There’s something about anxiety right now (2017)

stressBoth the West and the UK as a nation have had a difficult couple of years – from terror attacks in major European cities that many of us know well, to the Brexit vote and result, quickly followed by the political fall-out and Trump’s control of the USA. Just when we thought it couldn’t get worse, terror came back to the streets of the United Kingdom in the middle of yet more political uncertainty during the 2017 general election. Then, most recently, we witnessed the unprecedented loss of life in the Grenfell Tower horror.

For most of us, these events are stories we digest through the various forms of news and political and social media coverage – something happening in the outside world, well away from us. But these events have been quite triggering for people with worked-through and unworked-through trauma in their life stories.

At my own practice, contacts from people experiencing anxieties appear to have risen dramatically since the June 2016 Brexit vote; 2017’s events have done nothing to quell this near tide.*

Anxiety can be an extremely difficult and life-restricting thing to experience or have to live with. The professions of psychiatry, psychology and psychotherapy have created many working models of anxiety and many labels with which to subdivide or associate types of anxiety. Social Anxiety, Panic Disorders, Obsessive-Compulsive Disorder (OCD), Post-traumatic Stress Disorder (PTSD), Acute Stress Disorder and Generalised Anxiety Disorder form the kaleidoscope of disorders humans feel when anxiety gets overplayed and out of hand. And yet, anxiety is a natural thing to experience. Indeed it is the body’s response to danger. You can think of it like a monitor or alarm that is set to be triggered if you are put in the position of feeling threatened, under pressure or when you are facing a stressful situation.

In small amounts, anxiety is often a very good thing and in some situations it can even be the thing that saves your life. However, get too much of it happening inside a human being for too long a duration, and it can cause problems with pretty much any area of your life. At that point, we start to think of it not as a friend that can help us to feel alert, motivated and push us into action, but as a disorder that can control and even ruin our life.

If you find that you have – in addition to the primary anxiety symptoms of irrational and excessive fear or worry – other common emotional symptoms such as feelings of dread or apprehension, vigilance for danger signs, expectation of the worst, difficulty with concentration, feeling irritable or tense and jumpy, or that you experience mind fade (where your thoughts just go blank), then it might be time to think about taking steps to talk through your anxiety issues with a professional or, at the least, take some positive actions which might include things like mindfulness practice or regular exercise. And, if you don’t feel like being confined to a room to work through your issues with a therapist, then you might want to consider taking your anxiety to an outside environment with some walk and talk therapy – such as the type I offer within my Cambridge or Bristol practice.**

* There has been a reported five-fold increase in traffic to the Mental Health Foundation’s online anxiety page since July last year (Therapy Today Magazine May 2017)

** Walk and talk therapy will be the subject of a future post on this blog site.

The right to choose more than black and white

ThinkingBlog

Recently, I had a long and exhilarating conversation with a male colleague who had sought to challenge some black and white (binary thinking) by making a particular job application. We spoke the day after his application had been turned down on the grounds of occupational requirement – this is a circumstance where it is lawful to be treated differently due to your sex.*

One of the reasons it became such a meaningful conversation is that the failed application appeared to raise so much detail about the way humans get locked into simplistic or binary thinking. Take, for instance, the complex sociopolitical situation the UK has become embroiled in since Brexit first reared its head. You don’t have to look too hard to have seen numerous examples from both the ‘in’ and ‘out’ camps of over-simplification and binary thinking. Such debates perhaps underline that the world is a complex place but that our actual ability to cope with these complexities is limited. Maybe it’s best to see that, in seeking simple solutions, we largely ignore or hide the complexities.

After my conversation with my colleague I was left to consider something I have lived with the whole of my psychotherapeutic career – the fact that women who you might expect to want to work with another women often choose to come and work with a man instead.

Simple and binary thinking might lead you to imagine that a woman who has lived in a coercive or abusive relationship with a man would only want to work with a woman. Similarly, if you are female and have been raped by a man, then it might be expected that you would only work with a woman. However, as we have already discussed, the reality is that the real world is more complex. While it might be that many women feel far more comfortable working with a female therapist, some women make different choices. Some women – especially those who have also suffered at the hands of other women – actually need to work with a male therapist. It might be that to work in a safe, secure space with a trained, registered and accredited male therapist can offer certain women the opportunity to begin to work towards trusting men again.

On numerous occasions during my career, I am glad to have been prepared and able to offer to be a trusted man in the repair work women have undertaken. I just wish that all therapeutic and support organisations would consider getting their palettes out, mix the black and white, and do some ‘grey’ thinking by offering the opportunity for women who need it their choice of gender for their recovery.

*https://www.equalityhumanrights.com/en/advice-and-guidance/sex-discrimination

Everything has still to be learned

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On a wall in my consulting room is stenciled, in 2-inch high letters, a quote from C G Jung: ‘Let no day pass without humbly remembering that everything has still to be learned.’ The quote, which was first offered to me by my Jungian analyst during my own twice-weekly encounter in the late 1990s and early 2000s, made its way to my wall six years ago when I moved into my current workspace. It had, by then, become a mantra for me in my professional and personal life.

I’m aware that the simple idea of never-ending learning that the quote suggests has often been the inspiration for my writing of this blog; see, for example, Crying has an upside for men and women alike, On being ignored forgotten or abandoned and What are you living for now. When we really begin to look for learning in our lives we can be surprised just how much opportunity there is to do so.

While it is obvious and common that people think about therapy as being focused on re-working, understanding and narrativising (for example, past traumas, anxieties, bereavement, loss or depression) or that counselling and psychotherapy help us to move through issues like understanding communication or sexual difficulties as a couple, a simplifying, alternative view is that a surprisingly large amount of therapy is done around learning things. Of course, this learning is not in the way we learn in an academic institution but, nevertheless, therapy is about learning. In the unique non-partisan confidential space of the therapy room we might discover and learn how to look after ourselves better or we might learn a new way to look at a difficulty or problem. With the help of therapy, we might even be open enough to learn new things about old stories or patterns of behaviour; we might see that we can still alter the way we see ourselves within a relationship or perhaps in relation to a past situation.

In part of my professional life – working with sexual addictions – I am even more taken by the learning that therapy becomes. One exercise I use to help addicts become more aware of their behaviours, which I call ‘Stop Moments’, is a task focused on seeing the world in a different way. You ‘stop’ and find something to see in a way that you haven’t before. When people begin this special sort of observation, they often find themselves monitoring the movements of an insect on a window frame or watching a raindrop slide down a pane of glass. Later on in their therapy, I get to hear about wonderful and special moments that people find for themselves. These observations enliven the process but, more than that, they make me certain that therapy is created in a very individual way. Importantly, it continues to remind me, as the therapist, that I too still have everything to learn about a process I have been involved in for more than 20 years.

On beginning to change your life: the first session

blogfirstsession‘Signing up’ for counselling/psychotherapy can be a big move? It may even turn your life around in ways you hadn’t thought of. So it’s wise to consider a few things before, during and after your initial session.

Many people looking for a therapist do an initial search online. Others look through a directory. And yet others may be given recommendations by friends or a GP. However you ‘find’ a therapist, you may still wish to run the following checks.

First, your new therapist should, at minimum, be registered – if not also accredited – with a respected professional organisation such as the BACP or UKCP. (Psychologists should be graduate or chartered members of the BPS.) You should also read their website carefully to check they have the experience of, and feel comfortable working with, your general/specific issues. (This is particularly important in areas like sexual difficulties, as few general psychotherapy/counselling trainings offer enough input in this area.)

You shouldn’t be persuaded that someone is a good therapist because they have a lot of letters after their name. Studies suggest that once core requirements of education and training have been met, the effectiveness of the therapist is not dictated by their qualifications; indeed, research indicates it is the quality of the relationship between you and your therapist that can have a huge positive influence on the outcome of your work together.*

Remember also that, with personal recommendations, what works for one person may not always work for someone else. There is still a ‘goodness of fit’ to consider.

And so, having selected a therapist who you believe will be a good fit for you, the next step is to chat to them – through Skype, email, text or telephone call – and, if it still feels like a good fit – book an initial session.

***

So what can you expect at your first session. If your therapist works for an organisation, your initial session might be quite prescribed. You may have to fill in the organisation’s routine forms and even complete questionnaires or diagnostic tools. However, in a private practice situation, where the therapist works for themselves rather than an organisation, things might be a little more personal and relaxed.

In my own practice, for example, I like people to spend a moment or two getting comfortable on the sofa. It helps me to know how difficult it is for the person to be in the room with me at the start of it all. I often ask people how anxious they feel about coming along for this session – something simple like: ‘On a scale of 1 to 10, where 1 is low and 10 is high, how anxious do you feel right now?’ Perhaps people don’t always tell the truth – a little in the manner that doctors can’t always trust patients to be honest about the number of units of alcohol they drink in a week – but it gets us started. (By the way, the usual ‘anxiety score’ is around 8. Also, people who have had some counselling or psychotherapy before often find it easier to be in the first session with a new therapist.)

Quite often, we might then go on to talk about how odd it is for two strangers to meet in a room, knowing little about each other but being there with the intention of talking about some of the most challenging areas in one of those two people’s lives. I make no secret of the fact there was a time when I, too, needed the help of therapy. I might use that at some point in an initial session if it helps to build a bridge. After all, most of us understand things best when we know something about it – and sometimes going through a process is the best way to find out.

When you’ve said a few things about your issues and discovered that the therapist is a human being, just like you, your anxiety can fall a point or two.

As the session goes on, people begin to sit back on the sofa. They pick up a bottle of water, which I always have available. They might even check out the tissues. In short, they begin to dial into the character of my room, my therapy space. Their breathing deepens and they discover that therapy is just a special kind of conversation. It’s a confidential place where: the therapist won’t have expectations of what you want to do; the phone won’t ring; no one else will ‘break in’. It’s a special conversation because it’s focused on you. That doesn’t mean the therapist has to be silent or a tabular rasa (blank slate) like you see in the movies (although if that’s what you need, then that sort of therapist can still be found).

I see the therapist as someone who: joins you on your journey, facilitating you to find your answers to fulfil your needs; won’t get their story in the way of yours; can help you, from a detached position, to look at things. I also think that therapy is a distinctively creative process that, through working together, forms the unique therapy you need.

The first session normally races by. People often comment they were worried they wouldn’t know how to say things, or even what to say. Yet, somehow, in the end, there wasn’t enough time to cover all the things they wanted to mention.

***

Your first session is over. You are walking away from the place of therapy and are going about you real life again. What can you expect now? You may realise you feel pretty tired, perhaps even exhausted. This is the time to start looking after yourself. Between now and your next session you may spend time thinking about the process. You may even dream some answers or questions. An awful lot of the therapy happens between sessions. Your process has begun … Bon voyage.

* See for example: Lambert and Barley (2001) in Psychotherapy: Theory, Research, Practice, Training, Vol 38(4).


Why not visit my therapy website – therapy-space – where you can contact me or find further information about the therapies I provide for women, men and couples.

Blue Monday, acceptance and the ‘good enough’ New Year’s Resolution.

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This year, Blue Monday* – reportedly the most depressing day of the year – occurs on 16 January. But for a moment, I’m not thinking about why, for so many people, things might get so rotten early in the year. In fact, I’m thinking back to a workshop I ran for therapists who came a from wide variety of theoretical backgrounds, and the theoretical approach I’m particularly reminded of as I write this blog is Winnicott’s ‘good enough mother’.**

Beyond the technical details of theory, there is something almost magical about the simple phrase ‘good enough mother’ – especially if seen as a contrast to the idea of the ‘perfect mother’. I often find the same sort of clarity when I examine the word ‘acceptance’, because both the idea of ‘good enough’ and ‘acceptance’ offer us the chance of freedom or liberation from expectation.

As Blue Monday approaches, imagine how quickly you could realign some of the simple hurdles you have already erected in 2017 if you begin to use the ideas of being ‘good enough’ or ‘acceptance’ rather than seeking unobtainable standards.

Reportedly, more than 30 per cent of people will have broken their New Year’s resolutions by the end of the second week of January. So, I wonder how useful the concepts of ‘good enough’ or ‘acceptance’ might be in helping people to continue with the positive changes commonly set around 1 January each year.

Imagine your resolution is to run regularly. At a packed party on 31 December you announced enthusiastically and publically at the stroke of midnight that you’d run a marathon before the end of 2017. On 14 January, as you put on your running shoes and realise how dark and cold it is outside, you notice your determination and enthusiasm shrinking. Despite wanting to save face, you throw in the towel and return to your sofa – crisps and beer in hand. At some point later, you beat yourself up for being weak-willed or lacking commitment.

But what if you take the option to reframe? Drawing from the ‘good enough’ idea, how would it be if you simply decide that enjoying a bit of running could be good enough? In the following days and weeks, you might discover that 1 kilometre turns into 2km, then 5km, then 10km. It turns out that you can accept where you find yourself right here and now and allow your ability to grow naturally, rather than demand of yourself that you adhere to the unrealistic goal you first chose.

Similarly, if you set yourself the task of losing weight – a popular New Year’s resolution – then be realistic. Don’t set your goal at a huge weight loss in an impossible period of time. At least at first, just try to lose something each week – which is actually going to be ‘good enough’ until you have firmly built the habit. If you focus on the small, the sizeable will quickly grow from it. You will then have a much better chance of embedding the change in your life long term; it will become achievable and, therefore, much more likely to improve, rather than knock, your self-esteem.

As you begin to succeed, come from your continued acceptance of the here-and-now ‘good enough’ perspective. This will undoubtedly create chances for you to grow more, but without that demanding self-expectation.

Let me wish you a happy, ‘accepting’ and ‘good enough’ 2017!

*The concept of Blue Monday, the point at which we are supposedly at our most melancholy, was first proposed by psychologist Dr Cliff Arnall as part of a 2005 press release from holiday company Sky Travel. It is claimed that the date was calculated using the equation: [W+(D-d)]xTQ/MxNA – W is weather, D is debt, d monthly salary, T time since Christmas, Q time since failure of attempt to give something up, M low motivational level and NA the need to take action. See: http://www.independent.co.uk/news/science/blue-monday-the-science-behind-the-most-miserable-day-of-the-year-a6816926.html

**Donald Winnicott (1896–1971), a British paediatrician and child psychoanalyst, was the original proposer of the ‘good enough mother’.


Why not visit my therapy website – therapy-space – where you can contact me or find further information about the therapies I provide for women, men and couples.

Where we live: family, home and not making assumptions

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The situation in which people live is a common subject that comes up in therapy. There are students new to semi-independent living. There are couples going through the pains of divorce without knowing if one or other of them will be able to afford a new house or be able to keep the family home going. There are people who were brought up in care where the idea of family and home itself might be a challenge, even years after the childhood situation has been resolved.

In Cambridge and Bristol (the two cities in which I work) and, indeed, in much of the UK­, being able to afford to buy your own home is a far-off dream for many people. Home is often the fantasy; everything from situation comedy to the big-budget movies and advertising sells the home, the family, in terms of an ideal myth. Think of the Christmas hearth with burning logs, or the burgeoning table with succulent turkey and steaming hot gravy. And now, as we approach Christmas, the pressure really cranks up for the perfect home and the perfect family.

Anyone who has worked with me or read my blog knows that I keep what happens in the therapy space strictly confidential. But in the run-up to Christmas and the unbalancing pressure it can bring to home and family, I’ve asked two men if I might recount a little from recent conversations I’ve had with them for the Therapy Place Blog. They are men who, in the last few weeks, have challenged some of my automatic thinking about Christmas, home and family, and I hope they might make you pause and contemplate for a moment or two before December 25 arrives.

Simon* (54) was brought up in the care system north of Cambridge. He never knew his real parents, as he was placed in care very early in life. Growing up in care was difficult. He found himself in a series of foster placements but he never felt anyone cared for him very much. He reported being quite a naughty child. ‘I probably just wanted someone to notice me,’ he said. ‘A psychologist told me once that it’s better to get negative attention for being naughty [if you can’t get praise for positive actions] than it is to be ignored. I don’t know what it’s like these days, but when I reached my 18th birthday, that was that! I was sent to the hostel and just had to get on with life on my own.’

Through his 20s and 30s Simon was an alcoholic, but when the doctors told him he was going to die from the effects of his consumption he was able to stop permanently. Simon has never known any family, but he reports having friends he can trust.

Until 2002, Dan* (52) was the owner of his own engineering business in Bristol. ‘I grew up in a large family – two brothers, three sisters, me, my mum and dad, and my gran and pops all lived in the same house. It was pretty mad but we mostly got on. I had a lot of freedom, and from my teens I enjoyed recreational drugs. I never really liked to drink so I sort of joined in by letting go by other means. I got through tech college and set up my own business repairing mechanical things that went wrong. For a long time I had it really made when I think back on it.’

Dan pauses. His eyes tear up. ‘I repaired everything from washing machines to motorbikes. It all went wrong though. I lost my daughter, my wife and my house when I started taking heroin. Even my mum and dad refused to help me out. I stole things from them to support my habit, I was an awful person because of drugs.’

Dan has been clean for four and a half years.

‘I actually found it more difficult to give up the prescription meds than the heroin. I’d really like to get back with my family now but I understand why they can’t trust me – at least not just yet.’

So why do Simon and Dan challenge my automatic thinking about Christmas, home and family? I met Simon sitting on the pavement close to St Andrew’s Street, Cambridge; I met Dan on Prince Street Bridge, Bristol. There had been frost the night before I met each of them. Simon has spent 36 years living rough, and Dan has been sleeping out for 18 months. It’s interesting to think who we walk past in our busy lives planning for the illusive ‘perfect’ Christmas.

Joyeux Noël!

*Names and certain details have been altered in order to protect the identity of both men.

A mood forecast for the autumn

octoberblogAs the temperature and light levels drop at this time of year, so each day rapidly shortens. Falling leaves unequivocally announce autumn and the inescapable ‘decline’ towards winter. It’s difficult not to be aware of the lack of vitality in nature and the echoes of endings: the end of summer; the end of long days; the end of warmth; and, deeper down, the counterpart that yet another year has slipped through our fingers – and, for many people, an uncomfortable connection with death.

Like the change in leaf colour, the calls to my therapy practice also alter during this season. Certain types of depression become prominent, and relationships seem to suffer even more as couples and families are thrown into closer proximity by the shorter, colder days … not to mention Christmas already becoming a pressure point for many. I note, too, that the two times when existential issues flurry most prominently into my practice are spring (the counterpart to birth) and once autumn beckons (reminding people of the ‘what should have been’ moments of the year).

But it isn’t just a myth that lower light levels bring about a time of increased depression for many millions of people. The ‘winter blues’ (which start in the autumn) has scientific evidence in its support. Seasonal Affective Disorder (often just referred to by its highly appropriate acronym SAD) is thought to occur because of the way our bodies respond to the lack of light available in the short daylight months. Theory around SAD suggests that the light entering our eyes causes changes in hormone production levels in our body, lowering the ‘feel-good’ hormone serotonin and also interfering with our melatonin levels – a hormone that helps determine sleep patterns. And, overall, the low light levels disrupt our circadian cycle – our naturally recurring body rhythms during a 24-hour period. For many people, these changes add up to considerable lethargy and the experience of other connected symptoms of depression.

So far, I’m not really offering much positive about the final part of 2016 stretching into 2017 – especially as I mentioned death earlier (the one unavoidable issue we must all come to grapple with at some point). And while August has the fewest deaths in the UK, January looms at the top of the chart, which equates to an unwelcoming month with more anniversaries of people’s passing – another great trigger for dialogue in the consulting room.

While we can’t avoid death, we can take a leaf (or perhaps an acorn) from a squirrel’s book and prepare for those light-depleted winter days by taking action and planning a few things before the dark takes hold.

For example, think about good, clean eating rather than succumbing to sugary carbohydrates that will add to a feeling of sluggishness, not to mention a few pounds.

Get active before your New Year’s resolutions. According to Dr Andrew McCulloch, the former chief executive of the Mental Health Foundation, ‘There’s convincing evidence that 30 minutes of vigorous exercise three times a week is effective against depression and anecdotal evidence that lighter exercise will have a beneficial effect, too.’* Of course, it follows that exercising outdoors (e.g. brisk walking**) during this period will be useful in helping to expose you to higher levels of light than you would get indoors.

When it comes to that increase in relationship stress, it might be time to book in a relationship MOT session with a therapist, where you can talk in a safe, comfortable, non-confrontational space about any issues troubling you in your life together.

*NHS website

**Walking for health website

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Why not visit my therapy website – therapy-place – where you can contact me or find further information about the therapies I provide for women, men and couples.

Effective solutions for failing relationships

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It is never very comfortable to feel that one is failing at something in life. When it comes to a relationship failing, we can all bring out some pretty special defence systems that keep us away from this recognition: ‘Of course, I’m not perfect, but this really is all his/her fault’; ‘What do you mean we never talk? What were we doing when we went out with Rob and Sue?’; ‘I’m not avoiding you; it’s just that I’ve got to get this work done/answer this message …’;  ‘Oh come on! I’ve not had chance to watch any of my TV programmes this week’; ‘What do you mean I’m always on Facebook [bing … type, type, swipe]?’

If you find yourself in a relationship that is experiencing difficulties, it’s common to feel that you won’t be able to work things out. And if you are feeling that, then the chances are you’ve stopped (or perhaps never did) communicating well. That sense of not mattering in the relationship or the lack of intimacy will very likely have something to do with the couple not being able to properly reach or connect with one another and therefore not talking things through.

Of course, it’s not always easy to see where we are going wrong with our communications. It’s likely that many surface issues will be getting in the way of us finding our voices with one another. Even serious matters such as affairs and addictions can be the secondary issue – the disease symptoms rather than the cause of the illness, so as to speak. Once you realise that difficulties can so often arise from a hunger for real communication and understanding from a life-partner, then effective counselling or therapy can begin to change your joint life.

In my couples counselling and therapy practice I find it’s good to start by checking out what views people actually hold of the relationship they are in. Too often, as I mentioned in my blog ‘A stitch in time …’, people wait until very late in the day before taking action. In relationship therapy and counselling it’s as if one partner has already given up on the relationship. This sort of secret needs to be brought out into the open. Therapy attempts to help partners view the relationship in an objective way – importantly, stopping ‘blame conversations’ and attempting to replace them with a process that involves both partners making an enquiry into how they jointly and individually got to where they currently are. This style of working develops the narrative ­– the story of the relationship to the current point in time. If there are contextual situations lurking in the background – for example, loss in the family or money worries – it helps to see that these are factors that can be negatively influential on the immediate situation the couple find themselves operating from.

It is important to understand that couples therapy isn’t just a mental process. When fully engaged with, couples work is also about behaviour change and emotional understanding. Dysfunctional behavioural issues (such as addictions, anger and especially any perceived or actual physical threats) all need to be examined in terms of what damage they do to trust, intimacy and the ability to communicate. Emotional avoidance tends to lead to fears about expressing the inner dialogue. Depending on how we were brought up, our attachment patterns can lead us to acting out our attachment story in adult life within our close relationships – sometimes with very negative consequences. (Read ‘On being ignored, forgotten or abandoned’ for more detail.)

Your first session of couples counselling or therapy might not result in booking date nights, having meaningful sex with the person you are attending with, finding yourself buying them little gifts, writing love notes or perhaps simply having great fun with them. However, with an effective couples therapy approach, at the right point in your couple difficulties, you should be able to discover just what you need as you move along the therapy road together.

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Why not visit my therapy website – Therapy Place Couples – where you can contact me or find further information about the therapies I provide for women, men and couples.

Suffering from creative constipation …?

Blog awaiting imageI’m not quite certain if I first heard, read or spontaneously thought of the phrase ‘creative constipation’, but over the years I’ve made it my own. Often, when I first use it as a possible explanation for a feeling people are trying to express, it is greeted with a smile or chuckle before, on reflection, it begins to reveal its more serious nature in the therapy space.

The UK government reports that the creative industries are worth £84.1 billion a year to the UK economy, generating nearly £9.6 million an hour. Indeed, these have been a growth area of the UK economy as a whole: in 2014, they grew at almost double the rate of the rest of the economy.

While creative activity can be profitable, most people, at some point in time, decide they aren’t actually creative. Sometimes that moment of ‘discovery’ is quite clearly remembered. ‘My music teacher communicated to me that I was welcome to sing in the choir, just not on performance night’; ‘Our art teacher was a sarcastic man; he suggested to me that while the naive style was practised by many artists, first they had to learn to make it look like the thing they were drawing and then unlearn the rules. I never tried to draw again.’

While being creative is rightly connected with the arts, I tend to see it as a much wider human activity. Indeed, I’d boldly state that to be human is to be creative. While artists, musicians and actors are the creatives we think of most readily, teachers, builders and engineers, for example, can be hugely creative in all their various forms.

Creativity is an experimental activity. Small children do it naturally, acting out roles and bringing life to inanimate objects. But the socialisation processes of modern society, in the home, in educational settings, rarely stop to focus on the development and enhancement of the creative process. (I’m reminded of the lyrics of Harry Chapin’s ‘Flowers are Red‘.) And there begins the long constipating process. Life, vitality, energy, spontaneity can all begin to sludge up in our system when we abandon or refuse to see the creative spirit in human activity. When it gets really bad, even sex itself, the ultimate creative expression of human beings, can suffer.

Rather than a neat conclusion to this blog I thought I’d end this post with a challenge. How have you been creative this week?

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Why not visit my therapy website – therapy-place – where you can contact me or find further information about the therapies I provide for women, men and couples.

Just call me …

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“Yes you’re right,” says Jessica, as we begin to talk for the first time about the process of therapy. “The only clues I’ve got,” she says, “are from TV sit coms and films.” We laugh together for a moment and then I begin a fairly routine explanation of what my work role as a therapist is.

First, what I am not. I’m not a psychiatrist. The Royal College of Psychiatrists* describes Psychiatry as a “medical speciality, like general practice, surgery, general medicine or paediatrics. You have to train for 5 years as a doctor and in the UK – like every other medical specialty – do 2 further years of ‘Foundation’ jobs in hospitals before you can start to specialise in psychiatry. It usually takes another 4 years to pass the two professional exams of the Royal College of Psychiatrists, after which you can specialise further.”

Although I studied some developmental psychology during my initial degree, I am also not a psychologist. A Clinical Psychologist (the type of psychologist you are most likely to encounter within an NHS setting) will have gained an undergraduate degree in psychology. Again, according to the Royal College of Psychiatrists, psychologists will have gained “further experience working in relevant healthcare settings[;] clinical psychologists then do 3 years Doctorate clinical training in an approved training scheme at university. During this time they work with patients under supervision from experienced psychologists and study for an academic doctorate as well as their first degree. They complete training placements with adults, children, older adults and people with learning difficulties.”

Historically, psychology has applied experimental approaches to exploring sates of the human mind. My shorthand for people is that psychiatrists are doctors of the mind and psychologists are scientists of the mind.

So back to what a psychotherapist is and isn’t …

“I’m not an analyst.”

“So I’m not going to be lying on a couch answering your questions,” says Jessica. “It’s not a Woody Allen film, then?“

Indeed, in my own twice-weekly analysis that lasted nearly 6 years I never laid down on a couch because even analysts don’t all do that.

“I am a therapist who deals with people’s internal mental and emotional issues and difficulties,” I continue. “Sometimes people are comfortable with me as their counsellor – a word that is derived from one who walks alongside. Other people I work with refer to me as their psychotherapist, from the Greek for ‘soul and healer’. Some think of me as their coach, and others come to me for hypnotherapy.**

“What I will actually do is sit in a chair opposite you and listen, talk and engage with you in a relational manner. In short we will have conversations about you, what course of action you might need to take, often what you have done or experienced in the past, how you see the world and your interactions with it, and where it is you are trying to get to. I work with all the issues a human can have problems with – including things that are really difficult to talk about such as sex, addiction, relationships, anxiety and bereavement. But I’m not a doctor of the mind and I’m not a scientist of the mind. I’m more an interpreter or an artist, helping you to construct your own canvas by pulling things from one place and sitting them somewhere else.”

“I call myself a therapist, but my professional registration*** says I am a counsellor/psychotherapist. You can just call me Duncan.”

* http://www.rcpsych.ac.uk/

** I am fully qualified hypnotherapist and is registered with the General Hypnotherapy Register.

*** I am a fully qualified, registered and accredited BACP (British Association for Counselling and psychotherapy) counsellor/psychotherapist.

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Why not visit my therapy website – therapy-place – where you can contact me or find further information about the therapies I provide for women, men and couples.