Tag Archives: Counselling

Do you remember your first time?

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I was recently reflecting on the different approaches used by counsellors in their initial consultation session. For the client this first meeting may be massively anxiety-provoking. Perhaps they have only communicated with their potential therapist beforehand via email or text and are so filled with things to say that everything rushes out at once!

It has to be said that first meeting can often leave you feeling as though you are going on a blind date!

I come from a counselling background of mandatory form filling, monitoring, and evaluation and often found myself abandoning organisations’ protocol in order to really listen and engage with the person sat right in front of me. Although there is certainly importance in building up a bigger picture of my client’s difficulties I often feel the approach of, “please answer questions 1, 2 and 3” could mean that the real answer gets entirely overlooked. That is, if I try to direct you to what I think might give me insight, we might end up setting off in the wrong direction!

What can I expect in my initial consultation? What do I say and do?!

Since that first meeting is usually slightly shorter I would recommend going in with a broad overview of your difficulties. Remember, it doesn’t matter if you forget anything important in the initial session- there are no right or wrong answers. Therapists are not like doctors and we aren’t listening out for a list of ‘symptoms’ in order to medically ‘diagnose’ you and prescribe a form of ‘treatment’. The process is more about working with your feelings and getting to the root of your problems.

Ask questions.

Feel free to come prepared (carry a list of questions and ideas if that helps) so that your therapist can help clarify things for you. A good therapist should be happy to answer any questions relating to their experience, qualifications and practice and you will be able to get a ‘feel’ for them too. Does it feel right? Do you feel comfortable with them? Do you feel unsure or rushed? Are they open or defensive, warm or clinical? Do you feel valued or unimportant? These are all incredibly valid gut reactions which can help inform your decision as to whether you’d like to work with them going forward.

What are your goals? How will you know when you’re finished in therapy?

It’s a good idea to have at least a vague notion of what this might be for example: I’d like to feel more confident, I want a better relationship with my partner, I’d like to feel less angry. By understanding and setting some goals it can help to steer the process but remember – sometimes clients come into the therapy room thinking they want to address one issue and as the layers peel back they realise the issue was really something else all along! I review regularly with all my clients to see if they feel on-track and are happy with our progress. One important thing to note is that sometimes it can feel as though you are ‘stuck’ in therapy- like you’ve hit a glass ceiling and things feel stagnant. That’s something to discuss together and can actually bring up very valuable material- it certainly doesn’t mean ‘it isn’t working!’

Find out about the process.

In my consultation sessions I might talk a little bit about our boundaries, confidentiality, session arrangements and frequencies, note-taking and ethical policy. As there is no obligation to sign up on the day I give all my potential clients a copy of my standard counselling agreement to take away and read carefully- if they wish to come back they can complete and return it on the first agreed session where we will revisit it and make sure it is understood clearly.

Be yourself! Warts ‘an all!

This isn’t a job interview and you don’t have to do anything other than be yourself. I have had many clients who ‘prepare’ or ‘rehearse’ what they plan to say in a session, only to realise that all that goes out the window when you’re deeply in the moment! Take some deep breaths before you come in and try to relax as much as you can- we’re here to help you, not make you feel worse! Be as honest, open and authentic as you are comfortable being- that will go a long way in moving the process along- and above all, trust in the process.

Good luck with finding the right therapist for you.

Steph x

The Judging Mind

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I recently attended a fantastic course on object relation theory and transference presented by Helen Rowland. Aside from the practical teaching, casework examples and supervision, the group held some really interesting discussions around whether people really ever do ‘get fixed’! 

The group consisted of a wide range of professionals- some who had just completed training and some with decades of senior position experience. Interestingly enough the unanimous response was: No, we as humans never get fixed! You might be wondering then why anyone might want to enter into counselling!! 

Well, the first important thing to consider is that we’re not actually broken. We are not faulty parts of a machine which needs putting back together properly. We are all completely unique and have experienced different things in life- both the beautiful and the challenging. For someone besieged by painful intrusive thoughts, a heavy depression, crippling OCD or distressing PTSD symptoms, it might be easy to assume that it is the people “out there” who are “normal” (whatever the heck that word means!!). In therapy we would look at this in the way that your current behaviour is the way your body found to cope with the stress it experienced. Your anxiety for example, served a purpose. It made you sharp and aware. Maybe it saved your life at one point, but now isn’t so helpful in the day to day. 

Our life scripts begin early on and get regularly updated and revised as we move through life. Many times in therapy I hear things like: I’m just like this. And yet rarely (if ever) do I hear people say: I’m just like this and I accept myself as I am. The resistance from not being at peace with yourself creates and reinforces the inner psychological pain – feeling a need to constantly push ‘it’ away so you can be ‘normal’ (I hope we’re starting to all hate that word by now!!) is actually unhelpful and counter-productive. 

So, as the group of therapists sat in the room agreeing that ultimately people can’t be ‘fixed,’ now I respect and understand that even more deeply. We might be cut to the core by our pasts but we are not broken – even if we feel like it. We are survivors, maybe tired and weary, but still powerful, strong and courageous. It’s true, we can learn to change our behaviours and adapt with a greater sense of perception- we can also widen our field of awareness and teach ourselves to sit with the feelings, but we can’t magic the bad times away. Over time we can learn to embrace our emotions (both the good AND bad) from a place of authenticity, wisdom and truth.

We are who we are and we are good enough as we are- perfectly imperfect. 

Banish the Winter Blues!

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As we hurtle towards the dark nights and impending frosts you might start to feel as though you are slowing down too! A lack of sunlight affects our internal body clocks and our serotonin levels start to drop, which can leave us struggling with energy levels, mood, sleep and motivation. Whilst these kind of feelings seem to affect most of us to a certain degree, for around 10% of the population this may be medically diagnosed as something called Seasonal Affective Disorder (or SAD for short).

SAD is basically considered a sub-type of depression and like all mental health issues should be taken seriously. As difficult as it might seem when all you want to do is hibernate, the benefits of maintaining regular social contact, keeping active, eating well and trying to get as much sunlight as you can are all powerful tools in keeping the winter blues at bay.

For more information on SAD and tips to keep well, please visit http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/dealing-with-winter-blues-sad.aspx

Get over it! (said no one helpful ever…)

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*All names are changed to provide anonymity, and permission was given by the client to publish this article.

*Katie came to me presenting with some difficulties surrounding the relationship with her boyfriend. Despite having a strong, secure and loving relationship, Katie struggled to get over a comment her partner had made in only the first few weeks of them being together. During a casual conversation, her partner had mentioned that Katie wasn’t usually his type but that he was so enamored by her that he just didn’t care! Despite him continuing to say how kind, funny and intelligent he found her, Katie struggled to integrate the totality of his response, finding herself only selectively screening the first part.

The negative aspect of the statement began to gather momentum over time – the perceived hurtful comment playing out internally whenever he told her how beautiful he found her, or how much he loved her.

She struggled to connect deeply with him on an intimate level too, the negative thoughts escalating over time (I bet he fancied his ex-girlfriend more/ He’s probably just humouring me etc.).

At times Katie could catch these thoughts before they took hold by offsetting them against how good the relationship was and how great her partner was. She tried desperately to replace the negative thoughts with positive ones but found the reconditioning self-talk didn’t really change things, only mask them for a brief time.

Throughout her life Katie had struggled with depression and admitted in sessions that she was a very ‘all or nothing’ type thinker.

“I just don’t want to think about this ever again. It’s like there’s part of my brain which just refuses to update and replace old information with new stuff. It means I struggle to let go, even when I know it’s totally irrational.”

This type of incident wasn’t just a one-off for Katie who explained that she had a long history of similar experiences in relationships. As far back as she remembers, Katie had never been able to accept that her partners truly wanted to be with her. She felt they must all have some ulterior motive. She was able to identify that she had a pattern of ‘testing’ others, which in reality only ever culminated in dramatic, unstable relationships and pushing others away.

Katie and I worked together to explore some of her earlier relational patterns and her attachment style (insecure), and gradually moved onto discussions about her mother who often had angry emotional outbursts. Katie was able to recollect:

 “I remember being shouted at when I was a very little girl and although I can’t remember the exact words that were said, I remember the feeling. It felt as though my Mum had said she didn’t want me, or that I was a mistake – something like that anyway.
It isn’t clear but the feeling is.”

We explored this feeling of hers and how at the time – despite her mother later soothing her and apologising – little Katie felt as though she didn’t believe her apology:

 “I just didn’t believe her. It felt like because she said it, she must mean it, and it couldn’t be taken back. I felt like I knew the real truth – and the truth was that I wasn’t really wanted.”

As a young child unable to accurately interpret adult behaviour, Katie had internalised the abuse and developed a false core belief – that being:

 “I am unwanted and unlovable, others cannot be trusted.”

The biology of ‘all or nothing’ thinking is actually quite helpful in terms of primitive evolution. When faced with a large predator about to devour us for lunch, there is little time to think about what to do! We flip into our powerful flight or fight response mode so that we can make a snap decision under perceived threat.

Through therapy Katie discovered that her emotional triggers were all relating to her sense of feeling under threat, prompting her to react with maladaptive behaviours (set of programmes). Katie was an intelligent and self-aware woman but struggled to see a way out of this all or nothing (black/white) thinking:

 “How does it work though? How do I just rewire my brain like that? If I see a red triangle and everyone else sees it as a green square, how do I begin to believe them?”

Together, we looked at how such early negative experiences can lead to cognitive distortions and how we set the mind to ‘look’ for danger. Although all of our perceptions are coloured by our own particular version of events, we explored ways of broadening her perception in order in such a way that the perceived ‘dangers’ became diluted.

During our time together, Katie gradually began to update her core beliefs and start to feel less fixed in her all or nothing views.

“It’s still hard to see the grey areas at times, but being more aware of my processes really helps me to reflect on what I perceive to be a trigger in the first place.”

Steph Jones is featured on Counselling Directory Register and registered on the British Association of Counselling and Psychotherapy (BACP) Professional Standards Authority Accredited Register (Registered number 202917).