How to become a Psychotherapist

I often get asked, how did I become a Psychotherapist. There’s lots of different routes into the profession and often conflicting and confusing advise. It’s not easy and for a good reason, as being a counsellor is a tough job. However, I sometimes wonder if the methods and paths available mean the profession excludes segments of society, which doesn’t feel comfortable. There is lots of research being carried out into this and I hope to see the barriers being broken down over time. Here’s a summary of my route into being a psychotherapist:

Where did I start?

So I started my journey by doing my own research into all sorts of courses and got utterly confused! I finally settled on going to The University of Brighton, but before starting their Post Graduate Diploma course, I needed to complete a CPCAB Level 2 course (at The MET). This is a listening skills course, that I completed part time over a year. It was a great way to put my toe in the water and see if counselling was the right thing for me. I met some really lovely and interesting people on the course.

What I had done before

One of the entry requirements for the Post Graduate Diploma in Psychotherapeutic Counselling is to hold an undergraduate degree, or hold relevant experience you can evidence. Luckily I had already done an undergrad in Business Administration. To begin with I was concerned that this had no subject relevance, but luckily the course will consider any subject.

Applying for uni

Once I had almost completed my CPCAB, I started the process of applying for the PGDip. This consisted of writing a statement of intent. I spend tedious hours perfecting this before submitting it. I was thrilled to be offered an interview after this. I remember being super nervous and leaving feeling like I had been too honest and that I had got it wrong. On reflection, I think my honesty is the thing that sold it. After this, I was offered a place and I was excited to start.

Over the summer, there was an assignment set and I was assigned a rather intimidating reading list. I stupidly took a copy of one of the heaviest texts I’ve ever read on holiday to Mexico with me! I actually enjoyed writing that first assignment, even though I was aware that I felt completely out of my depth and no wonder! I was writing about philosophy, a subject that I had never studied before.

PGDip

The PGDip has two cohorts, humanistic and psychodynamic. These are both modalities, which basically means the way we think about the theory that we base our practice on. Most lectures are taught separately, but some are together. It was interesting to hear about a different perspective on what we were studying.

The humanistic route focuses on a philosophical approach, looking at existentialism and phenomenology, which ask the question what does it mean to be human in the world and look at how we make meaning in life, amongst other things.

The PGDip took 2 years to complete. As part of the course, I was required to undertake a clinical practice placement, where I needed to accrue 100 hours of therapy. I did mine at Carers Support West Sussex. I was very lucky, they provided supervision every two weeks that met the needs of the course, other colleagues had to pay for this. I was also required to be in weekly personal therapy for the duration of the course.

Setting up private practice

At the end of the PGDip, I was qualified to practice and a registered member of the BACP. I was very proud of my achievement. I soon set up my private practice and set up two clinics in Hove and Steyning. I found my business administration undergrad degree very useful to support me in setting up my business. It wasn’t long before I was busy enough to give up the day job and focus on building my private practice.

MSc

Despite being qualified to practice, I was eager to know more. I had the time and space to carry on studying, so I enrolled on the Master of Science in Psychotherapy degree at The University of Brighton for the following academic year. This was another 2 years of study. I am really pleased I did this, as I learnt more about other modalities and ways of working, including psychoanalysis and CBT and how to incorporate this into my humanistic practice.

Covid

During my second year of my MSc, Covid arrived. It wasn’t the best timing. The uni were brilliant and when we went into lockdown, all lectures were moved online. There was a real sense of learning how to do online learning together. Focusing on completing my MSc really helped me through the challenges of being in lockdown.

Needless to say, Covid impacted private practice. I decided to take my practice online a week before the country went into a national lockdown. I will always be grateful to the majority of the clients that agreed to continue our work together online. Since Covid, I have continued to work online and love it! I have been very successful with making a connection with clients when working online.

UKCP

The MSc is affiliated with the UKCP. I am still working on my portfolio to gain my UKCP accreditation. To gain this, I needed to evidence 450 hours of supervised practice at a ratio of 6-1. I needed to be in personal therapy for another 2 years during the MSc. I am currently working on completing my mental health familiarisation placement in the NHS where I work on a mental health inpatient ward one day a week alongside private practice. Once I have completed this, I will be applying for UKCP accreditation.

What I could do next

There are many opportunities for further learning, as I am expected to keep up to date with CPD. Psychotherapy really is a career where you never stop learning, another reason why I love it! My plans for the future are to undertake training to become a supervisor.

Although it feels like a long way off into the future, I would like to undertake a PhD at some point. I know now is not the right time in life, but I feel excited about the possibility of more study and undertaking more research into mental health.

9 steps to prepare for online therapy

I have been exclusively working online now since the country went into lockdown in March 2020. I have maintained working online despite restrictions lifting as I personally don’t feel safe working face to face, as I am clinically vulnerable to Covid-19. If anything this move online has helped me develop my specialism of working with those who are in chronic pain and those experiencing long term illnesses. I have been able to work with people all around the country, without the distance between us being a problem. Also it has helped bring therapy to profoundly disabled people, who might struggle to leave the house.

One of the things I’ve learnt to do, as the therapist, in supervision and during my own therapy is to prepare the environment I am about to work in. I thought I’d share by top tips and things to consider when working online with a therapist.

Step 1. Lighting

It’s important to consider the lighting in the room you are working in and any light changes that might happen during the session. Sometimes the room might look bright, but then you start the camera and things look a bit gloomy, especially during the evening. I also consider if the screen is going to be affected by natural light changes- which impacts me personally around sunset- so when I am working then, I will shut the blind in my office.

Step 2. Privacy

You’re in your own home, it might not be possible to be home alone. It is important you feel you can talk freely and in order to do this it is important to make sure you feel you can’t be over heard and make sure that others know not to enter the room you are in during the work. A simple do not disturb sign might be considered.

Sometimes being in your home isn’t an option. I have worked with some people who decide to sit in their cars for therapy. From a safety perspective, I would never work with someone who is driving, but would be happy with sitting in a stationary car.

How I personally overcome this is to make sure nobody comes upstairs, where my office is and communicate when I am working, so there are no disruptions on my end.

Step 3. Tissues

Therapy can be a time to have a good cry- your therapist won’t mind and there is no need to apologise for tears, they are very welcome. When working face to face, I’d always have a box of tissues on hand. I can’t do that online, but a quick reminder that they might be needed.

Step 4. Internet connection

Check your connection before the appointment. Make sure the room you are in has good signal from the router or if you are working on 4G that there is sufficient signal. Theres things we can do during the session if the connection drops- such as turn off the video and as a last resort talk on the telephone. It happens! The internet is an unpredictable element sometimes, but its always good to have a backup plan.

Step 5. Technology

Think about the technology you are using, does it have the right software (if relevant)? Will the power on the device last for the duration of the session? Do all the features work (such as mic and camera)?

Essentially you can work on a mobile phone, which is fine, but it might hurt your arm to hold the phone in selfie mode for 50 minutes. Maybe consider something to hold the phone, or use a device such as a tablet or computer resting on a table in front of you. You could consider using some headphones if you wish. Personally I choose to use Apple AirPods.

Step 6. Drink

Talking for 50 minutes can dry out the vocal chords. You are very welcome to have a non-alcoholic drink at hand. If we were working face to face, I would always offer one. There is nothing worse than feeling uncomfortable because you need a drink.

Step 7. Comfort

You are going to be sitting in one spot for 50 minutes, choose somewhere you are going to be comfortable, including temperature. This is more of a challenge during the summer months, as opening a window might mean privacy is lost. Personally I use a fan to keep me cool during the summer months, so I don’t have to open a window. I also use cushions to support me, so I am sitting comfortably.

Step 8. Distractions

In todays society it is easy to get distracted, particularly by a mobile phone or another screen. I tend to put my do not disturb button on my phone. There is also deliveries to consider- try and make sure that there is someone to accept a delivery on your behalf, or schedule the delivery for another time.

On a different note- children. They might be in another room playing, but are you being distracted by the noise? Maybe consider scheduling therapy for when they are not around to create background noise.

Step 9. After the session

Consider what you are going to do to leave therapy. You are in your space, but it might be important to get up and move about- leave the room you were working in for a bit, go for a short walk, do whatever feels right for you, so you feel like you have physically left the therapeutic space when the call ends.

Conclusion

So there we have it! My 9 tips to preparing your environment for online therapy! When I started working online, I wouldn’t have thought about how important some of these things are, but it is the little things that can make a big difference for therapy going smoothly.

Counselling in a pandemic- what I've learnt

When I look back at the past year, I can see the world has changed beyond recognition. Along with many other things, the way I work also changed. In March 2020, I made the decision to stop working face to face with clients, to protect both myself and them, especially as I was pregnant in March 2020. It was a bold move and I am grateful that so many of the people I was working with trusted me enough to take our work together online. I am pleased to say the transition into the online world went really well, so much so, that it is something I plan to keep up, even post pandemic, especially as a return to work after a short break for maternity leave.

Pre-pandemic me would have been sceptical about online therapy and would have privileged working face to face, however the experience of actually working online has taught me how affective the work can be and in some cases it can be enhanced.

One key advantage to working online, is not needing to plan in travel time! Therapy in your own home means that arriving is just a button click away, no public transport, no driving, no parking. A big plus in the winter months. This might also open up coming to counselling for those who may find it difficult to get out and about, ensuring inclusivity.

For me personally, offering therapy online means that I can be more flexible about when I work and can offer a wider range of appointments, including evening slots. Unlike when I work face to face, when I need to consider the room availability of where I am working. From a clients perspective this means being able to offer the most suitable time for them, resulting in less missed appointments.

Another advantage is being able to choose a therapist anywhere you want. Sometimes people worry about bumping into their therapist out of context, what better way to avoid this happening than to choose a therapist from a different geographical location. Also it removes the fear of bumping into someone you might know in the waiting room.

I have also noticed that there can be a deeper connection with a clients vulnerable part of themselves, leading to wider disclosure of concerning issues. Maybe this is because of being within familiar surroundings and therefore more able to open up freely.

Online socialisation seems to have become part of our new normal. However, there is something difficult about group communications online. Thankfully it is much easier to communicate when it is a one to one situation. Many people are seeking connection right now. My belief is that online therapy can provide an opportunity for connection and facilitate a safe space in which to work therapeutically. Of course it is important that the client feels like they are safe where they are and that they feel able to open up and talk.

Now therapy online is not to be undertaken without caution. There are various ways of engaging with people online and it is important that you choose a reputable source and ensure the therapist that you choose to work with is registered with an awarding body such as the UKCP or BACP. You can search registers online. In addition to this, make sure you choose a method that is right for you. There are lots of online apps offering therapy, which have limited evidence to suggest they are affective.

Of course there are downsides to online therapy. Not having the right technology can be a block for some. You need to have a device which can connect to the internet and has a camera, where you can see the screen at the same time. For this reason, I am happy to work with people on the telephone, to make sure that I remain open to working with those without the right technology.

Most importantly, right now counselling could go ahead in a face to face environment with the right covid secure measures in place, however, this is never a 100% certainty. Although I don’t believe that online therapy will ever be a permanent replacement for face to face therapy for some, it is a good stop gap for now, which is why I would always be open to starting work with someone online, with the view of moving to a face to face environment when we can. This might be particularly relevant for you if this is a reason for not starting therapy now.

There are some clear advantages to working online and having done it now for almost a year now, I am pleased to say my own pre-judgements of the world of online therapy were wrong. If you’re in the same position as me, then why not give it a go and see how it goes and find out if it’s for you…

Should you make a NYE resolution?

Let’s acknowledge that I (a qualified psychotherapeutic counsellor) have used a “swear word” in the title of this blog- “SHOULD”. If there were a handbook to my job, don’t say “should” would be chapter one. Should indicates something that you may not be fully on board with. i.e. “I should take my bin out” however I don’t really, so I can’t say “I would like to put my bin out”. So why does tradition dictate that we “should” make a resolution? What is it about the start of a new year that makes people feel like they need to change something about themselves? Why change? And why do we need a point in the calendar to tell us to start doing something differently.

My guess (without any hardcore facts, stats or figures) that these “resolutions” are potentially set up to fail. Reflecting upon my own experience, they are often made in haste and have a superficial foundation to them. Gym memberships skyrocket in Jan… Maybe people are lured in by special offers, but maybe the ad is tapping into part of the persons psyche that would like to be healthier or fitter. In many ways theres absolutely nothing wrong with that, however… I dare say that the gym may be emptier in Feb than in Jan. Why?

Part of me questions how much that NYE resolution means to the individual, the other part questions ok if this really is part of someone they wish to change, maybe they haven’t fully explored the underlying reason as to why they desire change in the first place? After all, what is so bad about “old” them that requires an overhaul and taking time to look at the value that “old” part has, if not, then what purpose does it serve?

The gym is just one example of many new years resolutions that will be made and broken this year. Whatever the resolution, there might be a temptation from some, to go 0-60 straight away. Consequently they are likely to fall at the first inevitable hurdle. Ok failure happens, but it’s how you cope with it that really matters. Can you pick yourself up from the low point and carry on? Or are you left bruised and injured from the fall of failure. How resilient you are can make or break meeting a goal. Regardless of how failure is managed, it could be said that the premise of a NYE resolution is setting up for a fail.

SO how is it possible to break the mould and make change possible? If only I had the answer to this! We live in times where change and uncertainty are ever present. Although there isn’t a magic solution, there might be ways to avoid the pit falls of the NYE resolution, assuming this is something that you REALLY want to do differently and not a half hearted whim. STEP ONE- if it is a whim, ditch it now. If not really question if what you want to change is realistic. If it is, are the steps in how to get to the end goal realistic? If you are not sure what is realistic for you, why not talk to someone you trust about what you would like to change and how you would like to achieve it. However, if it feels too big to share with friends and family, you may wish to consider talking to a counsellor or psychotherapist.

Having reflected upon NYE and the purpose of the resolution tradition, I can see that there is a significant factor in the timing of the start of a new year, as it is a significant benchmark to reach in the calendar, something to gauge progress or failure. The start of a new year might instigate the beginning of reflection upon life, what is going well and what isn’t, alongside what needs to change. These are the deeper “resolutions” that, in some cases, might be more difficult to change. It might be addressing the darker “shadow” parts of self, that are more difficult to acknowledge or even see in the first place. That bit of you that you don’t like and you know others see.

For some, they may wish to address something deep inside that bothers them, such as a mental health issue they live with daily. It is important that such changes are addressed with the right support in place. Many mental health conditions take time to address, however this is not to say it is impossible.

So as we say goodbye to 2019 and look forward to 2020, why not consider what you really want to make a resolution about, even if it is something that you might not be ready to action just yet, maybe the “good enough” thing is to do is just bringing it into awareness for now, after all, there’s 365 days+ to think about how you might want to take action. I’d like to think about it as being kind and compassionate to yourself, which is a pretty good way of being in itself.

“The curious paradox is that when I accept myself just as I am, then I can change” -

Carl Rogers

Psychotherapy and Counselling what is the difference?

Have you ever wondered what the difference is between counselling and psychotherapy? It’s a good question. Especially if you are thinking about making the decision to enter into talking therapy. Even as a qualified therapist, I find it difficult to distinguish between the two. This is partly because there are notable similarities between the two, yet there are equally apparent differences.

Similarities

The BACP state that the word “therapy” covers both counselling about psychotherapy. The aim of therapy is to offer a safe and confidential space to talk about your concerns with a trained professional. Therapists do not offer advice or solve problems for you, but they do listen to you understand yourself better.

Definition of “Psychotherapy”

Psychotherapy is defined by the UKCP as a range of approaches and methods, which help explore peoples emotions. Different therapists work in different ways, which can be found here. I undertake an existential humanistic approach, which means I aim to help you make sense of life and the challenges this can bring, such as finding meaning. Psychotherapy training is at Postgraduate level, so it is more in depth.

If you’re not sure what it’s all about, this video provides a great explanation, including views from members of the public.

Definition of “Counselling”

Counselling is defined by the counselling directory as: “A process people seek when they want to change something in their lives, or simply explore their thoughts and feelings in more depth”.

This video by the BACP explains the process and principles of counselling.

Key differences:

Counselling:

• Focuses on problems and situations within the present day

• Focuses on specific situations or behaviours

• Usually offered on a short term basis

• Guidance, support, and education to help you identify and find your own solution to a problem.

Psychotherapy:

• Focus on chronic or recurrent problems

• Takes an overview approach, to help you find the bigger picture

• Usually offered on a long term basis

• Focuses on facilitating the expression of internal thoughts/feelings (core issues) leading to personal growth

• Deals with complex issues and diagnoses.

Why Psychotherapeutic Counselling?

Although there are differences, the similarities between both psychotherapy and counselling are notable. However the more I consider the potential differences, the more I become aware that the variances between the two could be down to how an individual therapist is both trained and chooses to practice.

The way I work combines concepts from both counselling and psychotherapy, which is possible as I have had training in both areas. This means I can adapt the way I am working to meet the needs of the client.

Are grades equal to success?

Today is A-Level results day in the UK. Some students may be feeling over the moon, others may feel overwhelmed, some may feel disappointed and it might be that some feel a bit everything. The grades students receive are often the gateway to other opportunities, so understandably there is a feeling of pressure and wanting to succeed. However, I am left wondering what success really means?

Exams and assignments are an opportunity to pass a test. That’s it. However does this equate to success? When I think about it, each person has a talent, something they are good at. What if that thing isn’t passing the assessment? After all, you can’t fit a square peg in a round hole.

My other thought is the comparison factor… It is easy to compare grades with peers. However, what if the comparison remains with the individuals expectations. Obtaining a pass for some will be an achievement and that’s ok. As a society there is a push to be “the best” but what happened to being good enough? Striving for more is tempting, however when considering the potential impact upon mental wellbeing and self esteem, I question if more than good enough, i.e. being perfect is worth it.

I have personally battled with this element of education. Often feeling disappointed with anything less than the highest grade, which for me was often unobtainable. Eventually… I realised that the grade itself didn’t matter, even failing. What really matters is what I got out of learning about the subject along the way. Even if it was a topic I didn’t particularly enjoy. I got to this point of acceptance through my own personal therapy. I recognised that, to an extent, the answers on many essays were indeed subjective and a reflection of my opinion at a point in time. Therefore “doing my best” was simply showing up to an assessment prepared.

Although there is no “choice” over the specific grade given for a completed piece of work, there is an element of choice in the response given to the grade received. My own journey to acceptance came from reframing how I think about grades and success, therefore challenging my belief system.

The more I think about it, the more I am becoming aware that the meaning of “success” will be different for each individual. So much will depend on individual goals, dreams and expectations. Alongside this, long term life success is more than the grades on a piece of paper, surely a bigger part of success is what someone does with them. If a straight A (however many stars) student ends up doing the same office job in their 30’s as the student that scrapped by, is one more successful than the other?

Not getting the right grades might be a game changer for some. However, there might be other paths to your personal success. The initial emotions of not getting that grade can be extreme for some. It might be difficult to see past the obstacle present. Counselling can offer a supportive space to explore your emotions and thoughts, providing the opportunity to gain clarity to find a different path to personal success.

“What defines us is how well we rise after we fall”

— batman

6 signs of excessive smart phone use

6 Signs of Excessive Smart Phone Use

Smart phones. You may well be reading this blog on one. According to statista, 95% of 16-34 year olds own a “smart phone”. A device which connects us to the digital world of social media, emails, texts, phone calls, mobile banking, GPS navigation, google amongst many others. Modern day smart phones can be defined as PDA’s (personal digital assistant), which used to be a separate device, which is what technically separates a “smart” phone from a standard mobile or cell phone . All in all they are rather useful and have become a big part of modern day life. However, I am left wondering about our ways of communicating on smart phone and the impact this has on our lives. Are we really connecting with those who we have these digital interactions with and what impact does this have on our wellbeing?

How does this relate to our mental health?

Excessive smart phone use has been proven to have an impact upon our wellbeing in the form of:

• Stress

• Anxiety

• Depression

• Loneliness

• Sleep deprivation

• Self absorption

• Limited deep thinking

• Loss of self confidence

Smart phones facilitate overuse and therefore create an “addiction”. They create a behavioural compulsion within to respond to the sound of a ping or a chime tone, meaning it can become difficult to ignore new text messages, notifications or emails. According to Dr Erik Peper neurologically our brain is making a connection with the sound and a need to respond, which is a similar physiological response to an addict taking a substance. The addiction to smart phones has made its way into the Diagnostic and Statistical Manual of Mental Disorders (DSM 5).

There is also an impact upon physical health too- with reports suggesting that overuse can have an impact on eyesight, hearing and posture.

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What is “excessive” smart phone use?

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1 Time spent on a smart phone

According to research using or checking a smart phone over 60 times during a day is a sign of addiction. It has been highlighted that university students are the demographic most at risk of developing excessive use.

Another sign we are spending too much time on our phone is noticing other tasks are not getting completed, or not realising how long has been spent looking at the device, you meant to spend 10 minutes just quickly checking your email, but then an hour has passed, maybe you are falling into the trap of excessively using your smart phone.

Becoming so engrossed with a smart phone demonstrates a sense of self absorption, meaning there is less awareness of the world around us, not noticing the time passing by is a significant sign of this.

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2 Semi-Tasking

This means using your mobile phone when you are completing other tasks, such as eating or watching TV however by semi-tasking your brain is unable to fully focus on one task, which could result in either the task being incomplete of badly performed.

Our brains can become overstimulated, overwhelmed and overloaded with the information provided by multiple sources. When I think of being overwhelmed, I immediately associate the word with anxiety, therefore it would be fair to suggest that the behavioural pattern of using a smart phone whilst carrying out other tasks causes anxiety.

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3 Experiencing FOMO

“Fear of missing out”. The best description I can think of for this is being a child who has been sent to bed, but can hear their friends playing outside, feeling like it is unfair that their parents have sent them to bed. I suppose this links most of all to social media. Scrolling through a social media timeline of other peoples posts, thinking how great everyones life is. Essentially comparing self to other.

When thinking about how this impacts upon our mental health, I think about the impact this has on self esteem and self belief. After all what is posted on social media is a filtered lens of what others wish to portray about themselves, therefore the comparison is “real” life vs “rose tinted” filtered life. We no longer compare ourselves with airbrushed celebs, we are comparing ourselves with our peers.

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4 Avoiding other emotions

Is your smart phone a coping mechanism? If so, there becomes a negative feedback loop-as the process of looking at the smart phone may worsen the already negative emotions within.

The most important part of this symptom is recognising it as a symptom, although it might be difficult to spot.

We are more likely to avoid difficult emotions, however they are just as equally valid as other emotions. Talking therapy offers the space to explore difficult feelings.

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5 Late night use

Are you staying up late using your mobile phone, or sleep with your smart phone next to your bed? You’re not alone, 71% of people either fall asleep holding a smart phone, in bed, or on the night stand. Many people use their phone as an alarm, however, there is a strong temptation to engage with your phone when it is on the bedside table, “just” checking that text or email can be a temptation.

This has been linked to poor sleep quality, as the blue light omitted by a smart phone is misinterpreted by the brain as daylight, so the body produces melatonin, which interrupts the circadian rhythm- which helps the body know when it is time to go to sleep. Poor sleep quality has also been linked to increased risk of depression, stress and anxiety.

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6 Loneliness

Feeling lonely or preferring to contact friends and family digitally- evidence shows that the face to face relationships impact upon us greater than digital forms of communication, as we get additional feedback from others such as body language, which is missed by digital communications.

In a busy world, these devices open up the endless possibility to keep in contact with others far and wide. Although, I am wondering what impact this has upon the quality of the connection experienced. When sitting in a cafe or restaurant, I often see couples and groups of people sitting together all looking at their individual smart phones, meanwhile not engaging with each other. My experience of this is as an observer is a deep sense of sadness within me, as I am seeing a missed opportunity for relational depth with the person sitting right in front of them. After all I question how much we can really listen to one another whilst being absorbed within a digital world.

The Oxford dictionary defines loneliness as “the fact of being without companions”. By this definition, the premise of merely being with someone is enough to not feel lonely. However it is possible to feel lonely despite this. A person could be in a crowded room full of people, who could be companions, however a connection is made by reaching out to one another. I question if we are cutting off the possibility to truly connect with others in a physical form in front of our very eyes, in favour of the digital world our smart phones facilitate.

It could be argued that smart phones are connecting us to others through social media. However, smart phones don’t just use social media, they have games and other distractions on them that draw its users attention away from the present moment they are in.

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In conclusion, smart phones are a great way of managing modern day life. However the evidence does show that they may be harming our health. Being mindful of how you use your mobile phone may be positive, particularly if you already experience any of the symptoms above.

From carrying out the research for this blog, I have concluded that my own smart phone use is a bit like cake, tasty to eat, however I know I should only eat a slice and not the whole cake.

Why anxiety?

If you’re reading this, I am guessing you are experiencing anxiety or you know someone who is and therefore will probably know the devastating impact anxiety can have on a persons life. Although there is no quick answer to solving anxiety, please do not loose hope.

I hope this blog helps to inform you further about anxiety and how psychotherapeutic counselling could be one of the options to help you through a difficult time. As a counsellor, I am interested in hearing about your experience of anxiety. Although I can reflect upon the general causes of anxiety within this blog, only you know what it is like for you to feel anxious. Most importantly, therapy offers a space to explore why the anxiety became present in the first place- even if you do not know right now…

What is anxiety?

It’s a feeling that just won’t go away. You may feel worried, tense, afraid or a mixture of both. Anxiety can be experienced within both the mind and body.

Why do we experience anxiety?

It is our bodies natural response to being under pressure. It is part of being human. It is normal to experience short periods of tolerable anxiety when going through a stressful time, such as moving house or doing exams.

When does anxiety become a mental health problem?

• You feel extreme levels of anxiety

• The anxiety lasts for a long period of time

• The fear or worry is out of proportion to the situation

• Avoiding situations because you fear being anxious

• Your anxiety feels out of control

• You have panic attacks

• Everyday life becomes more difficult

What causes anxiety?

You might not know what is causing your anxiety, which is OK. There are probably many contributing factors. Common reasons include:

• Witnessing or being involved in a traumatic event

• Childhood experiences

• Physical health issues

• Mental health issues

• Drugs and medication

• Work or studying

• Being out of work

• Money worries

• Feeling lonely or isolated

• Loosing someone close to you

• Exhaustion

What can you do about anxiety?

You may wish to go and discuss your anxiety symptoms with your GP. They may discuss various options with you and may suggest taking medication, refer you to a counsellor, or both. However, your GP can only refer you to an NHS counselling service, this does not mean that you cannot seek private counselling in the meantime.

How can I help myself?

• Talk to a friend or family member

• Look after yourself physically- exercise helps release anxiety busting endorphins

• Breathing exercises, such as mindfulness

• Keep a diary

Talking about anxiety can cause feelings of shame. However there is a value in exploring these feeling with a therapist and reflecting upon the shame felt.

How do we respond to anxiety?

Our bodies have three responses to anxiety- fight, flight and freeze. Based on how a wild animal responds to anxiety.

Fight

Imagine you are a lion on the African Savannah… You come across another lion you don’t like, you’re both hungry and there is only one food source- you fight for your share of the food.

Flight

Now imagine you are a bird sitting on the same Savannah. You suddenly notice another animal hunting you- so you fly away. Unlike the lion who wanted to stand the ground- you think its better to remove yourself from the situation.

Freeze

This time imagine you are a rabbit and suddenly you hear something in the distance. The noise worries you- so you play dead in some long grass and hope nobody notices you.

Anxiety as anger

Anxiety comes out in many different ways, including some that are not obvious. It is common for someone to appear angry, but are actually really anxious. That impatient person behind you in the queue might be really anxious?

The shame of shame

This week I have been thinking about what shame really means. Shame is seemingly something we all experience, yet the quality of the experience feels isolating and like you are the only person to ever feel this. Even talking about shame is somewhat shame provoking. But why? Why is it so cringe-worthy to share our shameful feelings with each other?

First thing first- I decide to turn to my old friend- the dictionary, which gives two options- one being “bad luck” and the other being “bad feeling”. There were plenty of definitions- none of which really highlighted my own experience of feeling shame.

In my quest for an answer, I looked to the world around me and observed how others around me experience shame. This seems most apparent in my pets, I have two cats and a dog. They are all desperate to please me, yet when they mis-behave and are told off they demonstrate a very physical reaction, which I interpret as being shame. In many ways, their response is not overly dis-similar to that of a human response to shame. Their heads are lowered and there is something about the look in their eyes (you can see more of the whites of their eyes) that I acknowledge as shame- almost as if they are blushing. As they do not have a language to explain their shame to me, I am using my relational knowledge and what I know about them to intersubjectively explore their world.

As I breakdown my experience of acknowledging of my pets’ experience of shame, I am led to consider the cause of the shame. By this I do not mean the action they feel ashamed about, i.e. what they have done wrong, whether this be stealing human food, or growling at another dog. I notice the underlying cause of the shame relates to my response. My disappointment in the bad behaviour is a direct link to the expression of shame.

Linking this back into being human, I am beginning to wonder about the link between shame and feeling empathy, as parts of being empathic seem similar to the experience of being able to feel shame. When listening to BBC Radio 4 in the car, I came across “Seriously, I feel for you” which explored narcissism. There was a brilliant quote: “Narcissism is empathy’s evil twin” which made me think of shame, as to experience shame there is a level of awareness of how someone else thinks and feels.

When I think about how uncomfortable experiencing shame is for me and comparing this to imagining not feeling shame and not experiencing empathy for others, I personally would rather hold the experience of feeling shame, as I guess it shows that I care about what other people think and therefore care about others. I do not feel that I could be me, if I didn’t care.

Therefore despite being unpleasant, experiencing shame is an essential part of caring and having a sense of awareness about what others think and feel. I guess the important part is how we handle and cope with the inevitable uncomfortable experience of shame.

This leads me to consider what happens when something is so shameful that it has become unbearable? As we feel shame as a result of how we think and believe how other people experience us or our actions, healing from this may be found in a therapeutic relationship (Greenberg 1989). Although discussing shame maybe difficult, maybe there is a value to bringing it to therapy…

6 ways to narrow down choosing a counsellor

With so many options on the internet market place, where on earth do you start when choosing the right counsellor? Let’s look at some of the key points to look out for when choosing a counsellor and how to narrow down what is right for you.

1.“Type” of therapy

There are many approaches that counsellors take, which is often referred to as a “modality”. All this means is the theory upon which they are basing their practice upon. You may have come across the following words: Behavioural Therapy, Psychodynamic, Psychoanalytic, Integrative, Cognitive Behavioural Therapy, Systemic, Gestalt, Family Therapy, Hypnotherapy, Neuro-linguistic programming, Person Centred, Relationship, Solution-Focused, Transactional Analysis, Humanistic, along with others. For more information about what these all mean in more detail- have a look at The National Counselling Society. In a nutshell, each theory has differing ideas about human development.

Although the approaches may be different, there is one common factor, which research highlights as the most important for an good outcome. This is the therapeutic relationship itself. This means how two individuals work together in a room. All qualified counsellors receive training in how to form and build this relationship.

It maybe worth considering what sort of relationship you would like, are you wanting someone to direct you? Or are you wanting to someone to work alongside you? As a “humanistic” therapist, I take the latter approach, by working with you and working together on exploring your world. This does not mean I am non-directive, as there are times, whereby I may ask to look at something said in more detail.

2. Location, location, location: Narrow your options

How close by? Some people wish to travel to see a counsellor. There is something about the journey after counselling that is important. It is a space to reflect upon what just happened. Others may need to have counselling close by due to other commitments. Counselling is usually weekly, so how is counselling going to fit into your week? So what is best for you?

In the modern world of technology, the world has become a seemingly smaller place. Some counsellors offer online therapy, which can be comprised of emails, chat rooms and web cameras.

The advantages of working with a counsellor in this way are: Accessibility- anyone with a computer and an internet connection can access counselling. Convenience- fitting counselling in can be challenging for some, online therapy cuts out the travel. Anonymity- being behind a computer screen offers a level of protection of your identity. Multi-method- for some, writing or typing can be therapeutic.

The disadvantages: Absence of verbal and no-verbal clues- these are the “micro” skills we all use to pick up on who is going to speak next and may reveal how someone means what they have said. With this missing, part of the therapy is missed and it is often harder to form that all important therapeutic relationship (although not impossible). Security- counsellors have a responsibility to protect confidentiality, however with online counselling, it is the clients responsibility to find a confidential space. Technology fails- we have all that that moment when the internet fails us. This may disrupt the counselling.

3.Are they qualified?

Did you know, legally in the UK, someone does not need a qualification to call themselves a “counsellor”. However the “actual” training process takes years (it varies depending on the route you take). Here is a list of organisations verify counsellors qualifications: BACP, UKCP, COSCA, BABCP, BAPCA, BASRT, BPS.

4.Where to access therapy

NHS- depending upon the area you live in, you can either self refer, or your GP maybe able to refer you to counselling. Check out NHS services website for more information. However, waiting lists are often long, you often cannot choose which sort of therapist you see and session numbers maybe limited.

At work- Some companies offer a confidential “Employee Assistance Programme”. Each company is different. Referrals are often made from occupational health.

In education- Schools, Colleges and Universities often have a free and confidential “in-house” counselling service. You could get referred to a counsellor by asking a tutor or teacher.

Charities and voluntary services- Some charities or small organisations offer free or affordable access to talking therapies. It will depend on where you live as to which services are available in your area. Click here for a list of these services.

Private therapists- There are many private counsellors available. Finding the right one for you is important. Maybe ask around? Have you got a friend who might recommend a counsellor? The price of private counselling can vary. It is important to think about how much you can afford. Often private therapists (including myself) offer discounted appointments for those on a low income and students.

For more information click here.

5.Gender

It’s a simple, but important question to ask yourself. Are you going to be more comfortable talking to a male or female therapist. Counselling can cover some difficult subjects. How freely you talk about these subjects may be impacted upon the gender of who you are working with. There is nothing wright or wrong about which gender you choose to work with, however it might be useful to reflect upon why this might be, taking note of any strong feelings of “no way”.

6. Get in touch

Ask questions. You may have some specific questions for the therapist. Not everything you want or need to know will be available on a website. Although it might be daunting, picking up the phone is a good “taster” of what it would be like to work with a therapist.

Useful questions to ask:

• Have you worked with this issue before?

• What is your training?

• Have they had their own therapy?

• How long is a session?

• What happens in a session?

• Can I stop at any time?

• Have you got enough experience to work with me?

• How can you help me?

• Do you belong to a professional body?

• What if it’s not helping?

• How much does it cost?

When you find the right counsellor…

It is important to feel like you can trust them and that the they could help you talk about your thoughts and feelings. If you don’t then there is nothing wrong about wanting to look for another therapist. Why not visit a few, before deciding on which to work with?

What exactly are emotions?

Emotions. We all have them, but what exactly are they? Emotions can be both positive and negative, sometimes it’s possible to experience more than one at the same time. Most commonly, we can experience sadness and anger together. Have you ever felt really angry, but sad at the same time? It may be difficult to process both emotions and give a priority to one over the other. No wonder it is a common experience to feel confusion surrounding our emotions.

What is the science behind emotions? Thoughts and emotions are controlled by different parts of the brain. Thoughts are how the brain cognitively process, whereas emotions are released by the brains limbic system. This also controls the body’s immune system and most of the body’s major organs. This gives some insight into why our emotions affect our body. Have you ever had “butterflies” in your tummy when feeling nervous? This is the limbic system in action.

The idea that emotions have an impact on the body is sometimes viewed controversially. Thoughts such as “are you saying it’s all in my head?” can often arise when talking about this mind body link. In my opinion, the physical symptoms are very real and therefore not “in your head”. This doesn’t mean the body doesn’t react to emotions, which may impact upon the physical issue.

Part of being human is to experience things differently to one another. It’s possible for two people to feel very different emotions about the same situation, which is why it is impossible to know “exactly” how someone is feeling. This is particularly difficult surrounding complex and emotionally inductive situations. Imagine feeling happy when others feel deeply sad? It may be difficult to share your difference in opinion. Or maybe sharing your different opinions and differing emotions has caused upset.

How can counselling help with emotions? When thinking about emotions in context of counselling, I am aware as a therapist, I can be aware of the science behind emotions, yet the science doesn’t tell me about the individual experience of what it is like to experience emotions. Counselling offers a space to explore emotions further and help process the individual experience of having emotions, from identifying what they are, to exploring why. Essentially within counselling, I aim to explore the meaning behind an experience, part of this is looking at the emotional response.  

It is important to remember emotions are normal. Counselling may be helpful if emotions are causing distress. This could be feeling overwhelmed or noticing that emotions are felt to the extreme. Having said that, in some cases, emotions are difficult to experience, leaving a feeling of being “numb”. It would be equally valid to seek help for this experience. Counselling offers a safe space to explore emotions freely, without judgement. I aim to truly listen to your experience.

If you want to know more about emotions and how counselling may be able to help you, please do get in touch and I will be happy to answer any questions you may have.