Category Archives: Uncategorized

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:

High Court Ruling on Puberty Blockers

I have huge concerns over the recent High Court Ruling regarding puberty blockers for transgender young people. One person’s experience will set back transgender rights for all.

Keira Bell was assigned female at birth and following several appointments with the specialist services at the Tavistock clinic was offered puberty blockers and subsequently prescribed testosterone and then underwent top surgery. At this point Keira identified as male. Later, she made the unusual decision to de-transition and now lives and identifies as female.

The result of the court case is that now individuals aged 16 or under will no longer have access to puberty blockers without the intervention of a further court case. Anyone on the waiting list will be paused and those already taking blockers will have their medication reviewed.

The media have reported that booking an appointment with a gender clinic is as easy as booking a GP appointment; it really isn’t. They have also reported that clinics are actively encouraging young people to transition and that puberty blockers are prescribed at will. This is incorrect information. There’s a very rigorous process where individuals essentially have to prove to several practitioners that they are transgender before being offered any medication and/or surgical intervention. Assessments are carried out at every stage of the process so the individual has ample opportunity to reflect on the changes happening to them, their body and their identity. Over several years Keira had first puberty blockers, then testosterone and finally top surgery. At no stage did she raise concerns about the process or the ‘speed’ of the process. That she regrets her decision is heart-breaking and, as yet, it is unclear why she felt unable to raise concerns along the way but this one court case will now negatively impact many transgender individuals who are absolutely sure of their need for puberty blockers, hormone treatment and surgery.

The courts have given the impression that puberty blockers are new and dangerous. These drugs have been used for many years to stall early-onset puberty and are simply stopped once the child reaches the age when they would more naturally go through puberty. The only difference here is that puberty blockers are used to gain time for the individual to explore their identity before going through irreversible procedures. Going through a puberty out of alignment is traumatic beyond belief.

Anti-trans lobby now using Bell as a poster girl and, incidentally, I understand the entire case has been crowdfunded by anti-trans supporters.

Something that really concerns me is that, following this case, many will come away with the idea that somehow transitioning is a dangerous thing that should be put off into adulthood. There are some concerns here:

  1. Your child may not live to see adulthood if gender dysphoria is not recognised and treated
  2. The myth is that more people de-transition than they do and therefore we should prevent transition in the first place
  3. That therapists will, having read incorrect information in the media, support the idea that transition is wrong and will not provide the best care and support to their clients/patients.
  4. That not enough is being done within the NHS or private gender clinic arena to fully support those whose gender sits somewhere between the binary of male and female. See: https://bainesballcp.co.uk/uncategorized/thinking-outside-gender-binary/

This really useful link provides much needed information for people wanting to access gender clinic services.

Professional boundaries

Boundaries are really important to me both professionally and personally.

In my work as a psychotherapist and clinical supervisor I come across so many instances where professional boundaries have sadly been broken, often to the detriment of the client.

It’s been difficult during lockdown; the way we work as a profession had to change overnight. Thankfully (for me) I was used to providing services via video and phone so that part didn’t stretch me so much personally. What did challenge me was that for several consecutive months I worked from my very compact home office, a place where I also do lots of other things. The once clear work/home lines felt well and truly blurred. It took a couple of occasions of noticing I had checked my work phone as I was heading to bed – something I don’t generally do – to compassionately challenge myself. I’m pleased I did. It made me think about other small changes that could have evolved into something more unhelpful if left unattended. I’m now back in my therapeutic space, albeit mostly online still, but that clear demarcation between work and other is back where it needs to be.

Maintaining boundaries is often crucial. We need to maintain professional boundaries to keep our clients (and ourselves) safe. It’s why we don’t become friends, socialise or engage in social media with our clients, irrespective of how drawn to them we are, how much we care about them, and how much we might feel pulled into rescuing them. It’s why we also maintain confidentiality. We don’t post anything about clients online; we don’t discuss clients with friends and family. A huge portion of complaints to BACP involve boundary/contract violations and it’s got me thinking again about why we might potentially get pulled out of shape.

Naturally, for most therapists, there’s an element of ‘wanting to help people’.  Left unchecked though this desire to help – often rooted in early complicated histories – can lead us into hot water. Many a time a supervisee has announced a change with their client and I’ll gently ask, ‘what brought that change about?’. ‘Because the client asked for it!’ is so often the reply. If the supervisee is willing, we explore this in more detail with some deeper questioning about how they might respond if this question were put to them in a law court or through the BACP complaints procedure. Then we start to see something different emerging…that they have responded from an emotional place rather than a professional, ethically-driven one. So, in terms of professional boundaries, it’s not enough to simply say yes because a client asked or to become friends with a client because we feel sorry for them or because we genuinely like them. How is that remaining professional? Each decision we make professionally needs to be backed up with a sound ethical decision-making process. The client asking for something simply isn’t enough.  

Equally, with friends and family, it’s not as easy as saying ‘they asked me to so I will’. We need to know 1) if we have the resources available to carry out the request, 2) has the other person actually asked or are we perceiving a request through emotional content, e.g, ‘I don’t have the bus fare!’  = ‘please lend/give me the money’ and 3) are we actively consenting to using those resources on this person, at this time and for this particular thing?

It might sound a bit laboured but by doing this we spend less time tangled up ‘on the drama triangle’ and more time in an adult-to-adult space = much healthier = more resources available.

It’s often when our resources are more depleted personally that we get pulled out of shape professionally. Clearly the pandemic has made us all change some of our behaviour. Seven months on, maybe it’s time to check-in with ourselves to ensure we have enough resources to remain professionally boundaried and ethically driven in our decisions.

Thinking Outside Gender Binary

http://www.bbc.co.uk/programmes/b07kq5sv

This Radio 4 programme made me think about how very much we are still engaging from a binary perspective; that people are encouraged to decide either/or. In my experience as a psychotherapist, people tend to identify as male, female, both or neither; whilst this is oversimplifying that there are potentially as many genders as there are human beings.

From the moment a child is born they are presented to their parents as “it’s a boy/girl”. How can we know this until the child has told us how they feel about themselves? Babies are often put in gender binary clothing, given binary names, and expected to express the characteristics of their assigned gender. By the time they go to school they are conditioned as to what male and female roles ‘should’ look like. This is all based on what’s between their legs. No wonder there is so much confusion, fear, and shame.

Until we can simply allow children to express their gender identity as they are experiencing it, we are creating heartbreak. For an individual who identifies as trans, non-binary, gender fluid etc. it’s a very confusing world. For those that don’t identify in this way it can be equally confusing to relate to those that do. Couldn’t we help society as whole if we facilitated children just being that; to explore, to play, to express? This way each person could evolve naturally into who they are, male, female, both, neither and express themselves in a way that is natural for them. In the Radio 4 programme, one of the parents voiced that their child who was assigned female at birth had played with dolls, wore pink etc. so they had no idea that the child identified as a boy until a 12th birthday party ended in tears. 

We are not taught that boys and girls can wear whatever they like and be interested in whatever strikes a chord with them. Maybe parents who don’t see it are not looking for anything outside the small box that gets passed from one generation to the next? If we are told ‘this is a girl’ and have a fixed idea of what ‘girl’ means we project all this onto the child without asking them what their idea of being a girl might be. What feelings are evoked in us if we meet someone who identifies in a way that appears to challenge the male or female binary? Does this projection of gender binary expectation mean  some trans people think they need major surgery? Clearly, for many people, surgery is the only answer but I wonder if some feel they have to physically transition in order to be accepted, perhaps at the expense of being supported in discovery of their own unique gender identity. Maybe not all would need to if we embrace the idea of gender uniqueness.

Whilst sexuality is different to gender identity, there is a similarity here too with many lesbians being told they “don’t look gay” simply because they have long hair and are wearing a dress or no vest and tight trousers for gay men.

I wonder if the crux of this is fear. Historically, it was important to segregate men and women so they each knew who was the oppressed and who was the oppressor. This fear belongs to us all and it could help everyone if we could be brave and think it through in a safe, yet challenging, environment. 

In an educated world, I’d like to think that we could enable people to simply be people, wear whatever they feel comfortable wearing, using names and pronouns that they feel most comfortable with, doing jobs and hobbies that make them feel fulfilled, loving whoever they happen to love.

If you would like to explore your thoughts about gender identity in a safe environment please get in touch by whatever means is most comfortable for you. 

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

In my work with the BACP Ethics team I wonder how many complaints or threat of complaints could be resolved by simply having open dialogue. In the hearing and telling of each perspective we get the opportunity for greater understanding of ourselves and others, though this does require a level of bravery for all involved. 

As therapists we need to have done enough work on our own emotional development so that 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 so that we can 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 (and it’s these dual roles 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 and can 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.

Our aim is hopefully one of providing the opportunity for a different sort of ending or 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. 

Homophobic attacks must stop

Two dear friends of mine were on the receiving end of a homophobic verbal assault over the weekend as they walked arm-in-arm through their Leicestershire village. Two young men shouted at them from the safety of their car – a cowardly act. In these kinds of situations the young men feel entitled to use another person’s (assumed) sexuality for their entertainment, often with misogynistic overtones if not hatred.

First, I’m sad and concerned for my friends. People shouldn’t have to put up with this kind of behaviour from others. It has the potential to induce shame and make those on the receiving end shrink into silence and erasure – which is why I am speaking out on their behalf.

It also made me wonder about the state of mind of the two young men hurling the abuse. Similar thoughts crossed my mind regarding the two recent nationally reported cases of homophobic attacks on women. How in control, powerful and overpowering might they feel? Why the need to express their feelings in such an unfiltered way? Equally, how inept, insignificant and inadequate might these young men feel to carry out such a cowardly act? As a society, how can we protect the vulnerable, those who are oppressed or marginalised? How can we also help to educate those in the majority that they also harm themselves in the process of attacking those different to themselves?

As you can see, I have far more questions than answers. Some of my concern lies within the context of the current political landscape where tolerance and cohesion are seemingly being rejected in favour of power-play and one-upmanship. Since the EU Referendum there has been an increase in hate crime and sadly we are not seeing it decline any time soon. So I add my voice to those speaking out and declaring that it’s not OK to verbally, physically or mentally abuse another person simply because they are a bit different to you and you feel intimidated by this difference.

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.