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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?”.
 
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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
 
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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.
 
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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!
 
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Our latest article has been published in the Chiswick Herald, click here or read below; this article looks at our take on how relationship counselling would have been useful in the musical La La Land.

Love and relationships in La La Land
 
SPOILER ALERT - If you have not yet seen La La Land you might want to read this article when you have!
 
In the final scene of La La Land, as Ryan Goslings’ character plays the piece on the piano that first captured Emma Stone’s characters attention, an alternate outcome flashes by where they get together and stay together. 
 
The pivotal moment appears to be where instead of him roughly pushing past her, he instead stops and kisses her passionately. To me this suggested that if only he had acted differently in this moment, if only he hadn’t been so upset, then everything would have turned out differently? However putting my relationship therapist hat on, I would suggest a very different potential turning point in their relationship - one that if handled differently may well have led to a positive although maybe less dramatically satisfying outcome?
 
For me, the key moment in the film where I would expect the problems to have originated was where he overheard her speaking on the phone to her mother about their and his financial situation. He is seen looking at a damp patch on the ceiling and these things are shown just prior to him deciding to take on a new job. A job where it is clear is out of line with the way they had both been thinking and feeling until then. We can only imagine what he thought and how he might have felt hearing the situation and him discussed in hushed tones? And why was she speaking in this way we can also only wonder about whether she found it difficult to talk to him about this situation, there may have been a part of her that wanted him to overhear but also what she wanted him to understand? The most skilful thing for them to do at this point in time would have been to talk about something they were obviously finding difficult - so why didn’t that happen?
 
In therapy I would be wanting to understand how they both thought and felt at this point about the financial situation and to explore what they both understood about how the other was thinking and feeling? I would also want to know whether they talked together about making decisions that would impact on the relationship and to consider what had been talked about and what was not. For example, if he said that he had decided to take on this work how did she think and feel about questioning him about his reasoning? Likewise what were his thoughts and feelings about talking to her about what he saw as a problem and what he thought would be the best solution? So often partners will think or feel that talking might not be the best thing to do. They might think they should not question their partners decisions or might also not want to share for fear of burdening the partner. 
 
They might think certain subject areas are out of bounds or they might not be expecting their partner to be interested in a particular problem. An added dimension here might be how they were both very passionate about wanting to make a success in their separate careers and also aware of each others career dreams. I would want to know how they felt and thought about challenging but also being challenged about the priority they might give to their careers at that point in time?
 
So often things do not get talked about because people are so focussed on doing things in what they think is the right way they forget that in a relationship the right way is actually about teamwork. There are no rights or wrongs only the need for the couple to feel comfortable in the relationship and to think that it works for them.
 
Maybe in La La Land if they had talked about the financial situation at this point different decisions would have been made? However in my opinion, it is not so much the decision itself that is crucial as the fact that both think and feel that they made it together. It is this that I think ensures even through the most difficult of times, both partners see their situation as the problem rather than their relationship or each other and it is this state of mind and belief in their relationship that ensures they can find the energy and motivation to work in harmony.
 
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Our latest article has been published in the Chiswick Herald, please click here or read below:

How to make this Christmas the best ever!
 
The Christmas holidays are a wonderful opportunity for us to strengthen and improve our relationships and yet for many they can bring stress and anxiety. For some it can be more about surviving than enjoying the Christmas holidays.
 
The first thing to remember is that people think of Christmas in many different ways and there are often many competing expectations. For example people may use the following words to express their hopes for Christmas, family times, friends, relaxing, having fun, spirituality, charity, reflection, partying, staying in, going out, log fires, wintery walks, time alone, time with others, entertaining, being entertained. Remembering this means that you can be proactive and ask people what they are wanting to get out of Christmas and what they would like to do - you can then decide with those you care about how to ensure everyone can have a good time
 
Principle one - Examine yourself first
 
Priority number one is your well being. So it is really important that you know what you want to get out of Christmas. After all it is you who will have to manage whatever plans are made. Here are a list of questions to help you think about this:-
 
How are you? 
How’s life for you at the moment?
What is concerning you at the moment?
How do you feel about family life?
What would you like to get out of Christmas?
Why do you think you want this - is this what you want or need?
Now take a moment to now think what you NEED from Christmas?
What do you not want to happen?
Thinking through how the family is at the moment what do you foresee?
In terms of current challenges what have you tried and what haven’t you tried?
Do you feel supported? Again, if not what have you tried and not tried?
How self critical are you? Yes difficult behaviours in the family may well be coming from the dynamic created by traits that you see as your own shortcomings but be kind to yourself. Don’t make yourself do things because you feel you should - find creative ways to achieve the same aims!
 
Principle two - Use a constructive and collaborative communication style
 
Avoid escalation of conflict by simplifying your communication. When you feel that conflict may arise use this four step way of ensuring you express yourself clearly and in a non confrontational way.
 
  1. State the fact/s
  2. Share your response to the situation - say how you feel and think (never say you make me feel / think because that will escalate conflict)
  3. Explain why this matters to you
  4. Share the problem you now have, ideally tell them what you want to do but if you are unsure ask them for their input
 
For example one of your family arrives late, this means you will be under pressure to get somewhere on time, this is something that you have said is important to you, you feel angry and stressed. It also means that it is unlikely you can fit in both of the things that were planned.
 
  1. I said we would need to leave at 9am but you have arrived at 9.45am
  2. I feel upset, angry and under pressure
  3. I want to be relaxed and easy going and being late means to me that I am failing but being late also means I end up under pressure 
  4. Now that we are 45 minutes I do not think we can do what we had planned, I need help in deciding what to change. Do you have any thoughts?
 
Principle three - Maintaining boundaries
 
A constructive and collaborative style of communication does not mean that you now let others decide what happens. Particularly if you are clearly the one with the designated responsibility - for example the cook of the Christmas lunch! The key concern now is finding a new plan that works for everyone - including you. With the example above you may decide to take out one of the activities that had been planned. Before you do this double check with your motivations to ensure that this is the most practical solution - that the decision is not an outlet for your difficult feelings but an answer to the dilemma you face. 
 
So you have said your piece and have invited help but it is now for you to decide what you need next. Don’t fall into the trap of expecting others to know what you want and to step in. If it doesn’t feel right then say so - in the best relationships people work together to ensure everyone is happy, it is merely wishful thinking that someone else can know you better than you know yourself. So avoid disappointment this Christmas, take responsibility for your own happiness whilst working with others to help them realise theirs!
 
Have a wonderful Christmas and a Happy New Year!