Tag: Counselling Borough

Gas lighting

siobhantoner

Gas lighting takes away a persons ability to trust in reality and they can end up blaming themselves for the appalling behaviour of another person.

“If I was better/smarter/slimmer/kinder/quieter/cleverer/etc then they wouldn’t be so upset and frustrated with me”.

Other people can get pulled into it as well and can see the victim in the way the perpetrators wants them to so they miss the abuse that is happening.

This isn’t limited to gender roles either, despite the most common examples being reported as men abusing women. It also isn’t limited to partners; its a form of abuse that can occur with any type of relationship. Family, friends, work. I have worked with sibling abuse in this form and also adults who were raised by parents who did this.

It takes the victim time and space to trust their own perceptions again; to stop self blaming. They may never heal completely, but it is possible to bring about a lot of change.

https://www.independent.co.uk/life-style/health-and-families/gaslighting-and-how-can-it-change-a-victims-perception-of-reality-domestic-abuse-violence-a7347781.html

Sibling abuse – a parents story

siobhantoner

I have found this incredibly moving piece on being the parent of a perpetrator and survivor of sibling abuse.

What is most distressing is the judgement the parents are experiencing and the lack of support and action by authorities. When will people take this abuse seriously? Why should the victims horrendous experiences be dismissed in this way because of the fact her abuser was her sister. As long as this keeps being swept under the carpet in this way nothing will change to tackle this dangerous form of abuse.

I Am the Mother of Both an Abuse Survivor and a Perpetrator

Government mental health paper

siobhantoner

A government report has been published on the topic of Improving access to mental health services and it makes for sobering reading. If you think this isn’t something that effects you, maybe these figures will make it clearer “One in four adults is diagnosed with a mental illness at some point in their lives, but only around a quarter of people estimated to need mental health services have access to them.”

The conclusions in the report are summarised as follows:

1.Achieving parity of esteem between mental and physical health is a laudable ambition but pressure on the NHS budget will make it very difficult to achieve.

2.Structures are not in place to enable joined-up working across government to ensure the most appropriate action is taken to support people’s mental well-being.

Around half of people with lifetime mental health problems experience symptoms by the age of 14 and schools play an important part in identifying mental health issues among young people, but counselling services are not available in all schools. 

 3.It is difficult for people to access the support they need because the way mental health services are designed and configured is complex, variable and difficult to navigate. 

The National Audit Office found, for example, that in 2014–15, the proportion of people able to access psychological therapy within six weeks of referral varied from 7% in one clinical commissioning group to 99% in another.

4.There is insufficient information about the numbers of mental health staff and their skills, and there is not yet a clear plan to develop the workforce needed to achieve parity of esteem. 

Current structures, practices and payment mechanisms do not incentivise commissioners and providers to deliver high-quality mental health services for all who need them. 

One of the points that I found particularly sad was this section on children and young peoples experiences accessing mental health services. In my work as a school counsellor I have witnessed first hand how long it can take to get a young person into specialist treatment and it can be a very distressing experience.

32.The Centre for Mental Health told us that it had recently completed a review of children and young people’s mental health. This work had found that it typically takes 10 years between the first symptoms of a mental health condition appearing and a young person having access to effective, evidence-based support. Delays were partly explained by low mental health literacy among parents, who found it difficult to know the difference between a mental health difficulty and ordinary childhood experiences, but also because of difficulty accessing services. Even when people made contact with services this could be a remote, formal and frightening experience.Written evidence from Bringing Us Together reinforced concerns about children and young people’s experiences of poor mental health care.

The link to the full report is http://www.publications.parliament.uk/pa/cm201617/cmselect/cmpubacc/80/8002.htm

On kindness

siobhantoner

I was recently doing an exercise with a group and the question “if you could change one thing on the world what would it be” was asked to all the members.

My answer was the wish that we would all be a bit kinder.

When I thought about it some more I realised that while we can be very kind to others we are often very unkind to ourselves.

One of the common things I hear is about the critical inner voice so many of us has. This inner critic can have its uses as it helps us evaluation situations and motivates us, but it can also cause a lot of distress.

How often to you really listen to how this voice is speaking to you? What tone does it take? What sort of words does it use?

Most of all, how kind is it?

The reality is that a lot of the people I work with have a very unkind inner critic, it talks to them in the most horrible way.

We may consider ourselves really kind and caring people – to others. However, when it comes to ourselves it’s a different story. We in fact can be incredibly mean and spiteful, that inner critic can become a full blown bitch.

So what to do about it?

The first step is to notice it. When something becomes so habitual and ingrained, it’s an automatic respond that we don’t notice. Notice how often you are unkind to yourself. Become aware of what your negative inner voice is really saying.

The second step is harder. Start questioning the thought, below are some example.

  • Did I really deserve to call myself that name?
  • If I saw someone I loved being spoken to like that by a third person what would I do?
  • Would I speak to anyone else like this?

The third step is to challenge the thought. Depending on the situation and the thought it might be along these lines.

  • What I did wasn’t that bad, therefore I don’t think calling myself that name was justified.
  • Yes, I have put on some weight but I’m still a good person.
  • My future isn’t ruined because I didn’t get the job.
  • I’m not stupid, I have a good education.
  • I may be quiet but that doesn’t mean I’m boring.

This third step takes a lot of practice as the habits of unkindness need to be changed to ones of kindness to ourselves.

This takes time.

But it is worth the effort.

Give it a go and see.

What are the core conditions?

siobhantoner

I was really bothered by a news story a few days ago and very angry at the ignorance the individual at the centre of it displayed.

I don’t want to link to it and give it more attention, but basically a young man had no idea on what it was like for women to have their periods but felt qualified to spout opinions on the tampon tax which completely denied female anatomy.

How would I work with someone like this in the therapeutic space? Could I?

As therapists we can hear opinions that we disagree with every day, our client’s views and values may be different to ours and it’s something we have to find a way to cope with.

Like any model of therapy, the Person-Centred Approach has a lot of theory behind it but Carl Rogers the founder crystallised it into three Core Conditions. If these are present, then change can occur for the client.

The first is congruence, that the counsellor is congruent with the client. In respond to the opinions above, my first thought would be “You are a bloody idiot” but that really doesn’t sit with the next two conditions so maybe I will come back to that.

The second condition is that the therapist extends unconditional positive regard to the client. Rogers described this at times as “Prizing” his clients. If I think my client is an idiot, then that doesn’t really work.

The third condition is showing empathic understanding to the client. Letting them know you really get where they are coming from. It’s when I thought more about this I felt my views shift. What does a young man really know about a female body? He might have done some biology but not have been academic or too busy sniggering to take much notice. When it comes to the topic of our periods, we as females don’t on the whole share the details with men. If we don’t talk about the details, how do they really understand? Especially someone who is young and inexperienced.

So a way of showing my empathy might go something like “I understand that this is what you believe based on your knowledge of the female body….” because from the point of view of this person, that is truly what he believes.

Showing congruence with this perspective might mean adding “I know from my experience as a woman you are wrong in your view and I have to say that to you as otherwise it will get in the way of our working together”. How I say this, with an open and friendly manner can let the client see that I can still prize him while disagreeing with his opinion on this topic.

Unconditional positive regard doesn’t mean accepting everyone does as ok, it means being able to still value the person even if we dislike some of their behaviour or opinions.

However, I have to confess it took me a few days to really be able to begin to feel empathy with these views, so I don’t know if I could have got there in a therapy session.

Frequency

siobhantoner

I talked a bit about how long counselling should be in a previous post but I didn’t mention frequency.

The most common is to have a weekly session. This is so that the client has time to process what may have come up for them and review where they are before the next week while still keeping things fresh in memory at the next session.

However, this a huge commitment for some people both in time and money so every two weeks has become something that a lot of people choose. I work online this way but not face to face for personal practical reasons. I only have office hours on Fridays so I would have to find two clients that would use the same slot on alternating weeks which wouldn’t necessary be easy, otherwise I would be wasting a time slot every two weeks.

However working online I do offer every two weeks as I can be a lot more flexible with my working hours that way.

I really wouldn’t recommend planning to work on a longer frequency than every two weeks. I believe it would make it very difficult to build a therapeutic relationship and then see change occur. It may be that after a period of regular therapy then the client would like some check in sessions after a longer period to see what progress has been made and if it is being sustained. This could be useful towards the end of an alliance once an relationship has been formed and worked on. However again for practical reasons I could only offer this online.

How long is long enough?

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How long is long enough?

It’s one of the hardest questions to answer from a client. How many sessions do you think I will need?

It’s just like the question how long is a piece of string?

I have worked with people who got what they wanted from one session, others needed years.

I recommend giving the start of therapy six sessions. This six session model has become a bit of a standard. It gives the client and counsellor some time to get to know each other which I believe is the most part of the therapeutic process. There is time to address a specific issue the client wants to focus on and maybe see some results.

I say maybe because it really does depend on the issue. For example, if the client wants to use the space to offload about some work related stuff that is going on, then this can happen.

Some clients have an initial group of sessions and then come back later. E.g. they may want a few techniques for improving their behaviour when they are angry. They can get these and then take some time to put these into practice. They may choose to continue therapy during this process or take and break and come back to explore the results.

There are some issues that clients bring that may have built up over years and may need longer term work. Low self esteem, anxiety, bereavement and depression can take time to work on and it’s impossible to guarantee the outcomes or how long it will take. But there are always exceptions to this and sometimes the six sessions are enough.

It may be that the six sessions are enough for right now and the client may find what they are really looking for is coping mechanisms for the present time so that in the future when they are in a better place they can address more of the underlying issues.

So the answer to the question is no real help I suspect for people. All I can say is that when people commit to the process I have seen real change occur and I believe it is possible for anyone. Give yourself time to heal from the wounds of the past.

Loneliness

siobhantoner

I found this article on loneliness very moving and sad. there are so many lonely people yet it seems harder and harder for us to make meaningful connections with each other.

Its an issue that affects all age groups. I know how distressing it can be for younger people and children not covered by this survey as well who find it hard to learn how to develop social connections in the first place. This then follows them throughout their life.

Its important to acknowledge the difference between being alone and being lonely. An introverted person may be perfectly content with spending a lot of time alone and yet have enough connections in their life to never feel lonely.

An extravert may be surrounded by people at all times yet feel they are missing meaningful intimate connections and feel desperately lonely.

Its a complex social issue that impacts so many of us, but it also gets hidden because of the shame that comes with admitting it. So many of us are pretending that we are ok. Comparing ourselves negatively to others who seem to have it all and not noticing that actually we are not the only ones experiencing it. It takes enormous bravery to say “I am lonely”.