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What are the different therapies on offer and what is most appropriate for me? It can be really confusing when you start to think about accessing mental health support; there are so many different types of therapy it is hard to know what the best option for you might be. First and foremost, a good practitioner will help you to access the right therapy for you. They should be able to acknowledge when a client may present with issues that are outside of their competency and skill set, or when a client may require a lower intensity therapy to what they offer. When you first contact us, here at Talking Therapy North, we will make an assessment based on the issues you are experiencing, your history and what you are hoping to get out of therapy. At our practice we offer three main modes of therapy, but there are many more out there. Here I will outline the three that we offer to help guide you to what may be the most appropriate for you. Clinical Psychology and Intensive Short-Term Dynamic Psychotherapy A clinical psychologist studies for a PHD which is three years of post-graduate training at a doctoral level; this training means that a clinical psychologist has studied a variety of therapeutic modalities and has extensive experience working with a wide range of client presentations. Clinical psychologists can draw on a range of therapeutic interventions but often develop a preferred therapeutic model to work from. Dr Steve Hoole is our clinical psychologist, and his preferred therapy model is Intensive Short-Term Dynamic Psychotherapy. This model emphasises the real-time tracking of anxiety, defences and emotional responses and focuses on the unconscious emotional processes that underly many psychological and somatic difficulties. A client’s early childhood experiences, history, relationships and previous psychological difficulties can be explored. Steve often works with clients who may have tried different types of therapy previously but have still found themselves struggling, or clients who have long-standing and recurring psychological problems such as anxiety and depression. As a clinical psychologist, Steve often works with more complex presentations. Psychotherapy Psychotherapists usually have additional training in a specific modality of working, beyond the counselling qualification. Psychotherapy is often used to work with deep-rooted emotional patterns and past experiences, exploring how these impact the client in their present. Katy Hoole is our Integrative Psychotherapist, and she is trained in both a Person- Centred and Emotionally Focused Individual Therapy modality (EFIT). EFIT aims to help clients understand and improve their emotional connection with themselves and others. Working in this way, the focus is on emotion and how it is managed and used by the client. EFIT is based in attachment theory and so a client’s childhood experiences and relationships can be explored to understand how they learned and developed strategies to manage and use emotion. Some of these strategies may no longer be working in the present, but by strengthening a client’s connection to their emotions, they can build a secure sense of who they are which in turn helps to create strong , supportive bonds with those around them. Psychotherapy such as EFIT can be particularly helpful for working with anxiety, depression, or the emotional aftermath of traumatic experiences or relationships. Psychotherapy can be useful for clients who may not necessarily be struggling with a specific or current experience, but who are looking for a more exploratory approach which delves in greater depth into the history and patterns of their lives. Sometimes a current experience can highlight or intensify emotional patterns that are already present, and psychotherapy can be useful in these cases to look beyond the immediate issue to the underlying emotions and strategies that are at play. Counselling Counsellors have trained to at least a Level 4 or equivalent qualification and offer a supportive, empathic, non-judgemental space for clients to explore difficult experiences that are causing them distress. Counselling is appropriate for clients who are experiencing immediate, situational problems such as grief, work stress, relationship conflicts or life transitions. Our counsellors are person-centred which means the client is put at the heart of the work; the counsellor aims to offer an empathic, non-judgemental and congruent relationship to the client where they can explore whatever difficulties or emotions they are experiencing in order to feel less alone, gain new perspectives and feel better able to cope with their present circumstances. Counselling can be a good option for less complex psychological issues, clients who have never had any kind of therapy before, or those looking for support through a particularly difficult time in life. Whilst the information above is useful as a general guide, every client is assessed on an individual basis; for example, just because you have never had therapy before, it doesn’t mean that counselling is always the most appropriate option. Our clinicians will be able to suggest the best fit for you based on the information you tell us when we first speak to you.

With the birth of a baby comes a whole new world for the parent; a world of advice, judgement, opinion, exhaustion, anxiety, joy. Becoming a new parent has an impact on every aspect of your life, in ways that you probably couldn’t have anticipated before. Of course, you knew that this little person was going to need feeding, changing, bathing and putting to sleep. Of course, you knew that the house was going to become a little fuller and untidier. Of course, you knew that it was going to be challenging at times. But nothing can prepare you for the reality. The Demands of Caring for a Newborn Looking after a newborn baby is relentless; some days you will wonder what you have done all day, yet you haven’t had time to shower, let alone eat a hot meal. For the birthing parent, there is also the physical, mental and emotional impact of the birth itself, and the recovery afterwards, which is often overlooked by well-meaning friends and family who focus on the new arrival and their wellbeing. The Broader Impact of Parenthood However, having a baby is no small thing. It changes everything; your body, your sense of who you are, your perspective on the world and you must navigate this all whilst also caring for a small person who is helpless in the world without you. That is a lot of pressure for anyone, and this is not even considering the journey you may have been on to become pregnant in the first place, any previous miscarriages or infant loss, the birth itself, your own experience of being parented or your physical and mental health. Whilst for some parents, the baby is much longed-for and very welcome, in other circumstances, a baby can make an already fragile situation even harder, whether that be due to relationship issues, finances, health or trauma. Emotional Struggles and Recovery When Becoming a Parent The nature of parenting often means that the mental and emotional struggles it brings must be pushed aside in favour of caring for the baby and other children in the family. Perhaps the struggles become easier with time, as you adapt to your new life, reach out for support from family, or meet other parents who can share in what you are going through. Sometimes though, the emotional wounds from becoming a parent are lingering. They may not be obvious in day-to-day life, but you may catch yourself becoming tearful, or irritable. Maybe you have lost touch with friends or hobbies that you used to enjoy and have become more withdrawn and isolated. Becoming a parent sometimes shines new light on the way you were parented yourself, which can open scars that you thought were healed. It's Never Too Late to Reflect That newborn baby may be a mischievous toddler, a grumpy teen, or parent themselves, but no matter how long ago it may seem, it is never too late to explore the impact that becoming a parent had on you.

Choosing How Often to Attend Therapy When you first start considering therapy, there are many factors to take into consideration. Do you want in-person or online? What model of therapy do you want to engage in? How are you going to fit it into your working and family schedule? It is often a big step to even get to the point of researching possible therapists, let alone reaching out to speak to one. It is no wonder then, that it can feel like huge commitment, both in time and money, and sometimes this can lead to questions around regularity and frequency of sessions. Maybe it feels like spreading out sessions over a longer period feels more manageable, or that flexibility in attendance allows for the other demands in your life to also be fulfilled. There is a huge variation in how therapists offer their sessions to clients; some will be happy to work on an ad-hoc basis, fortnightly or monthly. Our practice, Talking Therapy North, offers weekly therapy sessions and it is a policy that we place a lot of value around. Committing to Your Wellbeing Matters We believe that when a client takes that decision to begin therapy, they are taking a decision to place their own emotional and mental wellbeing as a priority. Reaching out to make that appointment is saying ‘I choose to find support to help me change the way I am feeling because it is not serving me to stay the way I am’. This often takes courage, and sometimes a level of sacrifice of other things that may have to slip down the priority list. But a client who places importance on their needs, prioritises the time and money for them, and commits to therapy, is far more likely to experience the changes and growth that they seek. They are already stepping into that therapy room with a sense of value around their own needs, and that can make a huge difference to how successful the therapy is. We understand that lives are busy, and there are times when it is simply not possible to make that weekly commitment, and that’s OK. But we believe that a client is better served to wait until they are able or ready to prioritise their needs in this way, rather than stepping into an irregular and infrequent therapy relationship. Building Trust Faster With Weekly Sessions There are several reasons why we adopt this policy; a central one being ‘the relationship’. You build a therapeutic relationship with your therapist, one that takes time to develop. The trust in the therapist’s ability to hold you safely and empathically is essential to creating a space where you can share and explore openly, and like in any relationship, this trust takes time to build. Weekly sessions give the opportunity for that relationship to develop more quickly, so that the client can move more swiftly into the ‘stuck’ or vulnerable areas which are where the change will happen. Meeting weekly with someone is naturally going to enable that relationship to develop faster, leading to a felt sense of safety and trust. From a more practical standpoint, weekly sessions also aid in the recall of the work done in a previous session, meaning that it can be built on and developed. Two or more weeks is a long time and a lot can happen in a client’s life, and in less frequent therapy sessions there can be tendency to need to ‘catch up’ on what has happened between sessions, rather than keeping a focus and momentum on the areas of growth or development that have been worked on previously. In addition, when sessions are less frequent than weekly, the impact of holidays and other missed appointments becomes much greater; it can result in breaks of a month or more, which makes maintaining momentum much harder. What the Research Says About Session Frequency The research into the impact of the frequency of therapy sessions shows a general trend towards quicker clinical gains when the frequency of sessions is higher. (Erekson, D. M., Lambert, M. J., & Eggett, D. L. 2015) Whilst this initially could be interpreted as ‘getting better faster’, there is another impact that this could have which is more subtle. Many clients come to therapy because they feel stuck; things they have tried before haven’t worked, they don’t know what to do to change or help themselves, or they may feel a real sense failure. When therapy sessions are more frequent, and change is seen quicker, this can be a real boost to a client’s self esteem and view of self; there can be sense of achievement, of success, of a belief they can help themselves. The therapeutic alliance is strengthened, motivation to continue is high, and progress continues to grow. Where sessions are irregular or more spaced out, progress is naturally slower, and in some cases can lead to frustration, a feeling of failing and ultimately the belief that therapy ‘doesn’t work’. Once the trust in therapy or the therapist has gone, the motivation to continue also decreases and can lead to ending therapy, without achieving the goals the client set out with. Weekly Sessions vs. Spreading Out the Cost Of course, when you are engaging in private therapy, the financial aspect is an important one to consider. There can be the temptation to spread out the sessions to spread the cost, or to take pauses in months where there are more financial pressures. Private therapy is expensive and it is a huge commitment, we recognise that. However, we believe there can be a false economy in spreading the sessions out, seeing little or slower progress, and ultimately requiring therapy for longer. Instead, commit to a chunk of weekly sessions- 12 weekly sessions vs 12 fortnightly sessions over 6 months- then take a break, consolidate, reflect, and if necessary, return for additional chunks in the future. The likelihood of seeing change and having a positive experience with therapy is much higher and represents more value for money than spending significant amounts of money on more sporadic sessions where progress is slower. When Less Frequent Sessions Make Sense There are circumstances where less frequent sessions are appropriate; for example, after a significant time in therapy, a client may choose to end their weekly sessions but return for a few monthly sessions to ‘check-in’ and reflect on progress. The nature and purpose of these is very different to initial therapy, however; the client has done the work, they have seen progress and feel like they have the tools to continue to grow on their own, so these sessions are simply to aid the transition between therapy and going it alone. There are also many therapists out there who offer more flexibility for their sessions, sometimes because of the models they work in, their own scheduling limitations, or their personal philosophy of therapy. If you don’t want to, or cannot manage weekly sessions, there is support out there that will be accessible to you. It may just be worth considering what this might mean for your therapy journey. References Erekson, D. M., Lambert, M. J., & Eggett, D. L. (2015). The relationship between session frequency and psychotherapy outcome in a naturalistic setting. Journal of Consulting and Clinical Psychology, 83(6), 1097–1107

The Common Misconception About Who Therapy Is For It can be easy to assume that those who seek therapy are the people who are really struggling. The people who find it hard to get out of bed in the morning, those who are so anxious that they cannot carry out day to day tasks or people who have experienced a shocking or traumatic life event. And yes, therapy can be helpful for all of those scenarios. However, these are not the only people that therapy can be suitable or effective for. When You’re “Fine” on Paper but Not at Ease Inside There are many people who are ‘fine’. They have stable jobs, friends, look after their health and wellbeing, care for family members and ‘on paper’ are doing great. But sometimes, those who seem to be happy and coping, are actually working hard to be functional. They channel anxiety into a busy social schedule or hectic career, they fight feelings of depression by locking them away into a mental box and distracting themselves by caring for others, and they tell themselves ‘I’m not feeling ‘bad enough’ to look for help, I should just be able to get on with it, there are people far worse off than me out there.’ How Coping Strategies Can Become Your Normal This strategy can be effective; so effective, that after a while, the person becomes accustomed to a low-level anxious tension that sits in the jaw, or they no longer question why their weekend is so busy that they enter the new week feeling exhausted. Why “I’m Not Bad Enough for Help” Can Hold You Back This way of living becomes ‘normal’. The narrative that they ‘should’ feel OK, that they are ‘functioning’ adequately, or that they don’t ‘deserve’ to feel low, or sad or scared is soon a mantra that over time builds a wall up that not only aims to keep the bad feelings away, but also forces the bad feelings to divert to other outlets- physical pain, numbness of emotion, tears at unexpected times, a short temper. The body finds ways to express the struggle even if on the surface that person is a picture of calm and coping. You Don’t Need a Crisis to Go to Therapy These are also the people that therapy is for. It doesn’t need to be a crisis, or even a particular event that requires support. Sometimes it’s simply having someone else there alongside you, as you notice, stay with, and begin to explore some of the emotions that the mantra has kept at bay for a long time. And that can be scary to do; there’s good reasons why you have employed the strategies you have, to avoid, ignore or distract from the emotions. What Therapy Can Offer Beyond Crisis Support Facing and experiencing these feelings alone can feel overwhelming, but that is why therapy is so useful; you don’t have to be alone as you do it. Listening to What Your Body Is Telling You If you recognise yourself in the descriptions above, then take a moment to tune into your body. Is there a tension there that you have become so used to that you barely notice it anymore? Do you feel a fluttering in your stomach whenever you find yourself alone with nothing to do? Listen to your body, it is trying to tell you something about what you need. Letting Go of the “Not Struggling Enough” Narrative You don’t have to meet a threshold of struggle before you deserve some help; a lot of the time, you won’t realise you have been struggling until you stop and create some space to wonder about it.

The Generational Gap in Mental Health Awareness Mental health is a topic frequently discussed in the media and popular culture. It is built into workplace policies, education and healthcare systems. There is an openness about the discussion of mental health issues today that simply were not there a few decades ago. This means that children are receiving lessons in school centred around how their brain and emotions work, learning techniques to help regulate themselves and are getting the message that mental health is important and something to be talked about. The Cost of 'Just Getting On With It' But what about those people who grew up before this openness existed? For many, they simply don’t have the language to articulate their experiences within the context of their mental health. A phrase I hear a lot is, ‘I just get on with it’. If there was no language to talk about emotions and anxiety, no space created where it was acceptable to share individual experiences, and no support readily available, then it makes sense that whole generations grew up with the philosophy of ‘just getting on with it’. And this mantra serves a purpose; it does create a strength and a drive to keep going, to cope, to be there for friends and family, but it also has a cost. Sometimes, there comes a point where it feels impossible to ‘just get on with it’. The emotional burdens become too heavy, the responsibility overwhelms and it can begin to manifest itself in anxiety, depression, hopelessness and a sense of failure. Facing the 'Brick Wall' of Later Life Transitions For many clients who grew up in the times before mental health was a buzzword that everyone talked about, they can find themselves reaching a stage in life when things seem to hit a brick wall. Whether it be something like a big life transition like retirement, the loss of a partner or the children leaving home, or a physical health issue that changes the way life is lived, whatever it is, this stage of life can suddenly feel overwhelming. It’s also a stage in life that can sometimes be ignored or glossed over by popular media and culture. The image of retirement as a carefree life filled with long lunches, travel and hobbies, is often not the reality that people find themselves in. Even if retirement is everything you hoped it would be, it is still a huge life change that can bring up unexpected emotions and challenges. Redefining the Sense of Self Our sense of self is shaped through our life experiences, the people we interact with, our achievements and our challenges. Work forms a central part of life for most people, for decades, and when that comes to an end, it can sometimes shake the sense of self that we have built over the years. Maybe it raises questions over purpose and value, once we are no longer working. Loss of social contact and structure can create loneliness and boredom; and sometimes the opposite happens and work is replaced with caring responsibilities for parents, grandchildren and friends. When your sense of self shifts, it can create feelings of doubt, uncertainty and loss, and sometimes the change can be hard to navigate on your own. The Emotional Weight of Caregiving and Aging As we get older, there are other factors that begin to commonly impact mental health and wellbeing. Many people find themselves caring for a partner in some capacity which as well as the physical challenges of daily care and safety, can also have huge emotional strain. The worry and responsibility for looking after the household on your own, the sadness of losing parts of the person you have loved for decades, the anger at the unfairness of circumstances you have no control over. All of these can build up slowly over time as you get on with the day to day living that you must do, but the emotional cost to you can show itself as anxiety, depression, overwhelm and hopelessness. Sometimes it takes an outside eye to validate the strain that you are under, to help you to notice the impact and to create some space where your feelings and experiences can be paid attention to. You Don’t Have to Carry the Load Alone Whatever the challenges that later life throws up, one thing is certain. You don’t have to ‘just get on with it’. Seeking support through therapy cannot change the life circumstances you find yourself in. But what it can do is create a space where together we can firstly acknowledge the impact that this phase of life is having on you, validate the emotions and challenges that come with that, and begin to share and process the emotions and experiences in a way that lightens the load. Through doing this, your sense of self can begin to change and adapt to the new phase of life you are in.

“I Always Knew I Was Different”: Understanding Adult Autism and ADHD Diagnosis “I always knew I was different”. This is the phrase that many clients use when they come to therapy to talk about an adult diagnosis of Autism or ADHD. That feeling of difference often comes with feelings of loneliness, isolation, being misunderstood or misinterpreted, and sometimes a lot of anger. Growing up being neurodivergent but without the language to understand it can leave a complicated legacy. It is like looking back on your whole life through a completely new set of lenses; lenses that cast events and relationships in a different light and raise questions about how things could have been different if only you had known. Growing Up Neurodivergent Without Recognition Whilst screening and diagnosis for ADHD and Autism is now common for children and young people, and the indicators are more widely known and shared, 20 or 30 years ago it was a different story. Many children will have grown up struggling in school, experiencing anxiety or finding it harder to build and maintain relationships, but no one recognised that the ‘fidgety’ child, or the ‘naughty child’ or the ‘withdrawn child’ was neurodivergent and with some support and understanding could have had a totally different experience. These children are now adults; successful adults who have jobs and relationships, but who have now been diagnosed with Autism or ADHD. The reaction to an adult diagnosis is entirely personal, ranging from relief to resistance, to anger and grief, and often a mix of all of these. Re-Examining the Past Through a New Lens For some, it can be overwhelming to reconsider their whole lives with this new understanding. Incidents from childhood, or work or relationships now take on greater significance as they are re-examined in this new light. For example, a child with ADHD may have taken on the story that they were ‘naughty’ or ‘thick’ because they found it harder to sit still and concentrate at school or became so overwhelmed by tasks that it felt impossible to even begin. This is often a story about themselves that they carry through life, so to now realise that they were none of these things, simply a child struggling to fit within a system that didn’t understand or support them, can give rise to complicated emotions that need some time and space to be processed. It can also be common to feel let down by caregivers who didn’t recognise the struggle or noticed it and did nothing about it. Resistance, Doubt, and the Fear of “Making Excuses” There can also be a resistance to the diagnosis, centred around a feeling that it makes excuses for behaviours that up until now they have believed were faults or deliberate choices. The popular awareness around neurodivergence in the media can make it feel like ‘everyone’ is being diagnosed, but this takes away from the individual stories of adults who have battled their whole lives without the support or knowledge that could have helped them make sense of who they are and how they interact in the world. Why a Diagnosis Is Not a “Fix” Often, clients will come to therapy for reasons other than possible or diagnosed neurodivergence, but once that diagnosis is realised, they can sometimes feel like they have the ‘answer’ now and so expect to automatically feel better about everything. However, the diagnosis does not take away the life you have lived, the distress you have experienced, and it does not minimise the struggles you have had to go through. Yes, the diagnosis might shine a light on why you may have had some of these experiences, but you still deserve the time and space to process the impact that this has had on you. The diagnosis does not excuse or explain every choice, every interaction or every behaviour, and neither does it excuse others for mistreating, misunderstanding or hurting you. Adjustment, Acceptance, and Support For some people, the diagnosis is freeing, especially if it opens access to medications that can help everyday functioning. For others, it takes more time to adjust and process, and to work through complicated emotions that arise from this new information and understanding. Accessing an Adult Autism or ADHD Diagnosis If you are interested in accessing an adult diagnosis for Autism or ADHD then you can use the ‘Right to Choose’ system, where NHS funded assessments are conducted by certain registered private providers. Some providers offer a combined assessment for both, and it is also worthwhile checking which providers also supply medication, otherwise a lengthy wait for the NHS to provide medication can result. For more information, visit: Right to Choose ASD & ADHD Assessment Pathways ADHD UK – Right to Choose Wait Times

September Signals Change When the 1st of September hits, it somehow feels like the end of something. As soon as that date comes around, the shops are already filled with their autumn clothes, the Halloween (and even Christmas!) decorations are on the shelves and we are being encouraged to look towards the end of the year. Those light-filled summer months have drawn to a close, it starts to get darker earlier, and it really feels like the bulk of the year is behind us. Some people welcome the return to cosy jumpers and candle-lit evenings, but for others, this time of year can feel particularly hard. The Back-to-School Transition For parents of children and young people, September means the start of the new academic year. Whilst for many, this is an exciting time of new opportunities, new classes and new pencil cases, there can also be a lot of anxiety and social overwhelm at the thought of returning to the classroom. Some children have spent the summer in their ‘safe place’; at home, with family and friends they can trust, less structure and less pressure. To return to school or college where there is suddenly lots of noise, friendships to navigate, new teachers to get to know, and academic expectations, can feel thoroughly overwhelming. It is natural that this will take some adjusting to, but it may be that children and young people need a little extra support and understanding whilst this transition happens. When School Becomes a Struggle For some families, returning to school is more than something to adjust to. It is a battle. Whether it is complicated family structures, anxiety, neurodivergence, bullying or academic struggles, there are many reasons why September and the return to school or college feels like an unwelcome challenge. Parents who struggle to support their children into school can feel exhausted and isolated; the dread of the fight every morning, the worry about how their child is doing that day and the fear of the judgement if they cannot get their child into school. There are also the financial burdens of new school uniforms, charity donations and trips, and all this after a summer of paying for childcare, or expensive days out and activities.> Marking the Passage of Time The start of September also feels like a real marker for the passage of time. Children suddenly seem more grown up as they put on their uniforms again and move up a year group, and this can feel bittersweet as we embrace how much they develop and grow but also mourn the time we won’t have again with them. New projects begin at work as the interruptions of summer holidays fades and with these, new pressures and expectations. Even on the television it feels like a new phase, with the launch of the next series of flagship programmes. And often there is the feeling that we are now on the treadmill to Christmas and the end of the year, despite the fact there are four whole months to enjoy before we get there. Lots of people love Christmas, and relish in the preparations and planning, but for many others, Christmas can be a challenging time and so the ever-earlier looming of it on our social radars feels oppressive and stressful. A Gentle Reminder: It’s OK to Find September Hard This then, I guess, is a reminder to myself, and anyone else who needs it, that September can sometimes feel hard, and that’s OK. But it’s also a reminder that those longer evenings are still lingering, and whilst summer may be officially over, we don’t have to charge headfirst towards the end of the year; we can make the most of these autumn months and everything they have to offer first. Reach Out for Support If September feels heavy and you're finding it hard to cope with the transitions this season brings, you're not alone, and you don't have to face it all on your own. Whether you're a parent navigating school-related stress, or simply feeling overwhelmed by the pace of change, talking to a therapist can help. I'm here to offer a safe, supportive space to explore what you're going through. If you’d like to book an appointment or have a chat about how therapy might help, please feel free to get in touch .

Christmas is just around the corner, as the shops and media are keen to keep reminding us. But for many people, Christmas is not a Christmas-card perfect time of festive cheer, family and food. There are lots of reasons why the Christmas period can be exceptionally difficult; financial worries, family dynamics, the absence of loved ones or simply the pressure to ‘have a good time’. It can also feel extremely lonely to think that you are the only one feeling like this. Navigating Family Dynamics and Expectations Christmas is loaded with expectation; from the films that depict happy families and romance, to the traditions that are handed down from generation to generation - there’s often a high bar set for one single day of the year. I hear time and again about the deliberations over where to spend Christmas, who to see when and frequently the conflict between this and what the person would really WANT to do. In large extended families the result can be a Christmas filled with travelling from house to house, leaving everyone involved feeling exhausted. At the same time, others may not feel like they have anyone to spend the festive period with, and Christmas can be lonely and isolating.  Grief and Loss at a Time of Celebration Christmas can also be a time when losses and grief feel more poignant and closer to the surface. Many people will be facing their first Christmas without a loved one, which can often be particularly difficult, especially when surrounded by the decorations and festive spirit of those around them. It can be hard to know how to ‘be’ at these times; you don’t want to be spoil other people’s excitement but at the same time, when your heart is full of pain it feels impossible to join in. Families experiencing conflict, divorce or financial hardship, can also struggle to manage the complicated logistics of Christmas, leading to a time of great stress, guilt and sadness.   Why Christmas Feels So Overwhelming What I have learnt from my own experience and from working with clients over the years, is that despite what the media would like us to think, most people experience some kind of struggle through the Christmas period. And it is not surprising. There is no other day of the year that is romanticised and built up to for months on end. The children are hyped up from October, the shops want you to start stocking up as soon as Halloween is out of the way, and everywhere you turn from late November there is a Christmas tree, a Christmas song or a mince pie. So maybe we could all just turn down the lights a little on Christmas. Take the spotlight away from the ‘shoulds’ and ‘have tos’, and take a moment to consider what would bring us a moment of peace and joy? Re-imagining Christmas in a Way That Works for You Maybe that peace and joy is from a walk on your own on a cold, frosty Christmas morning with a coffee in hand. Maybe it’s fish and chips for Christmas lunch. Maybe it’s a noisy catch up with all your old friends you haven’t seen in ages, but it could also be a quiet glass of wine in front of your favourite box set. I guess it’s about trying to re-imagine Christmas a little, into the shape that suits you. And it may not be easy to do; it might be that whilst you’d secretly love to fly off for some winter sun on Christmas Day, you know it means a lot to your mum to spend it with her, and so that is the choice you will make. But seeing it as a choice , and accepting your mixed feelings about it, could be enough to change your experience of it.  Finding Your Own Version of the Day To those of you that I know have carved out a Christmas that is perfect for you; I salute you. Whether it’s a ‘roast turkey, family games and enough chocolate to sink a ship’ kind of Christmas, or a ‘Chinese takeaway in front of a Bond movie’ kind of Christmas, then enjoy it. And to those of you who don’t want to, or can’t embrace, the traditional expectations, then know that you are not alone.  Christmas is just another day after all, and there is no reason why it should be anything at all, if you don’t want or need it to be.  You’re Not Alone if You Struggle, Where to Turn for Support If Christmas is a time when your mental health really suffers then please don’t be afraid to reach out for support. Information about where to get help can be found here: https://www.mind.org.uk/information-support/guides-to-support-and-services/crisis-services/getting-help-in-a-crisis/ .

One of the most common concerns I hear when working with clients, is that they don’t want to come to therapy and feel like they are simply blaming their parents for the mistakes they made. In fact, clients often experience a great reluctance to talk about parents and other family at all, with many citing a feeling of disloyalty around doing so. Looking Back Through the Lens of Adulthood The clients I work with are all adults, many of whom can now look back on their childhoods and parents through the lens of ‘adulthood’, or maybe even through the lens of their own experience of being parents. Whilst this perspective can offer understanding of contexts that may not have been clear to their child selves, such as financial worries, relationship issues or simply the challenges of being parents, it can also rationalise these experiences in a way that wasn’t the child’s experience at the time.  Why Talking About Parents Can Feel So Hard This response to talking about parents is very common; and it makes sense why. From an attachment perspective, the emotional bonds with our early caregivers are formed within the first 5 years of life, at a time when without them, we literally would not survive. Protection of these attachment bonds therefore makes sense, even when those relationships in practise may not have been without complications. When Childhood Trauma or Secrets Are Involved In early childhoods that contain trauma, neglect or abuse, the need to have at least one parent who is ‘good’ can become essential to that child’s emotional survival, so even when the ‘good’ parent may have behaved in ways that could be considered harmful, it can be difficult to allow that view of the parent into the adult’s recollections. In some cases, children may have received messages about ‘not telling’, or threats about what would happen if they did, so their survival strategy is well-trained in not going there, even as an adult.  It is sometimes the fear of what might be remembered that creates a barrier to talking about parents, or a reluctance to re-open painful wounds and emotions that the adult client has found ways to manage. All of these are valid, and the therapist should respect the hesitancy with which a client might talk about their family.  When Love and Loyalty Complicate the Story Not all reluctance is due to a painful or traumatic childhood. In many cases, the adult client has developed a close and loving relationship with the parent as an adult, and so to talk about ways that parent might have impacted them as a child, can feel unrepresentative of their relationship now. This can often be seen when a parent has a completely different relationship to their grandchildren than they had with the adult client as a child. They may be more affectionate, playful, patient or understanding of their grandchildren, leading the adult client to question whether they can trust their own memories of the childhood that seems very different. Sometimes resentment can exist here, but also a caution about rocking the boat especially if that parent is relied on for childcare or financial support.  Moving Beyond the Blame Game So how do we begin to talk about our experience of parents, without bringing the blame game into it? We can start by remembering that therapy is about UNDERSTANDING. The therapist brings a curiosity about the client’s experience – present and past. What was it like? How did it feel? Has it left any impact on how you experience the world now? Making Room for Multiple Truths Every person, parent or child, has a complex history and a multitude of factors that influence how they behave and interact with others. The goal of therapy is not to work out who was wrong or right, or to explain why people behaved the way they did. Instead, it’s aim is to create a space where the client’s lived experience can be looked at, recalled, felt and understood, in all its complexities. There is very little in this world that can be seen as black or white, and I haven’t yet a met a person or childhood that can be viewed in such a way. More than one thing can be true at the same time: your mum could have taken you on amazing holidays but still made you feel unseen; your dad could have punished you physically, but you also have happy memories of playing football in the garden with him. Making room for all these things is the start of really understanding how your relationships, or lack of them, with your parents have influenced your life.

Self-care is the buzzword that we hear all the time nowadays; it’s on social media, it’s on the news, it’s even in our workplaces. But what does self-care mean? We live in a culture where focusing on ourselves is often synonymous with selfishness; the implication being that if we are looking after ourselves then we are  not  looking after someone else. These things are not mutually exclusive; in fact, it is essential that we look after ourselves so that we can  take care of others. I have a mug that reads ‘You can’t pour from an empty cup’, but how many times do I, like many others, find myself trying to do it all before I have ensured that my cup is full enough to give from.  Engaging in self-care At certain stages in our lives, the idea that we should engage in self-care feels so unachievable that the idea of it makes us angry and resentful; it becomes just another thing to add to the very long to-do list. When we are caring for young children, working and often looking after other family members, seeing where there might be anytime at all for ourselves is almost impossible. Especially when we see examples of self-care on social media that involve elaborate and extensive skincare routines, expensive trips to luxury spas or waking up at 5am to workout before the children wake up. These are not realistic or desirable for many people.  Re-framing habits So how can we re-frame self-care so that it becomes a habit rather than a burden, an essential rather than a luxury? Maybe by starting small. There are many aspects of our day that we rush through without thinking, or that we engage in whilst plugged into a screen at the same time. A cup or tea or coffee, that you actually sit down with, on your own, for 5 minutes, with no screen, no other task. You sit, you drink, you breathe, and you focus simply on the hot drink, on the quiet, on your breath. It’s only 5 minutes and the chaos may start again as soon as you have finished, but it was yours.  Mindful choices There are choices we can make to protect ourselves; don’t answer that work email right now, its 6.30pm and no catastrophe will happen if you leave it until the morning. Is it essential that you use the last 10 minutes of your child’s nap time to clean the entire kitchen, or could you use it to phone your friend who you haven’t seen in 2 months for a quick chat? And I know, it’s easier said than done. Will I gulp my tea down tomorrow morning whilst I answer an email, and dry my hair? Probably. But maybe I’ll think before I do it, and that pause might help me make a different choice.  Prioritising yourself When I talk to clients who are feeling overwhelmed, anxious, sad or alone, they are often not engaging in many self-care activities. But going to therapy, once a week for 50 minutes, is a huge act of self-care. What a valuable gift you give to yourself when you say, ‘I am struggling. I need help. I’m going to prioritise this need and spend 50 minutes of my week exploring myself, my experiences, my needs, my worries.’ It’s not self-indulgent and it’s not weak. It’s a way to fill your cup, so that you can head back out into your life and feel more equipped for whatever is coming your way.  If you want to start your journey to better self-care, reach out to book an appointment here.

How many times have you heard a bereaved friend or family member say this? How many times have you felt it yourself? It is such a common experience to feel that there is a time limit on how long we are allowed to grieve before those around us will reach their limit of compassion and want us to ‘move on with life’. Understanding the Pressure to "Move On" This can be compounded further when the experience of grief is linked to a traumatic or unexpected death, when your relationship with the person who died was fraught or complicated, or if the amount of grief you are experiencing feels disproportionate to the relationship you had with the person. I hear this, and many other variations, from the clients I work with all the time, and it also fits in with my own personal experience of grief.  Introducing the Pillars of Strength When I came across a model called the Pillars of Strength for grief by Julia Samuel, it really resonated with me. Unlike the models which describe stages of grief, which encourage the idea that people move through grief in a linear way, reaching similar milestones until they emerge at the other side, this model suggests that there are 8 pillars of strength which can support a person through the grieving process. Each pillar must be built slowly over time, and each pillar further strengthens the person’s ability to process their grief and begin to move forwards in their lives.  An overview of the pillars is:  Our Relationship with Others and Relationship with the Person who has Died Relationship with Oneself Ways to Express Emotion Time Mind and Body Limits Structure Focusing If you interested in exploring this in more detail, the reference to Julia Samuel’s website is at the end of the blog. Right now, I just want to spend some time reflecting on the pillars that stand out to me as being particularly relevant from a therapeutic perspective. Focusing on Emotional Expression As a practitioner of Emotionally Focused Individual Therapy (EFIT), expressing and processing emotion forms a key part of what I help clients to do in the therapy room. Emotions can often be perceived as a ‘frightening, alien or unacceptable’ feeling. Sometimes our minds and bodies work hard to develop coping strategies that help us to avoid experiencing these feelings. These coping strategies could involve practical things such as using activities to distract, or a withdrawing from or pushing away from the emotions; ‘putting them in a box’. These strategies can work well for a time, but eventually the repercussions of them can make themselves felt, perhaps through experiencing anxiety, detachment, angry outbursts or tearfulness.  When someone we know dies, experiencing and processing the emotions that come with this can feel overwhelming, but often this eases over time as we allow our emotions to be felt, and gradually the intensity decreases, and we grow around our grief as we move forwards in our own lives. Sometimes, however, this emotional wave feels too overwhelming; perhaps there is a complicated mix of emotions that feels too tangled together or maybe you assume the role of caretaker for others and simply can’t allow your own emotions space at that time. Whatever the reason, the connection with, naming and expressing of emotion is interrupted by your coping strategies and this pillar of strength is not able to be built.  Building Emotional Awareness in Therapy This is where an EFT therapist can help. Together, you and the therapist can start to become familiar with the emotions you are experiencing, building a picture of how you experience it in your body, what you tell yourself about what is going on for you, and gradually moving towards a place where you can connect with and experience that ‘frightening, alien or unacceptable’ emotion with the safety of your therapist. Experiencing the emotion in a new and corrective way is part of a process of integration, moving you towards a place where it no longer has the same impact on the way you experience it in the present.  The Body’s Role in Grieving This processing of emotion is both a mind and body experience. The body can hold and store emotion; consider the way fear is often described as being felt in ‘the pit of your stomach’. Similarly, your body sends warning signals of anxiety to us when we are in danger, or when it interprets an experience as dangerous or threatening, such as the ‘frightening, alien or unacceptable’ emotions associated with grief. For these reasons, tuning in to our bodies and listening to what they are telling us can not only help us to connect with emotions in a felt way, but can also help us to take action that will ease the impact of the experience. For example, fuelling our bodies in a way that creates a stable blood sugar level throughout the day, reduces the peaks and troughs of energy that can impact on how we are feeling emotionally.  Grief is Personal—Support Should Be Too In all, I like the holistic approach to working with grief that the Pillars of Strength provides. It leans into the idea that we are complex and unique individuals, and our experiences of grief will vary depending on how well supported we are by these pillars. For example, it makes sense that if you lack structure in your life due to fluctuating shift patterns or caring responsibilities, then you may experience grief differently to someone who is able to build structured routines into their day. This not only allows room for compassion for yourself and your circumstances but also offers ideas about changes that could be made that may support you with your grief process.  Further Reading and Support If you would like to read more about the pillars of strength then you can find more information here: https://www.juliasamuel.co.uk/8-pillars-of-strength . If you would like to read more about EFT then please visit  https://iceeft.com/ .  I am grateful to Julia Samuels for her thought-provoking model and the ways I can build it into my work with clients. If you would like some support working with your own grief then please get in touch via info@talkingtherapynorth.co.uk .

Understanding Emotions: More Than Just Feelings We all know what emotions are, right? We might describe them as our feelings, our responses to people and events in our lives. Some of these emotions are welcome for most people, joy, for example. Other emotions are not pleasant to experience, and in some instances can even feel dangerous or scary. This is a simplified way of looking and at and understanding emotion, and in many ways, underestimates the fundamental importance they play in how we function (or not function) in the world, both in our interactions with others, in how we understand ourselves, and in our behavioural responses. The Importance of Emotional Balance If life is lived in a way that denies emotions, experiences only a limited range of emotions, tries to suppress or avoid emotion, or in a constant state of feeling at risk of being overwhelmed by emotion, then this can be hugely problematic for an individual’s sense of wellbeing. In essence, emotional balance, which allows someone to access their emotions, regulate their emotions and use the emotion to acknowledge and articulate needs, is what therapies such an Emotionally Focused Therapy aims to achieve.  How Our Early Experiences Shape Emotional Responses As we are beginning to see, emotional responses are complex, and in many cases, our emotional responses to things are adaptive responses which we have learnt through our experiences, often through our childhoods and relationships with our early caregivers. This is the basis of attachment theory; secure attachment with a primary caregiver allows emotional responses to develop that mean that an individual is able to recognise and acknowledge their needs, send clear messages about their needs, reach out for and take in care, and give care to others. Attachment and Emotional Adaptation Sometimes emotional responses develop as an insecure attachment, due to the experiences and interactions we have with our early caregivers, other significant figures in our lives, or traumatic events that we experience. In these cases, when emotions are triggered, an adaptive response to these feelings may be avoidant; you withdraw, run away, minimize your needs, avoid connection with others. Alternatively, another adaptive response may be anxiety; you are on alert all the time and have high needs that you seek constantly to be met. Sometimes the response can be a combination of the two. The resulting experience of these adaptive responses, which worked well at the time when they developed, is a sense of isolation and ‘aloneness’ in the present when perhaps they aren’t working as effectively.    When Emotional Responses Become Problematic If any of this may be sounding familiar, then Emotionally Focused Therapy could be an effective model for you. So how would a therapist help with these adaptive responses to emotions that are causing you distress? First and foremost, it will be about creating a place of safety within the therapy room, and between you the client, and the therapist. How Emotionally Focused Therapy (EFT) Can Help Together, you will work towards starting to understand how you experience emotion, the meaning you make of it and your responses to it. This can be scary. Some emotions feel ‘‘frightening, alien and unacceptable”. Your body doesn’t want you to feel these emotions because it has learnt in the past that there is a threat there if you do. This makes complete sense; it is an adaptive response to a very real, felt sense of threat and danger in early life. That’s why the therapy is slow, follows your pace, and is collaborative; the therapist is with you in the experience. Gradually, the emotion and emotional response is broken down, processed, and experienced again in the present, but this time with a sense of safety, provided through the secure attachment with the therapist, or, as therapy progresses, with the reassuring presence of an older, wiser self. It is not about re-living a trauma, recovering traumatic memories, or re-writing history; it is about re-processing the emotional response so that your body can learn it can respond in a different way.   The Power of Reprocessing Emotions in Therapy The impact can be powerful, and once access to emotions is increased, and a client begins to be able to acknowledge their needs, they can start to reach out and ask for care, but also be able to receive it from others; the result is an escape from the isolation, the ‘aloneness’, which is often the experience of an individual who has developed an insecure attachment.   Take the Next Step: Exploring EFT If any of this resonates and you would like to talk further about how EFT may be able to help you then please contact me through the website.     Reference  Johnson, S and Campbell, L. 2022. A Primer for Emotionally Focused Therapy (EFIT). New York and Oxon: Routledge