Tag Archives: mental health

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

Benefits of the “Inner Smile” and other techniques we learned at our CPD event on meditation with Dr William Bloom

w-bloom-2016-seminar-edited

Seminar: “Meditation as a Therapeutic Strategy” with Dr William Bloom, organised by Wendy Bramham Therapy

The research into the beneficial effects of meditation on personal wellbeing and especially for depression and anxiety is compelling. Meditation as a concept is moving from the fringes into the boardroom, the classroom and the counselling room.

On the 11th November we had a workshop run by William Bloom, a leader in the field and author of books such as The Endorphin Effect, Meditation in a Changing World, and The Power of Modern Spirituality. Its aim was to support people from the helping professions in using meditation as a therapeutic strategy.

What struck me first was William’s passion for demystification. He wants people to understand how accessible it is: we can meditate anywhere. We don’t have to sit cross-legged. We can do it in the garden with a glass of wine (“but probably not three”), we can do it while we are dancing, or running or after yoga. We can make it fit us. We don’t have to bend ourselves out of shape.

The day was a mix of guided meditations, group exercises and theoretical underpinning. William introduced one beautiful exercise he called the ‘inner smile’ which harnessed our ability to feel compassion for a hurt child or a wounded bird and then turthe-inner-smilen the same ‘kind mind’ on our own failings and vulnerabilities. At another point he used participants to create a constellation of the competing aspects of one person’s personality, all calling out for attention, repeating core beliefs and yelling.  As an embodiment it was a powerful way of understanding the noise in our own heads that can make meditation, and sustaining that place of ‘quiet mind’, so challenging.  For me this was a key moment. As a psychotherapist I have many clients who find it almost impossible to be still and to be in contact with themselves. For them it can be an uncomfortable, even terrifying, experience. And yet we know that for people with a fragile self-process, meditation can help develop an ability to self-regulate and put the world into context. I found myself craving more at this point in terms of understanding how to create that safe bridge and safe container for my clients.

William Bloom brings a breadth and depth of understanding and a passionate commitment to his subject. This was not a workshop necessarily geared towards those who are already integrating a meditative practice. As an introduction to the field it was sustaining and enlivening.

By: Helen Franklin, MSc(psych) UKCP reg, Gestalt Psychotherapist
16th November 2016

Thank you to everyone for their feedback.  From 23 forms the average scores were excellent, as follows:

  • Speaker (William Bloom): 4.74 out of 5
  • Overall assessment of event: 4.61 out of 5
  • Value for money: 4.52 out of 5

Delegates written comments:

  • “The seminar achieved my expectations of the meditative state; ‘soaking in the hot tub of the goddess'”
  • “Thank you, very insightful”
  • “Engaging speaker.  I now understand that I need to be relaxed in body but aware in mind during meditation.  Great sandwiches!”
  • “Great presence.  Informative, experiential, transformative, focussed.  So much more to know.  Great sandwiches and brownies!”
  • “As usual, a WONDERFUL and hugely enlightening day”
  • “All excellent”
  • “Great space, excellent food and speaker”
  • “Great organisation”

Wendy Bramham MBACP (Snr Accred), Psychotherapist
16th November 2016

“A Must for any Parent”

The “Parents and Teens” talk, by parenting expert and agony aunt Suzie Hayman, followed by Q and A, at St John’s School, Marlborough on 22nd October 2016, was a must for any parent with children about to embark on their teenage years, or indeed any parent already in the midst of this often challenging and turbulent time. I only wish I had heard these words of wisdom long ago, both from Suzie herself, and also the teenagers contributing to the discussion.

Suzie has many years of experience counselling families and couples, and is also an agony aunt, broadcaster and author of 30 books on families, but most noticeably Parenting Teens 22 Oct 2016her own experience as a stepmother. She is a warm and wise soul, who brought clarity and calm to this topic without denying the challenges involved.

Suzie starts from the core view that the teenager’s main task is to separate from his/her birth family, while our job as parents is to manage these shifting boundaries while passing control over to the teen. And no, she does not say this is easy. Her approach is practical and pragmatic, and she makes you feel you too could manage this. She gives helpful hints for how to relate to your child in a way that enhances communication,  and on how you might approach such thorny subjects as alcohol use and pornography. She entreats us to remember that a problem might actually be our own, rather than theirs, such as our own expectations or dreams being acted out. She never pretends to have all the answers but offers a framework to work from.

The ensuing discussion brought enlightening tips from the teens present, whose overriding message was “please, just listen to us”, since we might not have any idea what our child is experiencing, as well as “be available”, in other words sometimes we need to wait until they are ready to talk rather than rushing in with our own agenda.  The wide-ranging questions and discussions from the audience could easily have gone on past the allotted time.

This well-organised seminar in congenial surroundings will, I hope, be the first of many such events. Highly recommended!

By: Anne Hutson (parent)
7th November 2016

 

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Wendy Bramham Therapy on BBC Radio Wiltshire

Wendy Bramham Therapy has contributed their expertise about mental health on BBC Wiltshire in 2013 and again recently.

In March 2016 we were asked to contribute to a discussion about whether time is a healer.  One of our team, Briony Martin, stepped into the breach to discuss this topic with radio presenter Graham Seaman.  Listen here

In 2013, when BBC Wilts presenter, Mark O’Donnell, suffered a panic attack in the streets of Swindon – and found that people gave him a wide berth! – he decided to try to break down the myths, fears and stigma surrounding mental health, by talking about it on the radio!

BBC Wiltshire - Bipolar programme September 2013

In the studio L to R: David Lathan (Richmond Fellowship), Wendy Bramham, Denise (bipolar sufferer) and Mark O’Donnell

Wendy Bramham gave professional insights and advice on this series of 7 programmes, which covered the following topics:

Unfortunately all the recordings have been lost except for the one on suicide – listen here.

However, following each programme, Wendy wrote self-help resources for listeners who would like to learn more.  Read more by clicking on the links above for each topic.

 

Wendy Bramham
April 2016

Exercise is a natural anti-depressant

Our modern western lifestyle, and particularly following industrialisation over 100 years ago, means that we have become much less physically active.   Our great grandparents had to be active just to carry out their everyday life.

Exercise shouldn’t be a chore!  Rather than jogging or going to the gym, consider things like gardening, dancing, or walking in nature.  It is important to find an activity you ENJOY, and to do something quickly enough so that you raise your heart rate (aerobic exercise), as it is then that the “happy” chemicals called endorphins are released into our body and make us feel good.

The Royal college of Psychiatrists state on their website that “if you keep active, you are:

  • less likely to be depressed, anxious or tense
  • more likely to feel good about yourself
  • more likely to concentrate and focus better
  • more likely to sleep better
  • more likely to cope with cravings and withdrawal symptoms if you try to give up a habit such as smoking or alcohol
  • more likely to be able to keep mobile and independent as you get older
  • possibly less likely to have problems with memory and dementia.”

Tips on getting started:

  • It is vital to pick an activity that you ENJOY
  • Any exercise is better than none.
  • Don’t start suddenly – build more physical activity into your life gradually, in small steps.

How well does exercise work for depression?

For mild depression, physical activity can act as a natural anti-depressant, and be as (or more) effective for some people than medication. In some areas in the UK, GPs (family doctors) can prescribe exercise.

Doing 30 minutes or more of exercise a day for three to five days a week can significantly improve depression symptoms. But smaller amounts of activity — as little as 10 to 15 minutes at a time — can make a difference.  (ref: Royal college psychiatrists).  Moderate exercise is best, such as the equivalent of walking fast whilst you can still talk to someone.

The mental health benefits of exercise may last only if you stick with it over the long term — another good reason to focus on finding activities you enjoy.

Why does exercise work?

  • It helps to release feel-good brain chemicals (neurotransmitters and endorphins) into the brain, which can ease depression. Brain cells use these chemicals to communicate with each other, so they affect your mood and thinking.
  • Exercise can stimulate other chemicals in the brain called “brain derived neurotrophic factors” (BDNF). These help new brain cells to grow and develop. Moderate exercise seems to work better than vigorous exercise. BDNF seems to reduce harmful changes in the brain caused by extreme stress.
  • Harder exercise (perhaps needed to fight or flight from danger) can help to dispel the physical effects of a trauma, loss, shock or crises as it helps reduce adrenalin and produces endorphins. Animals in the wild naturally do this by fleeing from or fighting danger.
  • Exercise can also reduce risks of high blood pressure, diabetes, arthritis and cancer.

Exercise can also help you:

  • Gain confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence and help you to feel more in control.
  • Take your mind off worries. Exercise is a distraction that can get you away from the cycle of negative thoughts that feed anxiety and depression.
  • Get more social interaction. Exercise may give you the chance to meet or socialize with others.
  • Cope in a healthy way. Doing something positive to manage anxiety or depression is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how badly you feel, or hoping anxiety or depression will go away on its own can lead to worsening symptoms.

How do I get started — and stay motivated?

Starting and sticking with an exercise routine can be a challenge. Here are some steps that can help. Check with your doctor before starting a new exercise program to make sure it’s safe for you.

  • Identify what you enjoy doing. Figure out what type of physical activities you’re most likely to do, and think about when and how you’d be most likely to follow through. Do what you enjoy to help you stick with it.
  • Get your mental health provider’s support. Talk to your doctor or other mental health provider for guidance and support.
  • Set reasonable goals. Your mission doesn’t have to be walking for an hour five days a week. Think realistically about what you may be able to do. Tailor your plan to your own needs and abilities rather than trying to meet unrealistic guidelines that you’re unlikely to meet.
  • Don’t think of exercise as a chore. If exercise is just another “should” in your life that you don’t think you’re living up to, you’ll associate it with failure. Rather, look at your exercise schedule the same way you look at your therapy sessions or medication — as one of the tools to help you get better.
  • Address your barriers. Figure out what’s stopping you from exercising. If you feel self-conscious, for instance, you may want to exercise at home. If you stick to goals better with a partner, find a friend to work out with. If you don’t have money to spend on exercise gear, do something that’s virtually cost-free, such as walking. If you think about what’s stopping you from exercising, you can probably find an alternative solution.
  • Prepare for setbacks and obstacles. Give yourself credit for every step in the right direction, no matter how small. If you skip exercise one day, that doesn’t mean you can’t maintain an exercise routine and may as well quit. Just try again the next day.

author: Wendy Bramham

Biography:

http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/physicalactivity.aspx

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.

Is Therapy Selfish? More perspectives on ‘healthy selfishness’

“When someone is in therapy it can seem like self-absorption to those around them, but this is a necessary and temporary state. Regular, well-boundaried therapy ideally leads to people developing clearer awareness of themselves and how they relate to others. The dynamics may change within their relationships. They may take a more equal footing in relationships that have previously diminished their self-value, or realise that there are areas in the relationship that they could give more to. The goal of therapy either way, is increased contentment for all parties, both the client and those around them – which is an act of love as well as self-love.”
Cassandra Human, psychotherapist
“On a visit to Laos recently I saw how the many statues of Buddha depict ‘The Enlightened One’ looking down. Locals told me this symbolises His focus on looking within himself to find enlightenment. Rather than this being a selfish act He believed that, in order to bring about change, we need to search within ourselves for answers. How tempting and easy it is for us to want others to change in order for us to be happy, or to look to others to carry the blame or take responsibility; and how brave it can feel to focus instead on taking responsibility for ourselves and our own decisions, life and happiness. Therapy provides a safe forum for our inner search and our exploration of the changes this can bring.”

Rachel Cooper, psychotherapist

Sir Richard Bowlby – “a rare and special opportunity” in 2014

Rachel Cooper, psychotherapist at Wendy Bramham Therapy in Newbury, reviews our recent day on attachment theory with Sir Richard Bowlby:

“Hearing Sir Richard speak at the recent Wendy Bramham seminar in Newbury felt a rare and special opportunity to get up close and personal with his father, Sir John Bowlby’s, pioneering work.

Richard highlighted the significance of attachment theory by taking us back to the fright we each felt when we got lost (and separated from our caregiver) as a child, even though we were not in any danger; caused by the terror of separation from an attachment figure. He also reminded us of its ongoing impact on all relationships held as adults and explained how he himself developed a secure attachment as an adult through his relationship with his wife.

Sir Richard Bowlby and Wendy BramhamSir Richard with Wendy Bramham

Richard provided an updated slant with research and views, sparking stimulating debates that ranged from the science of epigenetics to the art of using attachment theory creatively and individually within psychotherapy. Also the despair caused by the lack of influence of attachment theory on politician’s agenda within schooling, versus the hope from a psychotherapist providing a reliable, responsive, helpful and empathic secure base from which clients can begin to explore in a way that has previously been too scary. I loved Richard’s description of a psychotherapist being, “someone to hold our hand while we go into scary places”.

Richard was such an engaging speaker through his warm, humorous and down to earth style. His sharing of personal experiences with his upbringing and own family really brought the theory to life. A really engaging, enlightening and informative event.”

newburytherapy.com/rachel-cooper-therapist-newbury.php

Robin Williams

Robin Williams

Many of us were shocked and saddened by the news of Robin Williams’ suicide in August 2014. In 2013 as part of BBC Wiltshire’s series on mental health, Wendy Bramham spoke about this devastating issue.  The following information offers a resource for people experiencing suicidal feelings; or for those bereaved by suicide; and for people who are attempting to help those affected by this issue.

What causes a person to feel suicidal?

Suicide may seem to be the only way to end severe mental pain; the only thing that’s left within the person’s control.  It may also be a way to convey desperate feelings to others. Most people who feel suicidal are actually quite confused and conflicted about the desire for death.  Most wish there was an alternative.

What causes it is usually a complex mix of factors that builds up into despair that becomes overwhelming.  It may be caused by a sudden crisis, a major setback or loss, but more typically there is a slower build-up over time.

Many kinds of emotional pain can lead to thoughts of suicide.  Each person responds and copes differently and uniquely to the myriad problems and crises we all encounter through life.  Each person has their own psychological and social history and genetic make up, which means that what is bearable to one person can be unbearable to another, and vice versa.

Tragic Statistics

This devastating problem is much more common than many of us realise.  Shockingly, in the UK suicide remains the most common form of death in men under the age of 35 (Mental Health Foundation and Department of Health).  It is the second largest killer of people worldwide between the ages of  16-19.  In the  last 45 years suicide rates have increased by 60% worldwide (source: World Health Organisation).).  It’s estimated that approximately 5% of people attempt suicide at least once in their life.  Men are 3 to 4 times more likely to kill themselves than women. However, unsuccessful attempts are more common in women and young people.   More people die by suicide each year than by murder and war combined.

Accusation of selfishness?

Some people accuse those who have committed suicide as selfish, and that they took the “easy way out”.  This is extremely hurtful and shows a lack of understanding of mental illness and the suffering that some people try to endure.  The following quote is taken from theguardian.com on 12 august by Dean Burnett who I think argues the point well:

“One of the main problems with mental illness is that it prevents you from thinking “normally” (although what that means is a discussion for another time).  A depression sufferer is not thinking like a non-sufferer in the same way that someone who is drowning is not “breathing air” like a person on land is.  (…..) The selfish accusation  implies that there are other options that the sufferer has, but has chosen suicide or that it’s the easy way out.  There are many ways to describe the sort of suffering that overrides a survival instinct that has evolved over millions of years,  but ‘easy’ is not an obvious one to go for. Perhaps none of it makes sense from a logical perspective but insisting on logical thinking from someone in the grips of a mental illness is like insisting that someone with a broken leg walks normally.  Logically you shouldn’t do that.”

Who is at risk?

Most important factors that put people at risk include mental disorders, such as depression, bipolar, schizophrenia, post-traumatic stress and obsessive-compulsive disorder (OCD).  The second biggest influencing factor is substance abuse.  Eg alcoholism is a factor in 15-60% of all suicides.

Having  depression or bipolar increases the risk of suicide by 20%.  Depression accounts for approximately 50% of suicides.  Those suffering from severe depression and feelings of hopelessness, and who have little or no social support are probably the most at risk.  Often people who are just recovering from depression are in fact more at risk of suicide, because it is then that they actually have the energy to carry out the act of suicide.

War veterans are a high risk category due to the mental trauma and physical ill-health from war.  Genetics and social-economic factors play a part too, eg poverty, discrimination, financial worries, unemployment, bereavement, social isolation.

Some medical conditions can trigger suicidal feelings, such as traumatic head injuries. A diagnosis of cancer can double the risk of suicide.  Such medical conditions can lead to depression and suicidal feelings, and carers should be aware of this.

Media and internet can cause a copycat syndrome of suicide whereby it is romanticised or glorified.

Warning signs

Suicidal feelings are more likely to build up when a person feels they can’t talk about their feelings.  They may be experiencing or have experienced some of the following, which can also be signs and symptoms of depression:

  • withdrawal from friends, family and regular activities
  • isolation and hopelessness
  • sense of futility and meaningless
  • self-loathing (“everyone would be better off without me”)
  • loss of energy
  • major and sudden changes in personality or mood
  • big changes in sleeping and eating habits
  • difficulty in functioning, such as going to work, or cooking dinner
  • unusual neglect of personal appearance
  • feeling cut off from their body, feeling numb
  • impulsivity, lethargy or aggressiveness (especially in adolescents)

Obvious major warning signs include

  • talking about killing or harming oneself (it is a myth that people who talk about suicide don’t do it)
  • talking or writing a lot about death or dying
  • seeking out things that could be used in a suicide attempt, such as weapons and drugs.

The above signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide.

How to help someone who is suicidal

Talking about it can save a life.  Try not to feel embarrassed or afraid.  Talking about suicide won’t give the sufferer morbid thoughts – quite the opposite, it is the most helpful thing you can do.

However, it is not usually helpful to say things like “you should feel lucky because you’ve got a lovely house, job, family”, etc., or “that’s not enough of a reason to feel suicidal”.   The best way to help is by offering an empathetic, listening ear.   See notes below on “How to talk with  someone about suicide”.  Don’t take responsibility, however, for making the other person well. You can offer support, but you can’t get better for a suicidal person. He or she has to make a personal commitment to recovery. If you are helping a suicidal person, make sure you get support for yourself.

Practical steps:

  • Get professional help. Call a crisis line such as The Samaritans for advice and referrals.  Encourage the person to see a counsellor, or take them to a doctor’s appointment.
  • Follow-up on treatment. If the doctor prescribes medication, encourage them to take it.  Help to communicate about any side effects and be aware that it can be a trial and error process to find the right medication.
  • Be proactive. Don’t wait for the person to call you, or to return your calls. People who are severely depressed find it difficult to ask for help.  Drop by, call again, invite the person out.
  • Encourage positive lifestyle changes, such as a healthy diet, plenty of sleep, and getting out in the sun or into nature for at least 30 minutes each day. Exercise is also extremely important as it releases endorphins, relieves stress, and promotes emotional well-being.
  • Make a safety plan, help the person develop a set of steps if they feel suicidal, such as who they will call.  Include friends, family and crisis line numbers.
  • Remove potential means of suicide, such as pills, knives, razors, or firearms. If the person is likely to take an overdose, keep medications locked away or give out only as the person needs them.
  • Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person, periodically checking in or dropping by.

How to help yourself if you feel suicidal

Asking for help is not a sign of weakness but a sign of strength, wisdom and self-responsibility.  If we try to do everything on our own we will become mentally, physically and emotionally exhausted.

However, if you have suicidal thoughts it can feel impossible to tell your family and friends how bad you feel.  You may feel rage, fear, guilt and shame.  If you have been hurt by someone, it is natural to feel anger, and sometimes suicide can seem a way to get back at that person.  However, suicide is anger turned against ourselves.

The intense emotional pain that you’re experiencing right now can distort your thinking so it becomes harder to see possible solutions to problems, or to connect with those who can offer support.

It is important to work out with a professional counsellor why you feel the way you do.  Give this process time and commitment even after you begin to feel better.

Coping strategies:

  • Promise not to do anything right now.  Make a promise to yourself: “I will wait 24 hours and won’t do anything drastic during that time.” Or, wait a week. Wait and put some distance between your suicidal thoughts and suicidal action.
  • Avoid drugs and alcohol
  • Make your home safe. Remove things you could use to hurt yourself, such as pills, knives, razors, or firearms.
  • Take hope – people do get through this.   Give yourself the time needed and don’t try to go it alone.
  • Speak to someone you trust, whether it be a friend, GP, clergyman, teacher, family member or therapistOr call a helpline such as The Samaritans.

How to talk with someone who is (or might be) suicidal

Following text is taken from http://beta.helpguide.org/mental/suicide.  Adapted from: Metanoia.org

Ways to start a conversation about suicide:

·         I have been feeling concerned about you lately.

·         Recently, I have noticed some differences in you and wondered how you are doing.

·         I wanted to check in with you because you haven’t seemed yourself lately.

Questions you can ask:

·         When did you begin feeling like this?

·         Did something happen that made you start feeling this way?

·         How can I best support you right now?

·         Have you thought about getting help?

What you can say that helps:

·         You are not alone in this. I’m here for you.

·         You may not believe it now, but the way you’re feeling will change.

·         I may not be able to understand exactly how you feel, but I care about you and want to help.

·         When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.

When talking to a suicidal person

Do:

·         Be yourself. Let the person know you care, that he/she is not alone. The right words are often unimportant. If you are concerned, your voice and manner will show it.

·         Listen. Let the suicidal person unload despair, ventilate anger. No matter how negative the conversation seems, the fact that it exists is a positive sign.

·         Be sympathetic, non-judgmental, patient, calm, accepting. Your friend or family member is doing the right thing by talking about his/her feelings.

·         Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that his or her life is important to you.

·         If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head, you are showing that you are concerned, that you take them seriously, and that it’s OK for them to share their pain with you.

But don’t:

·         Argue with the suicidal person. Avoid saying things like: “You have so much to live for,” “Your suicide will hurt your family,” or “Look on the bright side.”

·         Act shocked, lecture on the value of life, or say that suicide is wrong.

·         Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.

·         Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, but how badly it’s hurting your friend or loved one.

·         Blame yourself. You can’t “fix” someone’s depression. Your loved one’s happiness, or lack thereof, is not your responsibility.

How to help someone who is bereaved by suicide

Bereavement by suicide can be more complicated because it is common for people to feel confused or guilty that they didn’t know the extent to which the person was suffering, and that they were not able to help.  They may also feel angry and disappointed with the person who committed suicide.  Because of stigma, they may feel they can’t talk about either the mental illness (if this was a factor) or suicide, adding to feelings of isolation.  Bereavement by suicide often carries feelings of deep shame. Following information is taken from sane.org

Common responses:

I don’t know what to say.

·         If not sure what to say, ask ‘ How are you feeling today? ‘

·         Tell the person you’re not sure what to say. Being honest will help to build trust

·         Try to listen 80% of the time and talk 20% of the time

·         Avoid making unhelpful statements such as, ‘It’s God’s will’ or ‘Time heals all wounds’.

I don’t want to make it worse for them. By allowing the person to express their grief you will be helping. Nothing you do can take away the sadness, but it is important to be there for them.

·         Allow tears or accept no tears

·         Understand that the way the person expresses grief may be different from the way you would express it

·         Don’t take anger personally.

They have lots of family and friends around. They don’t need me. People with lots of friends and family still need support from others. It’s important to have grief acknowledged by friends and colleagues so the person doesn’t begin to feel isolated.

They need help from a professional. There is nothing I can do. While professional help can be very important, don’t underestimate the importance of friendship when someone is grieving. You can do things a professional person can’t such as going for walks, cooking a meal or being there in the evenings and on weekends, remembering the birthday and anniversaries of the person who died.

I’m not sure what to say about the mental illness. Ask the bereaved person how they feel about this and reassure them you are happy to talk about mental illness if they want. Seek out some information so you know something of what the person may have been experiencing. Be compassionate and understanding about difficulties it may have caused in their relationship, and encourage them to talk to a bereavement counsellor if they are not coping or do not feel they can talk to anyone else.

 Useful Contact Numbers

Survivors of Bereavement by Suicide – 0844 561 6855

Samaritans –  08457 90 90 90

by: Wendy Bramham
Written as a resource for listeners of BBC Wiltshire mental health series, October 2013
Updated August 2014

What is Mindfulness?

Mindfulness is  paying attention, on purpose and with acceptance, to direct experience as it is.  It is not a concept but a practice, and its benefits can only be gained through regular, formal practice.  Mindfulness has always been a part of the ancient Buddhist meditation traditions, but has been developed recently into a more secular approach and used in various psychological therapies, for example to help with stress reduction.

Mindfulness is an important resource and life-skill for everyone because it helps regulate stress, promotes positive mood, supports the immune system and increases our ability to concentrate.  Above all, it helps us to accept “what is”, enabling us to become curious rather than anxious, and so enabling us to respond more creatively, rather than reacting or behaving in “auto pilot”, driven by old beliefs or habits.

We learned in our recent seminar with Margaret Landale that, as therapists, one of the best ways to “teach” clients is to model it through our own mindfulness practice – to “embody” mindfulness ourselves – which will then be communicated non-verbally to our clients.  Margaret says: “Communication is determined by sensory and felt experience.  The client will subconsciously respond to the therapist’s facial expression, eye contact, tone of voice and body posture/language. Language arises from a deep level of relational attunement”.

Margaret’s style, delivery and content were all excellent and we received extremely positive feedback from our attendees.  We all enjoyed her enthusiastic, informative and gentle approach to learning new techniques.  Best of all, I now have a much more accessible key to my own meditation practice which, prior to the workshop, had been tentative at best and quite often non-existent.  We look forward to part 2 when we will be applying mindfulness to helping our clients with complex trauma.

by: Wendy Bramham