Category Archives: Seminars for therapists

Working in Therapy with Adolescents and Young People: What is different? Key points of understanding.

On 25th April, a group of 16 therapists of varying disciplines and experience attended a seminar presented by Professor Stephen Briggs (whose books include: Working with Adolescents and Young Adults: A contemporary psychodynamic approach (2008).

We had had the opportunity to download 26 of his slides which offered a framework for the discussions.

In the process of working with this age group, we understand that we have to do things differently from our work with child and adult populations, outlined as follows:

THERAPEUTIC STANCE:

  • Providing a combined containing and exploring space..(containing anxieties and exploring meaning).   This combines taking in the feelings, making sense and feeding back whilst ‘holding’ urgency and anxiety.  Also, enabling the young person to tolerate the ups and downs, extremes of excitement and depression;  facilitating feelings of overwhelm and omnipotence, and taking these things seriously.
  • Being ‘adolescent-centred’..trying to understand the adolescent ‘world view’, without making assumptions about the adolescent’s knowledge or experience of the therapy process.  This includes noticing how quickly adolescents can change and how stuck they can be in the developmental process. The therapist is required to take on the ‘in-between-ness’ of the client, moving responsively between more adult/more childlike states as they occur.  Working with the ‘yes’ adolescent and the ‘no’ adolescent.

WORKING WITH DEPENDENCY:

  • Stephen Briggs explored the delicate issues around the adolescent’s potentially fragile sense of independence where the offer is to share with the therapist what is his, what can he share? What does the therapist need to know; what can be private and acknowledged as private?
  • The therapist needs to work out what the adolescent can and can’t bear, adapting to the fragile sense of separateness from parental figures, his aloneness in the world and the responsibility of his own thoughts and actions.

BECOMING A SUBJECT IN ADOLESCENCE:

  • ‘Being subject to’:  things happening, re-enactments and repeated patterns through change…(puberty, relationships, peer groups).
  • ‘Being subject of’: something that’s going on emotionally and rationally – relating to experience, learning from experience.
  • ‘Becoming a subject’ – the process of gaining ownership..new adult, sexual body, ownership of one’s own thoughts. Ownership of drives, sensations, impulses, feeling and powers. With ownership of bodily changes comes both power and the power to enact. Power relationships evoke different capacity to enact thoughts and feelings.
  • Increased separateness from parental figures at the above levels.
  • From neuroscience, we’re told that with brain development, the slowest capacity to develop is the capacity to reflect.
  • For Separation and Individuation at one end of the axis and Regression on the other, there are transverse opposites:

Self -esteem and competence.   Vs.  Fear of failure
States of mind (subject to).          Vs. Subject of
Power.                                              Vs. Dependence
Life.                                                   Vs. Death

So the binaries in the adolescent process are:
– Excitement v Loss
– Love v Hate
– Life v Death
– Online v Offline
– Powerful v Dependent
– Competence v Fear of Failure

The retreat from death can lead to omnipotence and/or the need not to fit in with convention.  Online/offline ambivalence engenders both omnipotence (with the provision of answers to problems) and the defeat of omnipotence (when the adolescent can’t solve the problem).

An example:
Exploring on line = securely attached
Looking for ‘belonging’ online = less securely attached.

These are part of the dichotomies to be held in mind through the therapeutic intervention in adolescent work.

We had a further three case studies to consider, discuss and apply the learning from the presentation as well as from our own experiences.

WORKING WITH TRANSFERENCE AND COUNTER-TRANSFERENCE:

In the transference:

  • drawing attention to connections between the social world and the therapeutic relationship.
  • making formulations about relatedness, maternal and paternal transference.

In the counter-transferential space:

  • what are we picking up as therapists of the adolescent feelings? What feelings are we evoking?
  • what about me is getting in the way of this work?

So what is both going on in the therapist and what from the adolescent is stirring up feelings in the therapist?  Much of the rich discussion from the case studies surfaced transference and counter-transference explorations.

Appropriately we talked of endings, particularly from the last case study where breaks in the therapy and missed sessions brought important material for therapeutic thought.

Stephen said ‘there is always something about separation with adolescents…in the therapeutic relationship, we replay through separation from the therapist, those other issues of separation’. ‘We are introducing the adolescent to him or herself’.

By: Angy Man, March 2017

Seminar on Sex Addiction with Karen Lloyd, 18 June 2016

Karen Lloyd, an accredited psychosexual psychotherapist and certified sexual addiction therapist, gave us a full day of insight and knowledge on the quite misunderstood and challenging subject of sex addiction.

Karen Lloyd with Wendy Bramham

Karen Lloyd with Wendy Bramham

We learnt that people with sexual addiction do not have fun, that it is not related to a sexual orientation, neither is it connected to sexual fetishes or paraphilias. Sexual addiction is not the same as sexual offending.

We thought about the many words we might use to describe a person with sexual addiction problems and that they are mostly negative. Shame is the most acutely felt emotion and trained therapists work mainly with supporting and helping their clients to manage their feelings of shame.

Karen helped us to understand how she and her fellow trained therapists work with clients and gave us lots of detail on the complexities of working in this specialist field. It is a “process addiction” and the primary driver for sexual addicts is for mood altering purposes. We thought about some similarities in how alcohol addiction is now managed, for example providing support groups as a powerful and effective technique.

Karen spent the 2nd half of the day focusing on how she and her colleagues help the partner of a sexual addict and how isolating and shameful the discovery of a partner’s sexual addiction can be.Seminar sex addiction 2016

The seminar was interactive and well paced, packed with information and insight and very much a taster of how to work with this very challenging subject.

By : Jo Turner, June 2016

We are pleased with the delegates’ average feedback scores as follows:
Overall assessment of event: 4.89 out of 5
Speaker: 4.5 out of 5
Value for money: 4.89 out of 5

Comments from delegates:
“Fantastic delivery of the course by Karen, very insightful and interesting”
“Excellent value”
“Karen’s experience, warmth and knowledge made it easy to engage and enjoy the seminar”
“Very relaxed, intimate and cosy to share”

Sex addiction workshop with Karen Lloyd -18 June, Newbury

We are looking forward to our seminar on sex addiction and how to work with this growing problem in the therapy room.

In today’s digital world we see reports in the news on a regular basis of out-of-control sexual behaviours, often attributed to the errant celebrity ‘caught with his trousers down.’ In the psychotherapy and counselling world sex addiction is fast becoming a common presenting problem.  We will address the growing problem of sexually compulsive/addictive behaviour, love and porn addiction, and sexual acting out behaviours, both on and offline.

Karen Lloyd is a BACP Registered Accredited psychosexual psychotherapist and a certified sexual addiction therapist. She also works as a trainer, and as an accreditation assessor for BACP. She has a Post Graduate Diploma in psychosexual psychotherapy and previously worked as a therapist and trainer for Relate for over 10 years. Karen has a long established practice in the West Midlands working with individuals, couples and groups. She runs a 10 week psycho-educational course and on-going women’s support group for female partners of men with sexually compulsive/addictive behaviours, as well as intensive residential psycho-educational groups.

For tickets, go to http://www.newburytherapy.com/psychotherapy-therapists-seminars-newbury.php

Seminar: Neuroscience and psychotherapy with Margaret Wilkinson, Sat 23rd April

Psychotherapy can help change the brain – this was the compelling take-away thought from Margaret Wilkinson’s excellent seminar on Saturday. Margaret reminded us how early childhood experiences shape not only our emotions and thoughts but our actual neuro-biology. However, these learned patterns and response do not need to be set in neural stone. Margaret outlined how recent insights from neuroscience indicate that the brain is plastic, creating new neurons and new connections throughout life. This means that whilst old patterns of thinking and feeling may be deep-seated and habitual, they can be changed. The empathic and boundaried psychotherapeutic relationship is a place which promotes this change, literally helping the brain think and feel in a new way.

Margaret helped us reflect on this through insights from her own clinical work, questions from the group and an interesting interactive exercise in which we practiced wordless empathy – simply receiving and responding to our partner’s body language and unspoken energy.

This was a good day’s learning, with plenty of food for thought and scope for exploring in our own work.

Briony Martin

(Counsellor and Psychotherapist in private practice and in an agency setting with clients presenting with addiction issues)

We are delighted with the scores from 19 delegate feedback forms:

Overall assessment of event: 4.63 out of 5

Speaker (Margaret Wilkinson): 4.58 out of 5

Value for money: 4.58 out of 5

written comments from delegates:

great organisation, lovely venue”; “excellent, clear, knowledge and experience shines through”; “speaker engaging, very knowledgeable and able to share this in a easy way”

Thank you to everyone who gives us feedback, which we take seriously and use to improve what we do.

Wendy Bramham 

Seminar on Working with Personality Disorder, with Pete Holloway

Pete Holloway, an experienced psychological practitioner within the NHS, treated us to an in-depth insight into working with patients on the Personality Disorder spectrum. Pete shared his vast knowledge and provided examples of clinical work to explain the different types of Personality Disorder.
We learned about how the enduring types of behavioural patterns are classified by the ICD 10 (W.H.O.) and DSM V (American Psychiatric Association) organisations.

Pete helped us to understand the dilemmas and contradictions likely to be experienced by the therapist working with patients and how important it is for the therapist to maintain therapeutic optimism in the therapeutic relationship to help both the patient and therapist.

The seminar was delivered by Pete with humour, drama and impact, making the subject matter come to life and be felt.

Jo Turner
PG Dip. Mar. Th. MBACP

We are delighted with our delegate feedback scores from this seminar as follows:

Speaker (Pete Holloway): 4.82 out of 5
Value for money: 4.73 out of 5
Overall assessment: 4.65 out of 5

Delegate comments:
engaging, clear and concise
v good diagnostic terminology
really excellent (i don’t often say that!)
great speaker, engaging and informative
great venue
Pete delivered a very challenging therapeutic process and experience very well with humour and insight.

Seminar: Autism & the Therapeutic Relationship – Alison Edwards, 27th February 2016

There was a good turnout for our morning seminar lead by the experienced Integrative Arts Psychotherapist, Alison Edwards.

I particularly enjoyed and benefited from Alison’s “grass roots” experience. The delivery of the seminar was with simplicity and directness – in parity with how those on the autistic spectrum communicate and express themselves.

Alison shared her deep and extensive experience in working with mainly children, in school environments, with vignettes of how her autistic patients react and behave to situations (which would be viewed and experienced very differently by the Neuro Typical population). She is passionate about her work and Alison feels greatly enthused by the steps now being taken in the fields of Education and Science to formulate ways of assisting our autistic population to live full and enjoyable lives in exactly the way they need to do so.

We talked about our perceptions of what autism is, the generalisations and labelling many of us retain. Alison dispelled some myths, for example; not all autistic people are highly intelligent, nor hugely creative; many DO have empathic skills and DO want to relate to others. Alison shared some of her own techniques used to work with autistic patients to enable the therapeutic relationship in communicating, build trusting and empathic relationships.

Neuro Typicals need to search “outside the box” too, to think in different ways, to engage on other levels – an enriching experience for the therapist as well as the autistic patient.
A thought provoking seminar, which has led to further self-reflection and reading on this subject.

Jo Turner, Feb 2016
PG Dip. Mar Th., MBACP (Accred.)
Relationship psychotherapist

We are pleased to announce that delegates gave this seminar the following average scores from 22 feedback forms:  4.43 out of 5 for the speaker; and 4.4 out of 5 for overall assessment of the event.  Thank you to all who attended this and previous seminars, we appreciate your participation and your feedback.

Written comments from delegates:

“I really have learned a lot and gained useful ideas of how to work therapeutically”
“Alison’s enthusiasm is great”
“very knowledgeable speaker”
“venue fitting and a good size”
“engaging, knowledgeable, informative speaker”
“venue great, speaker fantastic”
“well organised and relaxed atmosphere”

Seminar on Addiction

Addiction seminarRonnie Aaronson provided the seminar group with a well of her knowledge and experience on addiction, in particular focusing on the issues of alcohol addiction.   Ronnie explained how she works with clients using the Cycle of Change (Prochaska & DiClemente) system which helps both therapist and client to see quite clearly at what position they take in their process of tackling their addiction.   Moving along the cycle is helpful in motivating clients and the “lapse” stage is also an important part of the process of change and is not seen as a failure, but a chance to re-evaluate and to encourage a continuation of the work.

Supporting clients with addiction is complex and Ronnie believes that it is important for therapists to always work with the client’s needs, whilst at the same time being aware of the therapist’s own needs for rescuing and “fixing” which can often be unhelpful.   Ronnie uses the “Drama Triangle” (Karpman: Persecutor, Rescuer, Victim) to help explain the behaviour involved in addictive client relationships.  An understanding of Dependent Personality Disorder is helpful to asses for likelihood of addictive tendencies.

An important part of the therapeutic work with clients involves helping the client to manage their feelings of shame, which are often feelings associated with addiction issues.

Role playing and discussing scenarios helped the seminar group to understand in more depth how to think about working with addiction clients.

Participants rated this seminar in terms of overall assessment, on average, 4.03 out of 5.  Average ratings for the speaker were 4.11 out of 5.

By: Jo Turner
Edited by: Wendy Bramham
19 November 2015

Feedback from participants:

  • “All perfect”
  • “excellent organisation”
  • “great venue, very central”
  • “speaker very knowledgeable on the topic”
  • “gave a good insight into the complexity of treating addiction and the pitfalls of dismantling defences too quickly”.

Suggested reading:

  • AARONSON R. (2013) Addiction – this being human Bloomington: Authorhouse
  • BERNE E (1970) The Games People Play. London: Penguin Books
  • GERHARDT S. (2004) Why Love Matters –How affection shapes a baby’s brain. London: Routledge
  • KAUFMANN (1985) Shame: the power of caring. Cambridge, Mass: Schenkman Books.
    MILLER W.R. &
    S. ROLLNICK (1991) Motivational Interviewing. NY: Guildford Press
  • NATHANSON D.L. (1992) Shame and Pride. Affect, Sex and the Birth of the Self. New York: W.W. Norton & Co. Ltd
  • SCHORE A. (1994) Affect regulation and the origin of the self: the neurobiology of emotional development. Hillsdale: Erlbaum.
  • TURP M. (2003) Hidden self-harm. Narratives from Psychotherapy. London: Jessica Kingsley Publishers Ltd.
    WINNICOTT D.W. (1960) ‘The Theory of the Parent-Infant Relationship.’ In The Maturational Processes and the Facilitating Environment. London: Hogarth, 1965.