Category Archives: Anxiety & Depression

Associate Paula Fowle

Are you recently bereaved or struggling to come to terms with a life changing illness?
Are you a fellow professional looking for supervision or mentoring support?

Paula Fowle

Ways to work with me:

  • Therapy for bereavement or recovering from a life changing illness and trying to get your life back on track.
  • Supervision for professionals who help others who are qualified or in training,
  • Mentoring newly qualified therapists as they navigate setting up in Private Practice.

I am an experienced professional with a passion to help others. I have worked as a therapist 15 years and more recently a supervisor. I work face to face and online.

We can work together at your pace as you recover or undergo treatment for a life changing illness.

Trying to find your way following the loss of a family member or close friend takes time and courage. Together we can work at your pace as your attempt to understand the effect of your loss and consider working towards the future.

I am passionate to support trainee counsellors and therapists as they select and begin placements together, we can consider which placement is the best fit for you and your study requirements.

Are you considering the next steps in your career post qualification? I can work with you as a mentor to guide you towards setting up your private practice.


Therapy:

From £45 per session

Supervision/Mentoring:

From £50 per hour -Student rates considered for weekly/fortnightly appointments.

Private Practice Mentoring

Have you finished your studies and now qualified as a Counsellor or Psychotherapist and considering your next career steps?

If you decide to set up in Private Practice, I would like to offer my experience and knowledge to help you advance your career and achieve your goals.

I have been qualified as a Counsellor since 2012 and working in Private Practice since October 2020. During my career it has always been very important to me to have a good supporting network around me as my career progressed. This was especially necessary during the time I was considering and then took steps to set up my Private Practice.

I hope that some of the experiences that I have had will help you to navigate the next steps of your career.

I am offering a one-year package, or longer if we choose to continue, in which I will share my knowledge to help you through the process of setting up and growing your own Private Practice.

The package includes the following:

Monthly 1-hour sessions with information and resources to help you set up and grow your Practice.

Our session may include:

  • Choosing the right space for your Practice – whether it be home or office based.
  • Legal and Ethical requirements – including the recording of Supervision and CPD sessions.
  • How to advertise and get yourself known – support with directory profiles and entries.
  • Setting up of client documentation, including contracts.
  • Managing your diary and client appointments to fit with other personal commitments.
  • How to take and record your client notes.
  • Setting up of your finance records and how to record your monthly income and

expenditure and what record keeping is required.

  • Invoicing and dealing with non-payment of sessions fees.
  • Measuring your progress and seeking evaluation.
  • Self-care and peer support.
  • Review of progress – One year on – Where are you now? What are the next steps you would like to consider.

Our sessions can be either online or face to face, whatever works best for you.

The fee for each session is £45.00. (Introductory Price)

Call me on 0776 0840009 to book an appointment for FREE 30minnute introductory chat or email me on paulafowle63@gmail.com .


Contact:
paulafowle63@gmail.com
0776 0840009
www.counselling-directory.org.uk/counsellors/paula-fowle

Sitting with Uncertainty

Sitting with uncertainty. It comes up a lot in therapy. Many people have the idea that it’s about not caring about uncertainty or learning to cut off from it, but I think it’s much more about feeling it. Really feeling it. That doesn’t mean we won’t distract from the discomfort or that we may prefer to not feel it. Given we live in a world where there us so much uncertainty of many different shapes and sizes, I think it must be about living with it, alongside it rather than trying to convince ourselves we don’t experience it. When living with chronic uncertainty and/trauma it can quickly turn into further trauma and/or burnout.

How do we respond?

Then there is the question of how we respond to ourselves and other when we feel we are sitting with uncertainty. Often, we have more understanding for others when they feel uncertain or anxious, than we do for ourselves. Many haven’t had the experienced of being empathically attuned to as children so how can we learn to respond to ourselves and others with more compassion and understanding?

We tend to either avoid feelings altogether or sit so heavily in it that we can’t function so trying to re-ground and find a middle ground can often be helpful. When we are struggling the inner critic can have a field day so learning what the inner critic is trying to save us from can be a step towards compassion too. Having a sense of what brings us comfort can be a way of caring for those needs that may not have been met as a child.

What are your signs of living with uncertainty?

What are you signs of either living with too much uncertainty or not engaging with it at all? Is there anything you can you do to offset some of it? How can you be more nurturing towards yourself and others during this time?

There’s no shame in needing help too. So if you need to talk it through, get in touch and we can work through it together.

Young people and mental health

When I was asked to write about teens and young people’s emotional and mental wellbeing I wasn’t sure where to start. It’s such a vast topic. Then I got thinking.  There is a quote that has stuck with me for the last 23 years, from an essay I wrote at university: “Childhood is a Cultural Invention” Discuss. (Kessen, 1979: from The American Child and Other Cultural Inventions). I was fascinated when I wrote this assignment.  I read studies on children as young as five years being left in charge of camp, fire, cooking and younger siblings whilst parents went off foraging and hunting. I read of three year olds using a machete to chop food and gut fish. Later I watched programmes where young kids swam in waters far deeper than them, hunting for fish: diving down to tie and untie nets.  It has always intrigued me; how different societies treat their young – and the correlation to wellbeing. 

Mental Health Crisis

In this country (and other Western countries) now, we are facing what is being termed a ‘mental health crisis’ in our youth (and all ages) and many people are asking why.  My thoughts are this: Life has become so fragmented. If we think about key things that we need to keep us sane and happy: a sense of community of purpose and of belonging are high up the list.  Yet we live lives where parents go off to work, kids to school and very often we have little time outside of that to spend together. We may be busy with clubs, activities, chores etc, but often our lives and those of our young are quite separate. Then there is pressure for ‘quality time’ which often, in a capitalist society, can be translated into day trips or restaurant visits.  The slow daily ‘togetherness’ is lost.  The doing chores together, teaching our young as they work alongside us, to cook, clean, care for animals, build, or just communicate is lost too.

Family Environment

An acquaintance was talking to me once about the ‘domestic load’ on them, alongside full-time work.  I suggested they get their teenager to cook a couple of times a week. They looked at me, bewildered and said that their teen couldn’t cook. They had ‘never had time’ to teach them.   So here we can see clearly defined ‘roles:’ Mum ‘cares’ for EVERYONE.  She is therefore exhausted and quite possibly resentful.  Teen, practically, has an easy life – but they don’t feel like a real PART of the family. They also don’t learn the responsibilities of adulthood in a safe and supported environment. Mum has little time for anything other than chores, because they do all the caring and organising: therefore there is no ‘together while we work’ time, OR much ‘quality time’ together. She possibly feels the anger of ‘I do everything for you. You do nothing.’

Involving children in daily activities

How can this model possibly work? And yet it runs throughout our society. Young people have few responsibilities, which can lead them to feeling a bit useless … which can eat into their self-esteem.  My suggestion: involve your kids. Enjoy the chores together. This gives you time together, just being. It gives them a sense of pride, community, belonging and of being a useful and important part of something bigger. They develop skills, they gain your respect (and you theirs) and they build their self-esteem. You can chat through your day – and build connection.  

In the early days – it can feel like hard work, yes, but I promise you the rewards are worth it. Kids are capable of far, far more than we give them credit for in our society. I truly believe that it is in holding them back, that frustrations arise. When kids are little, all they want to do is help their parents. Often we tell them no: it seems easier to do it yourself. But think on this: if you don’t let them hoover or wash up when they are 4 (and I know, it can be frustrating and they may break things) – well, how can you expect them to help when they are 14? (this was my mantra when mine were small – through gritted teeth sometimes, as jobs took hours and had to be re-done!) 

I recently had a week off work with my husband and we built a cabin in our garden.  My kids helped.  It took us longer, because we had to teach them how to use tools and work with wood; to follow instructions, but … we had fun and they learned. They hammered in floorboards, screwed in roof boards, laid roof tiles … and when one was feeling off-colour, she cooked the meals, kept us hydrated and walked the dogs. Now: every day we can look outside and see what we built, together. Remember the fun and the learning. Have a sense of achievement. Yes, it took longer to do it this way, but as well as saving a significant amount of money by doing it ourselves, we learned together, talked together, had fun together, achieved together and also saved money on ‘activity days out’ during half term.  We have a communal sense of achievement, togetherness and growth – and a daily visual reminder of that. This kind of togetherness: being together, doing together, achieving (and not) together is,  I believe, fundamentally important to the overall wellbeing of everyone, but particularly for young people who are just finding their way in the world. They may seem ‘grown up’ and they may push us away – but what they really need is to feel like they truly belong with us, so that they can venture out with confidence.

Nicola Sinclair 10 June 2021

Combatting your anxiety gremlin

Will Davies 15 Jan 2021

In the 1920’s, RAF pilots originated the word ‘gremlin’ to describe mythical creatures that cause malfunctions in aircraft or other machinery. Use of the word grew during W.W.2. and Roald Dahl even worked with Disney on creating an animated film featuring gremlins sabotaging pilots and their planes for their own nefarious purposes.

But what’s all this got to do with anxiety you might ask? Well for me, the experience of having anxiety can feel a little bit like being a pilot fending off a gremlin that is playing havoc with my plane and trying to knock me off course. If you experience anxiety too, maybe this is something that you can relate to?

So, if you find yourself under attack from an anxiety gremlin, how can you combat it?

Here are three suggestions that may point you in the right direction: 

Firstly, I think anxiety can often make us forget the past, specifically those times when we’ve over-come our anxiety or when things we were anxious about didn’t end up happening. At the moment when we could be drawing on these experiences, it’s as though the reset button gets hit and we feel like we’re starting from scratch. A way of combating this is to consciously remind ourselves of our achievements and past experiences of anxiety, perhaps through a diary or recounting affirmations. Don’t let the anxiety gremlin make you forget that you’ve got skills in this area and those skills can be put to good use again.    

Secondly, when we experience anxiety we often start to feel that our lives have suddenly been knocked off course and that we are spiralling towards a new and often frightening future that is not of our choosing. Very little in life is pre-determined, so, to use another flight metaphor (I’m clearly craving some foreign travel right now!), try to see your anxiety as just a bit of turbulence that will pass eventually. Bring in your rational and soothing side as quickly as you can to assess the situation and calm you down. Practice controlled breathinggrounding techniquesmindfulness or meditation, whatever works best, to help you ride it out and reach your desired destination. 

Finally, when experiencing anxiety, we can often feel helpless and that things are suddenly out of our control. In these instances it’s a good idea to try and wrestle back some control and often the best place to start is with ourselves. For example, scheduling a time each day to practice self-care and ensuring it happens can reap numerous benefits in terms of both our mental and physical health. Even just admitting the existence of your anxiety and seeking ways in which to address it is a way of regaining control of your life.

More support

Here are some further suggestions of resources to help you armor up and go into battle with your anxiety gremlin:

US Election 2016

As we woke up to the news that Donald Trump had become the next president of the United States of America, I thought about the impact on so many people across the world. For some, it will be a time for celebration. For others it will be a time of fear and despondency; not unlike post-Brexit here in the UK. One thing is certain for all of us; that we are living in a time of great uncertainty. America is a big place and has influence on the rest of the world.

Fear was already very present post-Brexit and now post-election. Both elections have been heavily influenced by fear of difference rather than consciously finding a path forward for everyone, irrespective of where they are born, what’s on their birth certificate and how much money they have.

Uncertainty brings with it anxiety and so I am mindful of the damage that can be caused when we act out that anxiety. We saw a rise in hate crime following the EU Referendum and much of this is about acting out those fears.

I wonder if we can all be more mindful of what we feel and why we feel it so that we can engage with people who hold different, sometimes opposing, views to ourselves. The more we can be aware of our place of privilege, the less hurt we cause to those oppressed by our privilege. For both the US Election and the EU Referendum, race has been at the heart of the results. The thing is that when we are in a place of privilege we are often not aware of it so it takes some honest thinking about. It takes putting ourselves in a vulnerable position.

So, following the US Election result, can we be more mindful of who will gain from the result and who will likely be negatively impacted? Can we find more compassion for those in need? Can we hold them in mind alongside thinking about our own needs? Can we make choices that enhance equality, inclusivity and diversity? Can we collectively focus on humanness rather than race, gender, sexuality, dis/ability, wealth?

If you have been affected by the election and would like someone to talk to, please do get in touch.

Manchester Terror Attacks

Many of my clients (none are identifiable here) have voiced, since the recent attacks in Manchester and London, their concerns about being in a world where they feel under threat from terrorists’ actions. 

As news regarding the attacks unfolds I am mindful of how potentially unhelpful the gratuitous, detailed and repetitive reporting can be. I wonder what we can each do that would have a more helpful impact both on those immediately affected, those around us and ourselves. 

There are also many attacks that go virtually unreported in other territories; are their lives less important because they are not British or American, ?

Some of my clients are not British nationals and fear, even more post-Brexit, that they are no longer welcome here. It’s incredibly frightening to no longer feel welcome in a place you have lived and worked for many years and to live with uncertainty about whether you will be asked to leave.

Some of my clients are Muslim; a number of whom are now extremely anxious of being under attack themselves even though they have no affinity with the attackers. There has been an increase in hate crime post-Manchester attack and this saddens me greatly. Here in Leicester there are reports of heightened racist and homophobic incidents. Humanity and integrity seems to be difficult to hang onto whilst retaliation is so much at the forefront of the mind. 

Many of the people I work with are very different to me. I may not share all or any of their beliefs but I only need to look into their eyes to see their pain. We connect on this most basic level even if our histories do not cross over in any other way.

I am mindful that in spite of intolerance and avoidance I stand firm in my belief that, as humans, we have far more in common with each other than we have differences. My belief, as a psychotherapist, is that talking about our experiences and our differences can give us much greater understanding both of ourselves and others, so that we can become more compassionate with those around us, whoever they are and whatever their beliefs. 

Tracey’s reflections on mindfulness

What is mindfulness?

The Oxford dictionary definition is:

“The quality or state of being conscious or aware of something.”

So why are Gwyneth Paltrow and Jonny Wilkinson interested in it?

There is a lot of evidence that mindfulness practice can

  • reduce pain;
  • improve sleep;
  • reduce the impact that stress has on the mind and body;
  • improve concentration; and
  • increase happiness.

So a lot of people are interested in at least one of those things for themselves.

How did you discover the practice of mindfulness?

I read a book to understand the science behind it and get familiar with the available evidence for its benefits (Full Catastrophe Living, Jon Kabat-Zinn, Piatkus 2013). I then went on an introductory course run by Shehzad Malik (mindful-monkey.com) and followed a six-week guided meditation programme of 45 mins per day, six days per week using Kabat-Zinn’s book and his Guided Mindfulness Meditation CD.

How difficult was it to begin with?

In some ways the guided meditation part was easy, all I had to do was sit with the CD and pay attention. In other ways it was tricky, my mind kept wandering off as human minds do. During one particular practice (the “body scan”) I would always fall asleep and I wondered whether I was getting any benefit from doing it. However, I found that this six week guided practice gave me a good grounding that allowed me to develop my mindfulness in everyday life.

What difference has it made for you?

The first thing I noticed was that my memory functioned more effectively. Instead of remembering that I “should have” brought something with me five minutes after leaving home, the item would pop into my mind in the moments before I left, so I had time to pick it up and bring it with me.

I no longer feel frustrated by short delays (in traffic, in a queue, waiting for someone) and I take the opportunity to use one of the practices that I have become familiar with.

I notice the difference most in conversations. I am better and more often able to take a “third position” where part of my brain can observe myself and others from outside myself and gain a different perspective than the one I have from inside me looking out.

A friend of mine believes that my reactions are quicker and I am better at catching things – but this hasn’t been scientifically proven!

And now?

I currently use guided meditation podcasts (such as marc.ucla.edu/meditation-at-the-hammer) which vary in length from 3 min to 30 min to fit in with the time I have available, such as while food is cooking or when I am a few minutes early for an appointment. I also practice while cleaning my teeth and washing up.

And what about the sleeping?

I have always slept well so mindfulness didn’t have any space to improve my sleep quality. However, the learning from falling asleep during every “body scan” has incentivised me to change my bedtime routine and I am now hardly ever tired.

Do you use mindfulness techniques within your work as a therapist?

The adoption of the “third position” fits well with my therapy training and supports my focus on the client within a therapy session. Part of the way I work is to try to help clients increase their awareness of their thoughts and feelings so this fits nicely too.

How do you see mindfulness benefiting clients, particularly those who experience anxiety and depression?

Some of my clients have discovered the benefits of mindfulness for themselves while others have tried it and it hasn’t made sense to them at the time. It can be helpful for people suffering from anxiety or depression as it can help them put their habitual thoughts into perspective. People suffering from panic attacks can find it particularly helpful in understanding their body sensations and giving them back a sense of control.

What do you feel are some of the contributory factors for needing mindfulness

Like drinking plenty of water, having sufficient sleep and taking regular exercise, I see mindfulness as helpful to everyone. It seems to be especially helpful to people who feel bombarded by the number of things coming at them in the modern world and who want to reduce the amount of stress that this induces in them.

How can I find out more?

Check out the NHS guide to mindfulness:https://www.nhs.uk/conditions/stress-anxiety-depression/mindfulness/

Resilience to engage in dialogue

I’ve been thinking about resilience to engage in dialogue. I wonder how many complaints or threat of complaints to BACP could be resolved by simply having open adult-to-adult dialogue. As we hear and tell our individual perspective we create the opportunity for greater understanding of ourselves and others. Though this does require a level of courage for all involved. 

Personal development – resilience to engage in dialogue

As therapists we need to have done enough work on our own emotional development. This way we can truly tolerate hearing clients tell us that we have got something wrong. Reacting without retaliation, but with compassion and understanding is hopefully our goal. With an apology we can often bring in challenge where it’s needed. We help clients to see what part they may have played in the situation as well as check out our own responses.

Therapists often have a dual role. It’s these dual roles that are so often at the heart of conflict. So it’s also really important to be able to voice our concerns, disappointment, frustration etc. with our therapist, supervisor or manager. Without that open dialogue, ruptures go unrepaired and the roots of the conflict (envy, anger, frustration, misunderstanding etc.) are left unchecked. They easily fester into something much bigger than was originally there. We understand that sometimes clients need to run away from dialogue to (un)consciously generate a repeat of previous unresolved conflict.

Possibility of a different outcome

Our aim is hopefully one of providing the opportunity for a different sort of ending. Alternatively, a different response than has been experienced previously. We can only provide that space; the client then choses whether they can take the risk for a new experience. The same space is provided for supervisees and colleagues. In having more than one role we need to develop the resilience to engage in those difficult conversations. If we don’t have the resilience to engage in dialogue the relationship can break down and potentially result in unresolved conflict. 

In my own experience, across my roles of client, therapist, supervisor and manager, I have seen the benefits of open dialogue in bringing about change both for myself and others. 

Death By Shame

In the aftermath of another celebrity suicide death I have been thinking about the consequences of internalised shame…

All too often the shame simply becomes too big to survive. There are so many situations where we can internalise shame…not feeling like we fit into a group such as not appearing British enough, woman enough, man enough, trans enough, white enough, black enough etc. We are given so many signals growing up and into adulthood as to what is socially un/acceptable and if we happen to fit the ‘wrong’ category the shame carried can be fatally toxic. Finances is often another big driver for suicide; the ultimate cost being the life of someone who feels shamed that they have failed their family. 

The internet is great for helping those in marginalised groups being able to find information, community and support. 41% of trans people will have at least one suicide attempt in their lifetime. I’m sure the sense of community provided online helps to keep the number from being higher than this. It’s too high though. Shockingly high. One of the contributory factors…social media. So the internet both helps and hinders. People so often find their voice of hatred whilst protected behind a technological screen…some have little thought for the consequences, others post in the full knowledge and hope of causing distress. What readily gets missed is that hatred is so often fuelled by fear, fear of difference, fear of change, fear of our assumptions being shown to be incorrect, fear that we will be shown to be lacking in some way. . 

The language we use around suicide also has an impact. The term ‘committed suicide’ is rather outdated now and harks back to an area where it was illegal to end one’s own life. More recent terminology such as ‘taken their own life’ or ‘death by suicide’ have a less stigmatising effect both for the individual and for those left in grief. 

And then, of course, there are those left behind. Suicide loss is a bereavement like no other. It’s incredibly difficult to process and integrate into life. There are so often more questions than there are answers; questions that inevitably can never be answered. It leaves a particular scar, often laced with shame and so the cycle potentially continues.

So, the next time you take to social media, take a deep breath and ask yourself what the impact of the post might be. It’s OK to challenge, to disagree but it’s so shaming and wounding to be targeted by hatred. We need to each own our fears about things we don’t agree with or don’t understand. The cumulative effect could be an end to a life. 

Weathering The Storm

Will Davies 24 July 2020

Weathering the storm – 3 tips for not letting lockdown take you down

Change is an essential part of our lives, there’s just no getting away from it and as a counsellor, it’s a common thread that runs through my work. Often a client is seeking counselling to elicit change in themselves or their situation but what’s stopping them is their relationship with change, and it’s this that forms the basis of the work. So, after working as a counsellor for a number of years now, you think I’d be a dab hand at change myself, and being honest, I thought so too, but that was until the lockdown in Leicester got extended.

2 steps forward 1 step back

If you’re not aware, in late June, the government, having identified a surge in cases of Covid-19 in the east of the city, extended the lockdown in Leicester and a number of outlying areas. It happened quickly, announced Monday and implemented Tuesday, with the main message being stay in your home as much as you can. I think it’s fair to say that the fallout of this decision was felt by everyone in Leicester and the surrounding areas. In some cases, there was a feeling that we were being singled out and in others, a sense that the rest of the country saw us as pariahs. My own emotional response to the extension was an overwhelming sense of anger and frustration, specifically at having to take an enforced 1 step back after a very much needed 2 steps forward, (out of county trips were planned, my mother was due to visit that weekend). In addition, I also started to catastrophise that things might not improve and we might never get out of lockdown. Of course, I knew that these responses to the change weren’t ‘mature’ or ‘rational’, but they were real to me and so there was a need to address and try to overcome them.

Nearly a month later, I have found the following three ‘tips’ to be the most beneficial in coping with life in extended Leicester lockdown:

1. What can you change?

In terms of my anger, I identified what I could actually change about the situation myself. Alas, government decision making is out of my control, as is whether someone else chooses to break the lockdown and go on holiday, but what I can do is commit to reducing my negative feelings through regular exercise (yoga and walking) and regular instances of self-care (journaling and cooking comfort food). I also consciously decided to talk openly within my social circle about how I felt and admit that I was unhappy. The release of these thoughts and feelings was met with empathy and made the ‘load’ feel a lot lighter.

2. Dial it down

I made the decision to turn my back on the profusion of lockdown related news, updates and social media that had previously kept me up till the early hours. I’m not an expert on virus transmission, so why was I feeling the need to know everything? What purpose was it serving other than overloading me with unnecessary information? So I dialled it down, took a step away from the town square and instantly began to feel much better for it.

3. Take the smooth with the rough

Lastly, rather than dwell on what I thought I was missing out on due to the extension, I started to refocus on enjoying the benefits of lockdown again. The ‘threat’ of having to do a commute and return to an open plan office for one of my roles, was no longer there. The money I would usually be spending in bars, pubs and cafes is still in my bank account and so for the first time ever July and August are not coming in wildly overbudget. More lie-ins, more Netflix, hello Disney+, more times with the family and now that the school summer holidays have begun, no need to try and dredge up the memory of what a quadratic equation is. You might think I was naively looking on the bright side, but in making myself try and turn the lemon that is lockdown into lemonade, I feel able to keep going, keep working and carry on until the next announcement.

Be prepared

Everyone is different of course, so I realise that some of these tips might not work for you. However, I do think that starting to develop your own healthy coping strategies, for when more inevitable Covid-19 related changes happen, will be time well spent. That way, you won’t be caught on the hop like I was, without an umbrella.