'I felt truly held almost in a physical sense, despite the distance and pixels between us'
Feeling somewhat stuck, I started my first course of therapy at the beginning of lockdown in 2020, working remotely. Unfortunately, the sense of safety I derived from the apparent detachment of working online, combined with my ambitious nature, caused me to go at therapy too fast. A few months later, I found myself in my GP's surgery, underweight, exhausted and depleted. The previous night, on my son's fifth birthday, I had felt as though something was ripping through my body, causing me to grimace and grip onto my bed frame, white-knuckled, for what felt like dear life. I'd been petrified that something terrible was going to happen either to me or to my son. I had felt possessed. The time had come, I decided, to find a more suitable therapist.
In our first Zoom session, my new therapist introduced me to safety and pacing. Together, these were to form the cornerstone of my journey. Luke is a trauma specialist, and by this time I'd worked out that this was what I needed, although I was still at a loss as to what my terrifying visceral symptoms were about. In our first session, Luke confirmed my suspicion (gleaned from Google) that the unnerving 'floating away' feeling I explained with my first therapist was dissociation.
The next few months focused on developing a safe relationship. Under Luke's gentle guidance, I learned that I needed to develop my emotional regulation skills. By this point, I was accepting of my need for help - quite an achievement for a stubbornly self-sufficient, former high-achieving lawyer. I was till seeing Luke via Zoom but but now I was taking the sessions sitting on my yoga mat, with my iPad secured in a flexible 'gooseneck'. I could move around and I no longer felt a bit like a stressed lawyer, hunched over a screen at my desk, battling an overwhelming workload.
As the weeks rolled by I was able to be drip-fed difficult feelings from childhood. I could also dip into scary body sensations briefly but repeatedly, with Luke carefully managing the swing of the pendulum. I learned how to open and close what I have come to think of as my
feelings valve, and I gradually regained a sense of safety in my body. At times I felt truly held, almost in a physical sense, despite the distance and pixels between us I was amazed that, by learning to surrender to intolerable feelings, I could ward off panic and let the feelings pass through me. The source of my most visceral symptoms, however remained a mystery and that was still terrifying.
Then one day, several weeks into our therapy, I felt my anxiety levels rising drastically. My head was spinning and I felt like a car tyre being pumped harder and harder until it threatened to burst. I arranged an emergency appointment with Luke. The next few hours were unbearably long but as soon as Luke's face appeared on my iPad, I felt my body let go. I surrendered to the familiar gripping, rolling pushing and squeezing in my body that I had experienced on the night of my son's fifth birthday months earlier. A great reconciliation, unfolding dramatically as if in slow motion, commenced between my body and my mind.
Immediately, I knew, finally what the terror I had been experiencing intermittently during the nine months since first starting therapy had been about. I lay on my yoga mat, and, through tears of relief, was able to let what was happening to my body run its course. All the while, Luke metaphorically held me. He was gentle, encouraging, seemingly unfazed, asking me softly to try to put words to my experience. I told him that I was feeling sensations from labour and childbirth. Sobbing, grief-stricken and amazed all at once. I repeated, between sensations that felt like contractions, that I hadn't known. 'Now you know. Know you know,' Luke repeated kindly, as I rolled exhaustedly onto my side, knees hugged to my chest, about an hour later.
On paper, I'd had a normal, natural birth, but this was not how my body and my mind had responded to the excruciating experience, during which I had felt a complete loss of dignity and control. The night my mind finally reunited with my body and I could know and feel in unison, marked the real beginning, rather than the end, of my ongoing therapy journey. However, nearly every day since then, I have had the joy of experiencing life in all its colours. It's only with hindsight that I realised how dark the shadow cast by unrecognised trauma and anxiety had become. Needless to say, I now have a fascination with trauma and complex trauma, and I hope in due course to make my own contribution to this field.
Article first published in Therapy Today; May 2022, Volume. 33: Issue 4
'Medication gives me the fight I need to do weekly talking therapy'
Before the pandemic, I was on antidepressants, working on getting slowly better from an eating disorder, managing depression and anxiety and the voices that yell or chatter - depending on the day -telling me I'm a failure, that I should stop breathing, that my friends and family hate me.
Taking my meds significantly reduces the stretches of time I spend stagnant, gripped by blackness and staring at my bedroom ceiling. They give me the fight I need to do weekly talking therapy which in turn gives me the fight to get on with the job of living.
However, the pandemic unsteadied me, as it did everyone. The bad voices became clearer and louder as the world became more viscous, confusing and frightening. I barely slept, and when I did, my dreams started to seep into my reality. My mind was fraying.
My therapist referred me to a psychiatrist, who suggested an additional medication. 'But what I want is to reduce my meds, not take more', I said. 'why?' was his exasperated reply. No matter how irrational I knew this was, I somehow felt that I should.
I have suffered with mental ill health since childhood, not helped by a period of homelessness at a young age, and have been on and off antidepressants since I was a teenager. By the time I was admitted to the Maudsley Hospital's eating disorders unit in London in 2018 at the age of 32, my feelings about meds were raw. About six months before, I had been misdiagnosed by a psychiatrist and prescribed the maximum dose of mood-stabilising medication with some uncomfortable side effects that took me a full year to come off. The psychiatrist at the Maudsley helped me taper off and encouraged me to try antidepressants, which I eventually agreed to after a serious episode of low mood.
By this time, I had been in treatment for around eight months, part of which was weekly one-to-one therapy with a therapist who was also a clinical psychologist. Being able to discuss my medication with my therapist was a novel but enormously helpful part of my treatment. I could talk about previous side effects and concerns, and was monitored closely. I had agency, choice and professionals around me who cared about me getting better.
I still see the same therapist weekly now at a private clinic. Having this continuity of care has ben vital for me. And so I trusted my therapist when, during the pandemic, things took a turn and she believed a referral to a psychiatrist was needed. The therapeutic toolkit we had been building together to keep certain thoughts and behaviours at bay was not enough for the more hostile and frightening turn they had taken.
My psychiatrist suggested a few different types of medication that would work with my antidepressants to help with the insomnia and heightened anxiety and what he called the 'leaking' between reality and fantasy - something extra to patch the frayed edges.
The difficulty became obvious in just a few weeks. I slept better at night, I felt the warmth of the sun on my face, I knew when I was awake. I was out of bed and dressed and back on the ground.
There is so much stigma around medication, which only flourishes when patients are not listened to, are fobbed off or left to flounder with just a prescription and no follow-up - as I was for most of my adult life. A lack of psychological support undermines the good work the medication can do and, in the very worst of cases, it costs lives.
I do not believe my mental illness stems from a 'chemical imbalance'; I believe it is due to a complex mix of social, culture and internal factors that made me feel very unsafe and frightened in the world. This cannot be solved with drugs. It has been alleviated by years of hard work in therapy, accompanied by a long slog of learning self-care ad compassion. The act of eating when you are anorexic and taking care of yourself when you think you are worthless are, at times, exhausting. Add to that external life factors - grief, injury hurt, pain, instability - and that precarious balance of being well wobbles. It is in these times that I have found medication a helpful additional tool in keeping me well, sane and alive.
I do wonder what my life would have looked like had my eating disorder been picked up when it first manifested itself in childhood, and had I had the therapeutic support at the beginning. Would I still need medication? I cannot say. But I do know that I can only start from where I am right now. And from that place, the medication allows me a bit of a break when doing the work is hard.
Extract from article by Jenny Stevens, a journalist who has written about her experiences of mental ill health and an eating disorder for the Guardian, where she is a commissioning editor. Article first published in Therapy Today:February 2021:Vo. 33:Issue 1
Working with clients online
Covid has changed all of our lives. For some it has been devastating; the loss of a loved one or personal ill health. For others, the loss of income and struggle to make ends meet. For all of us it has meant a change in the way we lead our lives. A curtailment of our personal freedom, seeing friends and family, having to work from home. For many, loneliness.
Covid has also changed the way that I and most counsellors offer our services to clients. It has meant that I am not currently offering face to face work with clients from my therapy room. I have had to adapt to the medium of working with clients online via FaceTime or Skype. It has been an adjustment and it wouldn't have been my personal choice.
Most of my clients moved from coming to see me in my therapy room to seeing me online. A few clients decided they couldn't adapt to the change.
My clients who have made this change, and new clients, have found that working in this new medium has been rewarding. There are occasional technical hitches where the internet may briefly interrupt a session, but this is rare. Together we have been able to keep the connectivity of our therapeutic relationship even though we are not physically in the room together.
Recently I have received enquiries from people asking if I am now seeing clients face to face. As a professional counsellor and a registered member of the BACP (British Association of Counsellors and Psychotherapists) I have a duty of care to my clients and myself. The Omicron variant of Covid is highly contagious and it would be unprofessional at this stage to take the risk of passing on or catching this virus. I have therefore declined these requests as I do not feel that the current pandemic has subsided sufficiently for it to be safe.
Looking to the future I anticipate returning to seeing clients in my therapy room but I hope in the meantime anyone who wishes to seek counselling will consider online counselling as it offers huge benefits to people who are seeking help.
'Therapy is a place to heal my mind as I heal my body from cancer'
I was curiously reluctant to have therapy when I was diagnosed with bowel cancer at age 39. I say 'curiously' as I refer people to talking therapy all the time in my work as a GP. I see the benefits - it works. Yet I didn't want to go, not because I ws worried about the stigma or taboo, or concerned that it wouldn't help. I didn't want to go because I didn't want to be a cancer patient and I didn't want to talk about cancer all the time. Of course, that seems rather ridiculous now - I was a cancer patient and I was talking about cancer all the time, whether or not I wanted to be.
My diagnosis of bowel cancer was out of the blue. No one was looking for a cancer and it was as much as a surprise to my medical team as to me. And then things happen so quickly, because time is indeed of the essence when it comes to cancer treatment, and I found myself in hospital having major surgery, with an ICU stay, within a week of my diagnosis. There is no time to process, no time to think, and I put my energy into preparing my three young children, and practical things like filling the freezer.
After overcoming my reluctance, I started therapy within a couple of months of my diagnosis, and during my first session I barely let the therapist get a word in edgeways. She maybe spoke three or four sentences the entire session, as the words streamed out of my mouth. Like the women I see postnatally who have a need to tell their birth story, I needed to tell the story of my diagnosis and everything that had happened since. In my early sessions, I told it over and over.
I have wanted to be a doctor for as long as I can remember, because I wanted to help and care for people - a cliche, but the ruth. But I don't want to just help and care as a doctor; I do so as a mother, a wife, a friend, a charity ambassador and more. Therapy showed me that I have to also look after me and, importantly, that it is vital - not selfish - for me to do so.
Contrary to the advice to go to hospital appointments with a loved one, I chose to go on my own, because I wanted to absorb the information and begin to deal with it for myself before I had to deal with someone else's reactions. I struggled with other people's emotions throughout the whole of my treatment, and it meant that sometimes I couldn't truly express my feelings. I knew people were sad that I was said. I knew they hurt that I was hurt, so I couldn't keep hurting them more. I also struggled with people's need to be positive, telling me I was strong and brave, reminding me that I was halfway through chemo, I felt their need and I didn't know how to separate that from my own.
But therapy was - and still is - a space, both literally and figuratively (although the literal bit got harder when doing it on the phone, hiding in the bedroom from the kids during lockdowns); a space where my feelings are simply allowed and held be they rage, sadness or pain. It is a place to be held emotionally; a place where there are no expectations or judgments made; a place to allow the release of the flood of feelings that I worry overwhelms others, and a place to be seen simply as myself and not all the roles I play and responsibilities I have.
A safe place - that is what therapy now means to me: a place to heal my mind and heal my body. With cancer, I never felt safe; in fact, even having just had my first set of negative scans and scopes, I do not feel able to trust that I am safe as yet, but for that session, once a week, my mind is safe.
Dr Philippa Kaye is a GP, author and broadcaster. Her newest book, Doctors Get Cancer Too, is published by VIE.
Article first published in Therapy Today:December 2021/January 2022:Volume 32:Issue 10
'I have removed the sticky residue my experiences left me with
I am a 'yellow sticker' person. In supermarkets, yellow stickers are used to mark a product at a reduced price. The eye catching yellow sticker is securely glued onto the packaging. The product now stands out on the shelf.
In nature, yellow signals warning or caution. Is there something wrong with it? Is it damaged? Is it out of date? Is it worth investing in?
Does it really have the same value as 'unstickered' products? The reality is that there is something different about it - it may have damaged packaging, no box or nearly out of date, so may not last as long. However, before the sticker was applied, was it once 'perfect', valuable and attractive, and could be bought without hesitation or concern.
Twenty yers ago, I was like all the products on the shelf: ordinary, unassuming and unobtrusive. I was accepted in my community and lived in blissful unconspicuousness. Then my world changed. Following a serious illness, my marriage broke down, and I was left to raise our three children. I felt abandoned, vulnerable and lonely, as if my hopes for the future I had imagined had died. I had no box, my contents were delicate and my lustre faded almost completely. Surviving this, alongside the painful and prolonged aftermath, wreaked further damage to my fragile contents.
Overnight, people's reactions to me changed. I felt a wave of rejection, a tangible sense of being visible and judged as damaged goods. I had been gifted, by members of the community, a yellow sticker.
Was I the same woman? Was I still 'good enough', valuable and attractive? I had the same children, I was the same person, I had the same values but, confusingly, people treated me with caution.
I desperately wanted to resurrect hope and opportunity for my family. Therapy offered me a place to explore my sense of being stuck. I had attempted to remove the yellow sticker on my own, but it was clear that removing the glue from my psyche was a huge challenge and I would need help.
I started therapy, and my exhilarating journey of increased self-awareness and self-acceptance began. I realised that it was the feelings that arose from the rejection by my community that had shattered my sense of self. As a result, I became triggered when I heard bigoted comments or witnessed people being disrespected or treated unfairly. I imagine that anyone who is rejected from their community for being different may feel the same. My therapist asked if my lack of trust and emotional turbulence might be related to a deeper need to belong. It was.
It has been through the therapeutic work with my counsellor that I discovered the 'yellow sticker' phenomenon. I realised that my psychological responses to past experiences were preventing me from living the life that I had always hoped for.
Through therapy, I have systematically removed the sticky residue that my experiences left me with. I was able to replace the feelings of rejection with self-acceptance, and an increased connection and reliance on my internal locus of evaluation to once again feel grounded. I have been able to process my pain and referee my existence.
The trust that developed in the relationship with my therapist fuelled new ways of thinking, increased my insight and boosted my courage and confidence. I was able to understand myself better and make some sense of my unrest. It is a human need to belong; it is fundamental and underpins our sense of happiness and wellbeing. I understood that I was the same person after my husband left that I was before. We all deserve to be treated with decency and acceptance and are entitled to a sense of belonging.
I am training to be a counsellor now, and believe that, with therapy, it is possible for anyone to make changes in their life and adapt to life's challenges. There is life beyond the yellow sticker. I hope to be able to help others peel it off so cleanly that it's as if were never there before.
Exract from article by Anna Brooks, a mother and student member of BACP. She was formerly a cardiovascular scientist and teacher but later trained as a family group conference co-ordinator, mediator and restorative justices facilitator. Following her experiences working with families in crisis she decided to embark on a carer in counselling.
Article first published in Therapy Today:November 2021:Voume 32:Issue 9/