depression
Working Through Inner Conflicts with Talking Therapy
Lived experiences of inner conflict often generate emotional turmoil, characterised by intense feelings of doubt, anxiety, and tension. The contradictory thoughts and desires within us can create a sense of ambivalence, making it challenging to make decisions or take action.
While inner conflicts can often be distressing, they also present opportunities for personal growth and development. Through introspection, self-reflection, and seeking external support, individuals can work towards resolving these conflicts.
The lived experience of depression
Do the simplest of tasks feel impossible? Do you often feel overwhelmed, hopeless, and isolated? The lived experience of depression can vary from person to person, but there are some common themes that emerge. One of the most challenging aspects of depression is the feeling of isolation. People with depression often want to withdraw from the world around them and feel disconnected from their friends and family.
Feeling fine or feeling F.I.N.E?
So how are you and your loved ones doing?
A great place to start is with this very question. We are really used to asking this question, the problem is that it is often used as a greeting as opposed to an actual enquiry and then we are not always ready or equipped for the answer the question might bring. I’m sure we all have experience of answering or hearing ‘fine’ to this question where rather than the adverb meaning of ‘very well’ it might be more easily understood as an abbreviation such as Frustrated, Insecure, Neurotic, Exhausted.
Friendship as a Theme in Therapy
Friendship so often appears as a theme in therapy. Sometimes people come for therapy talking about loneliness and isolation specifically in relation to friendship whilst at other times people are experiencing isolation and loneliness, struggling with a concern in life alone, not because of a lack of friendship but because they choose not to talk about worries with their friends. Meanwhile sometimes friends, determined not to lose a friendship come to therapy to try and work through a concern they cannot resolve alone.
Dissociation and Dissociative Disorders and Therapy
If you are struggling, does your experience include not being able to remember things, feeling uncertain, noticing that you have a reduced response to things that ought to feel more painful? Does your experience make sense through the words disconnected, removed or outside of yourself, others or the wider world? Do you think of yourself as though you are or could be a different person or people depending upon the situation or do you experience another presence or presense? Maybe you experience life as if through a haze or mist and or can find yourself somewhere not knowing why you are there or how you got there? And thinking back to before you had this experience were you stressed?
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:
- 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.
- 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?
- 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?
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.
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.
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.
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.
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 -
- 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.
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?
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.
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?”.
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.
How does that make you feel?
Our latest article has been published in the Chiswick Herald, read it here or see below:
How does that make you feel?
I’ve been listening to this Radio 4 series where you hear psychotherapist, Martha, in sessions with patients. The first thing I found myself wanting to do was find out whether it is classed as a drama or a comedy - I was relieved to find that opinion by reviewers appears divided, that it is not seen as pure drama or an attempt to depict therapy in real life.
But ask me how I felt about listening to “How does it make you feel?” and my answer is disappointed and feeling less confident that therapy is being understood and embraced - you find me disheartened.
The title itself set alarm bells ringing for me. I can’t claim to never ask my patients “How does that make you feel?” because sometimes I might, but therapy is not just about getting to people to talk about their feelings. It is a common misconception which does nothing to encourage people to view therapy in a positive light. It’s not the only misconception, others include that people need to talk about their feelings, that men in particular are less likely to talk about them than women and/or it is a British thing not to talk about feelings. The problem with these concepts is that they put across such a simplified view of people and therapy that for anyone struggling, therapy might be seen as nothing more than a placebo.
In reality therapy addresses how we make sense and act upon the information given to us by our lived experience - feelings are just one element. Information is also available to us through our thinking, our bodily sensations, our dreams and our interactions with others and the world around us. There is no rule book as to how much importance we should give to each of these components but in therapy we work with our patients to identify how life is being understood and how this understanding is put into action. We then look together at the struggles that have brought them to therapy and look for connections and solutions.
So it is not just about feelings. It is also not just about being able to talk about feelings because research indicates that as little as 7 percent of communication is verbal - body language and tone of voice being far greater conveyors of information. It is natural for us to embody how we are and what we want and for us to understand how we do that but also how other people, especially those who are most important to us, is hugely valuable.
And it is important to remember that therapy is about understanding ourselves AND others. When we improve understanding of ourselves we can be better at understanding others, likewise when we better understand others then that helps our understanding of ourselves. As an aside, and something that probably merits its own article is my view about short term therapy - often thought of as “counselling” (longer term therapy is often thought of as “psychotherapy”) - in short term therapy I think people often start to see themselves in a new and more helpful way in a relatively short period of time however problems can start to appear in their relationships because the therapy finishes before it is integrated across all areas of a persons life. I regularly meet couples where misunderstandings and conflicts have only become more frequent and problematic after one or both partners have been to individual counselling.
Anyway back to my other thoughts about the Radio depiction. I also wasn’t surprised but I was disappointed that this series also seems to promote the misconception about men because three out of the four patients were men! Finally and most crucially I was saddened to think I heard the therapist as being at times tired, irritated and frustrated amongst other feelings with her patients. For me, I view therapy as a collaboration between therapist and client, an agreement to work together, it is a commitment by both of us to undertake a vibrant, energetic, stimulating exploration. It is a project where neither therapist nor patient can know what will occur, but where both agree to try because good things can come when we give something our best efforts and attention. Unfortunately with Martha I was not entirely convinced this was the case, actually I was wondering whether she might benefit from a sabbatical? And I wonder if future productions might possibly capture some of the wonders of the therapeutic endeavour that so many therapists and patients work so passionately to achieve?
“How does that make you feel?” Series 8 is currently available on the BBCRadio iPlayer.
Mental Health Round Up
Our latest article is being published in the Chiswick Herald newspaper and online here. Or read below:
Mental Health Round Up
It has been a very busy few weeks in mental health and it is heartening to see so many people agreeing it is time for mental health concerns to shake off stigma. The charity led by the Duke and Duchess of Cambridge and Prince Harry, Heads Together aims to encourage people to speak out when they are struggling.
Of course it is part of our experience of being alive that we have an internal and private world of thoughts and experiences that we do not routinely share with others. So how can we know whether we have a concern which needs attention?
At the present time it still seems that only in certain instances can it be accepted that someone might struggle with their mental health; so people who have experienced life changing trauma or those who through a number of factors are diagnosed with a mental health condition. It is also still a harsh reality that only if someone’s “presentation” fit with a recognised “condition” will their struggle be seen as genuine and treatment be provided through health services. Further with all the gaps still existing in the science around mental health we cannot yet be clear about whether existing treatments are in fact effective treatments.
All so called “mental health conditions” (still widely thought of as illnesses) are not identified by the presence of viruses, bacterias, infections, tumours or fractures etc but rather by observed “experiences”. PTSD, ADHD, Depression, Schizophrenia, Bipolar, Anxiety Disorders, Learning Difficulties etc are all identified through observation and judgement. The authors of the worlds most widely recognised diagnostic publication the DSM (Diagnostic and Statistical Manual of Mental Disorders) have stated that they are concerned that science has not yet been able to validate the categories of conditions it contains.
If you cannot be completely certain about the problem how can you be completely certain about the treatment? And if the treatment is not correct what might the implications be for the patient? For example, in the UK it has been identified that young black men are much more likely than young white men to be diagnosed with schizophrenia and no underlying biological cause has been found. So I think that a system that only treats and recognises “conditions” may be as effective at preventing people seeking and getting help as it is at encouraging treatment.
Indeed in response to my article published on the 24th February “What causes mental illness?” where I reviewed a seminar I had attended based upon a book by RD Laing and Aaron Esterson called Sanity, Madness and the Family, the seminar convenor, Anthony Stadlen wrote:
“I think the title is a bit misleading, as the whole point of the book, as I try to explain in the seminars, was to question "mental illness" and "schizophrenia", not to ask what "causes" them. The very first sentences of the Preface to the Second Edition were:
"There have been many studies of mental illness and the family. This book is not of them, at least in our opinion. But it has been taken to be so by many people."
I think this whole question is really important because the gaps in scientific understanding can mean only one thing - we need to look to ourselves and how we experience our lives and decide whether we need to make changes. So back to the question I posed at the start of this article - “How can we know if we have a mental health struggle that needs attention?” Firstly, if people who you are close to say they are worried about you or have noticed that you do not seem to be your old self then take some time to think about their feedback, ask them to give more detail and if you are unsure whether they might have a point then go and see someone to talk things through with. Secondly, if you wonder whether you are struggling then again go and see someone and talk things through. Be as kind and careful with yourself as you would your best friend!
New article - Latest advances in treatment of anxiety and depression coming out of the USA
Our latest article has been published in the Chiswick herald please click here or read below.
Latest advances in treatment of anxiety and depression coming out of the USA
I have just returned from the annual Anxiety and Depression Association of America’s annual conference. The Association is a huge organisation that aims to improve patient care by promoting the implementation of evidence-based treatments and best practices. The focus of this years conference was “wellness” and aimed to present the latest research findings coming from neuroscience and treatment.
I have for some time been interested in what neuroscience is able to tell us about how the brain appears to work differently when there are particular concerns such as anxiety and depression. For example, studies have shown that the practice of mindfulness appears to have a direct impact upon brain activity and the reduction of anxiety. And it is becoming ever clearer that “disorders” occur when there is some disturbance or interruption between the alarm raising part of the brain - (the amygdala) and the processing or thinking area - (the prefrontal cortex). But we still do not know whether the disruption is in the connection from the amygdala to the prefrontal cortex or from the prefrontal cortex to the amygdala; or a combination of the two. It also seems as though opinion is leaning towards the view that such disturbances occur following some kind of “trauma”, either event driven or biological. However this cannot be definitely stated.
In the therapy profession the behavioural community do tend to be more interested in research than practitioners in the other disciplines and so cognitive behaviour therapies or “CBT” have a bigger base of research evidence. As a result service provision organisations like the NHS tend to lean towards offering these services as they are easier to justify from a financial resources perspective and offer monitoring opportunities. Of course the absence of research from other types of therapy proves very little except that those practitioners do not see a need for research.
But research on outcomes from therapy generally conclude that the single most significant factor determining a positive outcome is not the therapeutic model or approach but the quality of the relationship between the patient and the therapist. The major issue here is that researching “relationships” and monitoring them is far more complex than therapeutic tools and techniques and so the focus is unlikely to change any time soon.
My experience tells me that what people need more than anything else is to meet with someone who they feel cares for them and is passionate about wanting to understand their particular concerns. Such an experience is helpful because the person won’t feel the need to justify themselves and can instead think clearly with another person about their situation and what they can do about it. But I also find that people make sense of their situations in different ways, some people are analytical, some clear about their feelings and others like to think through things. When someone is struggling it is likely that they may need to adjust the emphasis they put of the way in which they make sense or not of their problems. Sometimes people ask for CBT and then want to spend their time speaking about their past, whilst others may say they want to talk about how they feel but spend their time looking for solutions. So what does this mean for anyone wanting to seek help with their psychological well being?
- Keep in mind that all mental health conditions have been developed by grouping experiences and are not like physical health conditions that can be diagnosed like viruses, infections or fractures.
- We still don’t know whether conditions are nature or nurture or both
- The expectation of trauma can be misleading and sufferers can fear that their condition must exist because something has happened to them that they have no hope of coping with
- Chose a therapist with whom you feel comfortable - someone with whom you find it easy to speak openly with.
- Remember you are in charge and give feedback to your therapist to ensure you get the best possible outcome.
New article - reduce stress and anxiety FAST
Our latest article on reducing anxiety has been published in the Chiswick Herald, please click here or read below:
Reduce stress and anxiety FAST
Below are five things to think about to make you feel calmer:
- Are you taking things too personally?
We get upset with other people when our expectations are not the same. There is nothing wrong with expectations as long as you recognise them for what they are - our humanly attempt to reduce our anxiety about living. We try to reduce our anxiety by finding meaning and purpose and with this we form personal views based on all our experiences of living. What we have liked and not liked is fed into developing our personal framework of what we think is good and bad - it sets our expectations and our opinions and these become what we believe to be true about life.
When we come into conflict with another it is because our “truth” does not agree with their’s. We don’t want to think we might be wrong because that undermines our confidence in how we make sense of our lives, so it is natural to defend our “truth”. When we defend we come into conflict and this often causes more conflict.
Conflicting positions present us with a challenge so instead of getting angry try to think about conflict situations like this:
“I am right, but only for myself. The other person is also right, but only for themselves. We are in conflict because we are both anxious to be right.”
- Are you aware of how your time of life is affecting your stress levels?
Because we are so busy living our lives we tend to forget to take stock and think about just how much stress might be coming from our stage in life. Adolescence tends to get most publicity as it is the most easily recognisable - due most likely to its nature of being condensed into just a few short years - but differing pressures are with us throughout live. Relationships, careers, financial security, our health, families, retirements, redundancies, bereavements all bring pressure to what we do everyday. Stages often talked about are coming of age, leaving home, leaving university, 30, 40, 50, 60, empty nests, loss of parents, retirement…..
So if you are stressed and anxious think about the people you love most and think about how they put pressure on themselves and how you wish they would just relax. And now think about where you are in life, what disappointments have you carried from previous times, what impact might these be having today? What are your hopes for the current time and how are you doing with your plans? And what do you want for the future? You might find yourself tempted to start writing lists but maybe you could try to think like this:
“I am right to feel under pressure given everything I want for my life, it is what everyone does. I am anxious just like everyone else”
- Are you seeking perfection?
Do you describe yourself as a perfectionist? Or do other people see you as a perfectionist? It is natural to want to get things right and as the above questions show anxiety comes from expectations and standards. To be a perfect human though is to make mistakes - if you want to be a perfectionist then don’t strive for perfection. Another way of looking at things is to try and aim for good enough in all things rather than seeking perfection in some areas at the cost of others. You might like to think like this:
“To be perfect requires imperfection, my imperfections make me perfect.”
- Are you colluding with your anxieties?
Think about all the things that reduce your stress. Think of times when you have felt least stress, places that induce calm, people with whom you feel relaxed, ways in which you can release stress. Excellent you have just completed an exercise in not colluding with anxiety. When you feel stressed or anxious it will affect how you make decisions and not necessarily for the best. Feeling calm and level headed is a good starting point for decision making. So try thinking like this:
“Of course I WANT to think about the things that are stressing me so what I NEED to do is think about all the things that are not stressing me”
- Are your taking care of yourself?
A great way to turn yourself away from stress is to develop a kind mindset towards self care. DOING taking care of yourself is a great way to reduce from stress and anxiety that arises from THINKING about looking after ourselves. Recent research has shown that just putting one foot in front of another reduces stress, anxiety and depression. So when it comes to exercise, nutrition, finances, relationships, careers, hobbies, spirituality you will feel better just by putting one foot in front of the other. If you are still struggling with your thinking try this:
“To feel better I just need to approach everything with the aim of putting one foot in front of the other.”
We hope you have found this article helpful but if you have been experiencing anxiety for a prolonged period then we advise seeking professional help. In addition, anxiety and stress can also come from underlying health issues so if you are suffering from stress and anxiety symptoms we always advise you check out your health with your GP.
New article - Happy relationship, happy children?
When couples with children come to therapy one of their biggest fears is that any trouble in their relationship might be affecting the children and often guidance is sought about how best to protect them. The bad news is that such fears are well founded, the good news is that there are things that can be done. In this two part article we will talk about how to approach difficult situations, highlight warning signs and suggest ways for handling them constructively.
First of all you need to complete a thorough assessment of your relationship to be clear about what the concerns might be - a clear understanding of how you are in your relationship will enable you to think more clearly about the times and situations when things may be problematic and when your children might be affected.
So thinking about your relationship - are you happy with it? Do you always say whats on your mind? Do you feel listened to? Do you feel understood? Do your needs get taken into account? Is your relationship as strong as it has always been? Do you think your partner is happy? Does your partner do the things he or she used to enjoy? Do you laugh together? Do you enjoy your sex life? Do you have lots of happy memories together? Do you look to the future together with a sense of excitement?
If you are starting to identify think about some problem areas try and be as clear as possible about what you have noticed. Avoid conclusions like we are so loving anymore - instead identify behaviour for example we don’t have date nights any more. Once you have identified behaviours, think about when the behaviour change happened. What was happening in your lives at that time, what was the impact of events, what was discussed at the time and were issues resolved? Even if you were happy with the way things were handled, was your partner? Have you ever checked in to see if your partner was happy? Thinking about any unresolved issues, what happens when situations arise that remind either of you of it? How do you handle it? What is the impact of it? What gets said and what does not get said?
By now you should have a good idea of the situations, contexts and times where conflict may exist. Even if you feel comfortable with the problem areas identified and think that conflicts are manageable between yourself and your partner you may want to think about whether there is anything to address with your children. So the second stage is to now think about your children.
Bringing conflicts to mind what do you think your children would say, think and feel about them? Do you remember anything they said or how they reacted? Did you understand their reaction? Did you explore with them what they wanted from what they said or did? Has their behaviour changed at home, at school or with their friends and how do the changes correspond with changes in your relationship? Has their relationships changed with you, your partner, other family members and relationships?
If you are starting to think about times when things were difficult and finding yourself worrying about whether you handled them in the best way then the very first thing to do is to stop that negative train of thought. Instead congratulate yourself for your courage in giving this some thought and look at this as merely a stepping stone to improving things.
A relationship without conflict is unlikely to be one where those in the relationship are fully engaged so it can be really helpful to remember that intimacy can come from conflict in as much the same way as through good times! Conflict shows the existence of care and what is important is that it is handled in the most skilful way. The problem for children is that they often only see the negative situations and may start to worry about what might happen or even, in situations where parents have resolved a conflict not know for certain that is the case and suspect that worse is still to come.
In our next article we will look specifically at what to do now.
New article - Keeping yourself and your family safe online
Our latest article has been published in the Chiswick Herald, click here to visit the site or read below:
Keeping yourself and your family safe in a world of online communication
It is becoming clear that whilst the legal landscape is changing to try and keep up with the online communication revolution, ultimately our safety is dependant upon our own abilities to decide on the most skilful way to use new technology.
In this article Nicholas Rose suggests some information sources that provide valuable information about safe use of the internet and social media but also suggests how to most skilfully use them.
The wonder and the horror of online communication is its scale, immediacy and permanence. There is such a vast world of people and issues available online that we can engage with instantly however any mistakes are recorded and once information is out it can be impossible to retrieve it. What we do and say has consequences and so we have to develop skills and experience to ensure that we minimise the risks of being misunderstood and maximise our understanding of the things and the people with whom we engage.
It is obvious that new technology is providing new ways for criminals to steal, abuse and violate and an excellent website giving detailed information on security and safety is www.getsafeonline.org however here I want to look at how we can judge what is going to be the most skilful use of technology for us individually. And when I say skilful I mean how we ensure it is harnessed for positive benefit, enabling us to engage with subjects and people who can enrich our lives and how to avoid those that might be to our detriment.
So when I am talking about safety it is not just about physical, financial and psychological safety its about protecting our full potential. If you are parents then again there is lots of great information, even by age range on the above website but your children will still benefit from you teaching them how to be skilful in their use!
We live in a world where lives can be ruined by a seemingly simple mistake and so often we hear people being accused of “poor judgement” and this can have a devastating impact on someones life. Ultimately it is poor judgement that leads to us making mistakes, of course mistakes can happen but given the power of social media and technology what can we do to avoid them as much as possible?
- Boring as it might be do the research and read up on what best practice is for protecting yourself online.
- Think about your strengths and weaknesses in life - finances, relationships, health, parenting and then think about the benefits social media and technology can offer but also identify areas where you might be more vulnerable.
- Think about the experience of communicating and engaging with information and people and how this varies across situations and media.
- So what is it like for you to be with family, friends, colleagues in face to face situations - how does it vary and why?
- What is your preferred way of communicating in different situations and with different people and why? Face to face, telephone, text, facetime/skype, email, social media….
- So with whom and in what situations do you feel most at ease and in which do you feel least at ease?
- Can you now identify the people and situations in which you may struggle to communicate and those where you will find it easiest?
In guidance I have read it often says to notice how you feel and think in response to content or communications to see if they bring up any negative feelings or thoughts. The intention here is to encourage people to listen to the very good warning systems that we have but can so often dismiss. However, I also suggest looking out for very positive feelings or thoughts - whether we are nervous or excited such feelings can influence our actions and awareness of these feelings can be used as a signal that we may benefit from exercising some caution. Look out for your reactions both positive and negative and when you are aware of them consider the following:
Think about how you are feeling and ask yourself whether those feelings appear logical given the context. If you have no feelings or very strong feelings either positive or negative then try and take a step back before offering any information or entering into any further communication; try asking yourself:
- In what way is this material / content / communication triggering these feelings - what assumptions am I making and what are the other possibilities?
- What do I want to do or say now and what might the consequences be?
- If I put myself in the other persons place how might they interpret what I do or say right now and what might result?
- What am I wanting from this situation and what if I don’t get what I want?
- Am I feeling under any pressure here and what is the source of this?
- Thinking about past situations are any similar - do I have a pattern of behaviour that can be unhelpful and is this an opportunity to change it?
If as a result of this reflection you are left with any sense of doubt or dilemma then think about taking a step back to give yourself more time. Consider doing something else and going back to it later or ask someone else for their views.
New article - Depression how to think about it and how to recover from it
This article appeared in the Chiswick Herald. Please click here or read below:
Depression - how to think about it and how to recover from it
News reports last week covered research showing that 25% of architecture students in the UK are receiving or have received treatment for mental health problems related to their studies. Unusually this study sought to identify the sources of the distress and was able to list a number of factors - importantly all of these were outside of the students control.
It is often rightly stated that a stigma exists around depression and other mental health illnesses. However the point that often gets missed is that one of the biggest blocks to sufferers in recovery can be their own attitudes to both mental health and themselves for experiencing mental illness. It is really common for people to feel upset with themselves for struggling and to try and almost bully themselves out of their feelings. Unfortunately this tends to result in sufferers feeling even worse and they can become stuck in a vicious cycle of thoughts and feelings.
This research amongst students suggested that financial pressures, workloads, working conditions and sexual and racial discrimination were all serving to damage the mental health of one in four of these students. And as I have written previously, it seems that the mental wellbeing of students and employees in the education sector has been overlooked for some time. So much focus os put on results and processes with little emphasis on wellbeing.
So research like this is really important because it shifts focus when someone is struggling. Instead of questions being raised around how the person is coping (or not coping) with the inference being that they are not doing something right, it can be directed at looking and considering the context in which the person finds themselves.
We know ourselves through our relationships with others and yet when we are having a hard time, it can be really easy to conclude that it is only us that are finding things hard. I wonder just how surprised but also relieved architecture students were when they read the findings of the research? For many I suspect they will have felt intensely relieved, not that so many others struggle but that they are not alone. And more importantly the cause of their depression and anxiety is not simply themselves.
Getting a comprehensive understanding of the issues someone faces and the context in which they live and have come from is crucial in getting to grips with depression. Before anyone can start to recover they need to discover some hope in the potential for them to lead a life without such painful and overwhelming feelings, or as is often the case with depression absence of feeling. And hope comes from the realisation that the depression is only natural given where they find themselves in life, that it is not that they are doing anything wrong but the contrary, that it is only right that given their circumstances they can feel as they do.
Being able to make the connections that makes sense of the experience starts a process whereby positive connections can start to be made. Ways in which the sufferer can start to do things differently, take control, build confidence and distance themselves from the illness and increase their sense of connection with the world, others and their ability to find life satisfying and rewarding.
Again though, during recovery one of the biggest hurdles can be a persons impatience with their recovery. The desire to get away from the experience of depression can be so powerful that they can be vulnerable to almost addictive behaviours. Exercise can be a good example of this, the physiological feelings and rewards available from exercise can lead to addictive behaviour and ultimately this can act to sabotage recovery.
To prevent this it is important to spend time to reflect on whats happening, the changes being experienced and to consider the consequences of decisions moving forwards. It is a common phenomenon that people who appear to be on the point making a full recovery make a decision that can have devastating results. In fact suicide risk can be greatest for people who appear to be in recovery than those in the depth of their depression.
Mental illness is such an unpleasant experience for suffers and their loved ones that it is only natural to try to avoid dwelling on difficult feelings and to want to look forward and focus on the positive however taking time to think about how things are going and how to maintain momentum whilst allowing set backs is crucial.
If you or someone you know is suffering from depression then consider seeking help. A counsellor or psychotherapist will have the right skills and experience to help understand the depression, its causes and then provide support through the entire recovery process.
Patients often ask me how long it will take, how many sessions will be needed for them to recover. My answer is always a simple one - we know we are finished when we no longer have any concerns that are usefully talked through.
Nicholas Rose
Nicholas Rose is a psychotherapist registered with the UKCP working with adults both individually and their relationships.
