Tag Archives: depression

Working with Self-Harm and Suicidality – CPD with Pete Holloway

Having looked forward to this seminar since it was first mooted, I found that I wanted to take a few days after attending to process the experience. It felt as though it bordered on the transformational and I believed that it was worthwhile to just allow that post-seminar glow to recede if it was going to do so?

A week on, and I have to say that it still feels as though it borders on the transformational. The shifts in perspective it generated for me by examining what self-harm might mean for clients- what and who might be being harmed and who might be doing the harming- by taking a more object relations and existential tack- were truly “lightbulb” moments for me and have already enhanced my clinical practice. The concept that the body becomes the projective tool for what might be going on in the mind; that what is going on in the psyche might be enacted in or on the body sounds simple and yet it was remarkably illuminating.

It was also extremely helpful to address the therapeutic challenges and the “institutional anxiety” that might arise around suicidailty as we work with our clients. Whether we work within an agency as part of a team or whether we are the institution itself as sole practitioners, being able to explore how to work relationally without becoming hamstrung or paralysed by potential consequences around working with such serious issues and behaviours was incredibly valuable.

Looking more closely at risk factors and approaches to risk appraisal when working with the “suicidally contemplative” was also very beneficial in terms of being able to work effectively and appropriately in these areas.

This was an amazing seminar dealing sensitively and helpfully with complex and challenging issues. Pete brought a generosity and warmth to this work which made it accessible and, well, do-able. I am SO glad I attended and have left with the gift of a deeper and more reflective way of “being” with this aspect of therapeutic work and pathways of thinking on this subject theoretically opened to me.

Pete listed some key influences on his thinking and I wonder if it might be helpful to share them:

Felicity de Zulueta: From Pain to Violence

Irvin Yalom: Existential Psychotherapy

Wilfred Bion: A Theory of Thinking

Melanie Klein: Love, Guilt and Reparation

Judith Herman: Trauma and Recovery

I know I’ll be adding these to my reading list!

By: Merri Mayers,
October 2017

We were thrilled with the excellent feedback.  20 out of 21 delegates voted 5 out of 5 on all three questions to give these overall results:

Overall assessment of event: 4.95 out of 5
Speaker: 4.95 out of 5
Value for money: 5 out of 5

Delegates feedback:

  • “You have been highly informative and have re-ignited my interest and passions in this field of mental health and therapeutic interactions.”
  • “What an excellent day – Pete has a breadth of knowledge and a great human, realistic approach to therapy”
  • “I liked the group–size, helpful to promoting an atmosphere where engagement and participation is possible.  Wonderul speaker dealing with a difficult, painful topic in a positive way that affirms the therapist’s competence.”
  • “Excellent speaker, clearly an expert; enjoyable and enlightening about a sombre and disturbing subject”
  • “Pete has been so informative, interesting, engaging and funny – so interesting.  I would definitely attend another of his courses.”

Wendy Bramham
October 2017

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Healthy Selfishness – what is it and why does it matter?

Can Therapy Make You Selfish?

Do you worry that having counselling might be indulgent or selfish? Do you fear that focusing on your own desires and needs might result in neglecting or hurting others? Lots of people who go into therapy have these fears. And the fear of selfishness is understandable given that many of us were brought up to put others first. However, I’m wondering if there is a different way to look at this issue? Perhaps there is a kind of ‘healthy selfishness’ that we can explore in therapy and which might help us get our lives in better balance?

Take journalist, Sally Brampton’s**, experience. In ‘Shoot the Damn Dog’, a brave and excellent memoir of her own suicidal depression, she recounts how a therapist told her she was abandoning herself every time she:

  • pretended she was fine when she wasn’t
  • refused to rest when she was tired
  • didn’t ask for what she needed from a person with whom she was intimate, and
  • put someone else’s needs before her own but resented doing so.

The therapist explained that Sally suffered from a failure of care; care for herself but also care from her parents who should have taught her how to take care of herself in childhood. Sally explains that as a child she unconsciously learned that it was better not to need or become attached to people or things, because anything she loved – people, dogs, houses, schools – were taken away from her. As an adult she was able to see other people’s needs but not her own, and this contributed to her serious depressive symptoms.

Narcissim… is therapy just ‘all about me’?

Selfishness, defined by the Oxford English Dictionary as “…concerned primarily with one’s own interests, benefits, welfare, etc., regardless of others”, is not to be confused with pathological narcissism. This condition is characterized by self-inflation, grandiosity and lack of empathy, which are ways of coping with very low self-esteem. Narcissistic traits include self-serving attitudes and behaviours that exploit others. By contrast, therapy aims to help clients become less fearful and more accepting of their own feelings, which in turn fosters the capacity to build self-esteem, and relate more openly and fully to others through increased empathy, compassion and intimacy.

So, if ‘healthy selfishness’ actually promotes self-respect as well as respect for others, how can it be achieved? Our experience suggests the following:

* honest self-reflection, especially after setbacks

* taking responsibility for yourself

* self-care and self-respect

* acknowledging what you need and what brings you joy and meaning

* celebrating your achievements

* connecting with your authentic self

* learning to tolerate differences between yourself and others

What is Good-Enough Parenting?

Donald Winnicott, the famous paediatrician and psychoanalyst, coined the term ‘good-enough mother’ in 1953, and his thinking went on to become pivotal in understanding child development. If we are lucky as infants we will have had good-enough parenting; our primary care-giver will have responded to our needs and feelings, reassuring and comforting us in a fairly predictable and timely manner, and empathising with or tuning-in to our emotions. If this ‘good-enough’ parenting is available to us during our early years, we stand a chance of developing the ability to manage and care for ourselves through life’s inevitable ups and downs.

If good-enough parenting is not available, or we experience a great deal of loss or trauma, we don’t learn healthy selfishness and consequently get used to putting on a mask for the world, and living to please others. Therapy can be crucial in addressing this imbalance, helping clients learn to be their own ‘good-enough’ parent and to properly honour and care for themselves. In her book, Gift from the Sea, Anne Morrow Lindbergh, writes about the peace she found through rediscovering herself during a quiet island holiday, away from her busy life as mother to five children: “When one is a stranger to oneself then one is estranged from others too. …Only when one is connected to one’s own core is one connected to others.”

Perhaps it is only when we can consider ourselves as important that we can find peace and fulfillment? But why does it matter?

What Happens if we are not Healthily Selfish?

Anne* had been married for 18 years, and came to therapy with marital difficulties. She had always tried to please her husband, but recently he had become frustrated and withdrawn. The more she tried and failed to please him, the more Anne perceived him to be selfish.  What was really happening was that Anne was projecting her own unmet needs onto her husband, who in turn felt trapped and somewhat manipulated. Additionally, Anne had become silently resentful of her husband and had also developed stomach pains and indigestion. When her therapist commented that there didn’t seem to be “enough of her” in her life, she felt criticised and rejected. She enjoyed looking after others, she said. Surely this was a good thing? Gradually, in therapy, Anne realised that she had taken on the role of ‘pleaser’ early on in life, and whilst this gave her an identity, it made her self-worth dependent on another’s appreciation. Behind the role of helper she didn’t know who she was; she had become an empty shell.  And so had their marriage.  This pattern of relating, in an attempt to gain self-esteem, was simply no longer working.

Change came as Anne began to acknowledge her own feelings, needs and desires, and to believe she could exist in her own right. She began to develop an authentic sense of self. She started to take charge of her life, taking pressure off her husband and their marriage. The tension that was causing her indigestion also eased, because her unspoken, repressed resentment had been faced, understood and let go. Anne moved from unhealthy selflessness, to healthy selfishness.

Healthy Selfishness enables us to care for ourselves and others

Therapy promotes a ‘healthy selfishness’ which enables us to take better care of ourselves and helps us to form more satisfying relationships. It is better not only for the individual, but for all those we relate to.

We cannot take responsibility for our own happiness if we habitually or compulsively put others before ourselves. The concept of ‘healthy selfishness’ gives us permission to care for and nurture ourselves, which is particularly important if we have learnt to get love and affirmation by pleasing others. Indeed it is often those of us who protest most that therapy might be selfish, who have the greatest need of it!

 

Author: Wendy Bramham, Psychotherapist & Proprietor “Wendy Bramham Therapy”

*  “Anne” is a fictionalised conglomorate of clients and changed to protect confidentiality

** This article was originally written in 2015.  We were shocked and saddened to read of Sally Brampton’s apparent suicide in May 2016.

The Ups and Downs of Therapy; a client’s story

The thing I liked about my therapist when we first met was that she seemed different from me – the last thing I wanted was to talk to someone similar. The relationship would be different from anything I had experienced: it was the first time I had discussed my life intimately with another person.

 

The idea of ‘difference’ became the key to approaching therapy. Sessions were an opportunity to experiment with different ways of thinking, without relying on reason or analysis. Instead, I would talk about whatever popped into my head at the time – no matter how irrelevant it seemed – and see where it led.

 

My first fear was that I would sabotage therapy, probably by convincing myself that it had been going on too long. To counter this, rule number one was that there would be no time-limit: if it took years, it took years and I wouldn’t leave until it felt good to do so.

 

The second fear was that I would develop an attachment to my therapist that would become painful, so the boundaries of the relationship were very important. I determined not to cross these boundaries under any circumstances: no contact between sessions, no trying to discover personal information. The therapy room would become a bubble, although, as I later discovered, there was a downside to this.

 

As therapy progressed, the word ‘instinct’ kept cropping up, and I began to realise how powerful the unconscious mind is, and that it is often right. Understanding my past behaviour in this context – that a lot of it was actually self-preservation – was a huge relief. I began to trust my instinct more as a guide through the process.

 

Self-expression was surprisingly hard. I found the spoken word incredibly limiting and the habit of editing myself as I went along didn’t help. A lot of the time it felt as if I was talking around a feeling, but couldn’t be completely accurate – I just didn’t have the language. Images were very helpful in this respect. If I couldn’t describe a feeling I would imagine it as a scene or a story and describe that instead. In fact, the further away we got from the literal, and the closer we got to symbols, stories and art, the more satisfying and truthful the conversations felt.

 

Going to therapy for a long period, it was inevitable that some subjects would be discussed many times. This wasn’t a problem, but I was aware that each time we repeated a subject, I would describe a set of feelings that were different to what I had said before. Thankfully my therapist didn’t point this out, although I have no doubt that she noticed the contradiction. The question is, why did this happen when I was trying to be honest? The best answer I can come up with is that I was just saying what needed to be said on that particular day. This pattern of repetition/contradiction did lead to some answers that you could call ‘truth’,  but the answers seemed less important than the process of finding them.

 

One of the more unnerving sensations was the feeling that life was on hold. In the midst of the therapy bubble, most of my time was spent looking forward to the next session or thinking about the previous one. The outside world felt less important. If it had ended at this point I suspect it would have been pretty devastating and knowing that I was dependent made me nervous. It was a leap of faith to trust that one day I would feel differently. Until then, the frequency of the sessions gave me enough security to keep going.

 

But the relationship between therapy and my life in the outside world was something I struggled with. Whenever we discussed making a change, I had all the reasons not to do it. This inability to connect therapy and life felt frustrating at the time. Looking back, I probably didn’t realise how much was shifting around in my unconscious. Every so often change would rise to the surface and I would suddenly decide to do something completely out of character. Eventually I learnt that I didn’t have to force the change to happen, I just had to be open to it.

 

I think one of the great misconceptions about therapy is that it’s all about the moment of catharsis. That the right question will lead to a huge outpouring of emotion and then everything will be better. I never had that experience – therapy was more complicated and difficult than that, but also more rewarding. I certainly don’t think of it as getting things out of my system: I have more in my system now than when I started.

 

The decision to stop was surprisingly easy. It just felt right. Life wasn’t perfect but I had the strength to deal with it. As the end approached I knew how important it was to end well, to walk out the door without regret.

 

People who know me well say the change has been enormous. They are probably right, but it’s a difficult thing to see objectively. Superficially, life hasn’t changed that much, but there has been a fundamental shift in how I react to things. My stress and anxiety levels are certainly much lower, I’ve become more open to taking risks, and more patient with other people.

 

My life now is messier, dirtier, happier, angrier, faster, less predictable and more confusing than it has ever been. For the first time it feels like there aren’t enough hours in the day for everything I want to do. But I do what I can and don’t worry about the rest. So far that seems to be working.

 

Written anonymously by a client in 2015

Working with Depression, led by Gill Bannister – 26th September 2015

On a clear, sunny autumnal Saturday last week, I was treated to a full day’s seminar on depression… the conflict of light and dark didn’t pass by un-noticed and in fact resulted in a feeling of optimism and lightness – a surprise considering the darkness and negativity of the topic.    Gill Bannister delivered her seminar with feeling and containment – two very important aspects of a therapist’s role when working with clients with depression.

Gill’s 30 years experience as a psychoanalytic psychotherapist working with depression in clients was delivered in a style in keeping with her classic training, enabling us to have time and space to think, to sit with ourselves and our difficult thoughts and feelings, allowing a process to occur.   Gill believes that depression is a result of a client experiencing loss.   The depressed client suffers from a lack of self esteem, often projecting a super-ego which is rejecting, despising and attacking.

The experiential element of the seminar was invaluable, thinking and sharing thoughts, Gill challenged us to confront our own assumptions, experiences and prejudices around depression.  A word which is now loaded with a vast array of interpretation and stigma.    We were guided through the day with exercises and discussion which enabled us to experience the core essence of working with depression in the therapeutic room – trying to get in touch with our client’s inner world.  By experiencing a 30 minute solo role play, I felt more connected and understanding of my client’s depression than I had done before and will be processing and using these insights future sessions with this particular client.

An enlightenment of depression…. most valuable.

See our future seminars at our website www.wendybramham.co.uk (seminars tab)

by: Jo Turner

29 September 2015

This seminar was assessed by attendees as 4.69 out of 5 for the overall quality of the event. The speaker was rated 4.75. Thank you to all who attended this and previous seminars, we appreciate your participation and your feedback.

Eye Movement Desensitization Reprocessing (EMDR) – seminar update

Psychotherapist, Hannah Cowan, writes: “At our seminar on Saturday, Sarah House introduced us to EMDR (Eye Movement Desensitization Reprocessing) by telling us how the founder, Francine Schapiro, noticed that after a walk in the park she felt more able to manage things that had been troubling her. She connected this to the frequent eye movements that occur when walking and went on to develop a system of therapy that used rapid movement of the eyes from left to right. The purpose of the eye movements is to keep a person anchored in the present whilst remembering a traumatic memory.  Additionally these movements help to connect the left and right sides of the brain which, following trauma, can become disconnected.”

Thank you to all who participated in the event, and for your feedback. Your average rating for both the event and the speaker was 4.5 out of 5!

Our next seminar, 13 June 2015, looks at the tricky issue of how to talk about sex in the therapy room. For more information on this and all forthcoming events, visit our website wendybramham.co.uk

Author:  Hannah Cowan
Editor: Wendy Bramham
April 2015

Christmas message

Christmas in the UK seems to become more manic and commercialised each year, whilst growing numbers of people suffer from loneliness and depression which can be exacerbated at this time of year. The Christmas-hype can obscure the real opportunity of holidays and celebrations, as I see it. These occasions help us pause and reflect, foster closer connections with those we love or within our communities, and encourage charitable actions. Additionally, the end of one calendar year and the start of another can nudge us to make adjustments in our lives to bring more health, joy and meaning.

I recently attended a special carol concert in the privileged setting of Marlborough College’s chapel, in aid of Hope & Homes for Children, a charity that helps find homes for children in Europe and Africa who have no parents and who are living in institutionalised care. How easy it is to take our blessings for granted!

Bringing the tree homeWe all at Wendy Bramham Therapy wish our clients, colleagues and friends a peaceful Christmas-time and a healthy, joyful 2015.

Wendy Bramham MBACP (Snr Accred)
Psychotherapist & Counselling Supervisor
Proprietor & Clinic Director

Unlocking the Secrets of Dreams” with Matthew Harwood, Nov 2014

This seminar was akin to being in the theatre watching an absorbing drama unfold!  Matthew Harwood treated us to a fascinating and crystal-clear presentation of how he worked with a former client’s particular dream to help the client free himself from outmoded attitudes and a long-standing depression.

We learned that it is possible for just one sentence of a dream to provoke an hour’s worth of investigation and produce a powerful “aha” moment of insight that can create profound change at a cellular level. Like adding a drop of wine to water, we remain changed forever.

Science tells us that we all dream for about two hours per night, whether or not we remember our dreams. Dreams produce words and images that are metaphors ….. they are direct messages from our unconscious that can “compensate” for, and illuminate, our conscious (often unbalanced) attitudes.  Depression can often signify a fear of living, but when we remember a dream it is a sign that we are ready for change, and to have the courage to live.  By asking the right sorts of questions which enable the client to give descriptive definitions (prior to their associations) of the objects, characters and places in their dreams, Matthew showed us that it is possible to unlock their central dilemma and blind spots.

In the words of Carl Jung:

In each of us there is another whom we do not know. He speaks to us in our dreams and tells us how differently he sees us from the way we see ourselves. [CG Jung: Collected Works Vol 10 para 325]

It was wonderful to learn how to work in such a creative way with our clients.

Wendy Bramham
25/11/14