Marc Williams- Brighton Therapy |
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'If we don't change, we don't grow. If we don't grow we aren't really living.' Gail Sheehy. |
One to One Therapy |
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I work in a present-centred way focussing on what is happening in the here-and-now raising awareness about what we are doing and how we are doing it. This helps to develop our understanding of our ways of relating to others giving us more freedom in the choices that we make. I take an holistic approach to therapy and to the person, looking at what is happening both cognitively, emotionally and physically. I work on both a short-term or a long-term basis with a wide range of issues including: Gestalt therapy is also well suited to more general issues such as lack of a sense of direction, purpose or meaning, a loss of focus or a sense that something is lacking or not quite right. An initial session can be booked to see if this form of therapy would be suitable for you. Work can proceed on a time-limited basis (for example a contract of six sessions) which can be reviewed during the final session to see if you wish to continue. Sessions can also be booked on an ongoing open-ended basis. Knowing yourself is the beginning of all wisdom - Aristotle Whether you are looking for a therapist for a specific issue or a more general one embarking on a course of therapy will lead to greater self awareness or personal development. Clients can often choose to stay on after work through a specific issue because they are experiencing the benefits of greater self-awareness in their quality of life. Some people choose to work with a therapist purely for personal development. Working with someone else has the advantage of the input of an independent less attached observer who can help an individual look at his or her responses that are occurring out of awareness. The more our actions and behaviours are brought into our awareness the more choices we have over how we respond to events. We can become more flexible, adaptive and responses and more present in our everyday lives.
The death of a dear friend, wife, brother, lover, which seemed nothing but privation, somewhat later assumes the aspect of a guide or genius; for it commonly operates revolutions in our way of life, terminates an epoch of infancy or of youth which was waiting to be closed, breaks up a wonted occupation, or a household, or style of living, and allows the formation of new ones more friendly to the growth of character. - Emerson, Ralph Waldo The stages that the bereaved go through following the death of someone close have been recognised throughout time. Rituals have been developed to mark the passing of loved ones helping the bereaved to come to terms with their loss. Freud’s paper Mourning and Melancholia was the first attempt to look at the effects of bereavement from a psychoanalytic point of view. In the 1940’s John Bowlby developed his theories of attachment. Alongside the understanding of how humans develop attachments came a greater understanding of the affects of separation and loss. Behaviours such as crying, clinging and searching for the lost object are common. Elizabeth Kűbler-Ross described the stages that someone diagnosed with a terminal illness would go through: - Shock/Denial, Pain, Bargaining, Depression and eventually Acceptance. Shock/Denial - Initially the bereaved will often have a sense that it has not happened. There may be a period of denial because it is too much to accept the full reality of the loss. In her book, On Death and Dying, Elizabeth Kűbler-Ross stresses that she considers this a healthy response. Gradually, over time the bereaved will come to terms with their loss and be able to face the full reality. Traditional rituals such as funerals are designed to help people move towards acceptance of the loss. Acceptance can be particularly difficult if the death is sudden and unexpected. Pain - Once the full reality of the loss both intellectually and emotionally is experienced this brings powerful feelings such as sadness, yearning, anger, guilt, shame and fear. It can also bring physical sensations such as heart palpitations, breathlessness, tightness in the chest etc. Some people will take steps in order to avoid these feelings of pain. According to C.M. Parkes, Bereavement: Studies of grief in adult life, “If it is necessary for the bereaved person to go through the pain of grief in order to get the grief work done, then anything that continually allows the person to avoid or suppress this pain can be expected to prolong the course of mourning.” Depression - Typical feelings associated with this phase are growing depression, bitterness, loneliness and a breakdown of normal patterns of living. A transition process is going on where the bereaved is gradually adjusting to living in an environment where the deceased is missing. Acceptance - Moving on. The bereaved can start to invest their emotions into life and living. In “Grief Counselling and Grief Therapy” J. William Worden notes, “One benchmark of a completed grief reaction is when the person is able to think of the deceased without pain. There is always a sense of sadness when you think of someone you have loved and lost, but it is a different kind of sadness-it lacks the wrenching quality it previously had.” J. William Worden came up with the theory that there are certain tasks for the bereaved to complete, these were recognising the reality of the loss, dealing with the feelings associated with the loss, coming to terms with the world without the deceased and adjusting to the change in the relationship with the deceased. For much of the 21st century it has been believed that an individual must work through bereavement and eventually it will come to an end. This idea appears to have stemmed from Freud’ after he wrote Mourning and Melancholia and also the expectations of the developed western industrialised cultures. Previously cultures understood that individuals do not get over bereavement but learn to live with and accept it more. Based on his own writings of his experiences Freud was aware of this and appears to have been misunderstood. Two major theories - The Dual Process Model and Continuing Bonds - have helped develop our thinking and understanding of the effects of bereavement . The Dual Process model (Stroebe and Schut) . Focuses on two types of stressors in bereavement where the individual fluctuates between grieving and completing the practicalities such as taking on the functions that the deceased used to perform. Continuing bonds (Klass et al) - where there is a return to the recognition that there is a continuing relationship with the deceased. The deceased still has an important affect on the living and the bereaved individual does not ’get over’ the deceased but gradually over time integrates the experience into his/her own being and develops, changes and grows as a result of the experience. The deceased will always be remembered and affect the person. This theory helps mourners who feel embarrassed talking about their relationship to the deceased, because of a fear that there is something wrong with them. Death ends a life but does not end a relationship. Common symptoms of bereavement include insomnia, loss of cognitive functions such as memory, ability to function on the same level as previously during mourning and a temporary lack of drive, direction and purpose to life. Complications can arise from the severe stress of bereavement if there are underlying physical conditions, or if the bereaved is already living with stress and attempts to continue to function at the same level. Difficulties can often happen when the bereaved becomes stuck in the cycle of mourning often for the fear of letting go of the deceased. This does not actually happen but the fear can feel very real. Working through bereavement will generally naturally occur over time. It can help working through this with a therapist and can help prevent the individual becoming stuck in the cycle.
We can all feel low from time to time, but if this deepens and broadens over a longer period of time then depression can set in. Symptoms include changes in sleeping patterns (either too much or too little), a feeling of emptiness and of numbness (an absence of feeling), irritability or being short tempered, a loss of enthusiasm, and a lack of appetite or eating too much. In Gestalt terms we have lost our ability to cope in the present. Our range of adaptability and responsiveness is severely limited or dulled and we can not respond in ways that we normally do. We are less likely to be a ble to meet our needs. An example may be that we feel unable to reach out and call a friend to talk to because we are feeling so low, we can withdraw which perpetuates the vicious cycle leaving us with less and less energy and willpower to do anything about it. Negative self beliefs may emerge and become more prominent such as feelings of shame, not being good enough or feelings of worthlessness. At times depression is a normal part of our experience, for example, depression is known to occur following a bereavement or major life changes and is a natural way of adjusting by letting go of the past and moving towards the future. Depression can become a problem when we become trapped or fixed in it. Men are disturbed not by things, but by the view which they take of them - Epictetus 6th Century Stoic Philosopher Something that is frequently forgotten in modern society is that stress is a fight or flight response designed to get us out of danger. Adrenaline is released into our bodies giving us a heightened state of alertness, more strength and quicker reflexes to enable us to get out of harms way. In this context stress is a healthy response designed to protect the general well being of the individual.
For longer term periods of stress cortisol is released into the system helping us to keep going when we need to. This draws on and depletes energy in other parts of the body. So sustained periods of stress can physically and mentally wear us out in the long term,
A good example of how cortisol affects the body is getting ill on the first few days of a holiday after a period of hard work. The body keeps going at a sustained level but as soon as it relaxes the immune system is so run down it leaves the individual susceptible to illness.
Returning to modern industrialised society we live at a faster pace than our predecessors, overflowing in-trays, the constant demands of electronic communication e-mails, blackberries etc and performance targets and reviews. All these factors and others encourage us not to switch off and it can be easy to forget that we are biological organisms and need rest as part of our natural rhythms and cycles.
Some people seem better able to deal with stress and anxiety and often people say that stress is a good thing. In the short term stress can have a refreshing and vitalising effect on the body particularly when the individual comes down off the cycle.
One factor that can greatly affect our responses to stress are our beliefs which takes us back to the quote by Epictetus which still holds true today. If we believe that we are ‘not good enough’ or are ‘not worthy’ or fundamentally flawed in any way we may worry more, try harder in the things that we do to attempt to make up or cover these perceived flaws.
There are cognitive techniques that look at stress and our behaviours, possibly self defeating habits that can relieve stress in the short term but ultimately create more stress in the long term. We can also look at and explore our deep rooted beliefs about ourselves. Often these exist just outside of our awareness because they can feel too painful to experience but they continue to influence how we act and respond in our everyday lives, causing us to worry more, be less able to switch off when we need to.
Working with these beliefs can help us become more aware of our responses to stress and anxiety, or even helps us to become aware when we actually are feeling stressed so that we can do something about it before it sets in more.
“Everything changes, nothing remains without change.” Hindu Prince Gautama Siddharta, the founder of Buddhism, 563-483 B.C.All life is change and the Gestalt cycle attempts to reflect the constantly changing nature of reality.Although this guiding principle can be seen as an obvious statement as human beings we can have a tendency to resist changes and try to keep things as they are. You only have to look around at how humans have shaped the planet in order for us to meet our needs more easily and with more guarantee. Agriculture can be seen everywhere there is fertile land. This will guarantee our food supply. Current debates on the environment reflect the issue of our security and the tensions with maintaining our life styles without having to change too radically.On a more basic level we can resist change although it can be foisted upon us with the death of a loved one, accidents etc. At other times we can actively choose change such as changing jobs or relocating to a new area.In both cases change may have its’ benefits but it can also cause stress. Moving on from something also entails leaving something behind. Progressing within ourselves also means we have to let other aspects of ourselves go. This can have an affect similar to that of bereavement and loss (See the stages of bereavement) and cause a great deal of stress even if the changes are made for our ultimate benefit. Major life changes are amongst the most stressful factors according to many studies. Changes such as the death of a loved one, divorce and moving home involve a major upheaval to our lives. Similar stages to that of bereavement, accepting the reality of the change and adjusting to that change have to be negotiated until eventually we sttle in to the new patterns of our lives.
Gestalt therapy focuses on awareness and how we can prevent ourselves from becoming aware. Two areas that stop us from becoming aware and taking responsibility for our own lives are preoccupation with the past, fantasies about our perceived faults and also what we see our strengths are. The other area is low self esteem. Low self esteem if it is an established pattern can develop as result of how we take in messages from significant others from early childhood. i f the messages that we receive are consistently that we are 'no good' or 'not capable' etc then we may come to believe them no matter if they are factual or not. These beliefs are called introjections in Gestalt Therapy and can govern the way we relate to others. they can govern our behaviour if we are not aware of them. A gestalt therapist will work to understand and identify these introjections and help the client understand how they are affected. The key to working with irrational or not thought out beliefs is by raising awareness. Once awarenesss is attained of the unconscious messages that control behaviour the client then has choices whether he or she wishes to continue in this manner.
Gestalt therapy focuses on the relationship in the here and now. The styles that we have for relating to others have all been learned from childhood onwards, we adapt ourselves in relationship to our environment and to significant others within that environment. When we initially adapt and change our patterns of relating we can be stuck in what is known as a fixed gestalt. Although that adaptation may well have had its’ uses at the time it may not be so useful now. We bring all our adaptations and adjustments into our current relationships and if the same patterns are repeating themselves again and again, this can be indicative of a fixed gestalt. The question is – ‘Is it still useful to me?’ If not – ‘Do I want to change?’ If there are difficulties within relationships then they will manifest themselves within the client-therapist relationship. This can then be looked at. ‘How are we relating to each other?’ ‘What is happening now?’, ‘Is it working?’, ‘What alternatives might there be?’ A Gestalt therapist is prepared to stay with the difficulties that arise and to actively work with them providing a safe container to allow the work to emerge at the clients own pace. As Fritz Perls put it – ‘The safe emergency of the therapeutic situation.’
Spirituality and Existential Issues The personal life deeply lived always expands into truths beyond itself - Anais Nin Spirituality is distinguished from religion as a connection to something bigger within and beyond the individual. Without this sense of connectedness people can often feel diminished, small, lacking in vitality without apparent choices in their lives. The purpose of psychotherapy is to set people free - Rollo May (1981) Existentialism in therapy relates to the deeper underlying questions about who and how we are in the world. There are occasions in life where events challenge our basic assumptions surrounding our identity, the way that we relate and interact with others and the way we perceive the world and life. These events such as the loss of a loved one, a major change such as the change of a job, redundancy, a change of environment, diagnosis of a major condition or illness can affect our perception of life in ways that we may never have thought about before. Existential crises can take the form of the following broad categories: - Freedom and Responsibility
True psychological freedom can entail the shaking off of ways we have developed to avoid responsibility for ourselves. This avoidance of responsibility can take the form of how we conform to others expectations of us rather than doing what is right for us. Throughout our lives there are external pressures and conditions imposed on us, the familial values that we are born into, our cultural conditioning, societies expectations and values, our religion, social groupings, work environment and advertising to name a few. Going against the ’norm’ and following our own path can leave us feeling isolated and in conflict. Often we are unaware of how much we are conditioned. Otto Rank describes the amount of personal freedom we have as the extent to which we are aware of those forces which influence us. Taking the step to develop our self-awareness and find out who we really are can be a very frightening experience. Death, limitation and finiteness According to some schools of thought it is only when we come to terms with the prospect of our own death that we can truly start to live. This is often confirmed by those who have had near death experiences , life threatening illnesses or accidents. We all ‘know’ we are going to die but we don’t often think about it. This ‘knowledge’ is an intellectual knowledge rather than a deeper experiential knowing. Death can be the actual physical death or a symbolic death that precedes major change in us or in our circumstances. Transitions and stages in our lives force us to confront these issues, the classic ‘mid-life crisis’ being a prime example. We cannot know life unless we accept death in the same way that we cannot know happiness unless we have also experienced sadness. Some people can prevent themselves from truly living because of a deep underlying fear of death or a feeling that if they put off living then death will not be as terrifying an experience. It has been said that all anxiety is ultimately death anxiety. Isolation and connectedness We all yearn to feel connected, to be in contact with others in a deep and intimate way. It is only when we are in contact with others that we can truly be in contact with ourselves. But alongside this yearning for connectedness intimacy and understanding comes an equal and opposite fear, fear of rejection of not being accepted or valued for who we truly are. So the very thing that we so desperately want is paradoxically the thing that we fear the most. Intrapersonal, interpersonal and existential isolation We can feel or become isolated from ourselves or from others even though we a re physically near. In studies of people who feel lonely it has been discovered that they do not spend less time around people but that the quality of their relationships are different. They spend more time with strangers and large numbers of people. People who do not feel lonely spend more time in fewer but more intimate relationships. Existential isolation refers to us never being able to fully come to terms with our sense of isolation. Meaning People are meaning seeking creatures. We seek meaning in all that we experience. It is meaning that can make our existence bearable. A lack of meaning in our lives is one of the greatest existential terrors that we can experience.
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