family therapy

Philosophy Underpinning Counselling and Psychotherapy

Socrates, an ancient Greek philosopher, is often regarded as the father of Western philosophy and a prominent figure in the history of thought. His teachings and methods have influenced countless thinkers throughout the centuries, and his legacy continues to resonate in various fields, including psychology and psychotherapy. 

How does it feel if you are a survivor of abuse?

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.

Therapy for affairs and betrayals

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. 

Do we really need to talk about our feelings?

The anxiety of knowledge and what to do about it

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.

Latest article - How to make your family times happy times

Our latest article was published in the Chiswick Herald on the 14th September on page 27, click here to visit the site or read the article below.

How to make your family times happy times

For some people their family feels like the best place in the world whilst for others the worst however for most there are good times and bad times. For everyone though there will be a pattern to peoples behaviours and sometimes those patterns might change for the better!

When relaxed and happy people are able to rub along together with little conflict however individuals in groups often take on particular roles and this can lead to tension between people. When something changes or when stressful situations arise, behaviours may not change to adapt appropriately and / or the defence mechanisms deployed by people may add to conflict.

Staying quiet is an option but one that rarely changes an ongoing problem.

If you want to break patterns of behaviour that cause problems then the first thing to do is to think about your family and the particular roles people take. It is normal for people to assume a “job description” and tensions tend to arise because these job descriptions either overlap or leave holes. For example, you might have four people willing to cook but no one who is willing to clean up afterwards!

Unfortunately, when behaviours remain unchallenged and the resentment starts to build thoughts such as “they are so selfish, so thoughtless, self centred” start to occur and these tend to generate even more difficult feelings.

Do you think that person really wants to be seen as difficult?

Such patterns are normally formed because things change but habits stay static. It can be really helpful to think that the person with the annoying habit is most likely doing something automatically and doing it because at some point it was what people appreciated.

But now you need accept that the behaviour is simply one that you find difficult and this cannot be changed alone - if it could have been then you would have managed it by now! 

Even if you have been able to see the other persons behaviour as not intentionally difficult it is likely you will find raising this subject difficult. A good initial strategy is to think about how you tend to be under pressure and how others therefore experience you so you can find ways to stay calm. 

Fight, flight or freeze?

Under pressure people with have a tendency to respond in a particular way - this means it can be possible to predict with a degree of accuracy how someone - including ourselves will be when something goes wrong. There is “fight” meaning becoming active. It doesn’t necessarily mean becoming aggressive but if you think of movement it would be a “step towards”. For those who tend towards “flight” a “step backwards” and for those where “freeze” happens think “standing still”.

Once you have identified the response you can think about what this means in handling situations - imagine the situation then think of ways to ensure you both remain calm.

FFTP - Fact, feeling, thought, preference

FFTP is a structure for how to have those difficult discussions! In this method of communication you provide the other person with all the information about what is going on for you in relation to the issue you are finding difficult.

Here is a hypothetical but typical situation. Your brother (Arthur) who is married with three children has, since having the children, started turning up late to family events you organise and when he finally arrives tends to disagree with things arranged in his absence. Today when the family were due to meet for a walk and lunch he arrives an hour late by which time everyone had decided where to eat and ordered drinks. He says he wants to go to a different place as he has heard good things about it. You find yourself feeling annoyed and thinking here we go again. You know that you tend to get angry and that in the past you have ended up shouting so you know it will help if you can stay calm. You’ve been thinking about this and have already planned to ask if you can speak away from the rest of the family, you also know that when you sit down you tend to stay calmer - so you find somewhere you can sit.

You - 

Fact - “We agreed to meet at 1pm and when you didn’t show up on time we decided on this place, looked at the menu and ordered drinks. Now you want us to change what we are doing.”

Feeling - “I am feeling annoyed, hurt and unloved”

Thought - “I am thinking that my time has been wasted, what I want doesn’t matter and not good enough for you - it is hard for me to enjoy our family time with these feelings and thoughts”.

Preference - “Can we find a way to ensure our arrangements work but can I also ask you don’t ask me to change what has been decided.”

Arthur -

“It is always so hard for us to get places on time with the children, something always seems to happen when we are leaving the house. I should allow more time but sometimes I agree to something and then don’t feel I can change my mind. Arriving late today I felt stressed and nervous because you have been angry with me in the past so I am always thinking I have to make up for being late. I think I have spoilt things and I need to find a way to make things OK so I try and suggest something that I think will be better. Now I am thinking that if I arrive late I can just relax knowing that I don’t have to do that - I don’t need to fix anything. But you are right maybe we can change the way we make our arrangements - I would like to know its OK not to agree a time on the spot so I can think about timings?” 

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.

Article - Relationship Dilemmas

Our latest article has been published in the Chiswick Herald on page 27, click here or read it below.

Relationship dilemmas - what to do when you want different things.

Over the next few months we will be outlining different dilemmas faced in relationships, in this article we will look at what happens when couples want different things.

The struggle for couples to find a way to handle situations when they both want different things is often brought to therapy. Where there is a repeating pattern of a couple not getting what they want resentment tends to build, goodwill is eroded, the relationship becomes a power struggle and the couple grow further and further apart.

There are only two possible outcomes when a couple find they have different wants:

1. One gets what they want, the other changes position
2. A compromise is reached

There is often a misunderstanding about “compromise”. Compromise still means that neither will get what they originally wanted however through working together they will find something new they both want.

What this tells us is that being in a relationship means a couple cannot realistically have an expectation they will both get what they want. A healthy relationship is therefore one where both agree that they will do whatever is needed to maintain and develop the relationship. 

This sounds obvious however when a partner starts to struggle instead of the focus being on “what do we need to do?” it tends to go to what each partner needs to do individually. Whilst this is a natural response it is simply not helpful. It is often also something about trust - trust that we can be understood and that we will end up with something helpful. 

Here is a hypothetical but typical situation - J and M have been together for just over ten years, last year M’s father died suddenly. J was in the middle of a redundancy programme at work at the time and although J escaped redundancy the environment has been unpleasant. M’s work have been very supportive but M has increased the amount of overseas travel. Over the last few months arguments have started to do with domestic chores and money, whilst sex has become sporadic and routine. 

Summer is coming and thoughts have turned to the annual holiday. J wants to go somewhere hot and lay on a beach in an all inclusive resort whilst M wants to go on a walking holiday staying in self catering accommodation. 

When they tried to discuss this they argued, it happened much like the other arguments they had been having but this time J picked up a bottle of wine and threw it at the wall. They found they were both shaken by what had happened and came to therapy. We looked closely at what had been said and how argument had developed. What we found was that:

First, they each stated what they wanted and then commented on what the other said they wanted.

Second, they said how the other had hurt them.

Third, they criticised each others behaviour in their conversation so M criticised J’s anger whilst J criticised M’s withdrawing.

So what is wrong with this? Well lets start at the end and work backwards:-

1. In arguments peoples behaviours are the revealing of defence mechanisms. Their activation is actually a sign that the individual is upset and responding - so this needs to be seen as an issue of the relationship - not the individuals. (With the exception of abusive behaviours). So instead of the behaviour it is more helpful to focus and understand the triggers. Ultimately to catch and prevent situations before they require defences.

2. In our relationships we have hurt feelings when our expectations are not met. Whilst is makes apparent sense to blame the other person it is far more helpful to think about how it is we have differing expectations. (Unless we believe the other person is abusive - in which case what are you still doing there?)

3. People often come up with solutions for problems and then are annoyed when others do not agree with the solutions. In relationships, a solution for something affecting both can only be found when both have agreed and understood the problem. 

So back to J and M. The “problem” was that they were both exhausted and upset with how the relationship was going and they recognised that their exhaustion was preventing them from being as flexible as they had been in the past. They had both been worried for themselves and each other and realised they had been trying to go on as normal and that included the holiday planning. They both agreed that the solution was they needed a holiday to relax / recuperate and when asked to think about each other they accurately identified they tended to have different ways of relaxing and recuperating (“expectations”). It had never occurred to them that holidaying apart might be feasible, fleeting thoughts had been dismissed because part of being on holiday was usually about enjoying time together. But this was not usual and so unusual solutions were valid. They agreed that for this holiday they would take separate holidays but they would also plan an extended weekend away together for a month later.

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 - Keep your children safe and well in their use of the internet

Our latest article was published on Friday 27th April in the Chiswick Herald. Click here to visit the Chiswick Herald Online or read below:

Keep your children safe and well in their use of the internet - part three

My previous editorials have focussed on safety and how to speak to your children if you are concerned about how they keep themselves safe but also if you have any concerns because of they way you see them using the internet. Today I thought it would be useful to consider appropriate use of the internet to contribute to the wellbeing of your children.

In June this year new studies provided evidence that moderate use of the internet and social media does actually benefit children and young people. Suggesting that use of social media helps build resilience and develop social skills thus having a positive impact on mental wellbeing. So it looks as though the usual thinking about moderation in all things does also apply to the new digital age too.

More than a third of 15 year olds in the UK are understood to be classed as “extreme internet users” sending over six hours a day online and 95 percent are using social media. Extreme users are more likely to report being bullied online and research by the NSPCC identified that 80 percent of children felt unsafe using social media to some degree.

In all cases research suggests that parents need to be supported in helping children use the internet appropriately but there appears to be very little guidance out there on how to do that. Most focus is still on safety rather than wellbeing. 

Current thinking concludes it is unlikely that one size will fit all and that the appropriate use of the internet will depend upon a range of factors. You might like to think about your child’s age, interests, social networks and particular needs. 

If your child could do with help in particular areas then the internet will be able to offer advice, support and even tools. It is most likely that the most effective approach is to actively talk to your children about how they use the internet and look for how it can support them. Focussing purely on time spent online is going to be too limited.

To understand the uses that lead your child to experience positive outcomes and affirmation to their self esteem and seek to strengthen and support this use is likely to be more effective than focussing on usage where it either appears to be causing distress or at best appears to have little benefit.

Rather than any single solution, it appears that children benefit most when parents use a combination of approaches including modelling positive behaviour, using a collaborative approach to setting limits on usage, keeping up to date on developments and technologies around security and online safety and showing curiosity and a willingness to support positive behaviours. 

Technology can be something that parents can think they are ill equipped to deal with, especially when children can be more up to date and often more proficient in handling technology. However what parents do have more knowledge about is the importance of balance - you can therefore support your child in the same way as you would for any other issue - food, friendship, health. You don’t have to know about the technology - just about how best to find a healthy balance.

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?”.

New article - How to make this the best Christmas

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!

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. 

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!

Article by Juliet Lyons, Child Psychotherapist

Our latest article in the Chiswick Herald written by Child Psychotherapist Juliet Lyons on the international aspects of her work can be read here. Or please see below:

International aspects of my work

As an 18-year-old, I worked as a nanny in Italy. It was my first taste of child-care. I learnt how to care for a 1-year-old while being welcomed into this Italian family - Mother, Father, Grandmother and Grandfather. There was a sharing of languages - English and Italian nursery rhymes; nappy changing practice; foods for a one-year-old (variations on tiny pasta cooked in stock or ‘brodo’ with parmesan, of course). I learnt that learning another language can be a gateway into understanding and partaking in a culture, and to be really satisfied in our exchanges, we not only seek to understand, but partake. At the time, I had a very significant dream: I could talk across languages, transitioning in each sentence between several different languages to produce an extraordinary type of poetry. The dream has stayed with me ever since as does my experience as an English nanny in Italy. 

In some senses, this dream has come to fruition: over the past 7 years, working in Chiswick as a Child Psychotherapist, I have been struck by the number of international clients and how enriching this is to the work. My clients come from areas as diverse as Argentina, Russia, Bulgaria, the Ivory Coast, South Africa, Brazil, Italy, Sweden, US, China, Rumania, France, Germany, (the list goes on) as well as the UK. Occasionally, I even work with a translator. This cultural mix makes for very interesting and varied exchanges. They are multi-layered and complex in the interchange of attitudes and beliefs around caring for each other, parenting, and the forming of identities. 

It is not surprising then that in my consulting room, I have noticed recent political events have had an enormous impact. Following the American elections, I had an influx of young American, female clients who were experiencing enormous amounts of anxiety. Children in my consulting room seem highly aware of politics and environmental issues, particularly those who originate from outside the UK. There is a lot of uncertainty and anxiety in families that come from abroad about their future and where they will live in the near future.

People who come to this country do so for many reasons. Often to do with their work, sometimes for the hope of a better quality of life for themselves and their families. Some have married a UK resident; others have married someone from their own or a different country and culture. They often face enormous losses of friendships, family, and the familiarity of their culture and language. Sometimes they take tremendous risks to move and often feel very vulnerable in such a move. I have been deeply moved by parents that have sacrificed so much to come to the UK, at times to enable their already vulnerable child or children to have opportunities in schooling, therapies and medical care that is just not available in their home countries. 

Attitudes to parenting vary. What is accepted as normal parenting in one country, is seen as abusive in the UK. For instance, hitting your child is still accepted in many countries. Parents can find themselves in the hands of Social Services, learning about the dangers of hitting a child, and learning of more humane ways of setting boundaries and having a different type of relationship with their child. In such cases, the child can see the UK as a protective force, a caring and kind country. But equally, it can be hard for them to carry the burden of knowing that their country of origin did not protect them in this way. It is a complex situation to come to terms with. But these children are initiated into the extremes of cultural diversity that few experience in such stark ways, and often become deeply sophisticated in their understanding of difference. Some families, very sadly, have experienced abuse here in the UK. When people put their trust into a system and an individual in the system abuses the trust and vulnerability of a child and family, it is very difficult to come to terms with. The pain can be shared and born, but it is always there. 

At this particular point in time, when the UK is reconsidering its relationship with Europe and the rest of the world, it seems more important than ever to consider the psychological aspects of being native and being a foreigner. Above all, what I observe and learn from my international clients is around how they navigate the space between dependence and independence, and how they retain or lose their sense of cultural identity.

How we form our identity is relevant to this discussion. According to theories, based on observations of infants, babies and children, identity is formed in relationship. We take in how others view us and see us, how they understand us, and how they interact with us. It is a complex dance of interactions that are forever being built in our minds and held in our bodies. On each building block, the next identity forming interaction is possible. It is the interactions around the care of ourselves that seem to form our resilience and identities most strongly. 

What is significant in this dance is that where we are understood and feel ‘got’, we can accept closeness. Where we are misunderstood, and in particular our vulnerability is misunderstood, trust cannot be built and we therefore tend to break bonds, move away from closeness. Empathy is what allows us to reach each other, to hear each other to feel touched by one another. When one is vulnerable, fragile, unformed, forming, emerging, discovering, awakening, then the softness, safeness and attunement of empathetic responses will find their way into our very being and become part of us. If we are responded to without empathy, with misattunement, with harshness, with a lack of understanding about our vulnerability, then we will shut out the relationship, with long-term and ongoing consequences for us and others. Of course, we will constantly make mistakes as parents, but what is key is that we can repair the ruptures – change our ways, recognize it if we get it very wrong, work with others to find different ways. 

This process introduces the individual in a timely and careful way to their capacities to be an individual within a group. To retain a sense of individuality that, when under attack, can find itself again, and therefore is secure enough. This individual will therefore be likely to tolerate difference. This, in part, is what makes us able to have an interest in another without too much fear of losing our identities. When we meet another, a stranger, we are always taking a risk. But it is the capacity to be uncertain, unsure and how we manage this that is key. If we are too frightened, we might wish to either merge (to deny difference) or to project our fears and make the other more frightening than they are. Managing the tension between a child wanting to explore and keeping them safe is a key principle of parenting. Psychotherapist Nicholas Rose advocates ‘the importance for us to equip ourselves with communication tools so we can feel safe and secure in engaging with others whilst also knowing how to deal with abuse and dysfunction.’ This is inevitably complicated if we are communicating across languages and cultures.

At Nicholas Rose and Associates, we have a culturally diverse team. Psychotherapist Adriana Amorim says, ‘I think that working with diversity is at the core of what we do as counsellors and that having a better understanding of the mechanisms of diversity through personal experience of migration helps me to work more efficiently and in tune with clients' predicaments.’ For me, learning from clients from all over the world, I find that children and parents want to retain something of their original identities and yet, they want to be themselves at the end of the day. And who they are and are becoming can hold many cultural identities. For me, to be able to partake in and support this complex process of identity building, is a privilege.

New article - part two - happy relationship happy children?

In our last article published on Friday the 28th October we started to look at the concern many people struggle with when finding a relationship difficult, mainly that the unhappiness may affect children. I suggested that it is really valuable to think about this because you can do a number of things to manage any impacts. I even think addressing the issues head on can help with improving relationships both with partners and with children.

Child Psychotherapist Juliet Lyons says: 

“Protecting your children from abusive or frightening behaviour is important. But avoiding conflict for the sake of keeping the peace will not be helpful for your children in the long run. It is important that your children learn that it ok to stand up for yourself when you believe that your partner has got it wrong and that you can work through this. This can model for your children how to navigate your way through difficulties in relationships, how to express yourself, hear your partner and compromise”.

In the last article I encouraged doing a review of your relationship so as to gain a clear perspective on the areas of struggle. By doing this you should be able to recall actual events and situations and the details of what happened, when, where, why, how and who was there. The value of specific events is that they are much more valuable in resolving problems than thinking of struggles in terms of generics, for example I don’t feel loved any more, I am not cared for, there is no respect in this relationship.. 

Think about these events and bring to mind your children, were they there? did they say anything? ask any questions? show any behaviour that suggests they might have been aware of the conflicts? Again, identify specifics for example, they stopped doing homework, asked whether you are both ok etc. When you have done this think about how you responded to them, what do you think they understood, what did you want them to understand, what did you not want them to know and why, do you still feel comfortable with how you dealt with the situation?

If you are thinking about this with your partner it can be really useful because there will be two different perspectives feeding into the thinking around this but you should both agree that whilst it will feel very compelling to get drawn into the conflict again and about who was to blame this is not what you are attempting to do, stay focussed on the children and agree to agree that you will return to any unresolved issues between you at another time to be agreed.

Adds Juliet: 

“The language you use is very important. It is important to make sure that you are taking responsibility for your own feelings, aiming for an ability to express vulnerability, rather than blame and attack. Marshall Rosenberg has written an excellent book on this subject- Nonviolent Communication: A Language of Life”.

Hopefully you will now have been able to identify situations, behaviours, conversations that suggest whether your children may have been affected by your conflicts. Even if nothing comes to mind it is worth thinking about whether you have spoken to your children about conflict in relationships? Conflict is inevitable however what is important is to develop skills in handling them when they arise. And irrespective of whether you think your own struggles may have been affecting your children it can be really useful to remember that. In reading this article and thinking about this issue you are starting to change your approach to conflict and ultimately that is what will be important to your children not only because they will be reassured but because you are modelling skilful behaviour.

Safety must always be the first consideration. Abusive behaviours are not to be tolerated and if you are unclear about what is abusive take some time to read about abuse and bullying (our next article will focus on this) in the meantime and assuming you conclude that the conflicts are without abuse and you wish to speak to your children then the best way to get started is to ask them whether they have any concerns about conflict either in life generally or in the context of the family? If you have a specific event in mind then state it for example, when asked me whether we were ok after the argument I had with your mother / father I wonder whether my response was clear, whether you understood, whether you were left with any worries?

By starting this conversation you are showing that it is ok to talk about conflict, demonstrating that people may react in the heat of situations but that it can be useful to revisit conflicts rather than leave them unresolved, that talking about them may not resolve them immediately but is an important first step. Of course you may find it very hard to have these conversations, feel under pressure to be perfect parents or feel defensive, the important thing is to be aware of what is happening for you and remember it is always possible to say “I am not sure about that right now, I need to think and get back to you”. Ultimately you need to have a conversation where any concerns your children have can be understood and addressed. For example, some children can worry that they might be to blame for the conflict in their parents relationship. 

In addition to helping your children feel reassured such conversations may help you to further understand the conflict in your relationship. Remember though you are the adults and you have full responsibility to manage your conflicts in such a way that your children can feel secure, learn about conflict and learn about how to manage them skilfully. In finishing Juliet recommends:

“Of particular importance is that you don't endlessly argue over your children in front of them and that you find a way forward together during times when you can fully express your feelings without fear of disturbing your children”.

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?

1. Boring as it might be do the research and read up on what best practice is for protecting yourself online.
2. 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.
3. 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 - How to make the school holidays the best ever

Our latest article has been published in the Chiswick Herald, please click here or read it below.

How to make the School Holidays the best ever!

The school holidays are a wonderful opportunity for families to strengthen and improve their relationships and yet for many parents they can bring stress and anxiety. For some parents it can be more about surviving than enjoying the school holidays.

The first thing to remember is that as parents you are in charge and so before anything else take some time to think about how best to manage what can be a massive undertaking in terms of balancing time, logistics, money, competing demands and complex relationships.

Principle one - Look after yourself before looking after others

Priority number one is the well being of the person in charge and yes that is you. So it is really important that you know what you can manage and that you apply your knowledge about what will work best. 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 the summer holidays?

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 the holidays?

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. Say what your response 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 and ask them for their input

For example one of your children 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 a good parent 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. 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. The message you want your children to have is that when things go badly in life it is important to take the course of action that best puts things back on track. And if you think some form of punishment is also necessary then that is a different issue and should be handled as such.

So you have said your piece and have invited help but it is now your decision to decide what should happen next. Clarity about who is in charge is ultimately about safety. If any of the children do not like your decision remind them of the fact that you are responsible and that in life it is important that people take their responsibilities seriously. And of course remind them that one day they will be in the position of responsibility and then they will need to be the one making the decision.

New article - Traumatised by the EU referendum?

Our latest article on trauma, anxiety and the EU Referendum has been published today in the Chiswick Herald, please click here or read it below:

Traumatised by the EU referendum?

Last week Mark Carney, the Governor of the Bank of England said that the UK was already suffering from “economic post-traumatic stress disorder” or PTSD. Now in psychology this diagnosis is only applicable to people presenting symptoms once a month has passed since the traumatic event. 

To consider the referendum as a traumatic event may seem exaggerated however it really does depend upon a persons relationship both to it and the perceived threat an unwanted outcome held. In our practice many people have wanted to talk about the EU referendum and the entire range of emotions have been triggered by an event that for many connects to key life concerns such as security, belonging, identity, relationships and hope for the future to name a few. I think many people have found that much of their time has been taken up or influenced by the referendum and if you have too then I think now is a good time to consider how you are coping. 

Specifically, take some time to think about whether you have started to change how you are living on a day to day basis. Has how you experience or spend your days changed? Are you spending more time following the news / social media, are all your relationships as they were before, are you eating and exercising or have you slipped into some bad habits? 

If the answer to any of these is yes then the key is regaining balance. If you are doing things that add to your stress and anxiety levels then either think about reducing the negative activities or add in other positive things to counteract the effects. This is important because if you do not take corrective action then you could end up with a stress or anxiety disorder.

I would however also like to take this opportunity to talk about PTSD as it was the starting point for this article. Having worked with patients diagnosed with this devastating condition for many years, including five years working with survivors of torture for a specialist charity in London, I think there is a growing confusion around trauma and how it impacts on people. I’m not suggesting the referendum will or will not result in cases of PTSD however we know that at times of particular stress and anxiety its also possible for PTSD related to previously untreated traumas to surface. So here is what you need to know about trauma. 

Triggers for trauma are identified as exposure to actual or threatened death, serious injury or sexual violation and the person will have directly experienced the event, witnessed it, learnt of it in relation to a close family member or friend or, have been exposed to the details of the event.

Faced with a traumatic incident it is normal for a persons survival instincts to activate, so “fight, flight or fright” are the primary physiological responses combined with difficult thoughts, feelings and bodily sensations. However it is the symptoms that present following the event which are used to consider whether someone may need treatment.

In the weeks immediately following a traumatic event it would be usual to diagnose an Acute Stress Disorder or ASD. Sufferers with ASD will have the same symptoms as those with PTSD but not everyone who suffers a trauma and ASD will go on to have PTSD. 

The symptoms are grouped into four clusters and include reliving the event (in dreams or through flashbacks), having distressing memories, thoughts or feelings as reminders of the event, then a range of cognitive experiences including memory loss, distorted thinking, wanting isolation and finally “arousal”. So being hyper vigilant, experiencing sleep problems and / or reckless or self destructive behaviour, one example might be use of alcohol.

In returning to the EU referendum it is still too early to consider the use of the term PTSD to that event however it is not too early to take stock to ensure you are managing your stress and anxiety. Stress, anxiety and post traumatic stress disorders are types of mental distress and illness where much work has been done to both understand and treat sufferers. Following a time of stress/anxiety/trauma it may well be possible for us to find our way back to a post event way of living but it can also trigger an anxiety / post traumatic stress disorder particularly if there were already other underlying concerns in life or previous untreated trauma. 

New Chiswick Herald Article - Send us your dilemmas

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 

New article in the Chiswick Herald

The latest edition of the Chiswick Herald includes this new article helping with the common concern people often have about how to talk and therefore help a friend or relative who is struggling with mental health concerns. Read it here:

How to talk to someone who is really struggling….

The Mental Health Charity Mind quotes research that 1 in 4 people in the UK will experience a mental health problem each year. So its no wonder that in working as a psychotherapist people often seek my advice when they are concerned about a friend or, family member. In response to this I always ask “Do you believe offering your time and attention will not be helpful - that you won’t be able to think together about a way forward?”

Often I hear the problems appear so big and complicated there is a sense of not being able to help and people can be feeling fearful that anything they might try to do and say could make things worse. It is natural to experience such a response because it is likely the person you are concerned about is thinking and feeling this way too. At this point many people become nervous that they are not equipped to help, particularly if words come up like suicidal, crazy, murderous, out of control, psychopathic or any of a whole range powerful words or the many psychiatric terms that are becoming so widely used nowadays. So it can be useful to recognise that actually you are already developing a good understanding of what is happening for them and that this means you are already able to help. 

These thoughts and feelings are most likely coming from a place of isolation, loneliness and desperation and the most effective way to start dealing with things is not to panic but to see if you have understood correctly. Do this by asking something like “I am wondering whether you are thinking the problems are too big and complicated, things can only get worse and you are feeling isolated, lonely and desperate?”

In doing this you will already be helping with the feelings of isolation and loneliness and your willingness to ask questions will already be challenging the feeling of desperation. Now start to consider whether either of you might be struggling to talk freely. One of the most frequently given reasons people give for choosing to talk to a therapist is they don’t need to worry about what impact sharing their problems will have on either the other person or that relationship. So if you think that the conversation isn’t flowing freely then ask. You can then both think about whether there is someone else who it would be easier to talk to. 

If you both decide to carry on talking then the next thing is to ask for as much information as possible. If suicide has been raised ask about it - “you have been thinking about suicide? what have you been thinking of doing? what has stopped you?” It is likely that the conversation will move onto the underlying problems but if not then maybe this is the time to talk to them about taking more immediate action. Again, Mind’s website suggests what action to take. 

Assuming you both feel it’s proving helpful to talk then you can think through together the basis of the concerns. Consider questions like what is going on? What if anything has changed? Why might the concern have become apparent now? What has been tried to sort things out? Whats different that means you are not coping like in the past? Is this a completely new experience, if not what happened last time? What options have been considered and why have they been ruled out? What would you like to do if you could do anything you wanted? Ultimately to help them think through what to do to start to make their situation better.

Remember although you are asking questions it is not for you to answer them. You might have opinions or think your own experiences are relevant - it can be helpful to share these but ask whether they want to hear them. Opinions can be really helpful if you know the person well enough however remember answers are only really answers when we find them for ourselves - to give or be given an answer is rarely the answer! The most important opinions and experiences are the persons own. 

If after having talked things through the other person is still really distressed ask what they would like to do now and what they want from you? If you are concerned tell them what you would like to do, if suicide has been talked about ask if they are still feeling suicidal. If it’s a yes then again talk about the options for getting more help. If at the end you are left feeling nervous about whether they will be alright then think about what you need. You might find it helpful to talk this through with someone.

If you have any questions about this or to book an appointment, please contact us on 020 8996 9551 or send an email to info@nicholas-rose.co.uk and we will get back to you.

Off peak reduced fee service

We are pleased to announce the introduction of a number of reduced fees for services during off peak times. For full details click here.

Counselling and psychotherapy for adolescents, adults, couples and families in West London

We are a full service counselling and psychotherapy practice based in Chiswick, West London, able to offer male and female therapists for adolescents, adults, couples and families. To access our services you can make a direct referral or request referral to us from your GP or private healthcare provider. We offer a confidential and professional service with flexibility around availability without the expereince of waiting lists.

Formums.net advent calendar of top tips for Christmas

Our tip for today is about collaboration for a harmonious Christmas, to view the advent calendar click here.