During these uncertain times, it is more important than ever to be able to regulate your emotional experience. It is crucial because you need to stay intact, for yourself and others. We are all impacted differently, some of us to a lesser degree, some of us more directly. Uncertainty and crisis will trigger different responses in all of us. Remind yourself that on an emotional level, there is no right way of responding to crisis. You may feel anxious and worried, but you may also feel strangely calm and practical. Try to not judge your response and the responses of people you love, but notice them instead.
If you do feel calm, then the chances are you are better equipped to support people who are anxious around you. Try and not judge their anxiety but don’t absorb it either. Own your calm and use it. No emotional state is permanent so if you feel differently over time that is OK too. Attempt to connect to others in whatever ways you can but there are ways of engaging with each other that are less helpful and ways that are more nourishing.
Reaching out to someone in panic frequently without any sense of what you are doing it for, will only add to your anxiety. Try and put time constraints around when you engage with others and don’t be ashamed sticking to it. Do the same with the news. It is important to stay informed so you can better protect yourself and others. Exposing yourself to the same information over and over again however is not good for your immune system. Your anxiety rises and it clashes with your powerlessness, collapsing in on itself. All this energy builds up inside you, but there is nowhere for it to go. This process can gradually weaken not just your vitality but your physical health too. And you need your immune system to be OK right now.
The following exercise is designed to support you to be more in contact with your body. It can regulate your breathing and can help you to be more present. It is working on the premise that anxiety is fuelled by escalating thought processes and rather than focusing on those thought processes, it invites you to open your awareness to the rest of your body. It aids you to feel your senses more and utilises your natural, physical support functions.
You can do it as long as you need to and as frequently as you need to. You may decide to do it with someone together where you are either doing it in silence or take roles in talking each other through it. You can also do this on your own, wherever you are.
Grounding exercise for panic and anxiety
Sit on a comfortable chair and close your eyes. Push your bum to the back of the chair, so your spine is supported. Bring your attention to your body. Notice where your body and the chair meet, the points in which the chair is in contact with your body.
Now bring your attention to your spine. There is a point on your spine, roughly behind your navel, where you can tap into the meeting place of two opposing tensions – an upward pull and a downward pull. And just surrender into gravity.
Notice how the bottom part of your body feels heavy and how the top part of your body is almost stretching upwards, it is paradoxical like that. So, you're not holding yourself up artificially but not hunching either, it is almost as if you were suspended. You might feel a slight tingle, a burning sensation on your spine when you tap into that place on it – you'll know when you feel it.
Notice your breathing, notice where the most amount of air enters your system, whether it is through your left nostril, your right nostril or through your mouth. And notice where the air goes, whether it goes into your chest, or whether it goes to your abdomen. At first, just notice. Allow yourself to become aware of this organic, automatic movement.
If you find yourself breathing into your chest, then allow yourself to use your agency and gently support the air to go towards your abdomen. The way to do this is not to try and push the air down but make more space in your abdomen – expanding the muscles in your abdomen – and the air will naturally find its way down. We tend to hold anxiety and tension, which can develop into chronic tension in our chests and shoulders, so you want to breathe under the tension.
Now bring your attention to your skin. We take in so much information through our skin yet rarely attend to it. It is easier to feel it as it comes into contact with something physical, so see if you can feel your shirt on your shoulders or your pants on your thighs, your socks on the top of your feet. And see if you can also feel the air on your skin where it is exposed, like your hands or face. Just become aware of how the air is gently circulating around your skin.
Now shift your awareness to outside of your skin and notice any noise around you first. Try and listen to it like a baby listens to noise, don't try and figure out where it is coming from but just hear it and absorb it. Almost as if you wanted to imitate it in some way.
Whenever you are ready – take as much time as you need – open your eyes. And think of them as gates that are about to be open and all the visual stimuli is about to flood through them. Do take your time and maybe find an object around you first that you feel drawn to and try looking at it as if you wanted to draw it. As if you didn't know what it was for but just wanted to describe it – its shapes and colours.
Now begin to let your eyes swim about like that and look around. And as you do this, make sure you keep attending to how you feel in your body, so it is not immediately lost but simultaneously attended to. This is how you can begin to develop your capacity for dual awareness – that sense of engaging with something or someone visually and through your senses whilst staying in contact with yourself as a separate being. This is not easy, so even if you can only do this for a few moments, give yourself credit for it. Developing this dual awareness can also support you to not collude with others’ emotional state and therefore be more empathetic and available in a way that is safe.
As published on welldoing.org
Suddenly, I became aware of my clinched jaws, my shoulders tensing up and my hands forming into fists. I remember being shocked when my therapist told me to try not to relax. Instead of giving into my urge to relax, she invited me to pay attention. I could then actually get a sense of my tension and there was space for it to develop into a sensation that I could register as a feeling. In other words, I became available to the information my tension was holding, which paradoxically led me to feel relaxed.
When we respond to our tension by trying to relax:
When we respond to others’ tension by telling them to relax:
What can we do with tension?
The idea that relaxation is good for us is not something that needs protesting against. We now know that being relaxed can soothe us when we are overwhelmed, that it can regulate our emotional responses, that it can support our breathing. What seems to get missed is that relaxation – a bit like joy – works more as a side effect rather than something we need to aim for by direct means.
Responding to our own or other’s emotional expression or tension by trying to relax ourselves or them can fuel alienation. Moments of connection, which we so desperately need, can be undermined by our attempts to relax one another. We would achieve just that, only if we stopped trying.
As published on welldoing.org
British Gestalt Journal © Copyright 2019 by Gestalt Publications Ltd. 2019, Vol. 28, No.1, 5–14
Codependency seems to capture a more specific, addict–addict’s partner dynamic, whilst confluence would simply refer to the process of merging with one another.
Suffering partners of people with addictions would be less stigmatised if therapists from other approaches and society were to understand and adapt the term ‘confluence’. The problem occurring between substance-misusing people and their partners could then move from a heavily localised and pathologised issue of codependency to a more general and normalised understanding of unaware merging in relationships.
As a practising Gestalt counsellor, I noticed that I had an increasing number of clients who are not misusing substances themselves but are partners of people who do. I was struck by how little dialogue there is around this generally in the field of counselling and psychotherapy. The main support available to partners of people with addictions is support groups, but there is little understanding or consensus on how they may be understood and best supported in the counselling room.
A UK-based research group contrasted six different perspectives on understanding the dynamic between partner and substance- misusing other, which were co-dependency, psychodynamic, systems, stress-coping, feminist, and community (Velleman, Copello and Maslin, 1998). Looking at this from a Gestalt therapy theory perspective has generally remained unexplored. This small-scale research paper is a result of dialogues I had with three Gestalt therapists who have had experience supporting a partner of a person who suffers with addiction.
An overarching image emerged out of these conversations which I will use to describe the process these Gestalt therapists have gone through with their clients, in the hope of initiating dialogue around this, in and outside of the Gestalt community.
Keywords: co-dependency, affected family members (AFMs), addiction, Gestalt therapy, Interpretative Phenomenological Analysis (IPA), confluence, creative indifference.
Implications for practice
Seeing the client with a substance-misusing loved one as someone who is not a victim seems pivotal. Holding the challenging position of creative indifference and noticing when one gets too invested in a certain focus as an ‘it’ needs to be recognised as a process, which needs ongoing attention from the therapist. Losing creative indifference seems to be strongly coupled with becoming confluent with a client. Even though this may be true to working with any person, as Gestalt therapists, being active agents of non-confluence seems especially important with partners of substance- misusing people. This study indicates that attending to this helps to establish a relationship where therapist and client are extensions of contact, where the client can be in touch with their sense of power, integrate their disowned parts and rediscover vulnerability as a relational possibility.
Implications for further research
This study revealed areas in which future research is necessary. As I was making sense of the dialogues with the three Gestalt therapists, I found it hard to attempt to understand the clients’ situations without having direct contact with them. I became aware of my power and the discomfort I felt being in that position. It seems to me that seeking positions of responsibility, and not letting them emerge out of a co-created dialogue with the person who is actually involved in their situation, could turn into blaming from a superior stance. Beyond theoretical papers and practitioners’ reflections, like this study, hearing people who are directly affected or have been affected would be crucial.
Furthermore, I was struck by how lively the exploration with the three Gestalt therapists felt. There certainly is a lot that we, as Gestalt therapists, could say about understanding and supporting partners of people who misuse substance. Future research could focus on developing a coherent Gestalt theoretical understanding on the subject that is beyond the scope of this paper.
Although previous research has demonstrated that ‘LGBT populations have the highest rates of alcohol use’, the literature review uncovered no existing research into the experiences of LGBTQ partners of addicts and/or practitioners who work with them (Kerr and Oglesby, 2017, p. 341). Papers and discussions seem to be centred around cisgender, heterosexual couples in monogamous relationship structures. Richard Velleman confirmed my findings when he stated, ‘virtually all of the literature is related to heterosexual partnerships and most literature is hetero-normative’ (private email exchange, 8 June 2018). All three participants in this study were reflecting on experiences with a client who was in a monogamous, heterosexual relationship. Future research should broaden the focus to people of diverse genders, sexualities and relationship structures.
Although Interpretative Phenomenological Analysis acknowledges the subjective role of the researcher, I am aware that a different person might have foregrounded different aspects of the data. The research participants brought their rich and diverse experiences to the dialogue and there was difference in terms of gender. However, all three therapists have trained at the same institute and therefore the sample was rather homogenous. Even though generalisability is not expected with qualitative studies, it is important to note that the findings here should only be considered as an in-depth conceptualisation of the dialogues I had with the participants.
Being attuned to the relational field of clients with substance-misusing partners transpired as an important part of the three therapists’ process. The confluence that emerged on the contact boundary between clients and their partners became a fixed gestalt, which only shifted through a tipping point, in which all three clients became aware of their vulnerabilities. As they entered into therapy this fixed gestalt could have gone on, repeating itself and being co-created again, if the therapists were not attending to the immediate space between them and their clients. Particularly, in the beginning phases of the work, they colluded with their client’s focus on the substance-misusing partner. The participants’ tracking of their creative indifference and attending to confluence supported their clients to relate to them as other, not just a means to an end. Seeing them as other who is not confluent with them but has their best interest at heart supported clients to integrate relational experiences they have been deprived of.
The more I engaged with the subject, the clearer it became to me that partners of substance-misusing people are often represented as just that, partners. It is then not hard to see how we would have a part in contributing to their sense of insignificance. In the interviews for this paper, the three clients emerged as fully rounded figures in their own right. Having them in the foreground of our exploration pointed to one of Gestalt therapy theory’s important contributions, which is that backgrounds are not a given context to figures but form simultaneously with them. Recognising this led me to a sense of responsibility and with it came a yearning for ongoing dialogue so that we, as the Gestalt community, are not colluding with holding fixed perceptions these clients are up against.
This article developed from a qualitative research project conducted at the University of East London.
Evans, V. (2012). Challenging Stigma. Available at: <https://adfam. org.uk/files/docs/adfam_challenging_stigma.pdf> (Accessed 10 February 2019).
Kerr, D.L. and Oglesby, W.H. (2017). LGBT Populations and Substance Abuse Research: An Overview. In J. VanGeest, T. Johnson, and S. Alemagno (eds), Research Methods in the Study of Substance Abuse. Cham, Switzerland: Springer. Available at: <http://www.readcube.com/ articles/10.1007/978-3-319-55980-3_16> (Accessed 12 December 2018).
Orford, J., Velleman, R., Natera, G., Templeton, L. and Copello A. (2013). Addiction in the family is a major but neglected contributor to the global burden of adult ill-health. Social Science and Medicine, 78, pp. 70–77.
Roubal, J. (2016) (ed). Towards a Research Tradition in GestaltTherapy. Newcastle upon Tyne: Cambridge Scholars Publishing.
Velleman, R., Copello, A. and Maslin, J. (1998). Living with Drink: Women who live with problem drinkers. Harlow: Longman. Reissued edition 2007, London: Pearson Education
British Gestalt Journal © Copyright 2019 by Gestalt Publications Ltd. 2019, Vol. 28, No.1, 5–14
A short clip with me from the UKAGP conference I attended. We worked around ideas on sustaining Gestalt theory and practice in a variety of contexts.
UKAGP Promo Clip
'I need to know what to do with my relationship’ is a line I often repeat to myself, and I hear the people I work with say it too, as they talk about their struggles. The tone in which it is said is tired, disappointed, reaching the point of defeat. It speaks volumes of what is often an isolated process. A process the individual takes on alone: ‘I can figure this out’. This conviction coupled with impatience: ‘I should know what to do’.
Nobody knows what needs to be done. If they did, they would know what happens next. And yet, in my overwhelming anxiety, I often tell myself that I should know. If the only option is being all-knowing, then the relational experience of being lost together is never lived through. And so instead of turning to each other, we turn to the future and like solitary workers, start planning our next attempt to turn the relationship around. It quickly becomes about the next evening, the next weekend, the next holiday, all the while drifting further away from each other.
It is as if there is a silent, shared agreement to not rock the boat of the relationship; in this agreement it is conversations that represent the waves that do the rocking. And so we alienate our emotional reality and assign it to something other than us, a conversation. We label these conversations as heavy, deep and intense.
This is one way to carry on avoiding them, as if these qualities were not inevitable parts of any connection, of any relationship. By not leaning into them but trying to move forward as if they were not there, intimacy is sabotaged and growth is undermined. It is as if we are drifting alongside one another without being in the same river. This can feel even lonelier than being actually alone.
The more disconnected we are, the more tenaciously we hold onto the idea that dialogue is the threat. Talking can then seem a monstrous, deadly wave; a one-off event that could sweep our relationship away. The tragedy of it is that it becomes near impossible to be present in moments of joy as there is always an end in sight, in the form of a conversation.
It is important to remember that conversations rarely add to the truth, they purely reveal what is already there. Through having them, previously unaware choices may emerge, but a conversation never decides the fate of a relationship. It doesn’t have that capacity; in fact having honest dialogue with one another might restore a sense of power in you.
There is no pretending this isn’t hard, though it is possible to develop resilience to tolerate the experience of connecting with each other through trouble. We can notice when we withdraw into our own rivers and instead look for our loved one and say something about what is happening, rather than trying to figure out what needs to happen by ourselves. In those moments, we suddenly find ourselves in the same river, still drifting but together at last.
Beyond the unhelpful messages about our insecurities many of us encountered growing up, we also live in a society which either tells us to be confident, or to work on being confident. What gets missed is that the latter often implicitly means the former, which is that anything other than confident is not okay. At best, we’re told that our insecurities are to be managed, amended, overcome. At worst, they’re something to get rid of, to be kept at bay, to cover up. Working with people therapeutically made it clear to me how damaging living in that societal feedback loop can be.
With constant messages like, ‘be better’ and ‘be the best version of yourself’, it is not hard to see how we are led to strive for a version of us that is empowered and just feels good. There may be times when that is the case and it may feel lovely, but if a person were just that, they wouldn’t need anyone. These words are designed to give you a sense that you always need to look forward, and not around. There seems to be a denial about the relational aspects to living, the idea that whether we like it or not, whether it is safe or not, we do depend on each other.
What often feels like a personal lack is really the sense that we once needed something that wasn’t there. And it isn’t as if the messages we receive make these insecurities go away. They don’t have that kind of power. But they do achieve something: they can numb us to parts of our experience. We can then become desensitised to the point where we lose touch with needing others and believe that we can do it on our own. This is how we gradually stop being available to the information these insecurities hold, which is that actually we do need people, whether it is for reassurance, for support or just for company.
It is no easy task to come to terms with parts of you and parts of your experience you wish not to have. There is solace though in recognising that wishing them away is something that most of us share, partly due to the context in which we live in.
What seems important to me to hold onto is that as much as insecurities are painful reminders, they can also help us feel closer to each other. They hold the possibility of creating intimacy, which can heal the sense of alienation your insecurities emerged from in the first place. It is on these intimate grounds that you can begin to show how you actually are, instead of how you would like to be. These conversations then can lead to relationships that have the most potential to reframe your insecurities as being worthy of owning. It is the norm of one dimensional characters, which our society is flooded with that needs fixing, not you.
As published on welldoing.org
We don’t even notice anymore how harsh we can be with ourselves. We can be compassionate to friends and listen patiently to their problems, but we talk to ourselves condescendingly and with disrespect. When we’re struggling, we think, "I’m such an idiot!" with reflex-like quickness, yet telling a hurting friend that they are such an idiot feels forbidden.
How did it happen that I can be accepting and patient with others whilst insensitive and cold with myself? I don’t remember anyone telling me as a kid that I was an idiot. But I don’t remember anyone telling me the opposite either, which would probably be something like: "You’re struggling, and I’m here"
That’s not to say I had no one compassionate growing up, it’s just that for whatever reason no one was available enough to pick up on my hurt, to check in with me, to say something. And when that happens, a message does get taken in. It goes like this: "My problems are not worth talking about". And under that, the assumed, painful conclusion: "I’m not worthy". When we understand this, it's not a big leap to think and talk to myself like I’m less than others.
I often try to convince myself that my unworthiness and my harsh relationship with myself only concerns me, that it has no impact on people around me. "I can talk to myself however I want to, nobody knows it anyway" – I hear myself think.
The belief that I’m unworthy didn’t come from my private world however, it emerged from relationships. The fact that I’m trying to keep my troubled relationship with myself private speaks volumes about the mistrust I feel with others. So, I can go ahead and find comfort in no one hearing my thoughts, but I will inevitably create more isolation in my life and others will feel disconnected from me too. This is how I carry what I’ve experienced forward, this is how distance can continue towards further distance. But how do I create more connection?
If the hurt took place in between me and others, then the healing needs to take place in that space too. Whatever I needed to hear as a sobbing twelve-year-old, I didn’t hear it. It didn’t happen, it’s gone. As hard as it is to come to terms with that, only then I can grieve the kind of childhood I’ve never had. In my tears, I can take a risk and reach out to people who will listen, who are willing to feel with me. One dialogue at a time, I have a chance to feel a little less alienated, a little more trustful. And so they do in return.
These dialogues can then form an intimate ground, in which acceptance and affection don’t get lost but do get taken in. When they get into that same space where hurt is they have a chance to be felt just as strongly. From there the leap becomes a step to be more of me with more of you, and create something that’s more of us.
As published on welldoing.org
"Lee Bull's work is concerned with the way that idealism or the pursuit of perfection - bodily, political or aesthetic - might lead to failure or disaster."
We’re all built of different parts: we’re not easily defined; rather we are a multitude of experiences. Often we think that there’s a kind of ourselves that feels the most like our ‘true self’, and the rest is a façade. Almost as if the real you is imprisoned and often only known to you. The façade or wall then becomes something which isn’t you. By thinking of it that way you may end up feeling powerless and isolated.
A more helpful way of looking at it might be to consider that the wall you have built is you as well. The part of us behind the wall is often vulnerable and overlooked, whilst the wall is often cold, rigid and tense.
One of the difficulties is that once we become aware of that, there is often an instant urge to get rid of one or the other. We want to push the vulnerable part even further down, or make the wall disappear without having a feel of it and getting to know it first. In the former situation, you end up creating more distance between you and the people around you; in the latter, you might lose a source of your power and your boundary.
Acknowledging that you aren’t just the overlooked part within, but also the hard exterior isn’t just a rhetorical difference. Doing so is the beginning of a process of integrating more parts of yourself into a whole. Letting yourself express both parts with a friend or a professional who you feel connected to can be powerful. You can really begin to get a sense of the purpose of your wall, as well as get to know its limits. Similarly, by sharing the vulnerable part of you with a person you feel safe with allows space for a response you may not have expected. We’re usually convinced that we know how someone will react to something. That conviction is often based on previous experiences where significant people in our lives failed to respond to us in a way that we needed.
Taking ‘safe risks’ by sharing both parts of you with someone you trust can reduce loneliness and help you become more flexible about who you experience yourself to be. You can learn that it is OK to be vulnerable at times, as well as not giving yourself a hard time for having the ability to create distance and keeping yourself safe.
The way to quieten our inner opposites isn’t to try and get rid of one or the other but to acknowledge that you’re more than one thing, giving each part a voice and seeing how they relate to each other. Perhaps what’s needed more than anything is work on our tolerance of tension, our ability to hold more than one thing as valid. We can then be free of the pressure that there is an inner true self, deep inside of us waiting to be discovered and a wall around it that needs to be knocked down. Instead we can focus on what is already here – a dialogue between them waiting to happen.
As published on Health Unlocked.
Powerlessness is one of the first words people usually use when talking about an experience when anxiety or panic takes over. There is a sense of vulnerability in feeling this 'thing' take control; often anxiety and panic are experienced and perceived as though they aren't part of the self. As the pulse increases and the breathing becomes impaired, pressure follows.
Pressure to look a certain way to those around you and wishing to get over it in private without anyone else picking up on it. What is important to say, is that the thoughts that follow, of wanting to stay composed and wishing it was over, are not merely responses to the overwhelming sense of anxiety but are active contributors to how overwhelming it feels. The difficulty then is not that you’re unwell, but that you’re unwell and want to seem well.
It often seems to go something along these lines: If I pretend I don’t feel overwhelmed, I won’t be overwhelmed. This might work, at times. The risk however is that in those moments you seem well to friends and colleagues, but it isn’t your lived experience, and so it becomes a fragile performance. A desperate attempt to not let people, and yourself, see and experience a part of you that is vulnerable.
The importance of your response to anxiety and panic
Both myself and the people I work with as a therapist find it useful to try to make a distinction between what you are actually aware of in your body and the thoughts that follow. The thoughts – ‘I need to make it stop’ or ‘when is it going to end’ or ‘I hope no one realises how anxious I feel’ – are often what prompts you to spiral into overwhelm.
What helps to make that distinction is to notice what is happening and staying with that. Instead of trying to jump ahead as if it weren’t happening, make it clear to yourself that it is happening and it is okay for it to be happening. When you begin to feel as though you’re losing your footing and your breathing is becoming uneven, try not to make it stop or forcefully slow your breathing. Rather go along with it with awareness, don’t try to go slower or faster than your symptoms, just go with them, keep them company. People often tell me this helps to take the pressure off and make it a more bearable experience. They express that paradoxically what makes it go away is to try to not make it stop.
The importance of letting others respond to your anxiety and panic
Often there is fear: If people knew that I was suffering then they’d realise that I’m not as together as I want them to think I am. Actually, sharing your struggles with people often helps them relate to you and gives them a chance to surprise you with a response that you weren't expecting. This isn’t always the case though, so first try taking small risks: being seen by people you trust and building on these experiences, because these are the very experiences that will take away some of your anxiety’s power. Then you can begin to build more authentic relationship with others and own your experience.
How therapy can help with anxiety and panic
All of us feel anxious, to different degrees, at different times. Although these experiences share common qualities, counselling and psychotherapy can help you unearth the unique ways and contexts in which you encounter anxiety and suffer from panic attacks. Therapy can support you to uncover your deeply seated ideas of how you should be seen by others and how you shouldn’t be seen. By exploring your own relationship with vulnerability you can come to an understanding of how that shapes your relationship with people around you. Doing this work is not in an attempt to try to change you, but to support you to know yourself more so when anxiety kicks off you’re better equipped.
As published on welldoing.org.
David Darvasi is a therapist working in London
What attracted you to become a therapist?I became aware quite early on how much I enjoyed talking with and listening to people. I’ve taken that role in my family without awareness, it was my way to cope with some of the difficulties that went on. Being a therapist means embodying that role again, but with awareness this time. As soon as I started training, it instantly felt right, I felt at home. I’ve also had the opportunity to meet some incredible people doing therapeutic work and felt inspired by their ability to support others.
Where did you train?I did an Introduction to Counselling course at Birkbeck, University of London. I was then drawn to the Gestalt approach to counselling and psychotherapy and have completed a BACP accredited training programme in counselling at the Gestalt Centre, London.
What sort of people do you usually see?I see people of all ages, from early twenties to late seventies at the moment, and people with various gender identities, sexualities and relationship structures. I try to be as true to myself and as inclusive as I can in the way that I present myself online. Being part of the LGBTQ+ community, perhaps more LGBTQ+ people are drawn to me, who often share that they feel safer knowing that we share an important aspect in our belonging to the world. In terms of difficulties people bring, I often support clients who feel stuck in some way, experience anxiety attacks, have relationship issues or who have suffered trauma. Often people just need to have someone to talk to outside of their circle of friends and families.
What do you like about being a therapist?Being a therapist feels like an enormous privilege. I like how each therapeutic relationship is different and people relate to both counselling as a process and to me differently. Being with them in a contained space and trying to understand the depths of their struggle is something that deeply moves me. Supporting people to be more at peace with themselves and trying to extend the boundaries of who they experience themselves to be is endlessly interesting to me. Therapy preserves some of the intimate human to human contact that seems to be rarer, or at least less apparent with the way things go.
What is less pleasant?Although I like solitude, working as a therapist can be isolating. I pay attention to keep in touch with colleagues and friends as well as network and join professional gatherings and workshops to continue to be part of various groups of therapists.
How long you’ve been with welldoing.org and what you think of us?It’s coming up to a year since I joined welldoing.org. To put it quite simply, it is the best directory I’m currently on. I enjoy contributing as well as reading other therapist’s articles. The team behind it is professional yet manages to be personal, always available and helpful in a way that feels genuine. The word community is not just a word with welldoing.org, it is that rare thing where it is felt.
Do you ever suggest books or apps to clients?I don’t. I do read books now that I didn’t care for two years ago. I remember calling up a friend and saying how much I love a book, she laughed that she suggested that very book to me some time ago. I think however good a book or app is, it needs to be found at the right time when the reader is ready or interested enough to engage with it. Clients do bring in books though at times and I love hearing what they find helpful or exciting.
What you do for your own mental health?I write poems and I’m working on a novel at the moment. I go to exhibitions with my partner and try to see friends often. I also see a therapist weekly. I jog whenever I can and try and travel frequently, even if it is just for a weekend break.
What’s your consultation room like?I have three consultation rooms, two in Shoreditch and one in Camden. They’re all functional and serve their purpose. I like the ones in Shoreditch for their location and feel at home in Camden as that is where I trained.
What do you wish people knew about therapy?I wish more people would give it a go so they could see if it works for them or not. Therapy certainly isn’t the only way to ‘get better’ or to know oneself more. It is at its most potent when both people in the room believe in its use and therefore engage with it. There needs to be a sense of connection between therapist and client for that to happen, once that connection is in place therapy can be a nourishing, powerful experience. And so it is important that people try out different therapists to find a professional they feel safe with and can connect to.
What have you learnt about yourself in therapy?I’ve learnt that my therapy is about me and it is okay for it to be about me. I feel my self-worth has strengthened, I respect and care for myself more. I’ve come to realise that real growth happens relationally and that I need to be willing to let some of my control go and give into experiences more.
As published on Welldoing.org
The reality is that 1 in 4 people will be affected by their mental health at some point in their life. The World Health Organisation states that nearly two-thirds of people suffering from a known mental disorder never seek professional help.
‘Where there is neglect, there is little or no understanding. Where there is no understanding, there is neglect.’ – WHO
Today, on World Mental Health Day, we want to talk about how we can all help to remove the stigma that’s attached to something that affects so many of us on the day to day. As you can likely guess, we’re not professionals, so we reached out to our friend David Darvasi, a professional counsellor, to put together a list of things any one can do to improve your mental health and the conversations that surrounds it.
Think of it as Health
Using the term ‘mental health’ is helpful, in that it makes it more straightforward to talk about specific aspects of our experience and emphasise the importance of it. However, on a day to day basis, it might be easier to simply think of it as health. We now know that our emotional experience is intertwined with our physical well-being. Whenever you go through loss, experience anxiety, have relationship difficulties, or whatever it may be, it impacts you as a whole.
By taking time to pay attention to your emotional experience, you’re inevitably doing something good for your body and overall physical health too. If you begin to think of it like that, instead of needing to set a reminder to listen to that mindfulness app you downloaded, looking after your mental health starts to become an integral part of a conscious, healthy lifestyle.
Take Pauses in Your Seeking
Western pop culture tells us that we should constantly be on the lookout for new experiences, and strive to be our ‘best’ selves. Whilst it is important you nourish the part of you that yearns to discover and be out of its comfort zone, that kind of constant seeking can result in you feeling like nothing is ever quite enough – including you. With that outlook, your life can become solely about seeking; and you can get lost in the act of doing that. It is then easy to lose touch with what you’re actually after. By paying a bit more attention to where you are and how you feel rather than where you want to be and how you want to feel, you can gradually reconnect with yourself and what’s most important to you.
Listening is Therapeutic (for Both Sides)
Due to the fast pace of modern living and the multiple devices we surround ourselves with, our attention can become fragmented, and listening in an open way becomes a real challenge. The impact of this can be most felt in the relationships that mean the most to us. We confuse hearing with listening. Hearing is essentially data collection, and it can be useful when we need to respond quickly to a situation at work, but it can undermine intimacy with a person we love. Listening involves an element of actually taking in what you’re hearing, to let what you hear impact you. Lending an ear and giving space to your friend without rushing to fill in that space with advice or reassurance can feel therapeutic for both of you. Besides, by becoming more supportive, you also get a bit of time off your own struggles.
Connect Through Your Vulnerability
Good times and being happy have become a sort of mantra, and everyone wants to have just that, and at the snap of a finger. All of the people you follow on Instagram seem to be better looking than ever, hanging out in dreamy places with interesting people, eating gorgeous looking food. No wonder it’s hard to feel connected at times! Scrolling through it all, of course you end up colluding with the idea that “living life to the full” somehow means that you need to be happy all the time.
But we’re human. We experience fear, anxiety, hurt and loss. It’s harder to acknowledge these experiences as, inevitably, we feel lonelier when we do. Our bodies end up holding onto the pain that we ignore, and it becomes an undercurrent that’s always there. It’s easy to develop a fearful attitude to pain, and with that, we isolate ourselves even more. Try consciously checking in with yourself to see how you’re feeling as you go through your day. It’s not a thought exercise as such, so try to be patient as it may take some time for you to reconnect with your body that way. Then, seek and nurture connections with people where being vulnerable feels safe.
Living life to the full is to be open to all sorts of experiences. You might even find that happiness occurs naturally when you feel connected.
As published on The Modern blog by Grana.
I remember a person walking into the charity where I worked a couple of years ago, fleeing from his country where he had to face torture and the prospect of marrying a woman even though he identified as a gay man. He said to me, ‘I just can’t believe that there’s a place here just for us’. He then made telling remarks of how hard his life been as a gay man when he said ‘the only thing is that the rainbow flag above the door is too colourful’. He concluded that ‘it’s just too cheery for what it represents’.
People who are on the LGBTQ+ spectrum, including non-binary genders and people who are in relationship structures that are non-monogamous, need to be supported with awareness and acceptance. In an ideal world a service where LGBTQ+ people experience a sense of safety wouldn’t need to be a specialist service. However, from listening to clients it is unsettlingly clear to me how often they feel unheard and misunderstood in services that are not LGBTQ+ aware. It shouldn’t come as a surprise though, as we’ve had decades of pathologising people on that spectrum even, or especially so, in mental health literature and services.
Although the American Psychiatric Association removed homosexuality from its official Diagnostic and Statistical Manual for Mental Disorders in 1973, it was only in 1986 that all references to homosexuality as a psychiatric disorder were removed. This came following the hard work of lots of committed individuals who dared to challenge the status quo. Progress often takes a painfully long time and we know all too well that the complex issue of oppression wasn’t gone by making changes to a psychiatric manual. The trauma of maltreatment has had a lasting impact.
We also need to remember that people who enter these services are often from countries where revealing their gender and sexual identities can cost them their lives or put them at risk of being tortured, abused and imprisoned. The research paper by the International Lesbian, Gay, Trans and Intersex Association that was published just last year was a crucial reminder of how widespread the problem still really is. It reported that in 74 countries same sex sexual contact is a criminal offence. It further stated that in 13 countries, being gay or bisexual is punishable by death. Let alone countries where LGBTQ+ people continue to experience violence. Whilst the report was focused on gay, lesbian and bisexual rights, it is strongly believed that similar laws and practices are targeting the Trans communities as well. Seeing the letters of ‘LGBTQ’ or one of its variations in an institution often gives an instant sense of relief to those who are yearning for a safe place.
Whilst I feel privileged to be able to talk to people and learn from them it is a shame that so little is still being taught on sexual and gender diversity on counselling and psychotherapy training courses. Most colleagues I talk to have barely, if that, had a workshop on the subject of the LGBTQ+ spectrum. So it is no wonder we end up with support services with well-meaning mental health practitioners who are completely unaware of the struggles LGBTQ+ people experience.
Some argue that services that are exclusive in their support of people of sexual and gender minorities further a division in society. I would argue that inevitably a division is already there and we cannot effectively support people by alluding to the oblivious notion that every service is for everyone. Living in a society where everything often feels exclusively heteronormative people who in their identities and/or practices fall outside of that need to be seen and heard. LGBTQ+ services need to exist to respond to the needs and safety of many and we need to stay vigilant in continuing the work for a more whole and integrated society.
Services in London:
East London Out Project
As published on welldoing.org
The science of anxiety is being talked about more and yet the hands on ways of supporting one another gets little attention. Witnessing your partner going through an anxiety attack can be as overwhelming as experiencing it. Your partner may need to reach out for professional support or may already be in counselling, yet anxiety attacks can happen anytime and knowing how to respond can be crucial.
Some of the signs of an anxiety attack are accelerated heart rate, sweating, trembling or shaking, sensations of shortness of breath and chest pain. There is often a crippling sense of alertness and a feeling of being outside one’s body. It can be a lonely experience. Having someone’s presence who the person feels safe with can be of enormous support in itself.
Ways you can support themThe first thing you might do is shift the question ‘Why is this happening to my partner?’ to the statement, ‘This is happening to my partner’, so you can focus on them fully. Understanding the potential triggers behind an anxiety attack can wait.
Seeing a loved one in distress can be disorienting so you need to attend to your own experience. Have a feel of your feet on the floor, attend to your breathing and sit near to your partner. You need to show, even if it’s a little scary, that you can be with them through such experience. Stay with clear statements such as ‘I’m here with you.’ or ‘I have my feet on the floor and I’m not going anywhere.’ Sharing what you’re doing can support them in attending to their experience. Your partner might also have a sense of shame as you’re sitting with them, so once their symptoms are lessening you might want to establish eye contact and signal that it is okay, that they’re okay.
What to look out forAs your partner is most likely experiencing a sense of powerlessness too, asking questions can escalate their symptoms further. Trust that they will articulate what they need once they’re able to. Similarly, instructing a person to take deep breaths often just adds pressure on them and strengthens the sense that they have little control over their breathing.
Rushing to reassure your partner by hugging them might also not be helpful. Remember that they’re at their most vulnerable and no matter how close you are to them, they might still experience this as an intrusion. It is also important that anxiety attacks or anxiety as such doesn’t get assigned to your partner as if it is ‘their thing’ as we all have to deal with some amount of anxiety and anyone at any point in their lives can experience such struggle.
Anxiety attack or heart attack?Some of the symptoms of an anxiety attack and a heart attack can be similar. Some distinctions that may support you in differentiating them are that anxiety often produces sensations in the whole of the body that are dissimilar to those of a heart attack, such as a tingling sensation in the feet or tightness in the throat. Whilst your partner can feel as though they need to vomit or have a sense of dizziness, vomiting or passing out generally occur more often when someone is having a heart attack. It is always best to seek immediate medical support though if you’re having doubts which one your partner is experiencing.
Self-supportOnce there’s a sense of stability you might want to withdraw and have a bit of space, be it as simple as getting a cup of coffee or going for a walk. You might also want to reach out for professional support. Remember that supporting a loved one through an anxiety attack is a courageous task and no easy undertaking. Self-support does not mean you need to rely on yourself solely but that you’re able to reach out for help when you feel overwhelmed.
Hear from others who have experienced anxiety here: www.anxietycentre.com
As published on welldoing.org
David Darvasi registered MBACP counsellor
Following a successful fundraising project the Free Trans Counselling pilot will start in September. There are still places to receive brief structured counselling free of charge. If you're a transperson living in London and have been thinking about counselling but have not had the means to pay for it, please get in touch.
To book an initial session just send an email to the address above or leave a message on the number listed.
I'll be running on the 10K Pride Run on the 12th of August and need help to launch the Free Trans Counselling Project. I've noticed that the professional emotional support that is available for a transperson living in London is limited at best. There are long waiting lists at various services and they really don't get the support they need when they actually need it. Services where it is ensured that they meet with respect and the same kind of care that a cisgender person would receive are pushed to their limits due to the lack of funding that is available. The Free Trans Counselling Project would serve as a pilot for a more extensive project in future, it would help to increase the chances of getting funding for it. Essentially, your help wouldn't just contribute to the immediate support I'd be offering but would strenghten the basis for a greater idea.
Please, visit the fundraising site for more information -
Free Trans Counselling Pilot
Thank you for taking the time.
Making sense of our experiences is an important aspect of life, and one of the main reasons why people seek therapeutic support. As I work with individuals I often find myself feeling for them in their sense of hurry. Their first response to their difficulty is to try to understand the reasons that have led to it and to feel different, as quickly as possible. Drawing from my own experience and working with clients it seems as though we believe that our rational brain can rush in and solve the difficulty without having to engage with the emotional impact we’re left with.
When there seems to be an emerging sense of loss, anger, sadness, exhaustion or whatever it may be, our default response often is to explain it away. What gets lost in this compulsion for meaning is the process of experiencing. You might find yourself wanting to step ahead and manage a difficulty before getting to know it. It is then easy for feelings to remain unclear, and the more abstract they are the more unbearable it might seem to be with them. One of the implications of this process is that you may end up with an intellectual explanation that carries you forward for the time being and yet a sense of dissatisfaction remains.
There are societal and cultural, as well as personal and historic, experiences that may have led you to rely solely on your thinking as a means to come to terms with difficulty. There is no struggle that involves only thoughts; there’s an emotional layer to everything. It might not be apparent, but it is there. This emotional layer needs space to be felt, it needs to be engaged with. The search for meaning consumes a vast amount of energy, as does tolerating feelings before we can make sense of them. Working with people in therapy it becomes clear that once there is space given to feelings to emerge, thoughts do catch up and meaning is created in a way that feels more powerful. This way meaning evolves from experience rather than expecting an experience to come about from reasoning.
As challenging as this process may be, it is as rewarding. Clients share a sense of feeling less isolated, more accepting with what comes up for them and often tap into their own sense of direction. We need to support one another to have the patience and resilience to engage with often unclear feelings first and trust that meaning will emerge in time, without force.
As pusblished on Welldoing.
The aim of this brief article is to offer you an alternative understanding of depression, to locate it not in the private world of the individual but in relation. As a counsellor, I see various people coming through my door who either have been diagnosed with depression or feel a sense of hopelessness and end up self-diagnosing themselves as depressed. The title of this article is not meant to just present a shift in our language but a shift in our understanding.
Part of the struggle when one goes through depression is that it feels static, as if something alien took over one’s body and pushed it right down to deep, consistent melancholy. The colours are faded, everything feels measured and a sense of inability to move, to shift, to change overwhelms the individual. It can feel incredibly isolating as if it were to happen in one’s own private world.
Thinking about depression as depressing helps me in seeing how I am depressing in the room with my client. Noticing how my client and I relate supports us in understanding how they’re relating to people around them and vice versa. The person who is labelled as depressed is often seen as the lone one with the problem and that swiftly takes any responsibility off their environment. And so the family and friends of the person tackling the problem as if it belonged to the individual without realising that they’re relating to that individual and that they are part of this depressing. My aim is to keep my client company and see what their and my part in that dynamic is. We also work collaboratively on how we might gradually break out of that depressing and move towards different ways of relating to each other.
The word 'depressing' is also more suited as everything is changing all the time. Changing the noun 'depression' to the verb 'depressing' might in itself give you a sense of hope that what you’re going through is a process. Your sense of feeling low now will be different to your sense of feeling low tomorrow. It may vary so subtly that it will take all your energy to acknowledge that it isn’t the same as yesterday but it will come as a relief when you’re able to notice the small shifts in your feelings. Try not to evaluate it as better or worse but just note that it isn’t static.
An important aspect of depressing is a sense of holding back emotion in relation, which might be anger or an outward expression of sadness or joy. This is often due to the lack of support around you in allowing space for you to express whatever may be going on for you. Noticing how you’re holding emotion back in your body, how you’re tensing up in your shoulders, how you’re guarding that space in your chest can arm you with a sense of responsibility.
Counselling can give you the space to feel less isolated and more empowered. Depressing, like everything, happens in relation. It is a process, which you don’t need to bear the weight of on your own.
Roubal J., Depression – A Gestalt Theoretical Perspective, British Gestalt Journal, Vol 16, N1, 35-43, 2007
As published on Welldoing - https://welldoing.org/article/depressing-instead-depression
You’re continuously surrounded by stimuli and so you might find yourself going along and distracting yourself from how you feel, from how you actually are. Some of these distractions are more socially acceptable than others, for example overworking or extensive use of social media are far more acceptable in this society than substance abuse. The nature of the underlying dynamic is similar if not quite the same. Ultimately, it’s never about the thing you choose as the distraction but the need to escape. And, of course, you do need to escape every now and then, but doing just that for the sake of it feels as if something needs to be challenged.
What becomes difficult is that even though your attention is occupied by, for example, reading a social media thread and ignoring your partner next to you, you don’t stop feeling. What needs to be said is that this dynamic doesn’t discriminate either so feelings that are part of living, be it loneliness, anger, anxiety, fear, boredom or even joy get pushed down. Your ability to experience and express feelings weakens and so what connects you to others as a feeling being fades.
Looking at this phenomenon from a compassionate stance is crucially important. First, notice that we all do this. Let this bind us for the time being until we figure out how to find our feeling space again, until we learn how to be with whatever is going on for us, instead of chasing the illusion that distraction will lead to moving on.
Working on myself and supporting clients, it has become clear that the more I attempt to experience fully whatever I’m feeling, the sooner it’ll go away. Something shifts on a feeling level and when I manage to gather enough courage to meet it, be it disappointment or rejection, face to face there’s a sense of relief, a sense of completion that then carries me forward.
Learning to be with the pains of living and finding your feeling space is no easy task and we need to empathically support one another to do that. Paradoxically though, staying with whatever you’re experiencing has the most potent ability to transform your relationships with others and restore a sense of connection to yourself. Distractions around you will not lessen, so learning the skills and resilience to stay with your experience is needed more than ever before, so is a dose of kindness to the part of you that yearns to escape.
Counselling can give you the space to do just that, to strengthen your resilience and skills to stay with whatever is going on for you as long as you need to, so you can have a sense of completion, build relationships that feel more alive and reconnect with yourself.
As published on Counselling Directory.
Practical ways to support one another
(as published on welldoing.org)
This brief article is aimed to support you if you were to self-injure or if someone close to you has just disclosed that they self-injure and you’d like to know how to best respond. Self-injury can take many forms; there’s a misconception that it is only cutting or scratching oneself. People develop different ways to hurt themselves.
There are numerous ideas on the function of self-injury. Some people talk about the need to replace emotional pain with physical pain. Some people may self-injure in an attempt to feel more, at a time that they feel numb. Others discover that their self-injuring releases anger that they’re unable to share with others. One thing every person I work with feels strongly about though, is that their self-injuring is part of their way of coping. Giving yourself or your loved one a no-self-injury ultimatum is never helpful, in fact it can do more harm.
When supporting people who self-injure that initial reaction of acceptance is crucial, and the same goes for you if you were to be that person, that self-acceptance is key. As you’re listening to them disclosing this, remember that they trusted you with that information and keeping that trust is something you need to attend to. You may find yourself feeling unsettled as you’re listening to the various ways self-injury takes place but remember that we all hurt ourselves at times, even if not in external, visible ways. We do injure ourselves emotionally; harsh self-criticism is a good example of that. Try not to think differently of the person now that you know this about them and remember, we’re all in this together. As you’re having that intimate dialogue you may understand something more about yourself too.
It is pivotal that once you’ve listened to that person, you gently ask more about how they’re looking after themselves after moments of self-injury. Do this to get a sense of how they’re managing it all. Often there may be a sense of shame for the individual, so hear them out and sit with them a bit with whatever is going on for them now that they shared this with you.
If you did all that, you’ve already done so much for them. Make sure that you’re looking after yourself too. Supporting a loved one who self-injures isn’t easy and you may want to encourage them to seek professional support. Initially you may be the only one who knows this about them, but it doesn’t have to be this way. To fight the stigma and lack of awareness there are places you can go to for support, and you can pass these on to that person. The more support the better, given that it is the right kind of support.
On a finishing note, even as you’re reading this you may feel overwhelmed and lonely. It makes sense that you do; it is hard to deal with as there’s so much stigma around. Hear me out though when I say, there are people out there who understand that struggle and ready to support you in whatever ways they can.
As published on welldoing.org - https://welldoing.org/article/self-injury-awareness-day-practical-ways-support-one-another
This gem of a film lets us into the private world of a short-term foster care centre for at-risk teens, supervised by Grace (Brie Larson) and her boyfriend, Mason (John Gallagher Jr).
Grace finds refuge from the emotionally erratic work at the centre at home with her loving, good-natured partner. But the forthcoming departure of Marcus, a neglected boy who is about to turn 18, and the arrival of Jayden, a withdrawn, self-harming girl, forces her to face her own wounds.
The film’s central characters have a refreshingly natural and human approach to making contact. Grace and Mason meet the teenagers wherever and however they are, without imposing anything onto them. Due to their previous experiences of neglect and abuse, it seems that the young people are not ready to risk other relationships. Caretakers Grace and Mason find beautifully intimate but bearable ways to make contact with Marcus and Jayden, picking up on what each young person is drawn to and sensitively approaching them through those activities. This seems to allow the teenagers to express themselves more fully and genuinely.
I couldn’t help but see the parallels with the ‘conversations’ that are taking place in the therapy room. I often experience the client’s fear that I will react as others have done in their past, and this inhibits them in reaching out for intimacy. I have learnt not to expect trust to form overnight but to work sensitively at their pace, providing a consistency of which they have had little or no experience.
Grace and Mason often encounter rage as they attempt this, and they respond with real understanding and compassion, recognising that behind the fury lies a yearning for human contact. We then see how Grace is having to process her own hurt, being ‘held’ by her partner, and how this enables her to be more available to herself, as well as to others. As therapists too we need to be ‘held’, through personal therapeutic support and clinical supervision, in order to process our own hurts and become more available to ourselves and our clients.
As published in Therapy Today, also available here http://www.therapytoday.net/accessible.php