Regulating psychotherapists
For counselling to be effective, a trusted relationship between counsellor and client is key. It’s important that clients know what they can expect from counselling and that their therapist adheres to a code of conduct through membership of a professional body. I am with the British Association for Counselling and Psychotherapy, and am also insured. However, not all counsellors are members of a professional body and I’d advise anyone seeking psychological support to research the academic background of their therapist, that they are accredited by an awarding body and are members of a recognised professional body. Increasingly, there is an awareness that the our profession might benefit from further regulation to prevent potentially serious harm to clients of unregulated, amateur therapists.
Negative thought patterns
Sometimes, the ways we think and process information can have a real impact on how we navigate our way through the world. Challenging negative thought patterns can open up new possibilities for living in an emotionally healthier way. Here are just a few examples of negative thought patterns. Do any of these example thinking styles feel familiar? Would you like to ways to stop these patterns from holding you back?
Black and white thinking – we get stuck in ways of doing things and thinking that exclude alternatives that may offer positive change
Filtering- we often discount information that doesn’t fit in our world view or perception of ourselves. How often do we ignore positive feedback and focus only on something we hear or perceive as negative or as a criticism.
Fortune Telling – how often do we predict what might happen and, by focusing only on negative outcomes, fill our day to day with unnecessary worry about things that may never happen?
Generalising- often we tell ourselves stories about our life that mean we get stuck in a certain storylines that may not even be accurate. “I never have any luck.” “Nobody ever wants to hear what I have to say.” “Nothing good ever happens to me.” “Nobody’s ever grateful for anything I do.” “It could only happen to me.”
Catastrophising – sometimes we are all guilty of blowing things way out of proportion. In therapy, we can challenge some of these dramas we create for ourselves.
Mania and menopause
I notice that Menopause is becoming an increasingly mainstream topic after years in the shadows. Some women experience emotional as well as physical changes at this time and counselling can support with the many changes, including those to self-image.
Although some women may only experience mild to moderate symptoms, a recent research study published in Nature Mental Health highlighted that “participants without previous history of mania were over twice as likely to develop mania for the first time in perimenopause.” However, the study found “no specific association between schizophrenia spectrum disorders and the perimenopause.”
Exploration of the first assets of mania, schizophrenia spectrum disorders and major depression disorder in perimenopause. Shitomi-Jones et al. Published 15 August 2024 Nature Mental Health.
Looking at dreams
Do you ever wake up with the memories of a dream that you replay over the following days and want to feel less unsettled by it? Sometimes it can be helpful to write about your dreams in a journal so that you can recognise patterns and perhaps some important themes and issues that may be in your subconscious.
It can be helpful to work through dreams in a guided therapy session but here are some ideas for charting your dreams in a journal:
Give the dream a title
Describe what feeling the dream left you with
Where/when did the dream take place?
Was the dream in past, present, future?
What was the atmosphere?
Who was in the dream? People you know?
What role did you play in the dream?
Describe each element of the dream. What comes into your head now when you review each element ?
Describe yourself in each element of the dream – for example, if a house features in the dream, pretend you are the house and describe yourself and what you are doing in the dream and why you are in the dream.
Look at what you have written in your journal. Circle any words that stand out to you. If any people or feelings stand out, circle those too. Can you see any themes/ideas in the dream that could reflect what is happening in your life?
Growing your mental health
I am a very keen gardener. Growing plants from a tiny seed gives me enormous pleasure and I know it has a positive impact on my mental health - all life’s stresses are put aside as soon as I put my hands in the soil. There’s an optimism and hopefulness that comes with gardening and I find the energy in those thoughts helpful for me.
The Washington Post cites numerous scientific studies to support the argument for the benefits of gardening for mental health. “Why gardening can grow your mental well-being and cultivate friends.” Richard Sima, The Washington Post, May 17 2024.
https://www.washingtonpost.com/wellness/2024/05/17/gardening-mental-health-benefits/
Relational Drama
How many times do we interact with someone or a group only to come away from the conversation feeling unfulfilled, upset and unheard. In some relationships, we see that we keep repeating patterns that lead to the same feelings of anger, pain and hurt. How do we break these cycles to have healthier relationships? How do we challenge our own behaviour to make the changes necessary? We have to do the work of change because we cannot change other people. Therapy can help identify challenging relationships and the patterns within them and support the path towards positive change. Here’s an exercise to help start the process.
Think about a recent negative exchange you have had with an individual or group.
Think about the patterns – is there a negative cycle that has been repeated time and time again?
According to Stephen Karpman, a therapist from the 1960s, each exchange has three roles (the Drama Triangle) and people move between the roles of persecutor (blames and criticises), the victim (helpless) and the rescuer (saves the day whether asked for or not). Can you identify with these roles? How might an awareness of these roles help you to avoid them in the future?
If we want to change the negative relationship dance, we need to change the music and therapy can help you change the playlist.
Grief
I often work with anticipatory grief, which at least starts the conversations with patients and families about death and dying, but I know from working in palliative care that sometimes those conversations don’t happen, leaving loved-ones in shock even when deaths are expected. Adrian Chiles in the Guardian is surprised at how shocked he is at the death of his parent and why, in general, we are so unprepared for death.
Exercise for depression
I like walking for my mental health – a combination of fresh air, exercise and the beautiful views of the Surrey Hills offer me the opportunity to unwind and breath! However, recently published research in the British Medical Journal highlights that some exercise is better than others for mental health, with yoga, jogging and strength training, singled out as effective for treating depression. BMJ 2024;384:e075847
Estrangement
I have worked with a number of clients where there is some estrangement within the family. This can be very complex work and is emotionally distressing to all those involved. Those who feel themselves ‘shut out’ are left with no answers to their many questions; for some, it can feel that the party who has withdrawn from the relationship is as removed from them as if they had died. For those making the decision to withdraw, it can come from a place of anger but for many it comes with a strong need for self-care. Recent research shows that the main factors driving estrangement include mismatched expectations, clash of values and emotional abuse, and I have certainly worked with all these in therapy. Estrangements can be short or long-term, and learning to live with these changed relationships is part of the therapeutic process.
Seasonal Affective Disorder
I often get a rise in referrals at the start of a New Year. Over the years, I’ve found that there’s no one reason behind this but the dark, short days of January are often raised as unhelpful! This article from the BBC regarding Seasonal Affective Disorder certainly struck a chord with me.