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How to Choose a Counsellor
I sometimes get phone calls from people looking for a counsellor but too far away to see me. When this happens I often find myself giving advice about how to find a local therapist. It is important to get the right information as anyone can call themselves a counsellor or therapist, these are not protected terms therefore it is a case of ‘Buyer beware’.
Most of us I am sure will simply type in ‘Counsellor Ruislip’ or HA4 or somewhere else in our local area. But how do you know who you will be seeing? You can always ask for the name of the counsellor you will be working with and go from there.
The first thing to look for is to find out is whether the counsellor is a current member of a professional body. The BACP (British Association for Counsellors and Psychotherapists) is the biggest in the UK; the other two main bodies are UKCP (United Council for Psychotherapists) and BABCP (British Association for Behavioural and Cognitive Psychotherapists). Membership means that the therapist is professionally qualified and abides by exacting ethical standards. They work with a supervisor to ensure they offer the best they can to clients and also undertake ongoing training or continual professional development (CPD). Once you have a name you can usually look this up on the relevant register online.
I’m a BACP Accredited Counsellor. Accreditation means that after qualifying I undertook a further process; submitting my practice to the BACP and gaining recognition of a high standard of achievement, in terms of knowledge, standards and development in counselling and psychotherapy.
If you can, talk to the counsellor you will be seeing, before you book an appointment. It may be useful to have a list of questions about things such as payment, number of sessions, time and regularity of meetings. This is an important decision, don’t feel just because you have spoken to someone or contacted them that you need to take it further.
Finally once you start working with your counsellor ensure that you are comfortable. Do you feel confident in your therapist; can you be honest and truthful with them without worrying about what they will think? Study after study has found that the most important factor in successful therapy is the relationship between client and counsellor.
If you are not happy let your counsellor know. It is always worthwhile talking to your therapist rather than simply abandoning the sessions. Therapy can be difficult and it is worthwhile trying to find out where the problem is. As a client you are giving up money and time: it may take a few sessions to settle in but be realistic about how you are getting on. If you bought a pair of shoes and you found after wearing them for a while, they didn’t fit, you probably wouldn’t go back and buy the same again. Therapy and counselling involve something much more important, you may need to see more than one person before you find the right fit for you.
In summary, do a bit of research, try to know something about who you will be working with and how, and don’t stick with something that you feel isn’t working for you.
Best of luck!
© Marie Fernandes and Transition Counselling, September 2018
Letting the Sun Back In
Changing for the Better
Have you ever seen people walk around with their umbrellas open when it’s no longer raining?
We all adopt patterns of behaviour to manage in difficult times. Often these evolve in childhood or during times of stress as a coping mechanism. However sometimes these can become default reactions and that’s where problems can arise. For example the watchfulness that kept us safe in a traumatic situation can turn into anxiety, or the need to be in control when times were hard adapts into depression; when life becomes more settled.
Counselling offers a space to look at behaviours and attitudes by asking questions. How did they come about? What were the circumstances which created them? Are they are still helpful or necessary? Do these behaviours and attitudes act as a barrier to greater happiness? Would change be useful? If so how can this be instigated and supported?
Therapy, when delivered by a trained, professional counsellor enables change. We spend years learning not only the psychology behind behaviour but also the strategies which can help in moving forward.
Maybe it’s time to put the umbrella away and walk into the sunshine.
© Marie Fernandes and Transition Counselling, June 2018
Living with the Bear
The Relationship between Difficult Childhoods and Adult Anxiety and Depression
Anxiety and depression are now being spoken of more openly than ever before. Stories offering first hand experience of these conditions and the effects on sufferers and their families, statistics about the percentage who are impacted and encouragement to talk more openly are hitting the headlines more often. However many still feel silenced by their adverse mental health condition and understanding lags behind.
Many images have been used to describe why we become anxious and how it fits into our fight or flight response. One of my favourite metaphors is that used by Nadine Burke Harris in her TED talk (How childhood trauma affects health across a lifetime – TED.com). In it she describes how our stress hormones are affected by perceived danger. If you are walking in the woods and you encounter a bear your fight or flight response is triggered. The brain pushes everything aside to focus on the threat. Adrenaline and cortisol are released, our heart pounds, our breathing changes, we are hyper vigilant, watchful and aware of any potential escalation of our peril. We are ready to respond to the danger; flee or confront. Once the incident passes and safety is achieved our brains and bodies stand down, our stress chemical balance returns to normal.
When children live in unsafe circumstances, exposed to abuse, neglect or aggression their fight or flight response is triggered. Similarly children facing bullying at school have to deal with meeting a constant threat. For some there may be a single event which is so traumatic it impacts in a lasting way on their sense of personal safety and the security they feel in the world they live in. These children aren’t navigating occasional encounters in the woods. They are living with the bear.
So what happens when this is your life from a young age? The fight or flight response stays switched on, there is no stand down, it feels as if the danger is ever present or possible. The mind and body adapt: stress and worry become a way of life and if nothing changes the outcomes can be harsh. Children develop a maladapted system of stress which can rise and peak on a hair trigger: at the same time they try to manage this response and the misery it brings. As they grow this can manifest as adverse mental health conditions, such as anxiety and depression, which carry on into adulthood.
Anxiety evolves from being watchful and on full alert for signs of danger; initially in the abusive or insecure situation, but then in other areas of life. Already carrying high levels of fear and anticipation, any additional stress becomes difficult to manage. The difference between worry and panic narrows, the response can take on many different appearances, sometimes it is withdrawal, sometimes overconfidence, sometimes anger, sometimes something else, but always it is based in fear. Life can become dominated by what ifs. And these are never about something going well but the most calamitous of outcomes in any given situation.
Where does depression arise? In how children try to make sense of their world. They are egocentric and try to understand their lives through themselves. Something terrible is happening, I may feel better if I can control it, this must be my responsibility, maybe I did something, maybe I am not good enough, maybe if I try harder? That questioning voice can turn on the individual and morph into the bullying voice of depression: pervasive low moods, lack of motivation, fear, self criticism and internalisation of blame. The bear has taken up residence.
Does this always happen? Of course not. Some of us are born more resilient than others. Life can change and get better at the right time for some to bounce back. Strong relationships based on love and acceptance can make an important difference. A change in environment, effective support and greater understanding, all can have a positive impact. There are also interventions that can lead to improvement. As a therapist I have worked with some of those who have been less able, for a range of reasons, to successfully negotiate this struggle alone or have had to manage life situations which sent them back to a place they thought they had left.
It often seems to those who suffer anxiety and depression that they develop these conditions in adulthood and while this may be true for some: for others the roots may go deeper. The link between the present and the past may be totally obscure and seem irrelevant. To any of us who have managed life successfully no longer being able to do so can seem inexplicable. Medication may be suitable or enough for some, for others working to understand themselves and the basis of their issues may the better option. This doesn’t have to be an either/or choice, therapy and medication can be utilised successfully, in tandem.
Working with a trained, professional counsellor can enable those suffering from anxiety and depression to navigate a different way of living. While Cognitive Behaviour Therapy offers tools to reframe and manage thoughts and behaviours, Person Centred or Psychodynamic therapists invite a deeper exploration and understanding of these conditions and their origins. Integrative therapists, such as myself, may offer both CBT and Person Centred/Psychodynamic ways of working.
As with any adverse mental health condition many of those living with anxiety and depression do so unknown to those around them. They find ways to manage. This may involve, for example, developing a persona to get through difficult situations or avoidance of certain events, people or places. As I say to my clients this is not cowardice it is defiance. Your brain tried to make sense of an impossible way of living and this is where it ended up. But you survived. Now let’s think about how you would like to live and work on getting there. It’s time to leave the bear back in the woods and move on.
To find out more about Transition Counselling contact me directly by email (email@example.com), phone, text or WhatsApp (07572 282514). I am happy to answer any questions you may have.
© Marie Fernandes and Transition Counselling, February 2018. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Marie Fernandes and Transition Counselling with appropriate and specific direction to the original content