Counselling, Psychotherapy and Psychology Blog

27 - Apr - 2019

Chiswick Herald article - Brexit and Mental Health

Latest research shows the impact of Brexit on mental health and wellbeing in the UK.

 
 
12 - Apr - 2019

Article on Depression

Our article on Depression was published today in the Chiswick Herald. 

08 - Apr - 2019

Chiswick Herald article on anxiety

The following article published in the Chiswick Herald on Friday the 29th March.

08 - Apr - 2019

Improving your relationships

The following article was published in the Chiswick Herald on Friday the 15th March. 

13 - Feb - 2019

Colluding with your anxiety?

The following article appeared in the Chiswick Herald on the 1st February.

Sometimes people with anxiety start to withdraw and avoid things, people and situations where they experience heightened anxiety. Avoidance is a valid coping mechanism and a tool that can facilitate recovery from trauma but if you or someone you know is gradually withdrawing with no decrease in anxiety then maybe its not the most helpful one!

In fact this might be considered as “colluding” with anxiety, and collusion ultimately leads to greater anxiety.

Anxiety is a heightened state that is identifiable through a combination of physical, psychological and behavioural experiences. Anxiety is different to stress in that it is a longer term condition and it is for this very reason that it can be harder to identify and therefore to treat.

It is not uncommon for people to be unaware that they suffer from anxiety until they realise that other people do not feel like them and again, being able to identify anxiety can depend upon its cause. Where there has been a significant life event it can be easier to spot than if someone has been anxious since a very early age. Again it is common for people to not recognise anxiety because the way they experience life has never been any different. For people who have this type of anxiety it can be helpful to think about a persons early years and any childhood traumas.

And of course anxiety is linked to a wide range of other unpleasant experiences such as panic attacks, agoraphobia, other phobia’s, obsessive compulsive disorder etc. Long term anxiety may also result in clinical depression or other mental health conditions - so once recognised it is really important to start developing ways to manage and hopefully recover from anxiety.

Returning to colluding with anxiety, a common experience is for sufferers to be anxious about being anxious and this is contrary to how anxiety can be alleviated. This cycle which can only result in an escalation of the anxiety must first be broken. We need to recognise that the anxiety has a message for us - one that we need to understand and to do this we must adopt a “kindly curiosity” towards the experience of the anxiety.

Imagine someone who cannot travel on the Underground, how might you apply the idea of kindly curiosity? Here are a list of questions that might be helpfully worked through.

  1. What is the impact on the person of not being able to travel on the Underground? Answers may be practical for example the cost of having to get taxis or more personal for example feeling unhappy with oneself or a combination. 
  2. Has something happened on the Underground? If yes then traumas that have resulted in an unwanted change are something that people take to counselling.
  3. When did this anxiety first appear?
  4. Was there anything else going on in life at the time?
  5. What has been tried to manage or treat the anxiety?
  6. What hasn’t been tried?
  7. Have you looked for information on using the underground, anxiety and how other people cope?
  8. What do you think and feel about what you have found out?
  9. What would you like to do about it?
  10. What might you find supportive / helpful?
  11. Who might you find helpful / supportive?
  12. Is there any reason why you do not try to deal with this or why it is hard to get help?
  13. If a person you cared for was in your situation what would you say to them, or how would you help them?

In therapy, one of the approaches to overcome an anxiety linked to a specific situation is firstly to talk it through, secondly to talk about information that might be helpful and then thirdly to draw up a plan of action.

A plan of action in terms of travelling on the Underground will be tailored to the specific person, based upon what they want to do, what has worked for other people and what the therapist and the person senses to be manageable.

For example, the sufferer might first of all watch videos of underground journeys, they might then go to visit an Underground station, then they might take a train just one stop on an overground section before taking longer journeys. They might have a therapist or friend / relative travel with them the first few times, drop them at the station or meet them at the other end. They might take their mobile phone with them and have someone lined up who they can call. They might take a book or listen to music, carry food or water….. As you can see so many options. 

The important thing is to be kind, take small steps and listen to what feels manageable. 

The Underground is a fairly common example and one that can cause anything from mild to debilitating anxiety. If either yourself or someone you know is struggling with anxiety remember this is a very common problem and it is treatable.

16 - Jan - 2019

When you feel upset with someone

This article appeared in the Chiswick Herald on the 21st December:

Someone upsetting you? Here’s what to do about it.

In this article we will look at getting upset with other people, how we can usefully think about what is happening and what are some of the options available to stop this from happening.

Before getting into the main part of the article it is really important to acknowledge the times when relationship problems are serious and have serious consequences for the health and safety of ourselves and/or others. Some people find almost everyone else difficult and they can find therapy really useful in understanding how their own expectations are causing conflict and find new ways to improve their relationships. And some people are in abusive relationships and they need to get out of them. If you think you might be in an abusive relationship, and abuse can take physical, sexual and emotional forms, there is lots of really helpful information available. For example this page of the NHS website https://www.nhs.uk/live-well/healthy-body/getting-help-for-domestic-violence/. If you are in either of these terrible situations there is a lot of help out there and whilst it might feel hard to take the first step to get help you will be glad you did. Finally, particular in close relationships patterns of destructive and painful behaviour can really put a relationship under strain and often people can find couples therapy helpful. In all these situations the important thing is not to suffer in silence.

Now back to the main part of this article. Most people have difficult relationships with others at some point or another. Sometimes it is something a partner, family member, colleague or friend does that annoys on a regular basis or it might be something that has happened that you are really shocked or stunned by and can’t find a way to deal with it. 

Step One - Relax

Relax - this is something that happens to everyone. And it is not all bad - it means your psychological defences, designed to keep you safe, are functioning.

Step Two - Look at this objectively

Sounds easy and it is likely that your hurt feelings will not want you to do this but being able to be objective will enable you to find a way through. Think of an area of your life where you are strongest at being objective - for some people its work, others with their children, for others with authority - identify yours.

Step Three - Own your feelings

In the spirit of being objective it is valuable to remember this fact. Other people do not make us feel bad, we feel bad as a reaction to others - we make ourselves feel bad! 

Step Four - Review the facts

Recall exactly what happened and write it down. Then edit what you have written to remove all interpretation and subjective wording. For example a friend is late - you might write:

They are so annoying. They were late as always, they knew how important it was to me, we missed the train and they couldn’t even be bothered to apologise - they said nothing. It is so typical, never take responsibility for anything and doesn’t care about anyones feelings except their own. They ruined my day.

To rewrite this factually:

They were 20 minutes late and we missed the train. I had said not to be late, they said nothing when they arrived. They have been late before. My thoughts were that they don’t care about anyone else’s feelings. My day was ruined and in my thoughts I held them responsible.

Step Five - Review your interpretations and subjective responses. 

And question them as follows:

Are they always annoying?

They are always late?

You told them not to be late but how can you know they understood it was important to you - did you use those words?

When people do not apologise does that always mean they do not care? Isn’t there another explanation?

Do they really never take responsibility for anything? How can you be certain? Also how can you be certain they do not care about anyone else’s feelings? If so how do they manage in life? 

If they don’t manage in life then why are you taking this personally when you could have anticipated this happening?

You think they ruined your day - does that mean you were powerless to salvage your day - how come?

Step Six - Decide what to do.

By now three things will have happened:

  • You will feel calmer - you are taking back control of the situation and your feelings
  • You will be starting to think about what happened differently
  • You may now want to just forget about what happened or maybe you will want to talk to the person about what happened
  • When you replay things in your mind you might now find that the other person was even upset that you were upset - so maybe they are feeling bad too now?

Step Seven - If you decide to talk to them

If you decide you would like to speak to the person then use this simple framework:

State the facts - “you were late and I had asked you not to be so we missed our train and I did not enjoy the rest of the day”

Say how you felt - “I felt angry and upset”

Say what thoughts you had - “I was thinking it means you do not care about me and I remembered when you were late before”

Say what you would like - “I would like you to be on time in future”

14 - Nov - 2018

Article on reducing anxiety

Our article - "Reduce conflict and stress in relationships" published in the Chiswick Herald on the 9th November. Please read below:

Reduce conflict and stress in relationships

Conflict and stress in relationships often come from misunderstandings and poor communication. We cannot expect others to change how they communicate but we can change ourselves and when we find communications of others upsetting then having a better understanding can help.

In this article I’m going to look at how, by paying attention to our thinking and the words we use we can become more relaxed, have less conflict with others and become happier. Initially, I will explain how we have a natural tendency towards the negative, the role of our thinking, how the words we use can make things worse for us and how we can also apply this when we find the communications of others upsetting.

Recognising the difference between interpretation and fact

For example, a friend who you had agreed to let know whether you would or would not be able to make it for coffee, replies saying 

“You are late contacting me! Bad behaviour from a friend?” 

As you can see the response contains judgements which are negative towards your actions namely, “late” (no date or time had been agreed for confirming) and “Bad” (a subjective interpretation) - with such wording it is likely that you will have had a negative reaction to these words?

Beware - negative interpretations cause escalations in both yourself and others

Your feeling response to these judgements is likely to be negative. What feeling it evokes in you will depend upon your current situation and also how you to tend to respond to negative comments. Importantly your own negative reaction to the judgements may well lead you to negative judgements in return. For example, if you have been really busy and not very well you might feel upset and then your own negative judgement will be to think you are being misunderstood, if you have a history of disappointments, you might feel anger and think they are unfair, if you have had critical parents you might feel anxious or nervous and think you are in trouble?

So likely responses you send in these three scenarios might well be something like:

“You just don’t understand and are not being nice”.

“You are unfair, I know what it is like to feel disappointed and you have no right to feel this way”.

With these first two responses your friend is likely to be respond with further negative judgement and accusation. A third possibility and just as harmful to your friendship would be the following:

“I am sorry, I’ve changed my diary so I can make it”.

In this response you are dismissing yourself and doing what the other person wants just to avoid conflict, ultimately the cost to you of doing this is to have inauthentic relationships that bring you little in return!

Facts, facts , facts

So what can be done?

When you receive something from someone that results in a negative feeling here is what to do:

  1. Pause - It can be tempting to allow your thinking to take over but this is also unlikely to be helpful as your thoughts will be based upon your negative feelings.  Also when you have allowed your thinking to gain momentum you may find it hard to avoid taking action that has negative consequences.
  2. Take a breath and then ask yourself “what is factual here?”, with this example it can be helpful that having spotted there is little factual content and noting your negative reaction, that the important message from this interaction is that your friend is upset but not able to communicate this to you in a helpful way?
  3. Now develop a response with the following parts: first - state the facts, two - explain what thoughts it brings up for you. For example:

“I felt upset when I received your message and I do not remember us saying a time by which we would confirm whether or not we would be able to meet. As I felt upset, I am thinking that maybe you are upset that we are not able to meet”? 

Such a response is factual, offers a suggestion about what is going on and invites further communication. Unless you are in a friendship with someone who is abusive, in which case their response is likely to contain further judgements and criticisms, it is likely your friend will see that a misunderstanding has occurred.  Also if in the future difficult situations arise, this interaction will have helped build trust so that your friends initial response will itself be factual. They might for example say:

“I feel upset because I was looking forward to us meeting and I have not seen as much of you as I would have liked lately”.

And if you now note your reactions to receiving this kind of message, I imagine you feel upset for the other person and rather than defensive and wanting to avoid them, find yourself wanting to reach out and get something new organised?

15 - Oct - 2018

Reducing anxiety - article in the Chiswick Herald

Our latest article on reducing anxiety was published in the Chiswick Herald on page 31. 

View article Or read it below:

Feel happier - reduce stress and anxiety - here’s how!

Stress comes from being under pressure, anxiety comes from prolonged stress, anxiety reduces our happiness - so anything we can do to reduce pressure will have a direct impact on happiness!

In this article I’m going to look at how, by paying attention to our thinking and the words we use to describe things we can become more relaxed, have less conflict with others and become happier. Initially, I will explain how we have a natural tendency towards the negative, the role of our thinking, how the words we use can make things worse for us and then offer an experiment to help you start to make changes. This article will deal with events that we might come across everyday - in the next article we will look at relationships.

When we experience being under pressure the experience is one that is alerted to us by a combination of our feelings, thoughts and bodily sensations. Neuroscience is showing that our feelings are something over which we have very little control - our bodily sensations and feelings will be triggered in response to a perceived threat or pleasure and then our thoughts will try to make sense of what is happening and if it is a threat, to seek a solution.

Under pressure it is our thinking which often proves to be the weak link. 

Thinking happens through our language, thoughts are the assigning of words to our experience and the biggest single problem with our language is how it contains so much scope for subjectivity combined with its tendency to see things as either positive or negative.

Being first and foremost concerned with our survival, negative judgements take precedence. For example, when we have a feeling we see as “good” we do not tend to dwell, analyse and procrastinate because there is nothing to be done, we are not under any possible threat. However when we have a feeling that we see as “bad” we naturally tend towards needing to find out what is “wrong”. The issue here is that we are already looking for something “bad” - we are starting with a bias. 

Our experience of living may be made up of equally good and bad feelings but the importance given to the bad means the way we can end up looking at the world will be skewed towards the negative.

In addition, the difficulty of feelings that we experience as bad can mean we do not feel as though we have time to understand whether our judgement is correct. Instead our in built risk assessment systems will urge us to think about the worst scenario, draw upon our previous bad experiences and allow our adrenal systems to kick in and allow physiological action designed to save us. 

Our very sensitive but not necessarily accurate systems are great for saving us when we really need it - where our safety is at risk - but it also influences us in low risk everyday situations where we find ourselves reacting to things and making negative judgements. I am not saying we stop judging but we recognise when we do this and how it has the potential to make us unhappy.

Here is an everyday example:

Imagine you are walking down the street - you narrowly miss stepping on some dog faeces. Whilst you are pleased you missed it you remember a previous time when you stepped in some dog “mess” and how annoyed you felt and the extra work involved in cleaning your shoes and the entrance hall carpet at home. The word “mess” combined with the previous memory triggers irritation and you think about how “irresponsible” people can be, that reminds you of how you found a new scratch on your car the previous week, you think “vandalism” and now you feel angry but also a little frightened. In turn that fear then reminds you of what you saw on the news about an increase in muggings in another part of the city. Now you think about how the city is changing and how crime is getting worse, how people are “dangerous” and you now feel unsafe. 

Instead imagine this possibility:

Walking down the street you narrowly miss stepping in some dog faeces. Whilst you are pleased you missed it you remember a previous time when you stepped in some dog “mess” and how annoyed you felt and the extra work involved in cleaning your shoes and the entrance hall carpet at home. 

NOW at this point - at the time of your initial reaction - try to train yourself to pause. You do this so that you can now look at the reaction and look firstly for words which are not purely descriptive - so ones that contain a subjective / judgement - in this case “mess” and secondly look at how this event today is triggering past negative events.

Now, having fully understood how you are reacting in a way that is amplifying the event and its negative impact on you, recall how you were feeling before this happened, take a second or so to fully experience yourself as you were.

Obviously it is unrealistic to expect yourself to do this every time something generates a negative thought and feeling however if you can start to do this occasionally you will start to understand how set backs, surprises, misunderstandings, disappointments etc end up with much more power than they fully warrant and how that can sabotage your happiness. In our next article we will look at how to apply this to relationships.

 

17 - Sep - 2018

Latest article - How to make your family times happy times

Our latest article was published in the Chiswick Herald on the 14th September on page 27, click here to visit the site or read the article below.

How to make your family times happy times

For some people their family feels like the best place in the world whilst for others the worst however for most there are good times and bad times. For everyone though there will be a pattern to peoples behaviours and sometimes those patterns might change for the better!

When relaxed and happy people are able to rub along together with little conflict however individuals in groups often take on particular roles and this can lead to tension between people. When something changes or when stressful situations arise, behaviours may not change to adapt appropriately and / or the defence mechanisms deployed by people may add to conflict.

Staying quiet is an option but one that rarely changes an ongoing problem.

If you want to break patterns of behaviour that cause problems then the first thing to do is to think about your family and the particular roles people take. It is normal for people to assume a “job description” and tensions tend to arise because these job descriptions either overlap or leave holes. For example, you might have four people willing to cook but no one who is willing to clean up afterwards!

Unfortunately, when behaviours remain unchallenged and the resentment starts to build thoughts such as “they are so selfish, so thoughtless, self centred” start to occur and these tend to generate even more difficult feelings.

Do you think that person really wants to be seen as difficult?

Such patterns are normally formed because things change but habits stay static. It can be really helpful to think that the person with the annoying habit is most likely doing something automatically and doing it because at some point it was what people appreciated.

But now you need accept that the behaviour is simply one that you find difficult and this cannot be changed alone - if it could have been then you would have managed it by now! 

Even if you have been able to see the other persons behaviour as not intentionally difficult it is likely you will find raising this subject difficult. A good initial strategy is to think about how you tend to be under pressure and how others therefore experience you so you can find ways to stay calm. 

Fight, flight or freeze?

Under pressure people with have a tendency to respond in a particular way - this means it can be possible to predict with a degree of accuracy how someone - including ourselves will be when something goes wrong. There is “fight” meaning becoming active. It doesn’t necessarily mean becoming aggressive but if you think of movement it would be a “step towards”. For those who tend towards “flight” a “step backwards” and for those where “freeze” happens think “standing still”.

Once you have identified the response you can think about what this means in handling situations - imagine the situation then think of ways to ensure you both remain calm.

FFTP - Fact, feeling, thought, preference

FFTP is a structure for how to have those difficult discussions! In this method of communication you provide the other person with all the information about what is going on for you in relation to the issue you are finding difficult.

Here is a hypothetical but typical situation. Your brother (Arthur) who is married with three children has, since having the children, started turning up late to family events you organise and when he finally arrives tends to disagree with things arranged in his absence. Today when the family were due to meet for a walk and lunch he arrives an hour late by which time everyone had decided where to eat and ordered drinks. He says he wants to go to a different place as he has heard good things about it. You find yourself feeling annoyed and thinking here we go again. You know that you tend to get angry and that in the past you have ended up shouting so you know it will help if you can stay calm. You’ve been thinking about this and have already planned to ask if you can speak away from the rest of the family, you also know that when you sit down you tend to stay calmer - so you find somewhere you can sit.

You - 

Fact - “We agreed to meet at 1pm and when you didn’t show up on time we decided on this place, looked at the menu and ordered drinks. Now you want us to change what we are doing.”

Feeling - “I am feeling annoyed, hurt and unloved”

Thought - “I am thinking that my time has been wasted, what I want doesn’t matter and not good enough for you - it is hard for me to enjoy our family time with these feelings and thoughts”.

Preference - “Can we find a way to ensure our arrangements work but can I also ask you don’t ask me to change what has been decided.”

Arthur -

“It is always so hard for us to get places on time with the children, something always seems to happen when we are leaving the house. I should allow more time but sometimes I agree to something and then don’t feel I can change my mind. Arriving late today I felt stressed and nervous because you have been angry with me in the past so I am always thinking I have to make up for being late. I think I have spoilt things and I need to find a way to make things OK so I try and suggest something that I think will be better. Now I am thinking that if I arrive late I can just relax knowing that I don’t have to do that - I don’t need to fix anything. But you are right maybe we can change the way we make our arrangements - I would like to know its OK not to agree a time on the spot so I can think about timings?” 

05 - Sep - 2018

Relationship dilemma's - happily unhappy together and unhappily happy together

Our latest article on relationship dilemmas has been published in the Chiswick Herald. You can read it below:-

 

 

Relationship dilemmas series - happily unhappy together and unhappily happy together

Often people come to therapy to talk about how they feel confused about their feelings in their relationships. For example, they might say they feel unhappy in their relationship but that it is not their partners fault or they may say they feel happy about their relationship although they can struggle with how their partner behaves sometimes. It seems some people will be happy in their unhappiness and some unhappy in their happiness.

One of my first questions is always “have you spoken with them about this?” 

and often the answer is “no” or, “not really”. It is so common for people to struggle to talk about things. Unfortunately it is often the case that when someone struggles to talk about something they maybe judged as not being truthful or honest and that in itself can be a real barrier.

In my experience conversations are often avoided because of how difficult the person struggling with something may find it to start the conversation. For example, they might fear being misunderstood, they might fear the hurt or anger of the other person, they might not know how to start the conversation, how to pick the right time, they might also be thinking that it is not something worth talking about or when they think about what they want to say they find themselves confused and stuck, they might feel guilty about not being happy etc etc. Ultimately they may well fear that by talking things will get worse.

This reluctance is often a really positive sign as it shows just how important the relationship is and that means change, compromise and growth are always possible. 

The relationships I worry about are where apathy and exhaustion have become the norm.

So lets look at how to have those difficult conversations. Firstly there is talking and then there is communication and that they can be very different things. If you have the same conversations over and over again then you are talking and not communicating. Communication is about understanding and being understood and when this happens things can change. 

When people get frustrated about repeating conversations they start to get upset and at this point a common mistake is often made. It is so clear to them what they are saying they locate the “problem” in the person they are trying to talk to and this leads to conflict. Instead what I recommend is that you point out what you are observing, say how you are feeling and what you are then thinking. 

Here is a hypothetical but typical situation. J and P are a couple together for eight years in their early thirties. J has been feeling increasingly unhappy lately and wants them to do more social activities together. They have come to therapy because every time J raises the subject they end up arguing.

In the session J says to P “Do you want to organise a dinner with friends?” and P grumpily replies “Not really, I am too busy with work”. Angry, J replies “you are always busy with work, you work too hard”. P now also angry replies with “well at least I was brought up to understand the value of working hard”.

I ask them to both go back through the conversation and structure what they say differently and to do this I ask them to say how they felt and what they thought and whether there was anything they would prefer the other to do or say. I ask P to now respond to J’s question.

P says “when you asked whether I wanted to organise a dinner with friends I felt stressed and I thought how can you be asking me to take something else on when you know how tired I am?”. J then replies “hearing that you felt stressed makes me sad and I feel confused because when we have dinners with friends I usually do all the organising. I am also not certain I do know just how tired you are, I have thought you look tired but this is the first time you have said”.

P says “I feel confused now because I am sure I have said I am tired but I am also thinking that I misunderstood your intention, I would have preferred for you to say “Can I organise a dinner with friends?”

J thinks for a moment and then says “so you aren’t against doing things with friends? I have been feeling lonely and missing our friends and how we are when we spend time with friends.”

P thinks for a moment and replies “I miss that too”.

They have a dinner with friends and it is a great success but more importantly this change in their communication leads to them to speak about how P feels pressurised to be successful at work as J has been talking about starting a family. They realise that they have not shared their thoughts and feelings on starting a family for a long time and this was the conversation that was actually needed.

08 - Aug - 2018

Latest article - relationship dilemmas, when you or your partner wants change

Our latest article has been published on page 27 of the Chiswick Herald. Click here to visit the site or read below.

Relationship dilemmas - what to do when you want something to change

One of the concerns couples often bring to therapy is the conflict that arises when a partner wants something to change in the relationship. Maybe its something to do with lifestyle, socialising, money, sex - whatever the issue many couples struggle to integrate change.

A major reason is that before the need for change becomes clear there is often a period of growing dissatisfaction. During this period couples often start to argue and both end up taking polar positions on the issue, often the issue itself becomes overshadowed by a power struggle.

“Avoid playing the blame game.”

It can be difficult for the dissatisfied partner to talk because they can feel awkward or guilty asking for change or maybe the conflict has become so difficult they fear raising the subject? And for the other partner they may also actively avoid the issue, nervous that they might not want to make the change or that the change is the start of other changes for which they are not yet ready.

A very common situation is where something that was merely slightly irritating in the early stages of a relationship appears to grow in importance. We all tend to be on our best behaviour in a new relationship, not wanting to be difficult but also having a significant amount of goodwill. As our relationships settle down our desire for our relationship to be one we experience as supportive and relaxing means that things we find irritating can start to damage our relationship.

“It can be helpful to see this as a sign of a maturing relationship”.

Here is a hypothetical but typical situation - M & T have been together for two years. M has been increasingly annoyed about the amount of time T spends with children from a previous relationship. Things came to a head recently when there was a confusion about dates, there was a wedding for one of M’s friends on the same day as T’s youngest was graduating from University. They argued about it, M revealed that this was the latest in a long list of upsetting times, T was angry that M should be upset. The issue was not resolved, M went to the wedding and T went to the graduation - they both felt hurt and something between them shifted. After a few more arguments and with growing sense of unhappiness they came to therapy.

Through therapy the first thing we did was de-escalate the conflict. Both M & T could see that disappointing though it was to have struggled with this issue it was a relatively common problem. They were also able to discuss how having this issue had led to them “catastrophising” in other words they had starting to wonder if the relationship had been a bad one from the start. Such thinking had badly affected the relationship so by speaking about this they were able to see that the growing conflict was merely a symptom of a need to improve their communications.

In the second stage of therapy M & T learnt how to speak about things when they were upset or importantly sensed that each other might be upset about something. M spoke about how sometimes it had felt difficult to say how it felt in a situation and had seen something in T’s reaction that meant the possibility of conversation had closed down. Meanwhile T spoke about how it was difficult to see M upset, had spotted the upset but had been fearful that they would end up arguing. 

Following this M was now able to tell T that the worst thing about this was not that it prevented them finding a solution but that it raised a fear that T was not interested and that they could not communicate. Meanwhile T was able to say that M often appeared really angry and spoke in an aggressive way that meant it had to be M’s way. So they could easily see how they shared the fear that neither was interested in communicating but only getting their own way.

They were now able to see how the misunderstandings had occurred, they were relieved to hear that they both actually wanted the same thing - to be able to talk about things. When encouraged to make an agreement between them to deal with this going forwards M asked T to check out whether they needed to speak when such situations arose in future, meanwhile T stated clearly a desire to hear from M in those situations.

22 - Jul - 2018

Article - Relationship Dilemmas

Our latest article has been published in the Chiswick Herald on page 27, click here or read it below.

 

Relationship dilemmas - what to do when you want different things.

Over the next few months we will be outlining different dilemmas faced in relationships, in this article we will look at what happens when couples want different things.

The struggle for couples to find a way to handle situations when they both want different things is often brought to therapy. Where there is a repeating pattern of a couple not getting what they want resentment tends to build, goodwill is eroded, the relationship becomes a power struggle and the couple grow further and further apart.

There are only two possible outcomes when a couple find they have different wants:

  1. One gets what they want, the other changes position
  2. A compromise is reached

There is often a misunderstanding about “compromise”. Compromise still means that neither will get what they originally wanted however through working together they will find something new they both want.

What this tells us is that being in a relationship means a couple cannot realistically have an expectation they will both get what they want. A healthy relationship is therefore one where both agree that they will do whatever is needed to maintain and develop the relationship. 

This sounds obvious however when a partner starts to struggle instead of the focus being on “what do we need to do?” it tends to go to what each partner needs to do individually. Whilst this is a natural response it is simply not helpful. It is often also something about trust - trust that we can be understood and that we will end up with something helpful. 

Here is a hypothetical but typical situation - J and M have been together for just over ten years, last year M’s father died suddenly. J was in the middle of a redundancy programme at work at the time and although J escaped redundancy the environment has been unpleasant. M’s work have been very supportive but M has increased the amount of overseas travel. Over the last few months arguments have started to do with domestic chores and money, whilst sex has become sporadic and routine. 

Summer is coming and thoughts have turned to the annual holiday. J wants to go somewhere hot and lay on a beach in an all inclusive resort whilst M wants to go on a walking holiday staying in self catering accommodation. 

When they tried to discuss this they argued, it happened much like the other arguments they had been having but this time J picked up a bottle of wine and threw it at the wall. They found they were both shaken by what had happened and came to therapy. We looked closely at what had been said and how argument had developed. What we found was that:

First, they each stated what they wanted and then commented on what the other said they wanted.

Second, they said how the other had hurt them.

Third, they criticised each others behaviour in their conversation so M criticised J’s anger whilst J criticised M’s withdrawing.

So what is wrong with this? Well lets start at the end and work backwards:-

1. In arguments peoples behaviours are the revealing of defence mechanisms. Their activation is actually a sign that the individual is upset and responding - so this needs to be seen as an issue of the relationship - not the individuals. (With the exception of abusive behaviours). So instead of the behaviour it is more helpful to focus and understand the triggers. Ultimately to catch and prevent situations before they require defences.

2. In our relationships we have hurt feelings when our expectations are not met. Whilst is makes apparent sense to blame the other person it is far more helpful to think about how it is we have differing expectations. (Unless we believe the other person is abusive - in which case what are you still doing there?)

3. People often come up with solutions for problems and then are annoyed when others do not agree with the solutions. In relationships, a solution for something affecting both can only be found when both have agreed and understood the problem. 

So back to J and M. The “problem” was that they were both exhausted and upset with how the relationship was going and they recognised that their exhaustion was preventing them from being as flexible as they had been in the past. They had both been worried for themselves and each other and realised they had been trying to go on as normal and that included the holiday planning. They both agreed that the solution was they needed a holiday to relax / recuperate and when asked to think about each other they accurately identified they tended to have different ways of relaxing and recuperating (“expectations”). It had never occurred to them that holidaying apart might be feasible, fleeting thoughts had been dismissed because part of being on holiday was usually about enjoying time together. But this was not usual and so unusual solutions were valid. They agreed that for this holiday they would take separate holidays but they would also plan an extended weekend away together for a month later.

27 - Jun - 2018

New article - Chiswick Herald

Our latest article was published on page 29 of the Chiswick Herald on the 22nd June, click here or read below:

I’m a therapist because of loneliness.

For me, therapy works because the person struggling with something on their own no longer feels on their own! 

People come and see me because they are depressed, anxious, having panic attacks, having relationship problems, drinking too much, having problems becoming pregnant, have PTSD, are diagnosed with a mental health disorder, are suicidal, having trouble managing their anger but the baseline is they are coming to see me because they are alone with a struggle. 

No longer feeling alone brings a sense of relief and hope. 

The change, no matter how subtle brings new energy and makes it possible to express something that has previously been impossible to express. Feeling more relaxed means we can start to see the wood for the trees, be more rational, think about things more clearly, which in turn helps us to feel better.

It is only once we can express our difficulties we can start to understand them and once we understand them we have a chance of fixing them.

Although loneliness has been much in the news lately, the importance and scale of it is I think,  vastly overlooked. In my experience people find it hard to identify that they are lonely or even if they do feel lonely fail to see the importance of it.

When a person finds it hard to make sense of something, be it their thoughts, feelings or how they are experiencing themselves they can get stuck in their internal world. So they will find their thoughts going round in circles, have ever increasing and overwhelming negative feelings, have bodily symptoms - and the more they try to get out of the struggle the worse it gets.

This is a really lonely place to find yourself in.

When people find they cannot rely on themselves to find a solution they may move towards other behaviours, initially as coping mechanisms, that only act to escalate the problems and isolate them further - drinking, drugs, eating disorders, avoiding friends and family, giving up their hobbies, faith, work. 

It’s a natural response because once someone starts to focus inwardly they have already discounted, not thought about or had experiences which have led them to believe that they cannot be helped. 

But what is help?

The important thing about seeing a therapist is that you are meeting with someone who you do not know and who does not know you. This means that the problems you might experience in trying to talk to friends and family do not exist - you can feel more relaxed and speak freely, your conversations will be confidential, you do not have to worry about the therapists feelings, do not have to worry that they might not cope with you being upset, might change their opinion of you, be sure that they are there because they are focussed on helping you and as you are the client you are in control. 

One of the common problems people experience about sharing their struggles is a worry that somehow control might be taken away from them - with a therapist that is not the case.

Crucially though finding the right therapist for you is essential. Research consistently shows that the single most important factor in finding therapy helpful is the quality of the relationship someone has with their therapist. 

It is true that we go through years of training, undertake our own therapy, have experience in talking about things often not talked about in everyday life, so we might have some new way of looking at things, be able to share a wisdom but to know if you have found the right therapist I suggest you ask yourself “Do I feel lonely now I have my therapist to talk to?” If the answer is no, or not so much then I think you have found the therapist who is right for you. 

13 - Jun - 2018

New article - Interview with Nicholas in Chiswick Magazine

This month an article appeared in the Chiswick Magazine after Nicholas was interviewed by their Editor Katie Saunders. Please click here to read.

29 - Apr - 2018

New article - Keep your children safe and well in their use of the internet

Our latest article was published on Friday 27th April in the Chiswick Herald. Click here to visit the Chiswick Herald Online or read below:

 

Keep your children safe and well in their use of the internet - part three

My previous editorials have focussed on safety and how to speak to your children if you are concerned about how they keep themselves safe but also if you have any concerns because of they way you see them using the internet. Today I thought it would be useful to consider appropriate use of the internet to contribute to the wellbeing of your children.

In June this year new studies provided evidence that moderate use of the internet and social media does actually benefit children and young people. Suggesting that use of social media helps build resilience and develop social skills thus having a positive impact on mental wellbeing. So it looks as though the usual thinking about moderation in all things does also apply to the new digital age too.

More than a third of 15 year olds in the UK are understood to be classed as “extreme internet users” sending over six hours a day online and 95 percent are using social media. Extreme users are more likely to report being bullied online and research by the NSPCC identified that 80 percent of children felt unsafe using social media to some degree.

In all cases research suggests that parents need to be supported in helping children use the internet appropriately but there appears to be very little guidance out there on how to do that. Most focus is still on safety rather than wellbeing. 

Current thinking concludes it is unlikely that one size will fit all and that the appropriate use of the internet will depend upon a range of factors. You might like to think about your child’s age, interests, social networks and particular needs. 

If your child could do with help in particular areas then the internet will be able to offer advice, support and even tools. It is most likely that the most effective approach is to actively talk to your children about how they use the internet and look for how it can support them. Focussing purely on time spent online is going to be too limited.

To understand the uses that lead your child to experience positive outcomes and affirmation to their self esteem and seek to strengthen and support this use is likely to be more effective than focussing on usage where it either appears to be causing distress or at best appears to have little benefit.

Rather than any single solution, it appears that children benefit most when parents use a combination of approaches including modelling positive behaviour, using a collaborative approach to setting limits on usage, keeping up to date on developments and technologies around security and online safety and showing curiosity and a willingness to support positive behaviours. 

Technology can be something that parents can think they are ill equipped to deal with, especially when children can be more up to date and often more proficient in handling technology. However what parents do have more knowledge about is the importance of balance - you can therefore support your child in the same way as you would for any other issue - food, friendship, health. You don’t have to know about the technology - just about how best to find a healthy balance.

11 - Apr - 2018

Nicholas at Sky News to talk about relationship sabbaticals

Nicholas appeared on SkyNews this morning to contribute to a discussion about the recent and growing phenomena "relationship sabbaticals". A clip of the interview will be available soon.

27 - Jan - 2018

Vacancies for psychotherapists and counsellors

We are currently looking to invite counsellors and psychotherapists to join our team as Associates here in Chiswick. Associates are accredited / registered with either the BACP, UKCP or BPS. You will also have two years experience of working in private practice and hold your own insurance.

As an Associate you will join an established practice and team of like minded professionals with the opportunity to work with a wide range of presenting concerns.

Our ethos is to provide a base for therapists who want the opportunity to work with other therapists but practice independently. This means that patients / clients contract with you - not the practice.

We are particularly interested in therapists who can work with adolescents and couples.

For more information contact Nicholas on info@nicholas-rose.co.uk or telephone Nicholas on 07789488691.

27 - Jan - 2018

New article - Make sure depression does not destroy your relationship

This article was published in the Chiswick Herald on the 19th Janaury, click here to read it our their website or see below:

In my work with couples it often comes to light, that at some point in the past, one of the couple has struggled with depression. Through therapy couples often come to realise that the way they responded at the time harmed their relationship. In this article I explain what often happens and what to do.

Depression often occurs after something has happened in a person's life that has been difficult to cope with. The struggle can be very tiring, resulting in low confidence and a circle of behaviour that only serves to lead to more unhappiness. 

It can have a terrible impact on how someone experiences their life on a day to day basis, symptoms often include a felt sense of low desire to undertake daily activities including work, socialising, exercise etc. It can have a debilitating effect and often be a very confusing experience for the sufferer and their friends and relatives. It can also have a significant impact upon partners and can often lead to the breakdown of relationships.

So what goes wrong? In our relationships we generally expect that partners support each other during difficult times and illness. So far so good! However the difficulty tends to come from failing to support partners in a way that recognises the needs of a healthy relationship.

All too often, the person struggling will most likely be experienced by their partner as withdrawing and this creates a dilemma. On the one hand the partner will be upset to see the person they care about struggling and want to help them, whilst at the same time they are also likely to be struggling themselves with negative feelings about how the relationship with their partner has changed.

To be upset ourselves when our partners are struggling can be difficult as judging thoughts can come to mind like indulgent, selfish, uncaring. We prefer to think that when things go wrong for someone we care about we will drop everything and put the other person first and that they will do the same for us. Whilst this expresses just how important our partners are for us it introduces a mindset that leads to thinking about “them and me” and not about “us”. So at a time when we both most need our relationship to be working well we tend to put it on hold, relegate it, not give it priority.

Quite simply if you are affected by the fact your partner is struggling then you need to look at it as information telling you that your relationship is struggling. If someone is unhappy in a relationship then it is an unhappy relationship and no matter how tempting it is to try and hide this fact from a partner who is struggling, ultimately that partner will not thank you for this further down the line.

So what is it that happens that causes the relationship harm? Usually the partner not struggling puts their needs to one side, they might miss their “old partner”, but they give them space, or their sex life but don’t want to impose, or being able to talk about their own problems. Unfortunately the denial of needs tends to have a habit of impacting upon us in ways we do not expect. 

Of course the struggling partner will be finding it hard to carry on as though nothing is happening but if that partner also loses the benefit to their sense of self that comes from being able to make their partner happy, then thats just another thing to add to their probably ever increasing list of failures. They might not even realise this so it is up to the supporting partner to remind them!

Unfortunately patterns get put in place whereby the supporting partner also withdraws and changes their behaviour with the result the way the relationship works is changed to such an extent that a time comes when neither recognise it any more. The relationship can be experienced as lifeless, dead, lonely. 

Couples can often avoid this for years, particularly if they have children, busy jobs, other interests etc but ultimately they become to realise that their relationship is no longer there for them.

Main points - 

  1. Think about your relationship - it is not helpful to think just about your partner and yourself separately.  
  2. Take a step back and think together about what you can do so that you can both feel as though you remain committed to each other
  3. Even if your relationship is in a good place at the moment talk about this now - if trouble comes along you will have an agreed strategy in place and this will make it much easier to have the conversations that will help.
  4. If you or your partner is depressed share this article with them and think about seeking couples / relationship / marriage counselling.
27 - Jan - 2018

New Article - Keep your children safe and well in their use of the internet - part one

The first part of this article appeared in the Chiswick Herald on the 5th Janaury, read it on page 21 here, or read below:

Do you struggle to talk to your children about their use of the internet and their safety and wellbeing? Are you tempted to stop your children using the internet altogether? Are you unclear yourself on what is appropriate internet use? Do you fear that talking to your children will only serve to drive them to hide their use of the internet from you?

Over the next couple of articles I will endeavour to provide some useful information on current thinking. However I will also offer some guidance on how to prepare and raise potentially difficult conversations about the use of the internet with your children.

In June this year new studies provided evidence that moderate use of the internet and social media does actually benefit children and young people. Suggesting that use of social media helps build resilience and develop social skills thus having a positive impact on mental wellbeing. So it looks as though the usual thinking about moderation in all things does also apply to the new digital age too. In a future article we will look at what “moderate” use means however for this article we will focus on safety.

In the news this week has been the work by the National Crime Agency to protect children using live streaming platforms, work that resulted in 192 arrests and the safeguarding of 245 children. However National Police Chiefs' Council Lead for Child Protection, Chief Constable Simon Bailey, said: 

“We will keep working together to do this, adapting our approach so that nowhere online is safe for people out to groom children or view them being abused. But we also need help. We need internet companies to help us stop access to sexual abuse images and videos and prevent abuse happening on their platforms.We need parents and carers to talk to their children about healthy relationships and staying safe online.”

A new animation has been developed and released to show how offenders try to build relationships online with young people and guidance for both parents and children on the risks posed by live streaming is available on the “Thinkuknow” website.

The website is helpful in providing information on warning signs to look out for, actions to take and how to access further support and information. As they point out, the best way to address these issues is to be able to have “Calm and open conversations” however they also recognise that you might find trying to talk about safety overwhelming and that you might yourself struggle with difficult feelings. 

They provide really great information on how as a parent you need to act and also what you might expect to experience yourself and how to manage that. I think this is really valuable reading if you are at all hesitant in starting a conversation because it is possible that your hesitancy is indicating that you do not yet feel fully equipped. 

The only criticism I have of the information is that it is presented as a resource to be used if you find out your child has been abused, I would argue that it is really very good reading in terms of how to prepare for any potentially difficult conversation with your children. Why? Because as parents it is so easy to feel under pressure and carry expectations about how you should know what is right and wrong and know what to do. 

It is natural to feel this way and it is also natural for your children to feel nervous about not getting things right, upsetting their parents or have unrealistic expectations about what you know and can help with. The important thing is to be aware of this and think these things through in anticipation of starting any conversations.

In the next article I will write about what is needed from you as parents in talking to your children about the potentially difficult subject of their internet / social media use.

06 - Dec - 2017

New article - Is work affecting your mental health?

Our latest article published in the Chiswick Herald on the 1st December on page 21, to read it click here. Otherwise the article is detailed below:

 

Is work affecting your mental health?

 I have been thinking about how many of our clients are routinely impacted on stress that comes from work, either from the pressure of the work itself and or difficult relationships at work. And too much stress can so easily have a significant impact on a persons quality of life. Stress can lead to anxiety and depression that brings with it many symptoms that can prevent people from getting the most out of life.

 And did you know that employers should be thinking about whether your work is well designed, organised and managed? Employers in the UK have a legal duty of care to protect the health, safety and welfare of all employees and yet according to research conducted by the mental health charity Mind in 2013, work was given as the most stressful factor by 34% of respondents saying they found their work life either very or quite stressful. Other research quoted by the Health and Safety Executive also shows that workers in the public service industries tend to have higher incidences of stress.

 It can of course be difficult to attribute stress to just one source and yet if you find yourself saying that work is stressful, or if you notice that someone else tends to exhibit signs of stress in relation to work then it can be helpful to keep in mind that there are ways to manage and reduce stress. It is also helpful to remember that if you are stressed at work then your employer has a responsibility too.

 Bullying continues to attract much attention in the media for example, if you are struggling at work whilst it might be your first thought to think about how you are failing that might mean you fail to recognise that you are the victim of bullying. Instead of focusing on what you are doing wrong take a step back and think about the environment and context in which you find yourself. Examples of bullying can include overbearing supervision, constant criticism, exclusion and maybe you are working an a culture where this is routine but it doesn’t mean you have to put up with this. 

 But it is not just adults in the workplace who are suffering from stress. It seems this is an increasingly recognised problem for children too. In August 2015 The Guardian reported that English children are among the unhappiest in the world and again there seems to be a significant link with bullying. Head Teachers have been calling for improved mental health care and yet for some time now the news has been full of articles on how much stress teachers say they are experiencing.

 Marybeth Mendenhall, our Senior Associate and a Systemic Psychotherapist told me “The dynamics within organisations can usefully be likened to those that occur in families -  dysfunctional organisations are like dysfunctional families. For the members belonging to the group harmful behaviours may easily become so familiar that it is only when a new member joins or an outsider gets to see and experience being part of the group that the harmful dynamics can be identified”. 

 

Ia Tollstam, our Consultant Supervisor for business services told me “many medium and large organisations have services in place to help managers think about stress and employees deal with stress. Access to counselling is commonplace in many organisations but not so much for those that are smaller”. She added “there is so much an organisation can do to support its staff and the value of a workforce who feel looked after is something the most successful employers understand.”

 

As Marybeth says “Just like with a family, members can really help each other out when trouble strikes and good communications and strong relationships can build resilience that minimises the impact of difficult times or events.” 

 

In talking to my colleagues about stress at work and in families I have found myself thinking about how more and more of our work is with children and adolescents. It seems that stress is affecting everyone? Stressed parents equals stressed children, stressed managers a stressed workforce and stressed teachers stressed pupils so to end I guess I am thinking about just how useful it can be to think about the different roles you have in life - parent, manager, partner, friend, colleague, teacher - when you think of that role can you recognise stress and if so what impact might that be having on those who count on you?

28 - Sep - 2017

Article - Make sure depression does not destroy your relationship

Our latest article has been published in the Chiswick Herald click here or read below:

Make sure depression does not destroy your relationship 

In my work with couples it often comes to light, that at some point in the past, one of the couple has struggled with depression. Through therapy couples often come to realise that the way they responded at the time harmed their relationship. In this article I explain what often happens and what to do.

Depression often occurs after something has happened in a person's life that has been difficult to cope with. The struggle can be very tiring, resulting in low confidence and a circle of behaviour that only serves to lead to more unhappiness. 

It can have a terrible impact on how someone experiences their life on a day to day basis, symptoms often include a felt sense of low desire to undertake daily activities including work, socialising, exercise etc. It can have a debilitating effect and often be a very confusing experience for the sufferer and their friends and relatives. It can also have a significant impact upon partners and can often lead to the breakdown of relationships.

So what goes wrong? In our relationships we generally expect that partners support each other during difficult times and illness. So far so good! However the difficulty tends to come from failing to support partners in a way that recognises the needs of a healthy relationship.

All too often, the person struggling will most likely be experienced by their partner as withdrawing and this creates a dilemma. On the one hand the partner will be upset to see the person they care about struggling and want to help them, whilst at the same time they are also likely to be struggling themselves with negative feelings about how the relationship with their partner has changed.

To be upset ourselves when our partners are struggling can be difficult as judging thoughts can come to mind like indulgent, selfish, uncaring. We prefer to think that when things go wrong for someone we care about we will drop everything and put the other person first and that they will do the same for us. Whilst this expresses just how important our partners are for us it introduces a mindset that leads to thinking about “them and me” and not about “us”. So at a time when we both most need our relationship to be working well we tend to put it on hold, relegate it, not give it priority.

Quite simply if you are affected by the fact your partner is struggling then you need to look at it as information telling you that your relationship is struggling. If someone is unhappy in a relationship then it is an unhappy relationship and no matter how tempting it is to try and hide this fact from a partner who is struggling, ultimately that partner will not thank you for this further down the line.

So what is it that happens that causes the relationship harm? Usually the partner not struggling puts their needs to one side, they might miss their “old partner”, but they give them space, or their sex life but don’t want to impose, or being able to talk about their own problems. Unfortunately the denial of needs tends to have a habit of impacting upon us in ways we do not expect. 

Of course the struggling partner will be finding it hard to carry on as though nothing is happening but if that partner also loses the benefit to their sense of self that comes from being able to make their partner happy, then thats just another thing to add to their probably ever increasing list of failures. They might not even realise this so it is up to the supporting partner to remind them!

Unfortunately patterns get put in place whereby the supporting partner also withdraws and changes their behaviour with the result the way the relationship works is changed to such an extent that a time comes when neither recognise it any more. The relationship can be experienced as lifeless, dead, lonely. 

Couples can often avoid this for years, particularly if they have children, busy jobs, other interests etc but ultimately they become to realise that their relationship is no longer there for them.

Main points - 

  • Think about your relationship - it is not helpful to think just about your partner and yourself separately. 
  • Take a step back and think together about what you can do so that you can both feel as though you remain committed to each other
  • Even if your relationship is in a good place at the moment talk about this now - if trouble comes along you will have an agreed strategy in place and this will make it much easier to have the conversations that will help.
  • If you or your partner is depressed share this article with them and think about seeking couples / relationship / marriage counselling.
20 - Sep - 2017

Autism Spectrum Disorders - Trends and Therapy

 

Increasingly over recent years I have worked with patients where either they or their family members have Autism Spectrum Disorder (ASD) or other commonly associated conditions; some examples include ADHD, epilepsy, dyspraxia, obsessive compulsive disorder, dyslexia, Aspergers Syndrome.

I have also understood that for parents getting children assessed, statemented and into appropriate services the challenge has been getting increasingly difficult. BBC News article What is the provision for children with special needs? 2nd June 2016 states:

“Parents have long complained that they have had to battle to get the right support for children facing challenges with their education. The changes introduced from 2014 were an attempt to improve the system.

But many school leaders say they are struggling to offer adequate support for SEND pupils. A survey by The Key found 82% of mainstream schools in England said they did not have sufficient funding and budget to provide for these pupils”.

And a review of annual statistics from the Department of Education that present figures on the numbers of children with assessed Special Education Needs or SEN shows the percentage with an “Autism Spectrum Disorder” as having risen from 20% in 2010 to 26.9% in 2017. And the statistics coming out of the USA are even more alarming. According to the article “Autism cases on the rise; reason for increase a mystery” published on WebMD states that in the 1970’s about one out of every 2000 children had autism but now it is estimated that one in every 150 children at the age of 8 has ASD.

It appears that scientists are not entirely certain why diagnosis is on the increase. Is it because we are getting better at spotting the symptoms? Is it because the demands of our education and work environments has been changing in such a way that people with ASD are more easily recognised? Is it that more people are being born with ASD? But at the moment the exact cause of ASD is unknown, current thinking is that it may occur as a result of genetic predisposition, environmental or unknown factors. In essence no one knows at the moment.

However from my experience what is most clear is that people with ASD and its associated conditions, suffer in ways rarely understood by those that they come into contact with. At home, work and school they are punished, victimised, bullied and discriminated against and often do not get either the understanding or support that might enable them to live more fulfilling lives.

People may have ASD and associated conditions if you observe something that you think is different in the way language is used, how they respond to other people, how they interact, whether they avoid eye contact and / or they have a number of specific behaviours. For example, developing a highly specific interest in a particular subject of activity.

And in addition the difficulties people can have maybe compounded by depression and anxiety that comes about as a result of their painful and isolating struggle to live as they see others doing, to succeed as others do and to have meaningful relationships.

In therapy our work with people who have ASD and associated conditions has the same basic underlying assumption - as we get to know and understand ourselves better we are able to make better choices, be more skilful in our actions - in short know our strengths and weaknesses and increase our understanding of opportunities and threats specific to us as individuals.

As with all my patients, when working with people who have ASD the most important thing for me to do is to discard all my expectations of how I should experience this person. It is so tempting to come up with a list of things that someone else might do differently or better to improve their situation however my patients rarely make progress by being told what to do. I might make suggestions and offer guidnace however progress tends to come from them being able to explore how they experience life, what they see, hear, feel and think. Ultimately for them to come up with ways to improve and address the areas of life that they are finding most difficult. 

If you or a family member have been affected by the issues raised in this article there are many excellent information sources available. In particular I use www.NHS.uk and autism.org.uk.

07 - Aug - 2017

New article - Give yourself a summer mental health and wellbeing check up!

Our latest article has been published in the Chiswick Herald, click here to visit the site or read below.

Here’s how to give yourself a summer mental health and wellbeing check up!

Summer can be a great time to take stock. The disruption in our usual routines can remind us that there are different ways to live and this can be enough to help us make some simple but hugely important changes.

The summer holiday is for many people the one time when they feel they have earned the right to do what they enjoy. As a result it is a time when many things are enjoyed - some of which maybe vital for well being - but how can you decide what is vital and what is merely pleasure for pleasures sake? 

It is a natural tendency for us to let the things that support us fall by the wayside at times when the pressure of everyday life demands sacrifices. I use the word sacrifice intentionally because what I see people doing every day is “sacrificing” something. Firstly because there is a hope that some reward will follow and secondly because a sacrifice is mostly seen and understood as positive thing. Everyone has heard something said like “she sacrificed the best years of her live for  her children and see how they repay her”, or “he worked for them for years, put up with poor pay and now look at how he’s been treated”. It doesn’t change what has happened but it does position the one who has sacrificed as the one to be judged more sympathetically. 

In other words I think people can find themselves leading hard lives because they prefer to think of themselves as someone who sacrifices. And then of course people don’t sacrifice overtime for time with their families, don’t sacrifice promotion for staying in a job they are actually enjoying, don’t sacrifice the rush hour commute in favour of a yoga class, don’t sacrifice the hour they spend each day reading bad news for an hour listening to music, reading, walking, making love… A sacrifice seems to be about giving up something we find positive…

My point is simply that the judgements and beliefs we hold about the way to approach life will affect the way in which we make decisions and not always for the best! So use the summer holidays to give yourself a mental health and wellbeing check up and heres how. 

 

Think about and write down:

1. The things you do during your usual routines that you are pretty certain are unhealthy / unhelpful, the things you would like to change or improve for example, lose weight, drink less, exercise more etc. 

2. Your life when you are in your usual routines and without stopping to analyse/censure what comes to mind list the times when you have the most positive feelings/thoughts/bodily sensations.

3. When you get the most negative feelings/thoughts/bodily sensations.

4. How this compares to when you are on holiday.

 

Now:

 

1 Write down the three most significant things that you DO NOT feel compelled by when on holiday. For example “on holiday I do not feel under pressure to get everywhere on time” again do not stop to analyse or censure.

2. Again without analysing / censuring, write down what would need to be different for example, “I would need to start working part time”.

3. NOW is the time to allow yourself to analyse and censure your reactions to these changes - so list all the reasons why you do not think you can change.

This is the point at which you will see all your judgements and belief’s - ask yourself “what of the things I’ve listed here do I actually know, where does this come from and what evidence do I have that this applies to me and my life?”.

24 - May - 2017

A couple of common misconceptions about feelings explored….

Our latest article has been published in the Chiswick herald can be found here. Or please read below:

A couple of common misconceptions about feelings explored….

Is it wrong to have bad feelings when people die?

At a funeral I went to last year the priest spoke about how loss might bring up sadness, loneliness, depression and shock. The difficulty for me in hearing these feelings listed was that it led me to think that we were being told that only certain feelings are appropriate; ones that suggest we had a relationship with the deceased that was wholly positive? 

In reality bereavement can bring up many difficult feelings both about the relationship someone had with a person who has died and the fact that the person has now died, for example, these might include angry, vindictive, hurt, hostile, relieved, excited, numbness etc.  It was only at the wake afterwards people appeared to find themselves able to start to acknowledge the more authentic nature of their relationship with the deceased, for example to be able to say something like “I could get so annoyed with her because she used to be so stubborn” or “I could feel so disappointed because she could be so judgemental”. Even then I found myself wondering about other thoughts and feelings that remain “secret”. For example, people can feel relieved when someone dies but then feel guilty that they have that feeling of relief.  

As psychotherapists, when counselling we so often have patients where part of the struggle is because they have feelings that they think are wrong or inappropriate. That means we often have to deal with the persons feelings about their feelings before we can start to work on the underlying feelings themselves. 

So whats the answer? Firstly to accept that when things happen to us then the feelings, the types of feeling and the strength of feelings or even the absence of feeling are a reaction over which we have no control and no matter what we think of them they are all appropriate and justifiable. It is the actions that we take in response to feelings that can be problematic so instead of being concerned about the feelings and trying to control them, pay attention to them instead, question them, try and understand them and then think about what you would like to do.

Do you ever say (or think) “You are making me feel….”?

This is something that I think most people will find themselves saying at some time or other. For example, that person who you have told numerous times not to be late is late and you say to them (or think) “you are always late and you make me feel so annoyed!”. But of course the annoyance is yours and it is most likely because you have again fallen into the trap of expecting a different outcome? After all it is not really a surprise that they were late. So what is the annoyance? I suggest it is annoyance with yourself and because we like to try and get rid of negative feelings as quickly as possible we can mistakenly expect the best way to deal with them is to allocate them on someone else.

Because our feelings appear so powerfully to us when someone says or does something that generates a reaction, and because it is also usual for others to quickly think we are the source of their feelings, this basic notion is almost hardwired. However this misconception does not help us, because the way in which we respond to people and situations is a uniquely personal thing based upon a range of factors including our life experiences, expectations and cultural norms to name a few. And the proof? Can you say you never witness different people responding differently when in the same situation? It is a common phenomena that when there is an incident, police witness statements typically contain very different accounts of the same incident. And what about all the times when you have found that your explanation of someones behaviour is different to someone else’s? 

The reason why this is so important is that you can change your way of thinking so that you see your feelings as YOUR response to a situation or person. And when you do this you can consider what those feelings are telling you about yourself and how you are living your life. Back to that person that is always late, now you are no longer putting the responsibility for your feelings on them what do YOU want to do about avoiding either the situation or the feelings next time?

 

If you would like to speak to a counsellor for help and advice please don't hesistate to get in touch