Gay Counselling

30 - Jul - 2023

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.

17 - Jun - 2023
29 - May - 2023

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. 

05 - May - 2023
14 - Nov - 2022
06 - Sep - 2022
26 - Jul - 2022

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.

24 - Jun - 2022
12 - Mar - 2022

Dissociation and Dissociative Disorders and Therapy

If you are struggling, does your experience include not being able to remember things, feeling uncertain, noticing that you have a reduced response to things that ought to feel more painful? Does your experience make sense through the words disconnected, removed or outside of yourself, others or the wider world? Do you think of yourself as though you are or could be a different person or people depending upon the situation or do you experience another presence or presense? Maybe you experience life as if through a haze or mist and or can find yourself somewhere not knowing why you are there or how you got there? And thinking back to before you had this experience were you stressed?

14 - Nov - 2018

Article on reducing anxiety

Our article - "Reduce conflict and stress in relationships" published in the Chiswick Herald on the 9th November. Please read below:

Reduce conflict and stress in relationships

Conflict and stress in relationships often come from misunderstandings and poor communication. We cannot expect others to change how they communicate but we can change ourselves and when we find communications of others upsetting then having a better understanding can help.

In this article I’m going to look at how, by paying attention to our thinking and the words we use we can become more relaxed, have less conflict with others and become happier. Initially, I will explain how we have a natural tendency towards the negative, the role of our thinking, how the words we use can make things worse for us and how we can also apply this when we find the communications of others upsetting.

Recognising the difference between interpretation and fact

For example, a friend who you had agreed to let know whether you would or would not be able to make it for coffee, replies saying 

“You are late contacting me! Bad behaviour from a friend?” 

As you can see the response contains judgements which are negative towards your actions namely, “late” (no date or time had been agreed for confirming) and “Bad” (a subjective interpretation) - with such wording it is likely that you will have had a negative reaction to these words?

Beware - negative interpretations cause escalations in both yourself and others

Your feeling response to these judgements is likely to be negative. What feeling it evokes in you will depend upon your current situation and also how you to tend to respond to negative comments. Importantly your own negative reaction to the judgements may well lead you to negative judgements in return. For example, if you have been really busy and not very well you might feel upset and then your own negative judgement will be to think you are being misunderstood, if you have a history of disappointments, you might feel anger and think they are unfair, if you have had critical parents you might feel anxious or nervous and think you are in trouble?

So likely responses you send in these three scenarios might well be something like:

“You just don’t understand and are not being nice”.

“You are unfair, I know what it is like to feel disappointed and you have no right to feel this way”.

With these first two responses your friend is likely to be respond with further negative judgement and accusation. A third possibility and just as harmful to your friendship would be the following:

“I am sorry, I’ve changed my diary so I can make it”.

In this response you are dismissing yourself and doing what the other person wants just to avoid conflict, ultimately the cost to you of doing this is to have inauthentic relationships that bring you little in return!

Facts, facts , facts

So what can be done?

When you receive something from someone that results in a negative feeling here is what to do:

  1. Pause - It can be tempting to allow your thinking to take over but this is also unlikely to be helpful as your thoughts will be based upon your negative feelings.  Also when you have allowed your thinking to gain momentum you may find it hard to avoid taking action that has negative consequences.
  2. Take a breath and then ask yourself “what is factual here?”, with this example it can be helpful that having spotted there is little factual content and noting your negative reaction, that the important message from this interaction is that your friend is upset but not able to communicate this to you in a helpful way?
  3. Now develop a response with the following parts: first - state the facts, two - explain what thoughts it brings up for you. For example:

“I felt upset when I received your message and I do not remember us saying a time by which we would confirm whether or not we would be able to meet. As I felt upset, I am thinking that maybe you are upset that we are not able to meet”? 

Such a response is factual, offers a suggestion about what is going on and invites further communication. Unless you are in a friendship with someone who is abusive, in which case their response is likely to contain further judgements and criticisms, it is likely your friend will see that a misunderstanding has occurred.  Also if in the future difficult situations arise, this interaction will have helped build trust so that your friends initial response will itself be factual. They might for example say:

“I feel upset because I was looking forward to us meeting and I have not seen as much of you as I would have liked lately”.

And if you now note your reactions to receiving this kind of message, I imagine you feel upset for the other person and rather than defensive and wanting to avoid them, find yourself wanting to reach out and get something new organised?

15 - Oct - 2018

Reducing anxiety - article in the Chiswick Herald

Our latest article on reducing anxiety was published in the Chiswick Herald on page 31. 

View article Or read it below:

Feel happier - reduce stress and anxiety - here’s how!

Stress comes from being under pressure, anxiety comes from prolonged stress, anxiety reduces our happiness - so anything we can do to reduce pressure will have a direct impact on happiness!

In this article I’m going to look at how, by paying attention to our thinking and the words we use to describe things we can become more relaxed, have less conflict with others and become happier. Initially, I will explain how we have a natural tendency towards the negative, the role of our thinking, how the words we use can make things worse for us and then offer an experiment to help you start to make changes. This article will deal with events that we might come across everyday - in the next article we will look at relationships.

When we experience being under pressure the experience is one that is alerted to us by a combination of our feelings, thoughts and bodily sensations. Neuroscience is showing that our feelings are something over which we have very little control - our bodily sensations and feelings will be triggered in response to a perceived threat or pleasure and then our thoughts will try to make sense of what is happening and if it is a threat, to seek a solution.

Under pressure it is our thinking which often proves to be the weak link. 

Thinking happens through our language, thoughts are the assigning of words to our experience and the biggest single problem with our language is how it contains so much scope for subjectivity combined with its tendency to see things as either positive or negative.

Being first and foremost concerned with our survival, negative judgements take precedence. For example, when we have a feeling we see as “good” we do not tend to dwell, analyse and procrastinate because there is nothing to be done, we are not under any possible threat. However when we have a feeling that we see as “bad” we naturally tend towards needing to find out what is “wrong”. The issue here is that we are already looking for something “bad” - we are starting with a bias. 

Our experience of living may be made up of equally good and bad feelings but the importance given to the bad means the way we can end up looking at the world will be skewed towards the negative.

In addition, the difficulty of feelings that we experience as bad can mean we do not feel as though we have time to understand whether our judgement is correct. Instead our in built risk assessment systems will urge us to think about the worst scenario, draw upon our previous bad experiences and allow our adrenal systems to kick in and allow physiological action designed to save us. 

Our very sensitive but not necessarily accurate systems are great for saving us when we really need it - where our safety is at risk - but it also influences us in low risk everyday situations where we find ourselves reacting to things and making negative judgements. I am not saying we stop judging but we recognise when we do this and how it has the potential to make us unhappy.

Here is an everyday example:

Imagine you are walking down the street - you narrowly miss stepping on some dog faeces. Whilst you are pleased you missed it you remember a previous time when you stepped in some dog “mess” and how annoyed you felt and the extra work involved in cleaning your shoes and the entrance hall carpet at home. The word “mess” combined with the previous memory triggers irritation and you think about how “irresponsible” people can be, that reminds you of how you found a new scratch on your car the previous week, you think “vandalism” and now you feel angry but also a little frightened. In turn that fear then reminds you of what you saw on the news about an increase in muggings in another part of the city. Now you think about how the city is changing and how crime is getting worse, how people are “dangerous” and you now feel unsafe. 

Instead imagine this possibility:

Walking down the street you narrowly miss stepping in some dog faeces. Whilst you are pleased you missed it you remember a previous time when you stepped in some dog “mess” and how annoyed you felt and the extra work involved in cleaning your shoes and the entrance hall carpet at home. 

NOW at this point - at the time of your initial reaction - try to train yourself to pause. You do this so that you can now look at the reaction and look firstly for words which are not purely descriptive - so ones that contain a subjective / judgement - in this case “mess” and secondly look at how this event today is triggering past negative events.

Now, having fully understood how you are reacting in a way that is amplifying the event and its negative impact on you, recall how you were feeling before this happened, take a second or so to fully experience yourself as you were.

Obviously it is unrealistic to expect yourself to do this every time something generates a negative thought and feeling however if you can start to do this occasionally you will start to understand how set backs, surprises, misunderstandings, disappointments etc end up with much more power than they fully warrant and how that can sabotage your happiness. In our next article we will look at how to apply this to relationships.

 

13 - Jun - 2018

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.

28 - Sep - 2017

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.
07 - Aug - 2017

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?”.

24 - May - 2017

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

27 - Apr - 2017

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!

19 - Apr - 2017

New article - Latest advances in treatment of anxiety and depression coming out of the USA

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

Latest advances in treatment of anxiety and depression coming out of the USA

I have just returned from the annual Anxiety and Depression Association of America’s annual conference. The Association is a huge organisation that aims to improve patient care by promoting the implementation of evidence-based treatments and best practices. The focus of this years conference was “wellness” and aimed to present the latest research findings coming from neuroscience and treatment. 

I have for some time been interested in what neuroscience is able to tell us about how the brain appears to work differently when there are particular concerns such as anxiety and depression. For example, studies have shown that the practice of mindfulness appears to have a direct impact upon brain activity and the reduction of anxiety. And it is becoming ever clearer that “disorders” occur when there is some disturbance or interruption between the alarm raising part of the brain - (the amygdala) and the processing or thinking area - (the prefrontal cortex). But we still do not know whether the disruption is in the connection from the amygdala to the prefrontal cortex or from the prefrontal cortex to the amygdala; or a combination of the two. It also seems as though opinion is leaning towards the view that such disturbances occur following some kind of “trauma”, either event driven or biological. However this cannot be definitely stated.

In the therapy profession the behavioural community do tend to be more interested in research than practitioners in the other disciplines and so cognitive behaviour therapies or “CBT” have a bigger base of research evidence. As a result service provision organisations like the NHS tend to lean towards offering these services as they are easier to justify from a financial resources perspective and offer monitoring opportunities. Of course the absence of research from other types of therapy proves very little except that those practitioners do not see a need for research. 

But research on outcomes from therapy generally conclude that the single most significant factor determining a positive outcome is not the therapeutic model or approach but the quality of the relationship between the patient and the therapist. The major issue here is that researching “relationships” and monitoring them is far more complex than therapeutic tools and techniques and so the focus is unlikely to change any time soon. 

My experience tells me that what people need more than anything else is to meet with someone who they feel cares for them and is passionate about wanting to understand their particular concerns. Such an experience is helpful because the person won’t feel the need to justify themselves and can instead think clearly with another person about their situation and what they can do about it. But I also find that people make sense of their situations in different ways, some people are analytical, some clear about their feelings and others like to think through things. When someone is struggling it is likely that they may need to adjust the emphasis they put of the way in which they make sense or not of their problems. Sometimes people ask for CBT and then want to spend their time speaking about their past, whilst others may say they want to talk about how they feel but spend their time looking for solutions. So what does this mean for anyone wanting to seek help with their psychological well being? 

  1. Keep in mind that all mental health conditions have been developed by grouping experiences and are not like physical health conditions that can be diagnosed like viruses, infections or fractures.
  2. We still don’t know whether conditions are nature or nurture or both
  3. The expectation of trauma can be misleading and sufferers can fear that their condition must exist because something has happened to them that they have no hope of coping with
  4. Chose a therapist with whom you feel comfortable - someone with whom you find it easy to speak openly with.
  5. Remember you are in charge and give feedback to your therapist to ensure you get the best possible outcome.
11 - Feb - 2017

New article - Love and relationships in LaLaLand

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.

26 - Oct - 2016

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. 

11 - Jul - 2016

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. 

01 - Jul - 2016

New article in Chiswick Herald - anger management

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

Anger - are you an angry person?

 

“Anger management” is a very popular therapy search term and it is something patients often bring to therapy. Anger is a very healthy and normal feeling but what is often missed is that anger is generated from other underlying feelings; so people may easily be avoided because they are viewed as angry because the hurt or upset that lies underneath is not recognised. 

 

Treatment can start when someone has started to wonder whether they have a problem with anger. This sounds obvious but in my experience this is not always so simple. Whilst people think they know what anger looks like - probably more than many other emotions - the reality is that anger can be hidden in a number of ways, examples being by silence and withdrawal or passive aggressive behaviour.  Meanwhile some people can appear to be angry when actually they are more excited or desperate to be understood. I work with my dog in the room and she is an excellent barometer for identifying anger. Many times she has behaved in such a way as to alert me to anger when it has not been obvious to me.

 

Treatment can helpfully be seen as having a two pronged focus - the first is to work on identifying anger and putting in place strategies for de-escalating the anger, the second is to look at the feelings which lead to anger; so its about treatment and prevention.

 

So lets look first at identifying anger. Anger can make itself known through a number of physical, emotional and behavioural signs. Physically you might have an increased heart rate, start to sweat, have stomach pain or a headache, clench your jaw, shake or feel dizzy whilst emotionally it is common to feel a number of emotions for example like running away, wanting to strike out, anxious, guilty. Behaviourally, things that are common are things like pacing, being sarcastic, speaking loudly, doing things that you know are not healthy but you find change how you feel for example drinking, smoking or taking drugs. 

 

Another key way to know if you struggle with anger is to think about your interactions with other people. Does anyone ever make any comments about your behaviour? Do you come away from situations with others where the outcome has left a conflict outstanding? Ask your friends and family whether they experience you as being angry?

 

If you have come to the conclusion that you do have a problem with anger then its time to put in place some strategies to deal with it. Neuroscience is showing that a part of the brain called the amygdala is responsible for triggering our emotions and this trigger happens anything up to six seconds before the rational / thinking part of the brain steps in. This means you can be angry before you know why - so if you are now better able to identify feeling angry you can now manage it. One very useful tool is to count to 10 - it sounds like just one of those things people often say but given the neuroscience, what you are in fact doing is allowing the thinking part of your brain to catch up! Another very useful tool, and something to do at the same time is to focus on breathing slowly. Combine the two and count each breath - use 1001, 1002, 1003 etc.

 

With these tools in place it will now be possible to start to look at understanding the situations and feelings that are generating your anger. Take time to reflect on the times when you became angry. Exactly when did it happen, where were you, who were you with, how did you act, why did you react and what were the thoughts and feelings in the moments before your became angry? You will also find it useful to start keeping a diary so that you can start to identify patterns. 

 

What you may find is that you get angry in certain circumstances - in other words you have ended up with an automatic response and this needs to be challenged as it is no longer useful. Lets take a very simple example just for illustration, imagine you realise you always get angry when you hold open a door for someone and they do not say thank you and you think “that person has no respect, why did I bother?”. Ask yourself what are the other reasons why they might not have said thank you? If nothing comes easily to mind think about a time when you didn’t say thank you - what was happening for you? Once you have found one possible alternative others are likely to follow. Secondly, ask yourself what makes you hold open doors for others and the thoughts and feeling that surface when you challenge yourself to stop doing it? In my experience people often realise that they are reacting to an assumption and an interpretation that may well be unfounded and secondly they are more upset with themselves for having expectations than what actually happened.

 

In finishing though it is really important to be kind to yourself, if you struggle with anger and  the thought of attempting what I’ve written here brings up difficult feelings, maybe even anger then consider talking to someone. And of course if your anger is already at levels where you are putting your safety or the safety of others, (which of course is one and the same thing), then don’t hesitate to seek help, anger can be managed!

26 - May - 2016

New article - thinking philosophically

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

Or read the article below:

 

Feeling lost? What happens if you think philosophically?

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

In my view, our tendency to blame ourselves for having become lost feeds a sense of isolation and loneliness; one which helps prevent us from harnessing our innate abilities to again find our way. And of course any pattern of thinking that encourages us to think negatively will only escalate how bad we feel. We can feel sad about feeling sad, anxious about feeling anxious, confused by our confusion, lost in our lostness; I think you get the point.

To break the cycle we need to do something differently that results in us again feeling hopeful and enables us to again engage with our innate philosophical potential. After all, and to allow us a brief moment of philosophical thinking, to feel lost means that at some point we did not feel lost? And to approach philosophically the point at which this changed is where we will find the information we need to again find our way. But how? Firstly, we need to find a calm disposition and secondly foster a curiosity towards our situation. 

When people come to see me it will become apparent very quickly as to whether meeting with me has the potential to be helpful; whether we can develop a therapeutic relationship. In the first session the single most important factor determining the potential outcome for us is how the person feels in spending that first fifty minutes with me. Do they feel relaxed, are they feeling free to speak openly to me, do they feel heard and understood by me? Is there a glimmer of hope that has surfaced as a result of us meeting? Are my questions or questions that are occurring in them encouraging them to think about things in a new way? The therapeutic relationship is the foundation of healing and often research has shown that for many, a relationship where the person has felt safe, cared for, heard and understood has been what has mattered most. 

And as suggested earlier the second aspect of a philosophical approach is being able to think clearly about our situation. When young, we quickly learn through the use and questioning of the information our senses provide. Our thoughts, feelings and bodily sensations are converted into information that enables us to understand the world when we also ask when? where? who? what? how? and why? And this learning forms the basis of how we make decisions. As we go through life we will automatically respond to situations that we understand as familiar bypassing any great contemplation of our senses or any rigorous questioning.

This all works fine until the situations are in fact not similar enough that an automatic response is the best choice.   Our context may have changed, and/or we may have changed, either way a response that always used to result in a positive outcome is resulting in a negative outcome. We try again and again and that only leads to us feeling worse until we realise we are lost. What we missed at the moment when our choice did not provide the outcome we expected was the need to remember that everything changes. And with change comes the need for us to be prepared to accept that the things we have come to expect as certain may need us to revisit them.

The ease with which we can do this alone depends upon many things but I think that if you are not finding a way to feel calm and that as a result you may not be finding it possible to think clearly then do not punish yourself for feeling this way. Be as kind and compassionate as you would be to the person you care for most in life. After all, surely you would tell them that they deserve help, that it is ok to sometimes need to seek help, that they do not need to feel alone? And once you no longer feel alone and you are again able to access the full potential of your curiosity you will again find your way.

Notes about Nicholas:

Nicholas is registered as a Psychotherapist with the United Kingdom Council for Psychotherapy through the Society of Existential Analysis following a training that applies philosophical enquiry to concerns that are often brought to counsellors and psychotherapists. This particular approach to therapy combines the therapists wish to alleviate the suffering of others with a framework borne from existentialism and phenomenology. 

22 - May - 2016

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 

01 - Apr - 2016

New article - when stress leads to anxiety

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

Stress that leads to anxiety

In the last column I wrote about stress - as prolonged stress can develop into anxiety I thought it might be useful to write about how to recognise anxiety and how it can be treated.

Anxiety is a heightened state that is identifiable through a combination of physical, psychological and behavioural symptoms. Anxiety is different to stress in that it is a longer term condition and it is for this very reason that it can be harder to identify and therefore to treat.

It is not uncommon for people to be unaware that they suffer from anxiety until they realise that other people do not feel like them and again, being able to identify anxiety can depend upon its cause. Where there has been a significant life event it can be easier to spot than if someone has been anxious since a very early age. Again it is common for people to not recognise anxiety because the way they experience life has never been any different. For people who have this type of anxiety it can be helpful to think about a persons early years and any childhood traumas.

And of course anxiety is linked to a wide range of other unpleasant experiences such as panic attacks, agoraphobia, other phobia’s, obsessive compulsive disorder etc. Long term anxiety may also result in clinical depression or other mental health conditions - so once recognised it is really important to start developing ways to manage and hopefully recover from anxiety.

Neuroscience is starting to help us understand the impact of anxiety on how the brain functions and to confirm long held views about its nature. It is now being recognised that heightened anxiety can come from the part of the brain called the amygdala. From an evolutionary perspective this area of the brain is tasked with warning us of potential threats and we are starting to understand that whilst this is a very sensitive and fast acting system it is not particularly accurate. Some theorists are suggesting that it is not particularly suited to modern day life because there is so much external stimuli, this area of the brain is constantly activated. As such this is why activities such as mindfulness, yoga, meditation and others that involve reducing external stimuli are becoming increasingly important.

Returning to anxiety and how to treat it, a common experience is for sufferers to be anxious about being anxious and this is contrary to how anxiety can be alleviated. This cycle which can only result in an escalation of the anxiety must first be broken. We need to adopt a “kindly curiosity” towards the experience of the anxiety so that it’s particular nature can be understood. There is nothing wrong with anxiety, in might helpfully be seen as a gift that alerts us to something we need to address in our lives. However ultimately, life will only improve if we start to recognise that the anxiety is merely an alert to something and it does not mean we need to be frightened, rather it enables us to question whether we need to be frightened and importantly allows us to decide what action, if any, we need to take.

At the primal level the three main psychological responses to an immediate threat are fight, flight and fright and we tend towards adopting a response based not only upon what is most appropriate given the context but what has worked for us in previous situations. For example, the fright response whilst it may have worked for someone who in the past needed to keep very still but it is not going to be helpful if every time you feel anxious you freeze.

What this means is we need to start to think about how the information being given to us by our thoughts, feelings and bodily sensations may require us to apply a degree of consideration and reflection to enable us to understand what is going on and as a result take an active role in how we respond. In other words, unless there is an obviously apparent immediate threat then although we may feel impelled to adopt an automatic response what we need to work towards is pausing and taking time to think through how immediate the threat may be and develop an appropriate response.

06 - Jan - 2016

A Mindful Festive Season - Part two

This article is the second in a series by Nicholas reviewing an online Mindfulness Training he started just prior to Christmas.....

I hope you had a peaceful, relaxing and enjoyable Christmas? 

For my part a quiet Christmas with close friends and family has been a healing experience after three successive festive seasons with various painful, stressful situations and losses. Periods of calm, gentle relaxation with others who have been easy company, has been nurturing, restorative and facilitated a general sense of well being. 

Alongside this and the absence of any new difficulties, has also been the Online Mindfulness Training I’ve been doing as introduced in the last column published in the paper on the 17th December or available here online: http://chiswickherald.co.uk/on-the-couch-with-nicholas-rose-p4693-261.htm. The training itself is provided by www.bemindfulonline.org.

Overall, both have given me an experience of a period of time whereby the noticeable absence of worries again suggests to me just how much previously experienced day to day stress and anxiety maybe coming from nothing other than self made pressures. Of course it is natural to react to difficult situations by taking action and making lists of things to do, however a list of things will only bring additional pressure and a resulting bodily response that adds to the already heightened experience caused by existing difficulties.

As is always the case when I spend time practicing and learning more about Mindfulness I find something new and helpful that makes the time spent both easier and more rewarding. As I start week three of the training it is during a meditation I notice throbbing in my head, it is something I’ve noticed many times before. Previously I’ve tried doing what I’ve been taught, namely paying it attention but the outcome has been for me to feel somewhat nauseous and it has led me to feel reluctant at times to practice. However this time, right at the moment when the nausea is starting to appear the facilitator, Ed, says something like “if you notice any unpleasant thoughts, feelings or bodily sensations you can try paying them attention or you might find it helpful to return your focus to your breathing". This I do and the pain and nausea disappears. Todays learning was a piece of “unlearning” - I had been holding an assumption that there was only one way to deal with difficult experiences during mediation but now these few words have released me from something that was certainly unhelpful.

And I am finding Ed and Tessa, the facilitators, to be perfect companions to the training. In the middle of the second week just at the point I noticed thoughts around how the training was not enough I received an email inviting me to a mid week video. It was as though they knew exactly how I would be thinking and feeling at this stage and hearing them talk about the successes and challenges of the exercises as I had also experienced of them was just what I needed. I was left feeling reassured that I was in fact on course, not alone in my experience of suddenly doubting whether the training was useful and not failing.

This week I read two articles published on washingtonpost.com about Mindfulness, one from Neuroscientists again talking about how after eight weeks of practicing, changes to the brain can be seen in areas that they believe are helpful and healthy, meanwhile another article warns that Mindfulness is being “mindlessly” taken up by everyone when for some people it might not be helpful - in fact it might be unhelpful.

Mindfulness helps me to identify where stress and anxiety is leading me to do more than I need to, whether that is working, cleaning, eating, drinking, exercising, resting or like this week, paying attention to difficult experiences during a meditation. In other words it helps me to keep things in perspective and this is what I believe is most helpful. As a psychotherapist I’ve learnt and experienced many different approaches to gaining perspective but when I think of things that I have found helpful I would say that both therapy and mindfulness as it is taught and practiced today have been the most useful.

I’m still working through the Online Training so I will let you know in the next column what I think as I reach the end.  

04 - Dec - 2015

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.

13 - Nov - 2013

Saturday services for couples and relationships

We have recently extended our couples counselling service to include Saturdays. For relationship counselling, marriage counselling and couples counselling services please contact us to enquire further.

Couples Counselling London

Couples Counselling can be a positive experience at any stage of a relationship, as relationships pass through various stages new challenges and possibilities arise where counselling can facilitate growth, change and alleviate conflict. Very often, it is helpful when one or both of you are feeling misunderstood or isolated, or when you identify negative and destructive patterns.

If you are based in West London and feel that you could benefit from couples counselling then Nicholas Rose and his expert team are here to help you through any issues that you may be having

Please also remember we run evening sessions, and sessions via Skype, telephone and email. For further information please feel free to contact us.

06 - Nov - 2013

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.

06 - Jun - 2013

New article on sexual attractiveness

Nicholas has contributed to the latest publication of FS magazine in an article looking at sexual attractiveness. It considers the role of fashion and trends as influencers of preference.

07 - Mar - 2013

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.

28 - Jan - 2013

Will counselling be of benefit for you?

This simple online test can help you decide whether counselling or psychotherapy might be a benefit. Click here for the test that will open in a new window. Once you have taken the test you can contact us to talk through your results.

01 - Dec - 2012

New article on sex and relationships for gay men

Nicholas has contributed to an article on sex and relationships for gay men. Click here for more details.