The Thief of Time

I work part time as a teacher and so I am fortunate to get the long summer holidays; this year I promised myself that I would decorate the hall. I had loads of time and this would be an easy project, but suffice to say that come the end of my six weeks I had managed to sand down two doors and had filled in some cracks in the walls with Polyfilla. I started to paint the Saturday before I started back at college.

If procrastination is the thief of time them I was robbed blind? What was the problem? Why did I leave it so long? It was not a difficult job, in fact it should have been quite easy. Procrastination is one of my weaknesses– I crack the old joke to friends that I have a book on the subject but I haven’t got round to reading it.

CLOCKS

Are you somebody who procrastinates? Do you delay doing things, be it household chores, or contacting friends? Perhaps you defer making change in your life like getting a new job or losing weight or taking more exercise. Perhaps you are unhappy with your life circumstances but you never quite get around to seeing a coach or a counsellor?

If you are like me you move through life telling yourself that you are going to start the diet next week or sort out your CV once you get time and then suddenly another year has gone by.

As I contemplate my decorating progress (or lack of it) I came up with three reasons that I think contributed to my procrastination perhaps these might apply to you?

  1. Starting is difficult

If it was just the painting I would be ok, but I had to clear way furniture (one small book case) and then prepare the woodwork by sanding off the gloss paint and filling in cracks in the wall before I could start on the actual painting. There was something about the preparation that seemed overwhelming. The initial tasks were unpleasant so in comes a multitude of excuses at this point; I didn’t have a face mask for the sanding, I needed eye protection, and of course it makes a mess, there’s going to be dust getting on the carpet.

Sometimes we simply feel overwhelmed by the sheer enormity of instigating change in our lives – we don’t know where to start. You start one step at a time, do one little task and don’t look too far ahead set small intermediate goals with reasonable deadlines.  Perhaps it’s because we fear the upheaval it will bring; ask yourself – am I apprehensive about the disorder that might ensue? When people start to make changes in their life particularly through counselling they may fear the upheaval that ensues. The upheaval is less of a bother when we know our endpoint and sometimes small changes incentivise us to move forward.

procrastination

  1. Easily distracted

When I am dreading the upheaval of decorating, I am easily distracted. The dog needs a walk, it’s a sunny day so I should be out enjoying the sun or I could get a washing done. The most mundane task will suddenly become high priority.

What is distracting you from making change in your life? If it is important then you may have to focus on that task first. But be honest with yourself can it be postponed? There are often legitimate reasons to postpone something but we normally know what is a high priority and what is not. That is why deadlines are useful; if I know I have to have something done by a certain date then I can normally get my act together to finish on time.

  1. Not seeing the endpoint.

When I went along to the DIY store and had a look at the paints and the fancy furnishings I felt really motivated. I could imagine what the hall will look like when I see the paint colours and the new pictures I want to hang.  Once I painted fresh white paint on the doors and skirting I could see the dirt on the walls and it becomes more important to move ahead with the decorating.

However, in life we don’t often know what our endpoint will be. We have perhaps a slight inkling that all is not well but when it comes to personal change we are often unsure of what the change will look like. Sometimes we have an idea of the change we want to make in our lives or we know what type of person we want to become but that “new me” is scary. It’s a bit like deciding to paint your walls bright red when we have been used to magnolia. What if it looks awful and I’ll have to go back to the beginning?

Sometimes I work with clients that want to make change but they get worried that if they instigate change then they will become this completely different individual who will be unrecognizable and unacceptable to friends and family.

However, once they start to make small changes they realize they can’t go back and they don’t want to go back to the way they were and the changes incentivize them for more change.

If we trust ourselves to know that what we are doing will benefit us then we may be keener to move forward.

In the end, I eventually got my hallway finished; I set small achievable goals and deadlines, I prioritised the work and did it when I knew I would be free and available and as I saw the place brighten up I felt incentivised to carry on. Now the question is why has it taken me so long to write the accompanying blog!

 

 

When you meet with a new counsellor

What should you look for in a counsellor?

When you go to see a counsellor for a first time it might seem like a daunting experience. You are about to confide in a complete stranger about issues that are terribly personal and  you may feel a bit overwhelmed so this blog is about what you might want to know about your future counsellor.

When a client comes for the first time I always start by explaining confidentiality; this means that I will not disclose any content to a third party unless I think that the client might harm themselves or others. I may explain that our relationship is a professional one so I don’t make friends on Facebook with clients (although I have a professional FB page and Twitter account which you are welcome to like). I also will not see members of the family even after the client has finished so you can’t recommend me to siblings or partners or children. I discuss fees and cancellation policy and the possible duration of counselling and the frequency of sessions.  So, before we start with a therapeutic contract I offer a business contract. This is important because it puts a professional boundary around our relationship and in doing so you are protected.

When things get difficult therapeutically (and they might when a client is talking about painful issues) then that professional relationship strengthens the therapeutic alliance.

I will ask the client if they want to know anything about me, and few will ask mainly because they have read the relevant page on my website but I often encourage clients to ask questions about how I practice and I would say to anyone looking for a counsellor –take time to ask your counsellor questions!

This may run counter to your instinct, we don’t ask to see the doctor’s medical certificates or lawyer’s license to practice but you can check the medical register. Lawyers are also licensed to practiced but there is huge benefit to you and to the counsellor if you ask these important questions.

What are your qualifications?

Counsellors normally have a diploma in counselling at the very least; some may have a degree or a Master’s degree or a professional qualification that is ratified by a professional body. If you are seeing a counsellor within a charity or low cost scheme the counsellor may be a trainee but they will be considered fit to practice and should have a supervisor who is monitoring their work. They will also let you know that they are a trainee but they are considered fit to practice and are under supervision.

Are you in supervision?

All counsellors should be in supervision – end of story! Do not go to a counsellor who tells you they don’t have or need supervision. It is an essential part of the therapeutic process and it is the place where the counsellor reflects on their practice and their interaction with the client.  It is an anonymous and confidential arena where the supervisor and other supervisees are held to the same rules of confidentiality. When a counsellor is in supervision they will scrutinise their practice and check that they are doing the best for you their client. Supervision can offer a counsellor a new perspective on an issue and prevent them from getting stuck. I cannot emphasise enough how valuable supervision is for me. It enables me to see my blind spots and to find new and creative ways to help my clients.

Are you a member of a professional body?

Strictly speaking there is no legal requirement for a counsellor to be a member of a professional body but to be honest there is no legitimate reason why a counsellor shouldn’t be a member of a body. There are three professional bodies in Scotland: UKCP, BACP and COSCA, they all have a code of ethics and professional practice. If a counsellor is a member of anyone of these professional bodies, then they are bound by the code of ethics and professional practice of that organisation. If they break that code of ethics and act unprofessionally then they can be held to account through the complaints procedure?

Have you done any personal therapy?

Now you might think that a counsellor shouldn’t be seeing a counsellor because they should be “mentally well” but for me this is the most important point for any counsellor. A good counsellor will have spent a substantial period doing their own psychotherapy. The process of psychotherapy is deeper than counselling and looks at the past and how it has shaped the present and future. A counsellor needs to be aware that they have blind spots and that they may have parts of themselves that aren’t helpful or indeed are obstructive. We all have unconscious biases and baggage from the past and we need to understand these processes.

As an example, let’s say a counsellor had a parent with alcohol dependency and that seriously affected their childhood and the relationship with the parent is now fractured and angry. Then a client comes with alcohol dependency issues. You might think great – this therapist will really understand the situation but the counsellor will best understand the situation if they have analysed and reflected on their own experience as a child. If they haven’t then they might react to the client as the wounded child who struggled to help the alcoholic parent, and the unresolved anger will appear in the room and they either enable the client in their dependency or they shame the client rather than confronting the behaviour.

If these points are covered it still doesn’t mean your counsellor will suit you and I strongly recommend finding a counsellor with whom you feel comfortable.  The counselling relationship is a very profound relationship and I consider it a privilege to be the person that my clients entrust with their issues.

Minding the Boundary

A boundary is where something ends or begins.

A boundary has an edge or a limit.

There is the boundary of the body –our skin, the largest organ in the body and part of the innate immune system, acts as a natural barrier that protects us from infection and trauma.

We have the psychological boundaries of the self, it is physical in that we might call it our personal space. It is the unseen circle surrounding me that separates “me” from the “other”. It is also our “felt sense of self” it is where I begin and end.

We manage our boundaries in relationship with others. How close we let someone come into that personal space will depend on how much we trust them and feel safe with them.

Boundaries also apply to time and place; our home is a boundary. Hopefully a safe place where we spend time with those we love and trust the most.

Boundary hands

Our time is boundaried – the time we spend at work is limited, the time we spend with family, pursuing a hobby are naturally boundaried and this allows us to create structure in our lives.

If we were lucky the managing of our boundaries was learned as a child with our parents and caregivers. When they get it right we can manage our sense of self. We can get close to people and maintain our own sense of self. With strangers, we are initially guarded but in time as we grow to like the person and trust them then we gradually lower our boundary and let them in.

When we fall in love our partners are the people we let into our personal space, and that is where we achieve intimacy and connection.

If we had a caregiver who was not respectful of our boundaries as children then we will have difficulty managing our boundary, it may be too rigid or too woolly. Thus, we struggle to let our guard down and make connection with others (a rigid boundary). Alternatively, we may give away too much of ourselves to people we don’t know too well. We reveal too much or expect too much of others before they are ready to connect (woolly boundary).

If we are in a relationship that is emotionally abusive then the damage to our sense of self can be substantial. The boundary, that personal limit of our self, is damaged and like a wound to the skin it leaves a mark like a scar. If you listen to the vocabulary of someone who was in an emotionally abusive relationship the words recount this idea of breach or encroachment. “they cut me to the core”, “I was left bruised and battered”.

Boundaries matter; they allow us to be separate and they allow us to get close to people.

In the workplace, we may have our boundaries breached by bullying. The constant assault on the self by the abrasive manager may occur as a breach of personal space, standing too close, finger pointing and threatening body language. It can be breach of our work / home boundary, manifested by out of hours’ emails and texts that must be replied to immediately. The boundary between work and home is blurred, with the expectation that it is appropriate to breach these boundaries because the needs of the manager are more important.

Organisations may mean well but changes in a workplace will mean people must adjust their boundaries to accommodate new practices – yes, it seems petty and silly and the changes are meant to be economical and we need to have a flexible workforce (elastic boundary) but it takes time to adjust to the changes and sometimes a simple acknowledgement of the situation might help.

Besides, look at the CEO or the head of an organisation; they get to create a large boundary in their work environment, appointments are controlled and access to the boss is managed rigidly and they even get a private bathroom!

Perhaps the most important issue that arises in counselling particularly in trauma work is helping people to manage their boundary issues. When people experience a trauma such as an assault or a rape there is the most profound breach of boundaries at both the physical and psychological level. While the physical wounds might heal that terrible breach to the boundary of self is harder to heal and takes time to rebuild the sense of trust in the self and in others.

Boundary

When people are in emotionally abusive relationships, they are under constant attack from their “loved ones”, if they take down their defenses they will be wounded so they develop defenses that protect them. Sometimes the protection may come in the form of a discount “They do love me,  if I was a better partner they wouldn’t treat me like this”. In order to maintain the relationship they have to discount the self which is caught in a battle for survival. Alternatively, the individual shuts down emotionally to prevent further hurt and they become numb to the pain and isolation.

Yes, Boundaries matter because when they are breached they cause damage. Sometimes it is a traumatic rupture that requires substantial time to heal. Other times they might be a tiny little “paper cut” of a breach but over time they build up and cause pain and damage.

Take time to watch your boundaries. If you feel they are been encroached in work or at home, or if you feel you have difficulty maintaining a healthy boundary with someone then why not consider counselling? Counselling is constructed to create a safe and secure boundary for you the client, it is time limited and the counsellor is trained to respect and maintain healthy boundaries.

 

Introducing Coaching MO

Well I notice it’s been a while since I wrote a blog; there are a couple of reasons for that, the first is that I have been setting up my new coaching service and secondly I have started doing a piece of research on workplace bullying and both these processes have taken up my time. I want to say a little bit about these new projects as they are very much interconnected and very exciting new developments for me.

 

I will start with my research project; I am collaborating with a colleague of mine Dr Denise Borland at the Noble Institute in Edinburgh we are both interested in working with clients who experience workplace bullying. We are currently looking at the experiences of people who are bullied. Despite the wealth of literature about workplace bullying there is very little written about the actual psychological and physiological experience of the targets of bullying. How do they make sense of what is going on round about them and how do they feel about their situation?

This work is still in its early stages but one thing that I have found significant is that all the clients experience a high level of discount,

What is a discount? When I discount something, I ignore it or I do not notice it; it is a common process that we all do a lot of the time. Sometimes it is not a big deal but much of the time it has huge consequences for us.   I can discount at varying levels of severity, I can discount myself and I can discount other people and I can be discounted by others.

Let’s take something simple as an example; I am sitting in a cold room and wearing a T-shirt and I’m shivering, and when someone says to me “are you cold?” I might say “No, I’m fine” in this case I’m discounting my feelings of cold at the level of existence (the problem simply doesn’t exist).

I might notice that my hands are cold and I’m shivering so I acknowledge that it is a bit cold but I it’s not a big deal I’m fine. I have acknowledged that it is cold but I discount the significance of it.

I might then discount at the level of solution; I’ll just sit here and shiver instead of asking someone if I can put the heating on or could they close the window!

And finally, I discount my own capabilities I am wearing a t-shirt so I could simply put on a sweater or get up and close the window.

  • Existence
  • Significance
  • Solutions
  • Personal responsibility

These are the four levels of discount; the higher the level of discount the more difficult it is to resolve a problem. If I maintain I am fine sitting with a proverbial icicle hanging from my nose I will continue to feel the cold but when I take responsibility and put on a jumper, then I cease to discount the problem.

When it comes to bullying in the workplace the whole process is mired in discount; every party, the target, the perpetrator and the organisation frequently are discounting themselves and others.

The target discounts their experience by disregarding their levels of distress; they feel panic, they feel anxious and depressed but they continue to go into work every day. Clients will describe horrendous experiences of being criticised, ignored and ridiculed and yet they somehow go to work and try and ignore these feelings. Why might they do that?

One reason is they struggle to make sense of the environment because they are discounted by the perpetrator. One of the major processes that occurs in bullying is the manager (and I am going to focus on managerial conflict for the sake of simplicity) will simply discount their behaviour. If the target challenges the manager about something they will be met with a discount at existence level i.e. the manager will simply deny that it happened, so if they contradict the manager e.g. “you told me to have the task finished by 5 pm” the manager will say “No I didn’t; I distinctly said by lunchtime”

If they challenge the manager’s behaviour then the manager might discount at the level of significance, “you are being too sensitive” or “you are making a big fuss about nothing”

When discounting occurs at such high levels any solution or personal responsibility is going to be irrelevant the problem will continue.

Over time, targets struggle to make sense of their environment, their feelings of anxiety are telling them there is something wrong but the manager is telling them no it isn’t and so they feel as though they are “going mad” it’s sometimes called gas lighting and it is a common technique used in abusive relationships.

If an organisation fails to intervene and stop the process then targets feel discounted by their employer which further feeds feelings of mistrust and isolation. I think some organisations discount the targets by saying things like “are you sure you aren’t being a bit too sensitive” or “well we all have to work with difficult people – can’t you just get on with it” When they do this they seem to validate the perpetrator and normalise the experience.

Which takes me to the perpetrator; they discount at very high levels. There is a common perception that the manager is perfectly aware of what they are doing and some people may believe that they have malicious intent. However, there is a suggestion in the literature that many perpetrators of bullying do not have a clue about the impact of their behaviour. They lack self-awareness and they lack insight, they have no social sonar and so they are blinder than bats.

This takes me to my new coaching service. Last year I was fortunate to train with Dr Laura Crawshaw in Reykjavik and I learned about her coaching method for abrasive managers. What I love about her approach is that she confronts discounts in all parties. Her method empowers organisations to hold the manager accountable and the manager is also confronted with their discounts through detailed confidential feedback provided by the coach.

I now hope to start offering this service in Scotland, I will still be working as a counsellor and now hope to add coaching to the mix.

Dealing with Trauma

I have been reading a really great book “The Body Keeps the Score” by Bessel Van der Kolk, an American psychiatrist who is an expert in healing psychological trauma; he has an extensive research career and he is someone who is constantly seeking new ways of treating psychological trauma.

The Body Keeps the Score

The Body Keeps the Score

While perhaps a specialist text book it is nonetheless an interesting read and I was fascinated with his description of the biology of trauma in the early half of the book; he describes in detail the impact psychological trauma has on the brain and on the body as a whole. When people experience a trauma the injury is held in the body and is released only when the person able to feel psychologically safe to let the trauma go. For many people, getting to feel safe to let the trauma go is a massive task that requires substantial psychological support.

One other section of the book that I found particularly intriguing was his description of early childhood trauma. He stated that children who are exposed to an abusive or neglectful upbringing bear the scars of that upbringing into adulthood and it can have a profound effect on their behaviour as children and as adolescents too. He named it Developmental Trauma Disorder and stated that when children are exposed to severe abuse and neglect in childhood then certain behaviour and mood problems arise which include the following  symptoms:

  • Difficulty in regulating emotions (temper outbursts, feelings of panic, detachment and numbness)
  • Difficulties with concentration and attention (school becomes difficult as the child cannot sit still and concentrate)
  • Difficulties getting along with others; children have problems making friends and have difficulty interacting with others

Van der Kolk presents a more in depth rationale in his book so please don’t take my brief description as complete. He argues that an abused child is in a constant state of stress with hormones such as cortisol flooding their systems so that school activities that require paying attention and concentration and social interaction are all but impossible to achieve. As they enter adolescence and adulthood the impact of the abuse manifests as a variety of behaviour problems.

He was hoping this disorder would be included in the key mental health text book The Diagnostic Statistics Manual or DSM.  Published by the American Psychiatric Association (APA), the DSM is the “go-to” book to get a diagnosis and thereafter treatment.

However, when he and his colleagues attempted to have this disorder included in the DSM-5 it was turned down by the APA on the grounds that “the notion that adverse childhood experiences lead to substantial developmental disruptions is more clinical intuition than research based fact.

I found this completely bewildering when I read this; to me it would make sense to acknowledge the external factors that might affect child development.

In the latest edition, DSM-5, we find conditions such as Oppositional Defiance Disorder and Disruptive Mood Dysregulation Disorder; these are mental illnesses diagnosed in children and then treated by medication because they are ascribed a biological cause.

It would seem the APA consider is enough to pathologise behaviours which could possibly have their roots in abuse but not acknowledge the causes of abuse such as poverty, social exclusion and isolation, drug and alcohol abuse in families. It seems to discount the impact of life events and poor social conditions and prefers to see trauma as biological in origin that can be corrected by medication.

Many mental health professionals across the USA and indeed the world rightly complained to the APA about this omission but the fact is that it reflects a reluctance to account for social problems in healthy psychological development. Why might this be?

Van der Kolk emphasises the need for good social support for vulnerable children and their families and that means good early years provision, health visitor and social work support for families who struggle. And that means investment!

These are the services that are cut as austerity bites. We entrust nursery staff with our children yet it is considered appropriate to pay them a pittance. Instead of investing in staff so that children can have a good level of interaction we cut jobs so that staff have more children in their care and a large amount of paperwork they have to complete!

Social workers too are still being asked to manage ridiculously high case-loads in spite of the advice being that they should manage a number often less than half of what they actually do. Why? Because posts are not filled when social workers retire or leave and cuts to social service budgets mean they are not replaced (and they have a lot of paperwork too!)

Health visitor who might be able to pick up problems in a family are too harassed to spend time talking to mothers who are struggling as they have targets to meet and guess what they have a lot of paperwork!

Perhaps I am getting cynical but might a government trying to save money not find it preferable to frame the difficult behaviour of children and their lack of affect regulation on a biological cause? It is certainly cheaper than going with evidence that suggests greater financial investment in a child’s early years will result in psychologically healthier adolescents and adults.

Investment in children at a young age will reap dividends in the long run as healthy adults they will be able to work and contribute to society.

We forget that income tax funds these vital public services and the companies that avoid paying tax are withholding money that could be invested in vulnerable children. In the week following the publication of the Panama papers it would seem that people are getting rightfully tired of others avoiding tax. Don’t we need to start seeing income tax for what it is? A means of funding vital public services. Nobody likes to pay tax but it’s not an injustice and it’s not a punishment it’s the only way currently we know as a society to finance public services.

 

 

 

Mental Health and the Medical Model

When considering the history of mental illness it may seem to have come a long way from the days when mental illness was assumed to be the result of demonic possession.
The current treatment for mental illness has mostly been shaped by what is called the medical model; it dominates modern mental health and informs modern psychiatry and psychology to a substantial degree. It identifies mental illness as biological in origin and therefore it should be treated as a biological issue. Just as we display physical symptoms which lead to a diagnosis and treatment (medication) the same goes with mental illness; we experience symptoms which are diagnosed by a psychiatrist and then treated by medication or other treatments.
Take depression; the medical model would tell us that it is the result of a chemical imbalance in the brain. Therefore an anti-depressant is the best treatment to restore the balance and the depression goes. Depression may also be a genetic therefore we inherit this illness from our parents.
However the model has its critics, in a recent Guardian Article psychologist Richard P Bentall argues that mental illness has also got its roots in environment and experience. Bentall has a wide-ranging research background in mental illness and has written extensively on the subject of trauma in our lives and the correlation with illnesses such as depression and schizophrenia. In the Guardian article he argues persuasively that we need to account for personal traumas and negative experiences in our lives and rather than see mental illness solely as a manifestation of physical illness we have to account for the importance of life experience in shaping our brains.
So does my early childhood experience shape the wiring of my brain such that I am more prone to depression? Or was my brain wired through a predetermined genetic pathway so that I would respond negatively to events in my life?
If a mother is depressed does she pass that genetic trait onto her children or does her experience of being depressed influence her child’s mental health by wiring their brain in such a way to make them more vulnerable to depression as adults?
People may answer and say that not everyone who is depressed had a bad childhood and they would be correct. They might suggest that the person was hard wired to believe negative things (due to a genetic predisposition). But, how do you prove that the chemical imbalance creates depression and not the other way around that depression (holding negative beliefs) causes a chemical imbalance in the brain?
I find the argument of a reductionist medical model that sees all mental illness as having its roots in abnormal brain physiology and biochemistry as too simplistic.
Environment must have an impact on a young developing brain and therefore any treatment plan has to find a way of accounting for that experience. Designing a drug to alter brain chemistry is not a bad thing indeed it can be necessary to the individual’s survival but I believe we need a more holistic treatment of mental illness; the trouble is it is expensive and it takes time. And that is something we don’t seem to do these days.
In this age of austerity can we really ignore the impact of government cuts on mental health services?
Mental health services in the NHS are being cut, access to talking therapies and other treatments and support are become harder to access and waiting lists are longer.
Adhering to a medical model might mean that all these “add-ons” are not necessary and that medication is the solution. We invest in new drugs – problem solved, but medication is only part of the solution.
Mental well-being is not achieved overnight and medication doesn’t make the problem go away; whatever is making me depressed is not going to be fixed by a drug. The anti-depressant isn’t going to magically make my life better, it simply let’s me tolerate my situation with less angst. We paper over the cracks in our lives rather than look at the roots of our pain.
We have to consider the bigger picture and contemplate if our society is creating the conditions needed for mental well-being?
I sometimes wonder if we treat people with mental illness any better than we did in the past. Certainly we have made fantastic advances in the field of physical medicine but when it comes to mental illness in the 21st Century are we really doing a better job than those who exorcised the mentally ill?
When we have a society that stigmatises mental illness and is reticent to create the conditions for mental well-being then we really aren’t doing any better than our unenlightened forbears.

 

Coming to Counselling

Product of our past

Product of our past

As January comes to a close, the Christmas holidays probably seem like a distant memory but for some the holiday season highlights aspects of their lives that are unfulfilling and unsatisfying. Spending Christmas with family members that we normally don’t see regularly can bring up unpleasant memories of the past and old patterns of interaction are rekindled i.e. we end up feeling unhappy and perhaps even angry at the way life has played out.

Perhaps as a New Year Resolution people decide to make some positive change in their lives and opt for counselling.

What can someone expect from counselling?

If you think about it, counselling starts as a meeting with a complete stranger, this person doesn’t know anything about you but suddenly you are being asked intrusive questions that you wouldn’t disclose to your best friend. So why do people submit quite readily to this set up?

One of the reasons why it works is confidentiality; this is the bedrock of the counselling relationship. The first thing I normally explain to a client is that nothing they disclose to me will be revealed to anyone (unless there is a risk to health of self and others). Secondly the issue will only be discussed between us within a set time period (the session time). These boundaries help to anchor the counselling process in a safe healing environment where people can feel safe to say the un-sayable.

As your counsellor I am not there to give advice or to pass an opinion on you or your behaviour. Who am I tell anyone what to do? I sometimes struggle with making decisions and I get emotionally impacted by family dramas so I am not really in a position to be handing down advice. But I am prepared to accept what you say as important to you; you may have been told it is a petty worry or a minor issue or (my favourite) you may have been told to “just get on with it”. If something is causing distress then it is important because as is frequently the case, the distress will start to impact your health and your relationships with others.

When you come along to the session you know you can say anything and not be judged or shamed, but what happens in that therapeutic interaction that makes the difference?

I think there are lots of answers to that, perhaps it is the confidential space where anything that can be said, the acceptance and lack of judgement. There is much research evidence to suggest that the single biggest predictor of success is the therapeutic relationship with the counsellor. Therefore it is really important to find a counsellor with whom you feel safe and respected.

Sometimes people will ask me how long will counselling take – till I am better? The italics are perhaps the implied message people are really asking.

People are familiar with a short term model that might be available during workplace counselling. Since I do a lot of short term counselling I am aware that change can be made in 6 sessions but there is no guarantee.

People come to counselling with varying degrees of pain and distress and there is no predicting what will work quickly or what will require a lot of time. Not every client has the same background and not all clients come with the same internal processes.

This brings me to the notion of “Cure”: in Transactional Analysis, Eric Berne was not shy to talk about curing his clients and he describe cure as occurring on 4 stages

  • Social Control
  • Symptomatic relief
  • Transference Cure
  • Script cure

The first stage of cure is social control where the client starts to feel safe and act safe. For some clients who feel suicidal or who may want to self harm this is the first stage to treat. When clients feel safe with the counsellor they will start to act safer, the risk of suicide may reduce or they may start to drink less and they will start to take care of themselves better.

Symptomatic relief is more obvious; the client will start to feel better and many of the symptoms of distress will go. So sleeping improves they feel more buoyant and calmer. Perhaps anxiety symptoms such as panic attacks will abate. There is not too much reflection on the past and a lot of time it is about working in the here and now and giving people coping strategies.

In my opinion, most short term counselling will get you to the point of symptomatic relief. You feel more upbeat, you feel calmer and so you may decide to finish counselling at this point. This is something I see frequently in workplace counselling where sessions are limited to 6- 8 sessions; the client feels much better and so it is appropriate to stop. Sometimes it takes a little bit longer there is evidence that 50 % of people will see a significant relief of their symptoms with 11-18 sessions of counselling*.

Healing

Healing

What about the other aspects of cure?  These latter stages apply to people who want to make deep personal change. Sometimes the wounds are deeper and therefore healing takes longer.

It will involve looking at the past with a view to making peace with the past. Perhaps someone has experienced a neglectful traumatic past and the impact of their childhood is impacting on their ability to form relationship with others. They may have experienced a trauma in their lives. Sometimes we picked up negative messages from our families as we grew up and these messages contaminate our Adult reasoning. Eliminating them make take time especially if we have invested heavily in maintaining these messages.  If you spent thirty years maintaining these beliefs then is it feasible to be shot of them in 6 sessions? The work of counselling might take a lot longer but over time the client can be reconciled with the past and develop new ways of interacting with others.

 

* Kopta, Howard, Lowry and Beutler: Journal of Consulting and Clinical Psychology, 1994

Widdowson: Transactional Analysis Journal, October 2011

 

 

 

Blame and Responsibility

As I read the blogs I have written in 2015 I wondered if there was a way of tying them together. Was there a theme or something that might connect what I have written across the year?

I have discussed workplace bullying frequently and the impact this has on mental health. I also described the narcissistic process and the ok corral where I explained how we can be respectful and valuing of ourselves and each other. I discussed attitudes to rape and sexual assault and whistleblowing.

One of the ideas that I think unites these articles are the concepts of Blame and responsibility

Nothing to do with me

If we follow the news the word “Blame” will come up a lot. Who is to blame? It’s your fault? There is a blame culture in this organisation.

Blame is something people try to avoid because it is normally deeply associated with shame. If I get blamed for something then I will feel ashamed and I will receive the condemnation of others. It is all very unpleasant and horrible.

When I take responsibility for my actions it is empowering, furthermore we can really only take responsibility for ourselves. As I mentioned in my blog on rape and sexual assault, a person cannot take responsibility for other people’s actions. So the victim is not responsible for the actions of her attacker. We can only take responsibility for our own actions.

When I blame others, I am not taking responsibility for my role in the process. I am trying to keep myself OK by condemning other people. If it is their fault then I do not need to do anything, I don’t need to change my behaviour and I can continue to behave as I always do with impunity.

The blaming role is very prevalent in bullying – the perpetrator invariably blames other people (normally the target) for their own shortcomings. Rather than accept responsibility for mistakes or problems they choose to shift the blame to another person and in that way they stay feeling ok and they do not need to put any effort into solving the problem. Meanwhile the problem continues to grow like a cancer getting bigger and bigger and like a large tumour it becomes harder to treat.

 

We are often guilty of blaming ourselves too. Sometimes we strike up a negative self talk in our heads, where we tell ourselves that everything is our fault, we are to blame. This crushing monologue is prevalent in people with depression; they blame themselves often for the shortcomings of others. I may tell myself that I wasn’t smart enough or I wasn’t pretty enough – and if I had been then people would have accepted me.

This lets other people off the hook, often our own families and friends who have let us down and failed us in some way.

We hold ourselves as “bad” rather hold them accountable for their actions that way we get to preserve our relationship with them, albeit a rather toxic relationship.

Again in the bullying dynamic, the target often takes the blame in the process. They may say “I should have worked harder” or “I shouldn’t make such a silly mistake” meanwhile they are discounting their skills and talents and they are also discounting the mistakes of the perpetrator.

Its all your fault

Responsibility feels much more comfortable and mature. When I take responsibility I am accounting for my skills and talents and I hold myself accountable for my actions and I will still feel competent and capable.

Think how much healthier organisations would be if people took responsibility for their successes and more importantly their mistakes, instead of shifting the blame to others in an effort to look righteous. If people took responsibility for their mistakes in the workplace then there would be fewer mistakes made because people would know it was safe to own up to them without fear of shame and ridicule. Responsibility would create culture of accountability which is healthier; problems would be identified and resolved quicker.

Businesses, Hospitals and Social work services would be able to rectify mistakes in an atmosphere of collegiality and co-operativity instead of blaming and bad mouthing some poor hapless fall guy who has the misfortune to be at the end of the queue when the blame is being passed down.

We also have to take responsibility for our role in these games, it is so easy to blame someone else for our faults and failings, be it our partners or our friends. We get to push our horrible feelings of shame and dump it on others – great we feel  exonerated and justified our “terrible” partner or our “hapless” friend can take the blame – all is good. But soon the shoe is on the other foot when we find we are on the cutting edge of someone’s blame game.

Blame doesn’t work, it solves nothing and it is counter-productive.  The great thing about responsibility is that you are in control, there is nothing to feel shame about. It is healthy and productive. Oh I think I feel a New Year resolution coming on! Merry Christmas Everyone!!

Paulo Coelho Blame

Research Project on Workplace Bullying

I am using this blog to advertise for research participants in a study I wish to undertake in relation to workplace bullying .

Research Project

Workplace bullying is an insidious and destructive interaction that has no place in the modern workplace and yet it not only persists, it seems to thrive. The interpersonal dynamics that occur between the target and perpetrator are the subject of ongoing research throughout the world and we know much about its prevalence and the negative impact it has on the health of individuals and the productivity of an organisation. Much of the data has come from large scales survey type studies but there is also a lot of data derived from small qualitative studies that explore the impact of bullying on the targets.

I am hoping to carry out a small scale exploratory study where I wish to investigate the psychological impact of bullying on targets and then possibly apply the experience to the concepts of Transactional Analysis (TA). TA is a particularly effective counselling strategy and the concepts can be applied to individuals and organisations and so I hope to use these psychological concepts to explain the interactions that occur in workplace bullying. I have no expectation or anticipation about what will emerge from the research but what I do learn, will give me a greater understanding of this interaction. I hope to apply what I have learned to clients who experience workplace bullying so that I can offer better counselling service.

Research Format

Since this is an exploratory study I want to use a protocol that invites the participant to describe their experience without any preconceptions or bias from me, the researcher. The proposed format of the research is an Interpretive Phenomenological Analysis (IPA) which allows the voice of the participant to be heard and their experience to be analysed for underlying commonalities and themes by the researcher.

I will be recruiting approximately 4 participants for this study (maximum of 6, minimum 3) and each will be asked to complete two questionnaires and undergo a recorded interview (in person preferably or by Skype).

Each interview will be transcribed by the researcher and then analysed in detail; underlying themes from these interviews about workplace bullying and personal experience will be collated by the researcher to conceptualise the bullying experience in relation to TA. In order to prevent personal bias and to maintain impartiality a second researcher will also be invited to analyse the anonymised transcripts (and only the transcripts) for particular themes.

Anonymity and Confidentiality

Confidentiality is absolutely essential to this project and must not be compromised. It is my duty as the researcher to ensure your confidentiality and the confidentiality of your employer; therefore all data will be anonymised and purged of identifying features.

There are no names; participants will be referred to as P1 and P2 etc. roles will be described in non-specific terms such as teacher, healthcare worker or manager and the organisation will be described in terms such as school, public sector or private company. Since I may interview 4 participants from across the UK, I intend that nobody will be identifiable.

I am interested specifically in your personal experience (what you feel and think), the functioning of the organisation and the day to day work practices are not really relevant to the research so I will not be focusing on practice.

You may also have signed a confidentiality agreement with your employer in which case you may be wary about participating;  I do not want to compromise that agreement and if the assurances of anonymity are not sufficient or they may not meet the agreed legal requirements then please do not participate.   You may want to check your position with a lawyer or union and seek advice from them.

What Happens Next?

If you are interested in participating then please get in touch via my website, www.amaranthcounselling.co.uk  I can interview people by Skype if you do not live locally. I am aware that for people who have been affected by bullying, talking to a stranger is really daunting, (especially if it’s going to bring up a lot of unpleasant memories) and so I will really appreciate your participation and will do my best to help you feel relaxed. You may want to get in touch for more information and a chat please let me know and I will arrange a time for us to chat. It hopefully will give you a chance to discover if this is something you want to do.

Since you may find the interview distressing as you recount some of your experiences so please make sure you have support either from friends and family or perhaps from a counsellor. Although I am a counsellor I will not be counselling you and my role in the interview will be to simply ask questions and possibly seek further clarifications. If however you do feel it is too much for you please let me know and I will move to close the interview and make sure you are feeling better before you leave.

If at any point you decide you do not wish to participate your details and data will be removed from the project and destroyed.

If appropriate this work will be written up for publication in a specialist journal so that other counsellors and health professionals might read and learn from our work together.

If you have experienced what you consider to be workplace bullying in the recent past and would like to participate in this project please get in touch. If you have any queries or concerns about the work and need reassurances from me then please get in touch via my website.

 

Agency and Autonomy in the Workplace

October is world mental health month and when I read that 1 in 4 of us will experience mental health problems in our lives I am aware that the workplace can seriously affect mental health, in particular when we consider the impact of the government’s “austerity agenda”.

Whatever is thought about the austerity agenda for me the one important issue is that austerity seems to hurt the most vulnerable in our society. Those who are without a job or who are in low paid work seem to suffer the most.

Stringent cuts in public services have meant that the people working in the public sector have to do more with less. Budgets are very tight and the pressure on staff is significant, when people leave they are not replaced but the job still has to get done. Many in the public sector don’t earn a lot of money with salaries close to minimum wage in many cases.

In the private sector there is much made of the large multi-million companies who pay their staff minimum wage and commonly use zero hour contracts to avoid paying sick and holiday pay and it is not uncommon to find that individuals are actually living below the poverty line, unable to make ends meet because their salaries are inadequate.

Psychologists against Austerity have recently published a paper which identifies what they describe as Austerity ailments; the presence of these ailments in a person’s life will increase the likelihood of depression and anxiety: these ailments are

  • Shame and humiliation
  • Insecurity and instability
  • Fear and distrust
  • Isolation and loneliness
  • Feeling trapped and powerless

For me, the most significant ailment was humiliation and shame; the humiliation of losing a job can increase the likelihood of depression and perhaps unsurprisingly the most frequently reported emotion of food bank users is shame.

At the recent Tory party conference, Jeremy Hunt spoke at a fringe meeting about the cuts to tax credits and in regard to people who have an income supplemented by tax credits he implied that they lost self respect since part of the payment came from the benefit system. He stated “It matters if you are earning that yourself, because if you are earning it yourself you are independent and that is the first step towards self-respect. If that £16,500 is either a high proportion or entirely through the benefit system you are trapped. It is about pathways to work, pathways to independence … It is about creating a pathway to independence, self-respect and dignity.”

Jeremy Hunt probably experiences work as something fulfilling but this is because he has a high degree of control over his work, what is described as Agency and Autonomy.

Agency is when a person feels in control of the job and has motivation and the capacity to make decisions about the way to work. Autonomy gives the individual flexibility and freedom to control their work; they can make decisions and have a stake in the organisation.

Agency and Autonomy create a strong “Internal locus of Control” where the person feels engaged and they have a sense of mastery and that generates self respect.

Given these circumstances, work can give self respect but what Jeremy Hunt discounts is the lack of agency and autonomy an employer gives to the employee when they are paying them low salaries.

In my opinion, many modern work places seem hell bent on limiting agency and autonomy in their employees. When you are working long hours, with few breaks and you have to ask permission from a supervisor to go to the toilet you don’t have autonomy. If your opinion counts for nothing in the organisation and you are shouted down and told to just do the job then you have no agency.

If your employer pays you a miserly wage while they reap in millions in profit what does it say about how they value and respect for staff? When companies fail to pay a living wage to their employees yet they generate huge profits and dividends for shareholders then I personally don’t think they demonstrate much respect for their staff.

Respect is a two way street; if you want your employees to be invested in your organisation then surely you have to demonstrate that you are invested in them and that means treating them with respect and paying a decent salary.