Fertility treatments and counselling

18 03 2015

Last Sunday, the 15th March 2015, the Sun published an article about IVF treatments and the stress – both psychological and financial – that these can place on a family. They contacted me and asked me to say a little bit about the systemic, wider-reaching impact that such a process can have on all the family members. and how therapy can often be a way for everyone to come together and process these issues.

You can see some clips of the article  as it appeared in the paper, below.

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If you, or any family members, might be interested in counselling for fertility issues or any related problems, then please do contact me to arrange an individual, couples, or family session as soon as possible. I look forward to hearing from you.





Dealing with Addiction

11 03 2015

Recently I saw a couple of encouraging articles in the news which inspired me to write a brief post about dealing with addiction. I will link to the two articles at the end of this post.

Addiction is an issue that comes up all the time in therapy. Sometimes it appears in very overt and obvious forms – such as substance misuse, gambling, or sex addiction – but often in more covert and subtle ways as well, such as compulsive exercise, workaholism, or obsessive thoughts and habits. In many ways all humans are addicts, as we are creatures of habit; we thrive on things that are familiar and comforting, and carve out repetitive patterns for ourselves. This is no bad thing, as it means that we can create healthy routines, or stick to a structured approach when making changes or adjustments; but it can also be dangerous and become an unhealthy, destructive force where a reliance on a certain way of thinking or behaving can start to interfere with the rest our lives.

So, why is it that some people can keep their habits under control and choose healthy routines for themselves, whereas others find themselves losing control to harmful urges? What decides whether we will find a healthy or an unhealthy outlet for our need for comfort? This is a complex issue, with numerous answers (see Gabor Mate’s talk on The Power Of Addiction for some great points), but I think these three are the most important:

1. Psychobiology. Some people inherit genetic traits or learned behaviours from their ancestors, where they may be predisposed to certain ways of thinking or doing things, or have a particular physiological ‘weakness’ for a certain substance.
2. Environment. We are hugely influenced by our surroundings, and by our social networks (see Nicholas Christakis’ wonderful talk on The Hidden Influence Of Social Networks for more information). The people around us shape our ideas of accepted norms and influence the behaviours that we establish; we often look to see how others are coping with their lives, and then we copy them.
3. Early attachment experiences. Our early experiences shape our identities and also, crucially, our emotion regulation strategies. If we have positive attachment experiences then we learn that we can rely on others, and turn to them during times of need; and this also teaches us that we are ‘worthy’ of other people’s care and attention. However, if we have negative attachment experiences then we learn that we cannot rely on others, and instead have to develop our own methods of self-soothing; and this also teaches that we are ‘unworthy’ of other people’s care and attention. It’s this latter group of people who often seek external sources of affirmation and validation, which can slip into addictive cycles: if it doesn’t feel emotionally safe to turn to other people for reassurance, then they will seek that comfort from the escapism and rush of sex, drugs, or gambling instead.

Amazingly, many addiction treatment programs continue to focus on only the first of those three issues. They see addiction simply as a psychobiological disease, and they dissect the cognitive, behavioural, and physiological components of this disease, and then set out to replace previous bad habits with healthy new ones. However, they often overlook the crucial factors of social networks and attachment experiences; factors which will be massively influential on a person’s chances of maintaining their recovery over time. I believe a crucial element in treating addiction is to process and repair negative attachment experiences from the past, and then to create new, healing attachment experiences in therapy; so that a client can feel a sense of attunement, and learn that it’s safe to turn to others for soothing and reassurance, rather than having to self-soothe or seek out alternative sources of validation. This process also empowers the client to develop a new sense of worthiness, overcoming internalished shame from past rejection, and recognising that they are indeed deserving of the attention, care, and love of others.

I spent several years as the Clinical Lead of a substance misuse treatment agency within the NHS in North London, and always made sure that we were taking a holistic approach to our clients’ recovery; addressing all three of the factors I list above. I continue to use this approach in therapy with my clients.

Now, here are the two articles I referred to earlier:

1. A Huffington Post article, titled “The Likely Cause Of Addiction Has Been Discovered, And It Is Not What You Think”.
2. An NPR article, titled “What Heroin Addiction Tells Us About Changing Bad Habits”.

Hopefully you will find them as informative as I did. And if you are seeking information or therapy for issues related to addiction, then please do feel free to contact me.





Wishing everyone a restful end to the year.

20 12 2014

As we’re coming to the end of the year I just want to wish everyone a restful time over the next few weeks. It’s often a time where families get to come together, but that doesn’t mean it’s any less manic or stressful than the rest of the year; in fact it can often be a time of conflict and anxiety.

I work with a lot of my clients to raise awareness of their feelings at times of conflict or anxiety, and then to manage them using techniques such as mindfulness. I see mindfulness as a means of remaining focused on the here and now, and being completely in touch with the present moment; thus removing ourselves from the constant ‘noise’ of past-oriented or future-focused thoughts buzzing around our brain. Imagine your mind as one of those Christmas snowglobes, shaken up and swirling all over the place; and mindfulness helping all the snowflakes become settled and calm, so that the globe is clear again.

Scientific evidence has shown the effectiveness of regular mindfulness, and you can read the recent experiences of the American news anchor Anderson Cooper here, as he describes how mindful practice has changed his life; enabling him to be more calm, present, and efficient.

However you spend the next few weeks, why not try out some mindfulness techniques to simply catch your breath and gather your thoughts? For example, you might want to just focus on your breathing for a couple of minutes, or try some progressive muscle relaxation, or sit through a brief guided imagery exercise. These techniques should help you feel far less stressed and anxious, and much less overwhelmed.

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I would also like to briefly thank everyone at the ACPNL, as they kindly invited me to present a workshop for them last Sunday. I have to admit I didn’t expect many people to be present – considering it was a cold and frosty Sunday morning at the end of the year – so I was delighted to have almost 50 people in attendance. I presented for 3 hours, on the topic of Social Emotion Regulation, and talked about the difference between attachment and attunement, how to create lasting and secure connections in therapy, and the basics of Emotionally Focused Therapy (as a reminder, EFT is an evidence based modality with a proven ‘total recovery’ rate of 75%, and 90% of clients showing improvements; no other modality even comes close!). The workshop was such a success that the ACPNL have requested that I go back and do another one, so I will keep you posted once dates are confirmed.

Once again, I would like to wish you all a happy and healthy end to the year, and all the best for 2015.





Association of Counsellors and Psychotherapists in North London (ACPNL)

23 10 2014

I’m really honoured to have been invited to be a guest speaker by the Association Of Counsellors and Psychotherapists in North London (ACPNL). I will be presenting there on Sunday December 14th, from 10am to 1pm, and you can find full details on their events calendar.

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The title of my presentation will be “Social Emotion Regulation: Bringing The ‘Other’ Into Therapy”, and a brief description is as follows:

“Often in therapy we focus on the internal struggles our clients face, exploring intrapsychic variables such as troubling narratives, conflicting beliefs, or self- defeating messages. We discuss our clients’ emotion regulation strategies, and give them the tools to develop new ones, such as meditation, mindfulness, exercise, awareness of automatic thought patterns, and so on. However, these are all relatively isolated activities, and the social circumstances of our clients’ lives are often left unexplored. In this workshop, Stefan Walters explores the importance of social emotional regulation, and how a sense of being part of a supportive and enriching social network is absolutely vital to good mental health. Stefan looks at the links between self-worth and other-worth, and discusses how we can bring the ‘other’ into therapy, to assist our clients with their issues.”

Tickets are £30 for non-members of the ACPNL, or £20 for members, and can be purchased on the website. I hope to see you there!





Boys Do Cry

15 10 2014

I just wanted to post a quick link to a a couple of excellent articles.

The first was published by Vice last week, titled “A Stiff Upper Lip Is Killing British Men“. You can read it here and I think the facts speak for themselves:

“Even accounting for reproductive health, in any given year men are half as likely as women to visit their doctor in England, which doesn’t make a lot of sense. I’m pretty certain women don’t get ill twice as often as men. In the UK, the rate of premature deaths (under 50) is one and a half times higher among men than women, primarily due to cardiovascular disease, accidents, suicide, and cancer—the latter cause offering perhaps the strongest evidence of men’s reluctance to seek help. While affecting men and women equally, skin cancer kills four times as many men in the UK because we avoid addressing the issue until it’s too late… The disparity in suicide rates is another eye-opener. In spite of depression being more common in women, men are three times more likely to take their own lives in the UK. A 2012 Samaritans report concluded that the social constructs of masculinity were a major cause of this imbalance, noting that “the way men are taught, through childhood, to be ‘manly’ does not emphasize social and emotional skills,” and that, in contrast to women, “the ‘healthy’ ways men cope are using music or exercise to manage stress or worry, rather than ‘talking.’ Alcoholism is also significantly more prevalent in men, linked largely to self-medicating mental illness… Communication is the key to a successful relationship, as any happily married person will tell you. The worst part is that we know this. It’s been drilled into us by every book and TV show and film that deals with these kind of issues, but still we ignore it, forging ahead under the misconception that those rules only apply to others.”

In summary: it’s good to talk. And the stigma that men should be strong just deal with things by themselves is outdated, unnatural, and unhealthy.

The second is a lovely article by Robert Webb for The New Statesman which touches on topics such as going from boyhood to manhood, grieving a lost parent, and forgiveness. You can find it here.





Guardian Interview about sex for the over 60s

25 08 2014

A while ago I did a short interview with The Guardian, to discuss sexual health and relationships for the over 60s. It was recently published on their website, and you can read it here.

Unexpectedly, the story seems to have been picked up by a number of other international sites as well, including this American news site and some blog posts. It’s nice to see the story spreading around, and hopefully this will encourage further healthy discussion around the topic.

I think sometimes there’s a stigma that you “can’t teach your grandmother to suck eggs”; that after a certain age we just get stuck in our ways and refuse to change. So the misconception follows that therapy is reserved for younger people; from teenagers facing problems in puberty, up to married couples in their 50s facing divorce.

But the truth is that it’s always good to talk; no matter what age you are. I see many elderly couples who find it transformative to discuss their relationships and sex lives in therapy, and it’s always rewarding to see the progress they make together. It’s never too late to make a change!





Private Practice Made Simple

4 02 2012

My review of “Private Practice Made Simple” by Randy J. Paterson, PhD:

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There are plenty of books and websites out there offering advice to mental health professionals who want to know how to establish their own private practice. With this new release Randy J. Paterson, PhD offers his own comprehensive take on this popular topic, promising to provide “everything you need to know to set up and manage a successful mental health practice,” from “getting client referrals and creating a positive and comfortable office atmosphere to building a strong and thriving therapy practice that can serve both you and your clients.”

As the 2008 recipient of the Canadian Psychological Association’s Distinguished Practitioner Award, and the owner of a private multiple-provider outpatient practice in Vancouver, Paterson certainly seems to write with a wealth of personal experience in this area. Indeed, what differentiates this book from so many of the others available on the market is that personal touch, as Paterson shares his own journey into private practice, and the lessons learned along the way, explaining that:

No one really teaches you how to manage a mental health or counseling practice. As clinicians we stumble through our careers, gradually picking up shortcuts and strategies that make our lives (or those of our clients) a lot easier. Many of these useful ideas aren’t rocket science and could have been taught to us in an afternoon if anyone had thought about it. That’s what this book is for: it’s nothing more than a collection of useful basic tips … The emphasis of the book is on quick and easy strategies that can save a lot of headaches.

This light, conversational style typifies Paterson’s everyman approach to the topic, ensuring that the book is easy to read and full of accessible ideas for anyone contemplating the possibility of working in private practice.

While some other books might launch straight into the practical side of running a private practice, Paterson predicates this by starting his book with a chapter focusing on the importance of weighing up the pros and cons of running this kind of business in the first place. Paterson lists his ten most frequently-heard arguments both for and against private practice, and I can guarantee that any mental health professional will be able to relate to at least some of this debate.

The arguments in favor are listed as:

1. No Big-Organization Hassles
2. Getting Away from the Medical Model of Distress
3. Increased Accessibility for Clients
4. You Get to See Whom You Want
5. More Money
6. Supplement Your Salaried Income
7. Flexible Hours and Holidays
8. Work Fewer Hours
9. No Commute!
10. A Service Based on Your Own Vision

Whilst the arguments against are:

1. You’ll Never Get Clients
2. You’re No Good at Networking or Marketing
3. Uncertainty About Income from Month to Month
4. You Hate All the Clerical and Business Demands
5. You Don’t Know Enough to Practice Independently
6. Dealing with Fees will be a Huge Hassle
7. You’ll be Helpless in the Face of Insurers or Funders
8. No Retirement Plan or Benefits
9. You’ll Burn Out and Won’t Have a Safety Net
10. You Won’t have a Sense of Meaning in Your Work

Paterson follows this up with a considered appraisal of what is truly involved in the day-to-day running of a successful private practice, and then allows you to make up your own mind as to whether you’re really suited to this type of business. Assuming that you are, this book then serves as a comprehensive guide to everything involved in setting up and maintaining your practice, from such subtle nuances as the ‘olfactory environment’ and placement of clocks, to website design and finance tips.

As Paterson says, many of the ideas in this book aren’t rocket science, and might initially just seem like common sense, but don’t let this be a deterrent. As you make your way through the book you’ll realize there are also countless suggestions here which will leave you wondering “Why didn’t I ever think of that before?” and feeling enlightened. One such example is the section on ‘The Client’s View,’where Paterson explains the importance of the contents of the therapist’s bookcase:

Look at your own bookshelf from the client’s position. Notice where your eye naturally falls. These are the most salient shelves. Banish books that imply you are having significant problems yourself (Avoiding Burnout, The Wounded Healer), your introductory psychology textbooks, the trashy novels you secretly read at lunch, the books on handling problem clients, the self-help books you wouldn’t recommend to your worst enemy, and all the books on managing the finances of your private practice (including this book). Shift those books upward or downward, and replace them with scholarly books on your specialty areas of practice, books on diversity, a book or two on sexuality (this subtly gives clients to put such issues on the table), the self-help books you most frequently recommend, high-level books on practice and therapy, and other books that communicate your expertise, interests, and breadth of knowledge.

Once you’ve thought about it this seems so obvious, but I have seen plenty of counseling rooms where this advice had clearly been sorely missed, and where business may have suffered as a result.

It is these kinds of subtle tips which can make a huge amount of difference to the way a private practice is run, and which might distinguish an outstanding business from a mediocre one. Having all of these ideas listed in one simple book is truly invaluable, and will surely offer numerous benefits to anyone in the mental health profession. I couldn’t think of anything which Paterson had missed from this book, and he even includes a link to free downloads of practice worksheets and sample forms to help you on your way. If you’ve ever considered setting up a private practice, or you’re running one already, then this book’s for you.

3 out of 5 stars.