Archive for Health and Well Being

Change

At a time of seismic upheavals across the globe, we are currently dealing with changes that seemed unbelievable not long ago.
Change brings uncertainty and loss, and can sometimes be so unsettling that we can feel we lack the resources to know how to cope.
Twice in the last weeks, many of us have gone into a night expecting a political resolution which has been completely overturned by daybreak. And now we have to learn to live with realigned European systems and a movement in the USA, both of which recognise an anti-establishment feeling that has become so heightened that people have risen to take different controls.
In therapy, we see the uncertainty that seems to ripple out when the accepted norms are overturned.
First we have to accept what has happened and examine our worst fears. Shine a torch straight at the monster under the bed, don’t deny it but check what size it is – probably not as big as the imagined one.
Now, believe you aren’t alone. Others can understand what is happening, so talk your thoughts through with family and friends. Therapy can be a terrific sounding board and a safe place to unpick fear. Being vulnerable is normal and allows us to examine real feelings.
Humans have always changed and adapted to new situations, it’s part of life, but can be scary if we feel that the change has been imposed on us.
As the serenity prayer says:
God, grant me the serenity to accept the things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference
(You can, of course adapt this to whichever God is yours)
Change will bring growth, it involves learning and seeing things in different ways. There are always other possibilities and it can be where the unexpected happens that things become interesting.
‘Those who cannot change their minds cannot change anything’ 
GB Shaw.
A client leaving today turned at the door saying ‘goodbye, and keep the faith’
Let’s do that together.

Christina Fraser

Supervision: how it serves clients

It is widely accepted that all counsellors, whether experienced or starting out, will benefit from regular professional supervision. A supervisor acts in a mentoring role, providing emotional support as well as information and guidance.
Geldard and Geldard (2001).

Supervision provides a safe place for therapists to discuss their client work with a trained/experienced Supervisor. All the client work discussed in supervision is totally confidential between therapist and the supervisor. This can be weekly, bi-weekly or monthly depending on how many clients the therapist is seeing.

Supervision is perhaps the most important component in the development of a competent practitioner. It is within the context of supervision that trainees begin to develop a sense of their professional identity and to examine their own beliefs and attitude regarding clients and therapy. (Corey, Corey, & Callanan, 2007).

So how does supervision translate to our clients?

It provides a sounding board for therapists to voice their concerns about their clients.

It educates and expands a therapist’s knowledge, understanding and skills.

It offers feedback that enables the therapist to gain an objective insight into their own performance and skills to better serve their clients.

It gives a chance for a different perspective. Even therapists can have blind spots and lose objectivity. Supervision helps to see how they can be more helpful to their clients by pointing out when and where their viewpoint/boundaries with clients might have become blurred.

Supervision challenges ethical dilemmas ensuring that professional ethical standards are maintained. Duty of care for clients is the most important role of a Supervisor. The client’s best interest always comes first.

Supervision supports the therapist when they are struggling with their own issues, ensuring that these issues do not bleed into their work with clients.

Good supervision is necessity for all therapist to use their own resources better, to manage their workload effectively, learn new skills and theories; it keep them in check and aids self-development. At Coupleworks, we believe clients are entitled to expect high standards from their therapists. They bring in sensitive and vulnerable material so it’s more than reasonable for them to expect the most professional service we can offer in return.

Shirlee Kay

Inbox Anxiety – F.O.B.O (fear of being offline)

If we are to believe advertising agencies, the lead-up to Christmas is one glamorous flurry of excitement, parties and glorious food shared with smiling friends and relatives  (dozens of them, and all perfectly dressed and coiffured)
Rooms are styled and presents are heaped. Piles of gorgeous beribboned boxes of hope lie in wait. Children are cheerful and beautifully behaved and families are in full control of their happy lives.
Right then – let’s get real.
The wonderful Paul Simon wisely offered,
“The thought that life could be better, Is woven indelibly into our hearts and our brains.”
Counselling can often uncover feelings of shame and anxiety, which are amplified at Christmas when people are prone to wonder if others are having a more successful time.
This can so easily lead to a search for rescue through phones and tablets culminating in the infectious syndrome ‘FOBO – Fear Of Being Offline’
Could there be somewhere out there an invitation or message that could lead to a night of fun and frolics? Are others more organised, and worse still, are they more popular?
Research now uncovers a worrying trend showing that we are so linked to our smartphones that we are firmly attached to them constantly through our waking hours and keep them close even when we are asleep.
This leads to problems in couples when the phone starts to feel as if one, or both, partners are having a better relationship with their phone than with their significant other.
In some cases, the phone will be described as a major barrier to closeness. One in ten of us checks emails straight after having sex.
This can fracture real human closeness while we desperately try to keep connected with people and experiences contained in a tablet.
We search constantly to be linked to places, people and sites that could add to self esteem and fuel a sense of importance and acknowledgement.
Holidays such as Christmas take us out of our ordinary routine and our usual habits.
It can also be a time to relish quietness. But for some, the absence of ‘normal’ activity feels frightening.  Being relentlessly busy means always being connected …. But this is a false sense of self.
Let’s accept our real lives. At this time as at every other there will be disappointment and let-downs. Understand this and don’t let commercial and social pressures feed insecurity. Take a digital holiday break. Learn to do without phones and tablets, especially while in the company of others.
That backlit blue light raises Seratonin not compatible with the natural rhythms of our bodies.
Real life might not live up to the fantasy of what else could be out there – but the task is not to allow the need for imaging a better time spoil what is good enough, as especially during these holidays when we can so easily live with a constant state of yearning or disappointment.
Paul Simon finishes here by his thought that
‘Life is what you make of it, so beautiful or so what’

 

Christina Fraser

Counselling? NHS or Private?

The Differences Between the services offered on the NHS and by a Private Practice.

Clients are often in two minds about seeing a counsellor/psychotherapist in the NHS and seeing one who works in private practice.

The Pros and Cons of going NHS
Pros:
-Most importantly, there is NO cost involved.
-The therapist is trained and should be accredited (always check).
-The therapist will be provided with supervision to ensure that their clinical work is being overseen.
Cons:
-There is no choice in the therapist you see.
– There is little choice in the geographic location of the therapist.
-There is no choice in how long you are able to work with them.
-There is no choice in the approach of therapy you receive (CBT, psycho-dynamic, etc).
-There is little or no flexibility in scheduling.
-Your GP is the first step to being referred to an NHS therapist. Depending on where you live and the severity of the issues there may be a wait in getting your first appointment and you may be assessed first with another therapist or psychiatrist.
-Your medical records will note the referral.

The NHS website states the following regarding what they offer:
-Face to face Counselling
-Individually or in a group
-Over the Phone
-By email
-Using a specialized computer program
-You may be offered counseling as a single session, as a course of session over a few weeks or months or as a longer course that lasts several months or years.

The Pros and Cons of going Privately
Pros:
-There is a choice of therapist.
-Choice of times offered outside of the normal working hours, (evening and weekend appointments)
-Choice of length of the therapy (short term/long term)
-Choice of therapy (psychodynamic, CBT, couples therapy. The list is vast and diverse).

-Therapists are required to have supervision and further personal development and are insured and (should be) accredited under the BACP or UKCP.
Cons:
EXPENSE, there is a charge, which varies depending on the therapist.

In conclusion, there are pros and cons to both private and NHS counseling services. The main differences are the choice and expense. Choosing to go privately allows more of a bespoke service and works better for many people’s lifestyle.
When choosing to go privately, you are paying for a better environment to work in and more flexibility with times and whom you see.

It should be pointed out that there is a third alternative for those seeking therapy. There are several non-profit organisations out there that offer much lower fees with trained therapists for those financially unavailable to see a private therapist but wish for an alternative to the NHS. The services provided have their drawbacks as does going private or through the NHS, but that’s an article for another time!
Finally, please remember one thing: whether you choose to go NHS or Privately, the service should meet your requirements. It’s important to speak out if the service offered isn’t up to your expectations or needs.

Shirlee Kay

A longing to be told.

A longing to be told

 

One of the most frequent questions after seminars, workshops and lectures is:

“All very interesting and enlightening but how do I work with the client or couple now I have the knowledge and new ideas?”

This question is also present in many different dilemmas. How to vote in a referendum?  Which partner is the right one?  Which house or flat to live in, job to take, area to live in, holiday to go on or school to send your  child to? Doctors or specialists giving options about treatment and you, the layman, has to decide which choice of procedure your feel is best for you.

How do I work with this?  What do I do?  So many scenarios result in this uncertainty. Perhaps this is why the works of Irvin Yalom and Neville Symington are very readable. They are honest about themselves and at the same time offer guidance to the reader.

There is a bit of child left in all of us which hopes that as an adult there will still be someone to ‘tell you’ what to do or how to feel.

In work with couples, we find that this is present and yet unspoken in the room all the time.  A longing to be told by their partner, friend or therapist, yet the adult in them hates to be told and will most probably do what they were going to do in the first place.

At Coupleworks, we try to gently give our clients the trust in their own judgement by slowly finding the confidence that makes the risk feel worth while.

The knowledge that there is no one who can tell them, is a lonely and frightening moment but once accepted it is also an empowering and releasing feeling.

 

Clare Ireland

Happiness

It is interesting to look up the word happiness in Google. It appears in countries which in our privileged part of the world we might assume it doesn’t exist.
Happiness could be felt momentarily by a child on a rubbish heap finding some piece of cast out scrap which would, if sold on, perhaps, pay for some kind of food for the child and their family for one meal.
That moment of happiness might be felt more fully than a child given an ipad for Christmas which is not exactly the one they wanted in order to hold up their head at school.
No one knows because the word is so abstract and varied than it has never been defined in any other way than a word into which each person can place their own hopes and expectations.
In some cultures and time zones, Christmas is a culmination of fantasies, dreams, hopes, expectations, childhood stories, films, books, perfect family gatherings and a price put on love.
Does telling children how lucky they are to have whatever present or presents they are given fulfil their Christmas dream? Does telling them how starving and unloved some children are help them to be grateful for their luck and thereby create a day of happiness for them? Can it become a throw away remark from tired parents who might have overloaded the presents and occasion in order to try create the perfect happy day.
Google, John Lewis and Microsoft were the top three companies to work for in the UK in 2014. Money was a part of that but equally some priceless happiness wishes were about camaraderie, respect, support and care. Apparently these companies offer these possibilities, thereby creating a happy environment in the workplace.
There are no answers to the meaning of happiness. What is known is that happiness and unhappiness sit side by side and you can’t have one without experiencing the other. The cloud and sunshine idea is the perfect concept for that reality.
Clare Ireland

Body Language

The social psychologist Amy Cuddy has given a TED talk (June 2012) entitled ‘Your body language shapes who you are’. She discusses how our body language influences how we are perceived by others – but that it can also change our perception of ourselves. More than that, we can even affect our own body chemistry by adapting the way we sit or stand – and consciously alter our mood by shifting our body shape.
(Try it now…
Stand up and fling your arms wide apart.
Hold that position.
Now smile with your eyes as well as your mouth.
Hold that position.
How do you feel?)
When we feel confident of love we metaphorically and actually spread our arms out wide.
Think of greeting someone you love. We fling open our arms in a gesture of welcome and acceptance and envelop them in an embrace – bring them close. Our bodies feel full of energy, loose and relaxed
However, when feeling vulnerable we curl into the foetal position. When feeling defensive we fold our arms across our bodies. We shut out the person who might cause us pain and harm. When feeling hurt we can become cautious and wary. We withdraw and become emotionally unavailable. The face becomes closed, expressionless and unrevealing and we avoid eye contact. If we are angry our bodies hold a tension and stiffness and we become unapproachable – ‘don’t touch me!’
Our mental state mirrors our physical state. When feeling under attack, we become defensive and shuttered off from the feelings of the other person. It is a state of mind that is the opposite of ‘open wide’. We struggle with empathy or curiosity. Concern and intimacy, interaction and connection, can be lost.
In her book ‘Marriage Rules’, Harriet Lerner describes defensiveness as ‘the archenemy of listening’.
If you cannot listen without interrupting then, effectively, you are blocking your partner. Dialogue breaks down. There is no room for an acceptance of difference, or an engagement of ideas.
Sentences that begin with ‘Yes, but….’ and ‘No, no…’ are rebuttals of the perceived reality of the other. Both feel unheard.
But how to step out from behind a defensive barricade and start a conversation – not an argument?
Consciously choose to change position from passionate fury to ‘passionate listening’ (Harriet Lerner)
Change the body chemistry. Alter your mind’s position and lower the flood of adrenaline released by the ‘flight, flight, or freeze’ reflex reaction.
Pause.
Breathe in deeply.
Exhale slowly.
Metaphorically stay present (mind open wide).
Say ‘tell me more…’
Counselling with a Coupleworks therapist offers a safe environment to begin to take this first step towards change.

Kathy Rees

Dealing with Tension – A Quick Fix!

How often do you pour that glass of wine, or reach for the chocolate, or slump in front of the television, to try to switch off from the day’s problems and stress?

The relief may not last but, for a short while, you feel better. However, it may be that those choices are not so good for you in the long run.

It could be that taking a break from the computer screen, or going for a walk, or not drinking too much the night before, might prevent a headache. But, when our head begins to throb, we take a pill because we want rid of it quickly.

Similarly, although we need to address the causes of our difficulties, it is helpful to have a ‘quick fix’ to find short-term relief from tension and anxiety and feel, momentarily, emotionally stronger.

If you are feeling overwhelmed, or anxious thoughts are preventing you sleeping, then try shifting the focus from head to body and consider how you are breathing.

The way we breathe has a huge impact on the way we feel. Too often we are in perpetual ‘flight/fight’ mode and ‘shallow breathe’ with rapid breaths.

  • – If you are in work, go into a quiet room and straighten, standing against a wall. If you are at home, lie flat. Close your eyes and place your hands gently on your abdomen.
  • – Slowly take in a deep breath through your nostrils until you feel your abdomen begin to rise. Do not lift your shoulders or puff out your chest.
  • – Hold for a second.
  • – Slowly breathe out through your mouth feeling your abdomen fall.
  • – Repeat ten times.

You are opening up your lungs, expelling the stale air, and easing the muscular tensions around your stomach and ribs.

Consciously relax your jaw and your shoulders. Be aware of the muscles holding the tension and try to make them floppy.

The effect should be that the amygdala in your brain is reassured that all is well. It can halt the release of adrenalin and cortisol that keeps you hyped-up and tense.

Short-term relief perhaps, but a moment of calm allows a moment of recovery. We reconnect with the resilience required to face the challenges of work, family, and relationships.

(With grateful thanks to ‘The Big Book of Calm’ by Paul Wilson)

 

The Use of Antidepressants and Therapy

My views on antidepressants have changed over the years. Where I was once not in favour of their use, I now see their benefits with clients. The problem is that most antidepressants are too freely given out without thought or proper assessment and there is rarely follow up with clients to reassess their progress.

It is important to say that feeling low at times is part of the human experience and allows us the opportunity to know ourselves better and helps us to manage these feelings as they come and go.

Anti-depressants need to be prescribed by a Psychiatrist who is knowledgeable with psychopharmacology drugs. Because there are so many anti-depressants available, without a comprehensive assessment it’s difficult to pinpoint which drug will be best for which individual. An assessment will also help to differentiate whether the person is going through normal loss and grief or going through depression. This is a crucial distinction.

Antidepressants allow people to work through their issues with a therapist because it lifts the depression enough for the person to feel more hopeful and therefore allow them to begin to have another perspective on an issue.  I often use the analogy of a person standing in water up to their eyes; they can’t breath or do anything except try and survive.  If the water level is lowered (with antidepressants) it allows the person to see things differently.

Our brain’s neuropathways can change the way we think and experience things. If we have long periods of depression and our thought process is negative it impacts the way we see others and ourselves.  With antidepressants, we are able to bypass the depression and different parts of our self begin to emerge. With consistent and regular positive thoughts, our brain chemistry alters and our perspective can change.

My experience tells me that clients who are very depressed do not utilise the process therapy offers at that time.  The ideal combination is therapy with antidepressants. This can offer an opportunity for clients to understand the origin of their depression and work through and learn to manage their depression.

A new protocol is needed to look after clients from beginning to end to ensure they are on the correct dosage of medication and progressing. Psychiatrists/GP’s would do better to work together with psychotherapists/ counsellors in order to best serve their clients.

Shirlee Kay

 

Loss

It is not only the loss of a partner, or someone in our family, that can cause us to feel distressed and grief-stricken. Losing a close friendship can cause overwhelming feelings of sadness of bereavement.

Friends form part of the jigsaw which makes up the secure base of our lives. We feel safer and more confident when we create links and have a circle (no matter how tiny or how large) of people with whom we have understanding and on whom we can rely.

The reality of a friend moving away, or travelling, or even emigrating, will be hard to bear but can be rationalised. It will be painful, we will be sad, but the idea can be borne.

However, when the friend is focussed on another person, when they seem so preoccupied with another and there seems no room for us, uncomfortable anxiety can grow.

All-encompassing emotional life events like the birth of a child, or falling in love, can give the impression that there is no longer room for the friendship. It is very hard to cope with being suddenly demoted, side-lined and not the priority. We have thoughts of betrayal.

Although the rational, thinking, part of us explains that the friend is in a whirlwind of enrapture, we feel the cold wind of panic. The situation recalls, and resonates with, any abandonment or rejection we have suffered in our past.

If we have previously experienced traumatic relationship losses or break-ups, the re-opening of a painful wound is keenly felt.

Psychologically there has been a break in one of the attachment bonds which we wrap around ourselves. We feel displaced and insecure as the emotional ground we stand on has shifted. Our world seems changed and the kaleidoscope has been reconfigured.

We need time to assimilate the different patterns. Our other primary relationships become even more important by offering stability and reassurance.  We can be soothed when these other important attachment figures remind us that we are loved.

It may help to remember that our friend has been overtaken by a tsunami of emotion. It was not their intention to weaken the links between you both. Sadly they are no longer on the same track that you thought would continue forever, but their motive was not to hurt or be unkind. They might not even comprehend the impact on you.

 

The challenges of finding a Healthy Work/Life Balance

THREE:  Keeping a healthy Work/Life Balance…

  • It is crucial that the relationship itself is prioritised, considered, nourished and cared for.
  • There is a need for both partners to find the generosity and good-will within themselves to continue to reach out to the partner with arms open wide.
  • It is important that each identifies the ways they can enrich the partnership and not to wait for the change to come from the other.
  • If loving gestures are offered in a way that is meaningful, and recognised as such by the partner, then there will be a tangible easing of tension.
  • Often the biggest first step towards change comes from offering attentive, non-defensive, passionate listening.
  • The empathetic warmth created when feeling really ‘heard’ allows us to relax and stretch in the relationship.

The challenges in finding a Healthy Work/Life Balance: Relationships

TWO:   Relationship dilemmas…

  • In contrast to our work, dealing with relationship issues can often feel more complicate, ‘messy’, and daunting. Competing needs can be difficult to manage.
  • We are uncertain about the consequences of opening the proverbial ‘can of worms’, particularly if we are tired and busy, if we try to unpick misunderstandings and resolve conflicts
  • When we feel pressurised by the demands of a partner their requests can feel unreasonable and leave us drained and panicked.
  • There can be a tendency to minimise, and even dismiss, emotional distress.  It is easier to be practical and offer solutions to problems. The underlying vulnerabilities and feelings are left unaddressed and brushed under the carpet.
  • The danger is that, in turn, we feel misunderstood. We feel resentful that our own emotional needs are not acknowledged and nurtured.
  • With the relationship increasingly unattended and side-lined, we become defensive and frustrated. Good-will is withdrawn, the relationship feels brittle, and closeness and intimacy can be lost.

The Challenges in finding a Healthy Work/Life Balance: Work

ONE:  When we focus on work…

  • • We can often prioritise the demands made by work over the demands emanating from relationships. There can be a disproportionate focus on job over family.
  • • The requirements of the job seem more straightforward, more clearly defined and more easily understood. We list the assignments and achieve the deadlines and, as a result, receive a reassuring sense of competency. There can be a satisfying confirmation of our identity and role in the world.
  • • Feeling in control, being task-orientated, receiving positive feedback from colleagues, can stave off a susceptibility to insecurity and anxiety.
  • • Work can increase our confidence and self-esteem, and soothe a fear of failure; particularly if we have a tendency to feel ‘not-good-enough’
  • • In addition, the time and energy expended is difficult for a partner to challenge when it is justified in terms of earning money and developing a career.