Is Having Therapy an Admission of Weakness?

Some clients have avoided coming to therapy for a long time fearing that to do so would be an admission of weakness. In this week’s blog I challenge this notion.

Perhaps it is a residue left from our cultural history of keeping a stiff upper lip, where any display of emotion was seen as demonstrating a lack of moral fibre. It was almost as if you were supposed to process your emotions on your own. Things have moved on since then.  Psychological health is now viewed as being comfortable finding appropriate expression for our emotions.  Most often, problems occur because there hasn’t been an appropriate outlet for our emotions. This sometimes leads to depression as we cut ourselves off to varying degrees from the vitality of our feelings. We are social beings, needing emotional contact with others for our physical and emotional wellbeing and development.

Brene Brown gives an enjoyable and engaging talk on vulnerability :- https://www.ted.com/talks/brene_brown_on_vulnerability.html

She makes a compelling argument for the importance of daring to be vulnerable as part of our psychological well-being. Thus, therapy provides a safe space in which you can dare to engage with your vulnerabilities.

Another mistaken view of therapy can be that you are giving control of yourself to someone else. Actually, the reverse is true.  I see it as my job to empower my clients to take control of their own lives. I often ask in the very first session, how the client will know when our work is done. So, from the very beginning, I am encouraging the client to be in charge of how they use their time with me and to decide when they are happy to leave.

I truly believe that it is a strength to be able to engage with your vulnerabilities. If that is not happening in your life, then engaging with them in therapy is also a strength.

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk

What’s the difference between a counsellor, psychotherapist, therapist, psychologist, psychiatrist?

With so many different titles to choose from, it can be hard to know which type of professional is right for you in the your particular circumstances. This week’s blog gives specifies the different roles of the titles and some ideas about which may be best for you.

Currently, there are no definitions which are agreed upon across the profession that separate counsellors from psychotherapists. However, virtually everyone has their own views as to what the differences might be. I can only offer my personal view here.

Counsellor – someone helping you to address personal issues through listening, support & exploration.

Psychotherapist – as above, but may be more focused on the person’s way of relating to others, themselves and the world in general. They have tended to train for longer and be more open ended in their work with clients looking at underlying patterns of relating.

Therapist – is a generic term covering anyone treating clients. Often used as an umbrella term for both counsellors and psychotherapists. It may also refer to a wide range of complementary therapies which may or may not be relevant to your problems.

Psychologist – someone who studies the mind and behaviour, but may apply their studies in a wide variety of ways with differing specialities e.g. occupational, clinical, educational, child. Psychologists would be used to provide treatment under a private medical insurance plan.

Psychiatrist – They are the only ones to have trained in medicine and therefore are the only ones who are able to prescribe drugs. They tend to work with the more extreme end of the mental health spectrum, although it is standard practice that anyone seeking treatment through their private medical insurance would need an assessment via a psychiatrist.

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk

“How Will Just Talking Help?”

I have often heard concerns that therapy cannot help as they are unable to change their circumstances and so feel they cannot be helped. In this week’s blog, I address this concern head-on with various ways in which talking can and has helped many of my clients.

It can be a huge relief to simply tell someone else. Sometimes, in addition, there can be feelings of shame associated with admitting feeling hurt and upset. This may link to a sense of weakness for not being able to deal with your circumstances impassively on your own. Being listened to by someone who is not judging you and who is actively helping you explore your feelings and where you come from can help you develop a more compassionate understanding for yourself.

With more clients than I can count, by talking through their experience of their situation, they changed how they experienced the situation even when the situation didn’t change.  Bereavement counselling cannot bring back the person who was lost, but it very frequently helps you deal with your experience of that loss.

Some clients have had difficult relationships with their parents. They felt hooked by the pattern of relationship which had been present since childhood. They felt trapped in a cycle of resentment and guilt. By talking through these feelings, whilst the parents remained the same, the clients felt greater freedom to love and relate to their parents as they wished.

With trauma, there are safe and relaxing techniques which can allow panic reactions to be uncoupled from their triggering memories.

For some clients the very fact that someone can understand their experience helps them realise that they are understandable, and are therefore, not “losing it”.

Sometimes it is the very reactions themselves that use up all the client’s emotional resources, so they remain unable to process their experience by themselves. Gently unpicking the various threads of these experiences can gradually help the client to fully comprehend what’s happening within themselves and regain control.

There is even neuroscientific evidence to support the efficacy of listening.  Being heard and understood without judgement elicits the production of neuropeptides (oxytocin) in the brain. These chemicals help us feel good - an important evolutionary factor to help us co-operate as social animals.

Just talking can help you too.

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk

“That’s Just the Way I Am”

Some people feel that therapy will not be helpful to them as they feel that their patterns in relationship are simply an unchangeable expression of the way they are.  In this week’s blog, I challenge this notion.

Developments in neuroscience have shown that the brain is continuously adapting to the environment, thus we can continue throughout our lives to learn new things.  New learning is embedded in the brain by new connections and new pathways between the brain’s nerve cells. The more attention we give something or the more we repeat an action, the stronger the link is along these pathways.  Similarly, the less attention we give to things the weaker the connection will be over time.

Patterns of relating are nearly always formed in early childhood. Thereafter, the way in which we understand relationships is viewed through the prism of these early patterns. In this way, almost whatever happens tends to reinforce that early pattern.

For example, a child can learn that the world is a dangerous place. Think of parents’ understandable concerns for their children which can become anxiety provoking for a child if overplayed as part of an anxious style of relating “don’t do that”, “be careful”, or even anger (covering their own fears) when the child is trying to develop their own sense of mastery, exploring their environment. Having learnt that pattern without necessarily being aware of it, new experiences are likely to be seen as holding a potential threat, thus reinforcing the brain’s neural pathways that encode that pattern.

Now consider a child for whom exploration was supported. New experiences will be viewed as holding the potential for interesting stimuli. Thus the same new experience will reinforce completely different patterns in the two children.

Now imagine an adult, who has been relating to the world via a pattern of relating of which they remain unaware. This pattern has been reinforced for decades with hardly a second thought. Of course, this individual feels that this is just part of who they are.  It has been going on for the whole of their lives so feel their pattern of relating is unchangeable.

On top of that, they are likely to have chosen (without being aware of it) a partner whose patterns of relating reinforce theirs. They may be similar or complementary. Thus someone who has little confidence in their abilities may choose a partner who wants to take responsibility for both of them. Thus, the partner lacking confidence may feel more comfortable now that someone else is taking responsibility for them, but they are not put in a position to develop their own confidence. Thus their relating patterns are reinforced over and over again.

Like any long established habit. It may take some time to change. Further, their current relationships may expect them to behave in certain ways. It can be threatening to their loved ones when an individual starts to change. In the example above, the partner may feel that his control is being undermined, or simply that he is no longer needed if she starts to develop the confidence to do things for herself.  In such circumstances, the partner, usually unconsciously, may try to undermine her attempts at independence. The spectrum may vary from teasing, to derogatory comments, to expressions of anxiety, to outright anger and threats – all trying to get them to conform to the pattern they expect.

NB. Whilst I have used the terms “she” for the client and “he” for the partner in this example, the roles are just as applicable with male clients and female partners and in same sex relationships.

Perhaps the most extreme example of this kind of pattern is the abusive relationship.  All of the clients I have seen and spoken to involved in this pattern have stated that the emotional abuse is worse than the physical abuse. Whilst it is particularly hard for this client group to break free from their patterns of allowing others to dominate them, with the right support, they may be able to develop the strength to gain confidence in themselves.

Therapy is conducted in 50 minute sessions once a week. The historic pattern tends to be reinforced for the whole of the rest of the week. In the face of this, it can be a long, slow and sometimes painful process to develop new ways of relating.  However, change is possible. I have worked with many clients who have made significant changes through my therapeutic relationship with them.

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk

Your Concerns?

The intention of this blog is to give people who are considering therapy information about therapy so they may make a more informed decision about whether and how to enter therapy.  The topics I have written about come from my clients who expressed their concerns when considering therapy and what had got in the way for them.  Each individual has their own concerns. So, if there is a topic you would like me to write about in this blog, please feel free to contact me.  If you would rather talk about it, I would happily discuss any concerns you may have about therapy, without obligation.

There are several ways in which you can contact me. You can place a comment on my blog. Or you can contact me via my website: www.garycooktherapy.co.uk

On the website are all the contact details for me or you can email me directly via the website. I look forward to hearing from you.

Client Stories - "Superwoman"

In today’s society, women have taken up the mantle of full time employment, but often without relinquishing much of their traditional, and also full time role in looking after their children and house-keeping. This week’s blog is the story of a type of client with whom I have had many dealings. This is not the story of any one person, but a composite based on many clients with similar issues.

She is used to being the strong one in the relationship, has always worked hard, both at home and in paid employment and has been successful in both.  Other people come to her with their problems and she is happy to take on this role and is good at being there for others. She has good relationships with her partner and family who are supportive. However, over many months, pressure at work has been building progressively and she finds she is struggling to cope.  Despite being desperately tired, her sleep is disrupted with her waking up early and being unable to get back to sleep worrying about work and not feeling rested in the morning.

The final straw came when a colleague had criticised her work.  She burst into tears and withdrew to the toilets. She was not used to crying, let alone in front of others, and even worse, at work, so she went home early, feeling ashamed, confused and overwhelmed.

She contacted me seeking help to “get back to my normal self as this just isn’t me”. In the first session, she told me her story as above and a bit about her background. When talking about the situation at work, she became tearful for which she apologised. When I said that she didn’t need to apologise for expressing her feelings and that it was important for our work together that I heard and acknowledged her feelings, she started to cry but quickly stopped. I wondered with her how she felt about crying. She said that she felt stupid & weak, which she hated. I asked her where she had learnt this, but she didn’t know. I asked her how she would feel if her daughter cried. She recognised that she didn’t think her daughter was stupid or weak when she cried and would comfort her.  I wondered with her about why it was different for her than her daughter. We agreed that we would continue with the sessions in an open ended contract to help her cope with the pressures she faced.

Over the course of several sessions, we explored various aspects of her life in relation to her current situation & feelings.  Having initially talked about how her childhood had been “fine”, as we explored the way the current situation resonated with her past, she began to realise that any tears when she was growing up were “shushed” and she was told not to be so silly.  She had quickly learnt that such expressions of hurt would not be heard or acknowledged in her family, so it was better to “toughen up” and “get on with it” – this isn’t about blaming her parents, but developing a compassionate understanding for her experience as a child. 

Ignoring her difficult emotions had worked well for her until recently when she had become overloaded, so now a new way of dealing with them was needed. She had forgotten that she had needs, having for so long prioritised her family’s needs and those of her employers. She realised that she had not allowed time for herself for ages.

Whilst she understood her need to pay attention to her emotions intellectually, the habit of ignoring them had been learnt unconsciously in childhood and unwittingly reinforced throughout her life. Thus, it took some time for her to start to practice paying attention to, and finding expression for, her emotions in our sessions, through my questions exploring her experience. 

After so long ignoring her needs, she had felt like a passenger in the car of her life, allowing her direction to be chosen by the circumstances of the moment without really being aware of it.  As she began to notice her own wants and needs, she spent progressively more time in the driving seat of her life which enhanced her growing self-confidence. She decided to take some time each week in an activity she had loved earlier in her life but had been phased out whilst focusing on her family.

She discussed her workload with her manager. Whilst the pressure of market forces remained intense, she agreed with her manager a process by which she could feed back to him when her workload was becoming too much.  They could then re-prioritise her workload, identifying what might be delayed or shortcut with the least impact. In the past she had spent time, both in and out of work, worrying about how to manage her workload. The recognition from her manager implied in this process freed her up to be more productive.  Now she was worrying less, her sleep became less disrupted and she felt more rested in the morning. 

She realised that through stress she had become tetchy with the children when they misbehaved. She now felt differently in her relationship with them. She spent more time playing with them and clearly, she and they enjoyed this time together. They behaved more calmly as a result. They still had their moments, but even then she was able to manage their crises without feeling stretched.  Following open discussions with her partner, they decided to regularly spend some time with just the two of them away from the children.  Just the act of deciding together to do this re-established the strength of their relationship and more explicitly expressed loving feelings between them.

Her thoughts now moved towards her future and what she wanted from her career and life in general. She was considering various options including reducing her working hours & specialising in an aspect of her current career. She also started thinking about what they might do once the children had left home.

By this time, she felt she had got what she wanted from the therapy and was ready to leave.  The changes had crept up on her incrementally. So, when reviewing her progress in our work together, as part of the usual work of ending therapy, she found it hard to imagine herself as she had been prior to starting the sessions.  

She recognised that there was potentially yet more we could work with, but felt that what had been achieved was enough for now and would take some time to consolidate these benefits on her own.  She was aware of the warning signs and knew what to do if she started to feel stressed at work. However, she strongly felt that having got back in the driving seat of her life, and with all the supportive mechanisms she had put in place, she was unlikely to let that happen again.

She had valued our relationship, appreciating what she had learnt about herself in the process, and was sad that it was ending. She felt that if she needed to, she would imagine discussing things with me and find her own way forward. 

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk

Head and Heart

Many clients have a clear understanding of their issues, but find themselves behaving in ways that they know are inappropriate or unhelpful to them and can’t seem to stop themselves. In this week’s blog we will be looking at how therapy can help with this dilemma.

I use a simplified concept of head and heart to represent these two aspects of a person. This does not relate to the physical organs. It is merely a way of helping the client to understand that they hold within them two perspectives which disagree. This is most often a thought process versus one based primarily in the emotions. E.g. “I want to eat more even though I know I've had enough”.

In my experience, the emotions have their own logic – what I term crudely as “heart logic”. This may be more subtle and harder to uncover than “head logic”.  At its core, “heart logic” usually has an underlying message. All emotions may be thought of as messages from ourselves, to ourselves. For example, anger is a prompt to action, hence we get all fired up in readiness for that action.  Fear is a prompt to take defensive action in anticipation of some threat.

Babies need their caregivers, usually their parents, to help them learn how to manage their emotions.  No parent is perfect, so there can be issues for the child in this learning process. For example, anger or sadness, crying or complaining may be seen as “negative emotions”. The implication is that such emotions are not desirable. The child may infer from this that such emotions threaten their relationship with their parents on whom they are dependent for survival. This can make it a matter of life and death. Little wonder they try to swallow their anger, or feel ashamed if they are sad. “There must be something wrong with me”.  All of this typically happens outside of their awareness. In addition, Western society privileges an objective stance, which typically means logical thinking without emotions.  Thus, the emotions may be seen as irrational. 

Once the client has learnt that emotions are irrational, unhelpful, to be suppressed, kept within a particular range (no outbursts), then they are likely to respect their head logic at the expense of their heart. This means that the messages of their emotions are not being received. When they are not received, then those emotions try again and again to find a way to be heard.  It is at this point that the dilemma is born. As an adult, the client is not under the same threat as they were as a child, but now the “heart logic” has been buried in the unconscious, they don’t know that. So when a desire surfaces the client has no idea why it is so powerful.

Helping the client develop a compassionate understanding of the underlying logic of their emotions is an important part of the process of therapy. For example, they may realise that they hold a profound shame about some aspect of themselves that they are unloveable, too sensitive, too much, too needy, spoilt. They yearn to soothe this deep wound by any means. If the values in which they were brought up associated food with caring, then perhaps overeating is the heart’s “logical” response.  The next step is for the client’s compassionate understanding of their heart logic to enable them to work with processing the difficult emotions which prompted its necessity. When the emotional wound is healed through a loving relationship towards themselves, the message of the historically unacknowledged emotion is finally delivered. That emotion is satisfied and can now withdraw. Thus, the heart logic becomes redundant, resolving the dilemma.

This sounds all very straightforward. However, it can take time in establishing the therapeutic relationship to such a depth that a lifetime of unconscious and subtle defences dare to relax. Then they can start experimenting with expressing their most vulnerable parts of themselves. In becoming open to their whole being (head and heart) they can become more fully engaged with others.

If you have any questions about this blog or any of the issues raised please feel free to contact me via my website: http://www.garycooktherapy.co.uk