Page 5 for Counselling, Psychotherapy and Psychology Blog by Nicholas Rose

Contact us via Skype for an online therapy sessionLike our page on FacebookJoin us on LinkedInFollow us on Twitter
Home    |     Contact    |     Site Map    

Counselling, Psychotherapy and Psychology Blog

Comments (0)

Our latest article on anger management has been published in the Chiswick Herald, please click here or read the full article below:

Anger - are you an angry person?
 
“Anger management” is a very popular therapy search term and it is something patients often bring to therapy. Anger is a very healthy and normal feeling but what is often missed is that anger is generated from other underlying feelings; so people may easily be avoided because they are viewed as angry because the hurt or upset that lies underneath is not recognised. 
 
Treatment can start when someone has started to wonder whether they have a problem with anger. This sounds obvious but in my experience this is not always so simple. Whilst people think they know what anger looks like - probably more than many other emotions - the reality is that anger can be hidden in a number of ways, examples being by silence and withdrawal or passive aggressive behaviour.  Meanwhile some people can appear to be angry when actually they are more excited or desperate to be understood. I work with my dog in the room and she is an excellent barometer for identifying anger. Many times she has behaved in such a way as to alert me to anger when it has not been obvious to me.
 
Treatment can helpfully be seen as having a two pronged focus - the first is to work on identifying anger and putting in place strategies for de-escalating the anger, the second is to look at the feelings which lead to anger; so its about treatment and prevention.
 
So lets look first at identifying anger. Anger can make itself known through a number of physical, emotional and behavioural signs. Physically you might have an increased heart rate, start to sweat, have stomach pain or a headache, clench your jaw, shake or feel dizzy whilst emotionally it is common to feel a number of emotions for example like running away, wanting to strike out, anxious, guilty. Behaviourally, things that are common are things like pacing, being sarcastic, speaking loudly, doing things that you know are not healthy but you find change how you feel for example drinking, smoking or taking drugs. 
 
Another key way to know if you struggle with anger is to think about your interactions with other people. Does anyone ever make any comments about your behaviour? Do you come away from situations with others where the outcome has left a conflict outstanding? Ask your friends and family whether they experience you as being angry?
 
If you have come to the conclusion that you do have a problem with anger then its time to put in place some strategies to deal with it. Neuroscience is showing that a part of the brain called the amygdala is responsible for triggering our emotions and this trigger happens anything up to six seconds before the rational / thinking part of the brain steps in. This means you can be angry before you know why - so if you are now better able to identify feeling angry you can now manage it. One very useful tool is to count to 10 - it sounds like just one of those things people often say but given the neuroscience, what you are in fact doing is allowing the thinking part of your brain to catch up! Another very useful tool, and something to do at the same time is to focus on breathing slowly. Combine the two and count each breath - use 1001, 1002, 1003 etc.
 
With these tools in place it will now be possible to start to look at understanding the situations and feelings that are generating your anger. Take time to reflect on the times when you became angry. Exactly when did it happen, where were you, who were you with, how did you act, why did you react and what were the thoughts and feelings in the moments before your became angry? You will also find it useful to start keeping a diary so that you can start to identify patterns. 
 
What you may find is that you get angry in certain circumstances - in other words you have ended up with an automatic response and this needs to be challenged as it is no longer useful. Lets take a very simple example just for illustration, imagine you realise you always get angry when you hold open a door for someone and they do not say thank you and you think “that person has no respect, why did I bother?”. Ask yourself what are the other reasons why they might not have said thank you? If nothing comes easily to mind think about a time when you didn’t say thank you - what was happening for you? Once you have found one possible alternative others are likely to follow. Secondly, ask yourself what makes you hold open doors for others and the thoughts and feeling that surface when you challenge yourself to stop doing it? In my experience people often realise that they are reacting to an assumption and an interpretation that may well be unfounded and secondly they are more upset with themselves for having expectations than what actually happened.
 
In finishing though it is really important to be kind to yourself, if you struggle with anger and  the thought of attempting what I’ve written here brings up difficult feelings, maybe even anger then consider talking to someone. And of course if your anger is already at levels where you are putting your safety or the safety of others, (which of course is one and the same thing), then don’t hesitate to seek help, anger can be managed!
 
Comments (0)

Here is our latest article from the Chiswick Herald reviewing a Yoga retreat and Yoga approach. Please read below or see it here on the Chiswick Herald site.

Moving from the couch to the yoga mat

Many of my patients are often already practicing or take up “physical” activities such as Pilates, Tai Chi, Qigong or Yoga. Over the years I’ve tried yoga on a number of occasions but not been able to find one that I’ve wanted to continue. So when I heard of a form of yoga where the underlying assumption is about uncovering or more accurately rediscovering the innate expertise we have to live a healthier life, an association I make with therapy - I wanted to explore further. 

Fairlie Gibson teaches this yoga in London but also runs holidays to teach this approach, she told me “the yoga holidays I offer are based upon an approach practiced and shared by Vanda Scaravelli. Vanda didn’t want to give her style a new name but it has become known as Scaravelli inspired yoga. We set the holidays in either beautiful mountainous Andalucia or on the gorgeous turquois coast on Southern Turkey. The aim of these holidays is give the participants, no matter what their experience of yoga, the chance to experience this, as yet, little known approach”.

By way of some background and before I talk more about the potential interplay and complementarity of this yoga to therapy I want to go back in history as I think it provides some basic and helpful context. The word disease has its origins in 14c. coming from Old French desaise and it was an holistic term covering the experience of both physical and emotional distress. It is simply the opposite of ease so the experience of “dis”ease. As medical science has found treatable causes for many sources of distress the word disease has become associated primarily with the physical. With “ill at ease” being used instead of disease but also having the connotation of some minor discomfort. In the same way the word patient has its origin in patience meaning someone that endures pain and suffering.

The importance of all this is recognition that the physical and emotional are in fact inseparable. If you feel “dis-ease” then do see your doctor but remember that when you reach the limits of what current medical science can provide you will need to access your own resources to treat or manage any remaining “dis-ease.”

The relationship I build with patients aims to bring a sense of safety and relaxation as we spend time together. That sense of relaxation or comfort enabling us to look again at how life is being lived and identify misunderstandings, unhelpful thinking, unhelpful habits, automatic responses and physical actions that have become fixed when in reality in any given moment and in any situation a range of options will be available. In short our way of living or being that was helpful in the past may not be the most helpful now.

So now back to the yoga. The experience of many who have trained in yoga is the need to learn new moves, push the body, stretch to the limit in other words to add more instruction and to have to work harder – all at a time when they have been drawn to a physical activity because they want to make life better. Resulting struggles to achieve the pose, remember the sequences, to practice regularly combined with physical injury, negative thoughts and feelings can all lead to the exact opposite of what was hoped. 

Scaravelli is known to have said “if you are kind to your body, it will respond in an incredible way”. My own experience of the yoga was first and foremost one of kindness, creating space, allowing, appreciating and only then to move the body in ways that are known to result in greater flexibility, strength and sense of well being.

Fairlie told me “It’s about coming home to yourself rather than learning something new or put another way, about unlearning and then being with ourselves in a different way”. She continued “We have become so absorbed in the need to achieve. In yoga visuals of practitioners bent double in seemingly impossible stances have resulted in a lot of pressure to achieve whereas it is more about experiencing freedom in the body. The pace of the practice is such that there is great emphasis on creating space and allowing time for the body to find its optimum”. 

Fairlie Gibson - Scaravelli Inspired Yoga

As the week progressed I found myself feeling very at ease in positions that felt wonderfully natural only to realize I was actually adopting positions that I would have anticipated requiring a huge amount of effort. I’m not saying it is easy, its not about whether its easy or hard its more about what can happen once you have let go of trying. Fairlie called this “effortless effort.” And I find myself concluding that the space this yoga creates and the freedom it generates to allow for change is indeed very therapeutic. This is a form of yoga I am interesting in continuing to practice. 

Details of upcoming yoga holidays can be found on Fairlie’s website www.freeingthebody.com

 
Comments (0)

Our latest article in the Chiswick Herald publishes today and is available online here.

Or read the article below:

 
Feeling lost? What happens if you think philosophically?

When I first meet people and I ask “How is it that you are here?”  they often tell me they are feeling lost. The experience of feeling lost is one that can be so painful and confusing we naturally tend to look outside of ourselves for help in again finding a way forward. In other words we are no longer finding it possible to approach our situation philosophically.

 
In my view, our tendency to blame ourselves for having become lost feeds a sense of isolation and loneliness; one which helps prevent us from harnessing our innate abilities to again find our way. And of course any pattern of thinking that encourages us to think negatively will only escalate how bad we feel. We can feel sad about feeling sad, anxious about feeling anxious, confused by our confusion, lost in our lostness; I think you get the point.
 
To break the cycle we need to do something differently that results in us again feeling hopeful and enables us to again engage with our innate philosophical potential. After all, and to allow us a brief moment of philosophical thinking, to feel lost means that at some point we did not feel lost? And to approach philosophically the point at which this changed is where we will find the information we need to again find our way. But how? Firstly, we need to find a calm disposition and secondly foster a curiosity towards our situation. 
 
When people come to see me it will become apparent very quickly as to whether meeting with me has the potential to be helpful; whether we can develop a therapeutic relationship. In the first session the single most important factor determining the potential outcome for us is how the person feels in spending that first fifty minutes with me. Do they feel relaxed, are they feeling free to speak openly to me, do they feel heard and understood by me? Is there a glimmer of hope that has surfaced as a result of us meeting? Are my questions or questions that are occurring in them encouraging them to think about things in a new way? The therapeutic relationship is the foundation of healing and often research has shown that for many, a relationship where the person has felt safe, cared for, heard and understood has been what has mattered most. 
 
And as suggested earlier the second aspect of a philosophical approach is being able to think clearly about our situation. When young, we quickly learn through the use and questioning of the information our senses provide. Our thoughts, feelings and bodily sensations are converted into information that enables us to understand the world when we also ask when? where? who? what? how? and why? And this learning forms the basis of how we make decisions. As we go through life we will automatically respond to situations that we understand as familiar bypassing any great contemplation of our senses or any rigorous questioning.
 
This all works fine until the situations are in fact not similar enough that an automatic response is the best choice.   Our context may have changed, and/or we may have changed, either way a response that always used to result in a positive outcome is resulting in a negative outcome. We try again and again and that only leads to us feeling worse until we realise we are lost. What we missed at the moment when our choice did not provide the outcome we expected was the need to remember that everything changes. And with change comes the need for us to be prepared to accept that the things we have come to expect as certain may need us to revisit them.
 
The ease with which we can do this alone depends upon many things but I think that if you are not finding a way to feel calm and that as a result you may not be finding it possible to think clearly then do not punish yourself for feeling this way. Be as kind and compassionate as you would be to the person you care for most in life. After all, surely you would tell them that they deserve help, that it is ok to sometimes need to seek help, that they do not need to feel alone? And once you no longer feel alone and you are again able to access the full potential of your curiosity you will again find your way.
 
 
Notes about Nicholas:
 
Nicholas is registered as a Psychotherapist with the United Kingdom Council for Psychotherapy through the Society of Existential Analysis following a training that applies philosophical enquiry to concerns that are often brought to counsellors and psychotherapists. This particular approach to therapy combines the therapists wish to alleviate the suffering of others with a framework borne from existentialism and phenomenology. 
 
Comments (0)

Our latest article published in the Chiswick Herald and Chiswick Herald Magazine invites readers to write in with their dilemmas. Read the article below:

If you have a question you would like to put to us please write in and we will consider your question and respond to it in the next edition of the Chiswick Herald Magazine. When we publish the question we will not give any of your details - merely print the question and our response. Send us your question by email to mail@nicholas-rose.co.uk or in writing to Nicholas Rose, Nicholas Rose & Associates, The Cove Spa, 300-302 Chiswick High Road, W4 1NP.

Meanwhile, for this edition I’ve pulled together a list of the top questions people ask us about counselling and psychotherapy.

Q. What is the difference between counselling and psychotherapy?

The terms Counselling and Psychotherapy, these are often used interchangeably. However for the purposes of understanding what to expect, counselling is an endeavour that often has a clearer focus than psychotherapy for example a Bereavement or particular crisis. The nature of more clearly de ned concerns tends to result in a limited number of sessions.

Psychotherapy is relevant where there is a sense of struggle without any particular sense of a cause of the concern, often this struggle is something which has been experienced for a considerable period of time. A psychotherapy relationship tends to be of a longer-term nature.

Q. How does counselling or psychotherapy work?

Counselling & psychotherapy with us provides an opportunity to develop a greater understand- ing of your dif culties, to comprehend and clarify what was previously unclear and with this new awareness to identify and implement changes in your life. Crucially we offer a sup- portive relationship until the point at which you feel your dif culties have been addressed.

Q. How many sessions will I need?

It is never possible to say at the start how many sessions will be needed however it is usual to regularly review how your sessions are going and ensure you are nding them helpful.

Q. Will I have to lie on a couch?

The patients of psychoanalysts may well lie on a couch during sessions. But the many thera- pists will arrange the room so you sit in chairs.

Q. How do I choose the right counsellor or psychotherapist?

A great deal of research has and is being under- taken on the subject of Counselling Services, Psychotherapy Services and the different ap- proaches to therapy. It suggests that the most important factor in effective outcomes is the strength of the relationship between the client and the counsellor or psychotherapist. We al- ways suggest you meet a therapist for an initial session and then you can decide whether you feel comfortable, useful questions to ask your- self are: do I feel listened to and understood? Is it easy for me to speak to this person or are there things I am not saying?

Q. If I want a male, female, straight, bisexual or gay therapist is it ok to ask for that?

Of course, the priority is that you feel com- fortable. Having said that if you do not feel comfortable then it can be really helpful to ask yourself why that might be? Is it possible that the way you feel about the therapist is connected to the concerns you are bringing to therapy? If so maybe you have found the right therapist for you after all.

Q. How does couples counselling work?

Couples counsellors aim to provide a warm, supportive and non-judgmental environment, and do not take sides. Couples counsellors do not come to the sessions with an agenda; they are not there to tell you what to do or to manipulate you into staying together. They are there to facilitate you in nding your own way forward; for some couples this will mean nding a more creative and positive future for the relationship, while for others it may mean helping you to accept and manage the end of a relationship.

Q. What is family therapy?

Family therapy enables family members to listen, respect and understand different per- spectives and views, to appreciate each other’s needs and to build on their strengths to make useful changes and nd positive ways forward.

Q. Will I have to talk about my parents?

It is your space to talk about what you choose however a therapist might ask questions if they maybe relevant to the issues you want to explore. Ultimately you decide on what you want to talk about, having said that if you nd there is something that you are not saying it can be really helpful to ask yourself why!

Q. What is Child Psychotherapy?

Child Psychotherapists work with children by building a relationship through talking, play or the use of art materials to help children express themselves and help them to resolve issues concerning them. A space and time is created for them to think about life, to talk about growing up, about what happens at school with friends and about what it is like to be them. A child psychotherapist can also offer a great deal of support for parents and families at times of struggle.

Q. When can a child psychotherapist be help- ful?

If a child is showing signs of distress at home or school or if as a parent/s you are struggling in your relationship with your child. In addition there are a number of particular dif culties which can helpfully be brought to a child psychotherapist including pre and post natal dif culties, birth trauma, aggressive behaviours, ADHD, autism, divorce and separation, adop- tion, bereavement and loss, eating disorders, separation anxiety, selective mutism, obsessive behaviours. self harm.

We look forward to hearing from you

Nicholas Rose 

 
Comments (0)

The team at Nicholas Rose & Associates has been strengthened with the arrive of Renato Cristini who will take the role of Director with responsibility for the day to day management of the practice.

Renato Cristini, Director

 

Read all posts by Nicholas Rose Posted by: Nicholas Rose on April 25th, 2016 @ 6:03 PM

 
Comments (0)

Our latest article has been published on the Chiswick Herald website. Click here to view or read it below.

Stress that leads to anxiety
 
In the last column I wrote about stress - as prolonged stress can develop into anxiety I thought it might be useful to write about how to recognise anxiety and how it can be treated.
 
Anxiety is a heightened state that is identifiable through a combination of physical, psychological and behavioural symptoms. Anxiety is different to stress in that it is a longer term condition and it is for this very reason that it can be harder to identify and therefore to treat.
 
It is not uncommon for people to be unaware that they suffer from anxiety until they realise that other people do not feel like them and again, being able to identify anxiety can depend upon its cause. Where there has been a significant life event it can be easier to spot than if someone has been anxious since a very early age. Again it is common for people to not recognise anxiety because the way they experience life has never been any different. For people who have this type of anxiety it can be helpful to think about a persons early years and any childhood traumas.
 
And of course anxiety is linked to a wide range of other unpleasant experiences such as panic attacks, agoraphobia, other phobia’s, obsessive compulsive disorder etc. Long term anxiety may also result in clinical depression or other mental health conditions - so once recognised it is really important to start developing ways to manage and hopefully recover from anxiety.
 
Neuroscience is starting to help us understand the impact of anxiety on how the brain functions and to confirm long held views about its nature. It is now being recognised that heightened anxiety can come from the part of the brain called the amygdala. From an evolutionary perspective this area of the brain is tasked with warning us of potential threats and we are starting to understand that whilst this is a very sensitive and fast acting system it is not particularly accurate. Some theorists are suggesting that it is not particularly suited to modern day life because there is so much external stimuli, this area of the brain is constantly activated. As such this is why activities such as mindfulness, yoga, meditation and others that involve reducing external stimuli are becoming increasingly important.
 
Returning to anxiety and how to treat it, a common experience is for sufferers to be anxious about being anxious and this is contrary to how anxiety can be alleviated. This cycle which can only result in an escalation of the anxiety must first be broken. We need to adopt a “kindly curiosity” towards the experience of the anxiety so that it’s particular nature can be understood. There is nothing wrong with anxiety, in might helpfully be seen as a gift that alerts us to something we need to address in our lives. However ultimately, life will only improve if we start to recognise that the anxiety is merely an alert to something and it does not mean we need to be frightened, rather it enables us to question whether we need to be frightened and importantly allows us to decide what action, if any, we need to take.
 
At the primal level the three main psychological responses to an immediate threat are fight, flight and fright and we tend towards adopting a response based not only upon what is most appropriate given the context but what has worked for us in previous situations. For example, the fright response whilst it may have worked for someone who in the past needed to keep very still but it is not going to be helpful if every time you feel anxious you freeze.
 
What this means is we need to start to think about how the information being given to us by our thoughts, feelings and bodily sensations may require us to apply a degree of consideration and reflection to enable us to understand what is going on and as a result take an active role in how we respond. In other words, unless there is an obviously apparent immediate threat then although we may feel impelled to adopt an automatic response what we need to work towards is pausing and taking time to think through how immediate the threat may be and develop an appropriate response.