Wednesday, 16 January 2019

Blind in the Mind

After more than 25 years of practice as a therapist, it was a surprise to be presented with a condition that I had not only not encountered before, but had not even heard of!  It transpires that Aphantasia, although first observed in 1880 by Francis Galton, was only officially identified and named in 2015, by Professor Adam Zeman, of Exeter University, since when there has been little further research.  
Aphantasia, so called to describe the absence of fantasy, is a condition which deprives the sufferer from visual memory, although there is a spectrum of how severely this mind blindness affects the ability to visualise, some people being able to dream in pictures, whereas for others their only recall is by creating a narrative.  

It is also very difficult to assess how many people suffer from this disorder as most are unaware of what they are not able to access and in fact, seem quite surprised to learn that others have this ability.  There is therefore not necessarily a strong sense of loss, and in my client`s case, the only real regret he seemed to have was not being able to visualise the faces of close friends and family when he wasn`t with them.  On being asked whether photos helped this process, he replied that photography was not often used by other aphantasiacs that he knew - an observation that he himself thought was strange!  
My client, whom I shall refer to as AF for purposes of this blog, did not come to therapy because of his aphantasia, but because he had felt depressed and anxious most of his adult life and recognised that medicating this with alcohol was causing him further problems. 

My approach to therapy is based on an integrative model which includes family of origin influences and dynamics.  I soon found myself limited in this approach as AF's recall of his childhood was very fragmented and even when he did remember an incident he could not access any feelings that he might have had at the time and could only reflect on the event from the perspective of his adult mind.  

This was illustrated when he showed me a (rare) photo of himself with his mother and was able to remember where it was taken but had no recollection of how he felt at that time although he was able to acknowledge that it gave him pleasure in the here and now.  

I felt it important to share with him that not being able to access childhood feelings made a considerable difference to how I could approach the therapy and that this would also be new territory for me, and he has been very positive over the process of how we can explore this together.  

AF has expressed his complete support for his case to be placed in the public domain as he would like the condition to receive exposure in the hope of gaining more information and enlightenment.   

I would therefore be very interested to hear from anyone who has any personal experience of this condition or who may know of someone who has.  There are Friendship Groups on social media and a few blogs, but these are mostly in the US and do not seem to have led to any significant increase in the understanding of this unusual condition.
Written by Sue Sutcliffe

Photo by Darius Bashar on Unsplash

Wednesday, 9 January 2019

Make Or Break Time For Resolutions

New Year is the traditional time for taking stock of our lives. It's the time for deciding on where we are looking to go with our lives over the next 12 months. 

We may have some big decisions to be considered - and perhaps taken - or we may be looking at others which are seemingly small but, in the end, have more effect on our wellbeing than those dramatic preoccupations we might have expected to concern us more. 

The (smaller) new year resolutions I am thinking about here include such plans as eating less, drinking less, smoking less etc or, to sum up, generally doing less of what's bad for us and more of what's good for us.

Gym membership climbs at the beginning of the year and then, after a quick spurt of enthusiasm, the number of people trying to get body perfect drops off. Statistics indicate the same results with eating, drinking and smoking. We start off with good intentions but, as the stress and strain of everyday life returns, we are tempted to go back to our old, less than perfect, ways.

So what is the answer? What effect does trying and failing repeatedly have on us psychologically? Is it a question of "try, try, try again" or perhaps "practice makes perfect" or could it be that we should look at it differently and use another approach altogether?

Let's look at that old childhood saying: "If at first you don't succeed, try, try, try again". Legend has it Robert The Bruce came up with it as he hid from his enemies in a cave, feeling very despondent. He observed the spider's determination as it tried to spin its web - climbing, falling, climbing again and again and it was that determination that inspired him and his fighters to continue their battle, and to win. The saying is one that many of us can recall as second nature. It's been instilled in us since childhood. 

On the face of it, it's good. It helps a child to learn that she might need to work to get what they want; it encourages persistence and tenacity and helps the child gain in confidence as they develop a belief in their own individual capabilities. 

Some individuals are tenacious and determined and such a saying probably worked sufficiently well for them as children for there to be no need to rethink them as adults. The messages they learned at that impressionable time have carried them through to successful adulthood.

But what when we carry such inner resolutions and don't actually get to the stage of succeeding because life gets in the way or that saying never suited us? We may have outside influences that make it hard to stay on the stern, strict path to which we've committed ourselves? 

What about those of us who did try again, and fail again and perhaps not "fail better" as one pithy saying goes but found our self-esteem and confidence took a bit more of a knock than we were prepared for? 

Rather like the childhood sayings, New Year's resolutions are ingrained. As soon as Christmas is over, broadcasters are jabbering about theirs on the radio or inviting people to phone in while friends tell you what they're doing and ask what your resolutions are. Even if we had no plans, it's hard to admit that publicly so we may be forced into coming up with something to satisfy our friends.

The problem is, when we say something publicly, the act of saying it out loud means we are making a contract. We are pledging to do something and, if you remember from your childhood, a pledge is very important and considered unbreakable. When we make a resolution, we're making a contract, even if it's a promise only to our self. And, if we break it, we feel bad. "You promised," you can hear your little self say with disappointment. "And you've broken it," your punishing Super Ego points out triumphantly. "You've failed big time!"

I would argue that if, like many of us, your resolutions come and go without the satisfying end result you'd planned, it might be that the act of making a resolution, and then not achieving it, is worse than not making one in the first place.

So, if we want to go into the new year feeling peaceful and full of hope for the future, could it be time to give up being resolute in our resolutions. Could this be the time of year when, instead of looking forwards, we look back on the past 12 months in order to see how we can make the next 12 months be even better for us?

If we reflect carefully on what we have achieved and enjoyed over the past year and what we would like to do more of to enrich us emotionally over the next 12 months then, with luck, we stand a reasonable chance of having a happy and hopeful year ahead.

And if, at the same time next year, you're tempted to go down the resolution road all over again, how about saying positively: "I've resolved to give up making resolutions for the New Year." 

That way happiness lies! Meanwhile, may you enjoy 2019.

Photo by Clique Images on Unsplash

Wednesday, 2 January 2019

Best Wishes For 2019

All of us at 96 Harley Psychotherapy would like to take this opportunity to wish you a happy New Year.

May 2019 be a prosperous, productive and hopeful time for us all.

Tuesday, 11 December 2018

The pain of childbirth and PTSD as a possible after-birth

An interesting news feature dealing with the issue of post-natal post-traumatic stress disorder recently caught my attention.   

I am not at all surprised by its prevalence. 

It is important to understand that PTSD does not have to involve experiences of violence, war or car accidents.  It can occur following any event that a person is overwhelmed by and cannot properly emotionally and cognitively process.  

Of course, an event such as being shot at may give rise to a greater tendency to suffer from PTSD but that doesn’t mean it can’t happen as a result of, for example, a bereavement, a divorce or child birth.

Child birth is, according to a consultant orthopaedic physician I spoke to, “one of the most dangerous processes a woman can put her body through” which should get the attention of everyone involved of how a woman may potentially respond.  

Some 30,000 women are diagnosed with postnatal PTSD each year. Bear in mind these are the women who are diagnosed so this is not a trivial issue.  Psychiatrist Dr Rebecca Moore, a specialist in perinatal mental health, told the BBC in a recent interview that more needs to be done nationwide to improve perinatal care. 

It goes without saying that many women give birth and have no ill effects – some enjoy the experience – but so do some soldiers on tour.  

Those women who do not have positive experiences in childbirth and go on to show symptoms of PTSD need sympathy from loved ones and care and effective treatment from trained professionals to prevent the symptoms and implications going on for years.

As a trauma practitioner, I would place the women who have been unfortunate enough to suffer from PTSD in this way in the same category as those I have treated suffering from relationship break ups.

These clients do not automatically generate the same levels of sympathy from those around them and are more likely to hear friends and family saying: “Come on … what’s wrong with you?” Such a statement is not helpful and shows a lack of understanding of what trauma is.  

As I mentioned before, trauma happens when an individual is emotionally overwhelmed by an experience and then cannot make sense of or integrate the experience into the fabric of whom they are and what this experience has come to mean to them.  

Some symptoms may resemble post-natal depression such as withdrawal behaviours and mood swings but post-natal PTSD may include flashbacks, hyper- vigilance and extreme anxiety about their or their baby’s safety.  Prompt diagnosis is a key to helping these women, as well as seeing a trained trauma specialist subsequently.  

Midwives and obstetricians, who are present at a birth and ought to be more aware of the potential risks to the mother following a difficult birth, should play a key role in flagging potential for PTSD to GPs.

PTSD is one of the most debilitating of mental health conditions.  Post-natal PTSD is perhaps made even more devastating because it comes at a time in a family’s life when happiness should abound.

Written by Bert Stemarthe 

Photo by Hannah Olinger on Unsplash

Friday, 7 December 2018

Infatuation, Romantic Love and the Pursuit of Personal Happiness.

Anyone who’s ever been in love will easily remember the wave of powerful emotion that rushes towards us in the first few months. Countless unrealised needs and fantasies rise to find fulfilment through the heart of the beloved and we imagine everything we long for can be found in them. 
Is it any wonder that when we fall in love, it can be hard to grasp the true nature of our feelings: Is this really love or the riptide of infatuation?
The answer to this question can predict not only our relationship’s outcome, it can also tell us much about the pursuit of personal happiness, both within and beyond the realm of romance. 
So, what is romantic love? How can we differentiate it from infatuation? And what can these experiences reveal about our search for happiness?
  • Romantic Love is the profound recognition of the extraordinary qualities we glimpse in the being of another.
  • Infatuation by contrast is essentially about ourselves. 
Infatuation is centred on the certain desire and unlikely belief that someone can make us ‘whole’ and results in a highly unrealistic expectation of what that person is capable of and how far they can determine our future happiness.
If we’re infatuated with someone, we think of them constantly, so can easily fool ourselves into imagining we wish the fulfilment of their private desires The  reality however, is very different. Because we exaggerate that person’s power to determine our well-being, we will discourage any need in them which would leave us feeling separation, disappointment or lack.
They are the object of our subjective desire and as such their personal needs are entirely subordinate to our own. Any conflict which arises with our need to keep them close cannot be countenanced or even acknowledged.
In order internally to square the circle between professing love and acting out of self-interest, we often persuade ourselves we only have our lover’s best interests at heart when seeking to discourage them from something which doesn’t serve us.
It’s perfectly natural to pursue our own needs and life works best in an atmosphere of mutual reciprocity, but because we imagine our needs can only be met through intimate involvement with another, we essentially play a confidence trick on ourselves by denying our true motivations.
Romantic Love by contrast has at its heart the capacity for an extraordinary level of self-sacrifice.
For the first few months, the difficult, jaded and more cynical aspects of the beloved dissolve in the eyes of the lover and if circumstance demands, the lover is often prepared to forgo their own needs for the good of the beloved.
When both parties possess such feelings simultaneously it’s one of the most magical experiences we can have, but our admiration will inevitably become tempered by the reality of an imperfect world. As familiarity grows, our beloved must be recognised and acknowledged with all their fears and imperfections, as we recognise our own inadequacies.
And here we come to the central paradox: Romantic love and infatuation stand at opposite ends of the emotional spectrum, but as they draw closer and start to mingle their purpose is revealed as the same.
To ensure our survival, we all possess a healthy amount of self-interest, and this includes an awareness that the needs of our partner, children, family and tribe are intrinsically interwoven with our own ability to survive. As such, we are often willing to put their needs before our personal desires and this creates an emotional landscape defined by complexity, nuance and doubt.
The balance we strike between blatant self-interest and the subtler self-preservation of altruism, is essentially mirrored in the balance our psyche unconsciously strives for between romantic love and infatuation. What matters therefore in a romantic encounter is where that balance lies.
If the primary feeling is infatuation, then the emotional outcome will be a difficult one. As the beloved’s character is more fully revealed, our fantasy of perfect happiness is replaced by a growing sense of disappointment. They have failed to meet our expectations, either through wilful disregard or by proving themselves incapable and we become increasingly disillusioned. The more extreme the infatuation, the more likely the person once doted upon now becomes the object of our rage.
Romantic love will also carry its tinge of disappointment. It’s rare we experience this profound emotion without also experiencing the fantasy of complete personal fulfilment. Self-interest in fact is an important component, as it prevents the possibility of too great a self-sacrifice.
In contrast, however, with infatuation, as the difficult aspects of our beloved become apparent, disillusionment is replaced with acceptance. A more mature love for the person develops, one which recognises them as a flawed human being.
In the pursuit of personal happiness, acceptance and empathy trump self-regard; for in seeking to meet the other’s needs in a balanced and compassionate manner, we more fully meet our own.

(An extract from ‘Such is Love: Romantic Games and Why We Play’ by Petra Hassall)

Wednesday, 31 October 2018

Art Therapy – A Creative Approach To Change

Art therapy is a healthcare profession that uses artistic creation as a tool to facilitate the expression and resolution of emotions and emotional or psychological conflicts. Art therapy is practised in individual sessions or in small groups under the guidance of an art therapist. 

Sometimes it is difficult to find the words to describe your emotions or how you are feeling.

Art has the potential to heal. The art-making process and creative therapies can be a reparative and a holistic approach for people to develop new ways of being and relating, while gaining a deeper understanding and appreciation of yourself, and building on self-empowerment.

Art therapy may also be used to support - or as a precursor to - talking therapies, as it may be easier to express yourself visually before verbally. Art therapy combines visual art and psychotherapy in a creative process using the created image as a foundation for self-exploration and understanding. Thoughts and feelings often reach expression in images rather than in words. Through the use of art therapy, feelings and inner conflicts can be projected into visual form. In the creative act, conflict is re-experienced, resolved and integrated.

Art therapy is a profession with more than 70 years of history that fits within the care professions. Art therapy is practised following a strict methodology and under a defined therapeutic framework or setting. This therapeutic framework and the aforementioned methodology are mainly based on the theory of art therapy, analytic group psychotherapy, dynamic psychotherapies and contemporary art theory.

Art therapy is for everyone. It can be used with anyone of any age as long as there is the willingness in the person to start therapy in which they will be encouraged to undertake an artistic process.

The use of art media enables self-exploration and the expression of emotions in a non-verbal way. This non-verbal approach is particularly helpful for people who feel uncomfortable with more traditional “talking” therapies. 

The advantages of art therapy/art psychotherapy are that clients can be encouraged to:  

  • express feelings a client may find difficult to verbalise
  • explore their imagination and creativity
  • develop healthy coping skills and focus
  • improve self-esteem and confidence
  • identify and clarify issues and concerns
  • increase communication skills
  • share in a safe nurturing environment
  • identify blocks to emotional expression and personal growth

The psychological value of art therapy explores how past relationships and experiences affect an individual’s current circumstances. In order for this to be facilitated, a trusting relationship is built between therapist and client, and “art making” provides a form of expression so that personal development or growth can occur in a safe and supportive environment.

Written by Eden O. Shoro  2018

Art Psychotherapist MA, HCPC, BAAT

Photo by Alice Achterhof on Unsplash

Wednesday, 10 October 2018

Cannabis - Is It Wacky To Legalise It?

Psychiatrists are to reconsider their opposition to the legalisation of cannabis. The Royal College of Psychiatrists has decided on the move following the government’s decision to allow the use of cannabis for medicine purposes and on prescription.

Up until now, the college has opposed its legalisation and the College’s advice has been at the forefront of government decision making. Other medical bodies, however, are calling for reform and the RCP has decided to look at the matter again.

Dr Adrian James, Royal College of Psychiatrists’ registrar, told The Times the panel would start with an open mind. However, he said he was still concerned about the risks of psychosis.

Dr Robin Lawrence, founder and consultant psychiatrist at 96 Harley Street, believes the College is right to have concerns.

“Before, the government makes a decision about legalising cannabis, there are several pitfalls that need to be addressed. 

“First, it’s important to understand first of all that the cannabis plant contains more than one active ingredient: THC and CBD. 

“The cannabis smoked by students in the 1970s contained a high proportion of CBD, a relaxant that actually expresses anti-psychotic properties.  

“THC, on the other hand, causes hallucinations and leads to a short-lived psychosis in many, a few of whom may go on to suffer schizophrenia for the rest of their lives.

 “Skunk, which is what is now available on the streets of the UK has a very high proportion of THC – the ingredient connected with psychosis. 

“What is worse, is it is now very difficult to buy the earlier form of cannabis because the growers – by selective breeding – have actually changed the nature of the wild plant so that it contains higher quantities of THC.

“The THC gives the cannabis a much greater ‘kick’, making it much more dangerous from the psychotic perspective.”

Dr Lawrence believes legalisation, as long as it’s licensed in the same way as alcohol so that the strength of the cannabis can be measured, could improve safety concerns.

Even so, he suggests, it is highly likely that there would be a black market for the “strong stuff”, whatever legislation is passed.

The psychiatrist has another concern about permitting teenagers or young adults to take the drug.

Dr Lawrence says: “There is a risk is the long-term use of cannabis, usually from a young age, which can result in the user (normally a male) spending hours and days in his room smoking rather than going for a job interview or taking on any responsibility. This can mutate into an entirely wasted life. 

“The importance here, is that the adolescent brain should never be exposed to cannabis unless there is a pressing medical need (as in some cases of epilepsy where cannabis oil is the only available treatment). 

“I do not believe cannabis should be legalised for anyone whose character has yet to form.

“Currently that legal cut off is 18, but many would regard character as still developing right up until the age of 29.”

Written by Lulu Sinclair 

Photo by Roberto Valdivia on Unsplash