conscious holds the sum of all the experiences that are specific to us. This is where our personal ‘complexes’ exist, bodies of feelings, thoughts and memories attached to emotional states which inform our actions and behaviours. He added the concept of the collective unconscious to Freud’s map, a shared and accessible space available to every human being. He believed this collective space was the container of universal archetypes, motifs and knowledge from all of human culture and experience. Jung’s map of the unconscious was developed using metaphors from esoteric traditions. His approach to the unconscious was teleological, in that he felt the unconscious could be understood as functioning intuitively or instinctively, providing a means for the transformations of the self.

So how do we try to understand it today?

It might be useful to imagine the unconscious as an ever-changing territory which we live from, are informed by, and feel the effect of, in our conscious existence. In attempting to map its geography, climates, currents and systems, I find it useful to remember philosopher Alfred Korzybski words, ‘The map is not the territory, the word is not the thing it describes.’

Where do we begin when we look for it then?

I read a wonderful quote once, ‘the buying of more books than one can read is nothing less than the soul reaching towards infinity’ (A. Edward Newton). The narratives we find in stories, myths and fables can often present us with opportunities to explore our own inner worlds.

Phillip Pullman writes that ‘After nourishment, shelter and companionship, stories are the thing we need most in the world.’ Perhaps in these stories we are able to find maps to our unconscious? And in our approach to finding it, we might take Pullman’s analogy for finding his Secret Commonwealth as a guide, ‘You gotta think about it the same way as if you want to see it. You got to look at it sideways. Out of the corner of your eye. So you gotta think about it out of the corner of your mind. It’s there and it en’t, both at the same time. If you want to see… the absolute worst way is to go about the marsh with a searchlight.’ (2019).

How can therapy help understand our unconscious processes?

A therapeutic alliance is a relationship in which the therapist listens to and engages with the stories brought to them. Attending to these narratives with an open-minded curiosity, can help explore, bring to the surface and re-position experiences that are held in our unconscious.

In Bettelheim’s book The Uses of Enchantment he writes that, ‘when unconscious material is to some degree permitted to come to awareness and worked through in imagination, its potential for causing harm – to ourselves or others – is much reduced; some of its forces can then be made to serve positive purposes.’

Something remarkable happens to our physiology when we share stories. Neuroimaging data taken from a range of studies have illustrated how the practice of engaging in joint narrative retelling and creation causes a physiological mirroring in the brain activity of the collaborating parties, neural synchronisation or coupling. In this way, the act of sharing our personal stories with a receptive listener, can be understood as mapping our experiences into the mind of the other, which can be seen reflected in the brain’s physically synchronised response.

Why can this be a really helpful journey of exploration?

In my favourite quote from Donald Winnicott, he writes that; Psychotherapy is not making clever and apt interpretations; by and large it is a long-term giving the patient back what the patient brings. It is a complex derivative of the fact that reflects what is to be seen. I like to think of my work this way, and to think that if I do this well enough the patient will find his or her own self, and will be able to exist and feel real. Feeling real is more than existing, it is finding a way to exist as oneself, and to have a self into which to retreat for relaxation. (1971)

If we think of psychotherapy as a journey towards finding our way to exist as ourselves, we might then see it as an attempt to co-create a map of the intangible territory of our unconscious and its processes with our therapist. The map is not the territory, but we can suggest its form ‘out of the corner of our minds’ by sharing stories. These stories allow the therapist to feel and experience with us, as is shown to be reflected in the synchronisation of their neural networks. This mirroring is a mutual experience and often as illuminating for the therapist as it is for the client – a parallel process.

Where to next?

I have tried here to share my understanding of what the unconscious might be and how attempting to illuminate some of its processes is integral to the therapeutic approach I believe in. I hope this exploration is of use to the people who come and share their stories with me.

Sharing stories is how we communicate across many of our interactions with all sorts of people.

In psychotherapy, these conversations are held within a ‘third’ space that attempts to create unconscious resonance, regulation and revision within the alliance. This aims to facilitate the individual’s self-discovery, finding a secure base from which to live creatively from and enjoy, and this will be the subject of another story to share.

I believe wholeheartedly, that the benefits of exploring our unconscious territories, within a therapeutic partnership, can be life changing. After all, as Jung said;

‘Until you make the unconscious conscious, it will direct your life and you will call it fate.’

 

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. She is available at our Brighton & Hove Practice, Lewes Practice and Online.

by Leave a Comment

The empty chair in therapy

Can talking to an empty chair help ease our mental distress and help make us more positive and confident?

It may seem a strange idea, but evidence has been accumulating for more than ninety years that it can. The techniques involved, initially called ‘psychodrama’, originated in 1930s New York. They were refined in the 1950s by a pioneering psychoanalyst called Fritz Perls – the father of Gestalt therapy – and now form an important part of the ‘toolbox’ used in a range of therapies.

Chair work involves the use of physical or imaginary chairs to facilitate dialogue between different aspects of the self, or to explore conflicting emotions, thoughts, or perspectives.

Such work is at the heart of cognitive behavioural therapy (CBT) and schema therapy, which I have practised for almost a decade. It is designed to allow you to push away or reduce the impact of criticisms and deficiencies of care you have received from others from your childhood onwards, and to stop your own inner critic – usually rooted in shame – from hobbling your self-confidence and self-esteem.

The core premise of the technique is that talking in the present, in the safety of the therapy room and under the guidance of the therapist, to those who caused us problems in the past, helps to take the ‘sting’ out of negative memories stuck in the fight-flight area of our brains and to feel that we are back in control. Put another way, this is a route towards being able to regulate our negative emotions such as fear and anger more effectively.

Equally, talking to voices coming from within – for example our self-critical mode, or our ‘vulnerable child’ mode, both of which can be very debilitating if we have had insufficient care during our childhoods – can help us to boost our sense of agency and ability to self- soothe and self-validate.

What are the practicalities of chair work? To explain, I have created the example of John, an imaginary client now in his early thirties with problems typical of those which frequently surface in the therapy room.

As John grew up a key element was that his father – who was irascible and a big drinker – was very hard on him about doing homework and frequently yelled at him that he must do better. He regarded anything less than a grade A as failure – and failure led to consequences, from being grounded to pocket money being withheld and sometimes, beatings. Young John found such treatment very difficult to cope with because his
understanding of the world and his powers of reasoning were not fully developed. The father who was supposed to love him was a vengeful aggressor. It was cruel and frightening and his young self felt like there was no way of escape or answering back.

The impact went much deeper. John was traumatised by some of the more extreme punishments. He also came to believe that the pressure from his father was his fault because he simply wasn’t good enough. He was ashamed of himself and felt continually vulnerable because he was convinced that whatever he did was sub-standard.

When he started work, receiving criticism of any kind made him feel very insecure and often triggered him to defensive anger against his perceived attackers. At other times, he avoided exposing himself to the possibility of the type of behaviour his father had so often displayed by being insular. John was very bright but progress in his career was hampered by his very deep-seated negative beliefs about himself and the world – all rooted in his father’s mistreatment.

To help tackle these problems, I first went through with John the history of his relationship with his father and explained how such punitive and demanding behaviour undermined his self-esteem and of having a secure base in his life. Then came the chair work. The goal was to bring into the room the possibility of re-engineering what happened to him as a child, this time with him – rather than his father – calling the shots.

I asked John first to imagine how in his grown-up life, what he would want to say to someone who was treating a child like his father treated him. John was quick to say that he would tell him that such bullying was not acceptable and unfair to a child.

I then brought an empty chair at right angles to us both in the space between us. I asked John if he minded imagining his father as he was in his childhood sitting in the empty chair.

He was reluctant at first on the ground that it felt scary, even now. I reassured him that the difference between then and the present was that he was alone back then, and that I, as his therapist, was there to help and protect him.

I then asked John – as his grown-up, healthy self in the safety of the therapy room – what he would like to say to his father. His first reaction, exactly as when he was a child, was fear and reluctance. I reassured him again that he was safe, and eventually – at first slowly, but gradually gathering pace – he told his dad that he loved him but felt that what he had done to him regarding homework was very unfair, frightening and cruel. Gathering in confidence, he told him that it should never have happened and that he was still struggling with the consequences, that he had never felt good enough.

Much more happened on John’s therapy journey, but the chair work encounter with his father was a turning point in creating a new awareness of what had happened to him and in realising he had a choice in how he could control the distress he had so often felt. He had developed his own voice – and agency – in dealing with his father.

Reference works for further reading:

Cognitive Behavioural Chairwork, Matthew Pugh, Routledge, 2020.

Contextual Schema Therapy, Eckhard Roediger, Bruce Stevens and Robert Brockman,
Context Press, 2018.

 

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.

 

Further reading by David Keighley

How therapy can help with anger issues

Do you have unrelenting standards?

Why we need a ‘secure base’

by Leave a Comment

What happens in groups: free-floating discussion

There are many overlaps and similarities between what happens in one-to-one and group therapy. There are also many differences. Below I am going to talk about a group process called ‘free-floating discussion’ (Foulkes 1964, pp 40, 126).

In any group session, individual members are likely to bring in something for attention from the group. For example, this might be a problem, a narrative from the past or present, a dream, a dilemma, or a difficult feeling or experience, and so on. The group will generally respond to whatever is being presented in a similar way to an individual therapist. For example, by focussing on what is being said and offering a mix of interventions such as empathy, understanding, questions, reflections, links, and insights.

However, therapy group members are also encouraged to associate with what they are hearing and disclose what is being brought up for them. Here the group departs from individual therapy where the therapist is very unlikely to join in in this way and even if they did, they would not generate the multiple responses that a group can. If the group members can let themselves engage spontaneously with their associations and thoughts, the conversation can then start to move and flow between different members. In other words, into a free-floating discussion.

Those new to the experience of group work can sometimes find this disconcerting, ‘I don’t want to make it about me’ or ‘I don’t want to take it away from you’ are not uncommon comments. While socialised inhibition and politeness may be at play, group members used to one-to-one work might also feel reluctant to move away from what can be seen as essentially an individual therapy model – that is that the group acts together as the ‘therapist’ with one person as the ‘patient’.

However, this concept of free-floating discussion was developed from a Freudian idea of ‘free association’ for individual work. Freud encouraged his patients to let their thoughts,  feelings and fantasies wander and move from one association to another in a session, and to disclose these as spontaneously as possible. Freud believed this process allowed him and the patient to get closer to the unconscious.

Free-floating discussion in group therapy is a similar idea. The more freed up the group is to move from one association to another, the richer the conversation becomes. Group members can therefore move more deeply into less ‘known’ areas of understanding and profound emotional connectivity, opening the potential for a transformational, therapeutic experience.

What happens in groups: blog series by Claire Barnes

This blog is part of a series, in which I look at what happens in group analytic groups. I hope that this will give a sense of what it might be like to be in a therapy group and what are the ideas that underpin group analytic therapy.

Other blogs in the series include:
How psychotherapy groups can help change our internalised family systems
What is the role of the therapist in therapy groups?
What happens in group therapy: mirroring
What is it like being in a psychotherapy group? Case study – Joe

 

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

It’s not me… It’s us!

What are the benefits of a twice weekly therapy group?

Understanding feelings of guilt

A new psychotherapy group

The process of joining a therapy group

 

by Leave a Comment

Ageing and death

Ageing and death are two topics we find difficult to think and talk about.  

Do you remember when you first realised you were a grown up?  Major events like the loss of a parent signal a change in the social pecking order, and how society or the world sees us. There are moments that symbolise the start of a new phase, when we move from one stage of life to another, and age is the primary signifier.  It usually happens when we are least aware of the transformation.  Moving from child to adult, and young adult to adulthood, maturity and old age.  As ageing adults, might we be in denial? ‘I feel the same as I did when I was twenty-five’ – is this denial or how life is experienced for most of us?

A woman remarked the other day that a young man had offered her a seat on the bus. The comment triggered her to consider what this means.  Did she look as though she needed to sit down because she looked old? She was not the young woman she felt inside, but an older generation.  Of course, there could be many other reasons why he gave up his seat.

How does this impact our lives and relationships? In that period of life where we are developing a career, raising a family, or supporting parents in their old age, we are so busy that we may not want or have the time to reflect on how our roles and status are changing.  The encounter with the young man who gives up his seat for us triggers in our minds the reality that we are seen differently in the world than how we experience ourselves.

Rather than giving advice here, it would be useful to think about ageing with an optimistic lens, by identifying earlier on in life what is required to preserve our mental health:

  • avoiding isolation and loneliness
  • physical health and wellbeing
  • mental stimulation 
  • companionship with family and friends
  • keeping an open mind
  • dealing actively with loss and grief, and
  • actively managing our mental health to prepare for old age.

The last point is concerned with investing in your mental health throughout your lifetime. What are your relationships like with family and friends? Are problems swept under the carpet when resentments build up over months and years? We have an emotional economy that needs building on for those latter years.

In future blog posts I will elaborate on the above topics and suggest how we can help with some of the issues.  For example, joining a group where you can discuss these things with others. 

 

Thea Beech is a Group Analyst with many years experience working in the UK and overseas.  She worked as A Group Analyst in South Africa as a Lecturer at Cape Town UCT and at Kwa Zulu Natal University in Durban, lecturing on a Masters Program in Group Work.  Her MA in Applied research was on Eating disorders. Her interests are in cultural diversity and trans-generational influences on the individual.  Thea is available at our Brighton and Hove Practice.

 

Further reading by Thea Beech

The first 5 years

How do I know if I am ready to become a parent?

Our emotions are shaped by our relationships?

Group Analytic Psychotherapy – the slow open group

It is never too late to start therapy

by Leave a Comment

Radical self-care as an antidote to overwhelm

‘It’s all too much’

There are times in life when things get to a point where it is all too much. Usually, as a result of an accumulation of emotional, mental and physical demands without much respite. For instance, ongoing personal or professional conflict, a pervasive sense of stuckness, challenges with no imminent resolution, etc. These situations tend to be complex and multi-layered, adding to the sense of entanglement and therefore lack of clarity on a way forward.

Here are some typical ones: contentious and lengthy separation, ongoing conflict at work, complex family relationship dynamics, chronic health issues, responsibility for long-term care, fertility treatment, affairs and financial difficulties.

Things tend to get worse before they improve

It is often the case that change starts to happen once things reach their limit. This will of course depend on where each person’s limit is. Reaching the decision that things need to change is the catalyst for major shifts. There is nothing like the need to do something to propel someone forward into action. Sometimes it will be a small thing, like an exchange with someone. At other times it might be a painful realisation which leads to a feeling of ‘enough is enough’.

Patience versus paralysis

Some people stay in unhealthy situations for much longer than they should. Drawing a line comes with implications and losses which are sometimes hard to bear. Other times situations just need time to unfold and there isn’t much to be done about it. When we are right in the middle of something, it is difficult to know a way forward or out. In situations of threat, we might want to flee or feel paralysed (freeze), resulting in anxious or numb states.

In more severe cases, mania, depression, self-destructiveness and, ultimately, breakdown.

The antidote

Radical self-care involves uncompromising resolve to care for and resource oneself. Only when we are resourced again can we deal with challenges that require distance and  perspective. It is a way of going inward to find answers, to sit with uncomfortable and painful feelings and reflect rather than react. We can’t do this when firefighting. It may also involve changing unhealthy habits and looking after ourselves physically as well as emotionally and psychologically. Then, removing ourselves from the situation or finding a way to gain distance and find space. Some of us struggle with self-care more than others.

Being in a toxic cycle can feel like the familiar thing to do.

To summarise, here are some of the steps you can take if you are feeling overwhelmed and can’t see a way out:

– Take a step back and away from the situation.

– Resource yourself in whichever way you can.

– Do not go back into it until you feel that you are resourced enough and in touch with yourself again.

– Use both thought and emotion to find a way forward which is most constructive to your wellbeing.

– Implement these through actions which will serve you long-term.

 

This blog post was written by Sam Jahara, UKCP Registered Psychotherapist, Superviser and Co-founder of Brighton and Hove Psychotherapy

 

Further reading by Sam Jahara

There are no shortcuts to growth

5 good reasons to be in therapy

The psychological impact on children who grow up in cults

What psychological processes make us ‘choke under pressure’?

Having healthy conversations with men about the menopause

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

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

Copyright © 2025