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Introduction
The following are a set of articles concerning Counselling and Psychotherapy which we hope will help clients understand more fully the Therapeutic process and what Therapy has to offer. The list is by no means exhaustive and will continue to grow over time.

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(To acknowledge those that have contributed to our understanding and the development of our ideas please visit our Bibliography).

Divorce
As of 2008 45% of all marriages in England and Wales will end in divorce. This equates to anything from 120,000 to 150,000 married couples filing for divorce per year and this will affect anything from 100,000 to 160,000 children per year. These statistics were taken form www.statistics.gov.uk
Note: These statistics do not include unmarried couples and their children.

The social and personal impact of divorce and separation is immense and affects both the adults and children in the immediate family and also their extended families and friends. Children, especially young children, are particularly susceptible to the negative effects of familial breakdown and more often than not get caught in the crossfire between ‘warring’ parents. Children loose their sense of security, family and continuity, blame themselves, are confused, and often regress to earlier developmental stages. The adults in failing or failed relationships are also fare from immune to emotional and psychological ‘fall out’. There is often a loss or bereavement period; Depression concerning the lost investment; Anxiety concerning the future ; a loss of self worth; guilt, regret, anger, resentment, denial, blame; a sense of betrayal or abandonment, a loss of faith in oneself; and much more besides. Also our legal system is adversarial, encouraging blame between the parties which is less than helpful.

Counselling and Psychotherapy has a role to play under these circumstances and can be of great help to all parties concerned.

  • In relationships where there is a possibility of salvaging the relationship Therapy can:
    • Help both parties learn to better communicate their individual needs, provide for those needs and help meet the needs of their partner
    • Create better understanding and reduce stress
    • Overcome aggressive tendencies that are bourn out of insecurity, low self worth, frustration, fear and resentment
    • Create appropriate boundaries for children allowing space for ‘Adult time’ and thus recognising that one must have a direct healthy relationship with one’s partner rather than a relationship via one’s children
    • Improve communication and reduce stress within the family as a whole
    • Offer children and adolescents an outlet to express their fears, concerns and emotions with respect to their family lives.
  • In irreconcilable relationships or during and after divorce, Therapy can:
    • Reduce tension between parties and offer a route to a more amicable split thus reducing legal costs and help prevent children from being caught in the ‘crossfire’
    • Create ‘working’ relationships between estranged parties to facilitate cordial child access rights in which children can feel secure with both their parents
    • Offer children and Adolescents an outlet to express their fears, concerns and emotions and thus lessen the impact of divorce and the likelihood of self blaming and insecurity
    • Offer emotional release to adults to reduce stress, and frustration.
    • Help both parties recognise that we are all human; prone to mistakes, failings, fault and foolishness and avoid a blame culture that promotes frustration, resentment aggression and retaliation.
If you would like our help, arrange an appointment where we can discuss your needs and how we may help, please feel free to Contact Us.
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Domestic Violence and Spousal Abuse
Domestic violence is largely a hidden crime masked in shame, blame, and fear. It is mostly perpetrated against women and children by men however men can also be victims of other men and occasionally women. This type of abuse can take many forms including:

  • Violent Attacks
  • Sexual Abuse and Rape
  • Restraining and Imprisoning
  • Humiliation
  • Destruction of Property
  • Fear and Intimidation
  • Unreasonable and overbearing Control
  • Emotional manipulation and abuse
  • Neglect

The statistics concerning Domestic violence perpetrated by current or ex partners are unreliable since as a crime it largely goes unreported and only is recorded when police or other agents of the law are involved. If you are in or have been in an abusive relationship Therapy can help you. If you are the perpetrator of abuse Therapy can also help you. Therapy is a safe, non judging relationship in which anyone can work to improve their relationship with themselves, others and the world.

Counselling and Psychotherapy can help

  • Victims
    • Increase self esteem, courage and motivation to change the nature of their relationships or end an abusive relationship.
    • Understand why perhaps there may has been a string of abusive relationships and change the nature of relating to self which may allow or encourage such relationships to form
    • Undo the emotional damage done by abuse or at lease help come to terms with it
    • Raise self-empowerment, self-respect, self-belief, self-reliance, self-esteem courage, resilience, and self-love.
  • Perpetrators
    • Overcome the need to use oppression, abuse and violence as a means of getting needs met
    • Understand what is being expressed through abuse
    • Improve self-respect and self-esteem
    • Find healthy outlets for stress, frustration, anger and resentment and discover the causation behind such feelings and understand, reduce and manage them
    • Improve relational and communication skills
    • Change the perception of what is acceptable behaviour moving away from the cycle of abuse.
  • Children
    • Break the cycle of abuse by helping children understand the true nature of health relationships for themselves and others
    • Provide a safe place to express their emotions, fears, concerns and needs.
    • Improve self esteem and self awareness
    • Provide health and timely outlets for stress and frustration
    • Improve relational and communication skills

Therapy has much to offer with respect to all forms of relational difficulties and there is no need to suffer in silence or live in fear. Please feel free to Contact Us to confidentially discuss your needs.
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Loss and Bereavement
At some point in our lives we will all suffer all suffer losses and bereavements. These events are considered ‘common life events’ and as such there is a social expectation that individuals ‘should’, given an amount of time to adjust, be able to simply ‘cope’ with them. However, such losses and changes can have huge impact and can become overwhelming. Counselling and Psychotherapy offer a safe and confidential place in whish to express one’s emotional content and gradually come to terms with events and learn to reinvest in life once more.

Sometimes, due to formative experiences, loss and bereavement trigger deeper psychological reactions and an individual may become ‘stuck’ or ‘arrested’ at a particular point in their process. They may even sink into a depressive slump and find themselves unable to cope. There is no need to suffer in silence as the help of a trained professional Counsellor or Psychotherapist can assist an individual to overcome the issues that are preventing their progression through their grieving process.

If you feel the need to confidentially talk with someone please feel free to Contact Us.
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Depression
The vast majority of people will at some point in their lives suffer from Depression and therefore depression is probably the most common symptom or ‘presenting issue’ which brings people to Counselling and Psychotherapy. Psychiatrists tend to divide depression into two categories; Neurotic or Reactive Depression and Psychotic ‘Endogenous’, (from within), Depression with symptoms respectively ranging form loss of apatite and insomnia to hopelessness and suicide.

As Therapists we are uncomfortable with the labels ‘neurotic’ and ‘psychotic’ as these have social connotations that are unhelpful to clients. Instead, we prefer clients to recognise the ‘normality’ of their conditions and rather than single them out as abnormal and perhaps without prospect or hope; we, in recognising their normality, offer hope and the prospect of overcoming their difficulties. We therefore, prefer to use a scale by which we can describe the psychological traits of the vast majority of people. The scale we use is divided into two equal parts; the Depressive spectrum occupying one side and the Obsessive spectrum the other. The most people will fall somewhere on the Depressive-Obsessive scale and though it as a scale, an individual may occupy either one or two positions, i.e. just display ‘dominant’ traits or also display ‘subordinate’ traits. Most people display a significant number of traits which would result in them being described as having Depressive or Obsessive tendencies, however, they will also display traits from the opposing spectrum which ‘modify’ their dominant trait. That is to say that some people are either ‘purely’ Depressive or Obsessive but many are depressive-Obsessive or obsessive-Depressive.

The Depressive spectrum ranges from severe or chronic Endogenous Depression through milder Endogenous Depression all the way to Reactive Depression.

Counselling and Psychotherapy, when given the opportunity, can help with all forms of depression from severe to mild, however, there is sometimes difficulty with more chronic forms of depression because the efficacy (effectiveness) of Therapy is significantly affected by the Therapeutic Relationship and sometimes with chronic depression there is an inability for the client to relate to others or themselves which may thwart the Therapist’s attempts to form a relationship.

The following quote is taken from Shakespeare’s
‘The Tragedy of Hamlet, Prince of Denmark’, (Act II, Scene II).
In it Hamlet describes his melancholia or depression thus:

“I have of late, but wherefore I know not, lost all my mirth,
Forgone all custom of exercise;
And indeed, it goes so heavily with my disposition;
That this goodly frame, the Earth, seems to me a sterile Promontory;
This most excellent canopy the air, look you, this brave overhanging firmament, this majestic roof, fretted with golden fire:
Why, it appears no other thing to me, then a foul and pestilent congregation of vapours.
What a piece of work is a man!
How Noble in Reason?
How infinite in faculty?
In form and moving, how express and admirable?
In Action, how like an Angel?
In apprehension, how like a God?
The beauty of the world, the Paragon of Animals;
And yet to me, what is this Quintessence of Dust?
Man delights not me; no, nor Woman neither.

Reactive Depression
Reactive Depression is generally a temporary or episodic state marked by a number of varying symptoms including:

  • Feeling isolated
  • Low motivation
  • Listlessness
  • Unhappiness
  • Low mood
  • Tiredness
  • Loss of appetite, weight  and  energy
  • Insomnia

Of which an individual may experience one, some or many and each to varying degrees of severity. Reactive depression is so named because it is a state which tends to be a reaction to ‘normal life traumas’ such as:

  • Bereavement
  • Loss of employment
  • Failures and Rejections
  • Surgery and Illness
  • Divorce and Separation
  • Accidents
  • Crime and much more besides.

The depressive reaction can be immediate and recognisable to the individual or if the trauma is denied or repressed (psychologically hidden), the depressive reaction can seem more endogenous or ‘orphaned’ from its causation.

Also research has shown that there are a many social factors that increase the likelihood of a ‘normal life trauma’ resulting in a depressive episode including:

  • Having 3 or more children under the age of 14
  • Unhappy or unsatisfactory marriage or relationship
  • Hostile living conditions
  • Poor housing
  • Loss of own mother prior to 11 years of age
  • No adult confidant with to confide in
  • Poor education and low prospects
  • Chronic Illness
  • Malnutrition or Disease
  • Particular infections including Glandular Fever and Influenza
  • Post natal depression
  • Menopause
  • PMT

Counselling and Psychotherapy can assist in the resolution of Reactive depression by:

  • Providing a confidant in whom to confide their deepest thoughts and feelings
  • Offering the experience of a positive healthy and growthful relationship in which the client is truly positively valued
  • Truly understanding the client from the client’s perspective
  • Educating the client as to the nature of depression and assisting them in coming to their own solutions to their issues
  • Helping the client realise their own abilities, skills and resourcefulness
  • Helping the client Realise a healthier perspective concerning their selves and their lives
  • Mobilise, empower and support the client in their endeavour to move forward  

Endogenous Depression
Endogenous Depression describes depressive pathology as coming from within the client rather than from without and though it can be exasperated by external forces and events it is generally a long term psychological issue that is usually traceable to an individual’s childhood and formative years which at that point was ‘fixed’ within the psyche of the individual. This type of depression is characterised, to a lesser or greater extent, by

  • A general sense of deficiency in oneself characterised by:
    • A sense that you are not ‘good enough’, not worthy or ‘deserve’ to be rejected and unloved; or
    • A deep fear of rejection and loss, and an inability to let go and move on; or
    • An enduring sense of emptiness; or
    • Perceiving in relative terms such that one is never enough because there is always someone ‘better’, more deserving, brighter, faster, stronger, etc. A constant ‘measuring’ of oneself and one’s achievements and possessions against the achievements and possessions and finding oneself deficient; or
    • A fleeting or fragile sense of self worth  that is not upheld in the ‘self’ but rather is situational in terms of comfort zones; dependant on approval from others or dependant on controlling others and situations.
  • An insatiable need for ‘approval’ that can only be temporarily ameliorated characterised by:
    • A need to prove oneself, to do things just right or perfectly; or
    • A need for others to acknowledge or praise you; or
    • A need for the deference of others and to hold power or sway over others to prove yourself; or
    • Undue uncertainty and concern with respect to the beliefs and ideas that others hold about you; or
    • A complete rejection of the views and opinions of others as a pre-emptive response to a fear of being rejected.
  • A sense that there is not enough
    • A fear of your needs exhausting others or the world; or
    • A belief that there is not enough love, goodness, kindness, or sustenance for everyone and as such you will always not have enough; or
    • A sense that what others have diminishes what is available to you; or
    • Perceive in relative terms such that what is available to others is always ‘better’ than what is available to you, i.e. Envy.

Therefore the ‘key’ psychological characteristics of Endogenous Depression are persistent: insecurity and fragile self-worth; ‘approval seeking’ and proving oneself; and emotional hunger and envy. It is important when examining oneself not to judge a position of thing as ‘good’ or ‘bad’ but rather to seek understanding and ask why do I do what I do, why do I feel as I do and what motivates me?    

It is during one’s Formative or childhood years (0 to 5years) that the groundwork for a depressive personality is laid and therefore we must consider such experiences from the perspective of the child. Children need a secure environment with love, approval and a stable strong ‘surviving’ parent who can consistently provide for their needs without faltering, resentment or retaliation. Parents who are unable to provide such an environment will tend to be parents who:

  • Do not show sufficient affection or approval to meet their child’s innate needs, resulting an a depressive mal-adaption in the child or
  • Create conditional relationships that require their children to ‘perform’ or adapt to their parent’s needs in order to receive affection or approval or
  • Resent their children’s needs and demands as an imposition, inconvenience, or too much trouble; or
  • Are indifferent to their children such that the child is unable to adapt to gain affection and approval or
  • Are depressed and believe themselves to be lacking or the world unable to meet their needs and project this belief system onto their children; or
  • Force their children to meet their needs without meeting the child’s needs, e.g. when a child is forced to parent their own parent because their parent is alcoholic or misuses substances; or
  • Parents who are unable to cope with the demands of having children and are overwhelmed, unwell, depressed, without energy, etc.
  • Split their attention and affection across a number of children inspiring rivalry and resentment amongst siblings especially with respect to first bourn children who are then closely followed by siblings. They feel replaced or usurped by their siblings and lacking in their parents affections.

(In Freudian terms, depression relates to a metaphoric oral fixation in which the child is always hungry for more and the parent in unable to provide for his needs. From this experience the child concludes that they themselves are not worthy of proper care unless they adapt to service the needs of others or if unsuccessful in their adaptations, that the world is unable to meet their needs. In a society that continues to promote the perception of females as mothers and males as providers and protectors; depression in psychosexual terms manifests itself in males as an attraction towards ample breasted females (mother figures) and in females manifests as an attraction to what they perceive as strong protective providers (father figures)).

Depressive individuals whilst chasing approval and perfection can achieve greatness and appear to society as very successful. The world of Business, Politics, Entertainment, Religion, Criminal Gangs and the Military is littered with depressive individuals ‘over achieving’, demanding notice, recognition, deference, respect and approval. Alternatively they may seek or appear to seek popularity and be good company as they adapt to suite the needs of all those around them as an alternative more subtle means of getting their needs met. However, depressives are susceptible to abuse by those individuals that recognise depressives and needs and manipulate them by provision or denial of those needs in order to get their own needs met. Depressives can also become obsessive in their demands of others and adaptations to others and unable to tolerate what they perceive as disrespect or rejection.

The nature and symptoms of Endogenous Depression can range from the constant need to gain approval or prove oneself to an extreme sense of helplessness, hopelessness and suicidal tendencies. In its mildest forms a depressive individual may not recognise their ‘condition ‘ and be sufficiently adapted to it that they do not perceive themselves as being depressed but rather as an ‘over achiever’; such is the nature of our ability to compensate and adapt to our issues. And if that is the case, then it is reasonable to ask if there is a need to do anything about such a condition. Obviously, only the individual concerned can truly answer this question but as a Therapist, in general terms, the answer is simply yes. While there may sometimes be positive results from being driven to ‘achieve’ it is not the achievement that creates happiness but the motivation that creates unhappiness and it is the avoidance of that sense of unhappiness that motivates. Counselling and Psychotherapy offers the opportunity to truly free oneself from that unhappiness. 

Treatment
The treatment of Endogenous Depression is not a simple matter of modifying the behaviour and cognition of an individual that feels low. Firstly, diagnosis is often difficult because of adaptations that mask depression. Individuals are often diagnosed and treated for their presenting issues which are only masking symptoms that mask causation. One such common mistake is the diagnosis of ‘Obsessive’ when in fact the client is Obsessive Depressive, i.e. Obsessive adaptations are being used to compensate for and overcome Depressive tendencies; that is to say that their Obsessive tendencies are a symptom of their Depression. In such cases treating Obsessions tendencies will leave the client at the mercy of their Depression which is something I would not recommend. Therefore it is important that a considered and appropriate diagnosis is made and confirmed over time and appropriate treatment given.

[Contributing authors and theorists, Bibliography: Antony Storr ‘The art of Psychotherapy’ and Melanie Klein’s work]

More to come...
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