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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.

 

Read all posts by Nicholas Rose Posted by: Nicholas Rose on January 27th, 2018 @ 10:58 AM
Tagged with: counselling jobs psychotherapy jobs

 
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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.
 
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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.
 
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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?
 
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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.
 
Comments (0)

 
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.
 

Read all posts by Nicholas Rose Posted by: Nicholas Rose on September 20th, 2017 @ 12:39 AM