A Warm Welcome - Counselling in Exeter

I am a professional, qualified counsellor practising in central Exeter, Devon. I work privately from premises on Gandy St, in the centre of town, with a wide spectrum of people with differing presenting issues. Warm and approachable, I have the utmost respect for my client's individuality and life circumstances. 


This site is where you can find out information about counselling, my personal approach and some details about my background. This is also a blogsite which I use to make regular posts about my work and continuing professional development as a counsellor.


I would be very happy to discuss your requirements should you be interested in coming along for counselling. You are invited to a free initial face-to-face consultation. Embarking on a course of counselling can be daunting and I aim to help you feel relaxed and confident that you make the choice that is right for you.


Please call me on 07917 523494 or email me at:


awcounsellingexeter@yahoo.co.uk. 

You can also find me on Facebook and Twitter.

Please, whoever you decide to have counselling with,  ensure that they are a member of a professional body such as the BACP or UKCP. Without membership of a self-regulating professional body then clients have no recourse should they feel that they are being treated unethically. At the moment, there is nothing to stop people practising as counsellors without this protection for their clients.

AMANDA WILLIAMSON - COUNSELLING IN EXETER

Sex in the Forbidden Zone - by Peter Rutter, and words on power in therapy

I was loaned this book by a fellow therapist. I told her of a situation that I had been in, where a therapist had abused my trust, and that of other women, and I was struggling with the concept of how somebody can do that. She told me that my situation reminded her of this book.

It is probably the seminal publication on the subject of abuse of power in therapeutic/mentoring relationships (Freudian pun?). The blurb on the back (on this 1990 edition) states:

"In this moving and controversial book on sexual psychology, Peter Rutter explores the epidemic of sexual relations between men in authority and the women that are meant to help."

Reviews of the book state:

"This is a landmark book. It explores the dynamics of power in male-female interactions and the tragic consequences when those with power betray their trust. It should be read by physicians, therapists, teachers, clergy and lawyers." Carol C Nadelson MD

and

"The depth and truth of Dr Rutter's insights into erotically charged relationships will challenge and empower both men and women to make choices that matter greatly. Sex in the Forbidden Zone should be read by everyone in the helping and mentoring professions" Jean Shinoda Bolen MD

Our cultural attitudes towards abuse are changing. Just because it is horrifying and reflective of a part of humanity we'd rather didn't exist, doesn't mean that it doesn't exist. In fact, I believe that this aspect of ourselves, our sexual side, our more animalistic tendencies, are part of our collective shadow (in the Jungian sense - click here for some info). The taboo around frank sexual discussion could well have contributed towards our inability to deal with dysfunctional sexual relations when they arise. Instead, what society allows to leak out is pornography and the media portrayal of women as being "available" and in some parts of the world a huge anti-gay culture (with remnants here in the UK too, sadly). This doesn't seem healthy to me.

By the way, I'm a feminist and a masculist.

I digress (and for further digression along this tangent read this article on sexual assault and the chain of command: http://thefeministwire.com/2013/05/are-men-to-be-trusted-thoughts-on-sexual-assault-and-the-chain-of-command/

Power in the therapeutic relationship

Back to the book. I do agree that it is essential reading for anybody working therapeutically in a position of power. I have a personal dislike of the use of the word power in the therapeutic relationship. I don't see myself as having power over my clients. I don't want to have power over my clients - I see us as being equal. But the fact is, when we open up to a therapist, we are trusting them, and anybody we trust has some power over us, because they can abuse their position. Our therapist has intimate knowledge about us, but we don't have the same knowledge of them. I don't like it, but it's there. It is something I cherish greatly, this privilege of being entrusted. As Yalom states, we are "cradlers of secrets".

Rutter states that any sexual contact between a therapist and client is an abuse of position of trust because of the nature of the relationship, because the therapist often becomes a parental figure to the client. With this, the sexual exploitation is tantamount to incest, and the repercussions for the victim can be as devastating. It is interesting to note, that when I told the therapist (the one who abused my trust) that he was kind of like a father figure for me, he looked horrified and said "I do hope not". Another male therapist with whom I saw in a fatherly way was touched when I told him. Such a stark contrast.

"Because the forbidden zone reawakens these childlike parts within us, acquiescence to sex under these emotional circumstances can hardly be equated with adult consent. In the light of these underlying dynamics there can be no such thing as consent in the adult sense, to a sexual act by a woman with a man who has power over her in the forbidden zone. A man of this position of trust and authority becomes unavoidably a parent figure and is charged with ethical responsibilities of the parenting role. Violations of these boundaries are, psychologically speaking... acts of incest."

So, like any profession out there, there are a few rotten apples. There are some who are called to the caring professions because their shadow side takes them there. The statistics are worrying. The book refers to research on sexual exploitation by psychotherapists. The study looked at therapists who had treated patients who had a sexual relationship with a previous therapist. 70% of therapists reported at least one patient who had had such a relationship, 96% of these previous therapists were male. The book also looks at sexual exploitation between clergymen-parishioner and teacher/student relationships but my focus is on psychotherapy as this is the field in which I am familiar (although I have awareness of a clergyman abusing his position of trust with at least two parishioners, sadly, and of course the papers abound with stories about the church and abuse).

Like I have mentioned before, I cannot believe that counselling and psychotherapy are unregulated professions in the UK. It won't stop abusive therapists but will help make them accountable and give a course of action for people to take if they are affected by somebody's inappropriate behaviour (sexual or otherwise - breach of confidentiality, amongst other things, is also an abuse of trust).

I earmarked a few pages of this book as they really spoke to me and reached the part of me that was in an abusive situation with somebody I trusted, and the part of me that is in touch with and has heard the many stories of other people (male and female) who have been abused in one way or another. When I read articles on the internet with comments from the public such as "how could she be so stupid" or comments regarding Savile's victims saying "she must be lying - how can she have gone on all this time without saying anything" I feel immense frustration. I have been on the receiving end of such tripe. This is utter nonsense. Anybody who has an ounce of empathy will know that being on the receiving end of an abuse of trust has an extremely complex response to the abuse. It can take victims years to speak up, if ever. To speak up is unfathomably hard. And usually it is only one person's word against a manipulative, powerful individual. Such attitudes perpetuate abuse.

Rutter has a chapter illustrating the snapshot of a man who crosses the boundary. There are warning signs. Clinical supervision is an ethical necessity for therapists and erotic feelings towards clients should be explored professionally. Bury them and they'll pop out again somewhere and you'll have little control over them, is the message.

This paragraph stood out as particularly interesting:

"Success itself puts a man at higher risk for feeling that he can make his own rules and that his word (or his fabrications) will be believed against the words of a woman who challenges him. In most of the case histories I gathered for this book, the man who had a sexual relationship in the forbidden zone had been considered an outstanding member of his profession."

Power rears it's head again. The higher the position of power the more likely the propensity to abuse trust. Remember that quote? "Power corrupts, absolute power corrupts absolutely".

Give me humility over power any day.

My struggles with CBT

I receive a number of enquiries asking whether I "do" CBT. CBT stands for Cognitive Behavioural Therapy which is an approach which places importance on the thought processes behind dysfunction in moods such as anxiety or depression. I tell people that no, I do not stick to a CBT formula as this would mean having to leave out huge elements of the therapeutic relationship and the way I work. I appreciate that some people would like to have the safe distance to challenge certain aspects of their way of being in a structured way, without going too deep, such as CBT offers. Indeed,  CBT can be a useful stepping stone in the counselling journey. But I am unable to leave a huge chunk of myself, my knowledge, intuition and therapeutic tools out of my counselling work.  So if somebody wants pure CBT I recommend that they see somebody who's work focuses exclusively on CBT.

My training included CBT and REBT - Rational Emotive Behaviour Therapy (in my opinion more rounded and deeper than CBT as it involves core beliefs - not just the symptomatic thought processes. See this link for my blogpost on REBT vs CBT). I am an integrative counsellor with an emphasis on relational depth, The choice of therapeutic approaches I use is coherent with my humanistic outlook (please see My approach for further details). My baseline approach in the therapy room is Carl Rogers' person-centred therapy which places the importance of the relationship between client and therapist as the indicator of a positive outcome. I use elements of CBT, although I don't refer to them as being 'CBT techniques" - they are simply facets of a highly complex service that I offer to my clients. Challenging thought processes is an important part of the work, but is not the main emphasis.

Here are some elements of my work that a purely CBT approach does not involve:

The relationship as a tool

The therapeutic relationship can be a microcosm of the relationships the client has outside of the therapy room. Once trust and mutual respect has been built then I can give my clients respectful and helpful feedback about why they may be having problems with how they relate to others. This can be about finding it hard to trust others, or assuming that people think the worst of them. I use myself - my emotional reactions to the client, in conjunction with what they tell me about their relationships with others. This is not for the fainthearted therapist. A high degree of self-awareness is required and I believe that therapists should continue to engage in their own personal therapy, as well the clinical supervision (a professional requirement). Some of the most successful counsellors I know engage in personal therapy from time to time to enhance their professional work. 

Emotional expression

Irvin D Yalom states that successful therapeutic outcome depends upon there being cognitive and emotional elements of the therapeutic relationship (see Group Therapy - Irvin D Yalom). This correlates with what I know from looking at the work of Antonio Damasio - a neuroscientist who writes extensively about the role of emotions in our lives. He states that emotions are essential not only for survival but to help us make decisions. We are wired to emote and if we bottle up those emotions then they stay with us. What the mind denies the body remembers. There are books on this topic and two that spring to mind are The Body Remembers by Babette Rothschild and The Body Never Lies by Alice Miller (which I review here). So, expressing emotions during therapy helps in a couple of ways:

Processing trauma - trauma can be a huge life event such as abuse or a near death experience. Trauma can also be due to other stressful events such as being diagnosed with chronic or terminal illness, death of a loved one, divorce, loss of job etc. For me, trauma is common in childhood. The trauma of being born for one (from incubated, conjoined bliss to a rude awakening of separateness and sudden onslaught of bright lights, crashing sounds and independent respiratory, circulatory and digestive systems kicking in...). Sometimes we are unable to express the emotions associated with a trauma as we may be in shock, or we may have been in an environment where emotional expression was frowned upon or simply not modelled to us (we learn from experience and from example). Eventually, though, there may come a time when we are ready to express our emotions. Sometimes this is triggered by an event which is some way accesses our repressed trauma which causes it to resurface. Sometimes,  we are presented with the opportunity to deal with the past in the here and now and relegate the traumatic incident to where it belongs, in the past, by finally expressing those associated emotions in a safe environment.

We are wired to emote - I see it so many times; clients who have depression and/or anxiety probably due to not being able to express their emotions. This usually takes the guise of feeling uncomfortable burdening others with their problems. Ironically, these are usually the most thoughtful and generous people who are always there for others. But for some reason, it's not okay to take what they give. They find it easier to burden me as it is a professional relationship and I get paid to listen. Even then you may be surprised at how guilty a client may feel burdening me. However, the work for me here is to try and help them to understand that it's okay to be vulnerable and in time, to be able to express that to trusted friends/family. 

Emotions help us to learn - it's all very well having cognitive awareness. Our thoughts are wonderful things, but our emotions are not secondary to our thoughts - they are intertwined. Furthermore, the engagement of emotions during learning helps us to apply what we learn outside in the real world (read this neuroscience paper, We Feel, Therefore We Learn for more information). 

I have had a few clients who have had a batch of CBT before finding me. As I say, it can be a useful stepping stone until a client wishes to go deeper. It has been fed back to me that their experiences CBT dismisses the emotional element of being. It recognises that emotions are affected by thoughts, but does not utilise emotions in the here and now, as a therapeutic tool.

Creativity in therapy

Thoughts can be the bane of our existence if they are negative and repetitive. Thinking about thinking - switching on cognition is order to try and escape cognition does not always make an awful lot of sense. I believe that sometimes we need to switch off our thoughts processes and integrate a more natural way of living. I often recommend mindfulness based activities such as meditation, yoga, pilates, martial arts (see here for article on martial arts and psychotherapy). These give us a break from our automated thought processes and help to reduce anxiety and improve our brain's neuroplasticity (the brain's ability to change and adapt, see here for definition). 

Occasionally I use a creative intervention when the client is unable to access their emotions and "switch off" their negative thoughts. This may involve sandtray work (I rarely use it but it has been very effective where I believe it is indicated - more information on this here), working with miniatures or stones or visualisations. I often ask clients to try and write down the details of any dreams as there is often rich work here. It amazes me how many have dreams the night before therapy! Sometimes we work together using analogous language such as describing the holding of emotions as filling a bag to bursting point.

Something I do as a matter of course now in my work, with almost every client, is to "mindmap" the session. I take notes during the session - jotting down pertinent thoughts of the client's including their use of emotion words, and any revelations. I offer my client to read the notes at the end of the session and, especially for the visual learners, it can be a powerful way of consolidating the session. It is also useful to refer back to these notes as the therapy progresses. Showing a client a session map from a few months ago can really help them see how far they have come. This probably does not clash with the CBT approach as such and is but a small aspect of the way in which I work.

Yalom on CBT

"When a CBT therapist really gets distressed, who does he go see? I just have a strong sense it's not another CBT therapist. I think he wants to go out and search for somebody who's wise and can help him explore deeper levels."

Yalom refers to a "maniacal need to empirically validate everything you do" in an article published on Psychology Today, written by Ryan Howes. Ease of measurement is perhaps the main reason why CBT is so popular with institutions offering time-restricted therapy.

CBT and existential therapy

Finally,  my work is based upon my personal philosophy on life, which acknowledges the struggles with human existence. With all the potential joys of life that we may be able to access, there is always the knowledge that ultimately we will die, that we may struggle to find meaning in our lives, and that sometimes we feel a deep sense of loneliness. Chasing those thoughts away by replacing them with positive thoughts will not eradicate those existential issues. Only in honouring and accepting our struggles can we find relief and a sense of not-alone-ness. I would find it hard to leave that part out of my work. 

Our Mortal Wound: Interesting snippets from Yalom's Staring at the Sun

"In spite of the staunchest, most venerable of our defences, death anxiety is always there, lurking in the hidden ravines of our minds"

Staring at the Sun, inside cover blurb

Our Mortal Wound refers to our knowledge that we humans have, that ultimately, we will die. This book examines our fear of death, conscious and unconscious, and the ways we find to deal with that fear, in particular through therapeutic exploration.

When I first heard about this book, when it was released in 2008, I was very keen to read it. However, due to my being in the middle of counselling training, I decided that I wanted to get a better grip on my own relationship with death before I explored Yalom's work. I wanted to make my own journey and come to my own conclusions, rather than taking on somebody else's construct.

So, a few years later and I have completed counselling training, had extensive personal therapy, life events and a particular confrontation with the concept of the ceasing of my own existence, and I feel in a good place to read Staring at the Sun. I read Yalom's Existential Psychotherapy a month or so prior (my review for which can be found here) which had a huge section on Death Anxiety.

I was ready for the full weight of a book dedicated to facing the fear of death, written by somebody who at (then) age 70 was facing his own fear of death.

I needn't have stressed. I actually found the book quite untraumatic compared to my personal explorations. It was probably something to do with reading Existential Psychotherapy beforehand and I think that, ideally, the best order would be to read Staring at the Sun first.

Rather than review the book I would like to share some snippets that I bookmarked whilst reading. These are useful to me as a therapist and resonate with my way of being in the therapy room.

Chapter 1 - The Mortal Wound

"Death, however, does itch. It itches all the time; it is always with us, scratching at some inner door, whirring softly, barely audibly, just under the membrane of consciousness. Hidden and disguised, leaking out in a variety of symptoms, it is the wellspring of many of our worries, stresses, and conflicts."

"I feel strongly - as a man who will himself die one day in the not-too-distant future and as a psychiatrist who has spent decades dealing with death anxiety - that confronting death allows us, not to open some noisome Pandora's box, but to reenter life in a richer, more compassionate manner."

Chapter 4 - The Power of Ideas

On Schopenhauer's triplet of essays: What a Man Is, What a Man Has, What a Man Represents:

"1. What we have. Material goods are a will-o'-the-wisp. Schopenhauer argues elegantly that the accumulation of wealth and goods is endless and unsatisfying; the more we possess, the more our claims multiply. Wealth is like seawater: the more we drink, the thirstier we become. In the end, we don't have our goods - they have us.

2. What we represent in the eyes of others. Reputation is as evanescent as material wealth. Schopenhauer writes "Half our worries and anxieties have arisen from our concern about the opinions of others...we must extract this thorn from our flesh."....Opinions hang by a thread and make us slaves to what others think or, worse, to what they appear to think - for we can never know what they actually think.

3. What we are. It is only what we are that truly matters. A good conscience, Schopenhauer says, means more than a good reputation....Inner equanimity stems from knowing that it is not things that disturb us, but our interpretations of things."

Chapter 5 - Overcoming Death  Terror Through Connection

"The task, then, is not to offer answers, but to find a way to help others discover their own answers. The same principle operated in the treatment of Julia, a psychotherapist and painter, whose death anxiety stemmed from her not having fully realized herself and neglecting her art in order to compete with her husband in earning money. I applied the same strategy in our work when I asked her to assume a distant perspective by suggesting she imagine how she'd respond to a client who behaved as she did. Julia's instantaneous comment - "I'd say to her, you are living a life of absurdity!" - signalled that she needed only the slightest guidance to discover her own wisdom. Therapists have always operated under the assumption that the truth that one discovers for oneself has far greater power than a truth delivered by others."

Chapter 6 - Death Awareness: A Memoir

"In my practice, I've worked with several psychotherapists who, having just finished a graduate program consisting almost entirely of cognitive-behavioural therapy, feel despair at the prospect of working mechanically with patients in a behavioural prescriptive mode. And I wonder, too, where therapists trained to treat patients in this impersonal behavioural mode will turn when they themselves need help. Not to colleagues of their own school, I would wager."

Chapter 7 - Addressing Death Anxiety

"Terence's Maxim and Therapist Self-Disclosure - Terence, a second-century Roman playwright, offers an aphorism that is extraordinarily important in the inner work of a therapist: 

I am human, and nothing human is alien to me.

Beginning therapists would do well to use Terence's axiom as a mantra, helping them to empathise with their patients by locating their own similar experiences. This aphorism is particulalry apt to work in patients with death anxiety. If you are to be truly present with such patients, you must be open yourself to your own death anxiety...no training program prepares therapists for this type of work."

"...why is the here and now important? A fundamental catechism of psychotherapy training is that the therapy situation is a social microcosm; that is, patients will sooner or later exhibit in the therapy situation the same behaviour they exhibit in the life outside.....This is the first step in helping a patient assume responsibility for his or her life predicament."

"...the positive therapeutic alliance is a prerequisite for the effectiveness of any therapy. It is not the end, but a means to an end. A major internal shift can occur when patients form a genuine, trusting relationship with the therapist, disclose everything and still be accepted and supported. Such pateints experience new parts of themselves, parts previously denied or distorted. They begin to value themselves and their own perceptions rather than over-valuing the perceptions of others....The intimacy with the therapist serves as an internal reference point. Knowing that they have the ability to form relationships they develop the confidence and willingness to form similarly good relationships in the future."

"I never tire of telling student therapists that their most vital instrument is their own self, and that, consequently, the instrument must be finely honed. Therapists must have a great deal of self-knowledge, must trust their observations, and must relate to their clients in a caring and professional manner. It is precisely for this reason that personal therapy is (or should be) at the core of every therapy training program...they should return to therapy as they progress through life."

These selected snippets do not reflect the content of this book, more, my ideals on the therapeutic relationship.

The book itself is a useful accompaniment to a personal journey in exploring one's relationship with death. However, I already had gone deeper and further than this book took me, and I wish I had read it earlier. It is ideal for those dabbling with the concept, and wondering about therapy's place in such a journey. Referring to my fears expressed above before reading this book, there are no "constructs" to take on. Staring at the Sun is respectful of all the ways we find to deal with our mortal wounds.

MIND article on Seasonal Affective Disorder

Further to my post on Seasonal Affective Disorder written back in October, a friend recently pointed me in the direction of an excellent article on SAD written by MIND.

You can read the article here: http://www.mind.org.uk/mental_health_a-z/7998_understanding_seasonal_affective_disorder#.UO8Frwxdh84.facebook

As I explained in my previous post, I used to be significantly affected by the changes in light levels and have been using a special lamp, as mentioned in this article, for the last five winters. Well, actually, I use it as suggested which is daily from September until April. This might sound like a drag, but I use it first thing in the morning, in bed, and either read or catch up on emails. By the time I've had half an hour of light treatment I am ready to get out of bed. My energy levels and quality of life have increased significantly since using the lamp. I would say that my winters have been transformed.

Many people seemed to be showing signs of SAD earlier this year because of the lack of sunshine last summer. Let's hope for a sunnier year this year. Lamp or not.

You can read my previous article here: http://amandawilliamsoncounselling.blogspot.co.uk/2012/10/time-to-stop-being-sad.html

Cyber-relating

Becoming Online

When I first went online, I was fearful of the power of the ‘net and had lots of paranoia about having an online persona. Emails and eBay were manageable, and made Christmas shopping much easier. But just before my sister emigrated to Australia in 2006, I saw her clicking away on the social networking site “MySpace”. I decided to set myself up a profile so I could easily keep in touch with her. I liked the easy sharing of pictures and links and the broader opportunity of linking up with others outside of my usual social realm. It took me a few months to put a picture up, and even then it was of me in disguise. Initially my profile was public but I tired of getting rude messages of a sexual nature. So, swiftly making my profile “private” I continued to experiment with online social networking. I decided that I wanted to be very upfront about who I am , including all my quirks and bizarre preferences. I was sure that somewhere out there in the world there would be people with whom what I wanted to say resonated and this absolutely turned out to be the case. I scoured the lists of users for women roughly 10 years either side of me in age and looked at their profiles, sending a friend request if their profiles or blogs piqued my curiosity enough. Occasionally I would receive a friend request from somebody that wasn’t some dodgy bloke asking for private pictures, and so as time went on I accumulated many online “friends”.

Cyberlove

Online romance blossomed where it wasn’t being looked for and whilst on MySpace I was aware that two British "friends" were having online relationships with American men they had “met” on MySpace. It seemed a little crazy at the time, but they are all married now and really happy. One of the benefits to online courting is that you have time and space to really get to know each other without getting physically hooked on one another. Of course, the physical side is a valid and important part of intimate relationships, and I know a few people who “fell in love” online and then when they met in the flesh it was a disappointment,  because the chemistry just wasn’t there or because one or both had simply told too many fibs about themselves.

Forming close friendships

I am aware and cautious of the perils of an online presence but having spent a good while socialising in Cyberspace I am as aware of the good as the bad. I have had the privilege of being able to make very meaningful connections with people. My friend Sue, who shares her experience below, has shared ups and downs with me and she helped me through some challenging times through online messaging.

My longest and best online friend has got to be a man who I shall refer to as bollers. He writes a little about our friendship in a paragraph below.  We have known each other for nearly 7 years now and I believe that we have provided a lot of mutual support and companionship throughout life’s ups and downs. bollers was kind and trusting enough to share with me the difficulties of his diagnosis of suffering with schizophrenia and I have learned a lot about his experience. He has had his fair share of my issues directed his way so it feels, to me, like a two-way street with plenty of room for us to walk freely side by side. In fact, bollers very generously assisted me with my Counselling Certificate presentation on schizophrenia. As part of my presentation I asked my peers a week or so beforehand what they would ask if they could ask a person with schizophrenia anything. On the day, I handed them back their questions and asked them in turn to read the questions out loud. On a big projector screen was a recording of bollers, answering the questions individually, his face filling the screen, his voice booming around the room, his very presence felt by all. Not bad for a self-professed hermit and such a generous thing to do.  After 4 and half years of online friendship we met in the flesh – he came to stay for a long weekend, and it was so fantastic to spend time with him. He was as he is online.

I have made other good friends online. Codename is a marvellous mentor. I first met her on MySpace and was deeply impressed by her intelligence and philosophical leanings. She made the leap to Facebook, when MySpace started to lose what was good about it, and the friendship grew. She helped me with some of my written assignments for my diploma in counselling and gave excellent, supportive feedback. I finally got to meet her in the flesh a year or so ago and she is as sidesplittingly funny, gorgeous and deeply intelligent as her online persona.

From personal experience I am aware that meaningful relationship can be made online and am looking to integrate an element of online counselling into my private practice. For bollers, online relationship was the only feasible option. For me, it was an opportunity to be brave enough to express who I really am, a risk that was very much worth taking.

Here follows a few paragraphs written by people who have kindly agreed to share their experience of cyber-relationship.

Kate

I didn't meet my partner online, though we did start seeing each other and properly getting to know one another shortly before he was due to spend a four month stint in the States.

So when he went away, we were at that crucial 'are we going to carry on seeing each other stage'. Our interaction was quite constant on Skype, and we would talk for (literally) hours every day. It was kind of nice because I had the opportunity to separate the exciting physicality of a new relationship from the actually talking and getting to know each other. Having said that, it was also very frustrating not to be able to touch the other person, and we did engage in a bit of web cam naughtiness. As the months drew on, we both became more and more frustrated with the inadequacy of online contact, and by the end of three months, we were talking less on Skype. Interestingly, talking on the phone became preferable, I suppose because there was a juddering web cam, or slight time delay, it actually felt more real to speak.

Bainz 

I met my wife online and though one would think it wouldn’t be the most normal place to meet someone I did and I am glad I did. Never did it before, but if I didn’t I would have never met my wife. If you think of it bars, clubs, stores etc aren't really that good places. It took six months of writing back and forth before she gave me her telephone number, and another two weeks of texts before she allowed me to ring her but it was well worth it. I waited 46ys for the love of my life and I did it online. Crazy as it seems, it worked for me and I wouldn’t have it any other way.

Sue

I was probably the most unlikely person to ever have imagined I’d end up married to someone who I met online, but this is exactly what happened. In 2008 I got talking to a chap in America on MySpace and we messaged for nine months just chatting and catching up on life. Over this time we became really good friends and would ring each other and text, after some persuasion by him, as I was very cautious and doubtful of online friendships being anything other than that. However in 2009 we finally met in person and knew immediately it was going to be a big relationship, we always maintained our online relationship when he went back home and this became a huge part of our courting and when we married in 2011 in Las Vegas the first thing we did was publish our wedding pics on Facebook and MySpace as it has been such a major part in bringing us together over all the miles. Although at the moment my husband cannot live with me in the UK as he has various things to tie up before he moves here permanently, we still communicate by messaging and msn and truly think that online relationships are probably more likely to succeed than randomly meeting people the normal route ie pubs clubs etc... In online relationships you tend to open up more about your life and I think this can either determine if you are suited or not to one another’s lifestyles. So all I can say is I’m very grateful for online messaging as its brought me someone who is wonderful to me and my children. Along the way I’ve met quite a few new friends on it , of course there has been occasional "weird " people but I can say genuinely the majority of friends I’ve made are ones I will keep forever Amanda being one of them as she too has had lot of experience, and has often given us advice and help along the way to which we are extremely blessed and grateful.

bollers

in a land before facebook there lived a magical kingdom called myspace and it was here that i first encountered amanda. she had left a interesting comment about a television “face” and i had felt compelled to write to her, which was saying something as over the prior few years i had turned into a hermit who’d left all his friends long behind whilst learning to live with being schizophrenic. this was a new horizon for me that offered some hope of a future as well as being a worthy new way to pass the time as i convalesced. so “message” amanda i did and thankfully she replied and that is how it began.

what do i like about cyber friendships? well typing keys opposed to chatting face to face allows me to pause for thought, unlike when i am in a “real” life situations, as i have a proven record of putting my foot in it. it also suits my hermit lifestyle, a way of having company in my life without a lot of the hassle. then there’s the possibility of helping other people, which by its very act helps me- not that i ever expect anything back from a online friendship but more often than not it does happen, simple things like someone to hear my space like scream from time to time.

i am no expert on this sort of thing, the number of online friendships i’ve been in is low, but quantity is not the issue, it’s about the quality of the relationship, about creating meaningful relationships and that takes effort and honesty reciprocated both ways and this is something i have found with amanda. she’s straight talking in a gentle way and her words are always the righteous truth. she has much wisdom within her and being part of her life is something i shall always treasure. with cyber friends travelling the galaxy becomes a reality.

My presence on the ‘net as a therapist

The issue of therapist self-disclosure gets batted round from time to time. Should we be “blank screens”? Is it really possible to be “blank screens”? I don’t think so. What I believe, and this works for some people (but I do not claim that it will work for all), is that looking for a therapist is tricky. That there are many homogenised counselling websites out there – how do you choose who to see? Some of my clients have told me that it is purely down to the amount of information I share on my website that makes them choose me. They feel more comfortable knowing more about me beforehand, and I have even heard that they felt a connection with me before meeting me. This fits perfectly with my experience (click here for my blog on my session with the world famous psychotherapist and author Irvin Yalom) of feeling a connection of another through reading their written word.

Child Abuse - a review of The Body Never Lies, by Alice Miller

"Wherever I look, I see signs of the commandment to honor one's parents and nowhere of a commandment that calls for the respect of a child." 

                                                                                                                                              Alice Miller

“Never pretend to a love which you do not actually feel, for love is not ours to command.”

Alan Watts

I was very much looking forward to reading this book as I had heard good things about Alice Miller. The subject matter intrigued me and of course, dealing with issues of childhood neglect and abuse is very pertinent to the work I do as a counsellor.

Roughly speaking, the book explores the following concepts:

1) The body expresses our truths more than the self-deceptive mind ever can.

"Ultimately the body will rebel. Even if it can be temporarily pacified with the help of drugs, cigarettes, or medicine, it usually has the last word because it is quicker to see through self-deception than the mind.... We may ignore or deride the messages of the body, but it's rebellion demands to be heeded because it's language is the authentic expression of our true selves and of the strength of our vitality."

2) The commandment "Honour thy father and mother" has infiltrated our culture to such an extent that  it is taboo to not love our parents, regardless of what they do to us. If we have neglectful or abusive parents then it is expected that we forgive them, even if they continue the hurtful behaviour to us as adults.

(referring to literature on self-therapy and therapeutic care) "... readers are advised to "snap out" of the role of victim, to stop blaming others for the things that have gone wrong in their lives, to be true to their own selves. This, they are told, is the only way of freeing themselves from the past and maintaining good relations with their parents. For me such advice embodies the contradictions of poisonous pedagogy and of conventional morality. It is actively dangerous because it is very likely to leave the former victims in a state of confusion and moral uncertainty, so that the individuals in question may never be able to attain true adulthood throughout their whole lives"

3) The effect of the commandment echoes in the work of many therapists, who due to their own  beliefs about attitudes towards parents, encourage clients to forgive and move on.

"Time and again, I have asked myself why therapy works for some people while others remain the prisoners of their symptoms despite years of analysis.... In each and every case I examined, I was able to establish that when people found the kind of therapeutic care and companionship that enabled them to discover their own story and give free expression to their indignation at their parents' behaviour, they were able to take their lives into their own hands and did not need to hate their parents. The opposite was the case with people whose therapists enjoined them to forgive and forget, actually believing that such forgiveness could have a salutary, curative effect."

Alice Miller uses examples of famous people to make the links between mind, body and childhood abuse/neglect. Those she discusses include Checkhov, Kafka, Nietzsche and Virgina Woolf. She breathes life into her arguments by using real life examples of those whose lives we may have some familiarity with. Rather than being fantastical conjecture, as such an endeavour could end up becoming, it reads as convincing and compelling.

Miller aims to help individuals break the cycle of abuse. On the inside cover it states:

"Miller examines the cyclical nature of violence and abuse. Parents and guardians who abuse their children, both physically and mentally, leave them embarassed and hurt. The inability of most children to properly express such feelings causes them to perpetuate the cycle by lashing out at their family, friends, and, above all, their own children, who will inevitably do the same."

Somebody once told me that he only started to live his life when his mother died. This man was 65 and his mother had died 5 years ago. When he found out that I was a counsellor, he said he was happy that there were people like me to help free people from ruining their lives being a prisoner to their parents. I do hope that I am able to provide a truly non-judgemental space where I allow clients to fully explore their feelings of anger, rage, hate and many more emotions. This is not about "parent-bashing; it's about acknowledging a person's perspective of their experience and holding that for them, without steering them to reconciliation or forgiveness. Only that person can make a decision for what is right for them.

The idea of neglectful or abusive parents goes against the beliefs we have in place, as a collective consciousness,  to keep us feeling secure. We want to believe that parents, and in particular mothers, love their children and treat them accordingly. Unfortunately, reality does not reflect what we want to believe. Sadly, for some individuals, childhood is a place of hurt, neglect, cruelty, physical abuse, mental anguish or an inappropriately early introduction to the world of adult sex. This book helps to destigmatise the subject, and is a step towards society being able to validate these people's experiences.

I highly recommend The Body Never Lies to anybody who is in the therapy business, and to those who have sadly had a childhood and adulthood impeded by parental neglect or abuse.

I have received the book "Toxic Parents" by Susan Forward, and look forward to reading another perspective.

If you have been affected by the topics raised then please consider the following:

In crisis, contact the Samaritans on 08457 90 90 90

To find a counsellor in your area, try Counselling Directory. This is a good place to start as the counsellors listed are all members of a regulatory organisation. This is not a guarantee of ethical practice, but there is recourse in the rare and unfortunate event of unethical practice.

I provide private counselling in central Exeter, more details of which can be found above. I can also recommend a few counsellors around the local area. Please email me for more details awcounsellingexeter@yahoo.co.uk

Counselling in Exeter - Does Therapy Work?

Does Therapy Work? by Jane Barclay

A book review, with Q&A with the author

"You're going to be my father, lover, brother, friend."

"I wish all my clients knew that," replied Sam.

Appreciation at last. Special.

"I know I'm going to try and seduce you," I announced a few weeks later.

"Then let's make a deal, that we don't have sex."

We shook hands and smiled at each other.

Then my campaign began.

This excerpt from the book is printed on the blurb on the back and I found it quite different to what's usually on the back of therapy books.  Does Therapy Work? could be the title of a dry and research-laden pile of boring dirge that I would possibly have forced myself to read whilst in training. The snippet on the back however, promises something fleshier and most definitely more tantalising then a tome of empirical research and justifications that the most reductionist of therapies - CBT - is the only one proven to work (...yawn...).

A great brain

I have met Jane Barclay at counsellor network meetings and I like her. She is very professional and intelligent and I like the way her mind works. She did a very interesting talk on sex addiction and it is clear from the way she talks that her mind works on lots of differing levels simultaneously. I wish this could be measured as I think that it is the sign of a great counsellor. There are so many differing levels going on in the therapeutic relationship - the client's stuff, the counsellor's stuff, the effect on each other, background knowledge of the physiology/neurology/biochemistry of the interactions and emoting, psychodynamic models - there are a myriad of ways of looking at what is going on, which is a skill applied deftly by the truly integrative counsellor. (For more information on this see The Seven Level Model outlined by Petruska Clarkson - one of the frameworks that is used by integrative counsellors to give their work coherence.)

Jane is also a huge Irvin Yalom fan so I know she has great taste in books. I liked the look of Does Therapy Work? so was eager to get stuck into it.

I was also slightly (very slightly) worried in case I didn't enjoy the book and she might ask me for feedback...

An engaging read

Well, a few pages into it I was excited to find that I was very much engaged. She hooked me in with Part One which is split into The Component Parts and Struggle and Suffering. Jane writes about the therapist in training and the requirement to engage in personal therapy. She explores the therapeutic relationship from differing perspectives, drawing from neurology and attachment theory to explain how we form habits in our thoughts and behaviours and the difficulties in therapeutic change, and also refers to her personal therapy, although this is written about much more extensively in Part Two - Demonstration. Jane also writes about our cultural influences, from child-rearing manuals to society's version of happiness. A sample paragraph:

"...it is this very need for attachment to and dependence upon others that carries the greatest risk of disappointment, of betrayal, of experiencing primeval terror of abandonment and helplessness. When out of balance and frozen in conflict, the dual needs for trusting connection and self-reliance can potentially generate the very greatest suffering and lead to infinitely more creative ways of trying to escape this state that actually perpetuate it. Negotiating for balance is a way of living that I call Autonomous Independence which begins at birth and continues up to and including our last heartbeat, breath and synaptic impulse."

Indeed I like this phrase "Autonomous Dependence" as a way of describing the successful straddling of the apparently conflicting needs we have to retain our sense of self amidst the urge to merge with others. 

A book about the power of authentic relationship

This theme is revisited in Part Two where Jane describes the therapeutic relationship between her and her therapist, Sam, a remarkable sounding man. What I very much value about this book is Jane's risk-taking in describing her innermost fears and thoughts in the actual process of her therapy. This is very different to talking about the various approaches and techniques associated with counselling This is a narrative about the very unique meeting of two very unique individuals, which is exactly what every counsellor/client relationship actually is. We can research this and measure that but these are just reductionist constructs which take away the soul of what can be the most authentic and beautiful, if somewhat intense and at times uncomfortable, therapeutic relationship.

Jane shares her secrets, her shadow side, her shame,  sexual jealousies, babyishness and excruciating vulnerabilities in this gripping, moving account of authentic therapeutic process. This is not fluffy counselling, this is bold, visceral relationship. 

Any gripes? I was slightly disappointed with how quickly I finished the book, at just over 100 pages long. That said, there isn't any waffle to cut through. It's 101 pages of pure-spun gold.

In reading Does Therapy Work? I learned that Jane is at heart, like me akin to a Romantic Scientist - valuing scientific research but intent on looking at the whole of the human being, the whole of the relationship.

I wanted to ask some questions

I emailed Jane and asked if she would kindly consider answering a few questions regarding the book. She generously obliged and here follows my questions and her answers

Amanda: How would you describe your theoretical orientation?

Jane: Happy to state that I hate this question! Always have, feel boxed in. The closest I can get is to call how I work ‘Integrative Life Work’.

Amanda: What were your motivations for writing this book? 

Jane: Early on in therapy, I felt compelled to write to stay sane. I simply couldn’t hold all that was flooding in my head/body. Turning what I’d written into a book was a long (ten year) process, as I shaped and re-shaped (loathe to finish) and condensed approx 160,000 words down to 100 pages!!

Amanda: Can you tell me anything about what is was like being so frank with your self-disclosure?

Jane: Being so frank was a relief. Came easily. I just burned to tell it how it really was...

Amanda: Was writing the book a kind of therapy in itself?

Jane: So, yes, writing from day one to completing the book was always therapeutic.

Amanda: Have you had any repercussions since publishing?

Jane: The effects of publishing took me by surprise. I missed writing so much but skipped ‘saying goodbye’ and rushed into marketing. Going public, for real, jolted out of hiding the part of me who was terrified of being condemned and I plummeted into a very dark place for approx 6 months. This too, though, came from childhood experiences – none of my terrors were realised.

Amanda: Are you still in touch with "Sam"?

Jane: My after-therapy contact with ‘Sam’ dwindled in quantity, though we did email from time to time. I don’t judge our contact as ‘good’ or ‘bad’; I’m also pretty certain the child in me remained confused and continued some transference of longing-for-unavailable father. My learning from this is to be clearer about boundaries in the aftermath of a therapeutic relationship.

    ‘Sam’ died last year. I was honoured to be amongst the people to be informed and so went to his funeral. And have since been glad I’ve learned in the last few years how to grieve rather than continue the practice of ‘refusing to mind’

Amanda: What are your favourite therapy books?

Jane: Favourite therapy books?! The ones that speak to me ie are written by people to people. Alice Miller, Irvin Yalom (of course), Judith Hermann, John Bradshaw, Lance Dodes (I think that’s his name – writes on addiction) to name a few authors. Stanley Keleman is another, and mustn’t forget Ronnie Laing!

Does Therapy Work? is available via Amazon.

Jane Barclay has a private practice in Exeter: 

Amanda Williamson MBACP

Counselling in Exeter

Time to stop being SAD

The nights are drawing in and I am already noticing how much more difficult it is to get up in the morning. I have my weapon against miserable start-ups though, which I'll go into later.

Most of us are aware of the existence of SAD - Seasonal Affective Disorder, although I suspect that more people suffer from it than are actually aware of it. 

The symptoms of SAD, according to SADA - The Seasonal Affective Disorder Association website (click on link to read more):

• Depression
• Sleep Problems
• Lethargy
• Over Eating
• Loss of Concentration
• Social Problems
• Anxiety
• Loss of Libido
• Mood Changes

About 10 years ago I noticed that although I enjoyed the idea of winter, roasts, fires, snuggly clothes, cosy nights in etc,  the reality of the lack of daylight really got to me, on a physical level as well as mood-wise and by Christmas I would feel quite dreadful. I originally thought that maybe I had hang-ups about Christmas, and yes, the frittering of large amounts of cash for a load of c**p does sicken me slightly...but the idea of a mid-winter celebration to cheer up the depths of winter sounds marvellous....in theory. So why did I feel so grumpy?

As the years passed by I noticed that I was desperately craving light in the winter and would avoid darkened rooms - they made me feel agitated. On gloomy, mid-winter days, I felt almost suffocated by the darkness descending around 4pm. I became appreciative of the fact that trees lost their leaves so that a bit more sunlight could reach me.

About 5 years ago this self-diagnosed SAD came to a head. I noticed that every winter I was becoming more and more antisocial, that I was struggling very hard to get out of bed in the mornings - it felt like torture. My appetite was affected and my activity levels slumped. Whilst I think a certain amount of adjusting to the winter season is inevitable, I found myself spending nearly half the year feeling low and increasingly anxious. 

The Magical SAD Lamp

I researched the topic, on the internet and from books from the library. I decided that I should try a SAD lamp and spent hours looking into which would work best for me, or, indeed, work at all.

The Litebook

The reason behind why SAD lamps seem to work, is that in the winter there is a lot less light reaching our retina, and it is the action of sunlight on our retina that signals the body to stop producing the sleep hormone melatonin. By using the lamp we are telling our bodies that it is time to wake up.

I settled on the Litebook as it's small size and portability appealed. It is so powerful that you only need to use it for 15 minutes a day to feel the benefit. The slight downside is that you are advised to use it from September to gain full advantage, and use it until April. I bought mine in November so didn't get to feel the full benefits the first year, although it did help me to feel more awake and I noticed a big reduction in my SAD symptoms. The following winter I was even better, significantly better than I'd been in years and even arranged a birthday party for the first time in a very long time (my birthday is at the end of January, a time when I used to be at my peak of misery).

I use my lamp for 20-30 minutes in the morning before getting up. I read or check emails while lying there with the light shining towards my face. By the time the session is over I feel ready to get out of bed. More ready, anyway.

Sometimes, especially if I have an busy evening planned, I will use the lamp again late afternoon to give me a boost. A secondary use for the Litebook is for jetlag and I can confirm that it can be effective in helping if you suffer with that. I use it in conjunction with melatonin supplements, which you cannot buy in the UK, but American drugstores have loads of the stuff.

Other things to help enjoy winter:

Keeping warm 
I wear warm, woollen clothes and (fake) fur-lined boots on cold days and thermal underlayers if needs be. Also, I'm not as stingy with the heating as I was brought up to be.

Eating well
I try and keep to my usual, reasonably healthy diet which includes lots of salads, vegetables and fruit. Once I start going down the quick-burn carbs route I find it hard to get out of the cycle. 

Exercise
The levels of exercise are not as high as during the summer months but I make sure I do something. Any sunny days I try and get out for long walks meaning I get more precious light hitting my retina.

Winter Sun
I have yet to be in a position to be able to do this, but due to current commitments I cannot jet off for a week's sunshine to get a boost. If I could, I definitely would.

The NHS suggest that counselling or psychotherapy can be useful in alleviating the symptoms of SAD and I can confirm that I personally found some benefit in having counselling several years ago when I thought that there was something wrong with me; when I felt rather ashamed and somehow feeble for having SAD. Suffering with SAD may exacerbate existing issues with relating to others and with one's self-worth.  Counselling can help you with these difficulties. 

Here is a useful link with more information on SAD from the NHS website:

http://www.nhs.uk/Conditions/Seasonal-affective-disorder/Pages/Introduction.aspx

AMANDA WILLIAMSON MBACP

 COUNSELLING IN EXETER