Yearly Archive 2020

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.

A playlist for connection

Music is powerful. It can get under your skin and completely change your mood. It also affects your unconscious sense of safety, which directly impacts your ability to engage openly and creatively with other people. Create and play your own personal ‘ventral vagal playlist’ to help you feel calm, connected, exited, playful and joyful. Read on to find out more.

Way back in the 80s, when I was young and innocent, I used to listen to music.

I’m pretty sure I got a lot of the words wrong and I don’t think I always understood the meaning, but I connected with some of it. The rhythm had an impact. I listened again and again to certain songs, particularly sad ones, which tells a story in itself.

My connection was always emotional and as I grew and controlled my emotions more and more, music pretty much left my life. Working in the Midlands, I clocked up a lot of miles in my car. Instead of putting on my favourite tapes or CDs (the concept of an MP3 player or smart phone was not even a nugget in Steve Jobs’ brain then), I’d tune in to the news or the nearest equivalent I could find. I’d arrive well informed and steady. But rarely invigorated, energetic or excited.

Things changed when I started to train as a psychotherapist, particularly when the going got tough. The training is challenging. I had to connect with parts of me I had long since split off and engage with the feelings those parts held. It meant connecting with rage, sadness, grief and all the other big and powerful core emotions. I started to listen to music when I was driving. And again, I listened to a small number of songs over and over again. On the motorway, where no one could hear, I sang along as loudly as I could. Different songs served different purposes. Some really released the rage while with others I was crying in seconds, and it was never the ones I expected.

I’m a very contained person, someone who detaches and rationalises the challenges I face. It’s a ‘way of being’ I value but it’s not great if I feel really dysregulated. If I feel there is something wrong or I’m unsettled in some way, it doesn’t help me process it. It also means I’m far more likely to find a way to cope with something than say it’s not okay for me, which is ultimately destructive. With music I can change this. Get Siri to play a particular song, picked for a reason I might not be able to explain, and I’ll connect with my underlying emotion. Then I can start to explore what’s going on for me and work through it.

I wouldn’t call myself a music fan – my lack of knowledge of the latest artists is a standing joke in my family. But since training as a psychotherapist I have essentially created a playlist for my autonomic nervous system (ANS).

According to Stephen Porges Polyvagal Theory we continually gather information from our environment via an unconscious process called neuroception. Our neural circuits interpret the information and make an assessment of our safety: I’m safe, I’m in danger or I’m about to die.

If the assessment is ‘I’m in danger’ the sympathetic nervous system (part of the autonomic nervous system (ANS)) kicks into action. Pupils dilate, salivation stops, airways relax, the heart races, adrenalin is released. We’re ready for fight or flight. Cortisol gets released next, providing extra energy to meet the threat. We are in the sympathetic autonomic state.

If the assessment is ‘I’m about to die’ the parasympathetic branch of the ANS is triggered. The heart rate slows, blood pressure drops, airways constrict, the bladder empties. Pain reliving chemicals are released. This process eases the moment of death, the body shutting down reduces awareness. It also increases the chances of survival, predators often leaving prey that ‘plays dead’. This is called the dorsal vagal autonomic state.

When the brain assesses the environment as safe, balance returns. It’s possible to think clearly, talk and engage with others. We are in the ventral vagal autonomic state.

As Deb Dana explains in The Polyvagal Theory in Therapy, music can signal safety or danger, triggering or shifting our autonomic state. In therapy we can use it as a safe way to explore the sympathetic and dorsal vagal states. In day-to-day life we can use it to engage with our ventral vagal state, the state in which we can be expansive, creative, connected to others.

Experiment to find the music that takes you to this state. It might not be what you expect, and it could be a real mixture of style, rhythm and pace. Once you’ve got your ‘ventral vagal playlist’ prepared, put it on the next time you head off to see friends or attend a meeting and notice the difference it can make.

Leaders – containment counts

Lockdown is lifting and the Government is trying to get the economy moving. Amongst all the other measures, Rishi’s Meal Deal might be a nice bit of encouragement but there’s a lot of debate about how safe or otherwise people feel going out and about. The virus isn’t the only reason people don’t feel safe. The coming economic shock wave is bringing job insecurity and likely mass unemployment. Uncertainty is everywhere and with uncertainty comes anxiety. Leaders need to step up and provide containment.

There’s plenty in the media about a looming mental health crisis as people return to work. There’s no doubt, for some, lockdown has been a lonely, isolated experience. Furlough has been brilliant at saving jobs, but uncertainty is on the increase as its rollback looms. And, of course, the predicted large-scale unemployment was brought closer this week with the announcement from Boots and John Lewis. All this is before people deal with the reality of venturing back into a world where Covid-19 still exists.

Like everyone else, I used Zoom in the lockdown to work with my clients but this week I went back face-to-face. I obviously have an ethical duty to take every precaution. I’ve mentally walked through interactions with clients to try and identify all the touch points. I’ve prepared and shared the guidelines we need and sourced hand sanitiser, tissues, face masks and refuse sacks for double bagging. And this is just for me and my clients. It was challenging and I can only imagine what it will be like covering the bases in a busy or more complex workplace.

It’s not possible to guarantee absolute safety. All I can promise is to have considered the risks and taken appropriate steps. Then it’s up to me to offer my clients the sense of safety they need and deserve.

Fear is infectious. Yesterday I was walking my dogs early in the morning. A rabbit broke cover, ran across the field and into the burrow, with my two chasing. The rabbit was never in any danger, my dogs are getting on a bit now and lack the pace of their youth. The rabbit didn’t know that though. It charged into the burrow, having run for its life, spreading fear to every other rabbit down there. It’s a survival mechanism. Aware of the existential danger, no other rabbit was going to emerge at that moment.

Humans may be more sophisticated than a burrow of rabbits but we’re still mammals. The same basic process operates within us as within the rabbits. We pick up signals below our conscious awareness from everyone and everything around us. If those signals indicate danger our autonomic nervous system responds before we’ve got any conscious awareness of what’s going on. Our response is to fight, flight or freeze, depending on whether our unconscious assesses the situation as dangerous or life threatening. We won’t be able to focus on or engage with anything else until we’ve re-assessed the environment as safe.

There may be nothing to do about the initial infection of fear but it’s possible to soothe the response. A calm, assured presence can make a huge difference. Infants looks to Mum or Dad, or whoever is the primary care giver, for reassurance all is well. Panic hits if they can’t find it. The same is true for adults. When we’re frightened, we look to the authority figure and like it or not, that’s whoever is in the leadership role.

If you’re a leader you need to embody calm confidence. You need to build the trust of those around you, which means consistency and reliability are incredibly important. Pivot without a clear and understandable reason and people will find it almost impossible to rely on you. Communication is absolutely fundamental. Withholding information is destructive. People will project their anxieties into the ‘silence’ so communicate openly and if there is nothing new to say, then make that your update. For the same reason leaders need to be available and responsive. Anxieties will be attracted to the vacuum created by your absence. Actions matter more than words and there’s real trouble if the two don’t match. For example, saying a surface is clean and safe and then being careful not to touch it completely undermines trust, as does doing the reverse.

Finally, and perhaps most importantly, if you’re a leader, you need to take care of yourself. You’re human too. Containing everyone’s anxiety is demanding. A lot is being asked of you and if you’re going to sustain the effort you need a space in which you can offload and recharge.

Get in touch if you would like some help or guidance.

… Yet

Yet… it’s only got three letters, but it’s a word with power.

I use it again and again in my psychotherapy. The client’s struggling with something. Whether it’s breaking a repetitive pattern of behaviour, expressing a difficult emotion or feeling able to go out and about, they feel stuck – “I I just can’t do it”. They can’t make eye contact as they say it. They’re worried what they might see in my face. But when I say ‘yet’ they look up and very often smile. It’s as if there’s suddenly some hope. There’s a belief in the potential for something different.

It’s akin to what Dr. Carol Dweck termed the growth mindset.

A growth mindset is built on the belief intelligence can be developed and has a desire to learn running through it. People with a growth mindset get excited about challenges. Obstacles are there to be navigated, not barriers that stop you. Criticism is valuable feedback and hard work is the route to getting it right. Every time you step a little outside your comfort zone, your brain evolves. Neurons fire together and new neural pathways develop. The result is higher and higher levels of achievement.

The opposite of the growth mindset is the fixed mindset. With this mindset, you’re much more likely to believe you’ve either got it or you haven’t. However hard you work you’re unlikely to get there and criticism and the success of others can feel threatening. A challenge is to be avoided. It’s definitely not an opportunity for growth.

My personal goal is to live with a growth mindset and in the past 10 years or so I’ve moved significantly in that direction. But I know my mindset is heavily influenced by my environment. If I feel comfortable with the people around me and supported, I have a growth mindset. Making mistakes and giving it another go is exciting and engaging. But if I feel judged in any way or believe the other is quietly hoping I get it wrong I have a fixed mindset.

I have often heard people talk about the need to adopt a growth mindset, as if making the switch is easy, just a matter of choice. But as you can see from my example, it’s not that simple. If it was, wouldn’t we all do it?

My psychotherapeutic work is rooted in the knowledge our way of being (how we see ourselves, others and the relationships we have with them) develops in early infancy and childhood and is wired into our neural pathways. Brains are plastic. They change and adapt as a result of experience. They are most plastic when we are young. They double in weight in the first year of life, getting heavier as more and more neural pathways form. Early relationships, therefore, are incredibly influential. But brains remain plastic throughout life so there is always the potential for change.

Dweck highlights our approach to praise as a key factor in building a growth mindset in children. She says instead of celebrating their ability to get the maths sum right or their natural running speed, we need to praise their effort. Essentially, we celebrate yet. Her research shows this builds perseverance and resilience. Children are more likely to engage with challenges that stretch them, come up with new strategies and keep going until they get there. And with such plastic brains, children are likely to get the message pretty quickly and develop the neural pathways that mean it will be their way of being.

With our less plastic brains we might be slower, but we can change as adults too. One of the biggest barriers is our approach to past experience. Denying or ignoring experiences of the past is only likely to increase their grip. Resistance to change gets stronger and the belief change is impossible gets firmer. In essence, the fixed mindset gets more fixed. So, explaining the theory and its relation to the individual is interesting but not that effective. As has long been understood in the world of psychotherapy, insight alone does not lead to lasting change.

In my psychotherapy, I aim never to tell a client simply to do something different. Put myself on the receiving end of that and I would probably feel the challenges I face have been ignored. I might feel belittled. I would almost certainly feel misunderstood and I’d be unlikely to trust the person. In short, my mindset would get more fixed. Instead working collaboratively, we validate and explore the barriers. They are there for a reason and by acknowledging them we can gently unpick and remove them, brick by brick. In parallel, we openly acknowledge how the client feels, the difficulty of the process and celebrate their commitment to staying with it.

The same is true in the workplace. Any leader who wants to develop their own growth mindset or foster it within their team members needs to accept, understand and work through the barriers while focusing the reward system on the process. Then they can step back and bask in the growth in achievement.