Yearly Archive 2020

No defence left but to attack

I have been a fan of The Archers for about 30 years. Like every good, long-standing soap, it mixes funny story lines with both hard hitting and gentle ones. One of the harder ones right now is Alice’s alcoholism. There is history between Alice and her sister-in-law, Emma, so the latter’s motives may not have been that pure, but when she went to share her concerns with her brother, Alice’s husband, and Alice herself, things did not go well. The conversation quickly deteriorated into anger and accusation. For all of us who sometimes have to communicate a difficult message, there are valuable lessons in their exchange.

For a while, Alice has been drinking to excess. Now she’s started hiding it from the people closest to her. She’s definitely got a problem. A part of her knows it. Another part is probably too frightened to admit it to herself yet, let alone anyone else. So, when Emma told her straight that she’s got a problem, that she’s an alcoholic, Alice attacked to defend herself. Knowing each other’s vulnerabilities, the resulting slanging match left them both aggrieved and angry and their relationship in tatters.

What went wrong and how could they do it differently?

The first thing Emma could have done was to stop and take a moment to reflect. Why did she want to say anything? What was her real motivation? I have an over-developed sense of responsibility. More than once people have told me about someone else’s misdemeanour and before I’ve blinked, I’ve taken on board the responsibility to sort it out. I remember an employee reporting a colleague’s behaviour. With hindsight, I can see the behaviour might have been a little irritating but not really problematic and the hiccups around her performance were just that, hiccups. But instantly I felt like I had been handed something I had to fix. I acted and had a word. Probably feeling hurt and alienated, the person in question quickly started looking for another job. Not the outcome I wanted. A better plan would have been to stop and reflect. Why had the employee raised the behaviour in the first place? What was their motivation? What was driving my need to act? What did I believe the real issue was, or even if there was one? What was my goal? Even just a few minutes answering these questions would have achieved a very different approach and probably a better result. And imagine how important it is to get it right if the discussion is about concerns over someone’s mental wellbeing.

Next, Emma visited at a moment that suited her and started the conversation straightaway. She wanted to talk to her brother alone, but Alice was home too. Feeling blind-sided the couple instantly went on the defensive. “There’s nothing you can say to me that Alice can’t hear too.” The conversation has barely started and already the barriers are up on both sides. How much better to slow down and wait for the right moment.

Not able to get her brother alone, Emma waded in and said she thought Alice had a drink problem. Any care and concern she may have been feeling at the outset vapourised in the face of the aggressively defensive response. Then the slanging match kicked off and accusations and insults from their history were thrown by both sides. Alice’s problem with alcohol got completely lost and no one cared about the experience of the other.

If Emma had been really concerned about Alice’s wellbeing, she might have begun by just asking how she was. Listening attentively while giving her the space to talk might well have given her a better opening to express her concerns and show care for Alice. I’ve learnt two really important things as a psychotherapist. First, however certain I think I am, I am not inside the other person’s head. Instead of making assumptions about what’s going on for them, I need to take the time to enquire and really listen. Second, the client is on their own path. If they are not yet ready, pushing hard won’t work. It will simply trigger their defences. Instead I need to focus my energies on making it a safe space for them, one in which they feel there is a genuine desire to understand their experience. If Alice isn’t ready to recognise her problem, throwing it at her as an accusation is not going to get anyone anywhere and her angry response is a very understandable reaction to what must have felt like a threatening and judgemental environment.

So how could Emma have tackled it better. Based on their history, I’m not convinced Emma’s motivation for talking to Alice or her husband was pure. But assuming it was, a more constructive approach might have been simply to have found a mutually convenient moment to spend time together and listen. With genuine interest, Emma could have gently drawn out Alice’s experience. Without accusation or forcing her own opinions and perceptions on Alice, Emma could have shared her own experience of Alice at the moment. With this approach, whether she takes it on board in the moment or not, the chances of Alice reflecting later are much greater.

Getting tricky conversations wrong can have a devastating effect on relationships. Of course, no one is going to get it all right all the time. The example at the start is by no means the only mistake I’ve made! But if I slow down, take the time to listen and engage with the experiences of the other person, the chances of a good outcome go up.

Photo by cloudvisual.co.uk on Unsplash

Let’s talk about suicide

Do you feel suicidal? Does it sound like a shocking question? It’s one I’ve asked many times. I was a Samaritan for over six years and asked it of callers. Now as a psychotherapist, I ask it of my clients. Last month, when I raised it with a new client, she immediately began to cry. It was as if by asking the question directly I got around the shame she felt for thinking about suicide and gave her the space to talk openly about what she was experiencing. Yesterday was World Suicide Prevention Day. The purpose of the Day was to raise awareness that suicide is preventable. One of the big messages was don’t duck the difficult conversation.

According to the World Health Organisation, 800,000 people die every year from suicide. That’s one person every 40 seconds. It means, while you’ve been reading this blog, someone, somewhere in the world may have ended their life by suicide. By the time you get to the end, another two or three people will have killed themselves.

What is the decision-making process? How does someone arrive at the point where they feel they have no alternative but to kill themselves? There are lots of paths and for many they start in childhood if they were not then able to build the resilience we all need to survive what life can throw at us. Ultimately, though, we are individuals. Why we feel the way we feel and the motivations driving our actions are personal. In my experience, one thing that is common is that suicide is not a selfish act. I’ve never met or spoken to a suicidal person who is acting to spite others. They feel they won’t be missed or even that their death will be a relief to those closest to them. They’ll be better off without them.

The incredibly sad thing is suicide is preventable. Someone simply saying hello can be all that’s needed for a person to step back from the edge. It’s this that’s behind the Samaritans relationship with National Rail. Frontline rail staff have been trained to spot and approach someone who maybe thinking of jumping in front of an oncoming train. Engaging with someone contemplating suicide can make all the difference.

What Samaritans, Papyrus, other support services, and psychotherapists do, is address the topic head-on. We’re not afraid to use the words and talk openly about suicide. For us, it’s not a taboo to be avoided at all costs and we know there is a big difference between having suicidal thoughts and killing yourself. The former often represents a powerful need for things to change, that the way things are at the moment is no longer tolerable. Plenty of people have suicidal thoughts at different times of their lives.

People dodge the sadness of others for many reasons. It may trigger their own existential fears and I’ve heard plenty stories of, instead of being allowed and encouraged to grieve in a healthy and cathartic way, the bereft person is offered distractions. Many people feel they have to ‘fix it’ for the other person. Faced with extreme sadness, they try and come up with solutions – join a club, do some exercise, get out more. But it’s not their sadness to fix. They might just turn their back on the distress and talk about bright sides, silver linings and brave faces. Or they might opt for reassurance: “It might seem tough now, but it will get better, everything always does.’ Reassurance never works. Whenever I’ve made the mistake of offering it in psychotherapy, it’s quickly been clear the client has pulled away and our connection is broken. Offering reassurance suggests to them I haven’t really grasped where they’re at.

To someone feeling desperate and alone, who sees suicide as the only reasonable option left to them, these approaches these simply increase the isolation. It makes it completely clear that the other person doesn’t get it and, what’s worse, it suggests they are not interested in understanding them. It’s the deeply felt experience of loneliness that’s the real killer.

So be brave and upfront. Ask someone what’s going on for them and be willing to hear the answer. It doesn’t make it your problem to solve and it doesn’t mean you have to take on their pain. Just listening and offering a safe space in which they can talk makes a huge difference. And finally, care much more about trying to understand them and their experience than the precise words you use. They’ll feel that care deep inside and it will be more powerful than you imagine.

 

Photo by Aarón Blanco Tejedor.

The poison of perfectionism

All my life I’ve tried to start everything with a clean sheet of paper and make sure it’s perfect from that moment on. It’s never worked. I’ve never been able to achieve perfection, not even close. To protect myself from this recurring abject failure I’ve ‘split off’ and rejected parts of myself that represent whole periods of my life. It’s not a particularly rewarding way of living and the psychological kicking that comes with not achieving perfection fosters inertia. A healthy dose of self compassion and valuing the process now lead me to much better, more productive outcomes.

I’ve always loved stationery. Pens, pencils, crayons. I love a new notebook. Crisp clean pages full of potential. Every time I’ve started some project or other, I’d buy a new one, taking time to select one that really appealed to me. It was going to be the place I’d make insightful notes in a beautiful script. Or I was going to set out my goals on the first page and then record my steady and consistent progress on every subsequent page. But how could the very first words I wrote be a perfect summation of all my thinking. Whatever the goal, my progress was never steady and forgiving myself for these ‘hiccups’ felt impossible. To cap it all, my handwriting is messy, as pretty much every school report I ever had made clear. As soon as I put my pen on the first page I ‘ruined’ the book and the project with it.

The ‘clean sheet’ approach goes deeper. I split off whole parts of myself associated with times in my life when I’d felt I’d failed or struggled. I couldn’t accept those parts of me. They were imbued with shame. The memories were intolerable. I couldn’t talk about them or forgive myself for anything I’d done, even if an independent assessment might suggest it hadn’t been anything too wild or radical. The focus on perfectionism, on being perfect, came with a lack of compassion for myself.

It’s not surprising such perfection can drive inertia. The internal psychological penalty for not being perfect is severe. It’s easier to do nothing, to step back, than risk incurring it.

But is perfection all it’s cracked up to be anyway? Paediatrician and psychotherapist Donald Winnicott developed the concept of the ‘good enough mother’. A ‘good enough mother’ is attuned to her infant, recognising, acknowledging and responding to her infant’s needs. In the early days, weeks and months, this attunement is essential. But as time goes on, a ‘perfect’ response from the mother becomes harmful. Little misattunements or delays in responding help the infant develop his or her own resources in a safe environment, building their autonomy and confidence.

Humans are happiest and healthiest in the midst of nourishing and rewarding relationships, something perfectionism undermines. Anyone focused on achieving perfection, on being perfect is, almost by definition, directing their attention on themselves. It’s not much fun being around someone consumed by their own performance. What’s more, there’s probably an uncomfortable comparison going on somewhere, conscious or unconscious.

When I worked in communications, I read plenty of pieces that said the ‘good enough’ news release or mailshot, which gets finished and issued, is much better than the one that’s worked on again and again in an attempt to make it perfect but is never released. The point is clear, but if you’re struggling with perfectionism, it’s not that easy. You may get the ‘good enough’ mailshot, or your equivalent, out the door but the internal retribution could be painful and destructive.

Developing compassion and care for yourself is challenging and demanding but worth the effort. It means, instead of being crushed by mistakes and ‘failures’, you can learn from them. They can become part of the process.

Kintsugi offers the perfect metaphor. Grossly simplified, the soulful Japanese philosophy of Wabi Sabi is about experiencing beauty in the present moment, however imperfect it may be. Embedded in this philosophy, Kintsugi is a way of repairing pottery that celebrates the life of the china-wear. Every chip, crack or break is made gorgeous by repairing it in gold. It’s a beautiful and thought-provoking process, in which you slow right down and engage with and appreciate the piece. Imagine the rewards of giving yourself the same care, attention and love.

The image is of a lid of a coffee pot I broke. No longer perfect, I was going to throw it out. But after repairing it the kintsugi way, it’s much more beautiful. I almost broke the pot itself, just so I could repair it!

Invest in what matters – good relationships

Feeling stressed? The evidence is clear. Invest in the good relationships in your life to boost your wellbeing.

The engaging Professor Robin Dunbar, Emeritus Professor of Evolutionary Psychology at Oxford University, this week told us on Radio 4’s Today programme friendships fade quietly away if we don’t see the person. If we don’t invest time and energy in the relationships, the quality of the emotional connection will deteriorate and disappear from our life.

He gave me a wake-up call! I have good friends I haven’t seen for a long time, well before lock down.
I don’t want them to become nothing more than people I once knew. We’ve got history. I care about them, get pleasure from their company and want them to stay in my life.

As Professor Dunbar said, the body of evidence showing the number and quality of our relationships is incredibly influential when it comes to our physical and psychological wellbeing. The connection to our physical wellbeing might sound surprising but it’s true. The benefits include lower blood pressure, a strong immune system and even a longer life.

In the world of psychotherapy, the power of relationships has been clear for a long time. Psychotherapists and psychologists can be very wedded to their modality, their therapeutic approach. A Person-Centred therapist can be just as certain as a Clinical Psychologist or Cognitive Behavioural therapist that their approach is the only way to achieve change, that it’s their techniques that make the difference. I’m an Integrative Psychotherapist. It means I integrate early developmental and relational theories, adapting the way I apply them to suit the person I am working with. But for all my commitment to the theories, the evidence is clear. It’s the relationship that counts.

Analysing an extensive research base, in 1992 Michael Lambert proposed four factors as affecting positive outcomes in therapy: extratherapeutic; placebo effect; techniques; and common factors. Extratherapeutic factors are the client’s own resources, the connections they have and the environment in which they live. These account for 40% of the outcome. Placebo affects, which comes from the client’s and therapist’s belief in the restorative power of the process, account for 15%. Techniques, which stem the therapist’s modality, account for 15%. The fourth, common factors, is all about the relationship. It covers empathy, caring, warmth, acceptance, mutual affirmation and encouragement. These common factors account for 30% of positive outcomes. The relationship matters much more than what we do!

I’m a working mother. I went back to work full time when my daughter was only a few weeks old. It’s not a choice I would recommend and if I could go back I would do things differently, but at the time I felt I had no option. According to Bowlby’s Attachment Theory, securely attached infants trust their parent to be there when they need them and, as a result can go out into the world to explore. Being physically absent for much of the day will have impacted my daughter’s sense of security. I was lucky for two reasons. The woman who took care of her at nursery was brilliant and a constant in her life for years. The second, is that secure attachment depends on the quality not quantity of relationship. When I was with my daughter, I tried to be psychologically present. The best summer of my life was her first. After collecting her from nursery we’d sit on the rug in the garden and play.

Moving forward into adulthood, with a history of secure attachment it’s easier to build and hold on to the good quality relationships we need for our wellbeing. If we feel secure, we are happy to admit we need a few important people and to depend on them when life throws challenges our way. Professor Dunbar says there are about five of these very key relationships and calls them ‘shoulders to cry on relationships’. If our attachment type is insecure it’s much harder, if not impossible to establish and lean into these relationships. As John Bowlby said, it means our internal resources maybe overstretched. It’s then we can get overwhelmed and struggle.

So, this weekend, take a little time to think about the people who really get you, with whom you feel able to share your fears and vulnerabilities, who don’t shame you, and the connect. The boost you’ll get will permeate every area of your life.

Photo by Matt Gross on Unsplash

It’s tempting, but don’t rush to fix

“What can I do? I have to do something to make it better.”

I can imagine parents all over the country have been thinking this in the past couple of weeks as their children were immersed in the nightmare of A’ Level, GCSE and BTEC results.

The initial panic may be subsiding now the Government has U-turned and is accepting Centre Assessed Grades but there is still uncertainty. Can I go to the sixth form college I want? Are there still places on my preferred university course? Can I do the apprenticeship I wanted?

Plenty of young people have felt like their life has been ruined and I’ve heard more than one person say of course not. It’s possible and maybe probable that when they look back in years to come, they won’t feel their life was ruined, but that’s no help now. I know what it feels like to realise things have gone wrong. When it’s happened to me, it was like my insides fell out. The mind goes blank. It’s like you’re frozen to the spot. Then all sorts of thoughts start piling in, from self-annihilation to looking for someone or something to blame.

The uncertainty may not be as intense now as in recent days but it’s still present. It’s natural for parents to want to fix it for their child, to make them feel better. Many will have tried to find the perfect set of words or the right piece of advice to make the anguish and distress vanish.

“Don’t worry, it will all work out in the end.”

“Put it behind you and move on to something else.”

“You didn’t really want to do that at that university anyway.”

“Never mind. Plenty more opportunities out there for you.”

But, in truth this moment is awful. Pretending otherwise doesn’t help anyone in the long term. When someone’s felt experience is painful, if you suggest it isn’t you’re just denying their reality, which doesn’t help.

Waiting for exam results is always going to be stressful. Add the algorithm and the Government’s slow U-turn into the mix, and stress and anxiety are bound to be at the top of the scale.

When Mum, Dad or someone really important says “never mind, it’s only a blip, it’s not that bad, everything’s going to be okay” it’s easy to hear a subliminal message that says “I can’t really cope with or am not very interested in your distress, so please bottle it up or take it somewhere else, and move on”. They don’t find out how to cope healthily with stressful situations. And life is bound to throw up plenty problems and challenges so it’s a lesson we all need to learn.

In my psychotherapy practice I see the long-term impact of stress experienced when young not having been contained by the adult in the room.

My advice is to ask about and then validate the experience of the individual. What they are feeling and thinking really matters. They need to have the opportunity to voice it, to be heard and understood. This is not yet the moment for solutions and problem solving. It might sound easy, but it definitely isn’t. It’s incredibly challenging to sit with someone as they experience and express real distress, but it’s crucial. They need to be heard.

Next, support the young person to identify and explore the options that suit them. It’s easy to advocate the solution you think is the right one. Afterall, we all know what’s best for someone else, particularly our children! If the way ahead is going to work for the individual, they need to find it for themselves. That doesn’t mean you leave them to it. Get involved. With love and empathy, ask questions and challenge them in a way that helps them reflect, build a solid sense of what’s right for them. Then they’ll be equipped to reach their own decisions.

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