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Autism/Aspergers – Working together in the therapy room (mini-series- pt.5)



Hi, and welcome to this week’s post, part 5 in my series about working together in the therapy room with autistic clients.

This week I want to talk about transitions, anxiety, autonomy, self-esteem and self-talk.


Read part 1, 2 , 3 and 4 here.

I’ve also written a few posts about what to expect on your first counselling session (read part 1 and part 2 here).

You can also click here for my other posts on Autism.


For these posts, I’d like to reference Katherine Paxton and Irene A. Estay’s book called Counselling people on the Autism Spectrum (chapter 3)


Transitions


I’ve been working with autistic adults and young people for 11 years now in the care sector, and 5 years with counselling clients.

Something that’s clear from this time, is that transitions can be hard!

Staff change-overs might cause distress as there might be more people walking around and therefore maybe more noise and uncertainty for that half hour.

It has been easily alleviated by staff coming in straight to the office, to keep the environment calm and familiar for the individuals.

A social story (mentioned in the previous blog post) might be used to inform the residents about who is leaving and who’s taking their place. This brings reassurance and calm to them.


In the therapy room, it might help to stick to the same time and day for sessions, as well as having a routine set for the hour.

I’d say the best way to do this is ask the client what would work best for them at the start of the session, during the session, and at the end of the session.

At the start of the session, the therapist might have arranged the cushions in a particular way, left some stimming objects (like a stress ball or playdough or something else) near the client’s chair which they can access if needed.

The client might bring their own, which is very welcome in my room as it will be helpful for the client to have familiar things, especially at the beginning of the process.

Leaving the windows open or closed has also come up in my sessions, and I make sure I ask the clients what’s better for them. This will change as the therapeutic relationship changes and the room becomes more familiar to the autistic client.


During the session, checking in often about how the session is going and how the client is feeling, what needs changing or working on, will be helpful and reassure the client that they’re being heard and understood.

At the end of the session, the client might need a transition “ritual” or a few steps that might help them close down what was opened up during the session.

Maybe some processing time or some checking in with the surroundings and the next steps.

It is all person-centred, so this will be different for each client, as their transitioning needs and experiences might also be very different.


Anxiety


I’ve previously written some blog posts on anxiety, which you can read here (part 1, part 2, part 3)


Anxiety with autistics can be linked to transitions.

Sometimes an advanced warning with plenty of time to process might help the client with the transition by helping keep the anxiety at bay.

Other times having such an advanced warning might be anxiety provoking in itself. Keeping the warning to just before the transition is happening might be helpful in these cases.

Keeping clear on what’s going to happen next, and sticking to what we say, can be really helpful.

In the therapy room, if we say the session will last 50 minutes, make sure you stick to this time.

Ask the client whether a 5 or 10 minute warning would help, or whether you just end the session at 50 minutes without much warning.

A cue such as grabbing my diary to schedule the next session might become a transition clue for the client that the session is ending. This might develop naturally or as part of the conversations and agreements in session 1.


Do read my series on anxiety for more on this topic.


Autonomy


As part of the ethical frameworks I work under, respecting the client and providing a space for them to be autonomous is essential, and ethical, in the therapeutic relationship.

By asking questions like the ones described above, we are setting the client up for going from depending a bit on the therapist to understand their inner world and their relationships, to learning how to tap into these on their own, as time goes on.

The goal with therapy is not to keep a client forever, it’s to enable autonomous behaviours and thoughts, through practice.

By observing what goes on in the therapy room, which is usually a reproduction of what goes on in the client’s everyday world, and discussing their everyday events and past situations, the client becomes able to process their thoughts, emotions and events on their own, slowly through their therapeutic journey.

Seeing clients come into the room and talk about their progress with setting boundaries or asking for their needs to be met, or having an “a-ha” moment about something we’d been discussin in therapy, is so rewarding and it is great to see the therapy taking an effect in the clients’ lives.

Autonomy is essential in the client’s self-esteem and ability to live their best lives. Of course other aspects are also involved.

Estay and Paxton call this self-monitoring in Chapter 3 of their book.


Self-esteem and self-talk.


Focusing on the positive things clients say to themselves can be helpful when negative self-talk has been taking a hold of the client’s life.

Self-esteem can increase and the client’s moods and how they go about their daily lives can be impacted greatly by focusing on the positives.

I read somewhere (can’t remember where) that thinking that is not reinforced will be come extinct.

The same goes with thinking that is reinforced. It will be at the forefront of the client’s mind.

So if we don’t reinforce negative thoughts, then we can focus on the positive ones.

This seems to work well for autistic clients, and I tend to use it with many of my clients, in one form or another.


Keep speaking positive into your life, and I’ll see you again for next week’s post.


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New Stuff Coming Right Up!

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Hello, hello!

It’s been about 2 months since my last post stating I was taking a break due to health and other reasons.

I’m pleased to report that the time off has done its job, and I’m feeling refreshed and ready to go again!


Since then, I’ve achieved the following:

  • Finished contracted work that was helpful at the time but is now not necessary as running my businesses is taking precedence. (I can still do relief shifts, which I plan on continuing as and when, the fact that it’s my choice now feels so much better!)
    • This means that I will have more time for my self-care, my relationships and my work, which I love (it isn’t really work!)
  • I’m sorting out my health issues, which has meant paying privately to get some answers (for those not in the UK – the National Health Service, NHS is free at point of service – we pay through our taxes).
    • I’ve got some answers and I’ve got something in place, which I’m hoping will help in my day-to-day. Hoping it means the symptoms that have been affecting me (exhaustion, foggy brain…) will be less taxing and life-affecting.
  • Refurbished my website, which seemed crucial for me to be able to move forward, for some reason!
  • I have a plan for what I want to do with my next year in regards to writing (books and blogs), social media, and new services and products I want to offer.

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A lot of new things have come up since then, which I actually need to pick up (I’ll send a message out to the relevant parties when I finish writing this post!)

  • Events via www.onlinevents.co.uk
    • I am participating in a few webinar events, presenting topics I’m passionate about. I’ve enjoyed participating in online interviews with John and Saz Wilson.
    • Here is my practitioner page, where you can find 2 past interviews
        • 20 Self-Care Habits – I presented my book (published July 31st 2018), and gave some tips for self-care, alongside my lovely colleagues that also had sessions that day on the Self-Care Conference. I’m hoping to be a part of this year’s conference as well!
        •  Creating a supervision model that works for your practice – I spoke about how I run my supervision practice, and why I believe that my integrated model is relevant for practitioners (one supervision theory doesn’t encompass all, and the 5 that I’ve integrated compliment each other very nicely and add different aspects that I believe are important for a great supervisory relationship).

       

  • In the next few months, I’ll be participating in 3 more events, which can be viewed for free when they’re being recorded, either on the facebook page or in the Zoom meeting itself (this is sent to you when you book the event).

     

      • September 3rd 2019 – Supervision “Pain Points”: What To Expect From Your Supervisory Relationship
        • Part 2 of my supervision webinars There is so much to say about supervision that I asked John if I could come back and talk about what practitioners should expect from their supervisory relationship to make the most out of their time and have it be a great, positive impact on their practice, development, and client work, which is the first purpose of supervision and practising as counsellors and psychotherapists.
      • To be announced – 2019 Self-Care Conference

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  • Ayanay Events
    • Face to face and online webinars
    • Ayanay is a new membership body that aims to offer Elevated services for their members and other colleagues that might want to attend the CPD services. They also have a novel perspective on accreditation, which won’t break the bank and reinforces the knowledge you’ve already gained. The story behind it is very powerful as well!
    • As part of the webinars and supporting Ayanay with providing clear, transparent and congruent information, I recently interviewed the Founders of Ayanay in a set of 6 interviews, which tell you a lot about the company, their purpose and the future.
    • The Business of Therapy Weekend.
      • In September 7th and 8th, I’ll be presenting a masterclass on Social media and content creation, which is similar in content to the event with onlinevents but I’ll be adding worksheets and other things to take away.

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  • Peer supervision groups
    • I find it important to continue to have conversations with colleagues, either through formal supervision or other types of groups, and peer supervision is one of them.
    • I’m meeting with local therapists for general group support, but also online with therapists that work with neurodiversity directly.
    • This offers an opportunity to increasing our knowledge and increasing the way we impact the therapeutic world with knowledge and expertise regarding neurodiversity.

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  • Facebook groups
    • I run a couple of groups that I’ve set up from my interests, and a few others that have stemmed from collaborations with colleagues and organisations:
      • Counsellors working with neurodiversity – Set up as a resource and a meeting place for UK counsellors to share their knowledge, expertise, events, CPD courses and/or workshops. In the areas for example of Autism, Dyslexia, ADHD; although not exclusive to these aspects.
      • 20 Self-Care Habits – Self -Care group – this group came about as a result of my book and my desire to add even more value to my readers and those wanting to develop their self-care activities in a supportive environment with like-minded people.
      • Content creation group Grow your private practice through adding value on social media platforms and promoting your services in an ethical and professional manner (linked to the events and services described elsewhere in this post)
      • Ayanay Open – a group designed to peak your interest in the membership, and be a part of it while you decide to join, or just to be in the loop if you decide not to join at this point. Social media posts are shared here, which will benefit everyone that shares.

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  • New services coming soon!
    • I’ve set up my directory of services, which encompasses everything I do and want to do, now and in the future.
    • Do have a look via this link to read a brief description of what’s yet to come (work in progress!) and what I already offer at this point.
    • The Dream to Reality service is one that I want to work on first, alongside writing, because I believe I can meet you right where you are, even if there’s no fancy ready-made programme to support you. A sounding board session or a few sessions might be what you need to get you back on track and clear about the topics I can help you with.

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  • Books to looks forward to!
    • I am really looking forward to putting my head down and writing. I write because I enjoy it and benefit from doing research and putting my ideas into paper. But I also enjoy adding value to the people that I can reach via my books and other stuff that I do.
    • You already know about 20 Self-Care Habits and my blog posts. I am looking forward to offering books on the following topics
      • Self-Care (part 2) – Responsibility issues 
        • I’ll say more as I develop the ideas
      • A non-fiction novel based on a recurring dream I used to have (as a psychodynamically based therapist, dreams are very important and telling, and the value I got from working through the dream in therapy is something I believe will benefit everyone, not only myself)
      • Content Creation – a practical guide to social media marketing, based on what I’ve learned so far and what has worked for me
      • Supervision – A compilation of the information I’ve gathered and found useful for my own practice and for my supervisees and all the clients that this has impacted upon
      • Children’s books on mental health topics – if we have good mental health from the start, and are able to be self-aware and work through our emotions with clear understanding and support, we are less likely to struggle as much as adults. The topics will be around every day stuff (I work with clients working through everyday life issues, so this makes sense and is congruent with how I work)

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In regards to this blog, in the next few weeks I’m going to be writing about the following topics:

  • Continue the Counselling Autistic People series
  • Content Creation Blog series
  • Supervision blog series
  • ad hoc posts as things come up for me, the mental health world, or other current events I might want to discuss from a therapist’s perspective

I am really excited for the next half of 2019 and the whole of 2020! 

I am hopeful that things will be much better health wise and with more time to look after myself, to engage more in my meaningful and close relationships – both friends and colleagues -, as well as giving my businesses the time they deserve and that I want to give them, that it will be a great time from now onward.

I’m not saying it wasn’t good or great already, but sometimes life gets in the way, and I wouldn’t be being congruent with myself or the people around me if I avoided talking about it or addressing those issues so I can better look after myself.

I practice what I preach, which is something I’m pleased about.


Until next time…


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It’s time for some Self-Care – Normal posting will resume in June

cropped-fullsizerender.jpgDear readers, and those following me on Social Media.

Due to some health issues I’m going to take some time away from my regular posting schedule, both via this blog and via social media.

Don’t worry, it’s not serious, but it does mean my energy levels are depleted some of the time, it varies week by week, some weeks I’m fine, others it’s awful!

That means that I am saving up the little energy I have to give 100+% to my counselling clients, supervisees and tutoring students. 

I am not happy about not being my usual self in regard to social media posting and blogging, as I love what I do here, so this is very frustrating and sad, but it is also necessary.


I talk about self-care – heck I wrote a book about it! – and I must be true to what I’ve learned and also practice what I preach. 

I do have an arsenal of posts that you can browse through while I get myself back on track.

I am in the process of freeing more time for myself, so in the near future (Bring on June and July!), I will have more time allocated solely to social media and blogging, which will be great!

Until then, I need to take it easy.


Feel free to ask me any questions or comment in this post, and others I’ve written in the past.

There’s series on therapy related topics (from your first therapy session, to anxiety, to spring cleaning!), relationships (more to be added in due course), autism (miniseries to continue in June), self-care (looking after yourself series), supervision content, and more!


Do have a browse in the categories or do a search and see what comes up, I might have written about it already!

If not, email me or contact me via the contact form and I’ll write one up in the second half of 2019.


I’ll probably do the odd post or re-post some of my oldies but goodies, but it will be much less than you’re probably seeing from me!

I know my readers and socials followers are lovely and understanding, so for that, I thank you, and I’ll see you soon!


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What to expect from Supervision – personal development

new supervision blog post banner


As therapists, it is vital that we have a good support system in place for our professional and confidential work.

Personal therapy is one way in which we can get this support. Supervision is another, and it will be the focus of these posts.

In the next few months, I will talk a bit about 18 ways in which we should expect supervision to work for us.


I will discuss 18 things we should expect from our supervisory relationship in order to be accountable and working to a professional standard, for the sake of our practice, our profession, and most importantly, for the sake of our clients


Missed my previous posts?

Catch up here:

Containment and Holding Reflective Practice  * Autonomous Practice

Theoretical Grounding * Develop Self-Awareness * Working through tough times

Challenge how you work * Focusing on the Supervisee

Video: The Meaning of Supervision * Practice to a Safe Standard

Safe Space to Vent * Boundaries

Video: What’s effective supervisionSelf Care

A safe space to process *


Click here to visit my main supervision page.

Are you starting out in private practice?

Are you an experienced therapist looking for a new supervisory relationship?

To book supervision with me, do get in touch and I’ll be happy to set up an initial meeting.


As therapists, we know that we can (and sometimes might need to) access therapy for our personal development.

Supervision is seen as more of a professional development tool.

I hope that from past posts in this series, you can see the benefit of supervision on your personal development as well.

A brief summary, taking items from the previous posts, on how supervision can help with your personal development:

  • developing self-awarness helps us in the therapy room with clients, but it also allows us to work on our personal relationships. We can learn how to set boundaries and avoid resentments from and towards our loved ones, as well as learning how to meet our needs and not only everyone else’s. This is the self-care aspect of supervision.
  • As humans, we all need to feel contained and held at one point or the other. Practising allowing the supervisor to do this for us in our supervision sessions builds the ability to permit others to help us in our time of distress or need.
  • We might experience tough times in our lives that might require the support of more than one person – our therapist, our supervisor, our friends and family. All of this support will come in handy and help us get back on track and build our resilience to get back into the swing of things.
  • In supervision, the focus is mainly on you as a practitioner. Sometimes we might be introverted or not know how to ask for help or even be comfortable with the spotlight shining on us. The fact that supervision is a space where we talk about ourselves and ourselves with our clients is a great way to “normalise” the fact that we are also allowed in the spotlight at times.
  • We all have things we need to vent or get out of our systems. If we can’t do it in our supervision space, then we might need to reconsider our supervision arrangements!
  • Processing client material or situations in our work life is something to work on in Supervision. Sometimes the focus is on the clients, other times it’s on aspects of our work or life that need to be worked through in order to keep on top of things and be great practitioners.

Fancy watching a video intro to this post instead?

Feel free to share it with your colleagues, supervisees, supervisors and others.


The more we talk about what supervision should be about, what it should cover, and how it should support therapists in their private practice, the better equipped we all will be, and we will provide the a better service to our clients


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Empathy and Autism

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Hi, and welcome to this edition of my Autism series posts.

I hope you enjoy it.

If there is anything you’d like to know about Autism that I can write about, do let me know by using the contact form on the main menu, or leaving a message at the bottom of this post.


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It is regularly thought that people on the Autism spectrum can’t or don’t empathise.

I’d like to challenge that from a couple of different angles.

First, from personal experience.

Second, from the perspective I’ve read in Paxton and Estay’s book on Counselling people on the Spectrum.


I’ve worked with people with Autism for the past 11 years.

Each individual is different – as we all are – and has different abilities and personalities which make them unique and great to be around.

I’ve had empathy from autistic people I’ve supported, so I know that I can challenge this from personal experience.

A pat on the back when I seem sad.

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An attempt to make me laugh when someone has angered me.

Laughing at something funny we both happen to see at the same time, and knowing we are both laughing at that exact same thing.

Whether it’s “mainstream” empathy or not, does it really matter?


The general definition of empathy is to have the ability to identify someone else’s emotions or thoughts and respond appropriately.

Don’t the few examples I mentioned above fit into this?

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I think they do.

Right.

I think I’ve made point one quite nicely, with the help of those people that have changed my life through their particular approaches to life and relationships.


Point two – Paxton and Estay suggest that autistic empathy is more about systems than what we usually recognise within ourselves when we feel empathy towards another person.

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They say that “systemizing is described as the ability to understand and build systems, and predict how a system will perform given certain conditions. Systems can be mechanical, natural, envorinmental, technical, abstract or taxonomic. they do not include human systems – family, office.”

I agree with this, as I’ve challenged clients on the spectrum before with things such as:


“Well you say that when someone has their arms folded, it means that they’re being defensive. This might be the case some of the time. Other times I might fold my arms because I’m cold or I’m thinking and this helps me think.”


I work with people on the spectrum in a similar way that I would with anybody else, as you can see from that verbatim above. I challenge views and allow for space to think about alternatives.

In the case of someone on the spectrum, even more sensitivity needs to be used, as it has taken the individual quite a lot of time and effort to come to this conclusion.

It is by no means a wrong conclusion.

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It might just be incomplete, and my job as their counsellor would be to fill in the gaps, so that their empathic system has even more options and alternatives of what someone’s behaviour – i.e. folding their arms – might mean, and therefore allow even more responses – i.e. being defensive back or offering a blanket!


Systems help people function.

They help people empathise in a particularly clever way.

Whether someone on the spectrum empathises with you in the more “traditional” way or via the systems they’ve built, they are still being empathic towards you.

I believe there’s a lot to learn about how adaptable and how people with different brains than us neurotypicals can adapt to this world we live in.

We struggle. They struggle.

We are all human living in an imperfect world.

Let’s embrace everyone as they are. Let’s learn and grow from knowing one another, warts and all.


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What to expect from Supervision – Self-Care

new supervision blog post banner


As therapists, it is vital that we have a good support system in place for our professional and confidential work.

Personal therapy is one way in which we can get this support. Supervision is another, and it will be the focus of these posts.

In the next few months, I will talk a bit about 18 ways in which we should expect supervision to work for us.


I will discuss 18 things we should expect from our supervisory relationship in order to be accountable and working to a professional standard, for the sake of our practice, our profession, and most importantly, for the sake of our clients


Missed my previous posts?

Catch up here:

Containment and Holding Reflective Practice 

Autonomous Practice * Theoretical Grounding

 Develop Self-Awareness * Working through tough times

Challenge how you work *Focusing on the Supervisee

 * Video: The Meaning of Supervision * Practice to a Safe Standard

Safe Space to Vent * Boundaries *

Video: What’s effective supervision?


Click here to visit my main supervision page.

Are you starting out in private practice?

Are you an experienced therapist looking for a new supervisory relationship?

To book supervision with me, do get in touch and I’ll be happy to set up an initial meeting.


In this post, I’d like to talk about how supervision can be a space for self-care.

If you would rather watch a video about this topic, please scroll down to watch.


I usually address the self-care topic from a personal perspective, as you can find in my book 20 Self-Care Habits.

Therapists are also human.

We need to remember that when we go to our own therapy or when sitting opposite our clients as their therapists.

In that respect, we need to acknowledge our humanity and therefore what we need in order to be able to best support our clients through their own process.

To aide in this, I believe supervision should be a space for reflection.

To reflect on who we are as practitioners.

Who we are in our relationships with each client.

To reflect on the work we do, how we do it. Is it good enough?

Book Cover

Is there anything new we need to learn to help a particular client?

Are we up to date on our professional development?

What do we need from our supervisor and from ourselves?

From this, we can expect to develop our self-awareness and understand ourselves, who we are and how we practice better.

This will improve our practice and our relationships with our clients and with ourselves.

Being reflective in supervision, being self-aware and self-understanding will allow us to understand the need for keeping boundaries in order to keep the therapeutic relationship and ourselves as therapists safe.

When we reflect on how we use our time, we will find the ability to just stop and be.

If we are telling our clients to do that, it will be a great modelling tool if we have already learned to do this ourselves.

Supervision should allow you to just be, to reflect and to develop yourself as a practitioner through self-awareness and understanding.


Feel free to share it with your colleagues, supervisees, supervisors and others.


The more we talk about what supervision should be about, what it should cover, and how it should support therapists in their private practice, the better equipped we all will be, and we will provide the a better service to our clients



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Who are you in your relationship? (Moving Out Of The Drama Triangle)

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Hi, and welcome to part two of the Drama Triangle mini-series.

In the previous post we defined what each of the roles meant and what the individual in those particular roles might be thinking or doing.

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In order to improve your relationship, some things need to change.

Communication is key in relationships, so it’s a great place to start!

Neither the rescuer, the persecutor or the victim have good communication skills or good awareness of what they are saying or doing and how this affects their life and the people around them.

In this post, I’d like to leave you with some ideas of how to move out of those roles into healthier ones.

This is usually known as The empowerment triangle.

The word empowerment is key here, as it provides a way for each individual playing each role gets the knowledge and skills they need in order to get themselves into a healthier living position.


Let’s get right to it…


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From Rescuer to Coach


In order to stop feeling like you need to help without looking after yourself, in order to not get triggered when you see others being vulnerable, there are some strategies to use in order to still be compassionate and caring, without putting yourself last or doing things that aren’t really your responsibility.

Empowering those around you that you’d usually help or rescue, by verbally telling them that you care for them and that you trust in their ability to resolve and move forward from their current situation, will remove the burden from you whilst still allowing you to be helpful.

Move from  the fixer to the cheerleader.

Sometimes the best thing we can do when we see someone struggling is to listen to them.

Decide what is your responsibility and what isn’t. As a rescuer you’ll need to think about whether someone else’s problem is yours to solve or not.

Think about how you handle your own problems and situations.

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Do you let others resolve them for you or do you prefer to solve them in your own terms?

Setting boundaries on the time you spend helping others will allow you to look after yourself and realising that you also have needs to meet, whether that is through asking someone to listen to you or getting the support of friends or professionals, within reason (don’t let others fall into the rescuer role – although that’s their responsibility to sort out, not yours!)


From Victim to Thriver


A major step to take in order to move from victim to thriver, is the realisation that you have needs that you want to meet in order to live a healthier, better life.

You are valuable and valued.

You have strengths within you to achieve what you want.

You have people around you that you can rely on to help you get to where you want, in a healthy way that ensures your autonomy and allows you to be the best version of you that you can be.

The only one that stops you from getting the things you need and want is yourself.

Empower yourself to ask for what you need, as long as it doesn’t encroach on anyone else’s needs or boundaries.3

Find your own boundaries and find ways to cherish those things that you have, and add to that list as you go forward.


From Persecutor to Challenger


As we defined the persecutor in the previous post, they can be dominating, blame often and put others down. Anger and resentment can also take hold and lead to certain behaviours.

If you are in this role more often than not, maybe you can consider working through your anger and other emotions in a therapeutic setting.

This will allow you to differentiate between what’s within you and what is actually happening with the other person in your relationship.

Owning your own emotions will improve your way of thinking about yourself and your relationship, therefore improving the communication levels, as you are clearer on what is going on within you.

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Knowing that certain things are beyond your responsibility or remit to solve will also help you not believe that you know better and allow others to know best about their own lives.


Responsibility, reacting, acting, setting boundaries and knowing how to meet our needs is important.

Having healthy levels of communication and self-awareness will help us take what’s ours and let go of what isn’t. Balance is key when it comes to taking responsibility and helping others.

Sometimes things are our responsibility. Other times we must empower ourselves and those around us to take what’s ours and leave what isn’t.

I hope this post has helped you meditate on the behaviours that might impact on your health and on your relationships.


(Stephen Karpman, 1960; David Emerald, 2017)


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What to expect from Supervision – Boundaries

new supervision blog post banner


As therapists, it is vital that we have a good support system in place for our professional and confidential work.

Personal therapy is one way in which we can get this support. Supervision is another, and it will be the focus of these posts.

In the next few months, I will talk a bit about 18 ways in which we should expect supervision to work for us.


I will discuss 18 things we should expect from our supervisory relationship in order to be accountable and working to a professional standard, for the sake of our practice, our profession, and most importantly, for the sake of our clients


Missed my previous posts?

Catch up here:

Containment and Holding Reflective Practice  * Autonomous Practice

Theoretical Grounding * Develop Self-Awareness * Working through tough times

Challenge how you work *Focusing on the Supervisee * Video: The Meaning of Supervision * Practice to a Safe Standard * Safe Space to Vent


Click here to visit my main supervision page.

Are you starting out in private practice?

Are you an experienced therapist looking for a new supervisory relationship?

To book supervision with me, do get in touch and I’ll be happy to set up an initial meeting.


Boundaries are a topic dear to my heart.

It’s important in our daily lives, but it takes a different scope when we talk about it in professional terms.


Boundaries in the therapeutic and supervisory realms are key to keeping both relationships safe and doing what they need to do, which is effecting positive and long-lasting change in our clients’ lives.

By supervisors challenging their supervisee’s boundary keeping and setting in the sessions, they are keeping the standards high, as well as teaching the supervisee to stick to the boundaries they know are important but might want to relax due to different dynamics in their relationships with clients.

Don’t get me wrong, we are all human.

Therapists and supervisors are human too.

Our training and personal therapy requirements (ongoing therapy after training feels important, whether you dip in and out or go regularly) raise our self-awareness, but there might always be blind spots that our supervisor might spot easier, looking from the outside.

Keeping to an ethical framework also helps us to keep to boundaries that keep the therapeutic relationship a safe space to work through life’s issues.

Some boundaries might relate to:

  • keeping to the 50-60 minutes and ending sessions on time.
  • keeping communication outside of sessions limited to discussing session times or rescheduling.
  • how much the therapist self-discloses in the counselling sessions.
  • what to do if you are in the same public spaces or find your profiles on social media.
  • how to deal with endings.
  • payment boundaries – before the session, on the day of the session.

What other boundaries do you feel are important in supervision and in the therapeutic space?


watch video for this post - supervision

Follow this link for a video describing this process.

Feel free to share it with your colleagues, supervisees, supervisors and others.


The more we talk about what supervision should be about, what it should cover, and how it should support therapists in their private practice, the better equipped we all will be, and we will provide the a better service to our clients


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Who are you in your relationship? (The Drama Triangle)

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Hi, and welcome to this post, in which I’ll be touching on the topic relationships and who we are in our relationship.

I will be talking about how we view ourselves, our partner, and how we act in our relationship.

The way we act will ensure a better or worse experience, but it is not set in stone. We have the power to take control of what we do, what we say, and how we say it.

2Being aware of our behaviour patterns – both conscious and unconscious, will help us regroup and reframe our actions and our reactions to what our partner does or says.


In order to  guide you through this, I want to discuss the Drama Triangle (by Steven Karpman).

Of course, there are other ways to define what we do and say in our relationships, which is why I will be writing more posts on this topic, for example using Transactional Analysis, Genograms, Timelines and Psychodynamic theory (and others) to explain what might be happening in our relationships. The underlying theme will be that of communication – conscious or unconscious.

Karpman’s Drama Triangle categorises people into three behavioural realms:

  • Rescuer
  • Persecutor
  • Victim

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Each one of these has specific attitudes, behaviours, thoughts and reactions to the world and people around them.

 

Whether you feel identified with either of these as you read, don’t fret. These are not permanent. I will give you some ideas on how to move out of the drama triangle into a healthier pattern of behaviours and communication.

 


Let’s define each of these modes of being:

The Rescuer

A person that positions themselves as the rescuer are usually wanting to save someone else. This other is someone that is perceived as vulnerable, and will help out even when the help hasn’t been requested.

The rescuer will look after everyone else first and neglect themselves. If they are not actively taking on the roles and doing things to remedy someone else’s problem or worry, they feel guilty and even anious.

4The rescuer depends on the “victim” to feel connected to them, which also allows them to feel good about themselves.

Some identifying phrases:

“you need me to help you”

“you’re not ok, but I’ll fix you”

 

 


The Persecutor

Or the bully.

They are unaware of how powerful they can be, and they will use this in a destructive manner towards the victim or the rescuer.

5The persecutor can be very critical and make a habit of putting other people down; they are quick to blame and point fingers; they thrive on keeping their victim down and are driven by anger and resentment. They are also unable to open their mind to alternative ideas, can be bossy and dominating.

Some identifying phrases:

“this is your fault”

“you’re not ok but I am, so do what I say”


The Victim

The victim is vulnerable and unable take responsibility for the position they’ve taken in life. They are often overwhelmed by this, but they will refuse to get professional help or look after themselves.

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Part of the vulnerability of the victim is feeling oppressed, hopeless, powerless, incapable, misunderstood and a sense of shame.

The victim will seek a rescuer to confirm their need for help.

Some identifying phrases:

“poor me”

“i’m not ok, everyone else is ok”


Did you identify yourself with either of these?

In relationships, we can move from one to the other, depending on the situation and how we are feeling. It also depends on the dynamics of our relationship.

These positions are neither effective nor functional. Nobody gets what they need or want. Not really. Reality is skewed.

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Can you pin-point more clearly who you are or have been at different points in your relationships?

 

Are you thinking of improving your relationship by moving out of the victim, rescuer or persecutor roles?

It might be tricky to move out of either position as we might have been in this position for a long time.

It is by no means impossible though.


Small steps will lead to success in behaving in a healthier way and learning how to communicate our needs and feelings will be important to counteract the forces that want to pull us back in to the drama triangle.

It is only when we acknowledge and are aware of what position we are in, that we can begin to change it.

You might now have a clearer view of who you have been in your relationships in the past.

The question now is – who do you want to be in your relationship?

Moving out of the drama triangle into a healthier way of being will be the subject of next week’s blog post. 

For now, I leave you with this quote:


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How to talk about mental health stigma #TimeToTalk2019

tea-twitter-01This week’s post was prompted by Time to Change, who take the lead in the fight to end mental health discrimination and stigma. So today, I want to join in the movement by writing this blog post, as well as sharing on Social Media to get even more attention placed on this important topic.

Heads Together, a charity set up by the Duke and Duchess of Cambridge and Prince Harry, is also active in working on removing the stigma around mental health.

There are many other charities and organisations that also deal with this very important topic. Here are links to three of them.


Mind

Scattergood Foundation

MentalHealth.Org

#timetotalk   #TimeToTalkDay


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It takes guts to accept to ourselves when we are not feeling quite right with our mental health. It is even more difficult to accept it to our friends, family or even a therapist.

Drop in the added bonus of being looked at as [insert negative adjectives here] and also discriminated at work or your local community because your illness isn’t visible and you are probably exaggerating or making it up anyway, right?

 

    • Frees us to be authentic, honest and real with ourselves and others about how we are really feeling and what we are willing to do about it.
    • Challenges others to view mental health problems in a different light, and allowing more conversations to happen
    • From the two above stems the fact that relationships can improve and become more supportive as a result of these difficult conversations
    • Helps challenge the stereotypes that exist when someone mentions mental health problems
      • People with mental health problems are unpredictable
      • People with mental health problems are dangerous
      • People with mental health problems are incompetent
      • You are to blame for your mental health problems
      • There is no hope for recovery
      • (click here to read more) http://www.scattergoodfoundation.org
    • The chance of recovery increases significantly once the person is honest with themselves, and the support system is in place – more understanding family, friends, employers, and seeking professional help even if for a short time.

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  • Seeing someone talk about their mental health problems in an open and honest way will help normalise what ill mental health actually means
    • “if my friend has it, and I’ve known him/her all my life, then mental health can affect all of us.”
    • “actually I’ve felt my mental health dwindle in the past but have been afraid to have the conversations”
    • “I know him/her and wouldn’t say they’re unpredictable, dangerous, incompetent or that they brought it on themselves, or that there is no hope for recovery. My friend’s mental health problem challenges my view on mental health.”
  • tttd-2019screensavers07Mental ill health should be a topic of conversation as simple as physical ill health topics of conversation.
    • It is much easier to call in sick at work and say something like “I broke my leg and will need some time to recover” than “I feel so anxious today that I’m unable to get up from bed”.
    • It probably hurts just as bad – physically, psychologically and emotionally – to break your leg than to feel anxious or depressed.
      • The difference is one is quantifiable and visible, whilst the other isn’t.
      • It doesn’t mean that one exists and the other doesn’t or that one should be taken more seriously and with more compassion than the other.

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I feel blessed to live in this day and age where, even though mental health stigma and discrimination still exists, it is easier for it to be challenged and views changed about it. There are even laws and white papers created that protect people with mental health issues from being discriminated (See The Mental Health Act 1983 and The Equality Act 2010).

As a mental health practitioner, I value the conversation about mental health and overwhelming life situations that stop us on our tracks and/or hinder our everyday life. It is a privilege to listen to people’s stories and help them work through their difficult feelings, thoughts and behaviours that, so that eventually (sooner than later – it all depends on each person’s individual journey and process) they can get their lives back on track.

tttd-2019screensavers06Whether I see clients for 6 sessions, 3 months, a year, two years, three years or more, I trust that they have the strengths and resources within them and within their support group to help them get back on track. I trust in the therapeutic process and that together in the counselling room we can work through, process, understand, feel and think what needs to be worked through, processed, understood, felt and thought of so the person can move forward.


I believe in allowing our feelings to come out – I often use the phrase “out is better than in”, which is definitely applicable for getting your anger, sadness, upset, and any other feelings, out. Keeping them in might make us mentally ill but also physically ill or make it difficult for us to heal our emotional and psychological wounds.


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Something that I find is useful for certain things but not as a therapeutic tool, are mental health diagnoses. I don’t underestimate a diagnosis (such as depression or bipolar disorder), but I won’t treat my client as a depressed person or a bipolar person. I will treat the person as a whole, and talk about whatever they bring on a particular session. I find this is more helpful and has felt like a relief to some clients. Yes they keep their diagnosis and the medication they might be taking, but they are not treated like a part of themselves or like the only thing they are is that depressed or that bipolar side of them.


There are a few things that definitely won’t work and will do more harm than good when talking to someone that’s telling you about their difficulties with their mental health:

  • “go have a nap or a bath, you’ll feel better after”
  • “I’m sure it’s not that bad, you’re a bit dramatic”
  • “Aw, just get over it”
  • “you are just doing it for attention”
  • “you have mental health problems, therefore you are weak and broken”
  • “it could be worse”
  • “someone is worse off than you”
  • “I know exactly how you feel”
  • “go do something to distract you”
  • “stop being lazy”

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I want to end this post on a positive note. So, how can you support someone with mental health problems? It doesn’t have to be a massive thing. As you can see above, words can have a massive impact. Try these:

  • “you are not alone, I’m here for you”
  • “I’m listening”
  • “what can I do to help”
  • “have you tried talking to a counsellor”
  • “I understand if you want to be on your own, but I’ll be here when you’re ready to hang out”
  • “I believe you, I believe you are struggling”

I hope this post has been helpful and has challenged you in regards to mental health stigma and discrimination. Do share this post and the links I’ve left around the post, so others can have this conversation as well!


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