Welcome to the Brighton and Hove Psychotherapy Blog. Brighton and Hove Psychotherapy offer a wide range of short and long term psychotherapy and counselling services in Brighton. Here we will be helping you with friendly advice, tips and stories.
When you begin therapy you enter into a particular (perhaps peculiar) type of relationship, one with well defined boundaries and ethics. Beyond its method and structure, at the very heart of this relationship lies empathy.
As a therapist empathy means doing all you can to understand your client from inside their own experience. It requires an ability to communicate this understanding in ways that are sensitive, meaningful and useful, both verbal and nonverbal.
It is a powerful experience to feel understood, listened to, cared for and respected. Over time it can make it easier to have empathy for yourself, to take your own personal pain and suffering seriously, to judge it less, as trivial, stupid or simply a product of your own personal weakness.
When we begin to take our own struggles seriously, we gain access to another layer of empathy: compassion for the child that we were, often a child who made sense of what troubled them by deciding that there must be something wrong with them – that they were the problem. In the context of an authentic and empathic connection with another human being the shame or disgust or guilt that has become so entangled in our sense of self can begin to make way for new feelings. Sadness (perhaps) for what was lost and loving regard for the child who did the best they could at the time. When there is more space in our imaginations for the reality of our own struggle, we can begin to see other people differently too. When we experience the power of feeling understood we may also experience greater internal space for new thoughts and feelings, both about ourselves and about others.
The therapist as client
All psychotherapists have had their own experience of being a client in therapy. Sharing the most intimate and often painful moments of someone’s life is made possible when you have felt and expressed your own. It is not that as a therapist you become an expert on life (not even your own) but that having undergone your own therapy you will be more equipped with the clarity to differentiate your separate self and experience from that of another. To understand whose feelings are whose and to have the versatility and flexibility to step into and out of another person’s shoes.
The circuitry of empathy
Empathy is a complex system of mutual cues and responses that regulates each persons experience of self and other. We observe this very clearly in parent/ infant interactions. How attuned a parent is to the (myriad/micro) communications of an infant will inform the infants reciprocal response to the parent.
It is not that in an ideal world infants and young children would be perfectly attuned to at all times. Over-attunement can be stifling and intrusive. What’s more important is the experience of an ongoing relationship in which misunderstandings and mis-attunements can be repaired.
Emotional neglect and emotional intrusion are flip sides of the same coin. Anyone who has suffered either will have good reason to believe that they may never be understood.
As a therapist we cannot “know it all” for our clients, we cannot tell someone how it is they feel or what is true for them. What we can provide is an open ended, respectful curiosity for our clients and a willingness to share in the important project of “getting it.” Paying close attention to the unique form of connection that exists with each client means understanding empathy as a mutually influencing system. From this perspective, the communication of empathy becomes much more a mystery to engage with than a tool to master.
Therapy is often called a ‘talking therapy’ but what is talking exactly?
Generally speaking, what someone says is what therapists consider and explore in session. Body psychotherapies are often the exception because language and thought are understood as different aspects of being in and as the body. The rise of mindfulness-based therapies that explore therapeutic change via awareness of the body as a whole could suggest that the focus on talking therapy is changing.
Despite this, what someone says remains a significant focus in therapy. Other than words, what could be important to pay attention to in therapy and beyond?
Existential therapy is rooted in philosophy. Merleau-Ponty (1962) has been deeply influential in how existential therapy considers the embodied being. Merleau-Ponty illustrated how our embodied nature is our primary experience of the world and how we communicate.
He also emphasised the importance of our existential sexuality (which I will discuss in more depth in a later blog) and embodiment to how we feel and how we react to everything we encounter. This understanding seems fundamental to how we open and close ourselves to the world. Merleau-Ponty reminded us that however we are perceiving experience in our own way, we are always in an interpersonal encounter “like an atmosphere” (p. 168) .
Perhaps this atmosphere is most readily felt when we open and connect to something that generates sensation, for instance when doing yoga, meditating, making love. Or perhaps when we feel ourselves with others deeply, whether it is in an intimate and caring moment or perhaps feeling a difficult and challenging emotion. This ‘atmosphere’ is incredibly useful to consider both in therapy and in the moment when we feel the cluster of sensations that reveal our ‘being-ness’.
For instance, this atmosphere can point to how we are relating with others. It provides information for us personally but can also highlight how we feel in our relationships. Breaking through repetitive patterns in relationships can be tricky. However, a quick way to cut through stuck narratives is to stop and feel. Pausing the story telling and easing into the direct experience of being with another can sometimes reveal a deeper more intimate layer of being. We may notice we feel more open, or perhaps we may feel more closed. Defences may drop while a sense of feeling exposed becomes more prevalent.
In this moment, we may feel more deeply the sensations which illuminate the connecting space between all we encounter. We may understand more clearly whether we want to move towards or away from something or someone. This understanding can be a hugely significant when we are feeling confused intellectually.
Gendlin’s (1993) writes the “… living body always implies its right next step” (p.32). His commentary about being and focusing in the body seems to support Merleau Ponty’s ideas and suggests that it can be a guiding force to orient and anchor us. Even simple movements, such as feeling the pattern of breath and its impacts, can ground us and bring us into intimately present being. Paying attention to feeling sensations may encourage new understanding to arise. By broadening how we understand ourselves we may find more possibilities emerge where we once felt stuck.
These notions and an openness to experience it directly for yourself can be incredibly helpful in therapy. It is also a significant understanding and experience for anyone interested enough to pay attention to what is actually happening in your body, in any moment.
So, despite therapy often being considered a talking therapy there is much useful information that happens beyond this. Paying attention to what is actually happening in and as the body can be a fantastic starting point. This enquiry does not have to be difficult or complicated. For instance, next time you are out walking or sitting down just notice what it feels like. How do your feet and hands feel? Are they relaxed or tense? Do you feel any tension in your tummy? Let go of any judgement or speculation about it and just feel what is actually happening. If you feel like it, try sensitively easing into the tension. Relax, be curious and see what happens.
Social unconsciousness is a term used by Earl Hopper to describe the effect of living in a world where we are connected by our common histories, culture and social, political and economic environment.
But how does this affect us? With so much taking place in our ever-changing world, this has a place in our experiences in the present such as Brexit as well as in our past. When it then comes to looking at the therapeutic relationship we have, the focus tends to be on our close relationships. Very rarely do we take time to look at our minds and the effects it has on it.
It is clear however, that economics does determine whether we can reach our potential. The daily commentary on Brexit is primarily focused on the damage of fiscal instability on wealth, employment and the ability of the state to provide for those unable to look after themselves. This is turn creates fear and division resulting in anxiety, which, as a community we are suffering from. All this change creates dissonance which we need to learn to tolerate and adapt too. In a pluralistic society, psychological robustness is essential as we need to tolerate living and coping with the differences.
It is often questioned if part of the increased level of mental illness is due to the disturbances in the social matrix? Does it form part of our experience of the social unconsciousness? I personally wonder if social media and its potential to invade our personal space means we are unprotected from the outpourings of hatred, once confined to the mind where these thoughts can be reflected upon but has now spilt out onto the page for all to see.
We all need to take a moment and remember that not everything has to be shared publicly. We need to reflect on contextualization and take time to examine it against reality and critical thinking. The clinical space, its boundaries of time and location, can provide the holding and containing for our disturbance and anxiety in order to gain a better understanding of ourselves.
Thea Beech is a UKCP registered Group Analyst, full member of the Institute of Group Analysis and a Training Group Analyst. Her work in psychodynamic psychotherapy spans 20 years in the NHS and for the last 10 years overseas in South Africa. Thea is available at our Brighton and Hove Practice.
On the face of it, a
process that is long-term, happens at the same time, on the same day, each
week, would seem to be in stark contrast to modern life.
We are promised, and expected to subscribe to, a world where
our wants and needs can be met almost instantaneously, where we can have things
exactly as we want them and everything – society, identity, gender and
sexuality – is up to debate and can be changed. And changed and changed again.
Social media floods our senses with messages about how to be
happy, grateful and fulfilled whilst espousing ‘hacks’ and quick fixes for
depression, anxiety and every human condition in between.
The shelves in book shops buckle under the weight of the
latest ‘self-help’ guru or fad and life coaching promises tangible change in a
few sessions. And if it does not work for us? Well, then we are simply not
trying hard enough.
It is not quick, it is not an experience where you can get
immediate gratification or a relationship that will affirm you as always being
right. It is something very different.
In many ways, psychotherapy is an antidote to all of the
above. It is about learning through relationship to be in relationship with
Through relationships we begin to see ourselves through the
separate eyes of another who is compassionate, boundaried and can withstand us;
nobody should become a psychotherapist if they want to be loved.
Psychotherapy is the opposite of Instagram and Facebook – it
is about deeply knowing and accepting who we are and learning to live a
meaningful live of substance and depth: it is about learning to be ordinary.
And it is about accepting the realities of life: that life is unfair, often
hard and that the only substance is to be found in relationship.
Car crashes have a nasty habit of drawing our attention. And
then, of course, the likely outcome is another crash. When we see a car crash
it takes a mature mind and person to not join it; to keep their eyes on the
road and focus on their own experience.
The modern world is comprised of ever more car crashes – not
necessarily in the literal sense, but in the many dramas (real and streamed to
us) that draw our attention away from the road. Psychotherapy is an antidote to
this – helping people steer a steady course through the chaos and drama and
remaining in relationship to themselves. In this sense, psychotherapy matters
very much in the modern world.
I’m in agreement with Brett Kharr who argues that unfortunately we have a strange situation in therapy where there are an almost innumerable different types of therapies to choose from. I think this reflects the consumerist, swipe right, swipe left age we live in and actually makes starting therapy more confusing for clients.
Richard Chessick, a Psychoanalyst, writes that;
“It is the experience of
the therapists personality and the encounter with the therapist as a human who
is truly present, rather than any verbal exchange, that makes the fundamental
difference in therapy. It forms a link, that brings the patient in consistently
over years of treatment, even at times when the patient is very angry or upset.
If, as a client, you are serious about wanting to change things and about wanting to engage in therapy then it does pay to think a bit about which therapist and therapy may be a good match for you. Sometimes you may feel comfortable with the first therapist you meet after perhaps doing some online research or obtaining a personal recommendation. Sometimes you may want to have a few initial consultations with different therapists. As a therapist I would always be more than happy for you to do this. As a client I would advise on being as honest as possible with the therapists you meet about this, as it’s a good chance to gage their reaction. A therapist where you feel you might have to worry about hurting their feelings, may not be the best choice.
When I began my training the course leader, in one of our first
seminars, talked about the therapists needing to have personal therapy and how
to choose and get the most out of therapy, said one thing that has stuck with
“Make sure to give your therapist hell”.
I have often thought about that statement and have come to appreciate,
that I think at essence, its saying how important it is to be as honest as
possible in therapy, especially about the things you don’t want to say and
especially about the things you don’t want to say to your therapist.
This may feel strange. You may feel your therapist is annoying, a disappointment, etc. What’s useful about this and I believe unique to therapy is that the therapist who has had a thorough therapy themselves won’t take it personally, they will be able to reflect on the bits that may be true, but also may be able to help you think about the bits you may be bringing that you may also bring to other areas of your life. Is the experience of finding your therapist annoying/boring/uncaring or whatever, something you experience in other areas of your life in relation to other people? If so the special circumstances of the therapeutic relationship can be a unique chance gain insight into these recurring patterns as they are happening, not just in an intellectual way but also at a deeper more affective level. It is at that level that I believe change can really occur.
most people hear the words ‘mental health’ perhaps what they are most likely to
think of is mental difficulties, or mental ill-health. I always think it’s such a shame that ‘mental
health’ has these negative connotations, whereas just the word ‘health’ doesn’t
I am a big believer in being proactive about mental health and wellbeing, and in the importance of doing things to stay mentally and emotionally well – just as you might keep active, eat a healthy diet and clean your teeth to keep your body well and healthy. There is, perhaps unsurprisingly, a huge overlap between a person’s emotional and physical wellbeing. The negative impact of stress on health and wellbeing has been well researched.
Psychology is a branch of psychology founded by Martin Seligman, which is
concerned with the positive aspects of life; it focuses on potential and
thriving, or as one book puts it ‘positive psychology is concerned not with how
to transform, for example, -8 to -2 but with how to bring +2 to +8’.
what might be the emotional equivalents of cleaning your teeth or keeping
active be? There are lots of ideas that
can be helpful, and some will suit certain people more than others. It is worth trying out a few different ideas
to see what works well for you. Using a
planner can help, to ensure that you are regularly and frequently doing
something specifically to have a positive impact on your emotional wellbeing. It’s good to have a mixture of things across
a week, including things that bring you pleasure and things that bring a sense
of satisfaction or accomplishment.
list below includes different ideas and strategies drawn from Positive
Psychology, and other areas of psychology:
relaxing – this could be using imagery, or a progressive muscle relaxation
time engaging in hobbies
time with, and investing in close relationships
the ‘Three good things’ exercise; every night for a week spend some time to
identify and write down three things that were good about the day and notice
your role in them
about someone you are grateful to or for, and telling them about it
some time paying attention to the present moment (Mindfulness)
this year I will be running a series of workshops along with a physiotherapist,
looking at tips for having a healthy body and healthy mind which will go
further into the topics discussed in this blog.
Anyone who is or has been in “psychotherapy proper” will tell you that it can be really hard work.
First, you begin by telling a total stranger about the most intimate things in your life. Things you never even said out loud because it was all too difficult to admit to yourself, let alone to another human being.
Then, you find out that most things you were taught about yourself growing up turn out to not be true. Well, that’s a relief in most cases, especially since many of us are taught to believe pretty horrible and untrue things about ourselves like: “you’re stupid”, or “you’ll amount to nothing”, or something a bit subtler like “your sister is the good one”.
Next, you are encouraged to feel things you haven’t or couldn’t feel before because no one cared or knew how to deal with it. So, once you start learning that the stuff you swallowed in your childhood was more about your parent’s inadequacy rather than anything to do with you, you begin to feel pretty angry about this, or sad, or disappointed, etc
All of this inevitably leads to the painful realisation that your early life wasn’t as rosy as you thought it was, and therefore you are now feeling very anxious or depressed about seemingly unrelated things like work or your relationship. This then leads to more mourning of the loss of good experiences that you never had. And because you can’t go back in time and no one else can make up for these experiences, you then have to gradually come to terms with it.
Of course, this is all very uncomfortable and plus it turns your world completely upside down, which you weren’t expecting at all cause you just came here to talk to a lady (or man) with a nice face and (hopefully) a soothing voice.
But then, because you are feeling all this sad and angry stuff that you never felt before, you realize that you are also feeling other things, like relieved and happy. And that over time, you feel more and more alive and happy than sad and miserable.
This leads to you being more attractive to other people and them wanting to spend more time with you because you are a nicer and more interesting person.
You also get more secure in yourself and find better work, which in turn leads you to feeling even better about things and, oh gosh – a positive loop begins!
But of course, being sad and miserable has its advantages. People feel sorry for you and they try to rescue you. Plus, you don’t have to make any fundamental changes or feel very uncomfortable feelings and make some difficult realizations. It’s the devil you know, right?
Well, being in psychotherapy might change your life for good – it’s up to you whether you want to.
(P.S. The process of psychotherapy can take many different avenues, depending on what you are bringing and where you want to go. The above is only one general example).
It is important to recognise when things began to change. On the other hand you might realise that to some extent it has always been like this but it is only now that you recognise that.
Think back to the time when things began to change what else was happening around that time?
Life events make different demands on different people and individuals respond differently to the same events, often we don’t realise the impact this can have on how we feel as a couple. These events might include a new baby especially a first baby; changes at work, losing a job or being promoted; a house move to an unfamiliar area; children leaving home; serious illness, caring for elderly or sick relatives or the death of a parent.
How have these events changed how you and your partner spend time together and/or communicate with each other?
Most couples, consciously or not, have regular ways that they show their care for and communicate with each other. These may part of daily life, a cup of tea in bed in the morning, a lift to the station, a chat in the bathroom. These small rituals are important in keeping the relationship ‘oiled’ and for both partners to feel reassured and affirmed.
How did you meet and get together and what was it that first attracted you to each other?
Look back to what was happening for each of you when you met and think about your expectations of each other. You might have imagined each other would bring new opportunities or offer something that was missing in the other. Maybe one of you seemed warm, expressive and sociable when the other was feeling low or lonely or maybe one of you helped the other sort out practical problems or manage a difficulty at work; perhaps you saw each other as very funny, clever or sexy. One of you might have recently been left or left a relationship and have had high hopes that this one would be very different.
These questions begin to reveal the underlying hopes, dreams and expectations in a relationship. These may have been unrealistic at the start or they can become fixed and out of date. Thinking about disappointment is painful and it is easy to blame the other person for failing to live up to expectations or for changing, “You used to be thoughtful and sensitive!” “You used to care about me!” Life events make an impact and the picture keeps changing. Things that seemed important have drifted into the background, something new is brightly lit in the foreground and you can sense things emerging at the edges.
As a couple it is important to be responsive to life and what it brings for each of you, to give yourselves opportunities to reimagine what you want to create together as a couple.
“Both room and house are psychological diagrams that guide writers and poets in their analysis of intimacy.” (Bachelard, 1958/1994:38). This implies we have a tacit (a felt but not easy to express in words) understanding of the psychology of physical space. I suggest that the surroundings in which therapy happens are part of the therapy.
In contemporary psychotherapy there is a concern about the blurring of the boundary between the personal and professional. In the psychodynamic model if the therapist’s life comes too much into focus the client’s therapeutic potential can be compromised. It is a commonly held belief that therapy should ideally happen in a neutrally private room. However we would want to avoid any resemblance to anything cold, clinical or cell like. Freud is well known for his iconic rug covered couch and his large collection of figures that stood like a group of silent watchers in his consulting room.
A positive approach to the objects and disclosure can provide opportunities for working things through. Let’s think about books on display in the consulting room. A collection of psychotherapy books could be reassuring, showing that the therapist is well informed and takes their professional development seriously. If a client shows an interest in a particular book it can open up an area for exploration.
The impact of objects in the room can become important when a counsellor moves or there is a change in the room. Lapworth describes how when he introduced a sculpture into his consulting room, a client re-saw the room and noticed the books that had been in the room all along. When her attention was drawn to the books by the arrival of a new object, they resonated with her father and she talked about him for the first time (Lapworth, 2012:8).
Field notes the need for counsellors to take transitional objects with them, for example a rug on the floor. When she moved her consulting room a client was relieved to see the rug reappear in the new room. “We came to understand that it was symbolic of my perception of him: that I accepted him as he was; in his words ‘scruffy, imperfect, colourful and well travelled!’ ” (Field, 2007:174).
Therapists can use objects and images to support themselves in their work. A small sculpture or photograph with personal associations or special memories can help a therapist keep an open mind and feel connected with their own resources. Clients can sooth themselves through difficult times by finding reassurance when looking at familiar elements in the room.
A central idea of relational psychotherapy is that our thoughts, feelings and behaviours (healthy and unhealthy) are directly related to our interpersonal relationships. It is therefore about our self-with-other experience. We are all creatures of familial, social and political contexts, continuously formed (and forming) through our interactions with others.
Relational therapy can be an effective treatment for a whole range of psychological and emotional problems, understanding as it does that so many of them are rooted in troubled relationships past and present. Telling one’s own relational story in the presence of a carefully attuned empathic listener can be a powerful experience, generating shifts in self-understanding and ultimately in symptoms.
Not a medical model.
A relational therapist is not a doctor, there to administer a cure to someone’s emotional pain. This may seem disappointing to some clients. Rather s/he is a fellow human being, ready to engage with and understand the longings and the losses, the hopes, fears and struggles that might have brought a client into therapy.
Relational therapy does not hold with the notion that each of us is responsible for our own happiness. It rejects the tyranny of self-help models that suggest that it is only by “working” on ourselves will we claim our power, increase our self-esteem, become fully evolved etc.
Instead it believes that we all need good connections with others in order to feel good about ourselves. Individual power, agency and wellbeing are only achieved in the context of healthy interpersonal connections.
Relational therapy does not subscribe to rational, linear, cause and effect explanations of how change happens. We are complex systems of thoughts, feelings, beliefs, self-states and energies, all interconnected. Relational therapy takes a systemic, non-linear view of change. Having a new experience of oneself in the context of the therapeutic relationship may lead to new experiences of self and others outside of therapy as well.
Who needs Relational Therapy?
Anyone who has questions like “How do others see me?” “Am I good enough for them?” “Am I worthy enough?” might consider seeking a relationally oriented therapeutic approach. When your own answers to the questions above aren’t good, you feel bad about yourself and when you feel bad about yourself you are diminished.
A relational therapy will look at your everyday relationships with people in your life right now and seek to understand what it is that happens there that leaves you feeling bad about yourself.
Understanding the (repetitive) patterns of feeling bad in your life might be a reminder of earlier relationships. Consideration of these earlier relationships may help in developing an understanding of the sense you made of them, the sense of who you are and what you’re worth.
The here and now relationship between therapist and client is also kept in mind and attended to as part of a relational approach. As a relational practitioner I am always noticing the subtle shifts within and between myself and my client(s). The moments when a client might feel misunderstood or judged by me are important to “catch.” Understanding what goes on between “us” might be useful in understanding what goes on “out there” with “them.”
Therapy offers the possibility to reflect on what forms us and to make room for the changes we hope for. A relational approach understands the relationship itself between client and therapist to be a fundamentally important element in realising such change.