“It was when I stopped searching for home within others and lifted the foundations of home within myself I found there were no roots more intimate than those between a mind and a body that have decided to be whole.”
— Rupi Kaur, poet
Therapy - how does it work?
PLEASE NOTE - Consultations, both individual and for couples, are normally conducted face to face in regular scheduled sessions of 50-60 minutes. At present, whilst we all observe the national and state COVID-19 restrictions, face to face sessions have been replaced by tele-health sessions. You can read more about these here. Once restrictions are lifted, face-to-face meetings will resume. Tele-health will remain available to those who qualify under the guidelines.
Short term, focussed work
Short term work is a good option when -
The problem is straightforward: if you have a clearly defined problem and just need some help to sort it out, then practical, focussed, short-term work may be right for you - we focus on the problem and set about finding a solution to it.
Your capacity to attend is limited by money, time or other factors, meaning therapy has to be contained within clear parameters. Or, like a great many people, you are definitely restricted to the ten sessions available on your mental health plan because you cannot fund ongoing sessions at all.
In these situations, the goals of therapy will be very clearly defined and limited, and I will likely be quite directive as to how to proceed, often within a cognitive-behavioural therapy (CBT) framework. We may focus on psycho-education, or skills building to, say, manage an emotional or behavioural difficulty. Or perhaps what you need is support to get through a difficult process or transition, for example, a problem at work. Sometimes this kind of short focussed work is enough, mission accomplished. Sometimes, people may come back as resources permit and if their symptomatology is suited, for repeated short-term work, or perhaps for a ‘booster’ or refresher.
Whether this kind of short-term work is suitable for your needs is a matter we will assess in the first consultation.
Longer work
Psychodynamically framed psychotherapy
Sometimes it’s clear from the start, or becomes clear as we work through the assessment process, that short therapy is not enough to resolve the problem. In order to really understand their difficulties well enough to change, many people need to properly explore the antecedents and contributing factors involved in a symptom or a problem. The therapeutic relationship also needs time to develop, and for work involving deep change, this is the crucial factor. It takes time to get to know each other, to understand the extent of the problem and its symptoms, to develop the trust required to meet the challenge together.
Psychodynamic psychotherapy and psychoanalytic psychotherapy are much less directive ways of working than shorter term work; we undertake a committed journey of discovery together, our two minds focussed on understanding the forces at work in your life that create and maintain difficulties. The understanding gained can be transformative, allowing new ways of seeing, feeling and thinking, and therefore, changing how life is experienced.
Psychoanalytic psychotherapy is based on the same principles as psychoanalysis*, but differs in two important ways: patients are seen once or twice a week, (rather than three or four times weekly), and there is no requirement to lie on a couch, á la Freud. In this kind of work, we explore the way a person has developed and structured their internal world, enabling unconscious aspects of life to be uncovered. This way of working can be intense, but it is also strongly supportive of lasting and deep change.
A determination of suitability for psychotherapy is made according to several factors, including: the nature and extent of your problem(s); your life situation; and considerations such as your availability and capacity to commit to regular session times and to manage therapy fees. In essence, psychoanalytically oriented psychotherapy suits people who are essentially stable and functioning reasonably well, but who struggle to feel happy or satisfied, or who remain troubled by persistent symptoms - examples might be a successful person who is nonetheless plagued by low self-esteem and the anxiety that comes with it; or a person for whom there is nothing really wrong, but nothing really feels right either; a person for whom depressions descend for no apparent reason; a person who has already done a lot of psychological work but knows there’s more to understand before they have mastered internal conflicts. Psychoanalytic psychotherapy or psychodynamic therapy may also be the treatment of choice when problems are persistent, difficult to understand, difficult to shift and/or affect life in deeply negative and detrimental ways.
Psychoanalytic theories understand present day functioning to be affected by past experiences, much of which is unconscious. They posit the notion of psychological defences against psychic pain, and that these affect our ongoing development subsequent to their emergence. These protective systems continue to function as a kind of automatic pattern, out of awareness. By bringing these internal dynamics to consciousness, the way they affect present day relationships, emotional functioning, the idea of the self, can be examined, and understood, and the psychic energy bound up in them can be freed up towards a more fulfilling life.
My therapeutic approach
Different people and different problems need different responses, and there certainly is no one size fits all, either in terms of therapy modality or therapist. One of our first tasks together is to decide that we feel a ‘fit’ between us, and that is usually clear pretty quickly. Then, our beginning tasks are to agree on what we’re working on, how we’re approaching that work, and how long we might take to do it. These decisions are affected by the extent of the problem, what resources you can commit to it (time, money, energy, limiting factors and so on). To accommodate all of these factors, and like most experienced therapists, I draw on different therapeutic schools and tools, though the three main ones are Psychoanalytic Theory, Attachment Theory and Cognitive Behavioural Therapy. If these mean nothing to you, you aren’t alone - we’ll discuss at the beginning what approach is best for you.
I strive to remain flexible and open to new ideas - we are all alike in many ways, and utterly unique at the same time - I try to find what resonates for you, rather than apply a one-frame-fits-all approach.