Tag Archives: therapy

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

“Opening the Hidden Door; Working with Dreams in Therapy” – Matthew Harwood, 24 September 2016

dreams-seminar-2016

Matthew Harwood at Wendy Bramham Therapy seminar

I attended this seminar because of my training and experience in Deep Memory Process with Roger Woolger, and also because throughout my life I have had dreams that I remember vividly and have tried to make sense of.

Having gone through the day’s seminar with Matthew Harwood, a Jungian Analyst, it is a pleasure for me to write a few words about it.

The seminar was perfectly constructed so that on whatever level your training or experience, you could get something out of it.  Matthew performed his role with skill and humour and we all learned a method of how to look at dreams – both for ourselves and for our clients.  I personally think that dreamwork is an extremely important way of understanding where you are and what could be the next steps forward. And what a relief not to have to take notes, as Matthew had plenty of handouts!

I wish the best to Matthew Harwood and his important work.

By: Elly Nickson, Chartered Physiotherapist

Participant Feedback:
Quality of Speaker: 5 out of 5 unanimously from all 17 delegates! This is exceptional and never achieved before.
Overall assessment of event: 4.94 out of 5

Delegate comments:
“I have been to other dream workshops but I am going away feeling I have learnt more than I have done before!!”
“As usual, event top notch”
“Excellent attention to detail. Good sense of cohesion around group and speaaker”
“The events are always good and well organised”
“Nice setting with plenty of space. Matthew is an excellent speaker. Overall excellent”
“Full and informative day”
“Well done as usual”

 

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

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

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”

Happiness

Why is it so hard to be happy?
I have been giving much thought to this question lately. Is the goal of life to be happy, or is there a better way of looking at things? What affects our ability to find lasting happiness, and how can we each find meaning for our lives?

Does society have a part to play?
In the 1980s I travelled extensively in South-East Asia and was able to mingl
laughtere with locals as if I was one of them. I met people who were poor and yet seemed strikingly content in ways I hadn’t seen in the West. Their work and community were local, and this gave them a sense of belonging, inherited traditions and support; and they were relatively untouched by media networks, and consumerism. Conversely, the West, with its numerous distractions and overwhelming information, constantly bombards us with the idea that the next great job, cosmetic, romance or holiday will make us feel worthy, attractive, successful, and, finally, happy. And we’re not!

What’s the alternative?
 Unlike so-called ‘primitive’ societies, modernity favours doing rather than being; activity not stillness; individualism before community; reason more than emotion; instant gratification over waiting, and, now, virtual connections over face-to-face contact. We are embedded in the physical world in which everything changes and we have to grab on to whatever security we can find before it is lost or dies. I believe that part of the human condition is to experience (consciously or unconsciously) a sense of inner “lack”, and the more our self-esteem is fragile, the more we will be prone to compulsive striving for something outside of ourselves.  Therefore, we miss a connection with a ‘second reality’ which is the inter-connectivity of all life.  Some would call this: soul, nature, tao or universal energy, and it is constant, limitless and undying.  Carl Jung, the founder of analytical psychology, called it the “collective unconscious”. The holistic health and spiritual educator, William Bloom, defines this missing link as “connection with the wonder and energy of all life”(1). And it is through this deeper connection with ourselves, others, our activities and life in general – that I believe ‘happiness’ can be found.

But how?
Our physical lives, and our connection with a second, non-physical reality, are both important.  However, if we are only in the physical it is difficult to experience contentment because we know that loss or death will take away what we have in the end. But if we can also connect with our deepest core – the soul, if you like, or the authentic Self – that is already complete and which exists at a non-material level, then we might begin to access greater meaning, purpose and fulfillment. Personally I do this through simple things such as being in nature, sunshine, solitude and dancing.  For others it might be through music, art, human intimacy, gardening, yoga or mindfulness practice or being with animals. 

Log off! 
I was at a spa recently where, at the entrance, a sign read: “time to switch off your phone and come to your senses”. Logging off is a simple method for opening up the possibility of accessing the ‘second reality’ but is a lot easier to say than do. The digital world keeps us switched on, drawing us out of our inner experience, and supplying false comparisons with others’ seemingly glossy lives on facebook or instagram. It’s hard to slow down and experience our inner selves because that is where we might encounter our past pain and true feelings.

Therapy helps
Therapy can help to understand and resolve past or present traumas, losses and unconscious patterns that undermine our sense of “self” and authenticity. Many of us also need help with living in the second reality and accessing a deeper level of happiness, meaning and contentment than we have previously known. For many people therapy provides a space in which to work through the questions like ‘what do I really want?’ and ‘what will give my life meaning?’, and to find our own personal keys for transcending the everyday and connecting with the ‘wonder and energy of all life’.

Summary
There is not a great deal we can do about the culture in which we live. However, we can slow down enough to reflect on our personal values, meaning, purpose and integrity, which in turn can help us resist society’s pressures. Striving or grasping seems to drive happiness away from us.  We need to understand that “happiness” is almost always transient; like the waves of life’s inevitable gains and losses. But while life is tossing us around on the surface of the ocean maybe we can connect with the bedrock beneath the waves, where stillness, peace of mind and authenticity can be found. I believe that here we can access personal values, meaning and purpose; and have a better chance of experiencing moments of joy and happiness.

Author:  Wendy Bramham MBACP (Snr Accred)
Editor: Briony Martin MBACP
December 2015

This blog is an abbreviated version of a longer article Wendy hopes to publish in a professional journal.

References 
1. Bloom, W., 2011, The Power of modern spirituality, Piatkus, p. 6
Further reading

HH Dalai Lama & Cutler, H.C., 1998, The Art of Happiness, Coronet Books
Epstein, M., 2001, Going on Being, Broadway Books
Fordham,  F., 1991, An Introduction to Jung’s Psychology, Penguin Psychology
Hollis, J., 1998, The Eden Project, in Search of the Magical Other, Inner City Books

James, O., 2007, Affluenza, Vermilion
Somers, B. & Brown, G., 2002, Journey in Depth, Archive Publishing
Tolle, E., 1999, The Power of now, Hodder & Stoughton
Williamson, M., 1992, A Return to Love, Thorsons
Yalom, I. D., 1989, Love’s Executioner and other tales of Psychotherapy, Penguin Books