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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

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The psychological impact on children who grow up in cults

I have just watched the latest Netflix docu series “How to Become a Cult Leader?” and was pleased to see that images of the cult I grew up in appear in it with frequency, because it means it is undoubtedly and widely recognised as a cult. Familiar images of the cult leader doing “energy darshans” (so-called transmission of energy) with his disciples, who in turn look utterly blissful, was designed to portray him as someone who holds special powers and cures people’s suffering instantly.

Indoctrination from an Early Age

The indoctrination of children in cults differs from that of adults in that children are extremely vulnerable to adult influence – the people they look up to, especially their parents. Children’s brains are still developing, and they are like sponges, absorbing the world around them, the world of adults who create the environment they exist in. A child will absorb the world view of those around her and accept this as her reality because this is all she has known.

The Cult Leader’s Demands Always Comes First

In cults, the cult leader or doctrine always takes priority over anything else. The child who grows up in a cult will never be the centre of attention in her parent’s world because they will most likely be totally self-absorbed with the cult leader and the cult demands. These demands are usually great and unattainable because the leader is likely to be highly perfectionistic, insatiable, and persecutory of those who do not meet his or her ideals. Moreover, a cult leader will employ fear tactics with their disciples and keep them in a state of perpetual adoration towards him and shame towards themselves. In this state of fear, shame and total preoccupation with another, there is no room for the age-appropriate demands of a child who actually needs their parent’s care and attention.

“Have No Needs”

A child who grows up in a cult learns to have no needs because she quickly learns that they do not matter. To survive in the cult and gain some crumbs of attention from her parents, she will have no choice but conform to the leader’s demands, try to fit in as much as possible and override her natural developmental needs. This means the child will miss out on normal stages of development, if not also on education and normal peer interactions because of the insular and isolated nature of most cults.

Isolation and Abuse

Sending a child to school means interacting with the outside world, which most cults find threatening. Depending on how isolated a cult becomes, they will supply their own schooling, have children interact only with other cult children and make sure there is no outside influence that could lead the child to question her upbringing.

Keeping a child isolated from society also makes her vulnerable to abuse – sexual, physical, spiritual, emotional, and psychological. Isolated groups create their own rules and decide what is right or wrong. In the cult I grew up in for instance, children and teenagers were conveniently seen and treated as adults.  This meant that we were required to work long hours, worship and meditate with the adults. This also meant that schooling was minimal and there was no age-appropriate censorship to adult-only stuff. The cult leader – a self-proclaimed enlightened master – was seen as an expert in raising children, despite him not having any children himself or knowing anything about child development. If the cult leader condones inappropriate, harmful, or even criminal behaviour, then his disciples collude because all that matters is what the leader thinks. His truth matters above all truths, and he/ she is always above societal rules and norms, including the law. Under these circumstances, children are extremely vulnerable to predators.

The Objectification of Children

In cults, children are either seen as an inconvenience or used as means for growing the cult. In both situations, children are seen as objects and not encouraged to develop their own identity. In cults, nothing is in the best interest of a child. Everything is in the best interest of the leader and the organisation. Despite this well-known fact, cult leaders will make it seem that everything they do is for your good and the good of your children, even if there is plenty of evidence to the opposite (see ‘Gaslighting’ below). They will make you quash your doubts, question your sanity, and give up everything you have, including your children, in the service of “the greater good”. This “greater good” has very few winners, which are usually the leader and his inner circle.

Gaslighting

A central feature of cults is gaslighting – a term coined from the movie ‘Gaslight’ where it a young woman is manipulated by her husband into believing that she is descending into insanity. Cults do this on a large scale, which is designed to keep its disciples or followers in a state of perpetual doubt about their opinions and follow the opinions and ideas of the cult leader. It is an exercise in maintaining power over others and abdicating any responsibility for one’s actions. For instance, in the cult I grew up in the self-proclaimed enlightened master would attribute all personal suffering to his disciples and never take any responsibility. This extended to the sexual, financial, and psychological exploitation of ‘his people’ including children. When questioned, he would say that you had not surrendered to him enough and that this was your reason for suffering.

Leaving

When the child grows up and is lucky enough to leave the cult, she or he will have to contend with a long process of rebuilding or recovering her own identity. Everything that she is has been attributed to the cult or exists because of the cult. Sometimes, when a former child choses to leave, her family will want nothing to do with her. Or she may need to cut contact with her family to survive psychologically.

The Recovery Process

Cult recovery is a long and challenging process which requires the right support. Finding a group of like-minded individuals who share similar backgrounds is advisable, as well as finding a therapist who is experienced and knowledgeable about this type of work. Explaining to people what you have gone through is never easy. Former cult members and those who grew up in cults can feel a lot of shame about their past and have difficulty articulating what they have been through. Most people lack an appreciation of what it is like to live in a high control group and its effects.

Regaining One’s Mind and Setting Boundaries

Those who were born or grew up in cults will often need to learn or re-learn how to live in society. Although cults range in terms of how isolated and restricted their members are, the indoctrination of children is so deep that it will take a very long time to regain their own mind, learn to think for themself and have their own opinions. This extends to knowing one’s own preferences, wishes and needs. Because having own thoughts and opinions was frowned upon or even dangerous, it takes time to regain a sense of safety in doing normal things, having personal preferences, and even feeling entitled to personal space. Growing up in an environment where nothing belongs to you, all the thinking is done for you and personal space is not a thing, has big implications in later life when it comes to setting personal boundaries.

Sam Jahara is a UKCP Registered Psychotherapist and Clinical Superviser. She is experienced in working with the psychological impact of high-control groups and cults on individuals, families and organisations. She has also spoken about her personal experience of growing up in a cult in recent public interviews.

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Is spirituality an escape from reality?

Spirituality is an important part of our existence. It can provide meaning and purpose, give us a sense of well-being and peace, and provide a philosophical way of being that gives us an ethical code and a way of dealing with adversity. Additionally, it is an important part of personal development that enables us to be more authentic in the world, and to connect with a transcendental dimension that is greater than ourselves.

But can spirituality also be an escape from reality? At times, our spiritual practice and our spiritual philosophy can become a way to avoid reality, and this is called ‘Spiritual Bypassing’.

The term spiritual bypassing describes when we use our spiritual beliefs or practices to avoid or escape from dealing with difficult emotions or personal problems. This could be when we use spirituality as a way to rationalise or justify an avoidance of emotional pain, as well as using spiritual practices as a means of avoiding responsibility or accountability for our actions.

For example, we might use affirmations to deny our feelings of sadness or anger by saying such phrases as “I am happy and content” when we really don’t feel it. While this does have a use in terms of positive psychology, it can also deny and suppress our feelings. As another example, we might believe that everything happens for a reason, and because of this belief not take any action to rectify a problem or take responsibility for our part in a situation. At times, these sorts of ideas can hinder our progress on the spiritual path and also become problematic for our emotional development.

In terms of spiritual practice, this also can become a way of avoiding our emotions and the reality of life. For example, if we are able to get into blissful meditative states, then we might try to spend as much time as possible in such states and deny other experiences. This could then lead to a withdrawal from the world as we attempt to be fully occupied with meditative bliss. While mediation and other practices can lead to a more permanent feeling of bliss and contentment, resolving our underlying emotional issues needs to come first.

While spiritual bypassing can take many forms depending on the person and their practice, below is a list of the more common manifestations.

Denying emotions: This involves using spiritual beliefs to suppress or deny difficult emotions, rather than fully experiencing and processing them.

Overemphasising positivity: This is where we focus exclusively on positive thoughts and feelings, and dismissing or denying negative emotions or experiences.

Avoiding conflict: This involves using spirituality to avoid or minimise conflict, rather than addressing it directly.

Disregard for the physical world: This involves using spirituality to detach from or minimise the importance of the physical world and material concerns.

All of the above, (and this list is not exhaustive) are examples where the underlying thinking is rooted in spiritual philosophy, but that philosophy is taken out of context in order to serve the individual. As such, it can end up being harmful both for the individual and others around them.

It can be quite easy to fall into spiritual bypassing as most spiritual philosophies are beautifully simple and can lead us to thinking that it is an easy task to evolve spiritually as well as emotionally.

However, such development takes a lot of time, practice and self reflection. Working honestly with a good spiritual friend can help us to understand how we are applying spirituality to our lives, and if this is in a healthy manner. But at times we need to take this a step further and work with a therapist to help us resolve our underlying emotional patterns so we can truly bring our spiritual life into reality.

Dr Simon Cassar is an integrative existential therapist, trained in Person-Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

 

Further reading by Dr Simon Cassar

Sleep and Mental Health

Spirituality and mental health

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

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Relax: Watching people using their hands

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

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

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

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

 

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

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Nietzsche and the body

Here I reflect, a little,  on a few of Nietzsche’s words on and as the body. These reflections are not conclusive or comprehensive. The only agenda is inspired by Nietzsche,  to perhaps stimulate the reader’s curiosity and desire to experiment and explore.  Please do read my previous article – ‘Why read Nietzsche?‘

“The body is a great intelligence, a multiplicity with one sense, a war and a peace, a herd and a shepherd.” (1)

Nietzsche felt many philosophers, including Plato and Descartes, failed to grasp the significance of the corporeal nature of human beings and the pivotal role of affect.

In much of his writing he explored the impossibility of pure thinking, reminding us that we are embodied thinkers, and our senses and emotions are as much a part of this reasoning as thought, if not more so.

Nietzsche treasured being and walking in nature. In fact, Nietzsche (1967) seemingly suggests physical movement was necessary for a thought to be accepted as plausible when he said –

“Give no credence to a thought that was not born outdoors while one moved about freely”. (2)

He depicted how the air we breathe, the food we eat, the place we live and what we ingest through reading, writing and talking all have an impact on our physiology and philosophy and vice versa. Nietzsche (1974) even advised:

“Our first questions about the value of a book, of a human being, or a musical composition are: Can they walk? Even more, can they dance?” (3)

Nietzsche wrote a poem called ‘Writing with one’s feet’. It emphasised the principle of embodiment through metaphor and description of the anatomy of his writing.

“Not with my hand alone I write: 
My foot wants to participate.
Firm and free and bold, 
my feet Run across the field – and sheet”(4)

I understand Nietzsche as a passionate defender of the embodied lived experience. His philosophy is one that elevates both known and unknown instincts and drives that interplay with our bodily lived experiences. In fact, Nietzsche seems to suggest the self is the body.

“Behind your thoughts and feelings… there stands a mighty rule, an unknown sage – whose name is self. In your body he dwells; he is your body”(5)

Nietzsche was not defining the body in a conventional way, such as a physical body or a single unit. He viewed it more metaphorically as a collection of corporeal and psychic forces, including emotions and instincts which are in a continual and often conflictual interplay. He saw the self as a plurality of forces, or more precisely a plurality of (relational) affects. These relational affects each express a viewpoint and seek domination.  Affects, for Nietzsche, are dynamically and continually interpreting and creating perspective. (6)

This multiplicity can sometimes create confusion and conflict, especially if one gets stuck in thinking there is  a such a thing as supremacy, or the right way, or the truth. Perhaps the key is to recognise that they all say many things at once. Rather than seeing this multiplicity of meaning and often unknown elements as something to fear, one could be curious and trust there is something to be listened to in all aspects. This exploration and experimentation is something that therapy can be helpful for.  A potential space to sit in the unknown for a while, exploring, experimenting and experiencing,  and see what might emerge.

Perhaps as Nietzsche suggests this very experience of conflicting affect can dislodge the notion that there is one way to be and create an opportunity for us to be guided into new, more fluid and creative ways of becoming. It can show us there are no limits to novel forms and there is always potential for transformation even within the limitations, obstacles and challenges that we may face. It also tells me that the idea of a rational pure thought that can somehow ignore or overcome the influence of emotions, physical sensations and those forces that reside in the unknown or unreflected, is unlikely. For Nietzsche it seems, nothing is, or needs to be, left behind in this often enigmatic embodied endeavour we might call lived experience.

As I conclude I feel a pressure to tie this short piece up into a nice and neat bow, so that it feels complete and reassuring somehow. However, I also feel the desire to swim. Perhaps the former would be missing the entire point of Nietzsche and the latter highlights his case in point.

 

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

 

Susanna Petitpierre, UKCP accredited, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

 

Further reading by Susanna Petitpierre

Why read Nietzsche?

Magnificent Monsters

Death Anxiety

A consideration of some vital notions connected to Existential Therapies

 

References – 

1) Nietzsche, F. (1883/2010) Thus Spoke Zarathustra (Ed. B Chapko),Ebook.

2) Nietzsche, F. (1967) Ecce Homo, in On the Genealogy of Morals and Ecce Homo, trans. and ed. by Walter Kaufmann. New York: Vintage Books, 1967

3) Nietzsche, F. (1882/1974), The Gay science. With a Prelude in Rhymes and an Appendix of Songs, trans. W Kaufmann, New York: Random House

4) Nietzsche, F. (1882/1974), The Gay science. With a Prelude in Rhymes and an Appendix of Songs, trans. W Kaufmann, New York: Random House

5) Nietzsche, F. (1883/2010) Thus Spoke Zarathustra (Ed. B Chapko), Ebook.

6) Bazzano, M., (2019) Niezsche and Psychotherapy. London: Routeledge.

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Making Changes

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

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

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

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

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

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

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

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

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

 

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

 

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

 

Further reading by Rebecca Mead –

Social Connections

Back to ‘Bace’ics

Interpersonal Therapy (IPT) explained

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Why read Nietzsche?

Nietzsche reflected on and wrote much about the lived experience of human beings. He discussed many things that were seemingly in conflict with the last thing he wrote. I have sometimes heard this used as a reason not to read Nietzsche. This apparent paradoxical nature might sometimes leave you confused and resistant to look again.  However, I feel he is always worth returning to, especially if we are curious about life.

According to Kaufman (2004) Nietzsche depicted himself in Ecce Homo as “a psychologist without equal and many consider his philosophical work to have a deeply psychological understanding of the human experience.”  [1]

Freud apparently discussed the level of introspection Nietzsche reached as being greater than anyone else past or potentially in the future. [2]

When I began to read Nietzsche, I was actually surprised at how engaged I became, despite how little I seemed to understand. He inspired me then and continues to each time I return to his texts, often seeing it from a different perspective each time.  I feel his rhythmical and metaphorical offerings were made to stimulate exploration and awaken emotional responses rather than offer conclusive truths. He was purposely ambiguous and contradictory. For me, Nietzsche was on the side of experiencing and embracing the significance of creativity, music and dance. He
welcomed understandings about fluidity, multiplicity, becomings and going beyond. I feel he invited us to see that we are so much more than we have dreamed of thus far, and there are many dimensions to be explored.

My understanding of Nietzsche is that he was not one to be dogmatic, and he challenged scientific reductionism. Bazzano (2019) discusses how Nietzsche did not see science as able to explain life, only describe it. He challenged people to see how structures and systems were filled with our attempts to the bring natural dynamic and conflicting forces (both internal and external) into order and control [3] .

Or sometimes, perhaps, as a way to avoid taking responsibility.  In fact, Nietzsche was often suspicious of the systematisation of life, “I mistrust all systematizers and I avoid them. The will to a system is a lack of integrity.” [4]   (Part 2, sec 26)

Nietzsche welcomed the dance of life. His writings pointed to the multiple dynamic perspectives and interpretations that direct human experience, and the oscillating movements between chaos and structure that we all seemingly exist within on a macro and micro level. He championed understandings and explorations that focused on active over reactive forces. He centred the ‘need to know’ that can monopolise human thought and perhaps gave consciousness and intellectual knowledge its origins and apparent semblance of supremacy as, in fact, secondary
to the primacy of the body. The latter being a direct experience of active forces experienced through feeling the body’s affects. [5]

Nietzsche has both inspired and disturbed me. He manages to shake the ground beneath you, leaving you adrift at times. Equally he evokes a desire to live this opportunity to exist and experience more fully, within all facets presented. I feel he provokes a desire to feel, listen and move. To take responsibility for this existence we are living in all its uncertainty, intensity and affect and utilise creatively their influence in our transformations. [6]

Sadly, his thinking can be overlooked and dismissed due to his fall into apparent madness. I feel that is a fruitful encounter missed. He is worth reading if only to find out if any gems touch and inspire something within you.

Susanna Petitpierre, UKCP accredited, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice.

 

Further reading by Susanna Petitpierre –

Magnificent Monsters

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

References –

1 Kaufman (2004). Nietzsche, Heidegger and Buber- discovering the mind vol 2. New York: transaction publishers.

2 ibid

3 Bazzano, M, (2019) Nietzsche and Psychotherapy. London: Routledge

4 Nietzsche, F. (1888/1969) Twilight of the Idols, trans, R. J. Hollingdale, Harmonsworth: penguin.

5  Bazzano, M, (2019) Nietzsche and Psychotherapy. London: Routledge

6 ibid

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Spirituality and Mental Health

Spirituality is an often-used term these days, and around 20% of the population in the UK define themselves as spiritual, but not in the religious sense. So what does it mean to be spiritual?

There are many definitions of spirituality but generally we could say that it involves having a sense of something bigger than ourselves – a transcendental view of life where we start to realise that there is more to life that we see around us. This can include a sense that there is a God or creator, an intelligence in the universe, or maybe a deeper wisdom that we all carry. However we conceptualise it, spirituality often leads to a greater sense of purpose and meaning as we start to step back from the everyday world and see a bigger picture playing out before us. Spirituality also includes a sense of connectedness, which might be with others, ourselves or with something more transcendental. This feeling of connectedness can bring us a great deal of peace as we start to realise that perhaps we are not alone in the world. 

Spirituality is different from religion, but is linked to it. Religion is about adhering to a set of doctrines that define each particular faith. Religion will often have a spiritual component – a worldview that has an idea of something greater than us (God, for example) and may also involve a spiritual connection as part of the religious practice. However, you do not need to be religious to be spiritual, and indeed being religious doesn’t need to be spiritual!

So how important is spirituality to our mental health and wellbeing? There has been a lot of research over the past decade that considers this question. The findings show that engaging in spiritual practices have a positive impact on our mental health. Lower levels of depression can be found in those who are actively involved in spiritual communities. Levels of stress and anxiety can be lowered by engaging in spiritual practices, and spirituality can be instrumental in the recovery from trauma. Also, there can be a greater sense of purpose and meaning from having a spiritual perspective, which can have a positive impact on our wellbeing. 

Having a committed spiritual practice – whether it is mediation, prayer, or whatever feels right for you – reading spiritual philosophy and engaging with a spiritual or religious community can be hugely beneficial in improving and maintaining positive mental health. Even if you don’t consider yourself to be spiritual, it is worth spending a few moments thinking about life and the wonders that we see around us. It is easy to see that there is more to life than our own limited worldview and when we step back and consider this, our problems and daily issues can be put into perspective as we gain a more holistic view of life.

 

Dr Simon Cassar is an integrative existential therapist, trained in Person Centred Therapy, Psychodynamic Therapy, Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and Existential Psychotherapy. He is available in our Hove and Lewes clinics and also works online.

 

Further reading by Dr Simon Cassar –

Living with borderline personality disorder

Online Therapy

Student mental health – how to stay healthy at university

Four domains – maintaining wellbeing in turbulent times

Face to Face and Online Therapy Help Available Now

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How body stability creates psychic stability

There is No Such Thing as a Baby

I frequently blog about the importance about including the body in the process of psychotherapy and how the unconscious resides in the body.  However, unlike many ‘body psychotherapists,’ I believe that the involvement of the body is more profound than identifying the presence of the body in the process. Let me explain using one of Donald Winnicott’s most famous quotes, “There is no such thing as a baby.”

Winnicott famously made this statement in 1947. On face value, it may seem somewhat absurd. After all, we have all seen babies and know they exist. However, the reality is far more complicated, because every baby that any one of us has ever seen is only visible because it is in a relationship with its primary carer (which for simplicity, I shall refer to as its mother).

A baby cannot exist alone but is essentially part of a relationship.  Babies exist in an absolute state of dependence, such that the infant (the word is taken from the Latin – ‘infans’ – not able to speak) has no knowledge of maternal care, as this would require the knowledge of ‘an other’ providing the care.  The baby therefore is essentially indivisible from its mother and thus cannot exist in its own right.  The infant’s experience relies on the mother’s ability to merge with, and adapt to, her baby.  Therefore, whenever we see a baby, we actually see a baby, its mother, the relationship between the two and also the wider social context within which that baby lives and has come to be.

There is No Such Thing as a Body

The same principle can be applied to a body.  There is no such thing as a body in its own right.  A body is created, shaped, moulded and exists within the relationship that the mother of the owner of the body has had with it.  In other words, the body and how it is experienced by the person in the body is contingent on the relationship that the baby has with the mother and the wider environment. This then dictates the relationship that the owner of said body, has with him or herself (if any.)

Why Does the Body Matter?

Psychotherapy is about many things, but one of the primary tenets is that it is a relationship within which the client/patient can, through relating to the therapist, establish a relationship with themselves. Having a relationship with ourselves includes having a relationship with our body. However, I believe that too many psychotherapists assume that such a relationship is necessarily experienced as helpful by the client at the outset of therapy, or even possible.

The Body as an Enemy

If we come to inhabit, or embody, our bodies through the relationship with our mothers and the wider social context, and our mothers were abusive to us, then the experience of our body can be one of ambivalence (‘I don’t really care about my body”) through to experiencing the body as dangerous, attacking or not our own.

Examples of where internalised abuse/hatred is expressed towards the body include cutting and burning the skin through to anorexia and bulimia, to name a few.

Risk of Trauma

Assuming a pre-existing, or even conceptually possible positive relationship between a client and their body on the part of the psychotherapist is naive. At worst, it risks re-traumatising the client.

If, for the client, all that is bad resides in their body, then they need to slowly find a way to ‘meet’ their body in a different context and to tentatively form a different relationship with their body – to reclaim it from the ‘bad’ parent. The therapeutic process involves creating a different relationship with ourselves, one in which we are able to leave the echoes of past formative relationships behind. At the very least, we need to learn to think about ourselves as players in those stories in a different way. In the same way, we need to learn to relate to our body as our own and as our friend, guide and an integral part of us.

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

Further reading

Body psychotherapy

What is attachment and why does it matter?

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Existential therapy

What is existential psychotherapy?

Strictly speaking, existential psychotherapy and counselling is more akin to an approach to the therapeutic work (and to life) rather than a type of therapy.  However, this does in no way to minimise the importance and benefits of an existentially orientated psychotherapy.

One way of thinking about existential psychotherapy is to see it as a philosophical stance, rather than a rigid framework within which the clinician works.  As such it rejects the deterministic view of human nature found in more traditional psychoanalysis and the behaviour school approach.  Existential psychotherapy concerns itself with the problems of existing, or living, and sees clients’ suffering as their inability to accept life as it really is, rather than that their symptoms are manifestations of mental illness.

In existential psychotherapy, the clinician works with the client to help them to find purpose and meaning in their lives, and through the therapeutic alliance works with the client to live a more ‘authentic’ life.  In existential therapy, it is through the therapeutic relationship that ‘inauthentic’ ways of being in the world come to light.  Put more simply, it is within the therapy that the client finds safety and trust to explore the myriad of ways that they hide from themselves and others; how they avoid the realities of life. Whilst these realities can be hard to accept, it is only through embracing them that clients can find authentic – meaningful and purposeful – way of living their lives.

And, it is through the courage of accepting life as it is and embracing ones limitations, that many clients find their suffering and symptoms disappear; what in other types of therapy may be termed symptoms, or mental health problems.

Benefits of existential psychotherapy

In the existential approach, both counsellors and psychotherapists seek to come alongside the client as human beings.  What this means is that they seek to understand the client’s subjective experience of the world and their place in it.  If all neuroses and psychoses are fundamentally solutions to the problem of life and how to find meaning, then the dilemma is one faced by us all, the psychotherapist included.

Existential psychotherapy seeks to help clients find more constructive ways of creating meaning and alleviating their suffering.  For example, existential psychotherapy can be particularly useful in helping former addicts construct more meaningful and multi-faceted lives, where they can bear their distress and seek a wider range of healthy relationships and behaviours in lieu of their behaviour or drug of choice.

In the modern world where prescribed meaning is increasingly absent – religion, family, career – the existential approach can be extremely helpful in grounding clients and enabling them to firstly recognise the ordinariness of their humanity – all human beings must find purpose and meaning.  Secondly, the therapeutic relationship can be a vital collaboration helping clients to work out what will enable them to feel fulfilled and that they have meaning.

In essence, existential psychotherapy is about finding meaning in a world increasingly devoid of meaning.  A life lived without substantial meaning causes suffering, often experienced as anxiety and depression.

What happens during existential therapy?

Existential therapy is a collaboration between the therapist and client where the therapist helps the client to explore the meaning and purpose of their life. This may involve examining their values, beliefs and goals as well as their relationships and sense of identity. Existential psychotherapy is premised on an enquiry into what makes your life meaningful.

The first meeting

The purpose of the initial meeting is to determine whether you and your therapist are a good fit for each other. It’s a time to discuss why you’re there, what you hope to gain from the process and your background. It’s also a time for you to ask as many questions as you feel necessary to make your decision to continue. This first meeting is important for your therapist to better understand you so they can tailor their approach to your specific needs.

Confidentiality in existential therapy

Confidentiality is important in any part of therapy. It’s important you feel comfortable sharing personal and often sensitive information with your therapist knowing they will keep this information private. Your therapist will explain their approach to confidentiality and outline what is expected of you and what you can expect from them. In general, everything discussed in your sessions is confidential, unless there are rare instances when there is a need to break confidentiality. For example, if you are at risk to yourself or others.

The frame

The frame in therapy refers to the physical and contractual boundaries that create a safe and structured environment for the therapeutic process. This includes the length, frequency, and overall structure of the sessions and the process. Your therapist will work with you to establish a framework that feels safe and supportive, whilst focused on achieving the goals you have set out in coming to therapy.

Ongoing sessions

Existential therapy can be conducted over a period of weeks, months, or even years depending on the needs of the individual and whether you, as the client, continue to find the work and the process useful. Ongoing sessions are designed to provide ongoing support and guidance as you explore your inner world. Many of our clients, once getting into the flow of therapy, enjoy the intimate relationship and opportunities to make deep changes to their life.

Existential psychotherapy is offered by Mark Vahrmeyer, Dr Simon Cassar, Susanna Petitpierre and David Keighley.

If you are unsure of the type of therapy you need, you can search for a therapist here.

All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.


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