Whilst writing the preamble to the first chapter in his book ‘Relational Patterns, Therapeutic Stance’, Dr Richard Erskine talked about [clients] integrating, through therapy unresolved aspects of their egos and self. This was in order to enable people to “… have the courage to face each moment openly and freshly, without the protection of a preformed opinion, position, attitude or expectation.”

This sentence caused to me reflect upon many of my own past encounters with clients and friends (and some not so friendly), and wonder exactly why we need this as a protection. I immediately saw the truth in his words, and see people responding in this prescribed fashion all the time… in particular with politicians in this current time of pre-election hustings. They have carefully worded scripts and have been taught techniques to stop interviewers interrupting them. This often works as many interviewers are fearful of being seen as overly pushy or rude when they do try to get a clear answer. When they do manage to ask a question of the MP that they clearly don’t know the answer to / don’t want to answer, they are then trained to answer with another question whilst giving the impression that they are actually answering.

Of course many of us, not just politicians use this protection too. But protection from what? We use protection (think armour, castle walls etc.,) to keep us safe – but safe from what? Why is seeming to have a ready response / valid opinion to hand deemed so important? Why is ‘knowing’ how we should act or respond in not just any but seemingly every moment so vital for so many people? Why does their sense of being okay seem to rely on this ability? I hope to attempt some answers to these questions below.

Firstly I will look at what actually happens following a question being posed, an opinion sought or a response requested. In many different scenarios, I have witnessed people wallowing in a self-constructed internal maze, as they seek to mitigate the ‘surprise’ of the request with an immediate response. Or seek to find if they do in actual fact have an opinion about whatever the subject may be… and if they do not, attempt to formulate one quickly. This strikes me as a recipe for the inevitable disaster that follows, often accompanied by a stuttering, spluttering attempt at coherence. (Of course there will be plenty of times when an answer is known, or an opinion already formed and tested… but those times are not what this blog is about…)

Whether in the training room, therapy room or down my local with friends after work, I observed what appeared to be a familiar sequence of events; when someone, let’s call them the inquisitor asks a question of someone else, let’s call them the responder, and an answer is not easily or immediately forthcoming the exchange would follow a familiar format:

• The inquisitor poses a question or asks for an opinion
• A (usually) immediate initiation of starting to formulate a response on behalf of the responder – often starting with the word ‘so’… (of which more later)
• The responder stumbles about in their self-built maze as they try to answer, or formulate a viable opinion
• Resulting in confusion, as they realise the sought after response might be outside of their ken

What happens next is either:

• The responder starts to exhibit signs of shame as they struggle helplessly in a sticky web of words of their own making. Shame is usually indicated by a reddening of their features, head down, down-cast eyes (or a frantic looking to the left and right as if seeking for an escape route) or an abrupt attempt to change the subject.

Or:

• The responder starts to display signs of anger and defensiveness, usually indicated by a more belligerent tone; “Yeah, well if you’re so bloody clever, why don’t you enlighten us smart arse?” or an explosion of expletives… occasionally a more [physically] violent outbreak might ensue.

An important question though, is why do some people seem to believe they should have [to provide] an immediate response – this is clearly a belief introjected from some source close to them earlier in life … but where, or from whom? This alone throws up a myriad more questions … is it a ‘face-saving’ behaviour? Is this an adaptation from childhood or simply a form of narcissism? Is it an attempt to mitigate feelings of inadequacy, worthlessness and shame? … And what can we do about it?

One simple answer is to identify and own this behaviour for yourself, then explore with a good therapist the aetiology of why you do it – and how you can change your (automatic) response. Often people seeking to find an answer in the here-and-now, paradoxically look for their answer in the there-and-then. In other words, falling back onto tried and trusted options that have worked before, or adopting known positions of defence. Even more paradoxically, I believe that staying in the here-and-now is an antidote to this situation. This, though is what politicians (and others) are desperate to avoid, and why they are ‘rehearsed’ tirelessly by their ‘minders’ prior to a TV appearance for example, to trot out pre-formed answers, seemingly in this run-up to a General Election mixed nowadays with lies, or out-and-out avoidance of providing an answer.

But back to staying in the here-and-now, whilst this approach has its dangers (inasmuch as we can never know the result of any intervention we may make) precisely because we don’t have the protection of that ‘pre-formed opinion, position, attitude or expectation’ that Richard Erskine was talking about I mentioned at the start of this blog. That brings the attendant possibilities of shame and /or anxiety into the equation, and has been noted by many other authors elsewhere (Ken Evans, Gershen Kaufman, John Bradshaw et al) shame is the one emotion we put more energy into avoiding feeling than any other; Ken called it ‘the master emotion’. However, the here-and-now can also provide us with the ability to think creatively, form hypotheses, risk thinking something new and chewing over this newness whilst maintaining contact with others, ourselves and the newness.  
​
Preformed opinions risk dogma, we trot out the same old safe and tried-and-trusted responses we know work for us. If we don’t take risks we will never grow, change and become more of who we are / can be.

If you are interested in learning more about staying in the here-and-now, you might find the two day workshop detailed below of some interest...

Pete Lavender


Embodied, Relational Dialogue within Group Process
 
This two-day weekend workshop will be facilitated by Pete Lavender and Lydia Noor.
To be held at Scarborough Counselling & Psychotherapy Training Institute
 
29 February and 1 March 2020
10am to 5.00pm on each day
 
Cost: £145
Book before 30 January for early bird fee of £135
 
Pete and Lydia have been co-facilitating group process, for over ten years.  Throughout this time, we have become more and more interested in our here-and-now   embodied relational response, both to each other and towards group members.  We are committed to creating a safe, holding and shame-free space within which we invite you to explore aspects of your own process. 
 
Following an exciting and rich workshop which we co-facilitated at the recent MIP conference, the weekend will contain experiential exercises on the themes of compassion and heartlessness, hope and despair, love and hatred, if other polarities arise, these may be explored as well. We will discover what arises in the between of relationship as well as providing opportunity for individual work as it arises.  Although embodied relational dialogue can be challenging, it is also extremely supportive of health, growth and change.
 
For a place on this workshop, please contact Lydia on 07841 133426 or Pete on 07930 371369 or by e-mail on [email protected]  

ith the colder weather and the darker nights, the mid-winter festivals are a time to nourish ourselves. Yes, with good food, but also with good company, good conversation, stimulating discussion. This might also be a time to look forward and make plans for the new year. SCPTI has a range of continuing professaional development courses and workshops which will nurture and offer the possibilities for a widening and enhancing of our practice as therapists.

​Please contact [email protected] for more information or to book onto any of the courses below.

Attachment in Psychotherapy – theory & practice with Pete Lavender: seminars #2 & #3
Dates: 18th February 2017 (early bird 22nd December 2016) & 1st April 2017 (early bird 2nd February 2017); 930am-430pm. Fees: members £75 (eb)/£95. Non-members £90 (eb)/£110

Following on from the successful seminar #1. Can be attended even if you have not attended the first. Much research and scholarly study has been conducted into patterns of human attachment and development (see Bowlby, Stern, Winnicott et al), and much has been written about its application to counselling and psychotherapy, (see Wallin, Holmes et al). These seminars aim to explore what these theories mean for us as therapists and how (do?) we apply them to our practice.

Pete Lavender is a Director of SCPTI, course leader, supervisor and has nearly 30 years’ experience working with clients in both private practice and general practice in the NHS.
 
Here are some appreciative comments from his recent seminar held at SCPTI looking at the Role of Shame in the Borderline Process:
'Your workshop was timely, I was able to use some of what I had learned when I saw a client shortly afterwards. Due to what I had taken from your training, my client was able to say that our session was the most in-depth, difficult and powerful time he’d had with anyone since his recovery from addiction and trauma.' (Emily B)
'Refreshing, exciting, informative – meaningful CPD which will support clinical practice.' (Monika A)
'The workshop was full of richness, making a difficult and sensitive topic very interesting. Fascinating and rewarding on a personal and professional level.' (Paul C)
 
Some comments from Attachment Seminar #1
'Interesting workshop about a fascinating topic that underpins our work as therapists...'
'Exceeded my expectations - thank-you.'
'The training is very good - a definite must.'
'...we all - not just therapists , would benefit from a good understanding of attachment theory.'
 
 
Cognitive Behavioural Therapy – a relational approach with Neale Haddon
Cognitive Behavioural Therapy (CBT) has been both feted and decried in equal measures. Originated by Dr Aaron T Beck in the 1960’s it was hailed as a break-through in psychological health and well-being, and Beck was quick to bring in quantitative research proving the effectiveness of the treatment. Some practitioners of other approaches dismiss the use of CBT as being little more than a ‘sticking plaster’, which might show good short-term results, but the perception is that long-lasting relief of symptoms is a rarity. One of the tenets of CBT is that it works in the here-and-now on present day problems, focussing on physical feelings, behaviours and thoughts. It tends not to explore the childhood issues that may well be the cause of the client’s current problems, and the relationship between the client and therapist tends not to be the focus. (However, it is a misperception to think that a client’s historical issues or the therapeutic relationship are not domains that are utilised by CBT, especially in longer-term work.)
 
CBT is here to stay, and in the hands of a skilled practitioner can be valuable to some clients. At SCPTI we want to offer an enhanced version of CBT; RC-CBT or Relationally Centred Cognitive Behavioural Therapy. There is little doubt amongst professionals now that one of the most important part of any form of therapy is the relationship between therapist and client, indeed there are some who believe that the relationship is the therapy. SCPTI has got together with Neale Haddon (biography below) to design a CBT course focusing on the relationship as a central part of the therapy whilst still adhering to fundamental CBT principals. We have applied to the British Association of Behavioural and Cognitive Psychotherapists (BABCP) for the route to accreditation of our course; because the concept is such a new one and a radical departure from the ‘normal’ route to CBT practitioner accreditation this is taking quite some time.
 
However we would like to start the process anyway. To gain BABCP accreditation, practitioners must have completed a two level training course, successful completion of level 1 being mandatory prior to acceptance on level 2. Because of the uncertainty as to whether BABCP will give us the accreditation we are starting with Level 1 as a seven module CPD programme. People intent on gaining a full BABCP accreditation must attend all seven weekends. Others who may be interested only in learning to work with specific aspects of mental health (Social Phobia for example) can choose individual workshops.

Neale Haddon is an experienced and accredited Cognitive Behavioural and Gestalt Psychotherapist, Supervisor, Consultant and Trainer, with over twenty years’ experience in both the public and private sector. Alongside his thriving private practice he developed and currently runs the innovative specialist OCD & Anxiety group therapy programme for Nottinghamshire Healthcare. He is a Clinical Supervisor for psychological therapy professionals nationally and an academic Supervisor at Nottingham University. An accomplished musician, Neale has always had a strong interest in the collaboration between the arts and the sciences.
 
Programme
MODULE I: FUNDAMENTALS OF RELATIONAL COGNITIVE BEHAVIOURAL PSYCHOTHERAPY: 4 DAYS / 2WEEKENDS
Feb 4th - 5th 2017, 930am-430pm (early bird 8th December 2016): Fundamentals of Relational CBT - context, theoretical basis and application. The importance and place of the Relational component of CBT – philosophy and values. Assessment & suitability. Structure and process.
Feb 25th - 26th 2017 930am-430pm (early bird 5th January 2017) Formulation; cognitive interventions; behavioural interventions; the Scientist Practitioner approach & standards of practice  Advances in CBT theory and research
 
MODULE II: WORKING WITH SPECIFIC CLINICAL PRESENTATIONS - 10 DAYS / 5WEEKENDS
13th - 14th May 2017, 930am-430pm (early bird 16th March 2017): Depression & Specific phobias.
17th - 18th June 2017, 930am-430pm(early bird 20th April): Panic/agoraphobia & Generalised anxiety disorder.
15th - 16th July, 930am-430pm(early bird 18th May): Obsessive compulsive disorder & Health anxiety.
9th - 10th Sept, 930am-430pm (early bird 13th July): Post-traumatic stress disorder & Social phobia.
14th - 15th Oct, 930am-430pm(early bird 17th August): To be confirmed.
 
Fees
To undertake the whole 14 day level 1 certificate as a prelude to moving to level 2: £1500. You will have to join as a member of SCPTI (£35 per year) & fill-in an application form (downloadable from website)/be interviewed.
 
Individual weekend workshops early bird rates*: members £215; non-members £245
Individual weekend workshops standard rates: members £245; non-members £275
* Early bird rates expire 8 weeks before the start date of each workshop
Please contact [email protected] for a booking form. Thank you.
 
 
Brief & Focal work – the relational approach. With Neale Haddon & Tim Carrette
Six CPD days building up into a certificate looking at how to work relationally within a setting which demands a brief and focal approach. Both tutors work within the NHS. They will be exploring the topics through two differing lenses: the existential relational model; and the CBT relational model.
 
Dates: March 10th/11th 2017, 930am-430pm (early bird 12th January 2017); 29th/30thApril 2017, 930am-430pm (early bird 2nd March 2017); workshop #3 TBC.
 
Fees: TBC.

In 2014 there were around 6500 suicides in the UK, the rate was highest for men aged between 45-49 and in 2014 the female suicide rate in England was at its highest for ten years (source: Samaritan website).

​This month is an opportunity for all of us to think about how we can take small steps to prevent suicide. Here are some thoughts:

(1) It's a common myth that by talking about suicide we are increasing the likelihood of it happening. This is not the case. People who are able to talk about their suicidal feelings are less likely to kill themselves. If you know someone who is struggling, talk to them. If you are struggling, ask for help.

​(2) Suicide may not be about wanting to die, but more about wanting to 'have a rest' from current feelings or a present situation. Being supported by an empathic friend or professional can be enough to get someone through the moment of crisis. It's not about trying to persuade someone who is feeling suicidal that all will be rosy tomorrow, more about suggesting their worst feelings/fears may not last.

​(3) Finding a way to 'have a rest' from difficult feelings can help, this may be doing something pleasurable with people who care. Taking drugs or alcohol is not recommended, as both have depressive (and other) side effects.

​(4) Knowing people will truly care if we're not around can also ease some of the desire to die.

(5) It's hard to listen to someone who is expressing the wish to die, but if you can do so without criticism or judgement then this can help. Also seek support & advice eg from a GP or other health professional or from the Samaritans (phone: 116 123; or email [email protected]) or another crisis line.

Exploring a Gestalt approach to sexuality within the therapeutic setting
CPD workshop with Tim Carrette: 24th–25th September 2016
​
Fees: members SCPTI, early bird (before 15th August) £135/non-early bird £165
Non members SCPTI £175/£205
 
“As therapists one of our challenges is to be present in a way that creates a relational field that will allow for and have the capacity to tolerate the emergence of erotic energy.” (L O’Shea, BGJ 2003.)
 
Both Relational Psychotherapy and Gestalt Therapy emphasise the need to be authentic and whole in our approach to the world as therapists and human beings.
 
Historically psychotherapy training has often excluded sexuality from the training syllabus and minimised its presence in the therapeutic setting for fear of its ethical and potentially abusive misuse. Such repression is exacted at a steep price; the loss of relational aliveness and contactful energy, when ‘all’ that is needed is courage, honesty, good quality training and some very clearly negotiated and held ethical boundaries.
 
In this workshop we will create a safe environment in which we can explore our whole selves including our relationally alive sexual selves; our boundaried creative self and our whole authentic being.
 
Through relational group process, theory, practice and gentle movement we will seek to demystify and normalise sex, to empower ourselves with our existential choice. We will seek to reduce intra-, and inter-, personal tension. Through these processes we aim to develop an understanding of our whole naturally responsive and authentic self.
 
Tim Carrette is an experienced UKCP registered Gestalt Therapist, Supervisor and Trainer at SCPTI. He specialises in both Sexuality and Spirituality in the therapeutic setting, and has taught these workshops throughout the UK and Europe.
 
Venue: Scarborough Counselling & Psychotherapy Training Institute
     

There's a big banner in my local library which says 'Shelf-Help' and 'Books on Prescription'. My library, like many others around the country, is part of a scheme whereby people in emotional and psychological distress can be pointed towards or 'prescribed' a book.

​There's a lot to be said for this scheme - at least it's not drug lead and it gets people into their local library - but (and, in my view, it's a big 'but') I am disappointed with the range of books on offer. They are all self-help books, the majority Cognitive Behavioural Therapy oriented. Of course, self-help and CBT books have their place, but they are by no means the only books which can support people find a way forward. Where is the poetry? Where is the fiction?

​In research, it has been found that both reading and writing poetry and fiction can assist people to feel more confident about themselves, as well as gain a wider perspective on their experiences and other people's behaviour. Neuroscientists have identified what have been termed 'mirror neurones'. These are neurones in our brain which are activated when we see an emotional response in another person and they govern our response. So if we see someone who is upset, the activation of our 'mirror neurones' mean we will also feel upset, we will feel empathy. The same activation of 'mirror neurones' has been found to happen when people read about a particular emotion in a poem or a piece of prose.

Neel Mukherjee, shortlisted for the 2014 Booker Prize, suggests: ‘What should the novel do: be a mirror to the reader’s world, reflecting it back at her, or be a clear pane of glass, not reflecting but offering something away from the self, a vista of a bigger, wider, different world outside? The moral energy of the novel form derives from its capacity to imagine the lives of others. This empathy can be seen as the beginning of the moral sense.’

​Reading groups for people who are dealing with emotional and psychological distress have been found to aid recovery. Yes, there is the sharing within the group which (when carefully handled) is therapeutic, as is the act of getting out into a different environment, meeting new people. But the reading itself can encourage a sharing and an understanding of experiences, along with an empathy for self and others. Often, when people are beset by depression and anxiety it is the empathy for self which is woefully missing.

​What a shame then, that people cannot be 'prescribed' Staying Alive (Bloodaxe Books) a wonderful anthology of poetry about and by those who have struggled through loss, illness, depression and the other emotional challenges life throws at us. Yes, open up for people the idea of strategies and coping mechanisms, but also put before them the treasures of poetry and prose which can give a much needed 'window' or 'mirror' to ourselves, our experiences and our world.

What is your favourite prose work or poem which you have used in the therapeutic space?

​At SCPTI we want to encourage ourselves and all practitioners to work creatively. We have CPD workshops coming up in the Autumn in narrative therapy; art therapy and creative writing. Please see our CPD tab for more information.

There's a tendency to talk about mental health as if it is one condition, when in reality it comes in many different forms and degrees, and individual experiences vary greatly. Just as we wouldn't talk about cancer and flu in the same breath - or expect the same responses and interventions to them - nor should we lump together the myriad of ways that people encounter vulnerabilities in their mental health.

​It seems that it is more acceptable to take positive steps towards maintaining good physical health than it is to do the same for our mental health. No-one bats an eye-lid when I say I go to a yoga class once a week, but start to explain that I see a therapist regularly and foreheads furrow. I cannot be divided into mind and body, the two are interwoven, inseparable. I need to stretch, exercise, take care and build resilience for my whole self.

​Yes, of course, there are severe manifestations of dis-ease, wherever it occurs in the person, and there are medical interventions which might be appropriate and could deal with the emergency. However, if we got better at maintenance for our emotional and psychological wellbeing as well as our physical wellbeing, perhaps there would fewer individuals getting to the crisis point. We also have to look beyond the individual, as Richard Vize points out in his article in The Guardian (​http://www.theguardian.com/healthcare-network/2016/feb/19/funding-welcome-sources-mental-health-problems-still-thrive) we have to consider social causes for an individual's difficulties.

As Vize says, funding is still an issue, despite government promises. What little there is appears to go into the critical end of care. It goes into fire-fighting the results of ignoring emotional and psychological needs; rather than into building the resilience we all need to do what we have to do within modern society.

​What positive steps do you take to build resilience?

Perhaps there are two things which define us as humans - our capacity to ask questions and our capacity to attach ourselves (to other human beings, to objects, to causes, to beliefs).

Some would argue that what brings many into therapy is the very basic question: what am I here for? An existentialist question. It may be dressed up in all sorts of disguises - for example, anxiety about career or other people - but at the root we want to understand why we exist.

​The other issue which brings many people into therapy is relationships, especially when they go wrong. We are tribal, we yearn for healthy relationships with others, but so often these are thwarted by how we initially attached with our first care givers (see work by John Bowlby among others).

Existentialism and attachment - two vast areas of study and for exploration. Here at SCPTI, we are offering the opportunity to get a taster for both aspects of the therapeutic work.

Existential Psychotherapy with Mo Mandić
2nd & 3rd July 2016 (early bird ends 5th May 2016) & 24th & 25th Sept 2016 (early bird ends 28th July 2016)
A central tenet of working existentially in a therapeutic setting is to engage with the client’s worldview. A worldview is a person’s own way of making meaning of their existence through the stance that they take towards the world and themselves. As such, the worldview is the human being’s way of stabilising their existence, giving it a feeling of solidity and security. However, life itself throws unexpected challenges and uncertainties in its way, such that the worldview becomes unsettled, unmoored, and disoriented, whether temporarily or on a more continuous basis. The existential approach engages with the client’s worldview in order to explore and clarify it, so that the client can find ways to deepen their understanding of the ways in which their worldview contributes to their unease and distress.

Mo Mandić is a UKCP-registered existential psychotherapist in private practice, based in London. His background training was completed at Regent’s University London, where he now works as a Lecturer on the MA Psychotherapy and Counselling programme.

Attachment in Psychotherapy – implications for practice - with Pete Lavender
9th July 2016 (early bird before 12th May 2016) & 8th October 2016 (early bird before 11th August 2016)
Much research and scholarly study has been conducted into patterns of human attachment and development (see Bowlby, Stern, Winnicott et al), and much has been written about its application to counselling and psychotherapy, (see Wallin, Holmes et al). These seminars aim to look at what these theories mean for us as therapists and how (do?) we apply them to our practice.

Pete Lavender is a Director of SCPTI, course leader, supervisor and has nearly 30 years’ experience working with clients in both private practice and general practice in the NHS.
Here are some appreciative comments from his recent seminar held at SCPTI looking at the Role of Shame in the Borderline Process:
‘Refreshing, exciting, informative – meaningful CPD which will support clinical practice.’ (Monika A)
‘The workshop was full of richness, making a difficult and sensitive topic very interesting. Fascinating and rewarding on a personal and professional level.’  (Paul C)
'Your workshop was timely, I was able to use some of what I had learned when I saw a client shortly afterwards. Due to what I had taken from your training, my client was able to say that our session was the most in-depth, difficult and powerful time he’d had with anyone since his recovery from addiction and trauma.' (Emily B)

Fees
Two day workshop: member SCPTI (early bird) £135/(non early bird) £165. Non-member (early bird) £175/(non early bird) £205.
One day workshop: member SCPTI (early bird) £75/(non early bird) £90. Non-member (early bird) £95/(non early bird) £110.

To apply: mailto:[email protected]

The Spring Equinox is here, when day and night balance for a short while until the day-light hours become longer than the night time. All over blossom, daffodils and crocus are beginning to bloom. It feels like the earth is waking up after a slumber and, perhaps, it is a good time to think about activating our brains with some training.

As professional therapists, we have to keep our skills up-to-date. The UKCP requires at least 250 hours of continuing professional development for its registrants in any give five-year period. But we don't do training just because we have to, it keeps us curious, developing, supports our practice.

We have some great CPD workshops coming up (see the CPD workshop tab on the website). Particularly a couple of workshops on bringing bodywork into our approach to therapy (with Janet Hills, 23rd April & 18th June) and exploring what ideas around attachment may mean to us and our clients (with Pete Lavender, 14th May & 9th July).

For more information email mailto:[email protected]